November 2009 Issue

Living the Clean Life
By Diane Welland, MS, RD
Today’s Dietitian
Vol. 11 No. 11 P. 42

This up-and-coming eating plan emphasizes wholesome foods in their natural state and shuns processed, refined products to maximize benefits for not only the body but also the environment.

The rise of organic, natural, and slow foods has accomplished more than just reshaping the way Americans think about food. It has also sparked a culinary movement known as “clean eating.” Emphasizing whole, natural foods and regular physical activity, this eating plan boasts a nutritionally sound diet that promotes balance, variety, and moderation while building a stronger, leaner, healthier body. Best of all, it has built-in flexibility, so it can easily be tailored to meet almost any individual’s needs. At a time when many consumers are leery about eating processed, preprepared foods and concerns about food safety are rising, this approach to healthy eating is right on target and well worth understanding.

Clean Eating Basics
So what exactly is clean eating? Like all healthy eating plans, the main principles focus on choosing whole fruits and vegetables in their natural state; lean meat, fish, and poultry; beans and legumes; low-fat dairy products; and whole grains from a variety of food sources. Meals are high in fiber and low in fat, calories, sugar, and sodium. Where the diet differs is in what these foods are and how they are delivered.

Clean eating seeks to avoid all highly processed, refined fare, or foods that have been treated to change their physical, chemical, microbiological, or sensory properties.

As a general rule, clean eaters strive to eliminate all prepared frozen meals, desserts, and side dishes along with convenience, boxed, and canned foods. Off-limit ingredients include highly processed high fructose corn syrup; man-made ingredients such as artificial sweeteners; margarines; trans fats; artificial colors and flavors; unnecessary food additives such as excess salt, sugar, and corn syrup; and chemical preservatives such as butylated hydroxyanisole and butylated hydroxytoluene (or BHA and BHT, respectively). Of course, there are always exceptions to the rules, as many people who follow this regime opt to include a few low-sodium canned or boxed items such as tomato sauces, chicken or vegetable stock, beans, and salsa, as well as frozen fruits and vegetables without added salt or sugar. But, for the most part, followers get the majority of their food from whole, fresh sources.

Low-fat dairy products are preferred over nonfat dairy products because nonfat products often contain fillers such as starches and sugars and are more processed. Refined white rice, white flour, and white sugar are swapped out for brown rice, whole wheat or other whole grain flour, and honey, maple syrup, agave nectar, or minimally processed dehydrated sugar cane juice. 

The clean eating diet does not permit fried foods or foods doused in olive oil, honey, or salt. And since many processed foods are high in fat, sugar, and salt, reducing these foods automatically lowers fat, calories, and sodium. Still, clean eaters should keep track of these nutrients, particularly if weight loss is their goal. 

To maintain their energy levels, followers eat frequent meals, dividing them into five or six daily occasions: breakfast, lunch, dinner, and two or three substantial snacks (each meal ranging from 200 to 400 kcal). This sequence helps stabilize insulin levels, rev up metabolism, and prevent meal skipping or subsequent overeating. Research indicates that it may even improve cholesterol levels. When University of Cambridge researchers compared cholesterol levels of men and women who ate either one or two large meals per day or six small meals per day, they found that the people who ate more frequently had an average cholesterol level 5% lower in both total cholesterol and artery-clogging LDL cholesterol.1

Regular physical activity is an important component of the clean concept. The clean eating lifestyle is an active one that advocates exercising five or six times per week. Not only will this regular routine tone the body, strengthen muscles, keep bones strong, and improve skin condition, but it can also help people sleep better, boost their mood, build a more efficient immune system to ward off illness, and curb their appetite. In a British study published in Appetite in 2008, researchers found that after taking a brisk 15-minute walk, chocolate lovers substantially reduced their chocolate cravings for at least 10 minutes afterward.2

A Diet Whose Time Has Come
Although “eating clean” first gained notoriety in the mid-1980s when Ralph Nader published a book called Eating Clean, its roots date back to the natural health foods movement of the 1960s. Then, people shunned processed food for moral and ethical reasons, as well as for its poor nutritional value. Today, driven by a variety of factors (not the least of which is the newfound passion for organic, natural, and slow foods), clean eating is once again in vogue and can be tailored to fit nearly any lifestyle.

The following are reasons why clean eating makes sense for you and your clients:

Good for the Environment
Any diet that relies on produce, whole grains, and legumes for most of its calories is good for the environment, but clean eating has a few bonuses. First, because foods are whole and unprocessed, there is less work involved in producing them, ultimately leading to a lighter carbon footprint. Secondly, because foods are not preprepared, most “clean” foods do not require special or excessive packaging, decreasing waste and environmental pollution.

If you prefer buying organic, sustainable, and local foods such as meat and produce, never fear. Going clean and green is not only viable, but it is also easier than using convenience foods, especially if you shop at farmers’ markets.

Saves Money
Budget-conscious clients needn’t worry about the cost of clean eating. Many of the foods clean eaters count on, such as brown rice, sweet potatoes, beans, and yogurt, cost pennies to buy and may already be in their kitchen. Even lean meats such as chicken, beef, and pork are cheaper to buy fresh than seasoned or precooked. Consider that at 99 cents per pound, a 3-lb whole chicken costing $3 will yield nearly 2 lb of edible meat. This amount can feed a family of four two meals (based on a 4-oz serving size), and they can use the bones to make a third meal of chicken soup. The same amount (2 lb) of a prepared convenience breaded chicken breast can cost three times as much. Whole grains are an even better deal. At 10 to 15 cents per serving, these foods offer significant savings compared with instant or prepared varieties.

Eating clean also means your clients will spend more time eating at home and less time eating out. Restaurant foods are notoriously high in salt, fat, and calories. And, since many chefs rely on prepared sauces, salad dressings, and seasoning blends, not to mention loads of butter and oil, finding a clean meal when dining out can be difficult (though not impossible). Large portion sizes also pose a problem. For these reasons, individuals should view dining out as a special occasion rather than a regular part of their routine. Encourage your clients to limit these outings to protect not only their health but also their wallet.

Focuses on Quality, Not Quantity
When I first started eating clean, I expected it to be challenging. Eliminating all highly refined and processed foods is a daunting prospect, but after a few weeks on this diet, I noticed something I didn’t expect: The food tasted better. Without depending on fat, salt, and sugar to season your food, you allow yourself to savor the natural flavors of the vegetable, grain, or fruit, focusing on quality rather than quantity. With simple, easy-to-access and clean ingredients, these dishes are particularly appealing to clients with allergies, but they also speak to a larger audience.

According to Mintel International Group Ltd, a major research firm based in Chicago, “simplify and purify” is one of the top five consumer trends for 2009 and “fresh, clean, and pure will become essential values.” It also says that nostalgic skills such as cooking, sewing, and gardening will become increasingly popular. Consequently, the clean eating lifestyle, which emphasizes preparing foods from scratch with the use of simple, unprocessed, and unrefined ingredients, is ideally suited for this new trend.     

Improves Health
Many studies have shown that a diet high in processed foods and empty calories leads to obesity and increased risks for heart disease, cancer, high blood pressure, inflammation, and other illnesses. On the other hand, a diet high in fiber, fruits, vegetables, lean meats, low-fat dairy products, beans, and whole grains reduces these risks. Diets high in processed, refined foods have been linked to abdominal obesity. With this type of obesity, people have a greater chance of developing type 2 diabetes, stroke, and heart disease.

When Danish researchers noticed that women eating a diet high in refined starchy carbohydrates such as white bread and simple sugars had larger waistlines than those who got their carbohydrates from whole grains, fruits, and vegetables, they decided to investigate further.3 The result was a large 2009 study published in the August issue of the Journal of the American Dietetic Association looking at the intake of specific food items in groups of more than 40,000 adult Danish men and women.4 What they found was that a diet low in fruit and red meat and high in snack foods was associated with larger waist circumference in both sexes. In women, in particular, low intakes of vegetables, butter, and high-fat dairy products, along with high intakes of poultry, potatoes, and processed meats, led to increases in abdominal obesity. While the study doesn’t specify types of potatoes or poultry, the findings are still intriguing and will certainly lead to more studies in this area.

Like diet, regular exercise has an enormous impact on health. Aside from improving the quality of life by preventing or lessening the risk of chronic illnesses such as heart disease, cancer, stroke, and osteoporosis, daily physical activity can also help people live longer. Using data from the Framingham Heart Study, scientists found that compared with their sedentary counterparts, men who were moderately active increased their life expectancy by 1.3 years while women added an extra 1.5 years.5,6

What RDs Need to Know
The clean eating lifestyle focuses on healthy, wholesome, natural foods and avoids processed convenience, boxed, and bagged foods. With these preprepared foods out of the picture, chances are your clients will spend more time planning, prepping, and cooking meals. That's why it’s important for dietitians to emphasize menu planning when discussing the diet and offer clients a variety of time-saving tips, such as big-batch cooking, preparing frozen dinners, and cooking meals in advance. There are also certain types of meals, such as soups, stews, and casseroles, that lend themselves to this type of cooking, and yes, you can still save room for dessert, as long as it’s clean.

Another challenge clients may face involves clean eating’s lack of salt and sugar. Some people may balk that the diet tastes bland and boring. This is particularly common feedback from people who typically followed a diet heavy in processed or fast foods. There are two reasons for this complaint, the first of which has to do with sensory overload. Studies show that many of the tastes people enjoy and desire are learned. Consistently eating foods high in fat, salt, and sugar not only makes us crave these foods more but also raises our threshold for these tastes. Consequently, it will take clients a few weeks to “retrain” their taste buds and become accustomed to foods that contain less salt and sugar. When they do, they will learn to appreciate the tastes of many fruits and vegetables that they may not have noticed.

The second reason has more to do with culinary skill than taste. Many people rely on salt to flavor food, but in reality, there are many fresh herbs, spices, and spice blends that can also do the trick. To help clients overcome this hurdle, discuss different ways they can season foods without salt and sugar and offer recipes in “clean” cookbooks. The following are some other strategies to consider:

Teach cooking classes: Cooking classes and demonstrations are the best way to teach people how to eat clean. Not only does this provide them with the cooking skills and recipes they’ll need to be successful, but you can also provide them with the experience of eating clean, healthy, and delicious firsthand.

Offer shopping tips: Shopping clean means spending most of your time on the perimeter of the store buying produce, lean meats, fish, poultry, and low-fat dairy products. Teach clients to be smart shoppers and you’ve tackled half the battle.

Explain how to read food labels: Identifying processed foods can be tricky. Many times, the product name can be deceiving. Point out red-flag words and encourage clients to read both the ingredient label and the Nutrition Facts panel.

Create an exercise plan: Having a written exercise plan and keeping an exercise log can be extremely motivating and a great strategy, especially for people who are just getting started. Encourage your clients to start one.

Like most eating regimes, clean eating strives to meet the 80/20 rule, following the diet 80% of the time. Obviously, the closer people follow a processed-free diet, the more health benefits they will reap. But, even with little changes, clients can begin to notice a difference. Furthermore, although some people do well throwing out all processed foods and going clean cold turkey, others need to make a more gradual transformation and take small steps. Either way, their goal is clear: maintaining a clean, healthy diet that makes them look and feel their best.

— Diane Welland, MS, RD, is a dietitian and freelance writer based in Springfield Va. She is also author of the Complete Idiot's Guide to Eating Clean, scheduled to arrive in bookstores next month.


Clean Eating in a Nutshell
• Avoid all processed foods.
• Choose unrefined foods whenever possible.
• Watch out for fat, calories, sodium, and sugar.
• Eat six small meals per day.
• Exercise daily or at least five times per week.


1. Titan SM, Bingham S, Welch A, et al. Frequency of eating and concentrations of serum cholesterol in the Norfolk population of the European prospective investigation into cancer (EPIC-Norfolk): Cross sectional study. BMJ. 2001;323(7324):1286-1288.

2. Taylor AH, Oliver AJ. Acute effects of brisk walking on urges to eat chocolate, affect, and responses to a stressor and chocolate cue. An experimental study. Appetite. 2009;52(1):155-160.

3. Halkjaer J, Tjønneland A, Thomsen BL, Overvad K, Sørensen TI. Intake of macronutrients as predictors of 5-y changes in waist circumference. Am J Clin Nutr. 2006;84(4):789-797.

4. Halkjaer J, Tjønneland A, Overvad K, Sørensen TI. Dietary predictors of 5-year changes in waist circumference. J Am Diet Assoc. 2009;109(8):1356-1366.

5. Franco OH, de Laet C, Peeters A, et al. Effects of physical activity on life expectancy with cardiovascular disease. Arch Intern Med. 2005;165(20):2355-2360.

6. Mandic S, Myers JN, Oliveira RB, Abella JP, Froelicher VF. Characterizing differences in mortality at the low end of the fitness spectrum. Med Sci Sports Exerc. 2009;41(8):1573-1579.