Your favorite foods are poisoning you.
Even foods that you thought were safe are actually destroying your health, making you fat, and shortening your life.
That’s what you’ve been taught to believe.
If there’s one mistaken idea that’s become more embedded in the fitness and health industry than any other, it’s that certain foods are bad for you.
This myth is so entrenched that it’s promoted by everyone from gym rats to doctors to public health authorities.
There’s no doubt that what you eat can have a massive impact on your health, performance, and body composition. However, there’s no evidence you can’t achieve all of these things while still enjoying any food you like.
Clean Eating Doesn’t Exist
These are the words people use to describe foods they believe you should eat. On the other hand, these are the words for foods you should not eat:
“Double-plus un-good.” (1984, 1)
The biggest problem with the idea of “clean eating” is that “clean” has no objective definition. Everyone believes different foods are “unclean.”
Vegetarians: Animal meat.
Vegans: All animal products.
Bodybuilders: Milk, fruit, and white bread.
Paleo: Grains, legumes, dairy, refined oils, added salt, sugar, alcohol, and some vegetables.
USDA/United States Government: Saturated fat, cholesterol, red meat, eggs, trans-fats.
Low-carb: Sugar and other carbs.
Hippies: Artificial sweeteners, processed foods, cooked foods, packaged foods, BPA.
It’s safe to say that for every food, there’s someone saying it’s dangerous.
There’s no way to define clean eating, which means there’s no way to measure or quantify what effect this concept might have on your health. There’s also no way to objectively compare a “clean diet” to other diets.
Throughout this article, I’ll use examples from all of these categories and let you decide which group I’m referring to.
The one thing these ideas have in common is that there are “bad” foods that should be avoided or limited, and “good” foods that you can eat. This broad definition can be further classified into two forms.
The Two Kinds of Clean Eating
1. There are good and bad foods, and you should never eat any of the bad foods.
2. There are good and bad foods, and you should only eat a small number of the bad foods to limit the damage.
In this article, you’ll learn why both of these ideas are irrational, unscientific, and unhealthy.
We’ll start by looking at the three potential ways a food could decrease your health, lifespan, or body composition. Then we’ll see if any foods actually meet these criteria for being “unhealthy.”
Why There are No Good or Bad Foods
There are three ways a food could negatively affect your health, longevity, or body composition.
- Contributing to a caloric excess which leads to negative health problems from being overweight.(2)
- Causing nutrient deficiencies by diluting the nutrient density of your diet.(3)
- Directly interfering with your body’s functions, causing specific diseases, increasing fat gain, or accelerating aging.
Let’s see if any foods meet these criteria.
Excess Calories Can be Bad for You — From Any Food
There is no evidence that any food will cause more fat gain than the excess calories it provides. There is also no evidence that eating a certain food will help you lose fat.
Fat loss is ultimately about calories in versus calories out.
Any food that has calories can technically be bad for you — if consumed in excess.
This includes chicken breasts, sweet potatoes, whole grains, and even vegetables. The reason many people consider these “clean foods” is because they tend to be harder to overeat than things like cookies or ice cream.
For this reason, some people refer to things like sweets, baked goods, soda, and other junk food as “fattening.”
This is an inaccurate and myopic viewpoint. It assumes that you will over-eat these foods — regardless of the rest of your diet.
If your diet has enough satiating power to keep you satisfied and happy, then there’s nothing wrong with also consuming some less-filling indulgences. This idea also assumes that people can’t moderate their food intake, which they can.
For some people, eating enough to gain or maintain their weight can be a struggle.(4-6) In these cases, higher calorie, more palatable foods can be extremely useful for meeting their calorie needs — not to mention being more enjoyable. Yet you don’t find people saying ice cream and cookies are life-saving for an anorexic, or muscle building for someone who’s trying to get bigger.
People look at these foods in isolation and assume they’re unhealthy regardless of the context.
Remember these two points:
- The potential to over-consume a food does not mean that you will.
- Some people need to eat more — and higher calorie, more palatable, and less filling foods can be an advantage — even a necessity.
However, you’re also concerned with your long-term health. You want to make sure you’re giving your body everything it needs to perform optimally, and you don’t want to deprive your body of essential nutrients.
No Food Causes Nutrient Deficiencies
The second way a food could potentially be “unhealthy” is by displacing more nutrient dense foods — by providing “empty calories.”
You’ve probably seen articles about how most people are deficient in certain nutrients, and how you simply can’t afford to eat any “empty calories.” You’ve heard that all of your food has to come from nutrient-dense sources, and even then you should take some supplements.
Unfortunately, there isn’t a formal definition of what “nutritious” means.(7) Researchers and diet authors have tried repeatedly to come up with a system that ranks foods based on points or some other means — unsuccessfully. The problem is that each system uses arbitrary and unscientific means to grade different foods.(8)
The USDA is still heavily biased against anything high in saturated fat and favors everything high in whole grains.(8-11) Other ranking systems like the ANDI score place a greater emphasis on antioxidant levels, despite the fact that there’s still little evidence a food’s antioxidant or flavanol levels are a good representation of its overall healthiness.(12,13)
Classifying foods as healthy or unhealthy based on a score is a pointless and unscientific endeavor. In this case, common sense should prevail.
It’s true that some foods are far more nutrient dense than others. Cake icing doesn’t have the same nutrient content as an apple. As long as the majority of your calories come from whole nutrient dense foods, there’s no evidence you can’t meet your micronutrient needs while still consuming some “empty calories.”(14-17)
Research has shown that most people would have to eat roughly 20% of their total calories from refined sugar before it became impossible to meet their micronutrient needs.(3,18,19)
People who eat tons of sugar are generally malnourished.(20,21) However, most people who are serious about their health aren’t eating anywhere close to 20% of their daily calories from sugar.
The CDC also estimates that around 90% of Americans are consuming adequate micronutrients.(22)
There is some data that indicates nutrient deficiencies may be more common among people who are dieting.(23) This makes sense, since they’re consuming fewer total calories. However, it’s rare for someone to need to completely eliminate any junk food even when they’re restricting their calorie intake.
Some studies have also shown that vitamin D and magnesium deficiency may be more common than once believed.(24-30) However, this data is based on people eating an average American diet. It’s likely less relevant to health nuts, like you, who are probably already eating lots of nutrient dense foods and getting adequate sun exposure.
People often make the mistake of assuming certain foods are completely devoid of nutrition. This is rarely the case. Take ice cream, for example. There are multiple studies showing the potential health benefits of dairy.(31) Just because cream is frozen and mixed with sugar doesn’t mean these benefits suddenly disappear. There might be less total benefit, but it’s still there.
White flour is another example. People assume that because it’s been processed, it must be completely nutrient void. Flour isn’t exactly nutrient dense, but there are still some micronutrients present, especially if it’s been fortified.(32) It’s also worth noting that studies have generally failed to find any major heath benefit of whole wheat flour over white flour.(33)
Ironically, studies have shown that people who strictly avoid certain foods or food groups like bodybuilders, athletes, and people with eating disorders are often deficient in micronutrients.(34-40) As usual, balance and moderation are the most scientifically supported solutions.
Despite what you’ve been told, you probably aren’t deficient in most nutrients. You can still indulge in moderate amounts of “unclean” foods and meet all of your essential nutrition.
While many people accept this, they still believe that certain foods are still “bad.” They’re wrong.
No Food Directly Damages Your Health
The third myth is that “unhealthy” foods directly damage your health. People tell you that you will suffer *less* damage from eating *less* of these foods — but they’re still bad for you in any amount.
However, because these foods only damage your body a little, you’re told it’s still normal and healthy to eat them. Here’s the issue: You’re not happy with normal.
You’re more obsessed with your health and fitness than other people. “Normal” now means being overweight or obese, and you don’t want a “normal” physique. Eating “less junk” means “zero junk” in your mind. If a food is bad — it’s bad — and you don’t want it in your body in any amount.
This is the most ridiculous and harmful misconception of “clean eating,” largely because it’s promoted by doctors and other health officials who people trust more than most.
In this context, “unhealthy” foods do their damage in different ways:
Interfering with your body’s functions.
Increasing your risk of certain diseases
Making you gain fat.
Making you age faster.
… and other bad stuff.
The idea is that regardless of a food’s nutrient density or calorie content, it is still bad for you. Every group has a different idea of what this means.
Vegans believe meat is toxic and gives you cancer.
Dr. Robert Lustig and others claim that fructose is “a poison” and causes obesity and liver damage.
The USDA still tells people that saturated fat and cholesterol cause heart disease, and that whole grains should form the base of your diet.(41,42)
Paleo advocates claim that grains, gluten, beans, processed oils, and dairy give people cancer and pretty much every other known disease.
Mycotoxins are lurking in everything you eat, secretly making you fat and damaging your health.
“Processed” foods and artificial ingredients are dangerous.
GMO’s cause cancer and give you tumors.
Pretty much everyone claims all trans-fats are bad for you in any amount.
All of these claims are either untrue or out of context. Any food can be damaging in large enough amounts. The real question is whether or not these foods damage your health in the amounts they are normally consumed, in the context of a mixed diet.
The scientifically valid answer to this question is “no.”
Despite flawed correlational research,(43,44) there is no evidence that meat, red or not, causes cancer or heart disease or death. In contrast, there is controlled evidence showing red meat consumption can improve health markers as much as other meat sources.(45,46)
Fructose is not toxic and it doesn’t cause obesity or liver damage unless it is consumed in massive amounts and in caloric excess. There is no evidence it’s harmful in smaller amounts or that it encourages over-eating compared to sucrose.(47-50)
Consuming moderate amounts of sugar does not decrease insulin sensitivity or impair your ability to process glucose, as long as you maintain your weight and don’t over-eat.(51-53)
There is still no good evidence that moderate amounts of saturated fat and cholesterol cause heart disease,(54,55) but many of these studies also have significant limitations.(56,57) Recent evidence indicates even the correlations between saturated fat and cholesterol intake and heart disease are weak or nonexistent.(58-63)
Any food may contribute to heart disease if it leads to obesity or overweight, but there’s little evidence that consuming those calories from cholesterol-rich foods or saturated fat is worse than getting them elsewhere for most people.(64-66)
There is little evidence that omega-6 oils contribute to inflammation or heart disease.(56,67)
Gluten is not harmful to otherwise healthy people,(68) and there is still no evidence that grains, dairy, or legumes damage your health. There is also good evidence to the contrary.(31,69,70)
There is no evidence that processed or artificial foods are necessarily less healthy than natural foods. There is also no clear definition of what constitutes a “processed” food, and there are many “processed” foods that have proven health benefits, like whey protein.(31,71,72)
There is no evidence that the levels of mycotoxins in the diets of developed countries have a significant impact on your health.(73-76) There is no evidence GMO’s are harmful to humans.(77,78)
There is some evidence that synthetic trans-fats may be harmful, but the research is still inconclusive.(79-85) There’s little evidence that consuming a small amount of trans-fat is going to damage your health, especially since they’ve been removed from most foods. There is also evidence that some naturally occurring trans-fats like vaccenic acid may have health benefits.(79,86)
There are specific medical reasons for avoiding certain foods. And by “medical reason,” I don’t mean some naturopath, acupuncturist, homeopath, or voodoo priest reading chicken entrails said a certain food is bad for you. I mean a real doctor diagnosed you with a specific illness, and based their dietary recommendations on sound scientific evidence.
Here are a few examples. People with phenylketonuria should avoid aspartame.(87) People with celiac disease need to avoid gluten.(88) People with a severe peanut allergy need to avoid peanuts.(89) People with familial hypercholesterolemia may need to eat less cholesterol.(90) People with insulin resistance may benefit from a lower carbohydrate intake.(91)
Outside of very specific medical conditions like these, there is virtually no evidence that any single food can directly damage your health. There is also no evidence that certain foods will accelerate fat loss at the same calorie intake, or that other foods will slow down or prevent fat loss. You could eat 43% of your calories from table sugar and still lose just as much fat as someone who only consumed 4% of their calories from sugar.(92)
Elite athletes sometimes consume up to 20% of their calories from pure sugar, and stay at around 6-10% body fat year round.(5,6)
This is not a comprehensive list, but when you look at the evidence, virtually every food that’s ever been labeled as “dangerous” or “toxic” turns out to be fine in moderation, and sometimes even in large amounts. Any food could be “healthy” or “unhealthy” in different situations. This is something people forget when they talk about “clean eating,” and it’s something we’re going to address right now.
How to Know Whether a Food is Bad or Good for You
Whether or not a food is “healthy” or “unhealthy” depends on who is eating it, and how much they eat.
A healthy highly trained endurance athlete or bodybuilder exercising several hours per day is going to have very different needs and tolerances than a sedentary diabetic overweight office worker. The athletes can be far more relaxed about their diet. They can eat more total calories, more calorie dense foods, and assuming they’re meeting their micro- and macronutrient needs, more “empty calories.”
The office worker needs to eat fewer total calories, and should probably focus on far more filling, low-calorie foods, less palatable foods to avoid over-eating. They may also need to focus on more nutrient-dense foods since they’re eating fewer calories.
Personal preference also matters. Some people have a hard time eating in moderation, and it may be smart to remove some foods that they normally binge on, at least for a while. A food that is “healthy” for one person might be inappropriate for another in a given context.
Should you eat it, and how much can you have?
- Are you exercising or sedentary?
- How much are you exercising?
- What kind of exercise are you doing?
- What are your goals?
- Are you trying to lose fat, gain muscle, or improve your performance?
- Do you like a certain food or not?
- How many total calories are you eating?
- Do you have any specific medical conditions that warrant avoiding a certain food?
- Are you currently meeting your micro- and macronutrient targets?
- Are you hungry or do you feel satisfied throughout the day?
- What food(s) are you worried about?
- What do you think will happen if you eat it/them?
- Are you in a caloric deficit or caloric surplus?
All of these factors matter when deciding if a food is “healthy” or “unhealthy” for a given individual. In virtually all cases, there’s room in your diet for a little junk.
“Clean Eating is a Scam”
— JC Deen
It’s a scam that’s promoted by athletes, coaches, trainers, doctors, government officials, schools, diet book authors, and pretty much everyone else who eats.
“Clean eating” has no objective definition and no scientific support.
It’s also an eating disorder. Avoiding specific foods or food groups without a rational reason is one of the defining characteristics of orthorexia nervosa, and is common in people with binge eating disorder and anorexia.(93-95)
It’s no surprise this is a common disorder in athletes, dietitians, and other health conscious people.(96-103) People who hinder themselves with rigid dietary rules also have a harder time maintaining a healthy weight.(104-106)
- Food doesn’t make people gain fat — people over-eating food makes them overweight.
- Eating some of your calories from less nutrient dense sources is not going to give you a nutrient deficiency.
- There is no evidence that any food directly damages your health in moderate amounts in every situation.
You’re careful about your diet, which you should be. However, there’s no reason you need to avoid any specific food to achieve optimal health, a lean body composition, and maximum longevity.
Balance and moderation are what’s important, and the definition of both of these terms depends on who’s eating the food and how much they’re eating.
If you’re tired of being told that the only way to be healthy or lean is to demonize or avoid certain foods, please share this article on Facebook. Interested in actual nutrition advice from coaches who don’t buy into fear mongering and provide easy to follow, science-based plans? Learn more about our team here.
UPDATE: Here are a few of the nice things people have said about this article:
“That article on clean eating is absolutely amazing. It’s the best non-peer review article on nutrition I have ever read from anyone. It’s absolutely outstanding.”
— Layne Norton, B.S., Ph.D., IFPA; NGA Professional Bodybuilder and Powerlifter, Bodybuilding Coach
“Armi is really good at distilling complex, confusing information into points that can be easily understood and put into action – while not compromising a scientific basis. His discussion of “clean eating” is no exception.”
— Alan Aragon, B.S., M.S.
This article was originally published on Impruvism.com, which is now CompleteHumanPerformance.com. Within the first 12 hours of being published, this article got over 225,000 visits and 13,000 likes on Facebook. It has since been shared over 60 thousand times on social media and ready by over 2 million people. Thank you for sharing it with your friends, I appreciate it. – Armi
1. Orwell G. 1984: A Novel. New York, NY: Signet Classic; 1977.
2. Hill JO. Understanding and addressing the epidemic of obesity: an energy balance perspective. Endocr Rev. 2006;27(7):750–761. doi:10.1210/er.2006-0032.
3. Gibson SA. Dietary sugars intake and micronutrient adequacy: a systematic review of the evidence. Nutr Res Rev. 2007;20(2):121–131. doi:10.1017/S0954422407797846.
4. Bulik CM, Berkman ND, Brownley KA, Sedway JA, Lohr KN. Anorexia nervosa treatment: a systematic review of randomized controlled trials. Int J Eat Disord. 2007;40(4):310–320. doi:10.1002/eat.20367.
5. Onywera VO, Kiplamai FK, Boit MK, Pitsiladis YP. Food and macronutrient intake of elite kenyan distance runners. Int J Sport Nutr Exerc Metab. 2004;14(6):709–719.
6. Brouns F, Saris WH, Stroecken J, et al. Eating, drinking, and cycling. A controlled Tour de France simulation study, Part I. Int J Sports Med. 1989;10 Suppl 1:S32–40. doi:10.1055/s-2007-1024952.
7. Miller GD, Drewnowski A, Fulgoni V, Heaney RP, King J, Kennedy E. It is time for a positive approach to dietary guidance using nutrient density as a basic principle. J Nutr. 2009;139(6):1198–1202. doi:10.3945/jn.108.100842.
8. Fulgoni VL3, Keast DR, Drewnowski A. Development and validation of the nutrient-rich foods index: a tool to measure nutritional quality of foods. J Nutr. 2009;139(8):1549–1554. doi:10.3945/jn.108.101360.
9. Kennedy E. Putting the pyramid into action: the Healthy Eating Index and Food Quality Score. Asia Pac J Clin Nutr. 2008;17 Suppl 1:70–74. Available at: https://apjcn.nhri.org.tw/server/APJCN/17%20Suppl%201//70.pdf.
10. Drewnowski A. Defining nutrient density: development and validation of the nutrient rich foods index. J Am Coll Nutr. 2009;28(4):421S–426S. Available at: https://www.jacn.org/content/28/4/421S.full.pdf.
11. Drewnowski A, Fulgoni V3. Comparing the nutrient rich foods index with “Go,” “Slow,” and “Whoa,” foods. J Am Diet Assoc. 2011;111(2):280–284. doi:10.1016/j.jada.2010.10.045.
12. Robbins RJ, Kwik-Uribe C, Hammerstone JF, Schmitz HH. Analysis of flavanols in foods: what methods are required to enable meaningful health recommendations? J Cardiovasc Pharmacol. 2006;47 Suppl 2:S110–8– discussion S119–21.
13. Schroeter H, Heiss C, Spencer JPE, Keen CL, Lupton JR, Schmitz HH. Recommending flavanols and procyanidins for cardiovascular health: current knowledge and future needs. Mol Aspects Med. 2010;31(6):546–557. doi:10.1016/j.mam.2010.09.008.
14. Livingstone MBE, Rennie KL. Added sugars and micronutrient dilution. Obes Rev. 2009;10 Suppl 1:34–40. doi:10.1111/j.1467-789X.2008.00563.x.
15. Rennie KL, Livingstone MBE. Associations between dietary added sugar intake and micronutrient intake: a systematic review. Br J Nutr. 2007;97(5):832–841. doi:10.1017/S0007114507617206.
16. Ruxton CH, Garceau FJ, Cottrell RC. Guidelines for sugar consumption in Europe: is a quantitative approach justified? Eur J Clin Nutr. 1999;53(7):503–513.
17. Murphy SP, Johnson RK. The scientific basis of recent US guidance on sugars intake. Am J Clin Nutr. 2003;78(4):827S–833S. Available at: https://ajcn.nutrition.org/content/78/4/827S.long.
18. Gibson S, Boyd A. Associations between added sugars and micronutrient intakes and status: further analysis of data from the National Diet and Nutrition Survey of Young People aged 4 to 18 years. Br J Nutr. 2009;101(1):100–107. doi:10.1017/S0007114508981484.
19. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). National Academy of Sciences. Institute of Medicine. Food and Nutrition Board.; 2005. Available at: https://www.nal.usda.gov/fnic/DRI/DRI_Energy/energy_full_report.pdf.
20. Guthrie JF, Morton JF. Food sources of added sweeteners in the diets of Americans. J Am Diet Assoc. 2000;100(1):43–51– quiz 49–50. doi:10.1016/S0002-8223(00)00018-3.
21. Marriott BP, Olsho L, Hadden L, Connor P. Intake of added sugars and selected nutrients in the United States, National Health and Nutrition Examination Survey (NHANES) 2003-2006. Crit Rev Food Sci Nutr. 2010;50(3):228–258. doi:10.1080/10408391003626223.
22. Pfeiffer CM, Sternberg MR, Schleicher RL, Haynes BMH, Rybak ME, Pirkle JL. The CDC’s Second National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population is a valuable tool for researchers and policy makers. J Nutr. 2013;143(6):938S–47S. doi:10.3945/jn.112.172858.
23. Damms-Machado A, Weser G, Bischoff SC. Micronutrient deficiency in obese subjects undergoing low calorie diet. Nutr J. 2012;11:34. doi:10.1186/1475-2891-11-34.
24. Pearce SH, Cheetham TD. Diagnosis and management of vitamin D deficiency. BMJ. 2010;340. doi:10.1136/bmj.b5664.
25. Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008;87(4):1080S–6S. Available at: https://ajcn.nutrition.org/content/87/4/1080S.long.
26. Wang TJ, Pencina MJ, Booth SL, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008;117(4):503–511. doi:10.1161/CIRCULATIONAHA.107.706127.
27. Kulie T, Groff A, Redmer J, Hounshell J, Schrager S. Vitamin D: an evidence-based review. J Am Board Fam Med. 2009;22(6):698–706. doi:10.3122/jabfm.2009.06.090037.
28. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122(2):398–417. doi:10.1542/peds.2007-1894.
29. Ford ES, Mokdad AH. Dietary magnesium intake in a national sample of US adults. J Nutr. 2003;133(9):2879–2882. Available at: https://jn.nutrition.org/content/133/9/2879.full.
30. What We Eat in America, NHANES 2005-2006. U.S. Department of Agriculture; 2009. Available at: https://www.ars.usda.gov/SP2UserFiles/Place/12355000/pdf/0506/usual_nutrient_intake_vitD_ca_phos_mg_2005-06.pdf.
31. McGregor RA, Poppitt SD. Milk protein for improved metabolic health: a review of the evidence. The Journal of Nutrition and Metabolism. 2013;10(46). Available at: https://www.nutritionandmetabolism.com/content/pdf/1743-7075-10-46.pdf.
32. Pachón H, Kancherla V, Handforth B, Tyler V, Bauwens L. Folic acid fortification of wheat flour: A cost-effective public health intervention to prevent birth defects in Europe. Nutrition Bulletin. 2013;38(2):201–209. doi:10.1111/nbu.12023.
33. Giacco R, Pepa Della G, Luongo D, Riccardi G. Whole grain intake in relation to body weight: from epidemiological evidence to clinical trials. Nutr Metab Cardiovasc Dis. 2011;21(12):901–908. doi:10.1016/j.numecd.2011.07.003.
34. Kleiner SM, Bazzarre TL, Litchford MD. Metabolic profiles, diet, and health practices of championship male and female bodybuilders. J Am Diet Assoc. 1990;90(7):962–967.
35. Kleiner SM, Bazzarre TL, Ainsworth BE. Nutritional status of nationally ranked elite bodybuilders. Int J Sport Nutr. 1994;4(1):54–69.
36. Beals KA. Eating behaviors, nutritional status, and menstrual function in elite female adolescent volleyball players. J Am Diet Assoc. 2002;102(9):1293–1296.
37. Heaney S, O’Connor H, Gifford J, Naughton G. Comparison of strategies for assessing nutritional adequacy in elite female athletes’ dietary intake. Int J Sport Nutr Exerc Metab. 2010;20(3):245–256.
38. Beals KA, Manore MM. Nutritional status of female athletes with subclinical eating disorders. J Am Diet Assoc. 1998;98(4):419–425. doi:10.1016/S0002-8223(98)00096-0.
39. Economos CD, Bortz SS, Nelson ME. Nutritional practices of elite athletes. Practical recommendations. Sports Med. 1993;16(6):381–399.
40. Setnick J. Micronutrient deficiencies and supplementation in anorexia and bulimia nervosa: a review of literature. Nutr Clin Pract. 2010;25(2):137–142. doi:10.1177/0884533610361478.
41. Dietary Guidelines for Americans 2010. U.S. Department of Agriculture. U.S. Department of Health and Human Services; 2010. Available at: https://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf.
42. Lichtenstein AH, Appel LJ, Brands M, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation. 2006;114(1):82–96. doi:10.1161/CIRCULATIONAHA.106.176158.
43. Genkinger JM, Koushik A. Meat Consumption and Cancer Risk. PLoS Med. 2007;4(12):e345. doi:10.1371/journal.pmed.0040345.
44. Pan A, Sun Q, Bernstein AM, et al. Red meat consumption and mortality: results from 2 prospective cohort studies. Arch Intern Med. 2012;172(7):555–563. doi:10.1001/archinternmed.2011.2287.
45. Roussell MA, Hill AM, Gaugler TL, et al. Beef in an Optimal Lean Diet study: effects on lipids, lipoproteins, and apolipoproteins. Am J Clin Nutr. 2012;95(1):9–16. doi:10.3945/ajcn.111.016261.
46. Beauchesne-Rondeau E, Gascon A, Bergeron J, Jacques H. Plasma lipids and lipoproteins in hypercholesterolemic men fed a lipid-lowering diet containing lean beef, lean fish, or poultry. Am J Clin Nutr. 2003;77(3):587–593. Available at: https://ajcn.nutrition.org/content/77/3/587.long.
47. White JS. Straight talk about high-fructose corn syrup: what it is and what it ain’t. Am J Clin Nutr. 2008;88(6):1716S–1721S. doi:10.3945/ajcn.2008.25825B.
48. Melanson KJ, Angelopoulos TJ, Nguyen V, Zukley L, Lowndes J, Rippe JM. High-fructose corn syrup, energy intake, and appetite regulation. Am J Clin Nutr. 2008;88(6):1738S–1744S. doi:10.3945/ajcn.2008.25825E.
49. Livesey G. Fructose ingestion: dose-dependent responses in health research. J Nutr. 2009;139(6):1246S–1252S. doi:10.3945/jn.108.097949.
50. Livesey G, Taylor R. Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am J Clin Nutr. 2008;88(5):1419–1437. Available at: https://ajcn.nutrition.org/content/88/5/1419.long.
51. Brynes AE, Frost GS. Increased sucrose intake is not associated with a change in glucose or insulin sensitivity in people with type 2 diabetes. Int J Food Sci Nutr. 2007;58(8):644–651. doi:10.1080/09637480701395523.
52. Lewis AS, McCourt HJ, Ennis CN, et al. Comparison of 5% versus 15% sucrose intakes as part of a eucaloric diet in overweight and obese subjects: effects on insulin sensitivity, glucose metabolism, vascular compliance, body composition and lipid profile. A randomised controlled trial. Metab Clin Exp. 2013;62(5):694–702. doi:10.1016/j.metabol.2012.11.008.
53. Black RNA, Spence M, McMahon RO, et al. Effect of eucaloric high- and low-sucrose diets with identical macronutrient profile on insulin resistance and vascular risk: a randomized controlled trial. Diabetes. 2006;55(12):3566–3572. doi:10.2337/db06-0220.
54. Volk MG. An examination of the evidence supporting the association of dietary cholesterol and saturated fats with serum cholesterol and development of coronary heart disease. Altern Med Rev. 2007;12(3):228–245. Available at: https://www.altmedrev.com/publications/12/3/228.pdf.
55. Colpo A. LDL Cholesterol: Bad Cholesterol, or Bad Science? Journal of American Physicians and Surgeons. 2005;10:83–39. Available at: https://www.jpands.org/vol10no3/colpo.pdf.
56. Mozaffarian D, Micha R, Wallace S. Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med. 2010;7(3):e1000252. doi:10.1371/journal.pmed.1000252.
57. Micha R, Mozaffarian D. Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence. Lipids. 2010;45(10):893–905. doi:10.1007/s11745-010-3393-4.
58. Bonthuis M, Hughes MCB, Ibiebele TI, Green AC, van der Pols JC. Dairy consumption and patterns of mortality of Australian adults. Eur J Clin Nutr. 2010;64(6):569–577. doi:10.1038/ejcn.2010.45.
59. Kratz M, Baars T, Guyenet S. The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease. Eur J Nutr. 2013;52(1):1–24. doi:10.1007/s00394-012-0418-1
60. Goldbohm RA, Chorus AMJ, Galindo Garre F, Schouten LJ, van den Brandt PA. Dairy consumption and 10-y total and cardiovascular mortality: a prospective cohort study in the Netherlands. Am J Clin Nutr. 2011;93(3):615–627. doi:10.3945/ajcn.110.000430.
61. Huth PJ, Park KM. Influence of dairy product and milk fat consumption on cardiovascular disease risk: a review of the evidence. Adv Nutr. 2012;3(3):266–285. doi:10.3945/an.112.002030.
62. Kratz M. Dietary cholesterol, atherosclerosis and coronary heart disease. Handb Exp Pharmacol. 2005;(170):195–213.
63. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010;91(3):535–546. doi:10.3945/ajcn.2009.27725.
64. Astrup A, Dyerberg J, Elwood P, et al. The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010? Am J Clin Nutr. 2011;93(4):684–688. doi:10.3945/ajcn.110.004622.
65. Baum SJ, Kris-Etherton PM, Willett WC, et al. Fatty acids in cardiovascular health and disease: a comprehensive update. J Clin Lipidol. 2012;6(3):216–234. doi:10.1016/j.jacl.2012.04.077.
66. Hession M, Rolland C, Kulkarni U, Wise A, Broom J. Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obes Rev. 2009;10(1):36–50. doi:10.1111/j.1467-789X.2008.00518.x.
67. Johnson GH, Fritsche K. Effect of dietary linoleic acid on markers of inflammation in healthy persons: a systematic review of randomized controlled trials. J Acad Nutr Diet. 2012;112(7):1029–41– 1041.e1–15. doi:10.1016/j.jand.2012.03.029.
68. Bizzaro N, Tozzoli R, Villalta D, Fabris M, Tonutti E. Cutting-edge issues in celiac disease and in gluten intolerance. Clin Rev Allergy Immunol. 2012;42(3):279–287. doi:10.1007/s12016-010-8223-1.
69. Ye EQ, Chacko SA, Chou EL, Kugizaki M, Liu S. Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. J Nutr. 2012;142(7):1304–1313. doi:10.3945/jn.111.155325.
70. Bouchenak M, Lamri-Senhadji M. Nutritional quality of legumes, and their role in cardiometabolic risk prevention: a review. J Med Food. 2013;16(3):185–198. doi:10.1089/jmf.2011.0238.
71. Krissansen GW. Emerging health properties of whey proteins and their clinical implications. J Am Coll Nutr. 2007;26(6):713S–23S.
72. Yalcin AS. Emerging therapeutic potential of whey proteins and peptides. Curr Pharm Des. 2006;12(13):1637–1643.
73. Shephard GS. Impact of mycotoxins on human health in developing countries. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2008;25(2):146–151. doi:10.1080/02652030701567442.
74. Milicevic DR, Skrinjar M, Baltic T. Real and perceived risks for mycotoxin contamination in foods and feeds: challenges for food safety control. Toxins (Basel). 2010;2(4):572–592. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153222/.
75. Levi C. Mycotoxins in coffee. J Assoc Off Anal Chem. 1980;63(6):1282–1285.
76. vander Stegen G, Jorissen U, Pittet A, et al. Screening of European coffee final products for occurrence of ochratoxin A (OTA). Food Addit Contam. 1997;14(3):211–216. doi:10.1080/02652039709374518.
77. Safety and nutritional assessment of GM plants and derived food and feed: the role of animal feeding trials. Food Chem Toxicol. 2008;46 Suppl 1:S2–70. doi:10.1016/j.fct.2008.02.008.
78. Joudrier P. [Food safety of GMOs]. J Soc Biol. 2009;203(4):337–344.
79. Mozaffarian D, Aro A, Willett WC. Health effects of trans-fatty acids: experimental and observational evidence. Eur J Clin Nutr. 2009;63 Suppl 2:S5–21. doi:10.1038/sj.ejcn.1602973.
80. Chardigny J-M, Destaillats F, Malpuech-Brugere C, et al. Do trans fatty acids from industrially produced sources and from natural sources have the same effect on cardiovascular disease risk factors in healthy subjects? Results of the trans Fatty Acids Collaboration (TRANSFACT) study. Am J Clin Nutr. 2008;87(3):558–566. Available at: https://ajcn.nutrition.org/content/87/3/558.long.
81. Gebauer SK, Chardigny J-M, Jakobsen MU, et al. Effects of ruminant trans fatty acids on cardiovascular disease and cancer: a comprehensive review of epidemiological, clinical, and mechanistic studies. Adv Nutr. 2011;2(4):332–354. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3125683/.
82. Mozaffarian D, Clarke R. Quantitative effects on cardiovascular risk factors and coronary heart disease risk of replacing partially hydrogenated vegetable oils with other fats and oils. Eur J Clin Nutr. 2009;63 Suppl 2:S22–33. doi:10.1038/sj.ejcn.1602976.
83. Mensink RP, Zock PL, Kester ADM, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr. 2003;77(5):1146–1155. Available at: https://ajcn.nutrition.org/content/77/5/1146.long.
84. Teegala SM, Willett WC, Mozaffarian D. Consumption and health effects of trans fatty acids: a review. J AOAC Int. 2009;92(5):1250–1257.
85. Wallace SK, Mozaffarian D. Trans-fatty acids and nonlipid risk factors. Curr Atheroscler Rep. 2009;11(6):423–433.
86. Field CJ, Blewett HH, Proctor S, Vine D. Human health benefits of vaccenic acid. Appl Physiol Nutr Metab. 2009;34(5):979–991. doi:10.1139/H09-079.
87. Butchko HH, Stargel WW, Comer CP, et al. Aspartame: review of safety. Regul Toxicol Pharmacol. 2002;35(2 Pt 2):S1–93.
88. Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA. ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease. Am J Gastroenterol. 2013;108(5):656–676. doi:10.1038/ajg.2013.79.
89. Al-Ahmed N, Alsowaidi S, Vadas P. Peanut Allergy: An Overview. Allergy, Asthma & Clinical Immunology. 2008;4(4):139–143. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2868887/.
90. Robinson JG. Management of familial hypercholesterolemia: a review of the recommendations from the national lipid association expert panel on familial hypercholesterolemia. J Manag Care Pharm. 2013;19(2):139–149.
91. Accurso A, Bernstein R, Dahlqvist A, et al. Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutr Metab (Lond). 2008;5(1):9.
92. Surwit RS, Feinglos MN, McCaskill CC, et al. Metabolic and behavioral effects of a high-sucrose diet during weight loss. Am J Clin Nutr. 1997;65(4):908–915. Available at: https://ajcn.nutrition.org/content/65/4/908.full.pdf.
93. Janas-Kozik M, Zejda J, Stochel M, Brozek G, Janas A, Jelonek I. [Orthorexia–a new diagnosis?]. Psychiatr Pol. 2012;46(3):441–450.
94. Higgs JF, Goodyer IM, Birch J. Anorexia nervosa and food avoidance emotional disorder. Arch Dis Child. 1989;64(3):346–351. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1791897/.
95. Masheb RM, Grilo CM. Binge eating disorder: a need for additional diagnostic criteria. Compr Psychiatry. 2000;41(3):159–162. doi:10.1016/S0010-440X(00)90041-5.
96. Alvarenga MS, Martins MCT, Sato KSCJ, Vargas SVA, Philippi ST, Scagliusi FB. Orthorexia nervosa behavior in a sample of Brazilian dietitians assessed by the Portuguese version of ORTO-15. Eat Weight Disord. 2012;17(1):e29–35.
97. Barthels F, Pietrowsky R. [Orthorectic eating behaviour – nosology and prevalence rates]. Psychother Psychosom Med Psychol. 2012;62(12):445–449. doi:10.1055/s-0032-1312630.
98. Donini LM, Marsili D, Graziani MP, Imbriale M, Cannella C. Orthorexia nervosa: a preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon. Eat Weight Disord. 2004;9(2):151–157.
99. Eriksson L, Baigi A, Marklund B, Lindgren EC. Social physique anxiety and sociocultural attitudes toward appearance impact on orthorexia test in fitness participants. Scand J Med Sci Sports. 2008;18(3):389–394. doi:10.1111/j.1600-0838.2007.00723.x.
100. Fidan T, Ertekin V, Isikay S, Kirpinar I. Prevalence of orthorexia among medical students in Erzurum, Turkey. Compr Psychiatry. 2010;51(1):49–54. doi:10.1016/j.comppsych.2009.03.001.
101. Hepworth K. Eating disorders today–not just a girl thing. J Christ Nurs. 2010;27(3):236–41– quiz 242–3.
102. Kinzl JF, Hauer K, Traweger C, Kiefer I. Orthorexia nervosa in dieticians. Psychother Psychosom. 2006;75(6):395–396. doi:10.1159/000095447.
103. Segura-Garcia C, Papaianni MC, Caglioti F, et al. Orthorexia nervosa: a frequent eating disordered behavior in athletes. Eat Weight Disord. 2012;17(4):e226–33. doi:10.3275/8272.
104. Meule A, Westenhofer J, Kubler A. Food cravings mediate the relationship between rigid, but not flexible control of eating behavior and dieting success. Appetite. 2011;57(3):582–584. doi:10.1016/j.appet.2011.07.013.
105. Meule A, Papies EK, Kubler A. Differentiating between successful and unsuccessful dieters. Validity and reliability of the Perceived Self-Regulatory Success in Dieting Scale. Appetite. 2012;58(3):822–826. doi:10.1016/j.appet.2012.01.028.
106. Stewart TM, Williamson DA, White MA. Rigid vs. flexible dieting: association with eating disorder symptoms in nonobese women. Appetite. 2002;38(1):39–44.