“It’s Healthy Because It’s Natural.” Perceptions of “Clean” Eating among U.S. Adolescents and Emerging Adults

Abstract

Definitions for the culturally trendy “clean” eating phenomenon vary: whereas some characterize it as natural and healthy, others adopt more restrictive, moralizing, and affectively-laden definitions that may reflect disordered eating. We examined levels of familiarity with “clean” eating, sources of information, and perceptions of this dietary trend among a large, diverse sample of U.S. adolescents and emerging adults recruited from the National MyVoice Text Message Cohort (n = 1266; ages 14–24 years). Participants answered five questions assessing knowledge of “clean” eating, definitions, perceived healthiness vs. harm, and willingness to adopt “clean” eating, and responses were coded by three trained researchers. Results indicate that 55% of respondents had previously heard of “clean” eating, most commonly through social media, other online sources, and peers. Definitions were heterogeneous, with 40% offering “non-processed” or “whole foods” and 13% noting “non-GMO” or “organic” components. Few respondents (0.6%) expressed outright skepticism about “clean” eating, but many (30%) identified dietary avoidance and restriction as part of the definition. Overall, 71% characterized “clean” eating as a healthy approach, whereas 6% flagged it as “unhealthy”, and 18% noted elements of both healthfulness and harm. Notably, 41% reported they “probably would” try “clean” eating themselves, with greater willingness to try “clean” eating among cisgender women. Present findings highlight high levels of awareness and positive attitudes toward “clean” eating among young people in the U.S., with little recognition of the potential risks of dietary restriction. Further research should examine actual dietary behaviors to clarify potential risks of “clean” eating and related trends and thus inform strategies for eating disorder prevention.

Social Influence on Fad Diet Use: A Systematic Literature Review

“…Additionally, after completing the JBI critical appraisal on the remaining articles, the reviewers determined all studies had low to moderate risk of bias and decided to move forward with the eligible studies (see Appendix B for detailed summary of appraisal results). Therefore, the present review is based on the results of 13 articles: eight cross sectional studies (Allen et al, 2018; Ambwani et al, 2020; Condon et al, 2007; Eisenberg et al, 2005; Grigg et al, 1996; Marquez et al, 2018; Maxwell et al, 2017; Worsley and Skrzypiec, 1997), three qualitative studies (Poirier et al, 2016; Pujol-Busquets et al, 2020; Rydén and Sydner, 2011), one cohort study (Bonaccio et al, 2012), and one non-randomized experimental study (Paxton et al, 2002).…”

“…unhealthy weight control behaviours, weight control activities; Eisenberg et al, 2005; Grigg et al, 1996; Marquez et al, 2018), the remaining studies (n = 10) included specific fad diet names within the article. Popular diet plans were identified as the Mediterranean diet (n = 2; Bonaccio et al, 2012; Rydén and Sydner, 2011), clean eating (n = 2; Allen et al, 2018; Ambwani et al, 2020) the paleolithic diet (i.e. paleo; Maxwell et al, 2017), vegetarianism (n = 1; Worsley and Skrzypiec, 1997), and the Banting diet (n = 1; Pujol-Busquets et al, 2020).…”

Predictors of Vaccine Hesitancy: Implications for COVID-19 Public Health Messaging

“…Higher SES may be associated with improved knowledge of vaccines, based on the assumption that SES is associated with education attainment and, in turn, a general understanding of the relative safety and effectiveness of vaccines. The finding that higher SES is sometimes associated with vaccine refusal is less straightforward but may centre on clean living values, which emphasize purity and natural immunity and tend to be more pronounced among higher-income regions [28]. Moreover, middle-to high-income areas may have more ready access to information through the Internet and social media, which could lead to more exposure to anti-vaccine content [29].…”

Digging up the dirt on “clean” dietary labels: Public health considerations and opportunities for increased Federal oversight

“…First, the cultural moralization of eating behavior and preference for “clean” food could contribute to preoccupation with “clean” dieting among vulnerable groups such as individuals at risk for eating disorders. Dieting is a well‐established risk factor for disordered eating (Hsu, 1997; Liechty & Lee, 2013) even when it involves ostensibly healthy (Barnett, Dripps, & Blomquist, 2016) or therapeutic diets (Conviser, Fisher, & McColley, 2018), and many U.S. adolescents and emerging adults describe “clean” eating in the context of dietary avoidance and restriction (Ambwani, Sellinger, Rose, Richmond, & Sonneville, 2020). Furthermore, other research highlights distress and functional impairment associated with extreme preoccupation with healthy eating, termed “orthorexia nervosa” (ON), a proposed eating disorder diagnosis characterized by obsessive thinking, ritualistic behavior, and dietary restriction focused on perceived food healthiness or purity (Bratman, 2017; Dunn & Bratman, 2016).…”