June 2016 Issue

Hottest Nutrition Trends of 2016: Clean Eating
By Judith C. Thalheimer, RD, LDN
Today's Dietitian
Vol. 18 No. 6 P. 37

Nutrition professionals weigh in on this year's top nutrition trends, and clean eating is number one. Today's Dietitian explores the pros and cons of this move toward more whole foods and simpler ingredients and the companion trend of front-of-package "free-from" claims.

The fourth annual "What's Trending in Nutrition" survey from Today's Dietitian and Pollock Communications, a food, health, and wellness public relations agency in New York City, asked 450 RDs for their observations on what's hot and what's not. "The survey revealed that ancient grains stay strong, low-fat moves out, and seeds steal the show," says Jenna Bell, PhD, RD, senior vice president and director of food and wellness at Pollock Communications, "but clean eating is where it's at."

Related to the "clean" trend, the survey also anticipated a continued rise in interest in products that make "free-from" claims, in particular "antibiotic-free" and "gluten-free."

This article is the first in a three-part series highlighting the top trends nutrition professionals expect to see in 2016. The series will delve into these trends, exploring how they developed, where they're going, their pros and cons, and what RDs will need to know to address their clients' questions and concerns.

Eating Clean
From the socially conscious health food movement of the 1960s to the growth of the organic foods market in the 1990s to this decade's focus on local foods, the roots of the current clean eating movement run deep. But there are many different interpretations of what it means to eat clean. "The foundation of clean eating is choosing foods in their whole-food state or as close as possible to how they're found in nature," says Michelle Dudash, RDN, a Cordon Bleu–certified chef and creator of CleanEatingCookingSchool.com. Beyond that, the definition of clean eating seems to be up to interpretation. For some, only whole foods are clean; for others, minimally processed foods are acceptable. Some clean eating advocates recommend a vegan or vegetarian diet, but it's a matter of choice, Dudash says. "You can eat clean foods from all of the food groups, although fruits and vegetables would be at the base of a clean eating pyramid." Organic food, grown or made with no pesticides, hormones, or GMOs, are a part of clean eating for many, and choosing local and in-season produce may be as well. Several proponents even include principles such as eating multiple small meals throughout the day and being more active as part of a clean eating lifestyle.

"Clean eaters avoid highly processed foods that contain added sugar and unhealthy fats, as well as artificial ingredients such as preservatives and additives," says Diane Quagliani, MBA, RDN, LDN, a Chicago-area nutrition communications consultant who works with supermarket industry clients.

"When you eat a whole food, you know it doesn't have any added sugars or extra sodium or fat," Dudash says, "and I think any nutrition professional will agree that an apple plucked from a tree is more healthful overall than an apple fruit leather or apple juice."

Avoiding all "processed" foods can be limiting, since nearly everything we eat and drink is processed in some way. Washing, cutting, removing inedible parts, and peeling are all forms of processing. Even freezing, drying, pasteurizing, and fermenting may be considered minimal forms of processing.1 But, the more processed a food, the higher the likelihood that healthful nutrients have been replaced with extra sugar, fat, salt, calories, and chemical preservatives or flavorings. "Foods like oats and almonds have to go through some processing before we can eat them," says Joan Salge Blake, MS, RDN, LDN, a clinical associate professor and director of the dietetic internship at Boston University's Sargent College of Health and Rehabilitation Sciences, and a spokesperson for the Academy of Nutrition and Dietetics. "But we can choose oats without added sugar and almonds without extra sodium."

Eating more whole and minimally processed foods is in line with current nutrition recommendations and dietary patterns, which emphasize eating fruits, vegetables, whole grains, nuts, seeds, and lean animal proteins and reducing intake of added sugars, fat, and sodium. "The new Dietary Guidelines have moved away from focusing on individual nutrients and now focus on overall diet," Salge Blake says. "If clean eating moves people toward eating more whole plant foods, leaner cuts of meat, and more fish, that's in line with the DASH [Dietary Approaches to Stop Hypertension] diet, the Mediterranean diet, and other dietary patterns that are best at fighting chronic disease over time."

"Ultimately, a diet that is rich in whole foods is going to be very nourishing," says Katie Cavuto, MS, RD, a chef and author of the blog Nourish. Breathe. Thrive, "but it's unrealistic to expect that we're not going to utilize any packaged or processed foods."

Dudash agrees: "A lot of Americans are already scared to cook, or don't cook." In fact, 1 in 5 Americans spends less than 15 minutes cooking dinner on an average day.2 "Packaged foods can save time in the kitchen, require a lower skill level, and fill nutritional gaps, and some, like whole-grain pasta and canned vegetables, may encourage intake of certain important food groups. It's all about looking at the ingredient list. As long as the ingredients are mostly whole foods, it's still a good choice," Dudash says.

Stephanie Perez, RD, LDN, retail dietitian supervisor for ShopRite supermarkets, says customers interested in clean eating typically look for minimally processed foods. "This translates into more buying of whole foods but also foods with shorter ingredient lists," Perez says. In fact, one shortcut often associated with clean eating in the media is looking for labels that list no more than five ingredients.

"I totally disagree with that," Dudash says. "The number of ingredients has no relation to how clean a food is. Look at the long list of ingredients in a good vegetable soup: It's about the quality of ingredients, not the quantity."

Cavuto agrees. "Instead of counting ingredients, when I look at an ingredient list I ask myself a) 'Can I buy the ingredients in the grocery store?' and b) 'Is this how I would make this myself?'" Cavuto says.

Cavuto cautions that encouraging clean eating can have a downside. "The clean eating movement can put pressure on consumers and make them feel inadequate because they can't meet their self-imposed definition of healthy eating," Cavuto says. "Sometimes the clean eating mentality forces people into this 'all or nothing' mode. That can be very stifling for long-term goals, and can cause stress, anxiety, and failure. Perfection doesn't exist," Cavuto adds, "We have to be realistic about our food choices."

Salge Blake agrees: "It's great that more people are looking to eat less of the things we don't want in our diet, but it's important not to make people feel inferior if they eat something out of a bag or a box. After all, frozen vegetables come out of a bag, and they are often more nutritious than fresh that left the fields days ago only to be stored in your refrigerator for so long that there is a loss of nutrients. If people aren't eating clean, we don't want them to feel they must be eating 'dirty.'"

Free From
Despite the potential for negative feelings, the clean eating trend continues to grow. "Food companies are responding to the growing number of consumers who are clean eaters by removing certain ingredients such as gluten, high-fructose corn syrup, and GMOs from their products," Quagliani says. "The next logical step is for these companies to highlight that their products are free from these ingredients on their labels."

According to the "What's Trending in Nutrition" survey, many dietitians agree. "When it comes to the messages and claims that impact shopping decisions, 2016 will look for 'free from,'" Bell says. "These claims may include things like GMO-free and antibiotic-free when making purchasing decisions, as well as additive-free and locally sourced."

"Our shelves are definitely showing this trend," Perez says. "Manufacturers are removing ingredients seen as less desirable from their products and advertising that on their labels and in the media. Demand for 'cleaner' food drove the manufacturers' decisions," she says, "and the plethora of 'free-from' labels on foods is driving demand even higher as customers are catching on to it." According to Quagliani, the International Dairy-Deli-Bakery Association's What's in Store 2015 report found that almost 13% of global food and beverage introductions in 2013 included a "free-from" claim, up 3% over the previous five years.

A May 2015 report from the market research firm Mintel found that 84% of consumers buying products with "free-from" claims do so because they want more natural, less processed foods. Trans fat–free was most important to 78% of purchasers, 71% looked first for preservative-free, and sodium-free ranked number one for 57% of consumers who buy these foods. Foods free from GMOs also ranked in the top four most important considerations. Animal welfare and the health of the planet factor into buying decisions as well, with "cage-free" and "free-range" claims ranking high on "free-from" consumers' lists of concerns.3

Perez is seeing these data borne out on the supermarket shelves. "We see foods free from the top eight allergens, plus gluten-free, free from artificial colors and flavors, preservative-free, non-GMO, free from trans fat and high-fructose corn syrup, and more," Perez says. "Organic can be part of the discussion or not. Organic foods are free from pesticides, hormones, and GMOs but not necessarily free from allergens, gluten, or other ingredients that can impact health," she says.

According to Dudash, these "free-from" claims are becoming a bit much. "It's great to have allergen information and ingredients spelled out clearly on the back of the package, but all of these non, no, and free front-of-package claims can be overwhelming."

Perez agrees: "Nutrition professionals need to be aware of the confusion these labels can cause. Questions are coming up in weight loss classes, sampling events, and community presentations as well as in our stores. Our in-store dietitians regularly answer questions like 'Should I be choosing gluten-free products?' or 'What are GMOs?'"

"The word 'free' on a package has a legal meaning," Salge Blake says. "Something that is sodium-free, for example, has to have less than 5 mg of sodium per serving. But, just like in the 1980s with the cholesterol-free craze, we are again seeing foods that have always been free from a particular food component touting it on their labels as if it's exceptional."

Other experts caution that "free-from" labels can give consumers a false impression. "People might give 'free-from' foods a healthy halo and end up overindulging in certain 'free-from' treats like snack foods and desserts," Quagliani says.

Cavuto agrees people may wrongly equate "free from" with "good for you." "These labels are not all synonymous with nourishing and healthy," Cavuto says. "For example, unless you have a gluten intolerance, gluten-free does not equal nourishing. There are a lot of highly processed, high-sugar gluten-free products. The same goes for organic products. Consumers trust those labels," Cavuto says.

Another potential pitfall of trying to avoid particular food components is the risk of unbalancing the diet. "In their quest to avoid certain ingredients, people might forget the importance of getting enough of certain foods and nutrients," Quagliani says.

Bell agrees: "If we narrowly focus on finding foods that are 'free from' something, we may miss out on health-promoting options or—even worse—lose the joy of eating."

Helping Clients Come Clean
Whether a client is interested in eating clean or just has questions about the plethora of claims on product packages, nutrition professionals are perfectly positioned to help. "RDs are essential for cutting through the confusion," Perez says. "Our in-store dietitians work with customers to determine their individual health needs and lifestyles and help people choose the best products for them."

Quagliani supports that approach. "Nutrition professionals should respect clients' buying and eating preferences, but make sure they understand the evidence-based information about their 'free-from' choices," she says. "For instance, gluten-free is a must for those with celiac disease, but those who go gluten-free in hopes of losing weight without making any other diet changes will likely be disappointed in the long run."

To avoid the possible pitfalls of "free-from" claims, Cavuto suggests turning clients' eyes to the back of the box. "From a labeling standpoint, one of the biggest things I recommend is to avoid front-of-package labeling," Cavuto says. "It's essentially marketing, and it's not giving you the facts. The best place to go is the ingredient list. That's where you're going to find out what's in a food, not from the front of the package."

"It's very difficult not to get caught up in this idea that there is one way of eating and if you're not doing that then you're failing," Cavuto says.

Salge Blake agrees: "We all need to be careful not to go to extremes, and we need to help the public do the same. We can't just throw out unattainable absolutes. Our job as RDs is to take our nutrition expertise and fit it into the lives of consumers—invite the consumer to the table. Find out where they are and help them make shifts that they can be proud of and that motivate them to make more shifts to get the job done in the future."

Bell says if people want to clean up their diet, they should focus on variety. "Eat foods that you love from all of the food categories, all over the grocery store—in quantities that give you the nutrients you need—and with serving sizes that suit your body size and type," Bell says. "And do all of this with a keen focus on the pleasure of eating."

According to Cavuto, "at the end of the day, it's always better to eat any vegetable than a vegetable that's solely organic, for example. Don't fall into the trap of trends. Focus on food that is nourishing for your body, because, in the end, that's your intention."

— Judith C. Thalheimer, RD, LDN, is a freelance nutrition writer, a community educator, and the principal of JTRD Nutrition Education Services.

References
1. Monteiro CA, Levy RB, Claro RM, Castro IR, Cannon G. A new classification of foods based on the extent and purpose of their processing. Cad Saude Publica. 2010;26(11):2039-2049.

2. International Food Information Council Foundation. What's your health worth?: food & health survey 2015. http://www.foodinsight.org/sites/default/files/2015%20Food%20and%20Health%20Survey%20-%20FINAL.pdf

3. 84% of Americans buy "free-from" foods because they believe them to be more natural or less processed. Mintel website. http://www.mintel.com/press-centre/food-and-drink/84-of-americans-buy-free-from-foods-because-they-believe-them-to-be-more-natural-or-less-processed. Published September 3, 2015. Accessed April 2, 2016.