From media stories on the evils of additives and preservatives, to reports on the ill-effects of trans fats and high-fructose corn syrup, we are being fed a glut of information about what not to eat. It’s no wonder, then, that some of us are making ourselves sick with worry – literally.
Some people eat with blissful ignorance, or blatant disregard, of the latest food news. Others find balance in all the research and live in that ZIP code known as moderation. But there are those who heed the advice of avoidance with zeal, taking restriction – of sugar, preservatives, sodium or even gluten, without being diagnosed with celiac disease – to the extreme. These are not your average food-label watchers. They’re more intense than that – and sometimes, they’re even well-intentioned health care professionals. They may keep an Excel spreadsheet of food consumed each day; they may stop eating at some point during the day because they’ve reached the maximum allowed amount of whatever it is they’re trying to restrict; they often refuse to eat out at a restaurant – or even at a friend’s house – because they don’t have control over the meal preparation and content; and they tend to take exception to “eat in moderation” advice because it’s not specific enough to seem effective.
It’s those folks who worry Terese Scollard, MBA, RD, LD, regional clinical nutrition manager for Providence Nutrition Services.
Scollard, a dietitian for 35 years, says Americans’ relationship with food, culturally speaking, is, well, a bit dysfunctional. “In our culture, we use food as a vehicle for perfecting ourselves somehow,” she says, noting that many of us carry around the idea that if we eat more or less of something, we’ll land in that sweet spot of wellness (and weight loss). Advertisers aren’t above taking advantage of our feelings to get us to buy into – and buy – their products. From the time we wake up to the moment our heads hit the pillow, we are weighing our options regarding what (and what not) to eat. Scollard says it’s natural and good to care about what you’re putting into your body – to a point. With too many rules, however, we end up confused. When natural concern borders on or crosses into obsessive behavior, it can jeopardize a person’s physical and mental health. Long-term food restrictions can cause significant nutrient deficiencies.
Taking nutrition to the extreme
Managing your food intake with a precision bordering on obsession is a condition known in medical circles as orthorexia. Though it’s not a diagnosed eating disorder, the term is used to describe someone whose extreme restriction adversely affects his health and life. Such hypervigilance concerns Scollard, especially when it interferes with a person’s day-to-day life. “If watching what you eat is impeding your enjoyment of dining and causing problems in your relationships, you may be overdoing it,” she says. The only time you need to be that accurate about food, Scollard says, is when you’re in a metabolic lab, have been diagnosed with celiac disease, or have been diagnosed with diabetes, which means you’ll need to monitor your carbohydrates and insulin. “You don’t want to sacrifice other parts of your nutritional health because you’re sticking so close to those numbers.”
Scollard says she sees more men than women – and older rather than younger individuals – struggling with orthorexia. This may be explained by the fact that individuals who are getting on in age often develop more health challenges, which can be mitigated by adjusting certain aspects of their diet. What begins as a good eating pattern for managing a condition sometimes evolves into obsessive over-restriction.
Taking technology too far
Smart phone applications, or apps, are one way people can take food management to extremes. With the ubiquity of smart phones, we’re using technology to monitor our health without having the proper medical context or professional filter to do it accurately or even, sometimes, safely. Scollard points out that information in these databases isn’t as precise as we think it is, and that what is “precise” for one app will vary for another. She recommends using health-related apps as just one component of your overall health plan – not as your sole guide to wellness. “Enlist apps as useful feedback tools,” she said, noting that periodic use is adequate. In other words, don’t be afraid to put down the technology and let your conscience be your guide. “You just don’t always need that little app,” she says. “It’s OK not to perfectly measure every bite of food.”
Shaking up the salt numbers
Sodium has gotten a lot of press lately. A recent report from the Centers for Disease Control and Prevention noted that more than 90 percent of Americans consume more than the recommended amount of sodium. Scollard says that we have developed a taste for it, given its presence in so many foods. But its relationship to high blood pressure, which can lead to stroke and heart disease, has many people monitoring their sodium intake. One recommendation, however, does not fit all. People can get into trouble when they take one number and use it as an absolute – for example, focusing exclusively on sodium intake and therefore not getting adequate calories or enough other key nutrients.
“Let’s say that I’m a five-foot-one woman, and you’re a six-foot-tall man, and our doctors say we’re supposed to be getting 2,000 mg of sodium a day,” she says. “Those are two very different people. And if you’re reading app information without professional oversight, you can over- or under-restrict yourself with these programs.”
So much of the unnecessary salt we consume comes from processed foods – deli meats, cheese, and boxed and canned foods. When possible, opt for fresh foods and low-sodium deli meats. Enjoy cheese, but less of it, and less frequently. And use salt-free herb blends instead of the salt shaker. Making those simple changes can eliminate a lot of unnecessary sodium from your diet. Most people don’t have to get more precise than that.
Advice for a balanced life
It takes a certain personality type to restrict in the extreme, Scollard points out. Sometimes dietary caution is founded on fears about recently diagnosed health issues. “When you worry that you’re going to have a stroke, or get scared that you’re going to die, there’s a lot of motivation to take care of yourself,” Scollard says. But if you’re watching what you eat too closely – especially with the aid of apps – you can end up hurting, rather than helping, yourself. “These are great tools that provide great feedback on your choices, but be sensible with them,” she says. She recommends enlisting the help of a registered dietitian to sort through what’s relevant and to prioritize based on your unique needs and goals.
Stick with the big picture. Perspective is key to enjoying, rather than managing, your food, Scollard says. Even if you have a chronic condition that warrants special attention to salt, fat and sugar content, you can aim for progress rather than perfection. Guidelines are not hard-and-fast rules. If you’re organizing your life around these guidelines, it’s time to take a step back and reevaluate.
Don’t go it alone. With all the information we’re taking in regarding diet and nutrition, it’s easy to mistake ourselves for experts. Don’t do it, Scollard says. “People vary in height, activity, metabolism and weight, and all of these influence your own personal nutrition needs,” she says. That’s why it makes sense to work with a dietitian. A doctor can tell you what you need to do, and a dietitian can help you map out and execute a plan that will get you where you want to be without setting yourself up for failure, or fixation.
Take what you need and leave the rest. If you want to use apps or other such guides to help monitor your diet, Scollard advises using them for a couple of weeks, and then backing off and trying to make good choices on your own. “You want to be living your life – you don’t want to be living your life around how many grams or milligrams of something are in your food,” she says. And when you are doing nutrient analysis, she prefers “pretty close” to precision. Focusing too much on the numbers, she says, “isn’t healing in the long run.”