Do You Have to Drink Green to Eat Clean?

Green drinks and clean eating are all the rage, but what exactly is “clean eating?”

Margaret McCartney, GP, notes in the British Medical Journal,

“The command to eat cleanly implies that everyone else is filthy, being careless with their bodies and lives. It comes with promises of energy boosts, glowing skin, spirituality, purity, and possibly immortality. But this nonsense is all based on a loose interpretation of facts and a desire to make the pursuit of well-being an obsessive, full-time occupation.”

Let’s also add that there isn’t a single definition of clean eating that everyone agrees with. Here are a few examples…

  • At its simplest, clean eating is about eating whole foods, or “real” foods — those that are un- or minimally processed, refined, and handled, making them as close to their natural form as possible.  Fitness Magazine
  • It used to imply eating lots of whole, real foods — veggies and fruit, whole grains, animal and plant-based protein, nuts, seeds, and oils. It also meant that what you eat should be as close to nature as possible — minimally processed, not packaged or originating from a factory. Good Housekeeping
  • The soul of eating clean is consuming food the way nature delivered it, or as close to it as possible. It is not a diet; it’s a lifestyle approach to food and its preparation, leading to an improved life — one meal at a time. Clean Eating Magazine
  • Eating clean is simply the practice of avoiding processed and refined foods and basing your diet on whole foods. Eating Clean for Dummies Cheat Sheet

Some clean eating programs ban gluten, dairy, sugar, any food that’s not organic, or any food that isn’t sourced locally. What starts off sounding like a simple concept can get buried in an overwhelming list of food don’ts – without any science to back it up.

It’s clear from the 2015-2020 Dietary Guidelines for Americans that eating plenty of vegetables, fruit, whole grains, dairy, protein foods, and more healthful types of fat while limiting added sugars, saturated fat, trans fat, and sodium will result in a healthful eating pattern. Clean eating and green drinks aren’t mentioned.

How do you define a processed food?

While we probably all agree that Twinkies or frozen meals are processed, what about bread? Do you have to make your own bread to avoid processed foods? Do you have to mill your own flour? We most likely think of fresh fruit as fitting into the clean eating concept, but what if that fruit is shipped to my home in Arizona from China? It’s easy to overthink clean eating to the point where we throw up our hands and head to the nearest fast-food drive-through.

Here’s our take on clean eating: read the list of ingredients, and choose foods where you can visualize each of the ingredients. The Triscuits cracker label states: whole grain wheat, vegetable oil (soybean or canola oil), sea salt; while the Carr’s Rosemary Cracker label lists: enriched flour (wheat flour, niacin, reduced iron, thiamin mononitrate <Vitamin B1>, riboflavin <Vitamin B2>, folic acid), vegetable oil (sunflower, olive, canola and palm kernel oil), leavening (yeast, baking soda, monocalcium phosphate), contains two percent or less of dextrose, salt, maltodextrin, rosemary, spices, dried garlic, malt extract, onion powder, sugar, whey, natural flavor, and soy lecithin.

Which cracker contains ingredients you can visualize?

Now, if you relate to Sam I Am from Dr. Seuss and don’t like to drink anything green, does that mean that you’re missing vital nutrients? I’m convinced the green smoothie/juice craze was started by companies who make super blenders like Vitamix as a way to market their products. Before juicing became a health fad, we either ate vegetables raw in salads or cooked, drank fruit or vegetable juice, and ate fruit. While eating plenty of vegetables is of course an important component of a healthful eating pattern, you don’t have to drink green juice to get the health benefits of vegetables. Choose a rainbow of fruits and vegetables for optimum nutrients. Red, purple, blue, white, brown, orange, and yellow fruits and vegetables are important sources of phytochemicals that are crucial to good health. Stick to green veggies only, and you’re missing out on essential nutrients.

If you enjoy making your own vegetable/fruit juices or smoothies, use these tips:

  1. Choose plain, unflavored Greek yogurt for an excellent protein source without added sugar.
  2. Use ½ – 1 cup total fruit, choosing a variety of colors of fruit and incorporating fresh, frozen, or fruit canned in its own juice.
  3. Toss in 2-3 times the amount of vegetables as fruit. For example, if you use ½ cup fruit, use 1-1 and 1/2 cups vegetables. Vary the colors of vegetables for the most nutrients.

If you’d rather purchase juices or smoothies, follow these recommendations:

  1. Read the list of ingredients to make sure you can visualize each ingredient and that you’re purchasing a beverage made from whole foods.
  2. Avoid juices/smoothies with added sugar, even from healthier-sounding sweeteners such as brown rice syrup, raw cane sugar, honey, maple syrup, agave, etc. The fruit in the juice/smoothie will provide all the sweetness you need without added sugar.
  3. Note the number of calories per serving – you might be surprised! 1 cup of 100% fruit juice has about 100 calories, and 1 cup of tomato juice has about 40 calories.

By Lynn Grieger, RDN, CDE, CPT, CHWC


Margaret McCartney:  Clean eating and the cult of healthism. BMJ2016; 354:i4095

Jocelyn Voo. The Complete Crash Course on Clean Eating. Fitness Magazine. Accessed 3-20-17

Jaclyn London, MS, RD, CDN. Why Clean Eating is Total BS. 3-29-2016. Accessed 3-20-17

What is Clean Eating? Clean Eating Magazine. 4-29-13. Accessed 3-20-17.

Eating Clean for Dummies Cheat Sheet, from Eating Clean for Dummies, 2nd edition. Accessed 3-20-17.

Dietary Guidelines 2015-2020. Accessed 3-30-17

Eat a Colorful Variety Everyday. Fruit & Veggies More Matters. Accessed 3-30-17

Thoughts on the Dietary Guidelines for Americans

Let’s get serious about dietary guidelines.

HealthThe Dietary Guidelines for Americans are published jointly every 5 years by the U.S. Departments of Health and Human Services (HHS) and Agriculture (USDA), as mandated by Congress. The goal of the Dietary Guidelines is to provide science-based nutrition and food safety recommendations for people two years and older to help promote habits that maximize good health and reduce the risk for chronic disease.

Unfortunately, despite widespread efforts, eating habits overall remain largely unchanged. The majority of the population consumes too many refined grains, solid fats and added sugars, yet at the same time consumes too little fruit, vegetables, whole grains, and low-fat dairy products. I find it disturbing that vegetable intake has actually declined since 2001-2004. Many young children consume the recommended amount of fruit and dairy, but these levels drop once they reach school age.

The 2015 Dietary Guidelines Advisory Committee’s (DGAC) most recent recommendations outline what we can expect to see in the updated guidelines later this year. Overall, the dietary pattern recommended by the 2015 DGAC reaffirms the dietary pattern characteristics recommended by the 2010 DGAC. Let’s take a look at the highlights…

Over- and Underconsumption of Nutrients: Health Effects

HalfPlateVeggiesThere is a continued emphasis on consuming a diet high in fruit, vegetables, whole grains, and low-fat dairy products, all of which are good sources of the nutrients that continue to be underconsumed by the majority of Americans: vitamin D, calcium, potassium, and fiber. These foods are also low in the saturated fat and sodium that are typically overconsumed by Americans. Of interest, cholesterol is no longer considered a nutrient of concern.

There is strong evidence that a high sodium intake increases risk of hypertension, leading the DGAC to continue to recommend decreasing sodium intake to 2,300mg per day. There is limited evidence of the value of reducing sodium intake further, or in terms of the role of potassium in hypertension. So make of that what you will.

The DGAC strongly states that people should discourage the consumption of low-fat or non-fat foods when the fat is replaced by refined carbohydrates or added sugars. The committee continues to recommend that less than 10% of a person’s overall daily calories should come from saturated fat, noting that replacing saturated fat with polyunsaturated fatty acids (PUFAs) reduces LDL-cholesterol levels and cardiovascular disease (CVD) risk. There is strong evidence that replacing saturated fat with carbohydrates does not lower CVD risk, and there is limited evidence that replacing saturated fat with monounsaturated fatty acid (MUFA) leads to reduced CVD risk. Encouraging the use of non-hydrogenated vegetable oils including soybean, corn, olive and canola oils instead of animal fats or tropical fat is recommended instead of reducing saturated fat in the diet and increasing carbohydrate intake.

Instead of replacing fat with refined carbohydrates and added sugar, the recommendation is to increase nutrient-dense foods including whole grains, legumes, vegetables and fruit. It also includes increasing healthful sources of protein including legumes, nuts, low-fat dairy, and lean meats.

The DGAC recommends limiting added sugars to a maximum of 10 percent of total daily caloric intake. To meet this goal, sugar-sweetened beverages, which currently provide 39% of added sugars, should be replaced with unsweetened beverages.

Consumption Patterns and Plant-Based Foods

What's in your cart?What offers the most nutrient-dense diet? The guidelines explain that a diet that is based on vegetables, fruit, whole grains, legumes, nuts, and low-fat dairy, which includes more seafood and less red and processed meat, which is moderate in alcohol, and which contains low amounts of refined grains and sweetened foods and beverages provides the most nutrient-dense diet.

The DGAC notes that there are several different diet patterns that follow these guidelines, including the Healthy U.S.-Style Pattern, the Healthy Vegetarian Pattern, and the Healthy Mediterranean-style Pattern. Each of these patterns provides more plant-based foods and lower amounts of meat than are currently consumed by the US population.

The committee notes that overconsumption of nutrients from foods and beverages, including fortified foods is rare. However, folate, calcium, iron, and vitamin D may be overconsumed when using high-dose supplements.

Energy Intake

The information on the breakdown of energy intake is not surprising given the increase in overweight and obesity. Here’s a closer look at the breakdown of energy intake by Americans…

  • 28% from mixed dishes, primarily pizza and burgers/sandwiches (also major contributor of sodium and saturated fat)
  • 16% from snacks and sweets (also major contributor of saturated fat and added sugars)
  • 12% from beverages not including milk or 100% fruit juice; provides 47% of added sugar intake
  • 11% from protein foods
  • 11% from grains
  • 8% from vegetables
  • 7% from dairy
  • 5% from fruit and 100% fruit juice

The committee found that the majority of the population consumes three meals plus at least one snack, with adolescent females, young adult males, non-Hispanic Blacks, Hispanics, and individuals with lower incomes being the least likely to consume three meals a day. While breakfast tends to have a higher overall dietary quality compared to other meals and snacks, adolescents and young adults are the least likely to eat breakfast. Snacks contribute about 25% of daily energy intake, and unfortunately tend to be lower in important nutrients and higher in sodium, added sugars, and saturated fat.

It’s surprising that the USDA food patterns do not meet recommendations for potassium and vitamin D, and additional fortification strategies may be necessary to reach the RDA for vitamin D.

It’s well-known that rates of chronic disease are linked to overweight and obesity, playing a role in hypertension, CVD, type 2 diabetes, and some types of cancer, and that these weight-related illnesses now are present in children and adolescents who are overweight or obese. It’s not surprising that 90% of children with type 2 diabetes are overweight or obese.

Promoting Behavior Change

Balance diet and exerciseI believe that more research and emphasis on promoting lasting behavior change is crucial, especially since the overall dietary choices haven’t changed significantly in the past 10 years. The DGAC suggests focusing on strategies that address:

  • Reducing screen time, especially for children and adolescents to promote a healthy body weight as they transition into adulthood.
  • Reducing the frequency of eating fast food for all age groups
  • Increasing the frequency of family or shared meals
  • Self-monitoring diet and physical activity behavior to promote lasting behavior change
  • Effective food labeling to target healthier food choices

Food Environment

What's the food environment like near you?The food environment is an area that requires more research to establish the most effective strategies to improve nutrition and health in schools and workplaces and to presents opportunities for RDs to collaborate with other groups to effect change.

The DGAC found strong to moderate evidence that multicomponent school and worksite policies are associated with improved dietary intake, including increased vegetable and fruit consumption and reduced body weight. Polices that include increased opportunities for physical activity, nutrition education, food service changes, and in schools (and parental involvement) are the most effective.

Food Safety and Sustainability

Fish: where do you get it?The conversations around food safety and sustainability are often heated, with drastically opposing views. The DGAC recommends a moderate approach:

  • Both farmed and wild-caught seafood are nutrient-dense foods that are rich sources of healthy fatty acids. The risk of contamination is similar between farmed and wild caught seafood and does not outweigh the health benefits of consuming seafood.
  • Wild-caught seafood cannot meet the growing demand, creating a need for sustainable seafood farming practices.

Caffeine Consumption

The research shows that in general, caffeine intake does not exceed recommend levels.

Moderate coffee consumption is considered to be 3-5 cups per day, or up to 400mg of caffeine per day. Moderate coffee consumption does not lead to increased health risk, and in fact is associated with decreased risk of type 2 diabetes, cardiovascular disease, liver and endometrial cancer, and Parkinson’s disease. The DGAC agrees with the American Academy of Pediatrics and the American Medical Association that until safety has been demonstrated, vulnerable populations including children, adolescents and young adults should avoid high-caffeine energy drinks or other products with high amounts of caffeine. Alcohol and energy drinks should never be mixed or consumed together.

Women who are pregnant or planning to become pregnant should be cautious and adhere to current recommendations of the American Congress of Obstetricians and Gynecologists and consume less than 200 mg caffeine per day (approximately two cups of coffee) to reduce risk of stillbirth, miscarriage, low birth weight, and small for gestational age.


What do YOU think about aspartame?Aspartame is the football of sugar substitutes, going back and forth from being banned to considered a safe option. The DGAC concurs with the European Food Safety Authority (EFSA) Panel on Food Additives that aspartame in amounts commonly consumed is safe and poses minimal health risk for healthy individuals without phenylketonuria (PKU). The risk to pregnant woman is unknown. However, long-term human studies are needed to assess a possible relationship between aspartame and risk of non-Hodgkin lymphoma and multiple myeloma. The recommendation is to stay below the aspartame Acceptable Daily Intake (ADI) of <50mg/kg/day. A 12-ounce diet beverage contains approximately 180mg aspartame. A 150-pound (68 kg) woman could drink up to 18 12-ounce diet beverages sweetened with aspartame and meet this guideline.

Anyway, that’s a collection of my immediate thoughts about the highlights from the latest DGAC update. What stood out to you? What most affects your practice?

By Lynn Grieger RDN, CDE, CPT, CWC

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Energy Drinks: Just the Facts

It seems like we’ll eat or drink anything that will increase our lagging energy levels. Put the phrase “boost your energy” on a food or beverage, and we think, “Hey, I need that!”

Marketed to improve energy, promote weight loss, increase stamina, and boost athletic performance/mental concentration, energy drink sales are expected to reach $52 billion by 2016. Energy drinks are most popular with teens and young adults — 30-50% of them frequently consume energy drinks.

What’s in Energy Drinks?

Energy drinks start off with a combination of sugar or sugar substitutes and caffeine. Then herbal extracts like ginseng, guarana, yohimbine, and ginko biloba are added. There also might be amino acids, taurine, L-carnitine, or B vitamins too.

Although the Food and Drug Administration (FDA) limits caffeine content in soft drinks, there is no regulation of energy drinks, which are classified as dietary supplements. Many energy drinks contain 70-80 milligrams (mg) of caffeine per 8 ounces, which is three times the amount of caffeine in cola drinks. Since many energy drinks are packaged in containers that hold 12 ounces or more, the amount of caffeine can easily reach 200 mg or greater. 200-300 mg of caffeine per day is considered a safe amount for adults, and the American Academy of Pediatrics states that energy drinks are never appropriate for children and teens.

Manufacturers are not required to list the caffeine content from additives, which means that the actual caffeine content can exceed what is listed on the label – if it’s listed at all.

Plus, with 220-260 calories per 16-oz serving (that’s equal to 13-16 teaspoons of sugar), energy drinks also contain more sugar and calories than carbonated cola beverages. Sweetened beverages are a primary source of sugar in our diet, and they contribute to obesity and dental caries.

Should I Drink Energy Drinks?

I recommend that you skip energy drinks and instead choose beverages that promote health and hydration. Think water, fat-free milk, and 100% fruit juice. For optimum energy, eat a balanced diet, get plenty of sleep, and participate in regular physical activity.

By Lynn Grieger RDN, CDE, CPT, CWC


  1. The History of Energy Drinks: A Look Back. Wall Street Insanity. Samantha Lile. 5-6-2013. Accessed 5-21-14.
  2. Caffeine in the Diet. MedLine Plus. Updated 4-20-2013. Accessed 5-21-14.
  3. Proposed Actions for the US Food and Drug Administration to Implement to Minimize Adverse Effects Associated With Energy Drink Consumption. Thorlton J, Colby DA, Devine P. Am J Public Health. 2014 May 15.
  4. Sports & Energy Drinks: Answers for Fitness Professionals. Jerry J. Mayo, Ph.D., R.D. and Len Kravitz, Ph.D.
  5. Health Effects of Energy Drinks on Children, Adolescents, and Young Adults. Seifert, Schaechter, Hershorin, Lipshultz. Pediatrics. Mar 2011; 127(3): 511–528.
  6. Clinical Report – Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate? Committee on Nutrition and the Council on Sports Medicine and Fitness. Pediatrics 2011 Jun;127(6):1182-9.
  7. Energy Drinks. The American Association of Poison Control Centers. Accessed 5-21-14


Here’s a link to the free handout. Download it anytime!

Energy Drinks

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Weight Control Marketing Terms that Raise Red Flags

WhichFoodsAreHealthful“Fast, easy weight loss without exercise!”

“Lose weight while you sleep.”

“Enjoy your favorite foods and lose weight. Effortlessly.”

These claims have to be true because I : (a) read it in my local newspaper, (b) saw it online, (c) heard it on my favorite radio station.



We know better, but wouldn’t it be great if there really was a product that produced these types of results?

The Federal Trade Commission (FTC), the nation’s consumer protection agency, published “Gut Check: A Reference Guide for Media on Spotting False Weight-Loss Claims” in January 2014. This guide lists seven weight loss claims that experts agree are false and misleading, and which should prompt a “gut check.”

What’s a gut check? It’s a second look to make sure that publishers are not running advertisements with claims that are known to be false.

The FTC uses these guidelines to enlist the help of media professionals, asking them to prevent false claims from ever appearing. Even though the truth in advertising laws prohibit false or misleading advertising claims, obviously these claims still exist. Under the law, advertisers have two choices:  either the results in the ad must be typical of what other consumers can expect to achieve or the ad must clearly and conspicuously disclose the typical results.

The FTC created a teaser website that promotes FatFoe™, a revolutionary (and fake) product that produces amazing weight loss results. They built this website to demonstrate false advertising claims to consumers. Click on the ‘order now’ button and you are transferred to a site that explains how you’ve been duped and how to spot false weight loss claims.

So. How can you best put this information to use for your clients? Have them use the seven gut-check claims and examples of the fictitious yet all-too-believable FatFoe™ advertisements to avoid falling prey to wild and unrealistic claims. Here are a few examples — the more familiar your clients are with these compelling (yet false!) claims, the less likely they are to be duped by a sneaky product…

Don'tBeFooledClaim #1: Causes weight loss of two pounds or more a week for a month or more without dieting or exercise.

Many consumers believe that rapid weight loss is the norm, and are unhappy with losing the 1-2 pounds per week that experts believe is both safe and sustainable.

“Finally there’s FatFoe™, an all-natural weight loss compound so powerful, so effective, so relentless in its awesome attack on bulging fatty deposits that it eliminates the need to diet.” (Note the consumer endorsement: “I lost 36 pounds in 5 short weeks”).

Remember, don’t be fooled.

Claim #2: Causes substantial weight loss no matter what or how much the consumer eats.

Changing food choices and eating habits, especially eating smaller portions, is one of the keys to lasting weight loss. Unfortunately, it’s also a behavior change that many people find extremely difficult.

Watch out for claims like, “This revolutionary product lets you enjoy all your favorites – hamburgers, fries, pasta, sausage, and even gooey desserts – and still lose weight. One FatFoe™ tablet before meals does the work for you and you’ll lose all the weight you want.”

Claim #3: Causes permanent weight loss even after the consumer stops using the product.

Maintaining weight loss requires continuing the same behavior changes in food choices and physical activity that produced the initial weight loss.

How does this false claim get used? “Thousands of people have used FatFoe™ and kept the weight off for good” is just one example.

GetInBalanceClaim #4: Blocks the absorption of fat or calories to enable consumers to lose substantial weight.

Even legitimate medications that block fat absorption need to be used within an overall lower-calorie, healthful diet.

“The safe, all-natural active ingredient in FatFoe™, auberginium, binds with food to block the absorption of fat, carbs, AND calories. Lose up to 10 pounds per week – with no sweat, no starvation!”

Don’t fall for it!

Claim #5: Safely enables consumers to lose more than three pounds per week for more than four weeks.

Losing weight rapidly over a longer period of time can lead to gallstones and possibly other health complications. Weight loss should be closely managed by a physician.

So, when you see something like “Even if you have 40, 50, 60 or more pounds to lose, doctors recommend Fat Foe™ as the no-risk way to blast off the weight and inches in a few short months. Just in time for bikini season or that class reunion,” then you know to run for the hills.

Claim #6: Causes substantial weight loss for all users.

Individual rates of weight loss are all different, and there is no one established method that leads to weight loss for every person.

“FatFoe™ is guaranteed to work for you. Melt away the pounds regardless of your body type or size.”

Claim #7: Causes substantial weight loss by wearing a product on the body or rubbing it into the skin.

There is no research that shows any product worn on the skin or applied externally leads to weight loss.

Throw that “Bonus offer! Order now and get a free 60-day trial of FatFoe™ UltraThin Gel. Target the stubborn fat on your hips and thighs with this proven flab fighter.” into the trash!

So. There you have it. The 7 gut-check claims and some examples of how sneakily they can be used. Help your clients steer clear of this nonsense by sharing this post or sending them a copy of this free weight control handout.

Gut Check Handout

By Lynn Grieger RDN, CDE, CPT, CWC


  1. Federal Trade Commission, Bureau of Consumer Protection. Gut Check: A Reference Guide for Media on Spotting False Weight-Loss Claims. January 2014. Accessed 9-8-2014.
  2. Federal Trade Commission. With FatFoe™ Eggplant Extract You Can Kiss Your Dieting Days Good-bye. Accessed 9-8-2014

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