There's healthy eating, and then there's obsessive eating.
When innocent attempts to eat healthfully, such as cutting back on processed foods or eating more fruits and vegetables turns into a pre-occupation, or obsession with eating healthfully 100% of the time, and a mega-restrictive diet regime of only the purest of foods, there is an unhealthy (and scary) shift into the world of disordered eating.
Although Orthorexia, which is the term used to describe this obsession with eating healthfully (to the extreme), is not recognized as an Eating Disorder according to the DSM-V (the American Psychiatric Association's Diagnostic And Statistical Manual Of Mental Disorders), it is very much a form of disordered eating, and can - ironically enough - lead to health problems such as nutrient deficiencies, hormonal imbalances, and malnutrition. Those suffering with Orthorexia are not only at risk of physical detriment, but they can also experience severe anxiety and social isolation (often impairing relationships), because they often avoid any social situations where food is involved (like family dinners), in fear that they may be tempted to veer "off track."
Unlike people who suffer with Anorexia Nervosa or Bulimia Nervosa, who are pre-occupied with calories and weight, Orthorexics obsess about the healthfullness, overall quality and "purity" of foods. Orthorexia, which was coined by Steven Bratman, MD in 1997, literally means "fixation on righteous eating." The National Eating Disorder Association explains, "every day is a chance to eat right, be “good,” rise above others in dietary prowess, and self-punish if temptation wins (usually through stricter eating, fasts and exercise). Self-esteem becomes wrapped up in the purity of orthorexics’ diet and they sometimes feel superior to others, especially in regard to food intake."
Because Orthorexia Nervosa cannot be formally diagnosed, it is more difficult to recognize and treat, unlike other well defined psychiatric disorders. Without inclusion in the DSM-V, evaluation of and treatment for Orthorexia is more challenging. Fortunately though, there has been an upswing in research lately in the area of Orthorexia, therefore there is a glimmer of hope that Orthorexia Nervosa will be included in the DSM-V soon (even before the next edition of the DSM comes out).
As a Registered Dietitian who works in private practice, I can say that in the past 5 years or so, I've seen a rise in restrictive thoughts and behaviours around food. It's no wonder - we are all bombarded with messages that we MUST eat gluten-free, "clean", organic and GMO-free foods only, and avoid all chemicals, additives and preservatives at all costs (common examples). And then there is the absurdly popular Paleo Diet, where nutritious whole grains, legumes and dairy foods are demonized and banned from consumption. How can one not feel scared to eat...normally? Oh, and by the way, what is normal eating? I can see how it would be extremely difficult to figure out in our current diet-saturated world.
I often find myself giving my clients permission to eat healthful foods that they've banned from their diets, and am just as often met with looks of disbelief and skepticism. "But, I thought whole grains made you fat?!" and "I stopped drinking milk because it's full of antibiotics and hormones!" are common responses that I get. Because people are bombarded with false and conflicting information about food and nutrition, I find that I'm spending much of my counseling time myth-busting and trying to assure (sometimes convince) my clients that healthy eating doesn't have to be restricting; that less-than-perfect foods can be included now and again without guilt, and that stressing about every morsel eaten is not normal or healthy.
Consider the following questions. The more questions you respond “yes” to, the more likely you are dealing with orthorexia.
*These questions come from The National Eating Disorder Association (United States) website:
If you suspect that you have Orthorexia, or that someone you love is suffering from it (maybe even your child), it's important to seek help from a trained professional. There are Registered Dietitians who specialize in Eating Disorders and Disordered Eating Behaviours, as well as Therapists who are trained to work in this area as well. It's Eating Disorder Awareness Week--we need to start talking.
I post daily nutrition and weight management tips, resources and articles on my Facebook page for both adults and kids. Feel free to check it out!
Sending your child to school with a nutritious lunch and snacks is important not only for overall health, growth, and development, but also to keep their brains properly fueled during the day so they can focus and concentrate. But parents often feel limited in what they can send to school, not only because they have to avoid potentially allergenic foods, but also because of possible bacterial growth and the risk of food poisoning, so it's important to know how to keep foods safely packed. A school lunch that hasn't been packed properly can lead to spoiled food, missed meals, or - in a worst case scenario - food-poisoning.
Sending safe, nutritious, and tasty lunches is easy if you follow these 6 simple tips:
I'm always on the look-out for great lunch kits. Unfortunately, the character decorated ones usually aren't great at keeping foods at safe temperatures, unless you find a well-insulated one. An insulated, lunch bag is usually the best option.
Perishable food should remain at room temperature for no longer than two hours, so it's important that cold foods stay cold and hot foods stay hot. Foods should never reach the temperature "danger zone" of between 4 degrees Celsius and 60 degrees Celsius, because bacteria can multiply quickly and lead to food poisoning.
Foods such as dairy products, meats, peeled and cut fruits and vegetables, mayonnaise, hummus, eggs, and leftovers are all possible breeding grounds for bacteria and should be kept in an insulated lunch bag with a frozen ice pack until eaten at lunch time.
Tip: It's important to wash lunch kits, containers and ice packs with warm soapy water every day after school so they are clean and ready for packing and to avoid bacteria growth.
The safest containers are reusable BPA-free plastic or glass, spill-proof containers that are both dishwasher and microwave-safe. They are easy to clean, decrease the likelihood of messy spills, bacteria growth, and are environmentally friendly. This is why I love Rubbermaid LunchBlox containers. They are leak-proof (we've tested them with some fairly "leaky" foods such as cottage cheese, yogurt and soup!), yet easy for my preschooler to open by himself. They also come in convenient sizes that fit all of his favourite foods and dips and snap together to keep everything organized and neatly packed. I also use these containers for my work lunches and love them!
It's important to always use a frozen ice pack when packing anything perishable. One of the reasons I love Rubbermaid LunchBlox containers is because they each come with the "Blue Ice" tray, which conveniently snaps right onto (or in between) the containers, keeping them organized and cold until lunch time. The blue ice tray works better than most ice packs because it cools all the of containers (and contents within) equally, instead of some items staying really cold and others not.
Tip: Since ice packs are designed to keep cold foods cold (not cool room temperature foods down), it's important to pack cold foods the night before (preferably in the container that they will be taken in), and store them in the fridge. In the morning, simply snap the frozen Blue Ice tray on, and foods stay cold until lunchtime. Items such as sandwich ingredients, leftovers, tuna or egg salads etc. should be chilled beforehand (not made the morning of with room temperature ingredients) for the safest result.
For hot foods like chili, casseroles, soup or stew, make sure to use an insulated container such as a thermos. Before storing food, fill the container with boiling water, let it stand for a few minutes, empty it and then add the hot food (remember to heat it until piping hot beforehand). It's important that the insulated container be kept closed tightly until lunchtime to help minimize the risk of temperatures dropping into the "danger zone" where bacterial contamination or growth can occur.
Tip: Keep cold foods separate from hot foods in your child's lunch kit.
Some parents use frozen juice boxes to keep foods cool in lunch kits. I don't recommend sending juice (even unsweetened) every day because of the sugar content and I also think they are wasteful and costly, so instead I like packing a Rubbermaid Shaker Bottle full of water and ice to keep foods cool during the day (along with ice packs) and to keep my son hydrated.
Keeping hands, cutting boards, counter tops and utensils clean (by washing with hot soapy water) during food prep and packing is essential to keeping everything food-safe. Fresh fruits and vegetables should be rinsed thoroughly under cool running water, even if they will be peeled or cut. Remind your kids to wash their hands before they eat their lunch and snacks is also important.
Tip: Never reuse sandwich bags, foil, or plastic wrap.
Packing nutritious lunches, which include fresh whole foods, can be easy and safe with a bit of forethought. Having the proper lunch bags, containers, and ice packs, and getting your kids involved in the prep and packing will make your lunch duties seem a lot easier (and less nerve wracking) as well as increase the chances of your kids actually eating their lunches and snacks!
Packing safe school lunches is a snap thanks to Sarah's 6 tips. Now, be sure you have all the essentials.
Rubbermaid LunchBlox and Shaker Bottles are available at local Loblaws, Zehrs, or Superstores. You’ll now be able to pack your food, stay organized, and eat healthy and well on-the-go.
Visit our "No Sweat Guide to #GetFitIn2015" page for more tips on how to get fit, get organized, and stay healthy this year and beyond!
You may be wondering if you should take nutritional supplements. After all, there seems to be more conflicting messages flying around about supplements than there are supplements themselves. Although it's definitely possible to get all your essential nutrients through food, it's not always realistic. And at certain times in our lives, our nutrient needs exceed what we receive through food, just as in the case of women of child-bearing age (especially when pregnant or breastfeeding), or if we become deficient in a certain nutrient (which can only be determined through proper blood testing), or if we decide to experiment with a vegan lifestyle. It's important to speak with your medical doctor or a Registered Dietitian prior to taking supplements though. In some cases, taking too much of one (or several) nutrients can actually cause more harm than good.
I would be remiss not to mention the importance of a balanced diet. Ideally, you should aim to get all of your nutrition through real food. Yoni Freedhoff points out in a recent Weighty Matters blog post (referring to a new supplements study out of the Journal of Medicine), that "our bodies are incredibly well adapted to handle different levels of nutrient intakes and that we have mechanisms that help us to deal with shortfalls and surpluses of most supplements and that as a consequence, for true deficiency states to occur, usually a great deal of time (and dietary deficiency) needs to pass."
You should ideally be consuming a well balanced diet containing high quality protein-rich foods (meats, fish, beans, lentils, dairy), a nice variety of vegetables and fruits (I suggest at least 3-5 different colours a day), whole grain foods and healthy fats. If you're eating every 3 to 4 hours on most days and focusing on balance at each meal (I suggest including protein, veggies/fruits and a smaller portion of whole grains at each meal) and snacks (protein-rich food as well vegetable and/or fruit), then you are likely meeting your nutrient requirements.
All women of child-bearing age should be (ideally) taking a regulated pre-natal multivitamin daily, containing folic acid (0.4mg-1.0 mg) to prevent neural tube defects (these can occur in the first trimester--that's why it's so important to take a prenatal before you become pregnant). If you have a high chance of delivering a baby with neural tube defects (something to talk to your doctor about), you may be prescribed a higher dose of folic acid. Folate, the natural form of folic acid can be found in certain foods such as dried beans, peas and lentils, dark leafy green vegetables, and oranges. During pregnancy, your Iron needs increase (Iron is naturally found in meats, poultry, fish, beans, lentils, and some vegetables), therefore, your prenatal multivitamin should contain at least 16-20mg of Iron (your doctor, midwife or Dietitian may suggest more depending on whether you are deficient or not). Calcium and Vitamin D are also important nutrients during pregancy, so it's important that your prenatal contains these nutrients as well.
Prenatal multivitamins typically do not include omega 3 fatty acids, but it's important to make sure that you're getting enough prior to and during pregnancy, as your requirements are higher. During pregnancy, omega-3 fatty acids travel through the placenta to your baby to help grow his or her brain and tissues. The best way to ensure you're getting enough, is to consume at least two standard servings (2.5-3 ounces cooked is a serving) of fatty, low-mercury fish per week such as salmon, canned light flaked tuna, or trout. If you don't like fish, you should consider taking an omega-3 supplement (see Omega-3 section below).
Vitamin D has long been touted for its role in building and maintaining healthy bones as it helps with the absorption of calcium. There is also a growing body of research suggesting Vitamin D plays a significant role in many diverse disease processes. Studies have shown that people with Vitamin D deficiency have a higher risk of certain cancers and heart disease (specifically hypertension and heart attacks). Vitamin D may also play a role in preventing depression, autoimmune disease, Diabetes, Alzheimer’s, Multiple Sclerosis, and obesity. The Dietary Recommended Intake (DRI’s) for Vitamin D is as follows:
You have no doubt heard the buzz around the beneficial qualities of Omega-3 fatty acids over the past decade or so. Omega-3 fatty acids is an umbrella term to describe three various forms of Omega-3 fats (ALA-Alpha-linolenic acid, DHA- Docosahexaenoic acid and EPA-Eicosapentaenoic acid ). ALA is a precursor to DHA and EPA and can be found in plant sources such as canola oil, flaxseed oil and soybean oil. DHA and EPA are the two most important and beneficial forms of Omega-3 are found in fatty fish such as salmon, tuna, halibut and mackerel as well as certain Omega-3 fortified foods like yogurts, milk and cereals. DHA and EPA have been studied for their beneficial effects on heart disease, cancer, arthritis, depression and asthma. DHA is also important for development of the brain and retina, and for neurological functioning and cognitive development.
Health Canada recommends that healthy adults consume about 300-450 mg of EPA and DHA combined per day. To achieve this, it is recommended to eat at least two 75 gram (2.5 oz) servings of fatty fish per week (75 gram= size of deck of cards when cooked). For those with Coronary Artery Disease and/or high triglycerides their needs are higher (and must be discussed with a doctor or Registered Dietitian). For those with increased needs and those who do not eat fish, an Omega-3 supplement may be necessary. Omega-3 supplements can be made from ALA or DHA+EPA-rich oils in varying quantities, so it is important to carefully read labels.
Some nutrients can be harmful if taken in the large amounts. While this is rarely a problem when it comes to nutrients in foods, vitamin and mineral supplements (including multivitamins) may contain excessive amounts. For example, while the Recommended Dietary Allowance (RDA) for Vitamin C for adults is 75 mg/day, several vitamin C supplements provide 500 mg or more in just one tablet. Taking excessive amounts of Iron can cause severe stomach upset and even liver damage. Vitamin A in large doses can lead to liver failure.
Some dietary supplements can also interact with certain medications that you may be taking. If you’re unsure ask your family doctor, Registered Dietitian or a Pharmacist. Make sure that your supplement is government regulated as well. It should have a NPN (Natural Product Number) or NHP (Natural Health Product Number) written somewhere on the label to prove that it is regulated and safe.
Some people need supplements because their diet doesn't provide all essential nutrients. Vegans and vegetarians who do not eat any animal products most often need to eat Vitamin B12 fortified foods or take a supplement. They may also find it difficult to meet their needs for Iron, Zinc, Calcium, and Vitamin D with foods, and they may need to take a supplement that provides these nutrients as well (perhaps a multivitamin).
Adults and children who do not consume milk or calcium-fortified milk alternatives (and those who are at an increased risk of getting, or have, Osteoporosis) may need a calcium supplement and it is important to note that multivitamin/mineral supplements do not contain enough Calcium to meet daily needs.
People with poor appetites, or those with many food allergies or intolerances, may need a multivitamin and mineral supplement and/or other supplements to meet their needs. It is important for anyone with special dietary concerns to speak with their family doctor or a Registered Dietitian for guidance in terms of supplementation.
If you've read or heard that you should be taking a nutritional supplement (whether it be a vitamin/mineral supplement, sports/protein supplement or a special herb supplement) from a friend, personal trainer, the internet, a family member or someone other than your family doctor or Registered Dietitian, to cure or improve your health in a significant way, it's probably too good to be true and could even be dangerous. Make sure you double check with your doctor or dietitian to make sure that what you're taking is necessary and safe.