Orthorexia: When ‘healthy eating’ ends up making you sick

People’s obsession with healthy eating may paradoxically be endangering their lives. (AFP)
Updated 07 October 2017
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Orthorexia: When ‘healthy eating’ ends up making you sick

PARIS: People, it seems, have never been so afraid of their food — and, say some experts, an obsession with healthy eating may paradoxically be endangering lives.
Twenty-nine-year-old Frenchwoman Sabrina Debusquat recounts how, over 18 months, she became a vegetarian, then a vegan — eschewing eggs, dairy products and even honey — before becoming a “raw foodist” who avoided all cooked foods, and ultimately decided to eat just fruit.
It was only when her deeply worried boyfriend found clumps of her hair in the bathroom sink and confronted her with the evidence that she realized that she was on a downward path.
“I thought I held the truth to food and health, which would allow me to live as long as possible,” said Debusquat.
“I wanted to get to some kind of pure state. In the end my body overruled my mind.”
For some specialists, the problem is a modern eating disorder called orthorexia nervosa.
Someone suffering from orthorexia is “imprisoned by a range of rules which they impose on themselves,” said Patrick Denoux, a professor in intercultural psychology at the University of Toulouse-Jean Jaures.
These very strict self-enforced laws isolate the individual from social food gatherings and in extreme cases, can also endanger health.
Paris nutritionist Sophie Ortega said she had one patient who was going blind due to deficiency of vitamin B12, which is needed to make red-blood cells.
B12 is not made by the body, and most people get what they need from animal-derived foods such as eggs, dairy products, meat or fish or from supplements.
“A pure, unbending vegan,” her patient even refused to take the supplements, said Ortega. “It was as if she preferred to lose her sight... rather than betray her commitment to animals.”
The term orthorexia nervosa was coined in the 1990s by the then alternative medicine practitioner Steven Bratman, a San Francisco-based physician.
To be clear, orthorexia is not an interest in healthy eating — it’s when enthusiasm becomes a pathological obsession, which leads to social isolation, psychological disturbance and even physical harm. In other words, as Bratman said in a co-authored book in 2000, it’s “a disease disguised as a virtue.”
But as is often the case in disorders that may have complex psychological causes, there is a strong debate as to whether the condition really exists.
The term is trending in western societies, prompting some experts to wonder whether it is being fanned by “cyber-chondria” — self-diagnosis on the Internet.
Orthorexia is not part of the Diagnostic and Statistical Manual of Mental Disorders, set down by mental health professionals in the United States that is also widely used as a benchmark elsewhere. The fifth edition of this “bible,” published in 2013, includes anorexia nervosa and bulimia nervosa, but not orthorexia.
“The term orthorexia was proposed as a commonly used term but it is not medically recognized,” said Pierre Dechelotte, head of nutrition at Rouen University Hospital in northern France and head of a research unit investigating the link between the brain and the intestines in food behavior.
Even so, says Dechelotte, it has a home in the family of “restrictive food-related disorders — but it’s not on the radar screen.”
Alain Perroud, a psychiatrist who has worked in France and Switzerland over the course of a 30-year career, says orthorexia “is much closer to a phobia” than to a food disorder.
As with other phobias, the problem may be tackled by cognitive behavioral therapy — talking about incorrect or excessive beliefs, dealing with anxiety-provoking situations and using relaxation techniques and other methods to tackle anxiety, he suggested.
Denoux contends that between two and three percent of the French population suffer from orthorexia, but stresses that there is a lack of reliable data as the condition has not been officially recognized.
Denoux’s figure seems coherent to Dechelotte, who says that women seem to be more than twice as susceptible to the problem as men.
Outside the world of clinicians, orthorexia seems to be creeping into wider usage.
American blogger Jordan Younger has helped to popularize the term, documenting her own painful downward spiral — since reversed — into unhealthy living.
On her blog, she describes it as “a bubble of restriction,” obsessing over a diet that was “entirely vegan, entirely plant-based, entirely gluten-free, oil-free, refined sugar-free, flour-free, dressing/sauce-free, etc.”
Those who seem to be most worried about healthy food are often concerned about food scandals in the West, Pascale Hebel from the Paris-based CREDOC research center told AFP.
Over nearly three decades, Europe has experienced a string of food safety scandals — beginning with mad-cow disease and continuing recently with insecticide-contaminated eggs — as well as mounting opposition to the use of antibiotics, genetically modified foods and corporate farming practices.
The disorder reflects a craving for control, suggested Denoux: food is seen as a form of medicine to fix a western lifestyle that may be seen as polluting or toxic.
“We are living through a time of change in our food culture, which has led us to fundamentally doubt what we are eating,” said Denoux.
Among believers, this “suspicion of being poisoned is deemed proof of insight.”


Take a healthy approach to the issue of nutritional supplements

Updated 21 April 2018
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Take a healthy approach to the issue of nutritional supplements

JEDDAH: There is a growing need for dietary supplements in Saudi Arabia, given the increasing popularity of junk food and the effective role supplements can play in treating diseases caused by mineral and vitamin deficiencies.

A recent study found that 22 percent of Saudi people take nutritional supplements. It is no surprise, then, that many Saudi businesses have forged partnerships with international dietary-supplement companies.

Dr. Rowaidah Idriss, a Saudi dietitian with a Ph.D. in nutrition, said dietary supplements can be defined as substances that provide the human body with a nutrient missing from a person’s regular diet. However, she stressed that they are not intended to replace healthy eating.

She also warned against taking them without first talking to a doctor or dietitian, as some products can have side effects, especially if taken before surgery or with other medicines. 

“They can also cause problems if someone has a history of certain health issues,” she added.

A blood test can determine which nutrients we are not getting enough of in our diet, and therefore which supplements might be beneficial. Nutritional supplements are also used to help treat certain health conditions. 

“Vitamin C, for example, is often used to reduce cold symptoms,” said Idriss. “Fish oil is taken to lower elevated blood triglycerides.”

She suggested four daily essentials that can bridge nutritional gaps in our diet: a multivitamin, vitamin D, calcium and omega-3 fatty acids. 

“I routinely recommend a daily multivitamin and mineral supplement to my clients after consulting with their doctors,” she said. 

“For menstruating women, who require 18 milligrams of iron each day, a daily supplement helps boost iron intake.”

She said people over the age of 50 are advised to take a multivitamin to ensure they are getting enough B12, which plays a key role in the functioning of the nervous system and the development of red blood cells. 

“Older adults are more vulnerable to B12 deficiency because they are more likely to have decreased production of stomach acid, which is needed to release B12 from the proteins in food.” said Idriss. 

“It is also a good idea to take a daily multivitamin if one is following a low-calorie diet.”

She also pointed out that a high intake of DHA and EPA, the two omega-3 fatty acids found in fish oil, are linked with a lower risk of heart disease and Type 2 diabetes. A deficiency of DHA might also increase the risk of Alzheimer’s. 

“A daily intake of 1,000 milligrams of both DHA and EPA is equivalent to eating 12 ounces of salmon a week,” said Idriss.

The dietitian believes that the Saudis who take food supplements often do so more to benefit their appearance than their health. 

“Saudi women consume more dietary supplements than other people in Saudi Arabia,” she said. 

“They do so either to lose weight or to care for their hair and nails. Bodybuilders also take large amounts of supplements.”

However, both groups, according to Idriss, tend to take supplements on the recommendation of friends and trainers, not doctors. 

She warned that commercials and social-media rumors can persuade people to buy supplements online that may not be approved as safe by the Saudi Food and Drug Authority, and advised people to get as much of their daily nutrient needs as possible from healthy eating.

Dr. Rowaidah Idriss

“Along with vitamins and minerals, a healthy diet provides fiber and hundreds of protective phytochemicals, something a supplement cannot do,” she said, adding that the body absorbs natural food more effectively than supplements.

In addition, combining supplements with medications can have dangerous, even life-threatening, effects. 

“Drugs for heart disease and depression, treatments for organ transplants, and birth-control pills are less effective when taken with herbal supplements,” she said.

“Taking an anticoagulant, aspirin, and a vitamin E supplement together may increase the potential for internal bleeding or even stroke.”

 

Natural sources

With the spread of fast-food restaurants and their alluring ads, the long-term health of the Saudi people is in danger, as children and young people snub natural sources of nutrients, such as fruit and vegetables. 

“This can lead to many deficiency diseases. Moreover, vegetarians can develop similar illnesses due to the absence of meat in their diet,” she said.
Dr. Ashraf Ameer, a family-medicine consultant, said the importance of nutritional supplements lies in treating mineral and vitamin deficiency, especially for pregnant women, growing children, diabetics, people with chronic diseases, and the elderly. 

“However, these products should come from reliable companies and meet Saudi food and drug requirements,”he added.

Mohammed Yaseen, who has a food supplements business, said his company works with a leading British health-care company to provide the Saudi market with high quality products.

“With this we hope we can contribute to the national transformation program by raising private-sector spending in health care from 25 percent to 35 percent, which in turn would lead to the sector’s financial sustainability and boost economic and social development in the Kingdom,” Yaseen said.

Decoder

Vitamin Terms

DHA stands for docosahexaenoic acid. EPA stands for eicosapentaenoic acid.  Phytochemical is a biologically active compound found in plants.