You may have seen the trend on social media, in fact if you type in the hashtag #cleaneating on Instagram for example, we get close to 50 million results. On TikTok, it already exceeds half a million, but the big question is, what is clean eating?
Well, it’s not quite the easy answer you might hope, as it is an umbrella term for a whole hodgepodge of concepts opens up where the ideas of concepts such as “detox”, “gluten-free”, “transgenic-free”, “organic”, “vegan”, “additive-free” or “realfood”, and others. And it is that the concept of clean eating is like a tailor-made suit: there are as many ways to eat clean as people consider raising their diet to what they individually interpret as a healthier diet.
So, in the simplest of terms, what is clean eating?
The idea of ”clean eating” often includes the goal of minimising, or even eliminating, ultra-processed foods, increasing the presence of fruits and vegetables, or cooking more at home in order to control all the ingredients in each dish, including the amount of salt, the type of fat or added sugars, and depending on how flexible the person is with these principles, they can have a healthy relationship with food or enter territories close to an eating disorder, such as orthorexia.
To find out what people generally understand as “clean eating”, the International Food Information Council (IFIC) carried out a study among more than 1,000 adults in May 2021. The results revealed that two out of three people look at the ingredients of each product before putting them in the shopping basket. Half acknowledged fleeing whenever possible from foods whose list of ingredients includes ingredients that sound like chemicals to them. Specifically, they assimilated the concept of “clean” to not being artificial or synthetic.
Another very revealing fact from this study is that half of those who consider themselves clean eaters do not eat highly processed foods and prefer foods with few ingredients, if possible, organic and fresh.
No similar study has yet been carried out in Spain, although the idea of eating clean has also permeated society in the country too. In fact, it is easy to find the same tags or hashtags in many profiles of influencers or nutrition fans.
Eating clean: an imprecise concept
Clean food falls into a limbo in which, as food technologist Beatriz Robles explains, “there is no explicit restriction. Of course, in Spain, there are laws which must be abided by, such as Regulation 1169/2011 in its article 7 on fair information practices, which indicates that food information will not mislead the consumer by attributing properties to food that it does not have or by insinuating that the food has special characteristics, when, in fact, all similar foods have those same characteristics.”
The situation becomes more abstract when what is considered clean is not a specific food, but the entire menu, and it is not limited to commercial purposes of the sale of this or that product (where the regulations are relatively strict), but rather to extol “homemade” food cooked by an influencer.
There are no objective limits when it comes to considering that one food is cleaner than another. But it can generate in a certain part of the population an animosity that is not always justified towards some foods or additives.
Homemade or not, the important thing is the ingredients
Some experts say that using the ultra-processed concept as a synonym for unhealthy can be confusing in some cases.
The rule that if an industrially produced food has more than five ingredients is ultra-processed and, as such, unhealthy, it is not infallible. A pre-cooked lentil dish can be as healthy as some stews at home. And a homemade sponge cake with cane sugar from organic farming, as unhealthy as the one from the supermarket. The question is not so much “where” to cook, but “what” to bring.
Industrial food is not always bad for your health
In particular, you have to watch the amount of certain critical ingredients, such as added sugar, salt or fats. And in the latter, prioritise those foods with olive oil over other fats with a less outstanding nutritional profile, such as palm oil or, more recently, coconut oil.
Tracing each of the ingredients on the label ends up being a daunting and tedious task. Hence, nutritionists insist on promoting cooking at home and with fresh or minimally processed foods: fruits, vegetables, bread, meat, fish… And preferably season with spices to reduce the use of salt or sugar. A stew with chilli or garlic requires less salt, while vanilla or cinnamon are perfect allies to reduce the amount of sugar we add to sweet foods.
Fear of artificial and synthetic additives
The most slippery ground in clean food is additives. In 2019, the EFSA published a ‘Eurobarometer of food safety in the EU’ where it was clear that European citizens are concerned, above all, with antibiotic and pesticide residues in food, environmental contaminants and additives (colourings, preservatives or flavourings).
It is true that the names do not help to avoid a certain panic towards the E codes. The paradox is that behind that E there can be either natural or laboratory-created additives. Both will have identical safety guarantees from those responsible for food safety in the European Union (that is precisely what that E indicates).
In other words, the chemophobia that points to synthetic additives as dangerous to health does not make sense. “All the additives used in the EU, both natural and artificial, have passed scientific evaluations carried out by the EFSA (European Food Safety Authority) to determine their safety. These evaluations are the basis for their later authorisation, and that authorisation includes both the maximum dose that can be used, as well as the foods in which it is allowed”, underlines the food technologist, Beatriz Robles. “In addition, the additives are re-evaluated to ensure that the authorisations are based on the most recent scientific evidence,” she points out.
We also use additives at home
There is a belief that in home cooking additives are not used. However, every time we add a few drops of lemon to the guacamole so that it does not oxidize, we are adding citric acid (E 330) and the egg that we put in the meatballs “so that it binds well” takes advantage of the emulsifying qualities of its lecithin (E 322). That is, in home cooking, additives are also added, in this case, natural ones.
And many of those used by the industry are also natural: carminic acid, a red dye that is extracted from cochineal (E 120), carotenes from carrots (160a)… Other times, they are produced by synthesis in a laboratory, but with the same chemical structure and composition as those of natural origin. “The natural or synthetic origin of an ingredient has nothing to do with its safety. Natural or synthetic they can be dangerous or innocuous. For example, consuming large amounts of turmeric or nutmeg can cause adverse effects,” warns Robles.
Different types of food additives
Going back to the study at the beginning, it is especially striking that only 12% admit to knowing that certain additives extend the life of food by preventing the growth of microorganisms. In other words, they contribute to avoiding food waste and, of course, to preserving our health as consumers.
“Some additives are necessary because otherwise the food would not be edible: it would deteriorate, it would pose food safety problems or it would be rejected by consumers because it does not maintain its expected organoleptic characteristics. This is the case of preservatives, of course, but also emulsifiers, acidulants, acidity regulators, anti-caking agents … Others, typical in ultra-processed foods, are used not to maintain the qualities of the food, but to modify it and make it more appetising. They are sweeteners, flavour enhancers or colourings, Robles explains.
Both one and the other are safe, but the latter “are indicating that the food as a whole is certainly not suitable for our health.” The claim of “no preservatives” or “no additives” common among followers of clean eating is nourished by this chemophobia “as if that magically transformed the product into a better food than those of the competition.”
However, far from guaranteeing a safer diet, what it achieves is —says Robles— complicating our lives. Cooking everything 100% at home takes time. “And if we only close ourselves to those ‘without additives’, we are unjustifiably reducing our purchasing options. Without going any further, cooked chickpeas, whether they have preservatives or not, are a good food,” she admits.
Even so, the industry takes note of this new sensitivity of consumers and is already developing conservation techniques, such as high pressure, which reduce the activity of microorganisms, without having to resort to preservatives, or minimising their presence.
Best fresh and seasonal food
Eating clean for many people means eating fresh foods and increasing your intake of plant-based foods. This is linked to the United Nations Sustainable Development Goals (SDGs) of reducing meat consumption, increasing the intake of fruits and vegetables and betting whenever possible on local foods (which usually have a closer harvest date).
The paradox is that many of those who defend clean eating include out-of-season fruits and vegetables in their diet, the transport of which has a very negative impact on the carbon footprint. Sometimes, because crops that do not exist or have little presence in our field are chosen (açai, pineapple, many tropical fruits…). Other times, they are grown, but out of season or imported.
Luis A. Zamora, dietitian-nutritionist and founding member of the Spanish Scientific Society of Dietetics and Nutrition (SEDYN), recalls that consuming seasonal produce “is cheaper because at that specific time there is more supply. Furthermore, on an ecological level, we do not exhaust the soil with intensive agriculture to produce fruits and vegetables all year round, regardless of the season.”
For the consumer who is not very familiar with the seasons, it is difficult to know if their tomatoes are from an open-air garden or a greenhouse. “But at least we can look at the required provenance labelling to make sure it didn’t travel 15,000 kilometres to get to our table,” he says.
When looking for cleaner food, many are obsessed with ensuring that their agricultural products are organically produced, without industrial fertilisers or pesticides. They forget that although the compost is manure, it must also meet certain legal requirements and stay below maximum residue limits. Or that a New Zealand kiwi sold in a plastic basket “blows up everything we consider ecological.”
If there is “clean eating”, is there dirty food?
Eating healthier is a good goal. The problem is when it is established in terms of good-bad. Eating fruit is good, eating a cupcake is bad. The fruit is to eat clean, the cupcake is to eat dirty. The message is simplistic, but in people predisposed to polarised behaviours (or all or nothing) it becomes a mental health hazard that demonises food and greatly limits everything that surrounds eating.
“In Spain there is no proper study on what is understood as ‘eating clean’, but in consultation we usually find people who associate it with eating only grilled steaks and salads. It is also linked to accepting only bio, organic or little processed food. Realfood has had a lot to do with this. As a concept it is fine, but taken to the extreme it is a very dangerous movement because it turns food into an obsession”, declares dietitian Pablo Ojeda, member of the Spanish Society for the Study of Obesity (SEEDO).
He insists on the importance of prioritising fresh food, cooking rich and varied at home, but without losing sight of the enjoyment component of food. Adding the adjective clean next to the fact of eating implies believing that there are foods or ways of eating that dirty the body. “It is a very dangerous association. Just as no food by itself makes you fat, neither is a person dirty by eating in one way or another”, he explains. Alert of the danger of ending up assimilating obesity with dirty people. Or feeling dirty from being overweight.
“Let’s not read what we eat based on cleanliness or dirt criteria, but rather in terms of frequency. There will be frequent foods that contribute a lot in nutritional terms and that must be present 80-85% of the time. 15% remains for those more superfluous foods, but when well placed in the general context of our diet they allow us emotional balance and a normal social life. Let’s not forget that in our culture eating is also a family lunch or a pizza with friends”, he points out.
Quirónsalud Torrevieja receives the golden seal of the Joint Commission International, the most demanding quality accreditation in the world in the health field
The Hospital Quirónsalud Torrevieja has been accredited with the golden seal of the Joint Commission International, the highest distinction granted by this body, after an exhaustive audit in which more than 1,200 quality standards have been analysed, which the hospital rigorously complies with.
This accreditation of the Joint Commission International is the most demanding worldwide for the health field and analyses that all the care and processes of the hospital are focused on safety and quality, and in a process of continuous improvement.
Continuous improvement of quality and safety in care at Quirónsalud Torrevieja
The achievement of accreditation means an official recognition of the great effort to improve the safety and quality of care, guaranteeing a safe patient care environment and permanent work for the reduction of risks.
The Hospital Quirónsalud Torrevieja has carried out multiple actions in order to promote a safety culture established throughout the organisation, working on the improvement of the six international safety objectives recognised by the World Health Organisation (WHO): unequivocal identification of the patient, effective communication between professionals, improvement of safety in the use of high-risk medicines, safe surgery, decreasing the risk of infections and reducing the risk of falls.
The audit team has highlighted as a differentiating element of the Hospital Quirónsalud Torrevieja the great teamwork of the hospital, the excellence in the safety culture and the involvement and enthusiasm with the continuous improvement of the hospital.
The organisations accredited with this prestigious seal (which must be renewed every three years), respond to an international demand for evaluation in the health sector through quality levels based on evaluable standards and comparable with other countries, with the aim of stimulating constant improvement.
The Quirónsalud Group also holds this accreditation from the Teknon Medical Centre, the Dexeus University Hospital, the Quirónsalud Barcelona Hospital, the Quirónsalud Madrid University Hospital, the Quirónsalud Córdoba University Hospital, the Ricardo Palma Clinic in Lima (Peru), and the Imbanaco Clinic in Cali (Colombia).
Last year, Quirónsalud became the first private hospital group in the world to obtain the Joint Commission International Enterprise accreditation, as well as the first health entity in Europe to do so. The fact of having this recognition is an additional guarantee for patients seeking the best health care to treat their health problems.
What is Joint Commission International?
The Joint Commission International is a non-profit organisation, which has been working since the 90s in more than 100 countries to improve patient safety and quality of care, offering health accreditation services internationally. This organisation audits hospitals, health systems and agencies, government ministries and institutions, promoting rigorous standards of care. JCI is the most prestigious health accreditation in the world for its high level of demand, for the safety it provides to the patient and for the rigorous and exhaustive evaluation of all care processes.
Keys to a healthy heart free of risks
The specialists of the Cardiology Unit at Quirónsalud Torrevieja answer the most frequently asked questions about cardiovascular diseases.
What is cardiovascular pathology?
Cardiovascular disease refers to the pathological process that affects the entire arterial system, not only the coronary arteries, but also the brain, legs and the rest of the body.
Therefore, when we talk about cardiovascular disease we refer to stroke, transient ischaemic attack, angina pectoris, myocardial infarction, intermittent claudication and arterial ischaemia as manifestations of cardiovascular disease, among others.
The pathological process involved is usually atherosclerosis, which is the accumulation of fats, cholesterol and other substances within the wall of the arteries, causing progressive narrowing and even complete obstruction, blocking the flow of blood that should reach a part of the body.
Prevention of cardiovascular diseases
In addition to exhaustively treating the classic risk factors such as arterial hypertension, diabetes mellitus, dyslipidaemia (hypercholesterolemia and hypertriglyceridaemia) and tobacco consumption, there are a series of measures that help prevent the onset and progression of cardiovascular disease. The cardiology experts at Quirónsalud have drawn up the following list:
– Nutrition: is the integrating pillar for both prevention and treatment of cardiovascular disease.
– Exercise: most cardiovascular risk factors are improved by a combination of aerobic exercise, resistance training and stretching.
– Mind-heart interactions: A clear association between emotional state and heart health has been observed. Stress can induce ischaemia by causing both epicardial and microvascular vasoconstriction.
How to prevent heart disease
At Quirónsalud, heart health experts and cardiologists recommend the benefits of a comprehensive lifestyle intervention programme, including: nutritional changes through a low-fat, vegetable-based diet, frequent physical exercise and stress management, all of which have shown the disappearance of angina pectoris in 74% of patients included in the study by Frattaroli et al.
In addition, as shown in the 2011 study by Sattelmair et al in the scientific journal Circulation, walking 30 minutes 5 days a week reduces the risk of ischaemic heart disease (angina pectoris or myocardial infarction) by 14%.
Risk factors for heart disease
There are certain risk factors for heart disease that are not within our control, such as genetic inheritance, age, gender and environmental pollution. However, by knowing these factors in each person’s specific situation, we can take appropriate measures to try to minimise the harmful effects of these risk factors.
Keeping the heart healthy
Stress is pervasive in our lives today and we need to learn how to manage it effectively. Stress can induce ischaemia by different mechanisms, but it also alters autonomic regulation and triggers the release of circulating catecholamines that can even trigger stress cardiomyopathy. In the 2012 study by Schneider et al, it was shown that meditating twice a day can reduce cardiovascular events by up to 48%.
Diet to prevent heart disease
One of the best-studied dietary approaches in cardiology is the Mediterranean diet, which consists of increasing vegetable and fruit intake, giving preference to whole grains over refined grains, reducing red meat and increasing fish consumption, with a predominant use of olive and rapeseed oil.
Sport for an active heart
The sport with the most cardiovascular benefits would be one that combines aerobic exercise, resistance training and stretching.
Walking 30 minutes a day 5 days a week has been shown to play a beneficial role in cardiovascular risk management. Thus, sports such as running, cycling, jogging, trekking or swimming would fulfil this role. A notable cardiovascular benefit has also been demonstrated with tai chi, a form of martial art from ancient China that is characterised by smooth, flowing movements.