“The thing is – if you get rid of lactose, your body is going to produce less lactase, the enzyme that breaks down lactose. This enzyme is produced based on actual intake,” says Dr Padayachee. “If you stop consuming dairy, you are going to get bloated when you do eat these things because you do not have enough lactase in your gut and you’ve overloaded your system.”
It’s becoming increasingly difficult to distinguish legitimate allergies and intolerances from disordered eating patterns because the behaviours required of one are so similar to the other. Much of the behaviour exhibited by people who have orthorexia – like compulsive checking of ingredient lists and nutritional labels, thinking hours per day about what food might be served at an upcoming event, and the cutting out of foods from a number of food groups – intersect with those displayed by intolerance sufferers. For instance, less than 1% of the population suffer from histamine intolerance but they have to check labels for food colourants and additive. FODMAP sufferers, whose guts don’t properly absorb a collection of short-chain carbohydrates known as ‘FODMAPs’, have to cut out ingredients from disparate food groups such as vegetables, fruit, grains and pulses.
A self-test questionnaire developed by physician Steve Bratman (who also coined ‘orthorexia’) reveals that an obsession with ‘purity and rightness’ and judgement of others who eat foods that are thought to be unhealthy is what separates those who have orthorexia to those who have intolerances.
But what exactly is ‘healthy’ when food groups are being demarcated into ‘good’ and ‘bad’ binaries without scientific evidence? On any given day, ‘bad’ food can oscillate from fat and sugar to gluten and dairy. The pendulum swings back and forth according to which influencer you follow on social media.
“You’ve got a lot of self-acclaimed specialists who are not necessarily experts in nutrition or human physiology who are publicising the fact that they’ve stopped eating bread and aren’t bloated anymore,” says Dr Padayachee. “But this assessment is based on one person making one change in their diet but who doesn’t understand how or why this has happened.
“You can easily manipulate outcomes with food without having any knowledge of what you’re doing, and that makes it challenging for people who work in the nutrition and dietetics space.”
To combat the increasing fear around food and an increasingly one-dimensional view of health, Dr Padayachee has advice that can be encapsulated in another word that has become symptomatic of our time: mindfulness.
“Be mindful of when and what you’re eating. We often eat while talking, driving or sitting at our computers and we’re not paying attention to the textures, flavours and colours of what we’re eating. Health is about getting sensory enjoyment and pleasure from food.”
Sonia Nair is a Melbourne-based writer and critic who has been published by The Wheeler Centre, The Lifted Brow and Kill Your Darlings among others. Follow her on Twitter.