Why do we increasingly exclude more and more ingredients from our diet? What are the consequences of this? We analyze the social tendency to opt for exclusion diets without a medical diagnosis.


“Let your food be your medicine and your medicine be your food” is a 2,500-year-old Greek aphorism attributed to Hippocrates, the father of this science in the West. But today, eating is as much industry and marketing as it is health and tradition, and for many it has become a risky activity marked by allergies, intolerances, syndromes and other ailments. That is why, when we have gastrointestinal problems (according to an analysis by the American Gastroenterological Association, 40% of the world’s inhabitants suffer from these), it has become common to cast a suspicious eye on the shopping basket, to search among its ingredients for things that are good for us and things that are not. A process that in some cases is more moral than scientific, which turns our diet into a battlefield for angels and demons, superfoods and villains. Demons, as the Bible tells us, were banished from heaven, and it is precisely this dynamic that Fundación MAPFRE and the Spanish Academy of Nutrition and Dietetics (Academia Española de Nutrición y Dietética; AEND) have focused on in their study, Tendencia de exclusión alimentaria en la población española (Food exclusion trends in the Spanish population).

In Spain, according to the study Food exclusion trends in the Spanish population, conducted by Fundación MAPFRE and the AEND, 25% of people eat a lactose-free diet, which is probably the most widely practised, and 8% try to completely eliminate gluten. Of these, up to 72% “may be doing so without fully justifying the exclusion of these components”, say the authors, especially given the prevalence of selfdiagnosis: we are increasingly making decisions about what we eat without medical advice. We are turning the Socratic “know thyself”, to once again quote the Greek fathers of philosophy, into a “diagnose yourself” and implementing the corresponding opt-out diets that could pose “a risk to the maintenance of the population’s optimal health”.

These figures are in line with studies carried out at European level and, particularly, in the Anglo-Saxon world, where the consumption of “free” foods has become a fashion and, at the same time, an industry. According to an article published in The European Medical Journal, 35% of people self-diagnose food allergies or intolerances, or diagnose them in their children, when the general rate of these conditions is estimated to affect just 2-5% of the general population. More seriously, they take action on their own rather than seeking a clinical diagnosis. In the UK, 45% of Britons say they have a food allergy or intolerance and only 15% have confirmed this with a doctor, according to a study by DNAFit, a health testing firm. And in the United States, research from Northwestern University found that about 20% of people surveyed believed they were allergic to some foods, when only 10% experienced reactions consistent with the condition.

“A food allergy or intolerance is a pathology that must be diagnosed by a doctor”, stresses Dr. Eva Arranz of Fundación MAPFRE. However, the Spanish study notes that more than 40% of those surveyed admit to excluding a food from their shopping basket without medical advice or a prescription, but rather “as a result of personal reflection”. But, as Dr. Arranz points out, following an exclusion diet without justification and without proper advice can have unexpected consequences: “In the case of the lactosefree diet, there may be a risk of inadequate calcium intake, with the possible negative impact on our health and, in particular, on bone health. And a gluten-free diet may lack fiber, vitamins (B12, D, folic acid) and other nutrients (iron, calcium, zinc, magnesium).”

To counteract these risks, the Spanish Academy of Nutrition and Dietetics calls for “individual social responsibility, and that of the groups around them, since family and friends are powerful influencers of both positive and negative eating behavior.”

“We should follow the recommendations of healthcare professionals in terms of what a healthy diet is and, in the event that it is necessary to stop eating a certain food or follow a specific type of diet, we must do so under their guidance”, says Dr. Arranz. As a reminder, at Fundación MAPFRE we would also like to summarize the advice given by international organizations on how to eat a healthy diet: “Increase consumption of fruits and vegetables; decrease consumption of simple sugars, salt and saturated fats, especially trans fatty acids.”

In Spanish culture, these guidelines have already been instilled by tradition and popular wisdom in the form of the Mediterranean diet, rich in fruits and vegetables, whole grains, fish and lean meats, olive oil, milk, dairy products, and so on. But food is not the beall and end-all, no matter how much the Hippocratic dictum suggests this. “We should remember to maintain a healthy lifestyle, eating a healthy and balanced diet, doing physical exercise and abstaining from the consumption of toxic substances”, concludes Dr. Arranz.

Cover page of the report Tendencia de exclusión alimentaria en la población española (Food exclusion trends in the Spanish population), prepared by the Spanish Academy of Nutrition and Dietetics (Academia Española de Nutrición y Dietética; AEND) and Fundación MAPFRE.