Allana Blumberg, 20, from Toronto, Canada, in March 2019 and in July 2019, four months into food combining (Photo courtesy of Allana Blumberg)
Allana Blumberg stared at her unfamiliar reflection in her wall-mounted mirror as her stomach painfully expanded beyond the waistband of her sweatpants.
Meanwhile, her self-confidence deflated.
Blumberg, a 20 year-old from Toronto, Canada, began this day in July the same way she had for the last four months, with a fruit smoothie, avocado toast on ezekiel bread, and a falafel and vegetable salad. Unlike other days, she felt an intense pressure in her stomach and was uncomfortable in her usual attire of a sports bra and biker shorts.
By mid-afternoon, Blumberg was in visible pain. By the time the sun had set, she couldn’t even bear to put on pants.
“When I say painful stomach bloating I mean I looked six months pregnant,” Blumberg said. “My entire body inflated all the way down to my ankles, my entire legs, my face, my upper ribs were even bloated like that’s how far bloated my stomach was.”
Since March, Blumberg had been strictly following the concepts of food combining after trying social media influencer Kenzie Burke’s “21 Day Reset,” a nutrition program Burke promotes on her social media. She was one of nine women interviewed for this story who experienced bloating and stomach pain after following Burke’s diet.
There’s no licensing requirements in California, where Burke operates, to call oneself a nutritionist. Additionally, anyone, certified or not, can sell nutrition and meal plans to the public.
“There’s no regulation at all,” Registered Dietician Sarah Mirkin said. “Anyone can call themselves an expert and you don’t need any type of education.”
In California, 13,450 individuals give out nutritional information without supervision, where unlicensed health educators represent 45 percent of nutritionists in the state, according to data from the U.S. Bureau of Labor statistics. They are outnumbered by more heavily licensed registered dieticians by just 2,000.
Kenzie Burke Health
Burke did not respond to direct messages sent to her Instagram, emails sent to her website, or a letter sent to her address for comment.
Burke launched her first program, the 21 Day Reset, on her website KenzieBurkeHealth.com in February 2019. Burke’s online programs and Instagram content promote what Burke calls food combining.
Burke teaches that eating certain foods together, such as vegetables and starches, and other foods at separate times, such as fruits and proteins, will conserve energy, aid in the body’s digestion and even reduce bloating.
She currently has 117,000 followers on Instagram and a blog. Her programs include 21 Days to Your Best Body, which sells for $50 for the digital version and $60 for the physical book, and The 10 Day Reboot, which she sells for $45 and $55, respectively.
On her YouTube channel, where she has 31,000 subscribers, Burke promotes eating fruit by itself first thing in the morning on an empty stomach and waiting at least 30 minutes before eating anything else.
She also recommends against eating a protein and a starch together because she believes they digest differently in the stomach, and that combining them will cause a traffic jam in the stomach and decrease the body’s energy.
Burke also emphasizes a plant-based, gluten-free diet in her programs.
“When you use yourself as a science experiment, you will see how much of it makes sense,” Burke said in a October 2019 YouTube video. “If you have ever had a burger with a bun and felt disgusted after or had pasta with meatballs and felt bloated and uncomfortable after, it is a simple way to eat the foods you want to eat but in a different way.”
On her official website, Burke writes that she was enrolled in the Institute for Integrative Nutrition and completed its holistic health coach program.
Danielle Vita, admissions representative for the Institute of Integrative Health, said in an email that they train health coaches to support individuals in reaching their wellness goals by finding what works best for them in an unbiased way.
“This role does not include diagnosis, prescription, treatment, or take responsibility for bringing about wellness changes in a client’s life,” Vita said. “Rather, health coaches, they guide and support the development of and progress toward personal wellness goals.”
Vita did not return follow-up messages seeking to confirm whether Burke had completed their program.
Burke said food combining helps with physical symptoms
On her website and in a YouTube video from October 2019, Burke said her way of eating allowed her to almost completely eliminate the symptoms of her Lyme disease.
Many women, like Blumberg, tried Burke’s food combining because of the physical symptoms Burke said it reduces.
“I wanted to try it because I was experiencing stomach issues and her program claimed to help a lot with bloating,” Ali Carranza, 21, from Irvine, California, said.
Similarly, Kendra Schmidt, 15 from Eugene, Oregon, said she wanted to try the program because she was experiencing bloating and stomach pain and Burke placed a big emphasis on her program helping digestion.
“I remember feeling disappointed that my bloating and stomach aches did not get better,” Schmidt said, “and that they were actually getting worse.”
Karen Freeds, 23 from New York City, similarly started following Burke because she wanted to reduce bloating.
The restrictions of a health coach
While a health coach can guide someone to eat healthier, they are not certified to provide specific dietary instructions but instead should focus on general and evidence-based healthy eating, health coach attorney Lisa Fraley said in a September 2016 Health Coach Solutions article.
Health coaches also are not supposed to diagnose or heal any medical condition or disease, such as Lyme disease, Irritable Bowel Syndrome (IBS) or even stomach bloating.
“I’d imagine she can say that it helped her with x,y,z,” Registered Dietician Jeff Rothschild said. “But she probably isn’t supposed to say it can help others.”
Rothchild said that from his perspective, it is highly unlikely that the rules of food combining would help with Lyme Disease or IBS.
“It’s so ridiculous to think you can’t consume or combine, let’s say, rice and chicken,” Rothschild said. “Like it’s beyond absurd to me.”
LeeAnn Weintraub, registered dietician and nutrition consultant, said food combining is not supported by scholarly evidence and that physical symptoms, like those of IBS, need to be treated with a customized, personal food plan.
“Food combining is largely not science-based,” Weintraub said. “People with diabetes or prediabetes, for example, benefit from eating balanced meals – combining their carbs with protein, an approach which is science-based and counter to food combining.”
Abbey Sharp, registered dietitian, YouTuber, and founder of Abbey’s Kitchen Inc., agreed that food combining lacks scientific backing.
“The ‘rules’ of food combining don’t even make sense, as foods do not exist as single macronutrients – they are combinations and often these combinations actually have health promoting qualities,” Sharp wrote in an email.
Lack of regulation all around
In the state of California, anyone can provide nutrition advice without any education, accreditation or regulation requirements.
However, those licensed as registered dieticians complete an extensive education, with a minimum requirement of at least a bachelor’s degree and an eight-month internship as a dietician. Further, the Commission on Dietetic Registration oversees their practice once they pass the CDR’s exam, according to NutritionED.org.
The Commission on Dietetic Registration, a part of the Academy of Nutrition and Dietetics, which is the largest organization of nutrition professionals in the United States, monitors any misuse of credentials or public complaints for over 100,000 registered dieticians nationwide.
However, there is no organization that monitors the practice of those who consider themselves nutritionists, health coaches or health influencers.
The number of employed registered dieticians in the United States is significantly higher than the number of those in health education, including health coaches, according to U.S. Bureau of Labor statistics from 2015 to 2019. But when it comes to California, there is only a small difference between the number of registered dietitians and the number of unregulated health educators.
This lack of regulation allows for Burke to officially license her business, Kenzie Burke Health, as health and nutrition consulting.
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Further, most online businesses are unregulated unless consumers report them to the Federal Trade Commission (FTC).
In 2019, there were 21,114 consumer complaint reports filed with the FTC and $8.4 million lost in the category of healthcare, including deceptive or misleading claims regarding weight loss products and services and dietary supplements.
Women speak out about their food combining experiences
Sharp’s July 2019 YouTube video calling out Burke’s food combining for its misleading claims and restrictive qualities gained close to 378,000 views and opened the eyes of many women who had been trying the program.
“I saw it as just so misinformed and dangerous, especially to young girls who are following Kenzie’s recommendations every day,” Sharp wrote. “I got a lot of responses from women, particularly those saying it drew them into an eating disorder.”
One viewer of Sharp’s, Kelani Anastasi, 21, from Montclair, New Jersey, said as soon as she saw the video, she felt as if she had been brainwashed by food combining.
Anastasi, also a YouTuber, purchased Burke’s 21 Day Reset after she saw influencer Maggie MacDonald, a close friend of Burke’s, promoting the program.
Macdonald didn’t respond to direct messages to her Instagram or business email for comment.
Used to living a healthy lifestyle, Anastasi was happy with the program at first and even began making her own YouTube videos documenting her food combining journey, gaining subscribers and views in the process, which further inspired her to keep going.
About a week into the program, though, Anastasi noticed she was constantly tired and felt very bloated every day.
“I was having weird symptoms that I had never had before,” Anasatasi said. “Like the bloat. I couldn’t sleep. I was constantly hungry. And I just felt super lethargic. Like I would wake up in the morning and it was almost as if I had a fever and it was the same way for two weeks.”
Anastasi decided to reach out to her followers with these symptoms and the response she received from women experiencing the same symptoms was overwhelming.
“I was getting hundreds and like thousands of DMs a day from other girls,” Anastasi said. “ I made a video and it went totally viral. I think it has like 300,000 views right now.”
Anastasi said she told Burke on Instagram that her program wasn’t working for her, and received an apology.
Stefanie Brignac, 24, from Baton Rouge, Louisiana, a viewer of Anastasi and Sharp’s videos, experienced the same symptoms of bloating, fatigue and stomach pains.
“I didn’t notice any positive changes, only negative,” Brignac said. “My stomach would cramp so badly I felt like I was starving myself, but I felt so guilty if I wasn’t following the program exactly how it was written.”
Laura Schiepers, 20, from Belgium, said two to three weeks of food combining caused her to feel sick, dizzy, bloated and worsened her IBS.
“My IBS got worse and my meds weren’t working anymore, so I had to pay for a lot of doctor visits,” Schiepers said. “I felt tired, way too tired. When I was working I could feel myself slip away at times and I needed sugar.”
Also moved by Anastasi’s video, Liv Burr, 17, from Boston, Massachusetts, said the amount of carbs and the lack of protein she was consuming on the program caused her to gain 10 to 15 pounds and lose her muscle tone.
“I felt pretty good,” Burr said, “but then over time, I felt so fatigued, tired and I was just foggy. And all of this eating was like rice and vegetables with no protein. I wasn’t craving protein anymore, which made me not want it more.”
Once she quit the program and nervously introduced normal foods back into her diet, Burr said she constantly had stomach pain because she wasn’t used to digesting protein anymore.
Jane Simmons, 24, from New York City, experienced the same lasting symptoms.
“Honestly my digestion was horrible, like really bad,” Simmons said. “I was really bloated and my stomach hurt after the first week and then the week after, or maybe even two weeks after, my stomach really hurt for a while.”
Sharp explained that these physical symptoms make sense when considering the food combining rules.
“The rules basically force you to eat a lot of fruit without any protein or fat to reduce its glycemic load, which may contribute to muscle wasting,” Sharp wrote. “Fatigue is also common considering how little one would likely be eating. And any stomachaches or bloating may be because you’re largely instructed to have unbalanced meals since you can’t really combine macronutrients for the most part. This may leave people consuming a lot of high fodmap foods basically on an empty stomach.”
High fodmap foods have a high content of fermentable and fibrous carbs such as certain fruits, grains, legumes and vegetables, which Burke’s recipes include an abundance of.
Mirkin agreed that the symptoms women experienced could be an increase in high fod map foods, which can cause abdominal pain and bloating.
Mirkin said to combat these symptoms, a dietitian can recommend a low fodmap diet that prioritizes protein in place of these carbohydrates for a short period of time, then slowly reintroduces high fodmap foods back into the diet.
The mental impact of food combining
Anastasi said that for her and the women responding to her posts, food combining was in fact a diet and not a long-term lifestyle as Burke claimed it to be.
“She kept pushing: It’s not restrictive. It’s not restrictive. It’s not restrictive, but it was consuming my life,” Anastasi said. “To the point where I was like, OK, well, like I can’t eat a banana and peanut butter or like, I can’t eat chicken and avocado because it’s not food combining approved.”
Burr agreed that this was the most restrictive diet she had ever heard of.
“I became so nervous, like to eat peanut butter again,” Burr said.
Blumberg also felt this sense of nervousness toward food.
“Mentally it was kind of draining,” Blumberg said. “I became really obsessed with searching for that clean ingredient label which isn’t good for your mental health and your food relationship. To get over that curb of thinking ‘Oh I can’t mix protein with starches’ was very hard for me,” Blumberg said.
Similarly, Skye Rogers, 20, from Toronto, Canada, said the restrictive nature of Burke’s program caused her to constantly overthink her food choices.
“I felt like I could never eat fully what I wanted so I couldn’t enjoy food like normal,” Rogers said. “If I accidentally combined two groups I felt so disappointed in myself and just found the whole thing difficult to maintain, I was also more bloated than before.”
Nicole Drew, 19, from San Diego, California, heard about food combining from Macdonald. She and her sister attempted the program after a trip to Europe had left them yearning to get back on track with their diet.
After trying out Burke’s program for only a couple weeks, Drew and her sister decided to stop because of the restrictive nature of the food combining rules and their past experiences with anorexia.
“It was kind of triggering some of my old disordered eating habits,” Drew said. “That’s what made me stop because I didn’t want to fall back into that again.”
Bre Holmes, 22, from Boston, Massachusetts, said food combining made her feel as if she was running on empty.
“I was sad and cloudy all the time,” Holmes said. “I was frustrated that I didn’t feel good and wasn’t seeing the results I was supposed to. I found myself not wanting to go out to dinner in fear that I wouldn’t find something I’d want to eat that I could eat.”
Sharp wrote that the obsessive quality of the food combining guidelines can certainly increase the possibility of disordered eating as well as create nutrient deficiencies from eating too few calories.
“If your training predicts spending a lot of energy and you eat too few calories, your hormone levels can be affected,” Rothschild said. “You’re general day-to-day energy and recovery, but also bigger problems.”
Burke promotes products reported to the FDA
In addition to selling her programs online, Burke also recommends, but does not personally sell, detox and cleansing teas on her website and Instagram.
According to the U.S. Food and Drug Administration’s CAERS (Center for Food Safety and Applied Nutrition Adverse Event Reporting System) database that provides the public with complaint reports submitted to the FDA from 2014 to 2019, at least two of the brands Burke promotes were reported, including a specific product, Yogi’s DeTox tea.
In 2015, an individual reported Yogi’s DeTox tea to the FDA as leading them to visit a healthcare provider after experiencing neurological symptoms, dehydration and abnormal hormone levels.
Additionally, in 2018 individuals filed two separate reports of Yogi’s DeTox Tea to the FDA, both experiencing liver issues and hospitalization.
Registered dieticians agree on the dangers of social media
Because all of this nutrition information and promotion is available and unregulated online, healthcare professionals believe it creates many potential dangers for social media users.
“There’s a lot of like, just terrible advice,” Rothschild said. “So it’s, it’s unfortunate because then it ruins it for people. People that want to give good advice without being let’s say registered dietitian, it kind of ruins it for those people.”
Certified professionals, like Pepperdine Registered Dietitian Katherine McCune, emphasized the importance of education, not just subjective experience, in nutrition-based advice.
“I would always be aware of anything one sees in social media,” McCune said. “I think people are negatively affected by following a plan that isn’t individualized, especially if the potential client has a special need or a diagnosis that could be negatively affected by advice that is given without a complete thorough assessment.”
Mirkin agreed that the prevalence of unregulated influencers in the health space can be dangerous.
“People you know, they don’t realize the damage they’re doing,” Mirkin said.
Dr. Colin Zhu, family medical doctor and chef, said this leaves healthcare professionals with the responsibility to ground information in science and evidence-supported references.
“The most important thing, honestly is really that more and more doctors are coming out to really just kind of protect, you know, health care,” Zhu said. “We want people to be educated but we want people to be empowered to look things up on their own and not just believe the first thing that they read and to double and triple check their facts.”
Standing hopeless and self-consciously in front of her mirror, staring at the painful changes that had taken over her body while doing food combining for four months, Blumberg wished she hadn’t believed everything she read on social media.
In July 2019, Blumberg’s symptoms led her to visit her primary care doctor, who eventually referred her to a registered dietician.
Though Blumberg still struggles with bloating and nervousness about food, with the help of her dietitian, she started the low fodmap diet to combat her IBS symptoms and is learning what her body can and cannot tolerate.
In addition to no longer being able to tolerate a lot of the foods she over-consumed during her experience with food combining, one of the hardest parts for Blumberg was announcing to her followers that she was no longer following the program.
“A lot of them had followed me because I was doing it and because I was in that niche community so to announce that I wasn’t following it,” Blumberg said, “that I was now having eggs, I was now having fish, was a bit hard for me but I also learned how to not put labels on myself, moving past that point because I knew it was too restrictive for me mentally and physically.”
Today, Blumberg is focusing on eating what makes her body feel best and helping other women by posting realistic meal ideas on her YouTube channel.
The many women who came forward about their bad experiences with food combining after seeing videos like Anastasi’s and Sharp’s demonstrate that social media can be used to encourage healthy eating habits as well.
Jillian Johnson completed the reporting for this story in Jour 490 in Spring 2020 under the supervision of Dr. Christina Littlefield.
