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Book Review: The Giessen Raw Food Study by Carola Strassner

Dissertation on raw food from the 1990s shows mistakes that can be made with this diet. The target audience is specialists. Has a rather negative tone.

Collage book "Die Giessener Rohkost-Studie" by Carola Strassner with text statement on the right.© CC-by-sa 2.0, Collage Catalina Sparleanu, PhD, Foundation Diet and Health Switzerland

Conclusion

This dissertation examines the nutrition and health habits of people following a raw food diet in Germany in the 1990s — however, the persons responsible at Justus Liebig University Giessen may have been biased and/or inexperienced. An interesting and impressive amount of data was accumulated.

The findings show us mistakes that people on a raw food diet can make. This tells us something about those who describe themselves as raw foodists (minimum 70 % raw food), but not a lot about a "proper" raw food diet.

There is noticeable negative bias on the part of the participants. It is not the task of this type of study to give readers advice on raw food, so we should not expect this.

The book is a great find for those interested in reading about nutrition in detail, but the target audience is not the consumer. My book review is accordingly quite challenging to read.

1. Summary

JLU Giessen conducted a wide-scale study on raw food. The study was under the direction of the dean Dr. Elmar Schlich, analyzed by Carola Strassner for her dissertation, and published as a book in 1998.

Contents, blurb and remarks

Note: The chapter titles and all quotations in italics are translated from the original German.

Contents

The table of contents takes up five pages and is followed by six pages of indexes for pictures, graphs, tables, and abbreviations. These are the titles of the actual chapters:

  • Adequate Protein Supply from Raw Food? A Literature Review.
  • Study Design of the Giessen Raw Food Study (p. 61)
  • Instruments and Methodology (p. 66)
  • Descriptive Results and Discussion (p. 81)
  • Results and Discussion of the Energy and Protein Status (p. 100)
  • Closing Remarks (p. 163)
  • Conclusion (p. 163)
  • Summary (p. 166)
  • Bibliography (pp. 168–194)

This is followed by an appendix that contains a definition of raw food, a list of diplom theses on the subject of raw food (p. 197), and additional appendixes and tables. On page 210, you can review copies of the questionnaires and on page 238 there is a list of 17 publications based on the Giessen Raw Food Study as well as acknowledgements and the author’s impressive resume.

Blurb

Even nutrition specialists can get lost in the jungle of dietetics. Is it best to eat a primarily raw food diet? At what percentage of raw food should a person on a raw food diet be concerned about getting enough nutrients?

These and many other questions are discussed by nutrition specialist CAROLA STRASSNER in her thorough study of raw food.

She provides a detailed statistical analysis of the types of food consumed by the raw foodists and their state of health.

The author also addresses the problem of malnutrition in detail — especially in terms of protein supply — drawing on data from developing countries, anorexics, and chronically ill individuals. Without adhering to any dogma, she describes the current state of knowledge concerning this important issue.

To show that certain passages were not written by me or if I cite views that I don’t agree with, I often quote points that I find to be particularly important. These are always in italics and quotation marks.

The majority of the other sections are summaries of the book content and not interpretations of my own — if this is not the case, I state specifically that a certain section contains my own comments (e.g., in “About the study,” “The myths about plant protein,” and “My closing remarks”).

I wrote this book review in 2001. And then in February 2014 I decided to update it. I added boxes with images to provide more variety and to better set apart my own observations. This is similar to the structure of the book reviews on Salt Sugar Fat or Lies Lobbies Food.

The book is currently only available in German under the title Ernähren sich Rohköstler gesünder? (Is a raw food diet healthier?) and the subtitle Die Giessener Rohkost-Studie (The Giessen raw food study), published by Verlag für Medizin und Gesundheit (Publisher for medicine and health), 1998, ISBN 3-932977-04-1.

My preliminary remarks:

The dissertation concludes with the following sentence: Based on the results of this study, we do not recommend a pure raw food diet, particularly in the case of at-risk groups such as pregnant women, nursing mothers, children, and the elderly [217-164].

It is not surprising that this was the conclusion since the objective and purpose of the study was most likely to oppose a pure raw food diet.

The work could also have been an analysis of the situation, from which further helpful instructions and tips could have resulted.

Statistics show that people need advice for every type of diet form, including a raw food diet. This is the very reason why I created the website diet-health.info.

The impartiality of the individuals who conduct and review studies (in this case Dr. C. Leitzmann and Dr. H. Laube) is always questionable. I also assume that even Ms. Strassner was not entirely free of her own expectations regarding the final outcome or that she was influenced by the expectations of those around her. This is why I cannot just dismiss the views of the participants as has been done in some other books on raw food.

Science almost always needs quite some time before contradictory or new insights become accepted

Unfortunately, we cannot really expect things to have taken a different course as science almost always needs quite some time before contradictory or new insights become accepted.

A good but tragic example is Ignaz Semmelweiss proposal that physicians practice handwashing, an idea he advocated in the German-speaking countries starting in 1847. For over 20 years, his colleagues responded only with mockery, and Semmelweis did not live to see the introduction of hygiene practices. He was taken to a mental hospital, where he soon thereafter was beaten to death by a guard. Dr. Semmelweis died when he was 47 years old. Today, this reflex-like tendency to object new evidence is called the Semmelweis reflex.

Based on knowledge about bacteria established by Louis Pasteur (and Casimir Davaine, 1863), Joseph Lister was the first physician to successfully introduce hygiene practices. He did so in 1867.

It is true that new or different findings turn out to be incorrect more often than they prove valid and are fully accepted in science. But I am surprised by statements such as: A moderate raw food diet supplemented with foods such as whole grain bread or other whole grain products and animal products — such as dairy products — MIGHT be possible for healthy adults with sufficient knowledge of nutrition [217-161].

However, see this book review on the harmfulness of milk.

This raises the following question for me: Why would a person who is eating exactly what the “scientific trend” recommends, that is “as much raw food as possible” plus whole grain and animal products need to obtain a “sufficient understanding of nutrition” in order to eat a hopefully healthy diet?

Cynicism is the wrong way to achieve positive results. But the above cynical question serves to illustrate how this study maintained a one-sided view. The study could not come out as “pro raw food.” Nor is it helpful for raw foodists, but that wasn’t the study’s purpose.

Photo "Das neue Rohkostbuch" by Lisa Mar, 1973 was my very first recipe book for raw food.© CC-by-sa 2.0, Lisa Mar

In 1978 I was diagnosed with a “rare B-cell non-Hodgkin’s lymphoma” (now known as mantle cell lymphoma). It had already progressed to stage 3a, and I was given an average statistical life expectancy of only two and a half years.

Given the short life expectancy I refused the recommended treatment completely.

Click here to read more about Erb Muesli.

Instead, I made radical changes to my lifestyle. As a person who ate a 100 % vegan raw food diet with virtually 100 % compliance for seven years straight and had a very positive experience, I have to be careful not to react cynically.

Yet interested readers may benefit from reading this study if they focus on the details. Incidentally, the Giessener Formel der Vollwert-Ernährungen (Giessener formula for a whole foods diet) recommends eating 50% raw food [Koerber et al. 1994, p. 22]. A 100% raw food diet would certainly be hostile to the industry.

2. Book review

I will start with a description of the study.

2.1. About the study

After a 60-page description of various raw food diet recommendations from the past and present, the author provides a description of the study design, instruments, and methodology. On page 75. there is information about the study groups and their respective diets. On page 100, there is a section with results and a discussion about energy and protein, and on page 158 there are almost eight pages of closing remarks.

The questionnaire that was used takes up 28 pages. The book also includes tables and a 27-page bibliography. On page 197. the author lists 21 diplom theses on the subject of raw food that were published between 1994 and 1998. Based on their first names, I counted only five male authors. Are men that much less interested in the subject of raw food?

2.2. Study design

The study certainly was not an easy task, and Carola Strassner spared no effort.

Definition of raw food in the context of the study: the working group for raw food established the following definition for the study in 1995:

A raw food diet is a diet form that largely or exclusively consists of unheated vegetable-based (and for some people also animal-based) foods. Foods that are processed at high temperatures (e.g., cold-extracted honey and cold-pressed oils) or prepared by heating at low temperatures (e.g., dried fruit, dried meat and fish, and certain types of nuts) are also included. In addition, cold-smoked products (such as meat and fish) and fermented vegetables (using acetic or lactic acid) can be part of a raw food diet [217-14].

Recruiting participants

In December 1992 and January 1993, the team placed recruitment ads in nine popular magazines in Germany. The response rate was 81.7% [217-64], resulting in 1'085 people (in my estimation).

These included the Neuform Kurier (New form courier) (response rate 38.7 %; circulation 1'100'000), Lebenskunde/Fit fürs Leben (Life skills / Fit for life) (response rate 12.4%; circulation 20'000), Schrot und Korn (Groats and grains) (response rate: 11.6%; circulation197'000 ), and Reform Rundschau (Reform review) (circulation: 290'000).

Other magazines accounted for 9.9% of the responses. These included Der Naturarzt (The natural physician) (70'000), Der Vegetarier (The vegetarian) (4'000), Modernes Leben: Natürliches Heilen (Modern life: natural healing) (7'200), Natur und Heilen (Natural healing) (22'500), and Öko-Test (Eco test) (13'500).

Brochures, word of mouth, and the like accounted for the remaining 27.4 % response rate of the total of 1'328 individuals who were sent a pre-questionnaire.

Selection

The response rate of 87.6 % should have resulted in 758 questionnaires. I am not clear as to why other participants were excluded because only 572 people received the following psychological questionnaire [Koebnick 1994] and of these only 435 responses were received (76.1 %).

Twenty-four people who were associated with Guy-Claude Burger and inquired about participating in the raw food study were not selected. I could find no explanation as to why, but it became the subject of a diplom thesis [Weiss 1998].

Answers such as I eat a salad every day; I’m a raw foodist, or 8 % of applicants giving merely the parameter that the food they eat is mechanically intact [217-195], was not surprising, especially since advertisements were used as the main form of recruitment. People who provided answers like these were naturally not included in the study.

A comprehensive main questionnaire was then given to all those who in April 1993 reported that they ate a diet of at least 70 % raw food and had done so for at least four months. The final result was 865 participants.

Carola Strassner and her team had valid reasons for not accepting participants under the age of 16. The study also included people who only ate a 70 % raw food diet. This is close to the question: Are they then actually raw foodists?To obtain figures for more stringent criteria, the participants were divided into three groups: those who ate a 70 to 80 %, 80 to 90 %, and more than 90 % raw food diet.

Collage: photography of numerous fruits on market with text inserted on the right.© CC-by-sa 2.0, Collage Catalina Sparleanu, PhD, Foundation Diet and Health Switzerland

Blood samples and measurements

The study leaders invited 343 participants aged 25 to 64 to come and have blood samples and other measurement taken. This was done to accomplish the second objective of the study, which was to assess the nutritional status based on a survey focused on nutritional intake and to evaluate certain parameters in blood samples. The participants who had blood samples taken had eaten at least an 85 % raw food diet for at least 14 months. A total of 236 people came for blood sampling (which was after all 68.8 %).

The seven-day estimation protocol with 236 predefined foods [Bergmann 1994] reduced the number of participants to just 201. These were all nonsmokers who had never had bowel surgery.

The control group and separate dental studies

The real raw food group that consumed more than 90 % raw food in their diet comprised 73.1 %; the next level was 19.9 %. This study was set up similarly to the Giessen whole foods nutritional study (Vollwert-Ernährungs-Studie, VWK) and contains publications by [Groeneveld 1994], [Hoffmann 1994], and [Aalderink et al. 1994] (Aalderink wrote on the motives for health) [217-66].

Women from the Giessen whole foods nutritional study who ate a diet of both cooked and raw foods were used as the control group. Their eating habits as recorded in the nutrition log became the focus of a separate study [Szyperski 1996]. The nutritional intake was determined based on the German Nutrient Database (Bundeslebensmittelschlüssel, BLS) Version II. At the time, this database included more than 11'000 different foods. Using additional data from American, English, Swedish, Danish, and Dutch scientific works, the ingredient information was expanded to include a total of 176 nutrients and ingredients. They only had to make assumptions for a few exotic foods such as the nashi pear (also called Asian pear) and Sharon Fruit (kaki fruit from Israel) [Kroke 1992].

These calculations were made very thoroughly. The study also compared the estimation log of the control group with 72 other participants and with a weight log [Theurer 1996]. BMIs (body mass index) were measured precisely, and using the bioelectrical impedance analysis the proportion of lean and fat mass (divided into body cell mass, BCM, and extracellular mass, ECM) [Straw 1995] was also determined.

Redaction comment

Waist circumference, which is a better indicator of health problems, was not taken into consideration. At the time, it was not yet a standard measurement.

In my opinion, waist circumference should be measured after you have inhaled completely and stuck out your stomach (abdomen). Then measure again after you have exhaled completely and vigorously sucked in your stomach. Visceral fat can’t be displaced as easily as, for example, gasses in your intestines and intestinal contents. The first measurement and the difference between the two would be my parameters.

A detailed analysis of separate dental studies on 129 participants who had a very high proportion of raw food in their diet and mostly consumed fruit was published separately by the team because they suspected that the acidity in fruit attacks the enamel of the teeth [Schlechtriemen 1998].

A joint work by Dr. J. Diehl and Professor M.-L. Moeller (Med. Psych., Univ. Frankfurt) was based on the psychological questionnaire they developed, which 572 participants received. The response rate was 76.1%. The results are found in [Stork 1994], [Wilbert 1995], [Bettinger 1995], [Lehmann 1995], and [Kröner 1995].

The goal was to obtain an overview of any abnormalities in the psychological profile or any health concerns the participants might have. A control group of roughly the same number of people who didn’t follow any one particular type of diet served as a comparison.

2.3. Findings of the study

Of the 201 participants, 53 % were female and 47 % male. Initially, 60 % of the participants were women, who often did not actually follow a “strict” raw food diet. Interestingly, in the 25 to 34-year-old and 35 to 44-year-old groups, there were 23 % more men than women. The two older groups had more women.

Overall, the educational level of the participants is remarkably high, whereby the male participants have a higher level of education than the female participants.

42.8% had earned a university degree, and only 3.5% were unemployed and 4% retired. The monthly per capita income of the participants shows that the majority are among the higher-earning.

78.4 % had been on a raw diet for less than five years. Only five individuals (2.5 %) had been eating a raw food diet for 15 or more years. On average, the study participants had been on a raw food diet for 3.5 years; the longest period was 38 years [217-75ff].

This shows that a large number of the participants were actually just beginning to “get into” raw food and were still experimenting with it.

2.3.1. Protein in your diet

Since protein, or actually the amino acid composition, is considered the most important indicator of a person’s health, the first topic covered is adequate protein intake.

After a brief overview of the types of raw food diets propagated by authors from Ehret, Bircher-Benner, Waerland, Gerson, Sommer, Kollath, Evers, Bruker, and Schnitzer to Wandmaker, Burger and other German and foreign raw food authors, readers are provided with a wealth of information (and also a lack of information) about current findings on protein.

Collage of own photos of 5 dishes with raw natural food with explanatory text.© CC-by-sa 2.0, Collage Catalina Sparleanu, PhD, Foundation Diet and Health Switzerland

Some of these nuts and seeds contain a lot of protein, while others have different benefits, for example, flaxseed is the world's best source of omega-3 fatty acids.

In actual fact, science knows far too little about proteins. These high molecular weight condensates of amino acids, with more than 50% dry matter, are involved in building tissue and in the processes of active ingredients (enzymes and hormones).

Most of the 20 amino acids (there are more than 100 in nature) that the human body needs as building blocks for proteins are produced by the body itself. Some of these are essential (essential amino acids).

The essential amino acids considered to be possibly lacking in a vegetarian / vegan diet

However, science is not certain as to which amino acids are really essential amino acids, meaning they cannot be made by the body and must be consumed in food. Recent studies show that intestinal bacteria contribute as well.

The essential amino acids that are considered to be possibly lacking in a vegetarian diet include only leucine, lysine, and threonine and in a vegan diet also methionine and cysteine as long as the caloric values are within the correct levels. Children also need arginine.

Grains are the main source of protein for humans worldwide [Young and Pellett 1985]. In developing countries, plant-based foods are the primary source of dietary protein and often the only source [Bodwell 1979].

Apart from animal-based products that are rich in protein, other foods such as algae (e.g., chlorella, and spirulina), yeasts, and protozoa also contain a lot of protein [Belitz 1993b].

Nitrogen content is considered the yardstick for protein. Milk contains 17%, but nuts, for example, provide 19%.

Heating foods denatures proteins and causes a partial or complete loss of enzymatic activity or changes in functional behavior [217-18].

Fruits and vegetables are often blanched prior to freezing in order to inactivate enzymes such as lipases, lipoxygenases, proteases (peptidase), polyphenol oxidases, and glycohydrolases so that the taste, color, and texture don’t change.

On that note: A number of enzymes in foods are toxic or can produce toxic products if they stay active [Andrews in 1993].

Lysine, in particular, is lost at a rapid rate as a result of the Maillard reaction with carbohydrates.

The Maillard reaction

The author discusses the Maillard reaction by beginning with the following commnet: The result is a loss of sugars and amino acids, the formation of harmful substances that are anti-nutritive or toxic, and appetizing aromas. Dairy products that contain a large amount of lactose and thermolabile proteins are particularly sensitive, she adds and also calls attention to the mutagenicity (mutagen) of Maillard molecules [217-20].

In addition, the author states, Under severe heat, dietary protein may become resistant to digestion ... When protein-rich foods are cooked, heterocyclic amines form, which were shown to be carcinogenic in vitro mutagen and animals ... In one study, fruits and vegetables were found to be strong factors active in the inhibition of mutagenic pyrolysis products of amino acids in 11 of 59 tested food groups [Morita et al., 1979].

Raw foodists are often interested in issues such as the following, which I address in another article:

There are still large gaps in knowledge about the health benefits/implications of the many compounds found in natural, cooked, and processed foods [Gray and Morfton 1981]. The thousands of naturally occurring mutagenic substances in vegetables, fruits, spices, and the like are often not given sufficient attention. The same is the case with carcinogenic and cancer-inhibiting substances [Jallut 1989].

According to [Mauron 1985], it is best to minimize such products in your diet. Mauron is obviously referring to the products that have predominantly negative effects [217-21].

2.3.2. Our protein and energy requirements

Recommendations concerning protein and energy have changed greatly and also multiple times in recent decades. This is because earlier recommendations were based on assertions that “good protein” is only found in animal products.

No understanding of the fact that humans can get enough protein without eating animal products

This is why we find long quotations such as the following which show no understanding of the fact that humans can get enough protein without eating animal products [217-22].

Although the German Nutrition Society, along with the Scientific Committee on Food (SCF), uses the guidelines provided by the FAO/WHO/UNU of 0.75 g/kg/d, it believes a further increase of 0.05 g/kg/d would be appropriate as the digestibility of the reference protein is between 90 to 95% [Nutritional Requirements Committee, German Nutrition Society, 1995a, 1995b]. [UNU stands for United Nations University].

In Europe alone, there are a number of different recommendations for protein intake. For example, France recommends 81 g/d for adult men, the Netherlands recommends 70 g/d, and Spain recommends 54 g/d [Bender 1993a].

The SCF, which is part of the Commission of the European Communities [CEC 1993 p. 1f]) distinguishes between three recommendations as follows. The Lowest Threshold Intake (LTI) amounts to 0.45 g protein/kg of body weight; under this level it is likely that the majority of individuals would not be able to maintain their metabolic integrity.

The Average Mean Population Requirement (AR) is the average for normal distribution of the protein recommendations; this is 0.60 g protein/kg of body weight. The recommendation that would cover the needs of nearly all healthy people in a group is the Population Reference Intake. This recommendation is 0.75 g protein/kg of body weight.

These recommendations are made under the assumption that the requirements for energy and all other nutrients are met.

For some time now, studies have shown that we can be healthy eating a pure plant-based diet. Entire populations that have eaten a strict vegetarian diet for numerous generations are also proof of this. Just think of Jainism, a religion that has existed for more than two and a half thousand years.

Nevertheless, it wasn’t until about 1996 that the scientific community finally recognized this fact — although the majority of individuals still didn’t accept it. This is natural. It is very rare that a professor would recant and adopt a new view. In this case, attack is the best defense.

Protein intake is very controversial

Healthy adults can get the protein they need from plant sources alone [1990 Menden pp.14f, ADA 1980, Barness 1977].

Protein intake is very controversial: In a 1991 FAO report, it was decided in regard to protein quality that the values for the amino acids requirement from the 1985 report [FAO/WHO/UNU 1985], (based on experiments conducted by [Rose et al.]) would no longer be accepted or considered nutritionally relevant because there had been a number of recognized methodological errors.

The MIT values are again only provisionally valid since according to the IDECG (International Dietary Energy Consultancy Group [Clugston et al., 1996], Young and Scrimshaw are planning to conduct a full meta-analysis of the available data.

It is important to understand that with only a few exceptions almost all dietary proteins are made up of all 20 amino acids, but that these are found in different compositions [Bender 1993b]. It is also important to know that the experimental and biochemical basis of protein requirement values is less well-founded than assumed.

The highly praised combination of an egg and a kilogram of potatoes is no longer valid either. In one study, wheat or rather gluten protein was limited to less than 0.2 g/kg of body weight. The protein consumed was apparently fully metabolized regardless of what type of protein it was, and the biological value of the protein was estimated to be 100 or higher [217-30].

The order in which the essential amino acids are limited seems to depend partly on the amount of total nitrogen supply[Scrimshaw and Young 1978].

A raw food desert from "The Raw Gourmet" by Nomi Shannon. Photo: Edmond Fong.© CC-by-sa 2.0, Edmond Fong / Nomi Shannon

A protein and vitamin-rich raw dessert.

Such a treat should be the exception, but I highly recommend these natural, unprocessed ingredients (e.g., nuts and almonds).

Nuts can help you regulate your weight and almonds, in particular, are important to eat on a daily basis as they contain iron and various B vitamins.

The main ingredient in this dessert called “Very Carrot Cake” is the carrot pulp, which was left over after making carrot juice.

I have named the following three subtitles to show how false scientific findings can cause harm and misunderstanding for decades. With the exception of my comments, the information in these sections comes from the book.

2.3.3. The myths about plant protein

When you explain what a person on a strict raw food diet (perhaps even vegan) eats, people always have doubts as to whether such a diet is even possible at all — and physicians are no exception.

But there are many dangers that you must watch out for as another chapter of my paper shows. However, the “myths” about not being able to get enough protein if you eat “only” plant protein were disproved by Young and Pellet [Young and Pellet 1994].

Myths Today, we know that the following is true:
Plant protein is not a complete protein; it lacks specific amino acids. Plant protein is a complete protein, but specific types of plant protein can have low levels of certain amino acids.
Plant protein is not as ’good’ as animal protein. The quality depends on the source and dietary composition of the plant protein. It can be equivalent to high-quality animal protein.
Protein from different plant-based foods must be consumed simultaneously during a meal in order to achieve a high nutritional value. Different sources of plant protein do not have to be consumed together; it is more important to keep a good balance throughout the day.

I don’t want to quote all of the myths, but only want to point out that the myth that plant-based protein is more difficult to digest is obsolete as is the myth that eating only plant-based protein is not adequate. My comment: A vegan diet is now considered to be a good option ... (p. 31)

Nitrogen balance

[Crim and Munro 1994] state that when protein intake is low, the improvement of the nitrogen balance is proportional to the amount of additional protein. But when protein intake increases, metabolism becomes less efficient.

About 1 to 1.5 hours after oral administration, marked proteins can be detected as amino acids in serum.

The labile protein pool is sufficient for almost an entire day, and available protein can be used for another 6 to 8 weeks before loss of functional tissue takes place [Gassmann and Kübler 1994].

Experiments suggest that 250 to 300 grams of protein are synthesized daily by the adult body. Approximately 70 g of protein are secreted daily in the intestinal lumen.

In addition, a large number of amino acids are recycled as part of protein metabolism. Even with an intake of less than 30 cal/kg and nitrogen consumption below 50 mg/kg, both are efficient enough to improve the nitrogen balance [217-40].

Something that few people know: Normally one-third of the urea produced travels to the intestines and can be hydrolyzed by intestinal bacteria. This makes urea-nitrogen available for metabolic interactions, but the necessary carbon skeletons can be a limiting factor.

Another thesis not yet definitively proven is that the bacteria in the intestines fix nitrogen [Koishi, 1990, Tanaka et al., 1980].

According to [Düro and Schnur 1989], 5 g of nitrogen per day results in a good nitrogen balance in adults, and the intake of carbohydrates improves protein utilization. If food intake is reduced, the body reduces the excretion of urea.

According to [Acosta 1988], diets high in fiber are more likely to result in weight loss in obese men than are diets that restrict calories.

2.3.4. Too much animal protein

If you think that a raw food diet has to be a vegan or vegetarian diet, you are mistaken.
All edible raw foods qualify as raw food. Whether foods are not processed or undergo minimal or intensive processing is yet another topic. In general, I have not eaten meat since 1978, but every now and again I do have some sashimi.

Plate of sashimi: raw fish and raw vegetables. Tuna, Cuttlefish and Seabream.© CC-by-sa 3.0, Suguri_F, Wikipedia
Sashimi is raw fish and raw vegetables prepared in a Japanese style. My wife and I always look forward to this dish as it is a delicacy that we only eat on the rare occasion. Apart from this, we prefer not to eat any animal products as we have environmental concerns.

In Western countries, at 90 g/day the average protein intake is significantly higher than the recommended value. This causes excessive production of urea and abnormally high renal function. And it can also lead to increased kidney weight and renal impairment [Menden 1983].

Osteoporosis, cardiovascular diseases, gout, certains forms of cancer and stroke

A higher protein intake causes more calcium to be excreted in the urine, which promotes osteoporosis [Anon 1981]. But if your phosphorus intake is also higher than normal, this effect is lessened.

Consuming a large amount of animal protein is more likely to lead to cardiovascular diseases [Leitzmann and Hahn 1996a p.103] and promote high blood pressure (also called arterial hypertension) — both of which can have severe consequences.

The study [Gelfand and Sherwin 1986] indicates that fructose has little direct impact on "insulinsecretion", but that it has a noticeable protein-sparing action. It is a known fact that consuming high levels of animal protein increases the risk of gout, but fewer people know that there is also a strong correlation between the consumption of animal protein and specific cancers such as colon and breast cancer, and possibly pancreatic and prostate cancer [National Research Council in 1990 S.259f] [217-46].

It is undisputed that excessive consumption of animal protein over a long period of time increases the risk of strokes. According to [Flanigan et al., 1995], consuming less dietary protein and according to [Barsotti et al., 1991a, 1991b, 1990], eating a vegan diet decreases uraemic symptoms.

2.3.5. And the opposite?

On malnutrition: A longer period of malnutrition associated with weight loss in normal test subjects causes increased fatigue, muscular weakness, and decreased motor activity. In contrast, patients with anorexia nervosa (anorexia) show more activity up to excessive activity although they have a reduced energy supply.

Protein-energy malnutrition (PEM), also known as kwashiorkor or marasmus, is often accompanied by infections and a lack of vitamins, minerals, and/or trace elements. When sodium levels are elevated, deficiencies in potassium, magnesium, and vitamin A occur, and the immune system is compromised. [217-48].

Protein-energy malnutrition and chronic energy deficiency

In kwashiorkor (probably potassium deficiency [Golden et al., 1982a]) the most important characteristic is edema, whereas in marasmus it is muscle atrophy and loss of subcutaneous tissue.

CED stands for chronic energy deficiency and is the most widespread type of malnutrition. Three decades of research on the effects of CED in connection with behavioral development have brought no conclusive results [Pollitt]. For growing children, medicine distinguishes between two distinct reactions in malnourishment:

  • Type I nutrients are minerals and vitamins that are responsible for specific functions and produce specific nutritional deficiencies; the diagnosis is clear.
  • Type II nutrients are electrolytes and other minerals (potassium, sodium, magnesium, zinc, and phosphorus) as well as protein and energy that result in no characteristic signs or symptoms when lacking.

2.4. Food intake

In the test group, 27.3 % were vegan raw foodists who ate a diet free of any animal-based foods (apart from honey). Vegetarians (lacto-vegetarians, ovo-vegetarians, and lacto-ovo vegetarians) made up 44.8 % of the test group, and omnivore raw foodists, who also ate meat and/or fish accounted for 27.9 %. Consumption of fish and seafood was almost entirely in raw form, and for the women of the group it was actually 100 % in raw form [217-83].

Variations in the diet type and the proportion or raw food

After all, 73.1 % of the participants ate an almost pure raw food diet (at least 90 %), and the next group (19.9 %) ate more than 80 % of their food raw. The group of those who ate 90 to 99.9 % raw foods included 81.9 % men and only 65.4 % women.

It is striking that 35.1 % of the men and only 20.6 % of the women adhered to a strict vegan diet. However, in contrast, 30.9 % of the men were omnivores (eating animals and plants), but only 25.2 % of the women were in this group. Variations in the diet type and the proportion or raw food taken together show an even wider range of differences [217-77ff].

With regard to their professional career, more of the female raw foodists are fully employed than the female vegetarians or omnivores.

When compared with either women who ate whole foods or female omnivores, women on a raw food diet did not exercise more.

They are far behind on average (about one-third) but achieve more than double the results if they are very active in sports. With male raw foodists, 20.9 % rarely or never exercise, but 52.3 % exercise a lot.

A weak point for the raw foodists group is certainly the high percentage of people who don’t exercise at all.

Only 6.5 % of the women on a raw food diet took sex hormones as compared with 16.9 % of the vegetarians and 38.3 % of the omnivores [217-81]. According to the main questionnaire, 68.7 % of the raw foodists did not take any medications or supplements.

Conventional medicine and the pharma industry make people believe that their special diet is deficient

My comment: It’s a shame that medications and supplements were put into the same category as these are taken for two very different reasons.

Conventional medicine and the pharma industry make people believe that their special diet is deficient, and this may be why many raw foodists take supplements — just to be on the safe side. This is in spite of the fact that raw foodists automatically get more of the most advertised vitamins, such as vitamin C, in their diet than people on a “normal” diet or omnivores.

At least the traditional school of thought believes that raw food leads to anemia ...

The participants’ alcohol consumption was quite low. More than half (58.2 %) didn’t drink any alcohol at all, 38.3 % drank up to 15 g of alcohol per day, and only 3.5 % drank more. In contrast, 85 % of the omnivores drank some alcohol every day.

There was an extremely low proportion of smokers in this group of raw foodists. The average raw foodist in the study consumed 2,050 g of plant-based foods and 50 g of animal-based foods on a daily basis.

Animal-based foods, milk, grains, fluids and fruits

In the group of omnivores, the proportion of animal-based foods was higher at 4 %, or about 80 g per day, while for vegans it was 0 %. Overall, the animal-based products can be broken down into 55 % (28 g) milk and dairy products, 20 % meat and meat products, 18 % fish and seafood, 6 % eggs (approximately half an egg a week, preferably raw), and surely about 1 % honey.

The participants preffered to drink milk, about 5.5 g per day, as raw milk. The people examined as part of this study ate an average of 1'423 g of fruit, 489 g of vegetables, and 48 g of nuts and seeds, which adds up to 1'960 g. In addition, they consumed 7.6 g of cooking oils and 15 g of potatoes, of which 3.2 g were raw.

Specially prepared foods using recipes from raw food books, for example, by Ann Wigmore made up only about 6.4 g of daily consumption. Grains and processed foods comprised an average of 29 g, bread and baked goods added up to 19 g [217-87]. Soy products accounted for 3 g (also heated) and sweets and desserts came up to 6.7 g. The remaining 3.3 % of the 2'050 g fell into the miscellaneous category.

The vegetarian and vegan raw foodists ate a diet of 98 % raw foods, and at 13 mL the vegan raw foodists also had the lowest alcohol consumption.

The fact that the vegetarian raw foodists ate even fewer nuts and seeds than the “omnivores” (40 g) is actually surprising and does not say much about their knowledge of nutrition and dietary needs.

The female participants consumed 1'065 mL of fluids per day, whereas the male participants were only at 834 mL per day. Both groups easily met the fluid intake of 2.1 liters recommended by the German Nutrition Society (Deutsche Gesellschaft für Ernährung, DGE), but in a different way because 200 mg of electrolyzed water (from burning essential nutrients) plus the water intake from the plant-based foods were also available to the body. As a result, the total amount of liquids came to 2'536 mL since an average of 1'615 mL came from solid foods.

The following statement is found in the study: Overall, they seem to achieve the overall recommendation even without the electrolyzed water as they consume a large amount of water-containing foods [217–87]. And before that: This doesn’t seem to be a problem for the participants in the raw food study since they primarily eat water-containing foods.

The fact that the raw foodists consumed nine times less bread and baked goods as well as less milk and dairy products and significantly fewer sweets than those who ate whole foods or a “normal” diet was to be expected.

Consumption of meat and meat products was only 10 % of that what people on a “normal” diet ate. About half of the subjects refrained from eating grains completely.

Since fruits comprised the highest proportion, this category was divided into six groups: berries (63 g), drupes or stone fruits (14 g), pome fruits (331 g), wild fruits (0.1 g), citrus fruits (341 g), and tropical fruits (587 g not including citrus).

The consumption of wild fruits was quite insignificant, whereas tropical fruits were eaten in the greatest quantities, followed by citrus fruits and pome fruits. It is not surprising that apples (267 g), oranges (263 g), and bananas (228 g) were the fruits most commonly consumed.

This is followed by avocados with 90 g, pears at 63 g, pineapple at 54 g, and grapes at 50 g. Dried fruit comprised only 88 g despite the fact that the survey was conducted at a time of year when fewer fresh fruits were available. Of this, tropical fruits had the lion’s share with 76 g. Dried dates were listed separately at 49 g.

Several other individual fruits were worth mentioning as they accounted for at least 45 grams per day. These included cherimoyas, grapefruit, honey melons, persimmons, kiwis, tangerines, mangos, and papayas. Sharon fruits, watermelons, and dried figs came to more than 10 g.

But we can expect these values to change in the summer when more local and inexpensive fruits are available — there is simply less fruit offered between the months of February and April when many varieties are out of season.

Book cover "Rohkost - schmackhafte Gerichte für die gesunde Ernährung".© CC-by-sa 2.0, Foto Ernst Erb, Foundation Diet Health
This was most likely my second raw food recipe book from 1978. At least beginning in 1980 when I lived in Tenerife, I used the fruits and vegetables grown in my own garden. I prepared them quite simply by washing them briefly and sometimes chopping or slicing them before eating.

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