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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


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

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

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

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

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 control group and separate dental studies

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

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

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

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

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

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

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

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

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

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
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.

Kitchen work wasn’t necessary. If anything, I had to do some work with my bees.

There are very good vintage bookstores, thrift stores, and the like. You can often get raw food books like this for no more than a dollar, and they are still highly relevant today.

2.4.1. Nutrient intake

Conclusion: According to the exaggerated values set by the German Nutrition Society, vegans with a high proportion of raw food in their diet would achieve all of the recommended values except for the following: vitamins D, B2,and B12, as well as the minerals calcium, zinc, and iodine.

The overall nutrient intake

If we disregard the most commonly discussed issue of protein, conventional science refers to these as the critical substances in nutrient intake. This is not usually a problem if vegan raw foodists make sure they have a varied diet and maintain a balanced calorie intake. In the ideal case, we should aim for our ideal biological weight which is 10 % below our normal weight. This can easily be achieved by eating nuts and seeds.

Here are some examples of possibilities for a cumulative report and a few comments.

Vitamin D
Vitamin B2, Riboflavin
Vitamin B12
Cover of "Raw Food Made Easy" by Jennifer Cronbleet, 2005.© CC-by-sa 2.0, Foto Ernst Erb, Foundation Diet Health
In the United States, a country of great contrasts, there is a particularly wide selection of raw food books, and also raw food restaurants, some of which are even vegan raw food restaurants. You can find these even in small towns like Durango, Colorado. The raw food restaurants in New York City or other large cities, however, offer sophisticated gourmet raw food dishes.

I haven’t found as many in Europe. But I would love to make a list of raw food restaurants here. If you know of any, please send me the name and relevant information. You can use the form provided at the end of this article. Thank you.

2.5. Energy balance, body weight, and the like

The study shows an average daily energy intake of 1'976 cal or 8.3 MJ per day, for men specifically 9.0 MJ (megajoules) and for women 7.4 MJ. The vegan raw foodists got up to an average of 7.9 MJ. This means that 57 % of participants did not achieve the values recommended by the German Nutrition Society of 10 MJ for men and 9 MJ for women.

However, the author goes on to say: A group of five rheumatic patients who ate a vegan diet for three months had a dietary energy intake of 8.0 plus/minus 1.7 MJ per day, which was significantly higher (p > 0.001) than with their normal diet.

... Another group of subjects who followed the Living Food Diet for either a week or a month had a higher average dietary energy supply (8.0 MJ/d) than the control group (7.7 MJ/d) that had followed a normal Western mixed diet [Hänninen et al., 1992, Peltonen et al., 1992].

Vegetarian or vegan raw foodists and vegans do not always achieve the recommendations

At least the author came to the following conclusion through an enumeration and rough comparison of the many different diets, for example, the Lifestyle Heart Study:

It is remarkable that out of all the various (alternative) types of diet, the recommended nutrient intake is most often achieved with a raw food diet [217-112].

Body weight

Studies involving people with high blood pressure (essential hypertension) clearly show how eating a raw food diet results in important and significant weight loss. Diets high in fiber are more likely to bring about weight loss in obese men than are calorie-restricted diets [Acosta 1988].

An important finding: None of the raw food groups have body weights so low as to be comparable to people who have anorexia nervosa.


A group of women who had been on the vegan Living Food Diet for 0.7 to 14 years had an average BMI of 21 plus/minus 3 kg/m2 [Rauma et al., 1995b].

In terms of body composition, (in other words the ratio of extracellular mass (ECM) to body cell mass without fat mass (BCM)), lean body mass is relatively high because 44.9 % have an ECM/BCM ratio of below 1.0.

The total body water and the basal metabolic rate

The median protein intake of the participants was a total of 41 g (46 g for men, 39 g for women). Only 27 % of the vegetarians and vegan raw foodists reached the values set by the German Nutrition Society, which are clearly “industry-friendly” and too high. See more recent literature such as the China Study. You can also find the book review here. The nutrient density of protein was 5.4 g/MJ for the whole group.

But all groups reached the AR (average mean population requirement) of the Commission of the European Communities, Brussels (CEC) of 0.60 g protein/kg of body weight(!).

Protein intake
Cover of "Exotische Früchte und Gemüse - kennen, zubereiten, geniessen" by Brigitte Kranz© CC-by-sa 2.0, Foto Ernst Erb, Foundation Diet Health

I already had this cookbook when I lived in Tenerife (1980s). This is not a purely raw food cookbook, but contains a number of raw food recipes.

In other words, the cover photo is deceptive (even if this is not intentional).

I would very much welcome it if you would like to submit a short book review on a raw food cookbook. The selection of used books on the subject of raw food is quite large.

I am particularly interested in books that do not recommend a specific direction. In my mind, these are “factual raw food books” as opposed to sectarian or even esoteric books. The latter often provide advice that doesn’t promote a balanced raw food diet.

Essential amino acids

As far as protein, the mean value of serum albumin was 42 g/L. These values are also within the normal range of 25 to 50 g/L for vegan raw foodists. Transferrin was at 2.89 g/L overall for the test group and within the standard range of 2 to 4 g/L. The mean total level of protein in the blood plasma of the participants was 72 g/L and therefore within the reference range of 65 to 82 g/L.

The uric acid levels

The study then concludes:

As all participants have serum creatinine levels in the reference range (0.7 to 1.3 mg/dL for men and 0.6 to 1.2 for women), it can be assumed that renal function is intact.

Aflatoxins were discussed as a factor in the etiology of kwashiorkor, that is PEM (protein-energy malnutrition), as these occur at higher levels in nuts. Menstruating women may miss their period, but this is more likely to be observed in undernourished / anorexia nervosa patients — the explanation here is a bit vague [217-156].

The following is from the final conclusion. That pretty much says it all ...

The Giessen Raw Food study is a cross-sectional study that measures prevalence instead of incidence. It is therefore difficult to establish a relationship between a raw food diet (exposure) and deficiencies (outcome) or to interpret such a relationship.

Cover of "Rohkost - die lebendige Nahrung" by former gourmet chef, Urs Hochstrasser, Switzerland.© CC-by-sa 2.0, Photo Ernst Erb, Foundation Diet Health

A former gourmet chef, Urs Hochstrasser, from the School of Life in Flüeli-Ranft, Switzerland, provides readers with guidelines and tips for eating a raw food diet. He also gives courses.

For religious reasons, he is very much against eating meat. He has an interest in Kirlian photography and includes numerous recipes that incorporate sprouting and sprouts.

2.6. My closing remarks

This study is a very comprehensive work that took much time and effort to conduct and for which numerous assistants were required. The publication is for scientific purposes only and is not intended for laypeople. This explains why the study consists largely of a series of data and statistics from other studies, reference statistics, and comparisons. For this reason, it would have actually been nice if the book had an index.

It is good that this certainly valuable study was able to reach its intended audience. But at the latest at this point, this very in-depth analysis should have been supported by a synthesis.

The study examines and discusses individual parameters quite comprehensively and accurately in as far as they relate to nutrition and human metabolism. But unfortunately there are a lot of quotations from an overwhelming number of scientific works and only brief statements to introduce and/or explain these.


Readers therefore learn how science assesses a person’s nutritional condition. The study compares the health of raw foodists with that of people on a “normal” diet. It does so without taking into consideration the fact that when a person is on a raw food diet their body works “very differently,” in particular, because of the low amount of animal protein they consume.

For raw foodists, actual consumption of the “essential molecules" (those not made by the body) is several times greater and the “usage” of these is significantly lower.

The official values are actually based on unnaturally low absorption (or resorption) and usage of nutrients as is the case for people on a “normal” diet, and they also include high safety margins.

Many comparisons were conducted between these groups in regard to certain parameters; however, what was not taken into consideration was whether the individuals were healthier, more alert, or more energetic or whether they would live longer, how they felt, or how their bodies truly functioned.

On the contrary, the similar slim appearance and partly similar internal structure of the vegan raw foodists resulted in superficial comparisons with people from Sierra Leone and Ecuador [217-105]. This reminds me of conditions in the Sahel region.

For raw foodists, this practically constitutes an insult rather than being in any way helpful

But readers will also find some positive comments such as A number of people reported positive experiences eating a raw food diet. The immediate response was, Well, for people who previously ate a rather typical “Western” diet, that is really not surprising [217-160].

Now, why is this not surprising? It should actually be quite surprising that the study compares raw foodists with PEM or anorexia nervosa (anorexia) or with people from Sierra Leone, even if the following sentence states:

Eating a high proportion of unheated foods CAN very well have a beneficial effect. Fresh food provides many nutritional benefits. This includes a high concentration of essential nutrients, especially the partially heat-labile or volatile oxygen-sensitive phytonutrients.

And another positive finding: Chewing well and salivation also have a positive effect on our gums and digestion. And another benefit is that very few (essential) amino acids are lost as a result of heat damage, the Maillard reaction, and other processes.

However, the presence of protease inhibitors is a clear disadvantage as these can cause damage to endogenous protein and other substances and can only be inactivated by heat or processing [217-161].

Photo from cover of "The Hippocrates Diet and Health Program", Ann Wigmore, 1984, USA.© CC-by-sa 2.0, Photo Ernst Erb, Foundation Diet Health
Ann Wigmore (1909–1994) is the best-known proponent of a pure vegan raw food diet. As a very active woman, she died at age 85 of smoke inhalation from a fire at the Ann Wigmore Foundation. She is known primarily for her wheatgrass and barley grass drinks. Today, these often just come under the category of green smoothies.

But we as “consumers” tend to forget that a study is allowed to be biased in its investigations and reports, instead of helping those who are paying for it — namely, consumers and taxpayers.

It would have been very useful if the study would have provided advice for the “risk groups.” Even with a vegan raw food diet, it’s easy to rule out possible malnutrition.

Unfortunately I must admit that with raw food diets in particular there are numerous obscure views that can eventually lead to malnutrition.

For every type of diet, you can find people who have physical or mental disorders and therefore do not benefit from their nutrition or — more commonly — practice really senseless diets, which then naturally also get included in the statistics.

What would have also been positive to be discussed in this book

Fortunately, however, one thing that you will not find in this study, for example, is that the bioavailability of some substances in a purely vegan diet is very limited, without stating at the same time that there is a far greater occurrence of these nutrients in vegan foods.

Oversupply of beta carotene

But it always amazes practicing and aware raw foodists how young people in the medical field are often convinced by clichés and practice selective perception. They don’t consider the fact that a disease may have been the reason that a person changed their diet in the first place.

They are not able to recognize the fact that nature itself made sure that this diet — which is not always accepted by the medical community — produces people who don’t stand out for being overweight but instead for their athletic achievements or other activities. Numerous prominent vegetarians have shown us this. For example:

These are all vegetarians. You can also see this long list of celebrity vegans.

Some do not realize that humans have “grown” from their diet for millions of years, just like other living creatures. People will dissect and blindly trust statistics that they didn’t falsify themselves rather than life itself.

I know that such a work requires a special degree of meticulousness, accuracy, and diligence, and this work here has been done extremely well in many ways. However, as a book (available on it should also take holistic aspects into account, especially when the questionnaire asked the participants specifically about these aspects. But I guess this would have been the opposition to the clear purpose of the study.

References, which would likely leave inexperienced readers confused and overwhelmed

The study therefore comes from the “right institution,” and it provides detailed information for nutritionists and even for laypeople. At the beginning, it gives factual and balanced information, including the latest findings in the field of nutrition. However, in terms of occurrence and implications, it comes to biased conclusions.

The verdict made is mild but “black and white” instead of differentiated and balanced.

It seems as though a number of positive findings from the study did not find their way into this book or weren’t permitted to.

3. About the book

Title Is a Raw Food Diet Healthier?
Subtitle The Giessen Raw Food Study
Author Carola Strassner
Publisher Verlag für Medizin und Gesundheit
Publication 1998
Pages 243
ISBN 3-932977-04-1
Note Only available in German. Ms. Strassner is now Prof. Dr. oec.troph., MBA. [217-??] = internal. book no. (oec. troph. = nutrition specialist)


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