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  • Gazi University Faculty of Health Science


Raw Food
“RAW FOOD” Assoc. Prof. Leyla OZGEN
Nutrition is choosing the right nutrients a cell requires in order to
supply energy to the cell. Cells that fulfill their energy need function
properly. However, free radicals are created as the body generates
energy. Free radicals are also called acids. These cells congregate as
acidification increases in the body, leading to various diseases
(Çoruhlu, 2013). An alkaline diet means eating raw food, i.e. a raw
food diet, as much as possible. Raw food is a philosophy of life
rather than a type of diet. Raw food is characterized as a subset of the
vegan diet. Vegans do not eat animal foods including honey, milk,
eggs, yogurt and kefir or wear animal products such as wool, silk and
leather. On the other hand, vegetarianism is the practice of
consuming mainly plant-based foods while eating a limited amount
of, or abstaining from the consumption of, animal-source foods
(Karabudak, 2008; Yıldırım 2013; Pilis et al. 2014; Çetin 2014;
Vegetarian Society 2016 Turkish Vegans and Vegetarians Association
2015; Kınıkoğlu 2015; Türkmen 2015).
This chapter seeks to provide information on the definition and
historical development of raw food, heavy metals in vegetables, the
importance of enzymes in raw food, the effect of heating in raw food,
prebiotics, vitamin B12, minerals and sugar. In addition, this chapter
also features information on how long a practitioner can observe a
raw food diet from a health perspective.
Definition and Historical Development of Raw Food
Raw food diets are based on the consumption of raw fruits,
vegetables, nuts, seeds, sprouted grains and legumes (Bavcon Kralj
et al., 2017). Raw food diets are classified in two groups. One group
abstains from meat consumption while the other group eats a limited
amount of meat. However, those who eat meat only prefer fish
(Boutenko et al., 2012). Raw food is a term used for unheated food
or food cooked to a temperature of less than 460C. Russo (2008)
defines raw food as food heated up to 430C. Furthermore, Çoruhlu
(2013) asserts that higher body alkalinity (lower acidity) leads to a
stronger immune system as vitamins and minerals in raw food
regulate blood pH.
Food humans prepared before the discovery of fire is the inception of
the raw food diet. In fact, raw food dates back to Ancient Greece.
Many famous historical mathematicians, philosophers and priests are
reported to observe vegan and raw food diets (Cunningham, 2004;
Havala Hoobs, 2010). Hippocrates, one of the most prominent
figures in medicine, believed that raw food was the best medicine,
promoting longer life, increased resistance to illness, health and
fitness (Casupei and Kaupert, 2011).casupei Another study reported
that Sylvester Graham, the pioneer of vegetarianism in the mid-19th
Century, recommended eating more raw food for mental health
(Cunningham, 2004). A raw food diet helps to prevent and cure
various diseases, as well as, achieve better health with sufficient and
balanced consumption. Although raw food is currently regarded as a
trend in the literature, it seems that the raw food diet will persist in
the near future (Havala Hobbs 2005, 2010; Bavcon Kralj et al.,
Research on raw food indicates thath powerful antioxidants in raw
food such as phenolics, carotenoids, polyphenols and vitamin C and
E foster a stronger immune system and reduces the risk of
cardiovascular diseases, colon-rectum cancer, respiratory failure,
cataract, obesity, type-2 diabetes and Alzheimer’s disease (Temple,
2000; Key et al., 2004; Tümgör, 2013; Hunsaker and Jensen, 2017).
In addition to the vitamins, carotenoids and phenolics, the
glucosinolates in raw food, particularly crucifers, contribute to their
antioxidative properties. However, the antioxidative effects of
glucosinolates differ from those of carotenes and vitamin C and E.
Glucosinolates directly inhibit free radicals and prevent cell damage
(Kusznierewicz et al., 2008; Vig et al., 2009). However, other studies
report mycotoxins as the first group and oxalates as the second group
that impact health in the raw food diet (Holmes and Assimos, 2004;
Getting et al., 2013; Bavcon Kralj et al., 2017). High amount of raw
food consumption increases the possibility of oxalate and aflatoxin
intake, and nuts and dried food products contain mycotoxins (Afsah-
Hejri et al., 2011; Wu et al., 2016). Oxalates are salts of oxalic acids,
a basic component of fruits and vegetables. Excessive formation of
calcium oxalate stones in kidneys, in which dietary and genetic
factors might be influential, leads to renal insufficiency (Holmes and
Assimos, 2004). Research indicates that prolonged practice of raw
food or vegetarian diets based on the consumption of fruits and
vegetables rich in oxalate increases oxalate intake, leading to serious
health problems; however, cooking raw vegetables reduces the
amount of oxalate (Bavcon Kralj et al., 2017). Another study found
that a raw food diet increased the risk of dental erosion and that a
10% erosion of dental enamel was observed after extended practice
(Ganss et al., 1999; Atila and Eden, 2012). Particularly strawberry
yogurt and acidic drinks like orange juice was reported to increase
dental erosion (Sarı et al., 2010). Other studies revealed that raw
foodists ate vegetables, organic and/or natural foods, cranberries, sea
vegetables and drank vegetable juice and wheatgrass juice due to
their alkaline nutrient content, and consumed calcium, iron,
magnesium, zinc, selenium and manganese for their health benefits
(Mitchell, 2012; Boutenko et al., 2012).
Heavy Metals in Vegetables
Whether or not an essential element for plant growth, excessive
accumulation of heavy metals in tissues and organs is detrimental to
the development of vegetative and generative organs (Gür et al.,
2004). Heavy metals pollute the air, water and soil and are hazardous
to human, animal and plant health (Öktüren Asri and Sönmez, 2006).
The Codex Alimentarius Commission defines food contaminants as
substances added to food not intentionally but as a result of
production, manufacture, processing, preparation, treatment, packing,
packaging, transport, holding or environmental contamination (CAC,
2011). Consumption of food contaminated with heavy metals can
cause numerous health issues such as various types of cancer, organ
failure, neurological diseases and musculoskeletal disorders,
depending on the degree of accumulation in adipose, bone, etc.
tissues (Sanchez-Castillo et al., 1998; Steenland and Boffetta, 2000;
Järup, 2003; Karalliedde and Brooke, 2012; Pan et al., 2013).
Essentially, metals with a density greater than 5 g/cm3 are referred to
as heavy metals. This group comprises more than 60 metals
including lead, cadmium, chromium, iron, cobalt, copper, nickel,
mercury and zinc. These elements are generally found on earth as
stable compounds in the form of carbonate, silicate and sulfur, or
bonded in silicates (Kahvecioğlu et al., 2006). As vegetables contain
vegetable proteins, vitamins, carbohydrates, iron, calcium and other
nutrients, they are an important food substance (Ivey et al., 2012).
The greater intake of heavy metals in developing countries due to the
greater consumption of vegetable products in comparison to meat
products has caused concern. Various factors including point of sale
and/or storage hygiene, harvesting, industrial emissions and
contamination of irrigation water lead to heavy metal contamination
in vegetables (Huang et al., 2014). Türkdoğan et al. (2002)
indicated that the consumption of vegetables contaminated with
heavy metals could pose a risk to human health. Another study
reported the presence of various heavy metals at different amounts in
different vegetables (Huang et al., 2014). According to Bi et al.
(2018), rapid urbanization, increased industrialization, particularly
the establishment of factories in close proximity to cities, and
exhaust emissions of vehicles has led to increased food
contamination by heavy metals. Especially the existence of industrial
areas in the vicinity of vegetable fields, fruit trees and residential
areas has caused increased heavy metal intake. The study by
Türkdoğan et al. (2002) associated the higher prevalence of upper
gastrointestinal cancer in the province of Van with the high levels of
heavy metals (Cd, Pb, Cu and Co) in the volcanic soil. Liu et al.
(2013) and Hu et al. (2017) found greater concentrations of heavy
metals in leafy vegetables in comparison to non-leafy vegetables.
Other studies have also emphasized the intake of heavy metals
through the consumption of leafy vegetables (Bağdatlıoğlu et al.,
2010; Bi et al., 2018). Metal-based pesticides, agricultural fertilizers,
storage, harvesting, transportation, industrial waste and irrigation
with wastewater are only a few of the several factors causing heavy
metal contamination in vegetables (Bi et al., 2018). High levels of
arsenic, cadmium, chromium, lead and nickel were detected in
vegetables such as spinach and tomatoes irrigated with water from
industrial areas manufacturing medicine, petrochemical products,
paint and pesticides (Tiwari et al., (2011). Contaminants in the water
used in preparation, processing and packaging after harvesting
negatively impact food safety. Especially unprocessed fresh fruits
and green-leafy vegetables are open to contamination of waterborne
diseases. Furthermore, wash water used at markets and stores to keep
vegetables fresh for the consumer is reported to cause
microbiological contamination (Amponsah-Doku et al., 2010).
Importance of Enzymes in Raw Food Diet
The enzymes in raw food used in gastronomy are biological catalysts
that are conducive to the formation of chemicals in living organisms,
increasing reaction rate and ensuring 100% efficiency without
producing any by-products (Keha and Küfrevioğlu, 2005). Enzymes
are vital to both digestion and regeneration of the body. They help to
regenerate our DNA and RNA while protecting and strengthening the
immune system. Enzymes convert and store energy in the body and
break down fibers. Raw and unprocessed foods naturally contain
higher levels of enzymes, which contributes to physical stamina,
increased energy and good health, while enzymes from raw
vegetables are useful for digestion. Casupei and Kaupert (2011)
noted that the body makes use of 70-90% of the vitamins, minerals
and enzymes in foods in a raw food diet. Numerous types of fruits
and vegetables, grains, sea vegetables, sprouts, seeds, nuts and
wheatgrass are consumed in the raw food diet, which contain the
enzymes necessary for digestion. Enzymes in seeds and nuts are
activated upon contact with water. Enzymes are heat-sensitive and
lose their efficacy with cooking. Therefore, in addition to the
consumption of cooked vegetables at meals, raw vegetables must be
eaten during the day (Çoruhlu, 2013). There are two enzyme groups
with respect to the biological mechanisms in the body: proteases and
lipases. Proteases are an enzyme group critical to maintaining the
best level of health. They help to break down proteins and amino
acids, and eliminate various toxic substances. The elimination of
these toxic substances is critical to burning fat. If the body fails to
eliminate these toxins, it stores them in fat cells to prevent harm to
the body. This is the body’s method of protecting itself from toxins.
Increasing daily consumption of raw fruits and vegetables supplies
the body with a high quantity of protease. Lipases are an enzyme
group that burns fatty acids. Lipases are found in high quantities in
raw foods. As enzymes are destroyed during heating and processing,
consumption of heated foods leads to insufficient lipase intake.
Therefore, consumption of heated foods makes fat catabolism
difficult. Lipases contribute to digestion, absorption and fat burning
(Demirel, 2014).
Heating in Raw Food Diet
It is stated that heating reduces the nutritional value of food and
frying, boiling, grilling or roasting destroys the enzymes in food.
Heating vegetables above 460C denatures enzymes and reduces
vitamin and mineral content by 50-70% (Çoruhlu, 2013). Research
has shown that factors such as storage temperature and time of
vegetables prior to cooking or consumption, as well as, preparation
and cooking method (in water, steam, oil or microwave oven) and
cooking time affect the phenolic compound content and the
antioxidative property of food (Nilsson et al., 2004; Nicoli and
Anese, 1997). Other studies have shown that enzyme efficiency
varied by vegetable type and the method of cooking (e.g. cooking
temperature and time, vegetable-boiling water ratio, size of vegetable
pieces, cookware, cooking with lid open or closed, etc.) (Lombard
and Peffley, 2005; Tudela and Cantos, 2002; Andlauer and Stumpf,
2003; Zhang and Hamazu, 2004; Jeong and Kim, 2004; Lin and
Chang, 2005). The method and time of boiling, vegetable-boiling
water ratio, size of vegetable pieces and stirring of the boiling
medium are generally considered to act on the structural changes that
occur in vegetables and loss of nutritional value during boiling
(Ewald et al., 1999; Tudela and Cantos, 2002; Andlauer and Stumpf,
2003). Another study revealed that frying, roasting, baking and deep
freezing foods containing carbohydrates, such as potato chips, fried
finger potatoes, toasted bread, breakfast cereals and bakery products,
created a known undesirable by-product called acrylamide (Amrein
et al., 2005; Pedreschi et al., 2006). The most important
cancerogenic/mutagenic compounds produced by thermal processing
of food are heterocyclic amines, polycyclic aromatic hydrocarbons,
N-alkaline-N nitrosamine compounds and acrylamide. The study
conducted by the Swedish National Food Agency emphasized the
toxicity of these compounds (Claeys et al., 2005; Güven, 2010).
Researchers have emphasized that heated food samples contained 50
times more ETU (a mutation and cancer causing agent), and some
cooked tomato samples 90 times more ETU, compared to unheated
food and that heating reduced the nutritional value of food and
weakened the immune system (Casupei and Kaupert, 2011).
Vitamin B12
Havala Hobbs (2005) asserted that raw foodist needed to regularly
take only vitamin B12 as food supplement. Vitamin B12 is a vitamin
that is found only in animal source foods. It plays a role in the
formation and maturation of red blood cells and is critical to the
health of the nervous system. Vitamin B12 prevents and cures
pernicious anemia (Işıksoluğu, 1994). Due to its cobalt content, B12 is
also referred to as cobalamin. Vitamin B12 is the generic name for
corrinoid derivatives that exhibit the biological activity of
cyanocobalamin, which is formed through the attachment of the
cyanide group to a cobalt atom. It has derivatives like
hydroxocobalamin and nitrocobalamin. In addition, B12 supplements
taken into the body should contain active forms of B12 such as
adenosylcobalamin, methylcobalamin, cyanocobalamin or
hydroxocobalamin. Vitamin B12 is water- and alcohol-soluble but
ether- and acetone-insoluble (Baysal, 2007).
Minerals are an essential group of nutrients that perform structural
and functional roles for the human body. Although they make up a
very small portion (4%) of the body, they help the formation of body
structure. Each mineral has its particular and complementary
function, and minerals perform their functions together with other
nutrients (Işıksoluğu, 1994; Eroğlu Samur, 2012). As the majority of
the minerals in fruits and vegetables are water-soluble, the greatest
loss of minerals occurs through boiling, but this loss can be reduced
with boiling for a short duration or steaming. In the raw food diet, a
part of gastronomy and health tourism, seaweed, as well as, fruits
and vegetables contain easily absorbable minerals and trace minerals.
Wrack and dulse (Palmaria palmata) are dry seaweeds that live
attached to rock in coastal areas. This seaweed is a delicacy widely
consumed in Northern Atlantic. In Iceland, where it is known as söl,
it is used as dried or fresh in various dishes from soup to stew. It is a
rich source of B group vitamins, fiber and protein. Furthermore, as
the consumption of this plant is healthier than salt consumption, it
can be preferred instead of salt
(, 2018).
Sweet fresh fruits, dried fruits, stevia and agave are used in
sweetening raw foods. In the use of these ingredients in gastronomic
and culinary arts, flavor and harmony can vary and some sweetening
methods may be more suitable for some foods. The absorption rate of
a sweetener into the body varies by the type of sweetener.
Particularly agave nectar and stevia are reported to be better at
balancing blood sugar level (Casupei and Kaupert, 2011).
Raw food is important for public health and preventive health
services in gastronomy and health tourism due to its benefits to
gastronomy and health tourism. Raw food provides the healthy life
people desire, which stresses its significance to gastronomy and
health tourism. However, in view of gastronomy and health tourism,
a raw food diet can lead to a deficiency of some vitamins and
minerals in the long term. Therefore, it is insalubrious to practice a
prolonged raw food diet. The goal of this diet is generally to solve a
health problem, lose weight or eliminate toxins, edema or excess
protein from the body. The raw food diet is a dietary treatment that
healthy individuals can practice periodically from a week to a
maximum of 30 days in the company of a specialist dietitian after
medical examination. Therefore, a mixed diet from the four food
groups should be observed instead of the daily consumption of only
alkaline foods (Bayındır Gümüş and Yardımcı, 2016). However,
practitioners of a raw food diet have a high probability of consuming
high quantities of oxalate and aflatoxin, which causes various serious
health problems. In addition, although particularly vegetables are a
source of vitamins, minerals and antioxidants, the health risk arising
from the high quantity of heavy metal accumulation in leafy
vegetables must not be ignored. Vegetables should be steeped in a
mixture of vinegar and water or liquid bentonite for 10-15 minutes
prior to consumption, especially in gastronomic tourism. Although
individuals also make use of various vacation opportunities in health
tourism, their main goal is to receive a particular health service, for
which they travel to different cities, countries and hotels to receive
various services such as raw food diets and treatments, as well as,
health and wellness services. Thus, raw food affects the travels and
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