The document discusses the raw food diet as a potential intervention for obesity in New York City. It finds that the raw food diet is very restrictive and difficult to adhere to long-term due to its high costs and complex food preparation requirements. While the diet may promote short-term weight loss, it likely exposes dieters to increased risks of foodborne illness and nutritional deficiencies. The document concludes that the raw food diet is not well-suited for widespread implementation in NYC due to its prohibitive costs and challenges for low-income communities most affected by obesity.

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Obesity is major health concern in the USA and worldwide. It is such a problem that it is
often characterized as an epidemic. Obesity is one of the top three global social burdens generated
by human beings with its share of global Gross Domestic Product rivaling the impacts of smoking
and of armed conflict, war, and terrorism (Dobbs et al.). Annually, obesity is responsible for
approximately 5% of all global deaths and has a global economic impact of $2.0 trillion (Dobbs et
al.). Based on current trending, worldwide obesity plus overweight prevalence is on track to grow
from 30% to 41% by 2030 (Dobbs et al.). In the USA, obesity’s burden of disease ranks second
only to the cost of armed conflict and the war on terrorism (Dobbs et al.). Obesity contributes a
higher burden compared to all other health related issues – out-costing smoking, alcoholism, drug
use, and child/maternal undernutrition (Dobbs et al.). Direct US healthcare costs attributable to
obesity is estimated by the CDC as $147 billion annually (Hsu). Additionally, lost worker
productivity due to disability and death attributable to obesity costs the USA $148 billion annually
(Hsu). Obesity-related costs are estimated at more than $11.8 billion annually for New York State
(DiNapoli) (Trogdon et al.). These costs include obesity-related treatment for diseases such as
diabetes, asthma, high cholesterol, hypertension, and arthritis (Trogdon et al.). In New York City,
the percentage of adults reporting a BMI of 30 or more ranges from a low end of 15% in Manhattan
upwards to 28% in Staten Island and 30% in The Bronx (CountyHealthRankingsRoadmaps). This
amounts to approximately 1.55 million obese NYC adults currently
(CountyHealthRankingsRoadmaps). Also noteworthy are the socio-economic variables which
appear concurrently within areas of higher obesity prevalence. Higher percentages of Hispanics,
Non-Hispanic African Americans are noted in The Bronx, Brooklyn, and Queens than New York
State averages (CountyHealthRankingsRoadmaps). These boroughs also report lower levels of

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English language proficiency, high school and college education, and health insurance coverage
along with higher levels of poverty, unemployment, violent crime, children living in single-parent
households, and severe housing problems such overcrowding, high housing costs, and lack of
kitchen or plumbing facilities (CountyHealthRankingsRoadmaps). The NYC Department of
Health and Mental Hygiene has consulted with key community stakeholders throughout the five
boroughs. Obesity has been identified as the number one health priority in The Bronx, Brooklyn,
and Staten Island and within the top three priorities in Manhattan and Queens (Germain et al.).
Obesity has the highest prevalence in the following NYC neighborhoods: The Bronx’s Morrisania
and Crotona, Belmont and East Tremont, Williamsbridge and Baychester, Throgs Neck and Co-
op City, and Manhattan’s East Harlem (Germain et al.). In these neighborhoods obesity prevalence
is between 33% and 35% (Germain et al.).
One intervention to combat obesity is through eating a healthier diet. The balance of this
paper will discuss the Raw Food Diet and its potential efficacy in addressing obesity in New York
City. A raw food diet is comprised of mostly or exclusively eating uncooked and unprocessed plant
foods (UCHealth) (Katz) (Robinson). Additionally, raw food has not been microwaved, irradiated,
genetically engineered, or exposed to pesticides or herbicides (USNews&WorldReport). Some raw
food adherents also advocate for periods of fasting and regular enemas as a means of body
cleansing (Koebnick et al.). Typically, 55-95% of what you eat each day will be uncooked plant-
based foods (Hobbs) (Cunningham). This consists of eating substantial amounts of fresh fruits and
vegetables, sprouts, seeds and nuts (Robinson) (USNews&WorldReport). Grains and dried organic
legumes (e.g. lentils and chickpeas) are also ok if they are eaten uncooked. Other common choices
include cold-pressed extra-virgin olive oil, raw virgin coconut oil, raw coconut butter, along with
herbal tea (USNews&WorldReport). Most individuals following a raw food diet are vegan

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although some do also consume raw milk, sashimi, and raw fish (USNews&WorldReport). A
considerable number of foods are not allowed in a raw food diet. Anything pasteurized, all
processed foods, refined sugars and flours, table salt, and caffeine are off-limits (Robinson)
(USNews&WorldReport). This excludes pasta, baked goods and most store-bought juices, drinks,
and milk. A raw food diet does offer the health benefits of eliminating trans fat and of vastly
reducing the intake of saturated fat, sodium, and sugar (Katz). Many foods are most nutritious
when raw as heat can destroy nutrients such as some water-soluble vitamins, many antioxidants,
and unsaturated fats such as Omega-3s (Katz). A raw food diet also removes the risk inherent in
eating cooked foods: consumption of carcinogenic compounds such as heterocyclic amines and
acrylamide (Katz). However, some foods are more nutritious when cooked. For instance, tomato
sauces cooked in olive oil are more effective in raising blood levels of the carotenoid antioxidant
lycopene than eating raw tomatoes (Katz) (Robinson). Also, cooking is most effective in
eliminating pathogenic bacteria. Consuming unpasteurized milk and other raw foods can increase
the dieter’s exposure to salmonella, E. coli, and other pathogens (Katz) (Robinson) (Cunningham).
Because of the increased risk of food poisoning, a raw food diet in not recommended for pregnant
women, young children, seniors, people with weak immune systems, and those with chronic
medical conditions such as kidney disease (Robinson). Additionally, extremely restrictive diets
such as a raw food diet have been associated with impaired growth and therefore are not
recommended for infants and young children (Cunningham). Adhering to a raw food diet also
requires learning how to prepare the raw food into meals. This diet will involve gaining skill in
juicing, blending, dehydrating, sprouting, germinating, cutting, chopping, and rehydrating
(Robinson) (USNews&WorldReport). Typical raw food recipes involve some combination of
these processes. Although scholarly literature on raw food diet is sparse, this research does provide

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the following analysis of the diet. On average, subjects met or exceeded the recommended
consumption of vegetables, fruits, protein-rich foods, and fats based on the US Department of
Agriculture’s MyPlate guidance (Hobbs). This did help in controlling blood pressure (Robinson).
However, typically subjects did not meet the MyPlate recommended intakes of dairy products and
grains (Hobbs). Also, most subjects did not meet the recommended intake of vitamin B12 (Hobbs).
Raw food dieters will likely need to take supplements to cover nutrient gaps of inadequate iron,
calcium, and vitamin B12 (Robinson). Some research has shown long term raw food diet
adherence to promote such pronounced weight loss that the dieter becomes underweight. This has
been noted to lead to irregular or absent menstruation (Koebnick et al.). Research noted that the
typical raw food dieter perceived this diet to be beneficial for protecting from disease, promoting
faster healing, improving digestion, improving weight control, increasing energy, increasing
connectedness to nature, improved mental clarity, and promoting an increased sense of happiness
(Hobbs). Additionally, raw food dieters noted this diet was challenging to adhere to for the
following reasons: it was taxing to adjust to the change in eating habits, overcoming addictions to
foods outside the eating plan was difficult, it was a burden to find the required organic foods, the
organic foods needed are expensive (Robinson), food preparation was labor intensive (Robinson),
and social pressures often ran counter to the diet’s allowed foods so it was isolating (Hobbs) (Link
and Jacobson). In fact, successful adherence to the diet was associated with having fewer close
friends and relatives (Link and Jacobson). Diet adherence was also associated with higher
education level, higher income level, and being employed (Link and Jacobson). US News & World
Report 2015 Best Diet Ranking report noted that “most people have trouble sticking to restrictive
diets” such as the raw food diet (USNews&WorldReport). Scholarly research, although limited,
does support this claim (Moore et al.) (Link and Jacobson) (Hobbs). The majority of the raw food

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dieters studied indicated they did lose weight from adhering to the diet (Hobbs) (Robinson)
(Turner-McGrievy et al.). Considering these challenges in combination with the typical deficiency
seen in consuming adequate dairy and grain, the nutritional shortfall exposure suggests some
professional dietetic guidance would be beneficial for raw food dieters (Hobbs). One research
study employed a randomized controlled trial design. The results of this analysis further support
the suggestion that raw food diet adherence is facilitated by professional dietary support and this
support mitigates the barriers of dietary self-monitoring (e.g. burdensome, time-consuming, and
tedious daily recording of consumed foods and drinks) (Turner-McGrievy et al.). Also, to
accommodate for the nutritional short fall, one strategy recommended is a short term raw food diet
period to promote weight loss followed by a less restrictive diet for long term weight maintenance
(Koebnick et al.).
Thus far this paper has focused on analyzing and describing what is involved in adhering
to a raw food diet and providing commentary on the pros and cons of undertaking such a dietary
regimen. Narrative has been synthesized from a review and assessment of scholarly literature,
respected medical websites, and mainstream media. In consideration of the material gleaned from
these sources, a raw food diet is not well suited for across-the-board implementation in NYC. The
raw food diet is very onerous with very high food-preparation requirements. Obtaining the
necessary raw food and preparation equipment is very expensive and the food preparation burden
is high. The diet exposes dieters to higher risks of food poisoning. These issues would make it very
challenging for the citizens of NYC most in need of an obesity intervention: less economically
advantaged and health literate Hispanics and Non-Hispanic African Americans. It is most probably
cost prohibitive for these populations and overly complex to be of practical value. A smaller, subset
of the NYC population particularly in Manhattan and possessing stronger financial resources may

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find this diet to be attainable. Caution, though is simultaneously encouraged that even these
populations consider a raw food diet as chiefly a short-term weight reduction vehicle. And for
these populations, it is recommended that the potential harmful impacts of a raw food diet be
subjected to professional dietician supervision. In the opinion of the author, the raw food diet’s
risks of food poisoning and onerous cost and preparation requirements substantially outweigh the
recognized benefit of weight loss.

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