Are raw-food diets enlightened or inane?

By Mary Spicuzza
Seattle Times staff reporter

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For Nora Lenz, just the idea of going to a restaurant is enough to turn her stomach.

Lenz, 47, of Bellevue, has been on a raw-food diet for nearly three years. She doesn't eat any food that's been cooked, and eats only vegetarian foods close to their natural state. She says "going raw" changed her life, transformed her into a more vibrant person and helped her break away from the "cooked" lifestyle of most Americans, which she regards as unnatural.

While most vegetarian diets elicit little notice nowadays, there is a small but growing group who, like Lenz, restrict themselves even more — eating only raw food or only fruit, for example. They're convinced their diets are healthy, but doctors and some nutritionists worry that some are becoming dangerously obsessed with "healthy" eating.

In May, the death of a 5-month-old Florida baby whose parents followed a raw-foods diet fueled concerns about the trend. The baby, born at 7 pounds, weighed less than that when she died. State authorities say the baby and the family's other four children were all malnourished, and have filed one charge of aggravated manslaughter and four charges of child neglect against the parents.

Dr. Steven Bratman, a Colorado-based medical doctor and author, says the way some people practice health-food diets is so extreme that they've developed eating disorders. Bratman coined the term "orthorexia nervosa," which he defines as a "pathological fixation on eating proper food" in one book, and he is now writing another book about some of the pitfalls of holistic medicine. Bratman, who no longer treats patients, serves as medical director of The Natural Pharmacist, an online database for alternative and complementary medicine.

Eating disorders defined Anorexia Nervosa is characterized by self-starvation and excessive weight loss. Symptoms include: 1. Refusal to maintain body weight at or above a minimally normal weight for height, body type, age and activity level. 2. Intense fear of weight gain or being "fat." 3. Feeling "fat" or overweight despite dramatic weight loss. 4. Loss of menstrual periods. 5. Extreme concern with body weight and shape. Bulimia Nervosa is characterized by a secretive cycle of binge eating followed by purging. Bulimia includes eating large amounts of food — more than most people would eat in one meal — in short periods of time, then getting rid of the food and calories through vomiting, laxative abuse or over-exercising. Symptoms include: 1. Repeated episodes of bingeing and purging. 2. Feeling out of control during a binge and eating beyond the point of comfortable fullness. 3. Purging after a binge (typically by self-induced vomiting, abuse of laxatives, diet pills and/or diuretics, excessive exercise, or fasting). 4. Frequent dieting. 5. Extreme concern with body weight and shape. Binge eating disorders can include some combination of the signs and symptoms of anorexia, bulimia, and/or binge-eating disorder. While these behaviors may not be clinically considered a full-syndrome eating disorder, they can still be physically dangerous and emotionally draining. All eating disorders require professional help. Orthornexia Nervosa. Though not clinically recognized as an eating disorder, some health professionals are coming to believe that a pathological fixation on eating proper food, and obsession with "righteous eating" may eventually be considered a condition requiring treatment. Sources: National Eating Disorders Association and "Health Food Junkies," by Steven Bratman

The Vegetarian Resource Group, a nonprofit whose mission is to educate the public on vegetarianism and related issues, reports in its 2003 survey that 4 percent to 10 percent of Americans define themselves as vegetarians. It's difficult to find statistics on how many vegetarians have gone raw — especially because not all raw foodists are vegans (no animal products whatsoever), or even vegetarian. Some eat raw dairy, raw fish and raw meat.

But there is anecdotal evidence that the trend is growing. There are raw-only restaurants in San Francisco, Los Angeles and New York.

Several famous chefs are releasing raw foods "cookbooks" over the next few months, including "Raw" by celebrity chef Charlie Trotter and Roxanne Klein, founder of Roxanne's raw restaurant in California's Marin County. Web sites dedicated to raw foods and vegan diets seem to be constantly multiplying.

Lenz, who says she lost about 30 pounds after going raw, believes that the movement is growing because people have realized cooked foods lead to disease and obesity.

"Just sitting in a restaurant doesn't appeal to me anymore. Eating unhealthy foods just for the sheer entertainment, breathing all that smoke, perfume, burning food, etc. I'm grateful to be away from that scene," she says.

Lenz, a thin, tan woman with intense hazel eyes, says a typical meal for her is a couple of melons, a quart of blueberries, bananas or almonds — but usually only one thing at a time, because she avoids combining foods.

Most health-care professionals agree that people in the United States need to eat better diets, but they're also warning that rigid "healthy" diets can become dangerous and can take over your life.

"Many of the most unbalanced people I have ever met are those who have devoted themselves to healthy eating," Bratman writes in his book, "Health Food Junkies: Overcoming the Obsession with Healthful Eating."

"However, unlike these other eating disorders (anorexia and bulimia), orthorexia disguises itself as a virtue."

Mainstream objections

Orthorexia nervosa borrows from the term anorexia nervosa, but adds "ortho," meaning straight, correct or true. Most medical doctors have yet to adopt the term, but increasing numbers of health-care professionals and therapists are talking about orthorexia while cautioning against dietary extremes.

"Orthorexia is disordered eating," said Leslie Bonci, spokeswoman for the American Dietetic Association and the director of sports nutrition at the University of Pittsburgh Medical Center. "When people are taking it to the extreme that they won't eat out of their home, and they're being overly selective about what they eat, it really shifts toward the fanatical."

Orthorexia isn't exactly an epidemic that's sweeping the nation. About 61 percent of U.S. adults are either overweight or obese, according to the National Institutes of Health.

Bonci acknowledges the obesity epidemic, but says extreme behaviors such orthorexia, anorexia nervosa and bulimia are still serious problems for those caught up in obsessive eating.

"Whether you have someone who is anorexic or orthorexic, or someone who is morbidly obese, they're not responding to food normally," Bonci said. "People are doing drastic things with their eating."

Dr. Diane Mickley, a spokeswoman for the Seattle-based National Eating Disorders Association, says that like any other eating disorder, orthorexia is not exclusively about food.

"It's less about the specifics of different diets than the extremes to which more vulnerable people can take them," Mickley said. "They are psychiatric disorders."

Like most health professionals, both Bonci and Mickley say vegetarian and vegan diets can be extremely healthy. They say the problem begins when any diet is so rigid that it infringes on relationships, or causes someone to define who they are by what they eat.

Bratman says that his own diets became so extreme that eventually he "had a menu, not a life." He describes decades spent following macrobiotic, vegan, vegetarian and raw-foods diets. Bratman also went through phases of chewing each morsel of food 50 times, and while working as an organic farmer, made it a rule never to eat a vegetable more than 15 minutes after it was picked. He says he still eats a lot of fruits, vegetables and fish, but also eats potato chips and an occasional steak.

His diet aside, Bratman has horror stories from his work as a clinical practitioner. In "Health Food Junkies," he writes about a fruitarian woman who crashed her car and died after fainting from protein deficiency, and an extreme raw foodist who died alone in a hotel room while hiding from friends trying to hospitalize her.

He admits these are extreme cases.

"Usually orthorexia won't kill you. It's harm lies in what it does to your mind and spirit," Bratman says, adding that the rigid diet creates a distorted view of life.

His book is no longer in print, but the term orthorexia has become so popular that it was added to the Oxford English Dictionary last year.

Hannah Prunty says it's a term that could finally bring attention to a life-threatening problem. The San Diego woman says that when her ex-boyfriend became fruitarian, he grew extremely thin, irritable and preachy. Prunty says they once got into a fight when he became furious after reading her diary and finding out that she'd secretly been eating cookies. He was eventually hospitalized with an eating disorder, she says.

Raw reasoning

On the Web • Living and raw food: www.living-foods.com/ • Raw foods diet review: www.diet-i.com/diets/raw-foods-diet.htm • Beyond Vegetarianism: www.beyondveg.com/ • National Eating Disorders Association: www.nationaleatingdisorders.org

Raw foodists and fruitarians say they're some of the few people in the United States who are already leading healthy lifestyles. Lenz, who was a vegan for more than a decade before going raw three years ago, says that just because nearly everybody in society eats cooked foods "doesn't mean it's right." She says she made a personal choice to change her friends after going raw because she tries to avoid people who criticize her diet and lifestyle.

She thinks Bratman, with his warnings about orthorexia, sounds like another example of someone who tried going raw, wasn't successful, and has since made it his "life's mission to 'warn' others about the diet."

Lenz says she isn't trying to convert anybody, and just wants to live her life eating the way she wants to eat. She's met other raw friends from the Seattle Raw Foods Community Web site (rawseattle.org), which provides information about raw potlucks, meetings and other events.

Norm Bader, a 60-year-old Bellingham resident, is also a member of the local raw-foods community. He says he had painful digestive disorders before going raw in 1978, and is now "99 percent raw." He describes being sick and too weak to move when a friend visited and brought him a book about raw foods.

"It's the only diet that makes any sense," said Bader, who is now primarily a fruitarian. "You eat what appeals to you."

Bader and other raw foodists believe that cooking foods destroys their natural enzymes and depletes their nutritional value. Some believe foods should never be heated beyond 118 degrees the temperature at which raw foodists say healthy enzymes start to break down, but Bader says many foods are more sensitive and break down at lower temperatures.

Bader, who says he often eats fresh tomatoes and avocados wrapped in lettuce leaves, is 5 feet 10 inches and weighs about 135 pounds. He describes himself as "thin but strong," and says he feels much better than when he was living on milk, red meat, white flour and other foods from his "abusive dietary childhood."

Obsession is a problem

Whatever food plan people choose, health-care professionals urge giving thought to balance, and suggest people consult specialists about getting the vitamins and nutrients they need. NEDA's Mickley, who also works as the director of a Connecticut clinic for eating disorders, says that it's sometimes difficult to agree with her patients about what is a healthy diet and weight.

"Anorexia is a delusional illness. You feel like there is nothing wrong with you," she said. "You're able to maintain the illusion that you're healthier than everyone else."

Chances are there will never be agreement on whether orthorexia is an eating disorder, or at what point a healthy diet becomes an unhealthy obsession. But most health professionals say any diet that rules your life and leads you to worry endlessly about food sounds like trouble.

They advise seeking professional help from a dietitian or therapist.

"Anyone who becomes obsessed about food, it's a problem," said Tiffany Reiss, Ph.D., an assistant professor in nutrition and exercise science at Kenmore's Bastyr University. Reiss says orthorexia can lead to isolation, rigidity, and alienation.

"It can lead to the feeling of virtuousness," Reiss said. "It's like, 'I'm eating this way, everyone should be eating this way, too.' "

But Lenz says her raw food diet has helped her take control of her life and lose weight.

"Eating raw foods and living according to our bodies' true requirements is the ultimate empowerment," she says.

Mary Spicuzza has left The Seattle Times. Comments or questions on this story may be addressed to staff reporter Julia Sommerfeld: jsommerfeld@seattletimes.com or 206-464-2708.

Copyright © 2003 The Seattle Times Company