Dietary carotenoids are associated with a reduced risk of chronic diseases. Raw food diets are predominantly plant-based diets that are practised with the intention of preventing chronic diseases by virtue of their high content of beneficial nutritive substances such as carotenoids. However, the benefit of a long-term adherence to these diets is controversial since little is known about their adequacy. Therefore, we investigated vitamin A and carotenoid status and related food sources in raw food diet adherents in Germany. Dietary vitamin A, carotenoid intake, plasma retinol and plasma carotenoids were determined in 198 (ninety-two male and 106 female) strict raw food diet adherents in a cross-sectional study. Raw food diet adherents consumed on average 95 weight% of their total food intake as raw food (approximately 1800 g/d), mainly fruits. Raw food diet adherents had an intake of 1301 retinol activity equivalents/d and 16.7 mg/d carotenoids. Plasma vitamin A status was normal in 82% of the subjects (> or = 1.05 micromol/l) and 63% had beta-carotene concentrations associated with chronic disease prevention (> or = 0.88 micromol/l). In 77% of subjects the lycopene status was below the reference values for average healthy populations (< 0.45 micromol/l). Fat contained in fruits, vegetables and nuts and oil consumption was a significant dietary determinant of plasma carotenoid concentrations (beta-carotene r 0.284; P < 0.05; lycopene r 0.168; P = 0.024). Long-term raw food diet adherents showed normal vitamin A status and achieve favourable plasma beta-carotene concentrations as recommended for chronic disease prevention, but showed low plasma lycopene levels. Plasma carotenoids in raw food adherents are predicted mainly by fat intake.