"I lived on 99th Street across from some projects," she said. "I would walk to the train and think, 'Why are there so many amputees?'"
Keatley found out that many of them had to have amputations because of complications from diabetes. Diabetes can reduce blood flow to extremities and cause nerve damage, and sometimes amputations are necessary if serious infection sets in and there is severe damage to the tissue and bone.
The neighborhood where Keatley lived, East Harlem, has the highest diabetes rate in Manhattan, according to city health officials. It also has the highest obesity rate: One-third of adult residents are obese or overweight.
"It's so shocking to me to see people who are poor and unhealthy and literally dying in the street," said Keatley, an award-winning chef and nutritionist.
Keatley said that when she would visit more affluent neighborhoods near East Harlem, she wouldn't see nearly as many amputees. And she was pretty sure she knew why.
"You go over this invisible line, and there are people with farmers' markets, people with organic food ... healthy sandwich shops," she said.
There's not much of that in East Harlem. Instead, the poor community is saturated with inexpensive fast food.
"These people are literally dying for nourishment," she said.
Fresh out of college and determined to make a difference, Keatley turned down more lucrative jobs in the culinary industry to start Nourishing NYC. Since 2008, the nonprofit has provided fresh food and nutritional education -- for free -- to nearly 100,000 people in Harlem and the Bronx.