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The macrobiotic diet (also called macrobiotics) was designed by Japanese philosopher George Ohsawa in the early 20th century. Its name is derived from the Greek words “macro” which means great and “bios” which means life. The diet was brought to America in the 1960s and Ohsawa’s work was continued by Michio Kushi. Kushi later founded the Kushi Institute, the largest promoter of the macrobiotic diet.

The macrobiotic diet is based on the Eastern philosophical principles of yin and yang, which maintain that everything has both yin and yang. According to the George Ohsawa Macrobiotic Foundation, yin is an outward-moving energy and yang is an inward-moving energy. The aim of this philosophy is to achieve a balance between these two energies. Proponents of the macrobiotic diet claim that the traditional American diet contains too many foods that are at the extremes of the yin and yang spectrum. They believe that this instability is toxic for the body. The macrobiotic diet incorporates foods that have a balance of yin and yang, and is mainly composed of whole grains and vegetables. In its more restrictive forms, it is a strict vegan diet, although some varieties of the diet do allow small amounts of fish to be consumed.

In addition to being an eating plan, the macrobiotic diet is considered by some to be a way of life. It advocates a relationship with food that is peaceful and respectful. Followers of the diet are expected to cook their food in a peaceful setting using implements made of natural materials such as wood, glass, stainless steel and ceramic. The diet also discourages cooking with electricity or microwaves. In order to ease digestion, food is chewed thoroughly until it assumes a liquid form.

The main claim of the macrobiotic diet is that the eating plan and lifestyle can help to treat cancer, with some even declaring it a cure for cancer. This is the premise of the numerous macrobiotics schools and therapy centers that charge patrons a fee for macrobiotics counseling. However, these claims have not been substantiated by scientific research. The therapeutic version of the macrobiotic diet can be more restrictive than other versions and people considering the therapeutic macrobiotic diet should discuss its suitability with their physician and/or dietitian. 

The macrobiotic diet is a low-fat diet with generally under 25 percent of calories coming from fat and under 5 percent of calories from saturated fat, although this can vary depending on individual diets. The U.S. Department of Health and Human Services (DHHS) recommends that between 20 percent and 35 percent of total calories come from fat and less than 10 percent come from saturated fat. The specific recommendations of the macrobiotic diet vary depending on age, sex, activity level and local environment, but are roughly defined as follows:

• Whole grains and cereals – 40 percent to 60 percent of daily foods (by weight). This includes brown rice, barley, millet, rolled oats, wheat, corn, buckwheat and rye. It can also be composed of products made from whole grains such as pasta, noodles and bread.
  
  
• Green leafy, round and root vegetables – 25 percent to 30 percent. In the macrobiotic diet, cooked vegetables are preferred over raw. The following vegetables are recommended: green cabbage, broccoli, cauliflower, kale, bok choy, collard and mustard greens, turnips, turnip greens, onion, daikon radish and parsnips.
  
  
• Beans (e.g., chickpeas, green lentils, soybeans) – 5 percent to 10 percent. Beans comprise a small portion of the macrobiotic diet and may include bean products such as tofu.
  
  
• Fluids. Followers of the macrobiotic diet are encouraged to drink only when thirsty and to restrict fluid intake to purified water and tea made from fresh herbs.

Sea vegetables (e.g., wakame, arame, nori, hijiki, kombu), seeds, nuts and soups are also permitted. Soup can be made from a variety of ingredients allowed in the macrobiotic diet, such as vegetables, seaweed and miso (a fermented soy paste). It is recommended that foods used in a macrobiotic diet be organically grown and minimally processed.

The diet also allows a limited amount of locally produced, seasonal fruits. More flexible versions allow small amounts of white meat fish such as cod, haddock and catfish. However, stricter versions of the diet feature no animal products. In some cases, macrobiotic counselors advise followers of the diet to avoid all fruits and animal products.

Certain foods are restricted on the macrobiotic diet. These include:

• Most animal products, including meat, dairy products and eggs.
  
  
• Some vegetables, including potatoes, tomatoes, eggplant, peppers, beets and zucchini.
  
  
• Fruits that do not grow locally. This may include pineapples and bananas as well as other tropical fruits.
  
  
• Refined sugars and any foods that contain chemical additives. The macrobiotic diet discourages eating substances that have been processed in any way or contain any chemical elements. This may include prescribed medications and vitamin supplements.
  
  
• Seasonings. This includes refined salt, pepper, spices and other seasonings.
  
  
• Stimulants and depressives. Alcohol, caffeine and illegal stimulants and depressives are prohibited.

In its original form in the early 20th century, the diet progressed through 10 stages, each more restrictive than the last. In the final stage, followers of the diet ate only brown rice and water, although this practice is now denounced by both physicians and proponents of modern macrobiotics as unhealthy.