The macrobiotic diet (or macrobiotics) is a nutritional model that involves eating mostly whole grains and vegetables. The diet is based on the Eastern philosophical principles of yin and yang, described as the outward and inward moving energy in all things. Proponents of the macrobiotic diet believe that it is possible to balance the two conflicting energies by eating foods that have equal quantities of yin and yang. They encourage maintaining a relationship with food that is respectful and peaceful by cooking only with natural implements and preparing and eating food in a peaceful setting.
The macrobiotic diet is comprised of whole grains (40 percent to 60 percent of daily food intake, by weight), leafy and root vegetables (25 percent to 30 percent) and beans (5 percent to 10 percent). It is recommended that these foods be organic. Also permitted are sea vegetables and a small quantity of seasonal, locally grown fruit. Animal products (meat, eggs and dairy products), certain vegetables, refined sugars and any foods that have been artificially processed are restricted on the macrobiotic diet. In some variations of the diet, small quantities of fish are occasionally allowed.
The creators of the macrobiotic diet claim that it can slow, cure and prevent cancer, although there is no scientific evidence to support these claims. Like most well-planned vegetarian diets, the macrobiotic diet can be healthful. It emphasizes large quantities of grains, plenty of vegetables and other beneficial foods such as soy products and beans. These foods contain significant quantities of fiber and carbohydrates as well as moderate amounts of protein and certain vitamins.
However, because of its restrictiveness, it is possible to deprive the body of certain nutrients while following the macrobiotic diet. This is especially dangerous for cancer patients who need extra nutrients to ensure that their body efficiently recovers from cancer treatment. Lack of animal products in the diet can cause deficiencies in protein, iron, calcium and vitamins B12 and D, especially since vitamin or mineral supplements are not allowed. This can lead to serious health problems such as malnutrition and anemia. It is important that people consult their physician and/or dietitian before beginning the macrobiotic diet, especially if suffering from a chronic disease such as cancer.
About the macrobiotic diet
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.
Benefits and risks of the macrobiotic diet
Proponents of the macrobiotic diet claim that their eating plan can prevent and sometimes even cure cancer and other serious illnesses. There is no scientific evidence to support these claims. However, there are elements of the macrobiotic diet, particularly the consumption of large amounts of vegetables and whole grains, which may help to promote good health and reduce the risks of some types of cancer. The American Cancer Society’s dietary guidelines for cancer prevention recommend that individuals:
Eat at least five servings of fruits and vegetables every day
Choose whole grains instead of refined (processed) grains and sugars
Limit consumption of red meat, especially processed meats and those high in fat
Select foods and beverages that help achieve and maintain a healthy weight
Limit salt intake
Limit alcohol consumption to no more than one drink per day for women or two drinks per day for men.
All these recommendations fall within the guidelines of the macrobiotic diet, which is a low-fat, high-fiber diet. Fiber is found in whole grains, legumes and some fruits and vegetables. Studies have shown that there may be a link between low-fat, high-fiber diets and a reduced risk of cardiovascular disease and cancer.
However, there is no proof that eating a specific diet can slow, cure or prevent the occurrence of cancer. It is important that people with cancer eat a balanced diet that is rich in nutrients. The most common nutritional problem facing cancer patients is failing to consume enough calories and protein. After treatments such as chemotherapy and radiation therapy, the body needs more protein to mend tissues and help prevent infection. With insufficient protein, the body’s resistance to infection is reduced and recovery from illness may take longer. Protein is found in animal products, grains, nuts, seeds and soy. Animal products are the best source of protein, although the body’s daily requirement can be satisfied through a well-planned vegan diet. A poorly planned diet that is low in animal products may lead to a protein deficiency.
There is also evidence that the macrobiotic diet can cause complications during cancer recovery, especially if the patient is suffering from extreme physical wasting (cachexia). This condition can be exacerbated by the stricter “therapeutic” versions of the diet, which may require eliminating fish and fruit and therefore often lacks essential nutrients. It is important for cancer patients to consult their physician and/or dietitian before making any dietary changes.
There are several elements of the macrobiotic diet that may be harmful to healthy people as well. For example, the restriction on animal products puts people at risk for deficiencies in protein, vitamins B12 and D, iron and calcium. This could cause additional complications such as malnutrition, anemia and other serious health problems, especially since the diet prohibits vitamin supplements.
Also, followers of the diet may find that they are restricted in the amount of fruit and types of vegetables they are allowed to eat. Fruits and vegetables provide the body with antioxidants, which protect cells from the damage of free radicals. Insufficient fruit and vegetable intake may increase the risk of heart disease, cancer and stroke, all of which have been linked to free radical damage. In addition, because the macrobiotic diet requires followers to restrict their fluid intake, they could be at risk of dehydration. In the macrobiotic diet, fluids are only to be consumed when a person is thirsty. However, thirst is a symptom of mild dehydration and restricting fluid consumption in this way is potentially harmful for the body. Water is essential to good health. People, especially those with cancer or other health conditions, are advised to drink at least eight 8-ounce glasses of water each day.
The macrobiotic diet is not generally recommended for children as it does not provide adequate amounts of nutrients and calories children need to grow. Studies have linked the macrobiotic diet to insufficient bone growth in children.
A macrobiotic diet is not recommended for people who have intestinal blockages, celiac disease or cereal grain allergies. Pregnant women and persons with kidney disease, hypertension or intestinal disorders should consult with their physician before starting a macrobiotic diet.
Early versions of the macrobiotic diet that advocated 100 percent grain consumption caused malnutrition and death and have been widely condemned by health professionals and modern macrobiotics counselors.
Questions for your doctor
Preparing questions in advance can help patients to have more meaningful discussions regarding their conditions. Patients may wish to ask their doctor or registered dietitian the following questions related to the macrobiotic diet:
Is it safe for me to start following the macrobiotic diet?
Should I talk to a dietitian? Can you recommend one?
Is a high-fiber diet suitable for me?
Are there any foods in the macrobiotic diet that I should avoid?
If I have cancer, can I safely follow the macrobiotic diet?
Could the macrobiotic diet help me attain my health goals?
How can the macrobiotic diet help with my weight management goals?
Will I get all the nutrients I need from the macrobiotic diet?
Are there any elements of the macrobiotic diet that should be adjusted for me?
Are there any other diet plans you recommend to improve my health?
