Macrobiotic diet

Macrobiotic diet
Biologically based alternative
and complementary therapy
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NCCAM classifications
  1. Alternative Medical Systems
  2. Mind-Body Intervention
  3. Biologically Based Therapy
  4. Manipulative Methods
  5. Energy Therapy
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A macrobiotic diet (or macrobiotics), from "macro" (large) and "bios" (life), a dietary regimen which involves eating grains as a staple food supplemented with other foodstuffs such as local vegetables avoiding the use of highly processed or refined foods and most animal products. Macrobiotics also addresses the manner of eating by recommending against overeating and requiring that food be chewed thoroughly before swallowing. Macrobiotics writers present it as a means of combating cancer.[1]



The earliest recorded use of the term macrobiotics is found in the writing of Hippocrates, the father of Western Medicine. In his essay "Airs, Waters, and Places," Hippocrates introduced the word to describe people who were healthy and long-lived. Herodotus, Aristotle, Galen, and other classical writers used the term macrobiotics to describe a lifestyle, including a simple balanced diet, that promoted health and longevity.[2]

Christoph Wilhelm Hufeland

Hufeland, a German physician, in his book The Art of Prolonging Human Life (1797), first used the word "macrobiotics" in the context of food and health. Hufeland was an influential doctor who was active in medical research and became a medical professor at Jena and, later, the first dean of medicine at the University of Berlin. Despite the title of his book, he also considered macrobiotics a science aimed at prolonging and perfecting life. According to Hufeland, macrobiotics is a medical philosophy on a higher level than the curative, preventative, or health levels of medicine. "The medical art must consider every disease as an evil which cannot be too soon expelled; the macrobiotic, on the other hand, shows that many diseases may be the means of prolonging life."

First edition of The Art of Prolonging Human Life", 1797

In his book, Hufeland refers to a life force which he claimed is present in everything and most easily detected in "organic beings" (live organisms), where it manifests in its response to external stimuli. This force can be weakened, as well as strengthened, through external influences. He believed that our life force would be depleted through physical exertion and increased with rest. Hufeland proposed that moral and physical health are intertwined and flow from the same source, both marked by an abundance of life force. In his view, illness was to be prevented primarily by pursuing a proper diet and lifestyle. In terms of using the word "macrobiotics" in relation to health, food, and energy or life force, Hufeland could be considered the founder of macrobiotics.[original research?]

Sagen Ishizuka

In the late 1800s, Japanese military doctor Sagen Ishizuka, the founding father of shokuiku, had great success in helping people recover from their serious health problems. He carried out many clinical trials and published two large volumes of his works. His theory was that a natural diet, in which foods are eaten in season and attention is paid to the correct balance of potassium and sodium and acid and alkaline, leads to good health.[3]


Followers of the traditional macrobiotic approach believe that food and food quality powerfully affect health, well-being, and happiness, and that a traditional locally-based macrobiotic diet has more beneficial effects than others. The modern macrobiotic approach suggests choosing food that is less processed.

One goal of modern macrobiotics is to become sensitive to the actual effects of foods on health and well-being, rather than to follow dietary rules and regulations. Dietary guidelines, however, help in developing sensitivity and an intuitive sense for what sustains health and well-being.[4]

Japanese Macrobiotics emphasizes locally grown whole grain cereals, pulses (legumes), vegetables, seaweed, fermented soy products and fruit, combined into meals according to the principle of balance (known as yin and yang). Whole grains and whole-grain products such as brown rice and buckwheat pasta (soba), a variety of cooked and raw vegetables, beans and bean products, mild natural seasonings, fish, nuts and seeds, mild (non-stimulating) beverages such as bancha twig tea and fruit are recommended.[4]

Some Japanese macrobiotic theorists, including George Ohsawa, stress the fact that yin and yang are relative qualities that can only be determined in a comparison. All food is considered to have both properties, with one dominating. Foods with yang qualities are considered compact, dense, heavy, hot, whereas those with yin qualities are considered expansive, light, cold, and diffuse.[5] However, these terms are relative; "yangness" or "yingness" is only discussed in relation to other foods.[5]

Brown rice and other whole grains such as barley, millet, oats, quinoa, spelt, rye, and teff are considered by macrobiotics to be the foods in which yin and yang are closest to being in balance. Therefore, lists of macrobiotic foods that determine a food as yin or yang generally compare them to whole grains.[5]

Nightshade vegetables, including tomatoes, peppers, potatoes, eggplant; also spinach, beets and avocados are not recommended or used sparingly in macrobiotic cooking, as they are considered extremely yin.[6] Some macrobiotic practitioners also discourage the use of nightshades because of the alkaloid solanine, thought to affect calcium balance.[7] Some proponents of a macrobiotic diet believe that nightshade vegetables can cause inflammation in the body and osteoporosis.[5]


Some basic macrobiotic ingredients

Macrobiotics is considered an approach to life rather than a diet. Some general guidelines for the Japanese style macrobiotic diet are the following (it is also said that a macrobiotic diet varies greatly, depending on geographical and life circumstances):[8]

  • Well chewed whole cereal grains, especially brown rice: 40–60%
  • Vegetables: 25–30%
  • Beans and legumes: 5–10%
  • Miso soup: 5%
  • Sea vegetables: 5%
  • Traditionally or naturally processed foods: 5–10%

Fish and seafood, seeds and nuts, seed and nut butters, seasonings, sweeteners, fruits, and beverages may be enjoyed occasionally, 2-3 times per week. Other naturally raised animal products may be included if needed during dietary transition or according to individual needs.

Cooking according to the time of the year

In spring:

  • Food with a lighter quality
  • Wild plants, greens, lightly fermented food, grain species, fresh greens
  • Light cooking style: steaming, cooking for a short time, etc.

In summer:

  • Food with a lighter quality
  • Large-leaved greens, sweet corn, fruit, summer pumpkins
  • Light cooking style: steaming, quick cooking, etc.
  • More raw foods
  • Lighter grains, such as barley, and bulghur

In autumn:

  • Food with a more concentrated quality
  • Root vegetables, (winter) pumpkins, beans, cereals, etc.
  • Heavier grains such as sweet rice, mochi and millet

In winter:

  • Food with a stronger, more concentrated quality
  • Round vegetables, pickles, root vegetables, etc.
  • More miso, soy sauce, oil, and salt
  • Heavier grains such as millet, buckwheat, fried rice, etc.

Balanced content of food

Japanese style Macrobiotic eating follows the principle of balance (called balancing yin and yang in China).

Japanese style Macrobiotics holds that some foods are overstimulating and can exhaust the body and mind. These are classified as extreme Yin (stimulating) in their effects:

  • Sugar
  • Alcohol
  • Honey
  • Coffee
  • Chocolate
  • Refined flour products
  • Very hot spices
  • Drugs
  • "Chemicals" and preservatives
  • Commercial milk, yogurt and soft cheeses
  • Poor quality vegetable oils

Foods that are considered to be concentrated, heavy and dense create stagnation. These have Yang (strengthening, but stagnating effects if over-consumed).

  • Poultry
  • Meat
  • Eggs
  • Refined salt

Whole grains, vegetables, beans, sea vegetables, fruit, nuts, and seeds are thought to create balance. Foods such as these are used in a macrobiotic way of eating.

Other factors

The composition of dishes and the choices of foods is adjusted according to

  • the season
  • the climate
  • activity
  • sex
  • age
  • health condition
  • transition in one's diet

and any applicable personal considerations.

Japanese popularity and influence

The macrobiotic way of eating is thought by some to be Japanese. During the Edo period in Japan peasants were not allowed to eat meat and had a diet of primarily rice and soy beans to get their protein. According to macrobiotic advocates, a majority of the world population in the past ate a diet based primarily on grains, vegetables, and other plants. Because macrobiotics is popular in Japan, and many of its popular teachers are Japanese, Japanese foods that are beneficial for health are incorporated by most modern macrobiotic eaters. Some macrobiotic ingredients are also standard ingredients in Japanese cuisine. [1], [2]

Chinese macrobiotics

According to Chee Soo in The Tao of Long Life,[9] natural dietary therapy, or ch'ang ming, has been developed in China since prehistoric times, along with a range of health arts that have become what we now know as traditional Chinese medicine, or TCM.

Macrobiotics vs. vegetarianism

A macrobiotic diet includes many of the same foods as vegetarian diets, but in macrobiotics some types of fish and other animal foods are included according to individual needs. The two dietary styles share enough similarities that a vegetarian and even vegan version of macrobiotics is not uncommon.

The American Dietetic Association approves of carefully planned vegan diets. In the words of the Association, "Well-planned vegan and other types of vegetarian diets are appropriate for all stages of the life cycle, including during pregnancy, lactation, infancy, childhood, and adolescence.... It is the position of the American Dietetic Association and Dietitians of Canada that appropriately planned vegetarian diets are healthful, nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases."[10] However, as part of their dietary guidelines, the association did not opine against meat consumption, recommending that healthy adults eat lean meat, poultry, fish or beans each day, as lean meat has many essential nutrients without excess fat or cholesterol.[11]

On the other hand, according to the USDA's discussion of its current food pyramid, "Dry beans and peas are part of this [meat and beans] group as well as the vegetable group. ... Fish, nuts, and seeds contain healthy oils, so choose these foods frequently instead of meat or poultry."[12] Under the heading "Why is it important to include fish, nuts, and seeds?" they say, "Many people do not make varied choices from this food group, selecting meat or poultry everyday as their main dishes."[13]

Macrobiotics and cancer

Macrobiotics has long been advocated by some as a preventative and cure for cancer. Michio Kushi's book The Cancer Prevention Diet outlines the fundamental philosophy for the diet and cancer prevention. There is evidence that a diet high in whole grains and vegetables and possibly low in saturated fat, red meat, and preserved meat products can help to prevent many types of cancer.[14] A study at the Tulane School of Public Health conducted by James P. Carter and others[15] reported significant improvement in cancer patient longevity (177 months compared to 91 months) when patients practiced the macrobiotic diet, although an analysis[16] stated about this paper, "Scientific evidence on the potential benefits of macrobiotic diets for patients with cancer is limited to two retrospective studies with serious methodologic flaws."

There have been no randomized clinical studies published in the available medical literature to show the macrobiotic diet can be used to prevent or cure cancer. One of the earlier versions of the macrobiotic diet that involved eating only brown rice and water has been linked to severe nutritional deficiencies and even death. However, low-fat, high-fiber diets that consist mainly of plant products that are believed to reduce the risk of cardiovascular disease and some forms of cancer. The National Institutes of Health's, National Center for Complementary and Alternative Medicine has funded a pilot study to determine whether a macrobiotic diet may prevent cancer.[17]

Medical professionals do not consider that there is evidence that a macrobiotic diet is useful as a cure for cancer. The American Cancer Society strongly urges people with cancer not to use a dietary program as an exclusive or primary means of treatment,[18] and many long-term practitioners of the diet, including Michio Kushi's wife, Aveline, and daughter Lilly, died of cancer. Michio Kushi himself developed cancer and in 2004 had a tumor removed surgically from his intestines. Some macrobiotic teachers who followed more vegan type macrobiotic diets also passed away from cancer including Luchi Baranda, Patrick McCarty, Cecil Levin, Bonnie Kramer, and Murray Synder. Roel Van Duijn reported in the Dutch national newspaper Trouw on September 5, 1998, and later in the quarterly Skepter of the Dutch organisation Skepsis that following advice of a macrobiotic counselor over conventional medical treatments resulted in the death of his wife.[19]


Detailed information on the nutrients provided by a large range of foodstuffs is available in the USDA National Nutrient Database.[20]

The following nutrients should be monitored especially in children, because of their importance in facilitating growth and function: calcium, protein, iron, zinc, vitamin D, vitamin B12, riboflavin, vitamin A, omega-3 fatty acids.[21]

Humans synthesize vitamin D with adequate exposure to sunlight; supplementation may be necessary during winter months for people who live far from the equator. Calcium is available from hard leafy greens, nuts and seeds. Zinc is available from nuts and seeds. Fish provides vitamin B12 in a macrobiotic diet,[22] as bioavailable B12 analogues have not been established in any natural plant food, including sea vegetables, soya, fermented products, and algae.[23] Although plant-derived foods do not naturally contain B12, some are fortified during processing with added B12 and other nutrients.[24] Vitamin A, in the form of beta-carotene, is available from plants such as carrots and spinach.[25] Adequate protein is available from grains, nuts, seeds, beans, and bean products. Sources of Omega-3 fatty acids are discussed in the relevant article, and include soy products, walnuts, flax seeds, pumpkin seeds, hemp seeds, and fatty fish. Riboflavin along with most other B vitamins are abundant in whole grains. Iron in the form of non-heme iron in beans, sea vegetables and leafy greens is sufficient for good health; detailed information is in the USDA database.[26]



One of the earlier macrobiotic diets, which called for eating all grains, is severely deficient and has been linked to severe malnutrition and even death. Strict macrobiotic diets that include no animal products may result in nutritional deficiencies unless they are carefully planned. The danger may be worse for people with cancer, who may have to contend with unwanted weight loss and often have increased nutritional and caloric requirements. Relying on this type of treatment alone and avoiding or delaying conventional medical care for cancer may have serious health consequences.[17]


Children may also be particularly prone to nutritional deficiencies resulting from a macrobiotic diet.[17]


Macrobiotic diets have not been tested in women who are pregnant or breast-feeding, and some versions may not include enough of certain nutrients for normal fetal growth.[17]


In 1971, the AMA Council on Foods and Nutrition said that followers of the macrobiotic diet, particularly the strictest, stood in "great danger" of malnutrition.[27] On the other hand, in 1987, the AMA stated in their Family Medical Guide: "In general, the macrobiotic diet is a healthful way of eating."[28]


Michio Kushi and George Ohsawa smoked cigarettes. Kushi states that lung cancer can arise from dairy food in the diet: "In combination with tobacco, dairy food can trap tars and other ingredients of tobacco smoke in the lungs, leading often to lung cancer."[29] This is contrary to medical understanding of the connection between lung cancer and smoking.[30]

Cookbooks and resources



See also


  1. ^ Esko, Edward; Kushi, Michio (1991). The macrobiotic approach to cancer: towards preventing and controlling cancer with diet and lifestyle. Wayne, N.J: Avery Pub. Group. ISBN 0-89529-486-9. 
  2. ^ Blauer, Stephen, in Michio Kushi (1993), The Macrobiotic Way, 2nd ed. Avery, p. xi.
  3. ^ Simon Brown, Macrobiotics for Life (2009), North Atlantic Books, p. xi.
  4. ^ a b Kushi, Michio, with Alex Jack (1994). The Book of Macrobiotics. Japan Publications. 
  5. ^ a b c d Porter, Jessica (2004). The Hip Chick's Guide to Macrobiotics. Penguin Group. 
  6. ^ Kushi, Michio, with Alex Jack (1994). The Book of Macrobiotics. Japan Publications.  p. 119.
  7. ^ Stanchich, Lino. "All About Nightshades". New Life Journal: Carolina Edition, Apr/May 2003, vol. 4, no. 5, p. 17, 3 pp.
  8. ^ Kushi, Michio; Blauer, Stephen; Esko, Wendy (2004). The Macrobiotic Way: The Complete Macrobiotic Lifestyle Book. Avery. ISBN 1583331808, 9781583331804. .
  9. ^ Soo, Chee (1982). The Tao of Long Life. Aquarian Press (Thorsons/HarperCollins). ISBN 0850303206. 
  10. ^ American Dietetic Association. "Vegetarian Diets". June 2003 (vol. 103, no. 6, pp. 748-765).
  11. ^ American Dietetic Association. "Fit Red Meat in Your Low-Cholesterol Eating Plan"
  12. ^ U.S. Department of Agriculture. "What foods are included in the meat, poultry, fish, dry beans, eggs, and nuts (meat & beans) group?". Retrieved 2009-10-24. 
  13. ^ U.S. Department of Agriculture. "Why is it important to make lean or low-fat choices from the Meat and Beans group?". Retrieved 2009-10-24. 
  14. ^ International Food Information Council. "Questions and Answers About Cancer, Diet and Fats".
  15. ^ Carter JP, Saxe GP, Newbold V, Peres CE, Campeau RJ, Bernal-Green L. "Hypothesis: dietary management may improve survival from nutritionally linked cancers based on analysis of representative cases." J Am Coll Nutr. 1993;12:209-26. PMID: 8409076].
  16. ^ Weiger, W. A.; Smith, M.; Boon, H. et al (December 3, 2002). "Advising Patients Who Seek Complementary and Alternative Medical Therapies for Cancer". Annals of Internal Medicine. 
  17. ^ a b c d "Macrobiotic Diet". American Cancer Society. November 2008. 
  18. ^ American Cancer Society. "Macrobiotic Diets / Zen Macrobiotics".
  19. ^ Skepsis
  20. ^ USDA National Nutrient Database for Standard Reference.
  21. ^ American Dietetic, Association; Dietitians Of, Canada (June 2003). "Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets". J Am Dietetic Assn 103 (6): pp. 748–765. doi:10.1053/jada.2003.50142. OCLC 1083209. PMID 12778049. PII S0002-8223(03)00294-3. Retrieved 2007-12-19. "Vegetarian diets, like all diets, need to be planned appropriately to be nutritionally adequate." 
  22. ^ National Institutes of Health. "Dietary Supplement Fact Sheet: Vitamin B12". Retrieved 2008-05-27. 
  23. ^ USDA National Nutrient Database for Standard Reference, Release 20: Vitamin B-12 (μg) Content of Selected Foods per Common Measure, sorted by nutrient content.
  24. ^ Reed Mangels, Ph.D., R.D.. "Vitamin B12 in the Vegan Diet". Vegetarian Resource Group. Retrieved 2008-08-11. 
  25. ^ National Institutes of Health. "Dietary Supplement Fact Sheet: Vitamin A and Carotenoids (Table 2: Selected plant sources of vitamin A from beta-carotene)". Retrieved 2008-05-28. 
  26. ^ USDA National Nutrient Database for Standard Reference, Release 20: Iron, Fe (mg) Content of Selected Foods per Common Measure, sorted by nutrient content.
  27. ^ JAMA 218:397, 1971.
  28. ^ Kunz, Jeffrey R. M., and Finkel, Asher J., ed (1987). American Medical Association Family Medical Guide. Random House. p. 27. ISBN 0394555821. 
  29. ^ Kushi, Michio, with Alex Jack (1994). The Book of Macrobiotics. Japan Publications.  p. 112.
  30. ^ WHO Report on the Global Tobacco Epidemic, 2008

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