The Macrobiotic Diet

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Alternative medicine
Claims	Health effects from a diet avoiding refined foods and most animal products. Specific effects on cancer.
Related fields	Diet
Original proponents	Sagen Ishizuka
Subsequent proponents	George Ohsawa Michio Kushi William Dufty Edward Esko

A macrobiotic diet (or macrobiotics) is a fad diet based on ideas about types of food drawn from Zen Buddhism.^[1]^[2] The diet attempts to balance the supposed yin and yang elements of food and cookware.^[1]^[3] Major principles of macrobiotic diets are to reduce animal products, eat locally grown foods that are in season, and consume meals in moderation.^[2]

There is no high-quality clinical evidence that a macrobiotic diet is helpful for people with cancer or other diseases, and it may be harmful.^[4]^[2]^[5] Neither the American Cancer Society nor Cancer Research UK recommends adopting the diet.^[6]^[5]

Conceptual basis

Macrobiotic diets are based on the concept of balancing yin and yang.^[7]

The macrobiotic diet is associated with Zen Buddhism and is based on the idea of balancing yin and yang.^[3] The diet proposes 10 plans which are followed to reach a supposedly ideal yin:yang ratio of 5:1.^[7] The diet was popularized by George Ohsawa in the 1930s and subsequently elaborated by his disciple Michio Kushi.^[6] Medical historian Barbara Clow writes that, in common with many other types of quackery, macrobiotics takes a view of illness and of therapy which conflicts with mainstream medicine.^[8]

Macrobiotics emphasizes locally grown whole grain cereals, pulses (legumes), vegetables, edible seaweed, fermented soy products, and fruit combined into meals according to the ancient Chinese principle of balance known as yin and yang.^[9] 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.^[10]

Some macrobiotic proponents stress 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, and hot, whereas those with yin qualities are considered expansive, light, cold, and diffuse.^[11] However, these terms are relative; “yangness” or “yinness” is only discussed in relation to other foods.^[12]

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.^[13]

Nightshade vegetables, including tomatoes, peppers, potatoes, and eggplant; also, spinach, beets, and avocados are not recommended or are used sparingly in macrobiotic cooking, as they are considered extremely yin.^[14] Some macrobiotic practitioners also discourage the use of nightshades because of the alkaloid solanine which is thought to affect calcium balance.^[15] Some proponents of a macrobiotic diet believe that nightshade vegetables can cause inflammation in the body and osteoporosis.^[16]

Practices

Food

Some basic macrobiotic ingredients

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):^[17]

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, two to three times per week. Other naturally-raised animal products may be included if needed during dietary transition or according to individual needs.

Kitchenware

Cooking utensils should be made from certain materials such as wood or glass, while some materials including plastic, copper, and non-stick coatings are to be avoided.^[1] Electric ovens should not be used.^[1]

Japanese popularity and influence

The macrobiotic way of eating was developed and popularized by the Japanese. During the Edo period in Japan peasants were not allowed^{[dubious – discuss]} to eat meat^{[citation needed]} and had a diet based on staples of rice and soybeans. According to some macrobiotic advocates, a majority of the world population in the past ate a diet based primarily on grains, vegetables, and other plants. Because the macrobiotic diet was developed in Japan, Japanese foods that are thought to be beneficial for health are incorporated by most modern macrobiotic eaters.^[18]^[19]

Cancer

The American Cancer Society recommends “low-fat, high-fiber diets that consist mainly of plant products”; however, they urge people with cancer not to rely on a dietary program as an exclusive or primary means of treatment.^[6] Cancer Research UK states, “There is no scientific evidence to prove that a macrobiotic diet can treat or cure cancer or any other disease”.^[5]

Nutrition

The macrobiotic diet is a type of fad diet.^[1]^[20] Most macrobiotic diets are not nutritionally sound.^[7]^[21]

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, as its precursor 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]

Safety

Complications

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. 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.^[6]

Children

Children may also be particularly prone to nutritional deficiencies resulting from a macrobiotic diet.^[6]

Pregnancy

Macrobiotic diets have not been tested in women who are pregnant or breast-feeding, and the most extreme versions may not include enough of certain nutrients for normal fetal growth.^[6]

References

Bijlefeld M, Zoumbaris SK (2014). Macrobiotics. Encyclopedia of Diet Fads: Understanding Science and Society (2nd ed.). ABC-CLIO. pp. 127–128. ISBN 978-1-61069-760-6. Lerman RH (7 December 2010). “The Macrobiotic Diet in Chronic Disease”. Nutrition in Clinical Practice. 25 (6): 621–626. doi:10.1177/0884533610385704. PMID 21139126. Bender DA (2014). diet, macrobiotic. A Dictionary of Food and Nutrition. Oxford University Press. ISBN 9780191752391. Hübner J, Marienfeld S, Abbenhardt C, Ulrich CM, Löser C (November 2012). “[How useful are diets against cancer?]”. Deutsche Medizinische Wochenschrift (Review) (in German). 137 (47): 2417–22. doi:10.1055/s-0032-1327276. PMID 23152069. “Macrobiotic diet”. Cancer Research UK. Retrieved 8 July 2017. Russell J; Rovere A, eds. (2009). “Macrobiotic Diet”. American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies (2nd ed.). American Cancer Society. pp. 638–642. ISBN 9780944235713. Roth RA, Wehrle KL (2016). “Chapter 2: Planning a Healthy Diet”. Nutrition & Diet Therapy (12th ed.). Cengage Learning. p. 43. ISBN 978-1-305-94582-1. The macrobiotic diet is a system of 10 diet plans, developed from Zen Buddhism Clow B (2001). Negotiating Disease: Power and Cancer Care, 1900-1950. McGill-Queen’s University Press. p. 63. Before we explore medical reactions to therapeutic innovations in this era, we must stop to consider the meaning of ‘alternative medicine’ in this context. Often scholars use the term to denote systems of healing that are philosophically as well as therapeutically distinct from regular medicine: homeopathy, reflexology, rolfing, macrobiotics, and spiritual healing, to name a few, embody interpretations of health, illness, and healing that are not only different from, but also at odds with conventional medical opinion.William Dufty with Sakurazawa Nyoiti (1965) You Are All Sanpaku, University Books “Boiled Egg Diet”. Retrieved 26 March 2016. Porter, pp. 22–25 Porter, pp. 44–49 Porter, pp. 71–78 Kushi and Jack, p. 119. Stanchich L “All About Nightshades”. New Life Journal: Carolina Edition, Apr/May 2003, vol. 4, no. 5, p. 17, 3 pp. Porter Kushi M; Blauer S; Esko W (2004). The Macrobiotic Way: The Complete Macrobiotic Lifestyle Book. Avery. ISBN 1-58333-180-8. Make Mine Macrobiotic | Lifestyle | Trends in Japan. Web Japan. Retrieved on 2012-04-27. Panel 11: Globalisation, Hybridity and Continuity in Traditional Japanese Health Practices. iastam.org Hanning RM, Zlotkin SH (April 1985). “Unconventional eating practices and their health implications”. Pediatr. Clin. North Am. (Review). 32 (2): 429–45. doi:10.1016/s0031-3955(16)34796-4. PMID 3887307. American Dietetic, Association; Dietitians Of, Canada (2003). “Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets”. Journal of the American Dietetic Association. 103 (6): 748–765. doi:10.1053/jada.2003.50142. OCLC 1083209. PMID 12778049. Vegetarian diets, like all diets, need to be planned appropriately to be nutritionally adequate. National Institutes of Health. “Dietary Supplement Fact Sheet: Vitamin B₁₂“. Retrieved 2008-05-27. USDA National Nutrient Database for Standard Reference, Release 20: Vitamin B-12 (μg) Content of Selected Foods per Common Measure, sorted by nutrient content. Reed Mangels. “Vitamin B₁₂ in the Vegan Diet”. Vegetarian Resource Group. Retrieved 2008-08-11. National Institutes of Health. “Dietary Supplement Fact Sheet: Vitamin A and Carotenoids (Table 2: Selected plant sources of vitamin A from beta-carotene)”. Archived from the original on 2010-08-08. Retrieved 2008-05-28.

USDA National Nutrient Database for Standard Reference, Release 20: Iron, Fe (mg) Content of Selected Foods per Common Measure, sorted by nutrient content.