The macrobiotic diet is a lifestyle that emphasizes balance and harmony through a rigorous diet plan, gentle exercise, and behavioral changes, all geared towards achieving a natural and calm way of life. Although many people report enhanced health and greater well-being when following its principles, there is a lack of scientific evidence to back up the health claims associated with macrobiotics. Some people turn to macrobiotic diets seeking better health, while others try it when they have a diagnosis like heart disease, obesity, or premenstrual syndrome, hoping that macrobiotic eating will alleviate their symptoms and support recovery.
What is a Macrobiotic Diet?
Macrobiotics is a holistic approach to health developed by Japanese philosopher George Ohsawa, incorporating lifestyle aspects from diet to exercise and meditation. The word "macrobiotic" comes from the Greek words "macro," meaning large, and "bio," meaning life. It stresses a balanced lifestyle with food as a cornerstone, emphasizing organic, locally grown, and seasonal produce.
Macrobiotic eating places a strong focus on natural, organic food and advocates for the complete elimination of chemicals and artificial ingredients, extending to personal hygiene and household products. The types of foods allowed vary slightly depending on individual factors such as existing health issues, gender, age, and geographic location.
Core Principles of the Macrobiotic Diet
The macrobiotic diet is a high-fiber, high-complex carbohydrate, low-fat eating plan. It focuses on whole grains and vegetables while discouraging high-fat, processed, salty, and sugary foods. The diet also incorporates lifestyle recommendations, including eating and drinking only when body cues are triggered and chewing food thoroughly.
Foods to Include
- Whole grains: Approximately 50% of the diet should consist of whole grains like brown rice, oats, barley, wheat, and millet. Whole cereal grains are considered preferable to whole-grain pastas and breads, though these are permissible in small quantities.
- Vegetables and seaweed: About 25-33% of the diet should be vegetables such as broccoli, carrots, cauliflower, kale, and radishes. Sea vegetables like seaweed are also included.
- Pulses: This category makes up 5-10% of the diet and includes foods such as lentils, azuki beans, chickpeas, tofu, and tempeh.
- Miscellaneous foods: Approximately 5-20% of the diet may include fruit, white fish, seeds, nuts, and miso soup. Small amounts of pickles and fermented vegetables may also be included.
- Soup: Soup made of vegetables, lentils, seaweed, sea salt, and soy products like tofu and miso can also be a daily staple.
Food preparation techniques, including steaming or sautéing, are recommended, and natural seasonings, such as naturally processed sea salt, and vegetable oil can be used.
Read also: Comprehensive Macro Meal Plan for Effective Weight Loss
Foods to Avoid
The macrobiotic diet advises against eating processed foods and animal products. Foods to avoid include:
- Meat
- Dairy products
- Eggs
- Refined sugar
- Animal fats
- Artificial sweeteners or chemical additives
- Genetically modified foods
- Certain vegetables, including potatoes, peppers, and tomatoes
- Caffeinated beverages
- Alcoholic beverages
- Sodas, both diet and regular
- Sugar and products containing sugar or corn syrup
- Molasses
- Vanilla
- Pork
- Tropical fruits, such as pineapples and mangos
- Hot, spicy food seasonings, such as garlic and oregano
Other recommendations include using natural materials such as wood, glass, and china for cooking and storing food, avoiding microwave ovens and electric hobs, and purifying water before cooking or drinking it.
Potential Benefits of the Macrobiotic Diet
While no scientific evidence or research suggests that macrobiotic eating can cure disease, it may provide health benefits to some people when used as a complementary therapy.
Heart Health
Individuals who follow low-fat diets low in animal products, such as the macrobiotic diet, may have lower cholesterol levels, potentially reducing the risk of heart disease and high cholesterol. The plant-based, low-fat, high-fiber nature of the diet may also contribute to managing blood pressure.
Diabetes Management
Macrobiotic eating may be beneficial for some people with diabetes because it completely eliminates sugary foods and soda from the diet. A 2015 study reviewed research comparing the effects of various diets on people with diabetes and indicated that the macrobiotic diet produced faster blood sugar control in the short and medium term. Benefits included lower cholesterol, improved blood sugar, increased insulin sensitivity, decreased blood pressure, and reduced body weight.
Read also: Comprehensive Macro Diet Plan
Cancer Prevention
Elements of the macrobiotic diet have been linked to reduced inflammation, which may reduce cancer risk. The diet encourages a high consumption of vegetables and whole grains, which aligns with recommendations for cancer prevention. According to a 2001 study, its emphasis on vegetables makes it high in phytoestrogens, which may help reduce circulating estrogen levels in some women, potentially reducing breast cancer risk.
Risks and Considerations
Despite its potential benefits, macrobiotic eating isn’t right for everyone.
Nutritional Deficiencies
A person who strictly follows the macrobiotic diet does not eat animal products, which may lead to nutritional deficiencies. Because the diet is low in animal fat, fruit, and dairy, it can provide too little protein, iron, magnesium, calcium, and vitamins, including B-12 and D. People who adhere stringently to macrobiotic eating often frown upon taking multivitamins to supplement this loss of nutrients.
Restrictiveness
If you love spicy food or can’t live without that first cup of coffee or occasional margarita, you might find the macrobiotic diet too restrictive. The diet can be difficult to follow and socially restrictive, making it hard to eat meals with family and friends while adhering to the eating plan.
Sodium Content
It’s also top-heavy in foods that are high in salt, which generally isn’t ideal for those with high blood pressure or kidney disease.
Read also: Comprehensive Macro Diet
Weight Loss
For some people, macrobiotic eating causes too high a reduction in body fat. Over time, a person eating this way may lose weight, which may not align with their health goals.
Not a Replacement for Medical Care
Macrobiotics isn’t recommended as a substitute for medical care or traditional therapy for anyone dealing with a diagnosis, such as heart disease, diabetes, or cancer.
The Macrobiotic Diet and Cancer Treatment
Advocates of the macrobiotic diet claim that following the plan may help with chronic illnesses, including cancer. However, Cancer Research UK states that there is no evidence that the macrobiotic diet treats or cures cancer and warns that it may have detrimental effects. The American Cancer Society recommends "low-fat, high-fiber diets that consist mainly of plant products," but they urge people with cancer not to rely on a dietary program as an exclusive or primary means of treatment.
The National Cancer Institute (NCI) notes that the only evidence that the macrobiotic diet may offer an effective alternative cancer therapy comes from anecdotal reports and should not be used as a replacement for cancer treatment. Because of limited research, the NCI says it cannot draw conclusions on how effective the diet is as a complementary therapy.
Historical Context
In the 1960s, the earliest and most strict variant of the diet was termed the "Zen macrobiotic diet," which claimed to cure cancer, epilepsy, gonorrhea, leprosy, syphilis, and many other diseases. However, in 1965, a young follower of the macrobiotic diet died from malnutrition, and George Ohsawa was sued for malpractice.
Importance of Nutrition in Cancer Care
The nutrition status of patients with cancer can vary at presentation and throughout cancer care. Many patients experience unintentional weight loss, leading to a diagnosis of cancer. Malnutrition increases treatment toxicities, diminishes quality of life, and accounts for a significant percentage of mortality in patients with cancer.
Malnutrition in Cancer Patients
Malnutrition is common in cancer patients, with studies reporting its occurrence in a significant percentage of patients. Etiology-based definitions of malnutrition include starvation-related malnutrition, chronic disease-related malnutrition, and acute disease-related or injury-related malnutrition.
Weight Loss as an Indicator
Weight loss is often used as a surrogate for malnutrition and has been correlated with adverse outcomes. However, it does not account for the time course of the weight loss or the type of tissue loss and may be affected by fluid shifts.
Anorexia and Cachexia
Anorexia, the loss of appetite or desire to eat, is common in cancer patients and can hasten the course of cachexia, a progressive wasting syndrome evidenced by weakness and a marked loss of body weight, fat, and muscle.
Sarcopenia and Sarcopenic Obesity
Sarcopenia, the condition of severe muscle depletion, is associated with poorer overall survival and increased chemotherapy toxicity in patients with cancer. Sarcopenic obesity, the presence of sarcopenia in individuals with a high BMI, is an independent risk factor for poor prognosis.
Nutrition Intervention
Nutrition intervention improves outcomes by helping a patient maintain weight, stay on the intended treatment regimen with fewer changes, improve quality of life, and produce better surgical outcomes.
Ketogenic Diet as an Alternative
The ketogenic diet (KD) is a low-carbohydrate, high-fat diet that mimics the fasting state, wherein the body responds to the lack of glucose by producing ketones for energy. Some studies suggest that KD use is safe and tolerable for patients with cancer.
Metabolic Pathways
Ketogenic diets slow cancer by inhibiting insulin/IGF and downstream intracellular signaling pathways. They also amplify adenosine monophosphate-activated protein kinase (AMPK), which inhibits aerobic glycolysis and suppresses tumor proliferation, invasion, and migration.
Clinical Trials
Data from case reports and trials suggest KD use is safe and tolerable for patients with cancer. Several clinical trials are underway to study the effects of KD in various cancer types.