Macrobiotic Diet

This oriental-style vegetarian diet is low in fat, emphasizes whole grains and vegetables, and restricts fluids. These are some of the same dietary principles that have been found to help prevent heart disease. Low-fat high-fiber diets are also believed to play a role in preventing some types of cancer. And the macrobiotic emphasis on fresh, non-processed foods may prove helpful in dealing with certain food allergies and chemical sensitivities.

Despite these benefits, few mainstream nutritionists endorse a strict macrobiotic diet. The selection of foods is so limited, they warn, that you can easily develop significant nutritional deficiencies. They add that while a macrobiotic diet may indeed reduce your risk of heart disease and cancer, it will not cure any specific disorder--including cancer.

The macrobiotic diet is based not so much on Western nutritional principles as on elements of ancient Chinese philosophy. It is a nutritional attempt to balance the "complementary opposites" known as "yin" and "yang"--forces that the Chinese believed must be kept in harmony to achieve good health. These forces are woven into every aspect of life. Yin is said to be expansive, while yang is contractile; yin is cold, yang is hot; yin is wet, yang is dry; yin is slow, yang is fast; yin is passive, yang is aggressive; yin is sweet, yang is salty; yin is loose, yang is tight; yin is dark, yang is light.

To the extent that these qualities are reflected in food, the macrobiotic dietary regimen strives to bring them into balance. Certain foods are said to be very yin, others very yang, and some in-between. The most balanced foods in the yin/yang continuum (though not necessarily in nutritional science) are brown rice and whole grains. Hence these foods constitute the foundation of the macrobiotic diet.

To this foundation, the macrobiotic regimen adds foods reflecting different degrees of yin and yang, selected in accordance with the individual's dietary needs and temperament. In practice, this usually works out to a diet consisting of:

50 to 60 percent whole grains. Grains include brown rice, barley, millet, oats, corn, rye, wheat, and buckwheat.

25 to 30 percent fresh vegetables. Especially recommended are cruciferous vegetables (members of the cabbage family) and other dark green and deep yellow vegetables. They should be grown organically, and locally if possible. Macrobiotic advocates recommend lightly steaming or boiling them, or sautéing them with a small amount of vegetable oil. For purposes of the macrobiotic diet, vegetables fall into three categories:

--Eat frequently: cruciferous vegetables, including arugula, bok choy, broccoli, cabbage, cauliflower, collards, kale, kohlrabi, mustard greens, radishes, rutabaga, turnips, turnip greens, and watercress; Chinese cabbage, dandelion, onion, daikon, orange squashes, pumpkin

--Eat occasionally: celery, iceberg lettuce, mushrooms, snow peas, string beans

--Avoid: potatoes, tomatoes, eggplant, peppers, asparagus, spinach, beets, zucchini, avocado

5 to 10 percent beans, soy-based products, and sea vegetables. In this category, tofu (soy bean curd) is a favorite. Sea vegetables to consider include wakame, hiziki, dombu, noris, arame, agar-agar, and Irish moss.

5 to 10 percent soups. Miso soup, a broth made with soy bean paste, is a popular choice. Also permissible are soups made with vegetables, grains, seaweed, or beans.

Occasional treats: One to three times a week, a serving of seeds, nuts, fruits, or fish is considered acceptable.

Advocates suggest emphasizing local, in-season foods and avoiding processed, refined products. Completely proscribed are meat, poultry, dairy products, eggs, and warm drinks, all of which are considered too "yang" for consumption. Also to be avoided (because they are extremely "yin") are sweets and sugar, alcohol, coffee, caffeinated tea, and strong spices.

Proponents assert that the balance and harmony of the macrobiotic diet and lifestyle create the best possible conditions for health. They claim that the diet yields many positive health effects, including a general sense of well-being; and some studies do confirm that people on the diet have a decreased risk of heart disease and some forms of cancer.

However, claims that the diet can reverse cancer or AIDS (or generally strengthen the immune system) are based on isolated reports that have yet to be confirmed by scientific tests. The National Institute of Health's Office of Alternative Medicine is studying the macrobiotic approach to cancer, but for now there's no concrete evidence that it's particularly effective.

While a moderate approach to macrobiotics is not likely to cause harm and may promote health, extreme macrobiotic diets (often little more than brown rice and grain) lead to deficiencies that are especially damaging in children and pregnant women. Choose a more balanced approach to nutrition during pregnancy and a youngster's early years.

Vitamin and mineral deficiencies are a distinct possibility, particularly with the extreme versions of the diet. Studies of children consuming a macrobiotic diet revealed growth retardation in 6- to 18-month-olds, lack of energy, and deficiencies of protein, vitamin B12, vitamin D, calcium, and riboflavin. Researchers also found that the breast milk of mothers on a macrobiotic diet contained abnormally low levels of vitamin B12, calcium, and magnesium.

Another study links macrobiotic diets with an increase in iron-deficiency anemia, noting that impaired psychomotor development due to iron deficiency has been reported in infants fed a macrobiotic diet. Researchers have also linked macrobiotic infant diets with an increase in rickets, a disease of weakened bones and skeletal deformities associated with vitamin D and calcium deficiencies.

Cookbooks, special food items, and macrobiotic cooking classes are available in most health food stores. Many cities have "East-West Centers" which give courses in macrobiotic cooking and philosophy. Tuition can cost more than $1,000 per week, with additional charges for personal counseling sessions.

The leading proponent of macrobiotic beliefs in the United States is Michio Kushi, who teaches the macrobiotic way of life at the Kushi Institute, near Boston, Massachusetts. In California, the George Ohsawa Macrobiotic Foundation publishes books and magazines about macrobiotics, and offers classes in macrobiotic cooking.

Discontinue or moderate a macrobiotic diet if you develop any symptoms of nutritional deficiency.

Although a macrobiotic diet may possibly stave off heart disease and cancer, it's unlikely to cure them. If you suspect either problem (or any other serious disease) do not attempt to forego conventional treatment. Check with a mainstream doctor, for instance, if you have any of these signs or symptoms of cancer: changes in bowel or bladder habits, sores that don't heal, obvious changes in a mole or wart, unusual bleeding or discharge, a new lump or thickening in your breast or elsewhere, difficulty swallowing or frequent indigestion, or a bothersome cough or hoarseness.

The lack of animal protein in the macrobiotic diet is especially apt to cause a deficiency of vitamin B12 unless you include unfermented soy products fortified with B12. This, in turn, can lead to anemia, which is typically signaled by loss of appetite, diarrhea, numbness, tingling of the hands and feet, paleness, shortness of breath, fatigue, weakness, and sore mouth and tongue. See a doctor if any of these problems appear.

It's also worth a trip to the doctor if you develop any symptoms of general nutritional deficiency. These include fatigue, muscle and joint pain, poor concentration, irritability, or susceptibility to infections.