Health Tips / Macrobiotics

What Is It?

Macrobiotics is a philosophy embracing the idea that living one’s life within the natural order will ultimately lead to good health, happiness, and an enhanced appreciation for the constantly changing nature of all things. It is based on the ancient Chinese principles of yin and yang, which represent opposite yet complementary forces believed to exist in all aspects of life and the universe. Things that are yin are flexible, fluid, and cool; things that are yang are strong, dynamic, and hot. According to macrobiotic theory, illness is the result of an imbalance in these two forces. Therefore, macrobiotic practitioners attempt to treat ailments by bringing yin and yang back into balance through diet and lifestyle changes.

Although the origins of macrobiotics stem from the ancient principles of Eastern medicine, the contemporary basis for it was developed in the late 19th century by a Western-trained Japanese Army doctor named Sagen Ishizuka (1850-1910). Dr. Ishizuka had become frustrated with allopathic (or Western) medicine’s ineffectiveness in treating his own cancer, and he decided to try to cure himself by adopting a diet of brown rice, soybeans, fish, miso soup (made with soybean paste), sea vegetables, and other Oriental foods. He called this therapy shoku-yo, or food cure.

Ishizuka’s findings were published and later used for reference by Yukikazu Sakurazawa (1893-1966), a Japanese philosophy student who adopted the pen name George Ohsawa in the 1920s. Ohsawa sought to integrate traditional Asian medicine with Christian teachings and some aspects of Western medicine. He believed that by returning to a basic diet of whole, natural foods, humanity could regain its physical and mental balance and the world become more peaceful. It was Ohsawa who popularized the term macrobiotics (from the Greek words makros, meaning “large” or “long” and bios, meaning “life”).

In 1959, Ohsawa brought macrobiotics to the United States, where it was promoted by his students Michio and Aveline Kushi in Massachusetts and Herman and Cornelia Aihara in California. By the time of his death in 1966, Ohsawa had written more than 300 books in French, German, Japanese, and English, and was the hero of thousands of young Americans who flocked to macrobiotic restaurants and natural-foods stores across the country to embrace his teachings.

Today those who follow a macrobiotic regimen are urged to avoid foods that are processed or refined, or that are too yin (sugar, pungent spices, alcohol, and caffeinated tea and coffee, for example) or too yang (meat, poultry, eggs, and dairy products). Recommended instead is a balance of good yin foods (such as seasonal fruits and leafy green vegetables, seaweed, and tofu) and good yang foods, such as brown rice and other whole grains, legumes, soups made with miso (soybean paste), and fish and shellfish.

There are also specific guidelines regarding the preparation of foods according to yin/yang principles. For example, gas stoves are recommended over electric ones, because foods cooked on an electric stove are believed to have less-harmonious energy. And utensils should ideally be constructed of wood, ceramic , or stainless steel rather than aluminum or copper.

In addition to the proscribed diet, macrobiotics is also a spiritual and social philosophy of living. Five specific daily practices are encouraged: Greet everyone with a sense of appreciation and joy; maintain regular and positive communication with your family; enlarge your circle of friends; share your food by including more people in your life; and make time for introspection and reflection.

How Does It Work?

Macrobiotic practitioners believe that the macrobiotic diet improves the condition of the blood plasma which in turn improves the condition of the body in general. When you undertake a macrobiotic diet, you will notice a number of basic changes primarily during the first 10 days. These changes, practitioners say, will mainly be reactions to the “discharge process,” or cleansing of the plasma and the body. Fatigue, irritability, sweating, insomnia, and cravings are all common symptoms of this cleansing. After the first 10 days, the reactions tend to vary, but most people report feeling calmer, more alert, and more focused.

According to practitioners, after six to eight months on a macrobiotic program, your blood will become perfectly balanced and your body will show even more changes for the better. You will also start to experience noticeable improvements if you have a chronic condition.

If you plan to be on a macrobiotic diet for any length of time, however, it is important to be under the guidance of a licensed nutritionist or nutritionally oriented physician. In the 1960s, an incorrectly practiced form of macrobiotics was so nutritionally deficient that a few deaths from malnutrition were reported.

Today macrobiotics offers many options, and nutritional deficiencies should not occur. Even so, it is still important to eat a wide variety of foods to ensure that you’re getting key vitamins and minerals–particularly vitamins B12 and D, calcium, and iron. If you don’t eat any meat or poultry, it is also important to take a separate vitamin B12 supplement. And because the fluid restrictions on some macrobiotic diets can create serious health problems over time, drinking plenty of water is key.

Some people do need to take special care if they want to follow a macrobiotic regimen. Studies have repeatedly demonstrated that among individuals who have increased nutritional needs, such as infants, children, and pregnant or breast-feeding women, a macrobiotic program can produce serious deficiencies, which can only be partially corrected by adding dairy or vitamin supplements. In addition, macrobiotics limits total calorie intake, which may not be advised for these groups. In all cases medical supervision is a good idea.

What You Can Expect

Certified macrobiotic practitioners, like acupuncturists and other practitioners of traditional Chinese medicine, are trained in Oriental diagnosis. Depending on the symptoms and severity of the condition the practitioner may recommend a conventional diagnosis before prescribing nutritional therapy.

The initial examination by a macrobiotic practitioner will likely follow the procedures typical of Chinese medicine. The practitioner will take a careful medical history, noting your body’s reactions to stress and your tendencies for showing illness symptoms. He will also ask you about your diet and lifestyle habits. As part of the diagnosis, the practitioner will note the color and form of your face and body, listen to your voice, record the condition of your skin and nails, smell your breath, and observe your posture and demeanor. Your tongue will be examined for shape, color, and coating, which indicate how your circulation and metabolism are affecting your internal organs. Your pulse will be taken at three different points on each wrist, each point corresponding to a different part of your body.

After evaluating all this information to get a sense of your body’s current functioning, the practitioner will provide advice in three general areas. To correct your diet, you will be told which foods to add to your regimen and which ones to avoid. To improve your lifestyle, you will be counseled on such matters as exercise, personal hygiene, and clothing. To help with your philosophical attitude, you will be offered suggestions on how to live a more harmonious life.

Normally, two hour-long sessions, spaced about a month apart, are required with a macrobiotic practitioner. If you plan to be on the diet for any length of time, additional sessions may be required, as well as visits with a nutritionist or nutritionally oriented physician.

Health Benefits

A sensible macrobiotic diet is low in fat, cholesterol, and calories and high in fiber and complex carbohydrates. According to studies, people who follow such a diet tend to have much lower blood pressure and cholesterol levels than the average American. In addition, although unproven by clinical studies, the macrobiotic diet may help strengthen the immune system, increase stamina, and prevent or reduce digestive complaints, obesity, fatigue, and poor concentration. On a scientific basis, research has demonstrated that diets high in soy and low in animal fat may be of value in preventing breast and other cancers.

Some practitioners claim that a macrobiotic diet can help treat diseases such as arthritis and some forms of cancer. There is no scientific evidence supporting any claim that a macrobiotic diet can actually cure a specific illness. However, the macrobiotic emphasis on fresh, unprocessed foods may prove helpful for those with food allergies or chemical sensitivities.

How To Choose a Practitioner

There is no licensing of macrobiotic counselors in the United States. However, the Kushi Institute, founded by Michio and Aveline Kushi and located in Becket, Massachusetts, offers training programs for macrobiotic counseling. Counselors who successfully complete the testing process are awarded a Macrobiotic Educators’ Association certificate. To obtain the names of certified counselors in your area, contact the Kushi Institute.


Consult a nutritionist or nutritionally oriented physician if you plan to be on a macrobiotic diet for any length of time. If you have cancer or heart disease, do not refuse or abandon any proven treatments for the disease in order to follow a macrobiotic plan. If you are pregnant or breast-feeding, consult your obstetrician or pediatrician before adopting a macrobiotic diet. Never put an infant or young child on a macrobiotic diet. Infants fed a high-fiber diet without any milk or meat may develop rickets, scurvy, anemia, or osteoporosis. The lack of animal protein in the macrobiotic diet can ultimately cause a deficiency of vitamin B12. You should include unfermented soy products fortified with B12 or take a B12 supplement. A B12 deficiency can cause a condition called pernicious anemia, manifested as fatigue, paleness, sore tongue, shortness of breath, and numbness/tingling in the hands and feet. See a doctor if any of these symptoms appear. See a doctor if you develop any symptoms of general nutritional deficiency, such as fatigue, muscle and joint pain, poor concentration, irritability, or susceptibility to infections while you’re following a macrobiotic diet. Even when supplemented with missing nutrients a macrobiotic diet may have too few calories to support those who expend a lot of energy.

Be well,
David Edelberg, MD