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The primary food in the standard macrobiotic diet is whole cereal grains, including brown rice, barley, millet, rolled oats, wheat, corn, rye, and buckwheat.
A small amount of whole grain pasta and breads is allowed. Grains should comprise about 50% of the food consumed. Fresh vegetables should account for 20–30% of the diet.
The most highly recommended vegetables include green cabbage, kale, broccoli, cauliflower, collard greens, carrots, parsnips, winter squash, bok choy, onions, parsley, daikon radishes, and watercress. Vegetables that should be eaten only occasionally include cucumber, celery, lettuce, and most herbs. Vegetables that should be avoided include tomatoes, peppers, potatoes, eggplant, spinach, beets, and summer squash.
About 10% of the diet should consist of beans and sea vegetables.
The most suitable beans are azuki, chickpeas, and lentils. Tofu and tempeh are also allowed. Other beans can be eaten several times a week. Sea vegetables include nori, wakame, kombu, hiziki, arame, and agar-agar. Another 10% of the diet should include soups made with regular or sea vegetables.
Other permitted items include sweeteners such as barley malt, rice syrup, and apple juice; such seasonings as miso, tamari, soy sauce, rice or cider vinegar, sesame oil, tahini, and sea salt; occasional small amounts of seeds and nuts (pumpkin, sesame, sunflower, and almonds); and white-meat fish once or twice a week. Beverages allowed include tea made from twigs, stems, brown rice, and dandelion root, apple juice, and goodquality water without ice.
Items not allowed include meat; dairy products; fruits; refined grains; anything with preservatives, artificial flavorings and colorings or chemicals; all canned, frozen, processed, and irradiated foods; hot spices; caffeine; alcohol; refined sugar, honey, molasses, and chocolate.
There are no specific procedures involved in preparing for the diet, except to change from a diet based on meat, sugars, dairy products, and processed foods, to one based primarily on whole grains, vegetables, and unprocessed foods. Some advocates of the macrobiotic diet recommend making the switch gradually rather than all at once.
The macrobiotic diet does not include many fruits and vegetables that are important sources of nutrients and antioxidants, such as vitamin C and beta carotene.
If followed rigidly, the diet can also be deficient in protein, calcium, vitamin B12, folate, and iron. Persons accustomed to a diet high in fat can experience sudden and drastic weight loss if they switch to a rigid macrobiotic diet. In its original form, the macrobiotic diet required foods to be slowly eliminated from the diet until only rice and beans were consumed.
Carried to this extreme, the diet lacks significantly in necessary vitamins and nutrients.
A macrobiotic diet may worsen cachexia (malnutrition, wasting) in cancer patients. It is not recommended for people who have intestinal blockages, gluten-sensitive enteropathy (celiac disease), or cereal grain allergies. Children, pregnant women, and persons with intestinal disorders, hypertension (high blood pressure), kidney disease, or malnutrition should consult their physician before starting a macrobiotic diet. Side effects There are no negative side effects associated with a macrobiotic diet in adults, other than such minor problems as dizziness in some people who experience rapid weight loss.
Research & general acceptance
Like many alternative therapies, the macrobiotic diet is controversial and not embraced by allopathic medicine. Most of the controversy surrounds claims that the diet can cure cancer. These claims stem from anecdotal reports and are not substantiated by scientific research.
The American Medical Association opposes the macrobiotic diet. The allopathic medical community is also concerned that people with such serious diseases as cancer may use the diet as a substitute for conventional treatment. Scientific studies in the United States and Europe have shown that a strict traditional macrobiotic diet can lead to a variety of nutritional deficiencies, especially in protein, amino acids, calcium, iron, zinc, and ascorbic acid. These deficiencies can result in drastic weight loss, anemia, scurvy, and hypocalcemia. In children, a strict macrobiotic diet can cause stunted growth, protein and calorie malnutrition, and bone age retardation.