The role of your cancer health professional is to create an environment of openness and trust, and to help in making informed decisions about alternative/ complementary therapies. Collaboration will improve the safe integration of all therapies during your experience with cancer. The "Summary" and "Professional Evaluation /Critique" sections of this Unconventional Therapies manual are cited directly from the medical literature, and are intended to help in the objective evaluation of alternative/ complementary therapies.
Summary
"After studying the literature and other available information, the American Cancer Society has found no evidence that macrobiotic diet is useful as a cure for cancer in humans. Lacking such evidence, the American Cancer Society strongly urges individuals with cancer not to use a dietary program as an exclusive or primary means of treatment." (CA 1993)
Description/ Source/ Components
"The macrobiotic diet is a mainly vegetarian diet consisting of 50% whole cereal grains, 20 to 30% locally grown vegetables, small amounts of soups, beans and sea vegetables, white meat, fish and fruit in limited amounts. Potatoes, sweet potatoes, tomatoes, eggplants, peppers, asparagus, spinach, beets, zucchini, avocados, mayonnaise, tea, coffee, and red meat are to be avoided." (Ontario)
"The Zen macrobiotics is a ten-level diet whose "highest" level consisted of brown rice and small amounts of fluids." (Barrett)
The most restrictive diet number 7 is recommended as the ideal diet and consists entirely of cereals. For all diets, liquids must be taken sparingly. (CA 1984)
"Macrobiotic followers are encouraged to get fresh air, exercise, wear cotton clothing, avoid television, and meditate." (Carter)
The macrobiotic diet is now being taught at the Kushi Institute. (Fink 1997)
History
"The macrobiotic diet was developed by George Ohsawa, a Japanese philosopher who sought to integrate traditional Asian medicine and belief with Christian teachings and some aspects of Western medicine. Staring in the 1930's, he taught a philosophy of healing through proper diet and natural medicine. He moved to Boston in 1960, where an early disciple, Michio Kushi, came to spearhead the macrobiotic way of life." (Cassileth)
"Although a relatively recent creation, the macrobiotic diet is based in large part on the yin-yang principle of balance, a fundamental component of ancient Chinese medicine. Yin and Yang are opposite forces believed to describe all components of life and the universe. Here the world view of balance is embodied in diet, including the selection, preparation, and consumption of foods." (Cassileth)
"For treating and preventing cancers, diets are to be varied according to the "Yin" and "Yang" nature of the tumors." (Creasey)
Anthony J. Sattilaro, MD, an anaesthesiologist at Methodist Hospital in Philadelphia has become a vocal proponent. He "attributes this diet as the reason he recovered from metastatic prostrate cancer." (Wilson)
Proponent/ Advocate Claims
"The proponents of the macrobiotic diet believe that it cures cancer, that it prevents illness, and that it promotes good health and harmony with the external world." (Cassileth)
"The macrobiotic diet and lifestyle have been promoted as a therapeutic approach to cancer as well as a method for cancer prevention." (Bowman)
"Within the yin-yang ideology, whole-grain foods are considered ideal, not because they are low-fat, low-cholesterol, low-calorie, high-fibre foods, but because they are neutral: neither too yin (female) nor too yang (male)." (Cassileth)
"According to Kushi, cancer is the result of a person's behavior, largely due to improper diet but also to his or her thinking and lifestyle. Improper diet produces a "chronically toxic blood condition." He considers cancer to be a "natural mechanism" that localizes the toxic condition and detoxifies the body. Kushi writes, 'Of primary importance in dealing with cancer, then, is not to disturb this natural mechanism by taking out or destroying the cancer.'" The standard macrobiotic diet in cancer treatment is varied depending on the type of cancer. (CA 1984)
"Kushi calls the conventional treatments of radiation therapy, chemotherapy, and surgery 'violent or artificial' and 'toxic and unnatural'. He says the recovery of cancer patients treated macrobiotically is hindered if they have undergone conventional treatments. He states that compared with cancer patients treated only macrobiotically, conventionally treated patients who are then treated macrobiotically 'often take longer to recover... and their recovery is often more complicated and difficult.'" (CA 1984)
To proponents, cancer is seen as a result of an unbalanced condition, by which the body attempts to localize toxins and thereby produce balance. Therefore, after "macrobiotic diagnosis," specific dietary recommendations are made and implemented. The implication is that appropriate dietary treatment will resolve the cancerous state. (Bowman)
"The macrobiotic diet, however, can have value if not taken to extremes. The diet lowers fat and cholesterol in the body, reduces weight, and produces results associated with low-fat diets. These beneficial results include lower blood pressure and reduced chances of getting heart disease and certain cancers that appear related to fat intake, such as breast cancer." (Cassileth)
"Consumption of genistein through soybeans may be an explanation for Asian women's lower rates of breast and other cancers relative to those of American women. Soy versus animal protein has been shown in scientific studies to decrease cholesterol. The lower fat intake associated with dietary soy products may help decrease the incidence of breast cancer." (Cassileth)
Professional Evaluation/ Critique
"The explanation given for these effects concern energy, vibrations, and yin-yang balance, all abstract notions that cannot be measured or even detected." (Cassileth)
"Because this concept was developed without benefit of physiology, it is fanciful and far from accurate. It states, for example, that blood cells, which actually are produced in the bone marrow, are birthed by a 'mother red blood cell' in the stomach." (Cassileth)
"There is no scientific evidence of any such benefit, and the diet itself can cause cancer patients to undergo serious weight loss." (Hafner)
"The macrobiotic diet does not conform to any accepted theory of nutritional support for cancer patients, nor has it been demonstrated by properly controlled experiments to be helpful in maintaining nutritional status among cancer patients." (CA 1993)
"It is impossible to evaluate the safety and adequacy of the macrobiotic diet in cancer treatment because relevant scientific data are lacking. Neither descriptive studies of the clinical progress of cancer patients following such a diet nor controlled trials of the diet in defined animal cancer models are available. Many of the patients reporting "miraculous" cures have received conventional medical therapy concurrently." (Bowman)
Kushi provides no scientific documentation to support his claim that the recovery of cancer patients who have undergone conventional therapy is hindered when treated macrobiotically, compared with patients who did not have conventional therapy. He advocates the avoidance of conventional cancer therapies, thus cancer patients could be needlessly discouraged from undergoing surgery, radiation therapy and chemotherapy. In January 1983, The ACS asked Mr. Kushi for documentation of his work and references to relevant publications. No reply had been received by June 1, 1983. (CA 1984)
"Macrobiotic 'diagnostic techniques,' including iridology, or looking at a person's eyes to diagnose cancer and other diseases, appear to be less commonly accepted than they were a few decades ago. This is fortunate because in the past many sick people failed to have their illnesses properly diagnosed and they received proper treatment belatedly if at all, sometimes with fatal results. Also, some individuals were 'diagnosed' with a cancer they did not really have, 'cured', with macrobiotics, and presented publicly as evidence of the ability of macrobiotics to cure cancer. This kind of activity perpetuated an unfortunate cycle. Neither macrobiotics nor any other diet can cure cancer." (Cassileth)
"If eating certain foods evokes a desired closeness to nature or universal harmony, fine, but that is all one can expect from these ideas. They have no practical or therapeutic value." (Cassileth)
Toxicity/ Risks
"Caution is crucial because the diet can be seriously deficient in particular nutrients. In the past five years, several studies of the macrobiotic diet have been reported in the peer-reviewed medical literature... Every study found serious deficiencies in infants and children who had been on macrobiotic diets... Researchers recommend that children on the macrobiotic diet receive dairy products and eggs to provide the missing nutritional components and produce a safer, balanced diet. Pregnant and breast-feeding women similarly should supplement their macrobiotic diets." (Cassileth)
"A population-based study on the nutritional status of children consuming macrobiotic diets was carried out in the Netherlands." Results showed that these children suffered "deficiencies of energy, protein, vitamin B12, vitamin D, calcium, and riboflavin, which led to retarded growth, fat and muscle wasting, and slower psychomotor development." (Dagnelie)
"Recent studies showed that Dutch children who were fed macrobiotic diets were smaller and weighed less than other children who eat normally. Infants on macrobiotic diets often develop rickets and have deficiencies of vitamin B, C and iron." (Hafner)
"The Council of Foods and Nutrition of the American Medical Association and the Committee on Nutrition of the American Academy of Pediatrics have roundly condemned the more restrictive of the macrobiotic diets for their nutritional inadequacies. Strict adherence to these diets could result in scurvy, anemia, hypoproteinemia, hypocalcemia, emaciation due to starvation, loss of kidney function due to reduced fluid intake, other forms of malnutrition, and even death." (CA 1984)
The Zen macrobiotics "has caused the deaths of at least 19 zealots during the 1960s." (Barrett)
Two surveys of the dietary intakes of macrobiotic children and adults have been published. Some of the results were as follows:
The diets are low in calories - most of the healthy adults reported having lost weight on the diet.
Several cases of protein-calorie malnutrition have been documented among infants and children who were fed strict macrobiotic diets.
An adult woman who had followed diet no. 7 for eight months had lost 35 pounds and on hospitalization was "near death with the classical manifestations of scurvy and severe folic acid and protein deficiency."
Several cases of nutritional rickets have been documented in macrobiotic children.
Intakes of riboflavin, niacin, vitamin B, and folate are below the recommended dietary allowances (RDA).
Calcium intakes in macrobiotic adults and children were 50-60% below the RDA.
Iron intakes of macrobiotic women and children averaged 62-84% of the RDA; those of the men exceeded the RDA. (Bowman)
The current "standard" macrobiotic diet consists of 50-60% whole cereal grains. Allergic reactions caused by eating cereals may cause gastrointestinal disturbance with vomiting, diarrhea and bloating, eczema, urticaria, angioedema, asthma or anaphylactic shock. Because of the high fibre content of the macrobiotic diet, there is a risk of complete obstruction in the presence of a narrowed intestinal lumen. (Bowman)
Costs
"Macrobiotic way of life seminar, a two-day program, costs $250 and $175 for an accompanying support person." (Fink 1988)
The Kushi Institute charges $1,250 for week-long programs, and $350 for weekend programs. (Fink 1997)
References
Barrett S, Cassileth BR, editors. Dubious cancer treatment. Tampa, Florida: American Cancer Society, Florida Division, 1991:86-87.
Bowman BB et al. Macrobiotic diets for cancer treatment and prevention. J Clin Oncol 1984;2:702-711.
CA (Anonymous). Questionable methods of cancer management 'nutritional' therapies. CA: a Cancer Journal for Clinicians 1993 Sept/Oct;43(5):309-319.
CA (Anonymous). Unproven methods of cancer management: macrobiotic diets. CA: a Cancer Journal for Clinicians 1984;34:60-63.
Carter J. Diet and lifespan in cancer (Meeting Abstract). Adjuvant Nutrition in Cancer Treatment Symposium, Tampa, Florida, Sept, 27 1997:A10.
Cassileth BR. Alternative medicine handbook: the complete reference guide to alternative and complementary therapies. New York: W.W.Norton & Co., 1998:99-103.
Creasey WA. Diet and cancer. Philadelphia: Lea & Febiger, 1985;202-212.
Dagnelie PC, van Staveren WA. Macrobiotic nutrition and child health: results of a population-based, mixed-longitudinal cohort study in The Netherlands. American Journal of Clinical Nutrition 1994;59(suppl):1187s-1196s.
Fink JM. Third Opinion: an international directory to alternative therapy centers for the treatment and prevention of cancer and other degenerative diseases. 2nd ed. Garden City Park, New York: Avery Publishing Group Inc., 1988:161-163.
Fink JM. Third opinion: an international directory to alternative therapy centers for the treatment and prevention of cancer and other degenerative diseases. 3rd ed. Garden City Park, New York: Avery Publishing Group Inc., 1997:210.
Hafner AW, editor. Reader's guide to alternative health methods. Milwaukee, Wisconsin: American Medical Association, 1993:247-252.
Ontario Breast Cancer Information Exchange Project. Guide to unconventional cancer therapies. 1st ed. Toronto: Ontario Breast Cancer Information Exchange Project, 1994:110-113.
Wilson Ben R. (M.D.). Cancer quackery primer. Dallas, Oregon: The author, 1986.
Revised February 2000