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Laying on that stainless steel table and getting these little lines drawn on me, I felt like a piece of beef. I felt like I had no control, when they were getting ready to do radiation. And the chemo. I went . . . to see the oncologist, and seeing the other people in the waiting room, [I wondered], 'Man, is that what I'm going to be looking like?' I mean, they didn't look well. They did not look healthy. . . . If I had done chemo and radiation, I know for a fact I wouldn't be sitting here and having energy with you right now.
The speaker, whom I shall call John, was a tall, thin, youthful macrobiotic convert in his late forties who said he used to run about four to five miles a day. He was driving me to the Kushi Institute in Becket, Massachusetts, to attend the Michio Kushi Seminar for Medical Professionals on June 20-25, 1989. John said his cancer had been diagnosed in November 1988. A week later, friends gave him two books whose authors said they had recovered from cancer while following a macrobiotic regimen. Two days later, after reading the books, John flew to Massachusetts for a consultation with Michio Kushi.
I asked what Kushi had done. John responded:
Basically, Oriental diagnosis is old . . . very old. . . . I don't know how to do it. . . . But he can look at your face. He can look at your hands, your feet, the meridians of the body. . . . You'll see some material evidence of the chakras. He'll take a little thing . . . like a nail clipper dangling [from a thread] . . . and when he puts it over this area of the body where there is a chakra, that thing will start to rotate. For men, it goes clockwise; for ladies, it goes counterclockwise.
(In traditional Chinese medicine, meridians are energy conduits regulating yin and yang. In Hindu philosophy, the chakras are the seven occult centers of the body.)
I also asked whether Kushi had performed a physical examination. "Just looking at the face, looking at the arms . . . he can tell how far it's advanced," John replied. "Before my cancer was diagnosed, I remember looking at my hand, and this area right here was just blue and green as hell. It looked like a bruise. . . ."
"You're pretty clean; you're clean" John assured me. "But mine was really blue and greenish, and that is one of the signs of cancer. . . . This area right here [between the thumb and forefinger] is the small intestine. That was so damn sore-in most people it is, from bad eating-that I couldn't press it like that. But everything in the body corresponds. Right now, looking at my hands, which one is the redder of the two? Obviously. The tumor's on this side. It's discharging through an extremity."
When I asked whether Kushi ever referred clients to health professionals, John answered, "No, no. . . . Well, he recommends that you stay in contact with your doctor for the blood tests, which I'm doing. I've got a homeopathic doctor." He also told me that Kushi looks at and comments on his lab reports.
John said he had not told his former primary physician, an endocrinologist, of his decision to turn to macrobiotics. "When I was getting ready to leave his office and he told me what the verdict was, he said, 'Be careful. There's all kinds of charlatans out there that will take your money.' In retrospect, I felt like saying, 'Like you? You took my money, and you didn't fix me.'"
John also spoke about Anthony Sattilaro, M.D., whose book,
Recalled by Life (1982), had helped steer him toward macrobiotics.
"Sattilaro got off the diet three years ago. His cancer got
worse than probably ever. . . . He was eating very wide. . . .
And I think when he got well, he kind of disassociated himself
with Michio. . . . He always felt like he was being used to bring
Dr. Sattilaro, whose struggle with prostate cancer was widely publicized, underwent conventional therapy but credited macrobiotics for his improvement. In Living Well Naturally (1984), he said that his doctors had pronounced him in a state of permanent remission. But he died of his disease last year.
Macrobiotics was founded by Yukikazu Sakurazawa (1893-1966)-better known as George Ohsawa. His first book in English, Zen Macrobiotics, was published in mimeographed form in 1960. Macrobiotic insider Ronald Kotzsch, Ph.D., who wrote Macrobiotics: Yesterday and Today, portrays Ohsawa as a quixotic Japanese nationalist who, while preaching the "Unique Principle" of yin and yang, smoked heavily and occasionally enjoyed cheesecake, doughnuts, Coca-Cola, coffee, Guinness Stout, and Scotch whiskey. In Kotzsch's words, "Ohsawa was a man who for forty years taught about health with a cigarette in his hand."
The earliest version of the diet, termed the "Zen macrobiotic diet," was claimed to enable individuals to overcome a wide range of illnesses that its proponents attributed to dietary excesses. This diet had ten progressively restrictive stages. The lowest stage consisted of 10% grains, 30% vegetables, 10% soup, 30% animal products, 15% fruits and salads, and 5% desserts. Each subsequent stage increased the percentage of grains by ten while reducing the percentages from other categories. The fourth stage eliminated fruits, the sixth stage eliminated all animal products, and the final stage eliminated everything but grains. In all stages, fluid intake was discouraged.
In 1967, the Journal of the American Medical Association presented a detailed report of a case of scurvy and malnutrition induced by fanatical adherence to a restrictive macrobiotic regimen. This article set the tone for orthodox medicine's view of macrobiotics. In 1971, the AMA Council on Foods and Nutrition said that followers of the diet, particularly the highest level, stood in "great danger" of malnutrition [JAMA 218:397, 1971].
Kotzsch's book describes how a young woman in New York who had followed the highest-level diet had died in 1965-apparently of malnutrition and dehydration. That same year, Ohsawa was sued for medical malpractice and the Ohsawa Foundation in New York was closed after a raid by the FDA. Boston then became the macrobiotic mecca. The Macrobiotic Center of New York was founded in 1984.
Macrobiotic figurehead Michio Kushi was a student of Ohsawa. Kushi was born in Japan in 1926 and studied political science and international law before coming to the United States in 1949. During the mid-1960s he settled in the Boston area and established Erewhon, a "natural" and macrobiotic foods distributor. During the 1970s, he established East West Journal (a monthly magazine), the East West Foundation, and the Kushi Institute. In 1982, the Kushi Foundation was established as the parent organization for the institute and magazine.
The Kushi Institute now has two locations in the United States, one in Becket (in the Berkshire mountains) and another in Brookline, Massachusetts, a suburb of Boston. In addition to holding lectures, seminars and conferences, the institute markets more than a hundred books, audiotapes and videotapes about macrobiotics and other topics consistent with its beliefs. There are affiliated institutes in London, Amsterdam, Antwerp, Barcelona, Florence and Lisbon, and about 600 independent macrobiotic "centers" located in many parts of the world. Institute publications state that more than 1,000 people worldwide have attended classes at Brookline and Beckett and graduated from leadership training programs.
East West Journal, which has a circulation of about 100,000, contains more than 100 pages per issue. Its news and feature articles cover health, nutrition, psychology, and environmental issues-from the macrobiotic viewpoint. Its editorial philosophy is antagonistic toward scientific medicine and certain public health measures, including fluoridation. Fringe systems, such as acupuncture, chiropractic, homeopathy, naturopathy, Christian Science, and past-life therapy, are promoted in uncritical articles. Full-page ads appear frequently for food supplements, herbs, "natural" cosmetics, subliminal tapes, and similar products. Classified ads involve such offerings as aromatherapy, biofeedback, meditation for cancer, a solution for hypoglycemia, vitamins, herbal formulas, "spiritual numerology," natural fibers, astrology, tarot readings, "psychic counselors," "mind expansion video," "karmic life reading," and correspondence courses in natural healing, iridology and Chinese medicine.
"Macrobiotic" is derived from the Greek macrobiotos-long-lived. Webster's Dictionary defines macrobiotics as "the art of prolonging life." But descriptive definitions abound. A "short" one (five paragraphs long) appears in the December/January '89 Solstice, an independent macrobiotic magazine with a circulation of about 12,000. It states: "Macrobiotics is a way of living with respect for the physical, biological, emotional, mental, ecological and spiritual order of our daily lives." But it is "not a particular form of therapy or medicine," or a religion. Kotzsch says: "There is no explicit, generally accepted understanding of what it means to be 'macrobiotic.' Macrobiotics is many-faceted. It includes a diet, a system of medicine, a philosophy, a way of life, a community, and a broad social movement." Ohsawa offered a simple definition in Macrobiotics: An Invitation to Health and Happiness: "To live in perpetual ecstatic delight is Do-o-Raku. Those who do so are called Do-o-Raku-Mono. If you are Do-o-Raku-Mono, you are Macrobiotic, whatever you eat."
According to ancient Chinese theory, "yin" and "yang" are cosmic principles, complementary opposites. Nothing is completely yin or yang. A given object or condition is yin or yang only relative to another object or condition. Citing yin-yang theory, macrobiotics relates itself to everything in the universe, from world peace to sexual orientation.
In Zen Macrobiotics, Ohsawa gave cold and heat, expansion and contraction, outward and inward, up and down, purple and red, light and heavy, and water and fire as examples of yin and yang. As the "principal food," he chose whole grains, particularly brown rice, which he considered to be near the midpoint of yin and yang. Macrobiotics classifies foods according to: climate (hot yielding yin foods, cold yielding yang foods); pH (acid or alkaline); taste (sweet or salty); color (purple or red); and water content (perishable or dry). But an orange, despite its yang color, is yin because it is cultivated in tropical and subtropical regions, and is acidic, sweet, and juicy. Orange juice is more yin because of its greater water content. Both foods are undesirable from a macrobiotic standpoint, particularly for persons living in temperate or colder regions, because they are too yin relative to whole grains.
The relationship between macrobiotics and Chinese ying-yang
theory is not clear-cut. While macrobiotics distinguishes according
to structure, the Chinese theory-which includes acupuncture theory-distinguishes
by function. For example, macrobiotics classifies the earth (compact)
as yang and the heavens (diffuse) as yin, while yin-yang theory
does the opposite. Thus, as Kotzsch notes, "while Ohsawa
purports to present an ancient Oriental way of thinking, in practice
his [system] does not correspond to the classical Chinese system."
In the March/April '89 Solstice, Kotzsch suggested that a shift in emphasis toward healing started in the early 70s: "I remember Michio saying that if macrobiotics demonstrated that it could cure cancer, it would attract attention and influence many people." Kushi predicted recently that in 50-70 years, "the modern scientific orientation will be reexamined and discarded as a new science, based on a dynamic understanding of natural order and the unifying principle of yin and yang, begins."
Yin-yang underpinnings, quasi-religious overtones, and a Japanese culinary bias make macrobiotics complicated. Indeed, it could be considered an antiscientific, metaphysical hodgepodge. But as far as diet is concerned, it boils down to the consumption of unprocessed or minimally processed foods, primarily whole grains and vegetables, which, ideally, should be grown "organically" in the region where the consumer lives and eaten in season. Health Foods Business estimates that total 1988 sales of macrobiotic foods through health food stores was $29.8 million.
Throughout the year, the Kushi Institute conducts residential seminars, ranging from weekend workshops to a 5-week program for leadership training. The seminar I attended cost $450, including tuition, room and board. However, upon registering, there was an additional charge of $30 for membership in Kushi's nonprofit organization, One Peaceful World, which is required for participation in all Kushi Institute programs.
Nineteen people, including myself, attended the seminar. Twelve were medical doctors, including one unkempt homeopath. There were also two registered nurses, an endodontist, an osteopath, a chiropractor, and a Ph.D. involved in nutrition research. Their past experience with macrobiotics ranged from dabbling (one M.D. with cancer) to ten years, but most of the attendees had been practicing macrobiotics for more than six months, and some had been practicing it for several years. They had come from as far as Michigan, Tennessee, and Ontario, Canada. Only two were visibly overfat. The diet provided during the seminar was monotonous but appeared to be nutritionally adequate except for vitamins B12 and D.
The Becket facility, located on 600 acres, has three main buildings: a rambling, multistory Main House which originally had been a hunting lodge and then Christian monastery; a dormitory; and a house that contained a library, a kitchen, a dining room, and what appeared to be a Buddhist temple (from which I heard chanting). Orientation took place in the library after dinner. A tall, thin, self-possessed man named Charles Millman presided. Millman introduced our program host, Jimmy, who appeared to be either in his late teens or early twenties. Jimmy had completed Level III of the Leadership Studies Program after emigrating from Yugoslavia with his family. Then his parents, who ran the kitchen, were introduced. In broken English, Jimmy's father told how his wife had recovered from ovarian cancer through macrobiotics. Three years earlier, he said, doctors had predicted she would survive only two to three months.
Next, Millman introduced the co-director of the Berkshire center and plugged her recently published book-length testimonial. She told us she had grown up with a deep appreciation for health professionals, because she had always been sick. But since 1982, her only health problem had been one headache. The last staff member introduced was John, who gave an abbreviated version of the story he had told me that afternoon.
Each of us received a packet containing information about the diet, macrobiotic seminars and publications, traditional Chinese methods of diagnosis, and the Kushis' natural food store (Aveline's, named after Michio's wife) and restaurant (Ghinga). Millman informed us that Michio and Aveline want to turn the Berkshire facility into the world's leading macrobiotic educational center-a One Peaceful World Center. "By creating biological peace, by giving people health, you can create peace in various families, in various societies, nations, and throughout the world, spreading our teachings, and helping people to live healthy, happy lives," Millman said. Later he asked us to wash our own dishes and silverware. "This is not part of slave labor," he assured us, but "simply part of standard macrobiotic lifestyle practice, keeping everything very orderly and very neat."
The next morning, at 7:00 A.M., we commenced our daily exercise class in the library. Our instructor, Michael Joutras, said the exercises affected the flow of energy ("ki" or "Ch'i") through body channels ("meridians"), sharing the same system on which acupuncture and shiatsu (finger pressure at acupuncture points) are based. He instructed us to rub our palms together. "Our hands are especially charged with energy," he said. "There's a meridian going through each finger. . . . Now hold your palms slightly apart. Can you feel any electrical sensation? If you can't, pull them slightly apart, then bring them in closer again. . . . If you can't feel it, that's okay."
Joutras said that while nutritional scientists focus mainly on the physical aspects of food-vitamins, nutrients, fat, and so forth-the Eastern view was broader: "Meat has a certain kind of energy. Sugar has a certain kind of energy. Dairy food has a certain kind of energy. And when we ingest these things, then that energy is going into our body, and being released through the process of digestion, and going through the whole body, carried through the meridian system. And so the underlying basis of sickness was always that energy is imbalanced." Later he stated, "The definition of matter is . . . nothing but energy, and waves, and vibration. . . . There is nothing but condensed vibration. . . . Everything is spirit."
Our daily cooking class began at 10:00 A.M. in the Main House. It was conducted by Wendy Esko, a predictably thin, barefaced, 40-year-old woman with long hair, who stumbled onto macrobiotics 19 years ago and has been practicing it ever since. The class topic was "Medicinal Use of Food." We were warned that Cuisinart-processed vegetables caused hyperactivity.
Next came Martha Cottrell, M.D., a feminist with a Southern accent, who described Kushi as "psychic." Cottrell had contributed to the pro-macrobiotic collection of essays, Doctors Look at Macrobiotics, edited by Wendy Esko's husband, Edward Esko.
"I've been macrobiotic pretty much for about ten years. I started when I turned fifty in 1978," Dr. Cottrell said. "Without any doubt, I feel that macrobiotics has given me at least ten years' additional life, and maybe more. And I want to use it well, and have fun doing it, too." Before turning to macrobiotics, she said, she had suffered from arthritis, gastrointestinal problems, psoriasis, and other skin conditions. But she noted that some macrobiotic counselors have not learned how to take care of themselves very well. "Michio is so driven by what he wants to do before he dies," she said. "I was in Florida with him not long ago, and he looked extremely tired. And he's still smoking."
Dr. Cottrell's presentation was followed by dinner-which most of the participants appeared to relish. One M.D. even remarked, "If we have any more food like we've had in the last twenty-four hours, you'll have to roll us all down the hill."
The next speaker was Edward Esko, who is tall, thin, and blond, and looked anemic despite a mild facial sunburn. "There's a lot of misconception about macrobiotics," he lamented. "Especially the whole Zen macrobiotics and brown rice diet. . . . Actually 25 years out of date and it's still on some people's minds." Then he told how a writer who had recently done a computerized literature search found 23 articles on macrobiotics. Twenty-one were negative. "I think what we need is 20 positive articles about the standard macrobiotic diet published in journals, medical journals, which will counteract that false impression that many people have." George Ohsawa chose the name "Zen" because of a rough connection with Buddhist vegetarian cooking, and because Zen philosophy was popular at that time in New York. "So it was kind of a marketing strategy," Esko said. While explaining yin-yang theory, Esko nonchalantly refuted Newton's Universal Law of Gravitation, stating that gravity simply doesn't exist.
Esko introduced us to a woman from Lima, Peru, who said she had pursued macrobiotics after having a brain tumor diagnosed with magnetic resonance imaging (MRI). She was in her twenties and had beautiful, long hair-which had been temporarily lost as a result of therapy. One of the doctors asked whether she had had another MRI after turning to macrobiotics. She said she hadn't because her doctor had said it was expensive and needless.
Kushi did not appear until the afternoon of the seminar's third day, when he lectured on diagnostic principles. He is a thin, unremarkable-looking man with short, receded, salt-and-pepper hair and pronounced cheekbones. He wore a three-piece, pinstriped, navy blue suit. His broken English often made him unintelligible. Cameras flashed during his lecture.
"Modern medicine is physical, material way, analytical way," Kushi said, "therefore overlooking this universe's force coming in, and the earth force go up, coming in constantly, constantly, constantly."
To demonstrate this alleged force, Kushi produced nail clippers suspended from a dark thread. "This is no gimmick," he assured us. Then, dangling them over a supine M.D., he proceeded to give the chakra demonstration to which John had referred on our way to Becket. According to Kushi, the chakras caused the clippers to trace small circles over corresponding areas of the body. However, close observation revealed that the circling was caused by movements of Kushi's arm.
The methods espoused by Kushi do not correspond to scientific medical practice but are part of what he calls the "traditional arts of Oriental healing." They include pulse diagnosis, visual diagnosis, meridian diagnosis, voice diagnosis, astrological diagnosis, parental and ancestral diagnosis, aura and vibrational diagnosis, consciousness and thought diagnosis, and spiritual diagnosis-all of which were defined in the information packet we received.
Voice diagnosis supposedly identifies disorders of the glands, organs, and certain body systems. Kushi said, for example, that a "watery voice . . . means natural kidney-bladder is overworked. Also must be blood vessels expanded for too much water. . . . So when [you] hear a watery voice, then you should immediately know heartbeat overworked, and kidney overworked, and blood overworked."
Astrological diagnosis uses the time and place of birth and current astrological and astronomical conditions to "characterize the basic constitutional tendencies of the body and the mind as well as the potential destiny of the current and future life of the subject." After outlining nine Oriental "astrological types," Kushi summoned volunteers representing "opposite" types, compared their smiles, and commented that some were "idealistic, very romantic, uplifted" while their supposed opposites were "gentle" and "more reserved."
Behavior diagnosis supposedly reveals dietary imbalances related
to psychological functions. For example, if you eat too much fish,
the next day you will make fish-like movements, Kushi said, illustrating
his point by sitting in a chair and moving his knees repeatedly
apart and together.
Environmental diagnosis utilizes atmospheric conditions, including temperature, humidity, celestial influences, tidal motions, and other data to reveal the "environmental cause" of a person's physical and psychological disorders. To illustrate, Kushi said: "Your bed, whether you sleep head north, head south, also different. Which should it be? Head should be more north if you are living in northern hemisphere. If you are living in southern, opposite."
After supper, before the lecture resumed, two doctors tried to duplicate Kushi's demonstration with the nail clippers. When I pointed out to one that her arm was moving, she invited me to try. I did, holding my arm still, and when nothing happened, she responded, "Oh, my God, when somebody wants to, they can really botch this."
The next session opened not with Michio, but with his wife, Aveline, in traditional Japanese dress, discussing her recent translation of a Japanese fortuneteller's book on nutrition. Millman then "treated" us to an 9-minute sample of the translation. Later, Michio held the nail clippers over the head of a woman seated on the floor with her eyes closed and said, "Please just remain quiet, okay?. . . . Please, very quiet, please. . . . Now, start to think again. . . . Think of husband or boy friend. Or romance. Your partner. . . . Now, let's change the content of thinking. Think about war. Many of friends is hurt. . . . Towns and cities are burned and destroyed. Many thousand, thousand people are being killed, and we are burning. . . . You can see, huh? By thought, vibration change. . . . The chakra vibration change." I noted how slight movements of Kushi's arm caused the clippers to swing-this time circling the purported crown chakra-at progressive speeds alleged to reflect the intensity of the woman's mental activity.
Unfortunately, I had to leave the seminar before it ended. When I last saw Kushi, he was exhorting the physicians to fulfill their true role as teachers of the macrobiotic way of life. I think they will.
Lawrence Lindner, executive editor of the Tufts Diet and Nutrition Letter, saw Edward Esko for a private consultation at the Kushi Institute as part of an assignment for American Health Magazine and reported his findings in the May 1988 issue. Lindner was told: (a) his heart was enlarged because he ate too much fruit; (b) his kidneys were weak; (c) he was slightly hypoglycemic; (d) deposits of fat and mucus were starting to build up in his intestines; (e) cold drinks could freeze the deposits and cause kidney stones; and (f) he should avoid chicken because it is linked with pancreatic cancer and melanoma. The consultation cost $200. He concluded: "The macrobiotic lectures, courses, books and tapes . . . besides running into hundreds or thousands of dollars, teach a philosophy of life, not nutrient interactions." In a recent interview, he added, "Some people are attracted to macrobiotics because, like a typical cult, it seems to offer simple solutions to a variety of life's problems."
Stripped of its philosophy and bizarre notions of body function and disease, does macrobiotic eating make any sense? Over the years, many reports have noted arrested growth and other forms of malnutrition among children eating a macrobiotic diet. Several lawsuits have claimed that cancer patients who relied upon macrobiotic methods instead of proven therapy met with disaster. (As far as I know, no such case has come to trial. They either are still pending or were settled out-of-court with an agreement not to disclose settlement terms.) Dr. Dwyer's article in the March/April Nutrition Forum points out how the diet poses significant risks for cancer patients who use it in addition to conventional methods.
Macrobiotic proponents respond to these criticisms in several ways. They state that deficiencies are the result of following the diet incorrectly-in an overly restrictive fashion. They claim that they do not try to lure cancer patients away from medical treatment with promises that the diet will cure them. And they point to research findings that macrobiotic adherents have lower blood pressure and very low cholesterol levels that protect them against coronary heart disease. (A study by William Castelli, M.D., for example, found that over 100 followers of the macrobiotic diet in the Boston area had an average blood cholesterol level of 125, while a control group of similar ages averaged 185.) However, they are not likely to add that other dietary approaches to disease prevention, such as the Pritikin diet or well balanced vegetarian diets, are nutritionally superior and much more palatable.
No long-range study has been attempted to measure whether macrobiotic devotees wind up, on balance, better off than their non-macrobiotic counterparts. Since macrobiotics has so many variables, such a study could be difficult to construct. To begin with, as Kotzsch has admitted, no one can say with certainty what it means to be "macrobiotic." And if the results of such a study showed that devotees fared better, the reasons for their success might be extremely difficult to identify.
Thus, although macrobiotic eating might improve the health of many American adults-it presents significant and unnecessary risks of nutritional deficiency. Nutrient supplementation, lab tests, and consultations with a qualified nutrition professional could minimize this risk. But macrobiotic philosophy discourages such safeguards.
This article was originally published in the May/June 1990 issue of Nutrition Forum. At that time, Mr. Raso was Assistant Chief Dietitian at Wyckoff Heights Medical Center in Brooklyn, New York and had taught nutrition courses at Pratt Institute and Long Island University. He is now Director of Publications for the American Council on Science and Health and editor-in-chief of its Priorities For Health magazine.