The macrobiotic diet is a predominantly vegetarian, whole-food diet rooted in several principles that are said to create a condition for the body to heal itself.

The diet has been suggested to prevent and even treat cancer as well as provide other health benefits.

This article explains what the macrobiotic diet allows, its benefits and downsides, and provides a 3-day sample macrobiotic diet menu.

macrobiotic diet

What is the macrobiotic diet?

The macrobiotic diet — or macrobiotics — is a plant-based diet popularized in the early 20th century by George Ohsawa in Japan, and later introduced to America by one of his students, Michio Kushi (1).

The word “macrobiotic,” is derived from the Greek word, “macros,” meaning great or long, and “bios,” meaning life (2).

It was developed from a series of principles that were considered to promote a healthful way of living and prolong life.

Today, it’s commonly recommended as a treatment option for certain conditions and diseases, including cancer, either alone or alongside conventional treatment.

The principles upon which the macrobiotic diet is based include (1):

  • Eat local foods in season
  • Meals should consist of foods varying in taste, color, and texture
  • Eat until you are full but no more
  • Chew each mouthful at least 50 times for optimal digestion
  • Refrain from eating three hours before bed
  • Enjoy and be grateful for the foods you consume
  • Cook with a peaceful mind and with love

Ohsawa originally developed a strict, “Zen macrobiotic,” diet, which was completely vegan.

However, the macrobiotic diet has since evolved to be more flexible.

Comprising 35–50%, the bulk of the diet consists of whole grains, followed by vegetables, making up 25–35% (1).

The rest of the diet is composed of seaweed and beans, and occasionally, dried and cooked fruit, seeds and nuts, as well as white meat fish.

Foods that are to be avoided or eaten rarely — usually monthly — include red meats, eggs and poultry, dairy, and sweets.

By allowing meats and other animal products on occasion, the macrobiotic diet is similar to a flexitarian diet.

However, there is not necessarily a standard macrobiotic diet as it should be tailored to the individual.

Foods to eat and avoid

The macrobiotic diet consists primarily of whole grains, vegetables, and beans while limiting fruits, sweets, and animal products.

Food to eat

Here is a list of foods to eat daily on the macrobiotic diet (1):

  • Vegetables: mostly lightly cooked vegetables, with some raw vegetables allowed
  • Sea vegetables: nori, wakame, kombu, hiziki, arame, dulse, sea palm, agar-agar, Irish moss
  • Beans and bean products: aduki beans, chickpeas, lentils, tofu, tempeh, natto
  • Whole grains: brown rice, barley, millet, wheat, oats, rye, buckwheat, corn
  • Fish: white meat fish, such as flounder, sole, carp, and halibut
  • Nuts and seeds: pumpkin, sesame and sunflower seeds, peanuts, walnuts, pecans
  • Oils: olive and canola oil
  • Condiments: soy sauce, sea salt, brown rice vinegar, umeboshi plum or vinegar, rice syrup, barley malt
  • Beverages: green tea, roasted brown rice tea, dandelion tea, and cereal grain coffee

Foods to limit or avoid

Here is a list of foods to avoid or eat occasionally — either weekly or monthly — on the macrobiotic diet (1):

  • Fruits: primarily locally-grown and in-season
  • Nightshade vegetables: artichoke, asparagus, avocado, beets, eggplant, okra, peppers, potatoes, spinach, tomatoes, zucchini
  • Whole grains: processed grains, including bread and pasta
  • Poultry: eggs, chicken, turkey
  • Red meat: pork, beef, goat, lamb, veal, venison
  • Dairy: milk, cottage cheese, yogurt, butter, dairy desserts
  • Sweeteners: honey, table sugar, and artificial sweeteners

Keep in mind that the diet is designed to be tailored to meet individual needs so there is some flexibility with what the diet allows.

According to macrobiotic principles, foods that should be avoided depend on the climate and disease conditions.

For example, in temperate climates, the diet restricts meats, animal fat, dairy, chocolate, tropical fruits, potatoes, tomatoes, peppers, asparagus, avocado, hot spices, and alcohol (1).

With breast cancer, the diet restricts all animal products, ice-cold foods and drinks, and all flour products, except for the occasional consumption of unleavened whole wheat or rye bread (1).

Specific recommendations on what to avoid exist for other conditions or types of cancer.

3-day sample macrobiotic diet menu

Here’s a 3-day sample macrobiotic diet menu (3):

Day 1

  • Breakfast: baked millet balls and beicha tea
  • Lunch: vegetable soup with barley and a brown rice salad
  • Snack: barley croquettes
  • Dinner: vegetable soup and millet with vegetables

Day 2

  • Breakfast: baked millet and brown rice cake with onions
  • Lunch: brown rice with carrots and leaks and a lettuce salad with chickpeas
  • Snack: brown rice balls and beicha tea
  • Dinner: vegetable and millet soup and boiled chicory with soy sauce

Day 3

  • Breakfast: baked millet balls and beicha tea
  • Lunch: miso soup with barley and lentils
  • Snack: millet cake and beicha tea
  • Dinner: vegetable soup and boiled broccoli and chicory

Benefits

As a primarily whole-food, plant-based diet, the macrobiotic diet has many associated health benefits.

May reduce the risk of chronic diseases

The macrobiotic diet’s focus on whole grains, vegetables, and legumes makes it rich in fiber and beneficial plant compounds called polyphenols that may reduce the risk of various chronic diseases.

Fiber is the non-digestible component of plants that has been shown to support gut health, reduce cholesterol levels, and support healthy blood sugar levels, among other benefits (4).

Low-fiber diets have been associated with an increased risk of several chronic conditions, including diabetes, heart disease, and certain types of cancer.

Unfortunately, most people only consume half of the recommended daily amount, which is 21–38 grams per day, depending on gender and age (5).

In contrast to the standard American diet, an analysis of the macrobiotic diet suggested that it provides an average of 50 grams of fiber daily (6).

The same analysis also demonstrated that the macrobiotic diet has strong anti-inflammatory properties, in part related to its fiber content, but also its content of polyphenols, which offer potent antioxidant and anti-inflammatory properties (6).

Indeed, in one study, patients with type 2 diabetes who followed a form of the macrobiotic diet experienced significant improvements in blood sugar control, antioxidant activity, and LDL “bad” cholesterol compared with those who followed a Mediterranean-style diet (7).

The patients who received the macrobiotic diet also experienced significantly more weight loss, which was likely responsible for some of the observed health benefits.

Other small studies have also shown that a form of the diet improves blood sugar, cholesterol, blood pressure, and body composition in people with type 2 diabetes (8).

It’s healthier than the standard American diet

The macrobiotic diet tends to be more nutritious than the diets of most Americans.

For example, one study reported that the macrobiotic diet contains lower amounts of saturated fat and sugar and higher levels of fiber than the average American diet (6).

Compared with the average American diet, the macrobiotic diet also tends to be higher in antioxidants, iron, zinc, vitamin C, and many B vitamins (6).

As a result of higher contents of antioxidants, fiber, and other nutrients, the macrobiotic diet has been shown to be significantly less inflammatory compared with the average American diet.

Downsides

Here are a few downsides to the macrobiotic diet to consider:

It lacks key nutrients

Although the macrobiotic diet tends to be healthier than the standard American diet in some aspects, it still may lack many nutrients.

Research suggests that the macrobiotic diet contains lower levels of vitamins D and B12, calcium, and potassium than the recommended dietary allowance, likely due to the diet’s restriction of fruits, dairy, and animal-based proteins (6).

The diet also tends to be low in calories, providing less than 1,500 calories per day (6).

This calorie level may be appropriate for some but most people need more calories to maintain their weight, especially those with certain medical conditions, including some types of cancer.

The macrobiotic diet also provides around 15% of daily calories from protein or about 56 grams (6).

While this amount may be enough to prevent a protein deficiency, it’s likely suboptimal for health and much less than certain populations like older adults and those with certain illnesses or diseases need to support immune and muscle function (9).

Lacks evidence as a cancer treatment

The macrobiotic diet has been suggested to prevent and even cure cancer.

While several case reports have been reported on the apparent curative effects, there remains no strong evidence to support its use for cancer treatment (1).

It’s clear that diet plays an important role in the prevention of certain types of cancer and that it can improve cancer-related health outcomes, but relying on diet to cure your cancer isn’t a good strategy.

Instead, diet — not necessarily the macrobiotic diet — should be used in combination with appropriate medical cancer treatments, since it can help combat some of the adverse side effects of the treatments and bolster the immune system.

The bottom line

The macrobiotic diet is a predominantly vegetarian diet that consists primarily of whole grains, vegetables, seaweed, and legumes.

There isn’t necessarily a standard macrobiotic diet, as it’s intended to be tailored to the individual and influenced by food availability and climate.

Some smaller studies suggest that the macrobiotic diet offers a variety of health benefits in people with type 2 diabetes, but there’s no strong evidence to suggest that it can be useful for treating cancer.

Although the diet tends to be more nutritious than the standard American diet, it may lack several key vitamins and minerals, including vitamins D and B12, calcium, and potassium.

Keep these pros and cons in mind in determining whether the macrobiotic diet is right for you.


Gavin Van De Walle, MS, RD, LN
Gavin Van De Walle, MS, RD, LN

Gavin Van De Walle holds a master's degree in human nutrition and bioenergetics. He is a registered dietitian who aims to arm the public with evidence-based nutrition recommendations so they can make their own educated and informed health decisions.