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Macrobiotics Research Project
This study uses qualitative medical anthropological methods to evaluate the effects of macrobiotics on health, healing and cancer prevention.
The basic macrobiotic diet is primarily vegetarian: whole grains, vegetables, legumes and soy products, sea vegetables, some fish and some fruit, and is low in fat, sugars and processed foods.
We are collecting healing narratives, self-reports of lifestyle and health, and food diaries, and conducting extensive interviews with about 100 macrobiotic practitioners and 25 macrobiotic counselors.
A principal aim is to answer why people adopt macrobiotics and why they stay on, stop or modify the diet. We will also consider short- and long-term effects of macrobiotics, its use as a complementary or alternative cancer therapy and, for those who claim that macrobiotics helped them, how they used macrobiotics and conventional therapy, and the course of their disease.
This research aims to provide associative evidence to provide the groundwork for future prospective studies on macrobiotics. We have focused on gaining a broad understanding of the actual practice of macrobiotics in the Columbia, South Carolina, area.
Columbia has had one of the most active macrobiotic communities in the United States for the past 15-20 years.
The study of macrobiotic practice is complicated by the fact that macrobiotics is not just a set of dietary guidelines. Rather, food is seen as medicine and medicine as food within the oriental concept of balance. Macrobiotic counselors are reluctant to give hard and fast rules because in their understanding no foods are necessarily bad for a healthy person, except when eaten in excess. Thus macrobiotic practice is highly individualized.
The adoption of macrobiotics is also usually associated with a wide diversity of alternative healing practices and other lifestyle changes. The qualitative approach is thus essential for the study of the holistic context of health, healing and diet in people’s actual lives.
Principal Investigator: Jane Teas, PhD
Co-Principal Investigator: Joan Cunningham, PhD
Project Coordinator: Puja Verma, MSPH
Consultant: Ginat Rice, Macrobiotic Chef and Counselor
Graduate Assistant: C. P. Kanwat, MBBS
Interviewers: Jane Teas, Ginat Rice, Puja Verma, C.P. Kanwat, Angelica Kushi.
Defining Macrobiotic Practice
Macrobiotics entails a worldview of complementary dialectics. It is based upon Taoist principles of yin and yang illuminated by George Ohsawa, the founder of the modern macrobiotic movement. Ohsawa articulated seven principles and ten theorems that govern existence. For example, all phenomena are energetic manifestations either of expanding and centrifugal (yin) energy or contractive, centripetal (yang) energy. Everything is a mixture of both forces and weighted more heavily to one side or the other. Each force attracts its opposite and repels its likeness. Therefore all phenomenal matter is constantly in flux, making change the only universal constant.
Adherence to macrobiotic principles and practice may be narrow or wide depending on the person’s understanding and condition. Many people who identify themselves as macrobiotic practitioners occasionally eat foods generally excluded from macrobiotic dietary practice in a temperate climate such as meat, poultry, dairy, eggs, sugar, chemicals, and simple carbohydrates. They consider their macrobiotic practice wide. Other people consistently eat grains, beans and vegetables yet do not identify themselves as macrobiotic because they do not embrace its worldview.
Macrobiotic identity therefore is an issue of personal choice. Exact practice defies definition. Ohsawa delineated 10 levels of macrobiotic dietary practice; Michio Kushi, today’s principal instructor, presents the concept of a healing diet and a standard macrobiotic plate with variations according to season, climate, health condition, and so forth.
Ohsawa defined seven levels of consciousness or judgment. A clearer understanding of the variances within macrobiotic practice is possible with correlation to these seven levels. The levels of judgment are a progression of consciousness incorporating all forms of macrobiotic practice. Because all others rest upon it, Ohsawa declared the mechanical level the most essential. It is wrong to attach greater worth to the more exclusive stages.
Mechanical: Spontaneous, automatic response. This is the widest level of macrobiotic identification. A mechanical practice of macrobiotics means eating according to instinct, drive and habit. It is the physical level of macrobiotic practice—that is, digestion, absorption and elimination. In this sense, everyone is macrobiotic. This is the natural level of human judgment during the period of gestation.
Sensory: Awareness of pleasure and pain, beauty and ugliness, comfort and discomfort. Macrobiotic practitioners at the sensory level are concerned with the taste and aesthetics of food and the pleasure and comfort they derive from it. The presentation of food is important along with ambiance and mood. This is an infant’s natural level of judgment.
Emotional: Awareness of love and hate, joy and sadness, likes and dislikes, harmony and disharmony. Macrobiotic practice on this level focuses on sentimental attachment to food. Perhaps a dish reminds one of his grandmother’s table, a trip to Paris or the breakup of a marriage. This is the level of a 3-year old child who “loves” and “hates” gratuitously.
Intellectual: Awareness of reason and unreason, proved and unproved, general and specific causes and effects. This is the level of scientific theory such as governmental dietary recommendations or piecemeal advocacy of supplements and additives such as wheat bran, shark’s oil, and so forth. This is the level of adolescence when one begins to seek understanding and reasons.
Social: Awareness of right and wrong, suitable and unsuitable, proper and improper. Social-level macrobiotic practice focuses on society rather than the individual. Systems of distribution are sought, economics and ecology are considered, and common good is a goal. This is the level of young adulthood.
Philosophical: Awareness of justice and injustice, righteousness and unrighteousness, spiritual and material, invisible and visible. A philosophical practice of macrobiotics incorporates the belief that mankind can be served through macrobiotic principles and practice. Macrobiotics moves beyond food to a system of social justice. Practitioners reaching this level of judgment seek spiritual consciousness. They are interested in the philosophy of macrobiotics and yin-yang concepts of balance. Macrobiotics thereby provides a view of the world at the level of adult maturity.
Supreme: Awareness of universal and eternal consciousness, all embracing, unconditional love and acceptance, endless gratitude and complete freedom. This is the natural, universal level of eating according to seasonal and local availability in which need and desire merge. It is the level of intuitive eating without regard to any of the other six levels.
Choosing a Macrobiotic Lifestyle
Practitioners choose a macrobiotic lifestyle with one of three objectives:
Serious illness: The subject learns that a macrobiotic way of life successfully reversed a life threatening condition similar to his own. His primary focus is on health with no philosophical reasoning. He requires professional guidance for radical and immediate diet changes. Instruction is needed from a trained macrobiotic chef to learn principles and methods of cooking following a macrobiotic consultation. Follow up support during the detoxification process is essential to elucidate physical and emotional changes.
Conditions of discomfort and pain: The person seeks to relieve a chronic disorder such as a migraine headache, digestive disorder, overweight condition, sleeping difficulty, or modern day syndrome such as chronic fatigue, ailments which may be precursors of more serious illness. This person transitions into a macrobiotic diet gradually. He has few radical physical discharges as he slowly changes his eating habits. He needs guidance and instruction, but not necessarily follow up counseling.
Personal interest: A third type of person is attracted to macrobiotics for its enlightening philosophy. Eating in harmony with nature according to traditional dietary patterns appeals to his common sense. He seeks to prevent disease and develop his consciousness. This group includes many of the founders of macrobiotic communities in the 1970s and 1980s when American macrobiotic community life was at its peak.
Why Do People Cease Practicing a Macrobiotic Way of Life?
Social isolation: Macrobiotics is not a mainstream lifestyle. Practitioners may feel socially segregated and judged. They must withstand the pressure of family and friends to resume conventional food. Some form of social support is vital in maintaining this asocial behavior.
Physical Changes: Healing with macrobiotics entails bodily changes. Discharge may take the form of temporary pain, swelling, fever, rapid weight loss or even tumor growth. All of these are seen as positive signs of cleansing and rejuvenation. Long-term toxins are released progressively in reverse order of their accumulation. Without a counselor's guidance, these changes may frighten a newcomer. A qualified counselor will adjust dietary recommendations in accord with these transitions.
Inconvenience: Macrobiotics requires an effort. Pre-planning and time in the kitchen are required. Methods of preparation must be maintained. Good quality macrobiotic restaurants are at a premium.
Study Methods and Limitations: Data Sources
Macrobiotic services and activities were examined in forty-four study areas spanning thirty-one states. Data was collected primarily by telephone interviews of past and present macrobiotic practitioners. Without exception, everyone approached agreed to participate in the research. The interviews were supplemented by our personal experience during extended travel in the east, northeast and southern US from December 2000 to January 2002.
The population areas chosen for this study reflect a cross section of America. Nearly 80 million people, or about one-third of the country’s population, resided in the selected study areas (1990 US Census). Twenty-six of the areas are metropolitan regions; seven have over 3 million residents, including the nation’s largest metropolitan centers of New York, Los Angeles, Chicago, Philadelphia, and the District of Columbia. The remainder are separate cities, counties or regions. Interviews varied from fifteen minutes to multiple conversations over the course of several days.
Thirty-four people interviewed, or twenty-five percent of the total, have practiced macrobiotics for twenty-five years or more. Sixty-five percent of those interviewed have followed this lifestyle fifteen years or longer, and two are second-generation adults who have practiced macrobiotics from birth.
The number of persons interviewed in each study area varied with regional availability and the area’s services and activities. In six study areas all the information was culled from one interview; in eleven areas, two people were interviewed. Three or more people were consulted in the remaining twenty-five study areas.
Rating the Study Areas
A rating system was created to provide an overview of each study area and serve as a basis for comparison. Macrobiotic services and community activities were rated separately along an ascending scale.
Macrobiotic services include resident and/or visiting counselors and cooks. Advertising for counseling and cooking services is commonly found on health food store bulletin boards and community newsletters among the larger macrobiotic populations. Almost all areas have large whole food supermarkets with areas for seminars and gatherings. Some have kitchen facilities for cooking demonstrations. An abundant rating signifies five or more resident and/or visiting counselors and cooks; Healthy services indicate study areas with three or four counselors and cooks; Moderate describes an area with one to two counselors and cooks. Dormant services indicate a total absence of counselors and cooks. Twelve of the forty-three study areas were rated as having abundant services; only three were dormant. Sixty-nine counselors and ninety-two cooking teachers are currently working full or part-time in the combined study areas.
Macrobiotic activities serve as a social outlet and support network for practitioners. Common activities include social gatherings, dinners, lectures, seminars, newsletters and support groups. These forums allow an exchange of ideas and open discussion of issues and questions. Dinners include restaurant meals, potlucks and catered affairs. Potluck dinners generally rotate among private homes, or are held in churches, restaurants or other public venues. Restaurants offering a sole macrobiotic dish --incorporated into the report data --were not included in this rating; only those explicitly macrobiotic were rated. Like classification of abundant, healthy, moderate and dormant describes macrobiotic community activities in each study area. Six study areas were given abundant ratings for their activities whereas seventeen areas were dormant with no community activities at all.
The Kushi Institute in Becket, Massachusetts is the leading macrobiotic educational center in the United States today. Certificates of completion are offered in residential training courses. The final level of study recognizes the participant as a counselor and cooking teacher. Of 130 people interviewed, thirty-seven studied at the Kushi Institute, twenty-five of these completing three levels of macrobiotic career training. Two are currently perusing level IV counselor certification.
Counselor training is also available at schools including the Strengthening Health Institute in Philadelphia, PA, Vega Institute in California, and on the Internet with David Briscoe. Twelve people contacted studied with the Aiharas in California and three at Denny Waxman’s Strengthening Health Institute.
Many macrobiotic counselors are self-taught through books and personal experience. Prior to the establishment of the Kushi Institute in 1977, twenty-two long-time macrobiotic friends who we contacted studied with Michio and Aveline Kushi in their frequent lectures around the country, and with Herman and Cornelia Aihara in California. Others have the distinction of being wounded healers, learning first hand how to transform illness to health.
The majority of macrobiotic cooks learn their skills in the homes of private mentors in either group or individual classes. In addition to the Kushi Institute several macrobiotic schools train students for careers in professional care taking and cooking. Six of the people contacted attended formal cooking schools other than the Kushi Institute such as the Natural Gourmet Cookery School. Founded in 1977 in New York City by Annemarie Colbin, it offers public classes and dinners and a Chef’s Training Program. The Natural Epicurean Academy of Culinary Arts in Austin, Texas offers a Natural Food and Macrobiotic Training Program for chefs. The School of Natural Cookery in Boulder, Colorado has graduated more than one thousand students since 1983 as personal chefs or professional cooks.
All states require certification in order to offer medical advice; a number require licensure to give nutritional information. Macrobiotic counselors have no licensing procedure or legal certification. Some require the client to sign a disclaimer of medical advice and emphasize the educational aspects of their work. Plans are currently underway by the Kushi Institute for state accreditation. Like counselors, cooking teachers are not certified.
Macrobiotic Practice Historically
Within the forty-four study areas, nine macrobiotic centers were created in the 1970s and twelve more in the 1980s. Macrobiotic services began in the 1990s in six areas. The other study areas enjoyed some aspects of macrobiotic service during these decades without formal centers. Only two macrobiotic centers remain today, that in Cleveland, Ohio, and the Macrobiotic Foundation of Central Florida in Orlando.
The demand for macrobiotic teaching and counseling peaked in the early 1980s. As counselors and cooking teachers developed family commitments they found themselves unable to sustain themselves without a second income. Multi-level marketing became popular either in addition to or instead of professional macrobiotic endeavors. Some moved on into alternative practices where steady income was possible. The deaths of Aveline and Lilly Kushi from cancer shook the macrobiotic community. Other top leaders who have passed away include Herman Aihara, Murray Snyder, Harriet McNear and Cecile Levin. Leading macrobiotic educators who have discontinued their community affiliations include Sanford Greenberg of Boulder, CO, and former instructors at the Kushi Institute such as John Mann, Richard France, Steve Gagne, Jerome Canty and Bill Tara.
The best counseling or cooking ability does not assure good leadership, and vice versa. Sandy Pukel of Florida consistently separates administration from services, allowing teachers and counselors to practice their art while he organizes their activities behind the scenes. He established multiple macrobiotic centers around the country in the 1980s. He continues to operate the health food store that he founded in 1970, currently adding a macrobiotic restaurant with plans for a macrobiotic cruise in January 2003.
In ten of the areas studied, macrobiotic services and/or activities appear dependent on a single leader. Examples include Ginny Harper in Nashville, TN, Linda King who is creating a community in Portland, OR, and Bonnie Kramer in Hartford, CT. In other areas new leaders are emerging as long-time principals are renewing activities, including Karen Martin in Seattle, WA, Roxanne Koteles of Charleston, SC, John Kozinski with plans in Chicago and Northamptom, MA, Phil Jannetta in Pittsburgh, and Margaret Lawson in Dallas, TX.
In the four study areas of Omaha, NE, Sarasota, FL, Wichita, KS, and Charlotte, NC, activities organized by a lone macrobiotic leader ceased when that leader left. In many cases, macrobiotic practitioners have remained active while services and/or activities diminished. In Seattle, WA, Chicago, IL, Cincinnati, OH, Pittsburgh, PA, Indianapolis, IN, Miami-Ft Lauderdale, FL, and Washington, DC thriving macrobiotic centers in the 1980s generated many macrobiotic practitioners but only moderate to dormant activity today.
Some study locations function without leadership. A case in point was the vacancy created when Harriet MacNear of Orlando, FL died. Thanks to the people that she trained, Orlando continues to be one of the outstanding macrobiotic communities in the country. Other communities with multiple leaders include Bob Carr and Francois Roland of Cleveland, OH, Kaare Bursell, Michelle Nemer, Patricia Murray, and Suzanne Jensen in the Bay Area, CA, Mina Dobic and associates in San Diego, CA, and the Waxman family from Philadelphia, PA.
One hundred and eight of the interviewees reported a sense of satisfaction with macrobiotics. Nine who are still associated with the macrobiotic movement voiced a sense of discontent. Eighteen others remain committed to macrobiotic principles and are displeased with some aspect of its presentation or practice.
Many people reported a general widening out of their diet from their beginning days. Mary O’Farrell says that she doesn’t expect her clients to embrace a total practice, but rather “wants any degree of compliance I can get.” John Pell says, “I eat less brown rice now and more salad. It works for me.” Dr. Robert Ruggles rides a bike 100 miles a day at the age of 79. He stopped wearing trifocals after incorporating barley greens into his diet. Dr. Gordon Saxe believes, “Wide macrobiotics is the healthiest diet for most people.” Dr. Jay Stone reports that variety is the key to successful macrobiotic practice. Ettia Tal explains, “You have to align with nature in order to be in touch with yourself. Then you can eat whatever you want.”
Some people criticize macrobiotics. Alice Blistein considers the restrictions of macrobiotics to be an eating disorder. Brenda Clark added animal protein to her diet but believes that macrobiotics helped her considerably for the time that she adhered to it. Carolyn Dino finds macrobiotics too yang and restrictive.
Some practitioners take the presentation of macrobiotics to task. Michel Abehsera claims to be “happy that macrobiotics derailed as a movement—it started to become a form of natural medicine.” Chuck Collison “uses macrobiotics daily” but is less outspoken about it now. Patricia Murray “goes in and out” of macrobiotics. “Some days I am inspired; other days I ponder why the keys to the kingdom have not been accepted by the sick and unhappy.” Joshua Rosenthal finds macrobiotics successful “in spite of itself.” Verne Varona considers macrobiotics to be “in a time warp, needing terminology other than yin and yang that nobody understands.” Naomi Waxman thinks that “macrobiotics is amazing as a philosophy; as a practice, it needs work.”
Among positive comments, 51 people recounted personal healing stories in which macrobiotic practice reversed a serious health condition. Of these, twenty one were instances of cancer; four more were pre-cancerous cysts. One woman revealed that her son’s autism has improved with his dietary changes. Macrobiotics was called, “The greatest thing in the world,” “an inspiration,” “a huge gift,” and “powerful.” Mina Dobic reported an “incredible sense of satisfaction and deep gratitude.” Sylko Dorsett found, “Macrobiotics has great healing powers.” Ann Gentry told us, “I see the power of food. I recommend it to my entire staff.” David Jackson asserted, “Macrobiotics is my life.” According to Phillip Jannetta, “I knew right away that this was it—macrobiotics ties everything together.” John Kozinski enthused, “Macrobiotics is personally satisfying and probably saved my life. It is an endless, fascinating study of life and how to help people.” Phyllis Libby insists she couldn’t eat any other way. Karen Martin explains, “Macrobiotics is tremendous. I have tried so many things for health and nothing approaches macrobiotics.” According to Meredith McCarty, “I don’t know if macrobiotics is growing; I just know it’s great.” Judy Waxman cannot imagine life without macrobiotics.
Natural Food Stores
Natural food stores and macrobiotics are closely intertwined. The emergence of the natural food movement in the last twenty years is the result of macrobiotics and continues to sustain its growth.
Approximately 3,600 natural food stores of varying size and variety operate in the United States today. In addition to these, approximately 4,200 stores nationwide generate at least 20% of their income with natural foods. Curiously, Seattle, WA, with 54 natural food stores, and Detroit, MI with 46 exceed all other study areas, yet show little evidence of current macrobiotic activity.
There are two nationwide whole food chain stores in the United States, with 235 branch stores between them: Wild Oats, founded in 1987 and Whole Foods, established in 1980. 255 natural food supermarkets, including local and national chains, are found in the 44 study areas. The Boston metropolitan area alone has 28 such stores, followed by Los Angeles with 24. Only five of the study areas have no natural foods chain store. Product availability varies by store.
Food cooperatives frequently have specialty products not found in the larger stores. Macrobiotic co-op members determine store inventory based on personal product use. A total of 59 natural food co-ops were found in the study areas; Minneapolis alone is home to ten.
Restaurants are an important part of our culture. Like most Americans, macrobiotic practitioners enjoy the pleasures of dining out. Although vegetarian and ethnic restaurants with vegan options are common in most urban areas, macrobiotic restaurants are a rarity. We were able to identify only 65 restaurants with macrobiotic-quality food, many of which are vegetarian or vegan with a single macrobiotic offering. More than one-third of these restaurants are located in New York City and Philadelphia, PA. Many former macrobiotic restaurants eventually widened their menu selections. Twenty-two study areas, more than half of those reviewed, have no restaurants offering macrobiotic food
Macrobiotics is a national movement in America. Several counselors, including Warren Kramer of Boston, MA, Verne Verona of Omaha, NE, and Lino Stanchich of Asheville, NC, travel periodically from city to city to lecture and consult. Alex Jack publishes Amberwaves, a quarterly magazine with national distribution, and the Georges Ohsawa Macrobiotic Foundation of California issues Macrobiotics Today, the longest-running macrobiotic organ. Internet learning and publishing is flourishing. Bob and Christina Pirello produce the popular Christina Cooks magazine in Philadelphia, PA along with a weekly PBS television cooking show and international macrobiotic tours. Mail order food supply houses have long supplied the national macrobiotic community with top-quality products. Thanks to all these efforts, distance is no longer an impediment to a macrobiotic lifestyle.
The majority of the 44 areas in this study are home to nearly two decades of macrobiotic practice, creating a strong infrastructure of available resources to support a macrobiotic way of life. Numerous individuals in all these areas remain dedicated to macrobiotic principles, even where macrobiotic activity has diminished significantly. Natural foods and life styles are more prevalent than ever before. It is safe to say that interest in traditional patterns of food and living is strong in the United States, and gaining the attention of the public at large as they seek answers for the difficulties of modern life. As the spiral of history unfolds, macrobiotic popularity will continue to wax and wane.
A 2-year grant sponsored by Centers of Disease Control; October 2000 to September 2002 University of South Carolina, Prevention Research Center-Special Interest Project, School of Public Health 15 Medical Park, Suite # 301, Columbia, SC 29203
This work was supported by Grant/Cooperative Agreement Number U48/CCU409664-09 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.