Pros and Cons of a Macrobiotic Diet

Pros and Cons of a Macrobiotic Diet
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What happens when you put diabetics on a diet composed of largely whole grains, vegetables, and beans?

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Macrobiotic diets have been described by the American Medical Association as “one of the most dangerous dietary regimens, posing not only serious hazards to the health of the individual but even to  life itself.” After all, macrobiotic diets are “predominantly vegetarian with a great emphasis…placed on whole grain[s].” What’s wrong with that? Well, they also used to tell people to not drink water, which isn’t good, and to avoid fruit—so much so that it’s resulted in modern-day cases of scurvy.

Now thankfully, “[t]he macrobiotic diet has evolved over the past 30 years. This is the more contemporary version: an emphasis on whole grains, vegetables, and beans, while minimizing most meat, eggs, and dairy. I don’t like them restricting fruits; don’t like all the added salt; but compared to the standard American diet, it’s got a lot of things going for it. Only a quarter of the saturated fat intake, less than half the sugar intake. A very respectable fiber intake, two-and-a-half times the national average, but actually taking in more sodium. So, while the macrobiotic diet is an anti-inflammatory diet—has a negative dietary inflammatory index score, as opposed to the pro-inflammatory American diet—some of the most anti-inflammatory foods are herbs and spices. So, instead of adding all that sea salt and soy sauce, the macrobiotic diet could be improved by using natural seasonings instead.

Okay, but has the macrobiotic diet ever been put to the test? Yes, for diabetes. The restriction on water probably wouldn’t help, as “higher plain water [consumption] is associated with lower type 2 diabetes risk”—though part of that may be because they’re drinking less soda. And, fruit restriction is probably not helpful, since fruit consumption “is associated with a significantly reduced risk of type 2 diabetes” as well. But same with green leafy vegetables, which is where the macrobiotic diet can really shine: it includes lots of greens. Look, you can do randomized, double-blind, placebo-controlled, crossover studies of kale, and show that it suppresses the after-a-meal increase in blood sugars. Eat a meal of white rice, chicken, and eggs and get a big spike in blood sugar—though significantly less adding just a tablespoon of dried kale powder, as opposed to some kind of placebo powder (though the effect is visually exaggerated by their y-axis shenanigans).

And macrobiotic diets use whole grains, which can significantly improve insulin sensitivity compared to refined grains, which may be due in part to all the wonderful things fiber can do to help our good gut bacteria thrive—which could potentially lower inflammation, and decrease diabetes risk. But you don’t know…until you put it to the test.

Just three weeks on a strictly plant-based diet composed mostly of whole grains, vegetables, and beans and… they got about a 10% drop in blood pressure, a whopping 35% drop in LDL (bad) cholesterol, and a 38% drop in fasting blood sugars—in just 21 days. Were these changes statistically significant? Here’s some three-month P values for you.  Those are my kind of P values. In other words, yes, the changes were significant in every possible way.

Similarly, short-term interventional studies on diabetics with these so-called Ma-Pi 2 macrobiotic diets have been performed across four continents. The “Ma-Pi” comes from the guy that came up with the diet, Mario Pianesi, a strictly plant-based diet based mostly on whole grains and vegetables, with legumes and some seeds, and decaf green tea as the preferred beverage. Look at these extraordinary numbers: a near 40% drop in fasting blood sugars; near 27% drop in LDL cholesterol in 21 days.

Now, they did lose weight, a few pounds a week, but those kinds of results were way more than one would expect with weight loss, and—here’s the kicker—that 40% drop in blood sugars was after cutting their insulin in half! So those numbers greatly underestimate the effects. Better results, on fewer drugs. That’s the power of plants. All we need now is a randomized, controlled clinical trial to really seal the deal—which we’ll cover next.

Please consider volunteering to help out on the site.

Image credit: Char Beck via Unsplash. Image has been modified.

Motion graphics by Avocado Video.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Macrobiotic diets have been described by the American Medical Association as “one of the most dangerous dietary regimens, posing not only serious hazards to the health of the individual but even to  life itself.” After all, macrobiotic diets are “predominantly vegetarian with a great emphasis…placed on whole grain[s].” What’s wrong with that? Well, they also used to tell people to not drink water, which isn’t good, and to avoid fruit—so much so that it’s resulted in modern-day cases of scurvy.

Now thankfully, “[t]he macrobiotic diet has evolved over the past 30 years. This is the more contemporary version: an emphasis on whole grains, vegetables, and beans, while minimizing most meat, eggs, and dairy. I don’t like them restricting fruits; don’t like all the added salt; but compared to the standard American diet, it’s got a lot of things going for it. Only a quarter of the saturated fat intake, less than half the sugar intake. A very respectable fiber intake, two-and-a-half times the national average, but actually taking in more sodium. So, while the macrobiotic diet is an anti-inflammatory diet—has a negative dietary inflammatory index score, as opposed to the pro-inflammatory American diet—some of the most anti-inflammatory foods are herbs and spices. So, instead of adding all that sea salt and soy sauce, the macrobiotic diet could be improved by using natural seasonings instead.

Okay, but has the macrobiotic diet ever been put to the test? Yes, for diabetes. The restriction on water probably wouldn’t help, as “higher plain water [consumption] is associated with lower type 2 diabetes risk”—though part of that may be because they’re drinking less soda. And, fruit restriction is probably not helpful, since fruit consumption “is associated with a significantly reduced risk of type 2 diabetes” as well. But same with green leafy vegetables, which is where the macrobiotic diet can really shine: it includes lots of greens. Look, you can do randomized, double-blind, placebo-controlled, crossover studies of kale, and show that it suppresses the after-a-meal increase in blood sugars. Eat a meal of white rice, chicken, and eggs and get a big spike in blood sugar—though significantly less adding just a tablespoon of dried kale powder, as opposed to some kind of placebo powder (though the effect is visually exaggerated by their y-axis shenanigans).

And macrobiotic diets use whole grains, which can significantly improve insulin sensitivity compared to refined grains, which may be due in part to all the wonderful things fiber can do to help our good gut bacteria thrive—which could potentially lower inflammation, and decrease diabetes risk. But you don’t know…until you put it to the test.

Just three weeks on a strictly plant-based diet composed mostly of whole grains, vegetables, and beans and… they got about a 10% drop in blood pressure, a whopping 35% drop in LDL (bad) cholesterol, and a 38% drop in fasting blood sugars—in just 21 days. Were these changes statistically significant? Here’s some three-month P values for you.  Those are my kind of P values. In other words, yes, the changes were significant in every possible way.

Similarly, short-term interventional studies on diabetics with these so-called Ma-Pi 2 macrobiotic diets have been performed across four continents. The “Ma-Pi” comes from the guy that came up with the diet, Mario Pianesi, a strictly plant-based diet based mostly on whole grains and vegetables, with legumes and some seeds, and decaf green tea as the preferred beverage. Look at these extraordinary numbers: a near 40% drop in fasting blood sugars; near 27% drop in LDL cholesterol in 21 days.

Now, they did lose weight, a few pounds a week, but those kinds of results were way more than one would expect with weight loss, and—here’s the kicker—that 40% drop in blood sugars was after cutting their insulin in half! So those numbers greatly underestimate the effects. Better results, on fewer drugs. That’s the power of plants. All we need now is a randomized, controlled clinical trial to really seal the deal—which we’ll cover next.

Please consider volunteering to help out on the site.

Image credit: Char Beck via Unsplash. Image has been modified.

Motion graphics by Avocado Video.

Doctor's Note

Stay tuned for the thrilling conclusion in Benefits of a Macrobiotic Diet for Diabetes.

The pros and cons remind me of a video I did on four ways of Improving on the Mediterranean Diet.

I’ve got dozens of other videos on preventing and treating diabetes with diet. How Not to Die from Diabetes is a good place to start.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

84 responses to “Pros and Cons of a Macrobiotic Diet

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    1. Chris,

      These are not studies of the people kept basically in captivity from a cult.

      The double-blind studies are testing the diet itself and I know that the people in the cult didn’t always thrive, but the diet does have a lot of oil and sodium and most of the WFPB doctors would lower the vegetable oils and some would also lower the sodium.

      There are correlational studies, for instance, between salted soy products and stomach cancer.

      And people like Dr. Barnard get people off of insulin taking people basically off oil so them getting those results without getting rid of the oil is pretty good.

      Dr. McDougall implicates oil with MS and says that it causes Cancer to spread faster and Dr. Greger did an excellent talk on the Omega 3/Omega 6 balance and these people are limiting things like flax seeds and are not limiting vegetable oils, so that would be a vulnerable area.

      They also may not be supplementing B-12 or eating enough calories and other vulnerabilities, but, as compared to what most Americans do eat, they probably have excellent results.

      Okay, I have said all of that, but mostly, it is valid to look at the double-blind studies and, you are right, the cult had people losing so much weight that they got down to 77 pounds, but I don’t know how many vegans are getting down to that level if they aren’t being fed by a cult leader, unless they have an eating disorder or have Cancer.

      1. To me, you take Ma-Pi off of it and look at the food itself.

        It is whole grains and greens and beans.

        Are you afraid when Dr. Fuhrman calls for a diet similar to this, except that he changes a few things?

        I haven’t heard of people getting down to 77 pounds on the Nutritarian diet.

        1. The problem is when the diet imposes restrictions on healthy foods and people don’t get enough nutrients. Fuhrman wants you to eat a pound of salad, beans, fruit, and nuts. Ma Pi wants you to eat a bunch of brown rice, some soup, and maybe a leaf of kale. And not enough energy to support life, apparently. There is no evidence for restricting veg, fruit, spices, seeds.

          1. “There is no evidence for restricting veg, fruit, spices, seeds.” Exactly. Seems irresponsible to restrict something proven to be so healthy with no evidence showing any benefit to its restriction.

  1. I am trying to understand why NutritionFacts does not include the year of publication in the upper right corner label. In this video, for instance, it is evident that the information in the very first article is several decades old, but why make interested readers look up the volume elsewhere in order to find out the year? When the publication year is actually included on the article shown, it often flies by too fast to read. Sometimes not stating the year has given the impression of old data being current, which makes me question the premise of the point being made. All could be solved if the publication year could just be included in the overlaid label along with the journal, volume and issue. As it is, it appears to be left off for some reason that goes unexplained.

    1. Under the Sources tab there is the list of all the articles (linked) cited including the title, journal, and date published. Seems convenient to me.

      I remember when the macrobiotic diet was very popular, and a version of it was my first try at a vegetarian diet. I was not a fan of sea vegetables (nor am I now) and wondered how that would impact the overall diet. I look forward to the next video.

    2. Hello Jeanne,

      Great attention to detail. While the date may not be displayed in the upper corners of the videos, all the articles are referenced in the “sources cited” section just below each video. That will be the most convenient way for you and other viewers to find each article; however, I will forward the message about including dates on the videos to the NutritionFacts staff.

      Thanks for being a viewer :)

      Matt

      1. Matt,

        That was a cheerful and helpful response.

        The dates are actually on the first page of each study, but the editing is done to make things go so quickly sometimes that it is harder to read without the pause button.

        Occasionally, leave the date on screen for a few milliseconds longer.

        Probably doesn’t need to be a whoe 25 frames.

    3. People seldom mention the date that the Law of Gravity was first formulated (i686) or Einstein’s Theory of General Relativity was first proposed (1915), either.

      If the studies were well-designed and conducted, the date of publication is pretty much irrelevant. However, I agree that it is important to know if newer but equally well-designed and conducted studies contradict, expand or modify the results of those earlier studies.

      Nevertheless, one of the problems with discussions of nutrition is that many alternative health proponents and the food industry like to argue that more recent but clearly confounded studies, often by people associated with particular industries or funded by commercial interests, render all earlier studies – experimental and observational – comptely invalid no matter if they were much better designed/conducted and are supported by multiple other lines of evidence. Or at least that they cast doubt on all the evidence that has gone before. We can see this happeneing now with the arguments about the guidelines for the consumption of sodium, saturated fat and dietary cholesterol.

      This technique actually worked with the dietary cholesterol guidelines despite all the evidence that serum cholesterol levels are increased by dietary cholesterol in most people who eat healthy diets and follow healthy life styles. Since most Americans don’t, and dietary cholesterol is only a minor factor in those circumstances (as demonstrated by large numbers of more recent egg industry studies), the recommendation limiting cholesterol consumption was dropped from the headline 2015-20 US dietary guidelines. However, they couldn’t completely ignore the science on this and the main body of the guidelines still state
      “As recommended by the IOM,[24] individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern.”
      https://health.gov/dietaryguidelines/2015/guidelines/chapter-1/a-closer-look-inside-healthy-eating-patterns/#other-components

      As an aside, I would say that the obvious conclusion of this statement is that the 2015-20 US DIetary Guidelines clearly imply that people should be eating a well-planned “vegan diet” since this is the only healthful eating pattern recognised by those Guidelines which provides no dietary cholesterol. See Appendix 5 to the Guidelines discussing the “Healthy Vegetarian Eating Pattern”
      “This Pattern can be vegan if all dairy choices are comprised of fortified soy beverages (soymilk) or other plant-based dairy substitutes.”
      https://health.gov/dietaryguidelines/2015/guidelines/appendix-5/

      Apologies for the long-winded post, but the point I am trying to make is that the date of the study or studies concerned really isn’t that important. What is important is the quality of the study itself and the ‘spin’ put on the results by the authors, media and industry. Sometimes that ‘spin’ simply ignores a raft of confounding factors that affected the statistical fundings. Newer studies aren’t intrinsically better and old studies aren’t automatically worse.

        1. Mr FF,

          Yes, I agree.

          The date the science is put to the test is not as important as the design of the study.

          This one, he showed the types of P Values he likes to see and that should be enough.

          Plus, he showed the process in his Behind The Scenes video and the process is extensive.

          They review the studies, plus all of the studies cited within each study used, etc.

          It was layer after layer of P Values for most of these topics.

        2. So, what did you fumble to get the nickname “Fumblefingers” ????

          Did you drop something and demonstrate the law of gravity or is it that you fumble with the little keys on your cell phone or something?

          1. Hi Deb No, it’s a rueful acknowledgement of the large number of typos that my pots usually contain. I like to blame my cheap laptop’s keyboard but it’s mainly my fault. You know what they say …. if the cap fits, wear it. I am now wearing it.

  2. One big “con” not mentioned in this video – the fact that originally – and apparently still in this Ma-Pi 2 updated version – brown rice may make up a high % of this diet – and rice, even the best organic brown rice – has become unfortunately loaded with arsenic.

    Dr. Greger released a whole series of short (3-5 min) videos on this topic, like this one: https://nutritionfacts.org/video/Where-Does-the-Arsenic-in-Rice-Mushrooms-and-Wine-Come-From/

    “Studies on the levels of arsenic in the U.S. food supply dating back to the 70s identified two foods—fish aside—with the highest levels: chicken and rice, both of which can accumulate arsenic in the same way. Deliver an arsenic–containing drug, like roxarsone, to chickens, and it ends up in their manure, which ends up in the soil, which ends up in our pilaf. “Rice is [now] the primary source of [arsenic] exposure in a nonseafood diet.””

    Or this one: https://nutritionfacts.org/video/how-risky-is-the-arsenic-in-rice/

    “The problem is, according to the National Research Council, with “the current [federal] drinking water standard for arsenic of 10,” we’re not talking an “excess cancer risk” of one in a million people, but as high as “1 case in 300 people.” What? My 300 extra cases of cancer just turned into a million more cases? A million more families dealing with a cancer diagnosis? “This is 3000 times higher than a commonly accepted cancer risk for an environmental carcinogen of 1 in [a million].” “[I]f we were to use the normally accepted” 1 in a million odds of cancer risk, the water standard would have to be like 500 times lower—.02 instead of 10. Even the New Jersey standard is 250 times too high. That’s a “rather drastic” difference, but “underlines how little precaution is instilled in the current guidelines.”

    Aside from some rice from India or Thailand, no rice grown anywhere in the world had less than ¼ of what American rice has, and even ¼ seems much too much given that apparently politics determined the safe level of arsenic in the U.S. not science.

    So even if a macrobiotic diet has positive results in the short term, if it still includes a large % of rice in the diet, the long term effect from potential arsenic poisoning makes a very big “con”.

      1. Hi Liisa –

        Yes I had – not impressed. I’d go with Greger on this one.

        Granted, McDougall makes one good if obvious point – people eating a WFPB diet – even one with a lot of rice high in arsenic – for most people will work a LOT better for health than a SAD type diet that promotes diabetes, cancer, and heart disease, etc.

        But if you aim towards an optimal diet, so that you can live as long and healthy a life as possible, just eating a diet high in plants does not seem enough. Some plants have become heavily contaminated with all sort of toxins, and choosing to eat a WFPB diet primarily consisting of plants low in pesticides, herbicides, lead, cadmium, and arsenic makes a lot more sense than choosing to eat a diet of plants loaded with them.

    1. True, although animal studies suggest that the bioavailability of arsenic from brown rice is less than 50% while from white rice it can be up to 90%
      https://www.sciencedirect.com/science/article/pii/S0048969717310677?via%3Dihub

      So brown rice might still be a better choice. This is relevant in countries like the Philippines where I live and where there are no practical (ie affordable and widely available) alternatives to daily rice consumption for the vast mass of ordinary people.

  3. With short term results like these from a halfway decent diet, it is a mystery to me why a WFPB diet is not standard treatment for T2 diabetics and pre-diabetics. What’s wrong with our medical system? How can doctors be so highly compensated yet ignorant and not good health advisors?

    1. We have a disease care system not a health care system. The current system says ‘just stop in for a occasional checkup’ and waits until a person has something chronic. Then they kick in and you become part of the machine until it heals or you die. Doctors are trained in what to prescribe/medications and available surgeries/therapies, however look at many doctors and you will also see some of the most out of shape bad eaters because they were not ever taught nutrition that could be applied to their lives like most people.

      There also is very little profit in prevention compared to treatment.

  4. I ate macrobiotic before and still have the cookbooks. I find it hard to believe that it is supposed to be high in seasonings and sodium. All the recipes I have ever made relied on subtle flavors and very little seasoning. Here is a quote from The Macrobiotic Way under A Note on Spices: “One important thing to remember about the macrobiotic diet is that the foods themselves, enhanced with just a little sea salt, flavor the meals.” And even the salt is just ‘a pinch’ in most recipes. Strong spices are even discouraged. In fact one of the main reasons why many people who tried the macrobiotic diet quit eating it is they found it too bland.

    1. Jimbo,

      It is Sodium, which it is high in.

      Dr. Greger is recommending other spices as a healthier replacement for the Soy sauce and Salt.

    2. Jimbo,

      You are spot-on! I was confused by what the Dr. was saying there. Except, there were many who would over do things. For example overuse the miso and some other things (I for example would over do the rice, we all have our issues!).

      But Michio would always say that the “standard” macro diet would always need to be adapted. For the individual. For the condition. For the region and for the season. For example, what was totally macro for living in tropical climates–eating MORE fruits–would not be appropriate for those living in a 4 season local. Similarly, it was considered totally macro that Eskimos would rely largely on meat, especially in the winter when vegetation was not locally available.

      Anyway, yes. Most of my friends I tried to turn on to Macro diets thought it very bland indeed.

  5. Going macrobiotic was my gateway into eating healthy. Like most things in life you take what you need and leave the rest.. I’ve modified my diet over the years and still use things I learned in my macro cooking classes.. Love my miso, shitaki and tamari.. I just use less sodium containing foods now.. YMMV and it works for me
    mitch

  6. The two worst cases of Combined Systems Degeneration thatI ever saw in macrobiotic diets, functionally quadriplegic, developed due to low B12; it must be supplemented!

    1. I was at a seminar where I saw Michio Kushi, the head of the macrobiotic foundation. He was sneaking a cigarette out back…
      Got me thinking…Humm
      mitch

        1. He did die of cancer. Which has been a never-ending joy to those who refuted his work and the Macrobiotic diet (which was also known as the anti-cancer diet).

          But hey, he was 88, and ya know, we all have to die of something (and this was before the “how not to die” book was published–wink-wink). Who knows, had he not smoked (how much I don’t know) perhaps he would have lived longer. Or had he not eaten Macro, perhaps he would have lived shorter.

          As an aside, I got into Macro because of a family member’s cancer. She had stage 3 cancer, and it had already gone into the lymph system. She was operated on and the tumors grew back. And she was given about three months to live from the oncologist in the hospital here in NYC.

          Within weeks of going Macro, her whole body started to change and improve. And within the three months she was to have passed away, the tumor that had grown back again, was disappearing. This was in the fall of that year. And by the following summer she was running the Appalachian Trail in Pennsylvania and the healthiest she had ever been.

          She went on to live a full and healthy life, and died at 12. Oh, I should mention, she was the family Doberman. Yes, a major part of the family and the reason I learned and became Macro. I later went on to meet many humans who had beat cancer with macro as well. So I do believe it, as well as the variations of it that Dr. Greger teaches, are very anti cancer.

          1. Do you remember which foods you fed her?

            My dog had Tempeh and carrots and cauliflower and broccoli tonight.

            It is hard for me to figure it out.

            I don’t do a whole lot of variety myself, so it makes it harder when he rejects beans or lentils or rice.

            I don’t know how to spice things properly for him.

            The canned foods all have gravy, but when I ponder gravy and sauces, I can find low sodium but the have onion powders.

            If I could find a good vegan gravy which wouldn’t kill my dog, I would be happy.

            1. I fed him vegan for the first three and a half months. Back then he ate a lot of sweet potatoes and other things, but he is sick of sweet potatoes.

              Then added salmon dog loaf in, but which is good because it has vitamins but i don’t want to give fish every day and he isn’t a hundred percent thrilled with that either.

              He is hungry all the time but I don’t understand how to feed him.

              I pondered Keto and even ordered the food they use at KetPet but they were out and two weeks later they never sent it and that you mix with a ton of coconut oil.

              90% coconut oil and 5% meat, 5% vegetables and he eats a few bites of coconut now and then but it isn’t his favorite right now and I don’t think I understand that I could give him a few cups of coconut oil and he might get healed of Cancer. Yuck!

              1. Hi Deb,

                a FB friend, who is a long time vegan and excellent cook (judging from her posted photos), recently posted these comments about dogs eating a vegan diet:

                ” Btw, until recently the longest lived dog in Guinness book of world records was a border collie who was lifelong vegan and lived to be 27.

                my dogs eat a completely non-natural choice vegan diet. I researched for about a year before I was sure I would do it right. But dogs are NOT obligate carnivores, and if you look at most commercial dog food, it’s made entirely of supplements. Even the proteins are added back in to kibble because the rendering process destroys them. So I do supplement several amino acids, which is optimal, and I add a balance of fats (because one proof that humans are not Omni- or carnivores is that we get arterial fat deposits from dietary fat and they don’t), B12 and vitamin D. They probably don’t need the B12 because they eat disgusting things and dirt and sticks, but it won’t hurt. They do get occasional animal proteins from the scraps from one friend’s catering business and another’s family.

                my dogs eat food I make – legumes, oats, occasional Thai brown rice, leftover grains and other from our food, sweet potatoes, greens, coconut oil, vit D3, B12, L-carnitine, Taurine, branch chained amino acids, veggies and fruit puréed or cooked. The peels are always puréed. I don’t cook with walnuts, macadamias, onions or anything else that dogs can’t eat since they get our leftovers. It isn’t hard – 2 days worth goes into the pressure cooker and then if we get scrap from outside sources it lasts even longer. Takes an hour of unattended time, can be frozen. And we have 9 dogs [all rescues, I think], so this is pretty easily doable. The harder part was getting the research right. Btw, all amino acids are lab synthesized – it’s easy and cheap and extracting from animals is expensive. So, semi vegan dogs, other than the castoffs of friends who eat the other beings.”

                I can ask her for more details, if you’d like. (I told her that we eat all the left-overs I make: I LOVE left-overs!! Less cooking the next day!)

                1. Thank you so much, Dr. J.

                  I am not sure if my dog will eat that without some sort of gravy.

                  In the beginning, I was giving him beans and rice and sweet potatoes, but he is not that into any of those or oatmeal.

                  I probably could put maple syrup or honey on oatmeal and he would eat that, but I am not sure that would be good for a dog with Cancer. I looked at more gravies tonight, but most of them put onions. I found a mushroom broth, which uses sea salt. Not ideal.

                  He would do anything with flavoring but looks at me like I am crazy if I put a dish with oatmeal or rice or beans or lentils or fruit or vegetables without some sort of flavor. Then, he looks at me as if I am crazy if I put too many spices, even though he wants to lick the bowl every time I have chili. He eats tempeh but looks at me crazy if I give him tofu without figuring a way to add flavor.

                  I am thinking a lentil loaf might fool him. I have been pondering the glazes people use. Ketchup isn’t exactly what I think of when I think of dog food.

                  1. Do you have a blender for making “gravy?” And can dogs eat cherries? I saw a “sauce” made of cherries (dark/sweet) for meat that Chef AJ made.
                    Alternatively, how about a “gravy” made of fruit? Applesauce is typically paired with meat and goes well with a lot of things. “Pearsauce?” I buy frozen dark sweet cherries and it would be easy to put them in a blender (with a pared apple?) Or something else you want to add?

                    1. Hey, people eat cranberry sauce with turkey, applesauce with pork, etc….. so maybe it could help solve your gravy problem. Just think a little differently….

                2. Dr J.,

                  You are a good person to ask about the dog artery logic. Do you believe it or does it feel like Keto logic to you?

                  It doesn’t make sense to me.

                  Dogs get Diabetes and Cancer and have strokes and have heart attacks, are they not from the same causes humans get?

                  Do the fats not affect his pancreas or his endothelials? What causes their Diabetes? What cures it? Does saturated fat not cause arthritis or pain in old dogs, like it does in people? What causes theirs?

                  I have genuinely been trying to understand it, but it just feels like Keto logic.

                  I do believe they could get rid of Cancer when they have the dogs eat 90% of their calories from fat, but old dogs get pain and diabetes and have strokes and I just don’t but the logic.

                  Are there scans of their clear arteries? Then what causes dog strokes?

                  1. I was listening to Keto doctors and I have listened to the WFPB doctors debunking it and the WFPB show me pictures. I honestly trust the pictures more than half the studies because there is so much money at stake that people do manipulate studies.

                    Dogs used to live until 17 average and now they die at 11 and I don’t trust any of the dog experts. I don’t trust my dogs vet, even though I genuinely like him.

                    They haven’t studied WFPB with dogs versus Keto.

                    1. I could use raw as an example. That whole community says that dogs eat poop off the ground and don’t get sick from bacteria and that if you clean things properly or freeze the loaves there won’t be bad bacteria. I know people who proclaim that rabidly. Then, I look it up and the vets say it isn’t safe and that freezing it doesn’t get rid of the bacteria and they tell what to do if dogs get sick and 1 out of every seven samples tested with bad bacteria conservatively. One testing it was almost 50%. They give it to dogs to heal them of Cancer but the dog food specialty shop owner said basically use at your own risk because dogs do get sick.

                    2. My vet has said some of the logic, but when it was hot, the vet would say be careful not to take him out in the heat of the day, he could have a heart attack and when he had to be carried in he talked about looking for signs of stroke and when he sent my dog home with me, he told me to not excite him because he didn’t want his blood pressure to go up.

                      And steroids can cause Diabetes.

                      So all of those are the same diseases….

                      But they come from different mechanisms?

                      And I will even point to cats which need certain nutrition but all of the cat owners are talking about Diabetes and Cancer too.

                      I just don’t think they have looked at it properly and I blame the evolutionary framework instead of using science.

                      But that is my theory.

                    3. I don’t mind when the teeth and age of mummified beings are examined for what they ate, but people even now eat different things different times of the year and switch what they eat based on what is available. I feel like the evolutionary arguments for animals and for humans end up being a way for people to present their Keto or Psleo or Vegan framework and unless there are old people skeletons found with perfect teeth and proof of long survival and no diseases, then we end up with Dogs evolved from wolves and should eat like them logic rather than dogs can digest carbs so let’s test which diet works better.

                    4. Anyway
                      Dogs and cats get Cancer and it is either the same mechanism that me. Gets Cancer or not.

                      They get diabetes and the cat owners were talking about it but there isn’t a Dr Barnard checking to see if it works the same in the animal world.

                      He is someone I would like to hear his opinion because he might say, “nope, their pan erases don’t fill with fat because of this: ” and if his answer had any logic, I would be happy.

                    5. Yes, Deb! I have those same questions. I asked my vet to read “The China Study” and he did! But now he’s retired and I’ve lost touch with him. I wish I could get his read on this topic, too.

                    6. Another would be grains.

                      For humans and T Colin Canpbell level research it is the animal products causing Cancer to grow faster, but the prevailing winds of logic blame the grains and all of the people around me avoid grains, too, and it feels like they are blaming carbs and promoting fat like Keto does and adding on if they were still wolves they would be eating raw meat and never getting sick because dogs in the wild are so much healthier than dogs with owners and I haven’t seen that evidence yet.

                    7. I thought of a better example:

                      We do evolutionary dogs teeth aren’t designed to chew plant food.

                      But Purdue studies say that dogs improve their odds of not getting Cancer by 90% if the eat plant food regularly.

                      Which is better to learn?

                    8. Dear Deb with the Amazing Dog, It doesn’t matter in the end what the teeth look like or what dogs ate in previous years IF the science supports a different type of food–no?

                    9. Liisa,

                      You make me smile!

                      It has been so hard to talk things through with the Keto People.

                      I can say that they may have success with Cancer giving their dogs 90% Coconut Oil, but they can’t give me any points for my thoughts. It is nice to have a sweet community.

            2. Hi Deb,

              I am new here, so I may not be familiar with any backstory you have shared before on the forum. Should I assume that your dog has cancer as well? Or some other illness?

              Regardless, after my dog passed, and I ended up with two new additions to the family after, they only ever got human grade food. Despite that I have to say they did not live extraordinarily long lives. But, and this is important, they were demonstrably healthier while they were on this planet. (One of them would get sick if on any dog food for even a few days, so it made a difference).

              I will also share that I found some breeds take to healthy macro style eating instantly. Others, not so much. My doberman went wild for it. When I would start cooking veggies, she would sit there at the foot of the kitchen literally drooling. One of my next was a rottie/black lab mix who was equally in love with the good food. Yet a golden/collie/dingo/bunny rabbit mix I had (ok, I may be off on the exact mix here!) really only liked meat and was much harder to feed in a healthy way.

              When Macro was first suggested for my dobie’s cancer I called the Kushi Institute, and did as much research as I could (given it was the very early days of the internet, it was much harder than today). The bottom line that I came away with was that dogs have been living with humans, eating as we do for thousands of years. Dog “food” was only invented ~100 years ago, or less. And it is designed for a lot of things, good health being only one of them, and that is rarely high on the list. Firm stools, shelf life, palatability to dogs so they will eat it, all usually come first.

              Variety is key for health. As the Dr.’s videos show, we need so many different veggies to get so many of the nutritional items we need. If you dog won’t eat what you cook, you can convince him/her by using a homemade “gravy”. And by that I mean some type of meat broth or small amounts of meat blended into other items and mixed in and over the food. Ideal? No, but better than nothing.

              A couple of more things: If your dog is sick with cancer or whatever, there will likely be a detox period. For my dog this included skin eruptions so bad that she would start bleeding from her chin. If she didn’t have cancer and a death sentence hanging over her, I would have cut back and slowed down the process. Regardless, it was mostly passed in a 2-3 months. But taking things slower is a good option if it has been eating poorly for years.

              The other thing is that about a year and a half later, she began to have terrible food allergies. After months of work on it I found the only two things she could eat without side effects was beef and broccoli (No Chinese take out jokes please). Again, patience and a couple of months later and she could start widening her foods again and all was fine.

              Sorry for the long-windedness of my reply. The take-away is that everyone is a bit different, but the answers are there. You just need to fiddle and tweak longer than you would prefer.

              1. ” The bottom line that I came away with was that dogs have been living with humans, eating as we do for thousands of years. Dog “food” was only invented ~100 years ago, or less. ” What a great reminder! Also, I suspect that dog food incorporates a lot of the offal that people don’t want incorporated in *their *food so into the commercial dog food it goes?
                (Maybe someone who works or has worked at a pet food company will comment?)

              2. Lance,

                Thank you for your detailed answer! I appreciate it so much! My dog is a golden mix with Hemangiosarcoma. He had a tumor the vet called the size of a basketball, the biggest he ever had seen, and that was just one of the tumors. He also had some tiny tumors on his neck and face. He went in after collapsing and was carried in not eating at all and not walking at all. He had an infection with a very, very high fever and was bleeding internally with the Cancer. That was 18 weeks ago. I was told that he wasn’t expected to live, possibly not even the weekend, but that I could take him home and that the vet would come and put him down when I was ready. It is a Cancer where if I had chosen to have him have the $10,000 surgery, he was likely to die on the table and even if he lived, I was told they only live a few weeks to a month or two even with the surgery and they live not much longer with the surgery, plus chemo. So, I took him home and have fumbled with what to feed him and he is just like your golden mix. I do always get food into him, but I have made big batches of food and had trouble getting him to eat one bowl. I thank you for your counsel. I will look for a meat gravy. It is better than nothing.

                I honestly, almost have changed him to a Keto or meat diet, but the Keto site never shipped the food and I bought two loaves of turkey meals and one was cooked Sous Vide and he gobbled that down, but the other was raw and I didn’t understand that he took one bite and walked away and I had to throw it out, because I couldn’t just leave it out and do a power struggle with him and I ended up not bringing it outside and got a garbage can full of tiny bugs by morning. My brother used to say that fruit flies were in the fruit. Well, apparently, they are in the meat, too. Or they just flew in while I was sleeping, which I don’t sleep very many hours, but they were there in the morning.

                Anyway, he had a few cans of salmon and he had a few meals of turkey and he loves the turkey, but he is looking so good and I feel like I am speeding up his cancer, so I have been looking at vegan dog food recipes again, but so far all of those have failed. I think gravy is what is missing.

    2. Michio used to say ( and it is in his books) that IF YOU ARE IN GOOD HEALTH then eating fish 1 or 2 times a week was fine. He was not a fan of eating chicken or beef. And while he recommended white meat fish, salmon was generally very popular with macro followers and at macro restaurants. (at least here in NYC).

  7. Hah! “Do what I say, not what I do.”

    So Kushi died of pancreatic cancer at age 88, according to his bio. Another hmmmmm…..

  8. Hello Doc,
    I am a new fan of yours this year, and have been devouring your videos. And I have been repeatedly surprised how similar what you teach is to what I learned studying Macrobiotics (Lucky me, I got to study with the Master, Michio Kush at the Kushi institute. Which after an over 50 year run, was shuttered a couple of years ago.)
    I studied there over 20 years ago, and have to tell you that the “scary” Macro diet that I frequently read about–well I never saw those recommendations. And most of those things are related to “Zen Macrobiotic”, which you can assume has little to do with what Kushi was teaching over the past many decades.
    That said, I recall Michio saying to drink reasonable amounts of water, not the gallon or so that has been the popular health recommendation for years. He also recommended, like you do, that much of your daily fluid intake be tea. His institute would have green tea and twig and barley tea earns around the campus to drink any time of day.
    I have to say, when I was strict Macro for a few years, it was the healthiest time of my life!

    1. “I have to say, when I was strict Macro for a few years, it was the healthiest time of my life!”
      – – – – –

      Lance, if it was the healthiest time of your life, is there a reason why you didn’t want to stay on the diet permanently? It’s too boring maybe?

      1. Hello YR, Good question. But there is no good, nor any singular answer to it. As to macro being too “boring”, that would not be how I would have put it.
        Because it both is, and is not.
        On one hand, it is not boring as you have the most vibrant range of great natural food to choose from. Nothing boring there. But on the other hand, we live in the western world and everyone around us is eating from a much broader range of choices (even if they may not be healthy).
        Being macro, or WFPB is far easier if you have a partner that wants to eat the same way. If not, it is very easy to slip.
        Plus, eating this way really does require one do a good deal of cooking in general, and a lot of prep. I love cooking, but day after day, sure, it does become easier to simply “grab something” while on the go. And even if its a supposedly healthy Chipotely dish, it still is not the same.
        Finally, what I will answer end with that while I am no longer fully macrobiotic, I do strive for what I call “Mostly Macro”. That may mean 80%, or maybe even 50%. And along the way have tried out keto and Paleo, all of which have their pluses and minuses.

  9. Most older people and men can do fine on this diet. Younger, and pregnant women, need to include more iron rich food to avoid becoming anemic. Blackstrap molasses (1 tablespoon) will provide 20% of needed iron. Couldn’t find any videos in Nutrition facts on anemia, or how to get more iron on a plant based diet. Anyone?

    1. Lots of lentils, chickpeas, and peanuts; eat vitamin C with them to increase absorption (citrus and bell peppers are great); don’t drink coffee, tea, or calcium fortified plant milk with meals. Address the root cause of anemia – are periods abnormally heavy? Try ginger to reduce blood loss. How is GI health? Overexercising? If you are currently anemic it’s safe to take an iron supplement until ferritin levels are back up.

    2. Hi Marilyn

      I presume that you are discussing only iron deficiency anaemia and a full medical work-up has ruled out the many other types of anaemia including pernicious anaemia.
      .https://www.mayoclinic.org/diseases-conditions/anemia/symptoms-causes/syc-20351360

      As Miki says, eat plenty of foods containing non-heme iron with fruits and vegetables high in vitamin C to boost absorption, while avoiding tea and coffee for a couple of hours before and after meals since these inhibit iron absorption.

      1. Hi Tom, yes, have had a few young women vegans who just had low ferritin levels. They were eating the higher iron plant foods with fruit, or even taking some vitamin C with meals.
        Nothing wrong with them other than anemia.
        At our high altitude anemia causes more symptoms than it would at sea level.
        Was wondering if anyone here, or maybe a monitor, knew of NF videos addressing this, as I couldn’t find any.

          1. Hi Marilyn

            Can’t help much I am afraid. However phytic acid (as well as tannins) inhibits iron absorption. It might therefore be useful to suggest not eating grains, nuts and legumes at the same time as eating foods containing non-haem iron. However, sugar (fructose) does appear to aid absorption so also sugggest lots of fruit along with the high non-haem iron containing vegetables?
            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3858368/

            Yes, chlorella is supposedly a good non-haem iron source.

            Just one final point, this article and comment may (???) be relevant to those young women. Or not..

            “…..restrained eaters may be at greater risk of low iron status”
            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793309/

            1. Tom, the article on ‘restrained eaters’, is extremely relevant. I learned quite a bit from it. Didn’t know ferritin levels were affected by inflammation. Never had a Doc do a CRP, no less an a1GP along with ferritin level.
              I was aware that non-heme iron isn’t absorbed as well, but didn’t know about the specialized receptors.
              Lots of information, things to consider, thank you for posting.

              1. Marilyn Kay, and Mr. Fumblefingers, thank you both for this discussion and your links. I have been suffering anemia for a long time now and this info is helpful!

              2. Thanks Marilyn.

                The $64,000 dollar question then becomes: are those young women overweight/obese?

                I ask because of your inflammation point. Adiposity itself appears to be an inflammatory condition and not only impairs non-haem iron absorption, it also halves the ability of vitamin C to boost non-haem iron absorption. If we assume that overweight/obese young women are the ones most likely to be engaging in calorie restriction diets, then they have multiple factors pre-disposing them to iron deficiency states.

                https://academic.oup.com/ajcn/article/102/6/1389/4555164

    3. Marilyn, I can’t offer any incredible insight but in my experience I find it more than easy to get iron on a plant based diet. I used to use cronometer and even when I was calorie restricting, my iron levels were always in the red zone (meaning it was above the safe upper limit) of course I knew it was fine because it was all non-heme iron. I don’t seem to have any problems with iron absorption, I do consume a lot of vitamin C and I do incorporate onions and garlic with a lot of meals (Dr. Greger has a video with a chart showing how just a small amount of onion drastically increases iron absorption–garlic and vitamin C work as well). There’s a lot of plant foods with exceptional amounts of iron though. According to the %DV listed on my cans of black soy beans, black soy is an incredible source of iron compared to other beans which are also good sources.

  10. Just hearing the term “water restriction” makes me thirsty. I think the fact is simply that when you eat whole plant foods, it’s going to do incredible things for your health. Restricting some of the healthiest whole plant foods instinctually just feels wrong. What this shows to me, is that whole plant foods are incredibly powerful things no matter how they’re arranged on a pyramid.

    1. S,

      I feel the same way about water restriction.

      If anything, most of the elderly people around me suffer from dehydration and so do many of the young people. I spent years trying to get the 8 glasses per day and rarely got more than 3 or 4, except when I went to restaurants, which kept filling my glass.

      Seems like to focus on not drinking water is something, which would make my mind confused because I would be taking the same water I might drink and put it in a teacup and put a tea bag in. I know that tea is healthy, but I don’t have a sense that the water in it isn’t.

      1. Yeah, water is one of the most essential things to our health and survival. For immediate survival as far as the essentials go it would be oxygen, water, then food. To advise people to restrict water is insane to me at best, like telling them to watch how many breaths they take and restrict oxygen instead of just breathing as their body tells them it needs to. The water in itself is incredibly healthy, our bodies couldn’t function without it.. we couldn’t detoxify, our digestive systems wouldn’t work, nothing would work.

  11. Dear Dr. Gregor,

    again I have a question:

    Is it true that you can eat as much fruits as you want?

    Or is it dangerous to eat a lot of fruit, because too much
    fructose morphs into fat, which settles around the inner organs
    (especially the liver) and causes serious illness?

    Viele Grüße
    Joachim Koch
    Dipl.-Psychologe
    Aalstr. 18a
    DE-32549 Bad Oeynhausen
    Germany

    1. Hello Joachim,

      This is a very common question and Dr. Greger has some videos targeting this exact topic. While high fructose corn syrup is certainly harmful,whole fruit does not have the same negative effects on blood sugar or triglycerides (via liver metabolism). This is due to fiber and phytonutrients found in fruit. You must remember that food is a package deal, and you do not only receive individual components. Furthermore, researchers have also done studies in the attempt to determine what the maximum safe dose of fruit is, and they found there were no negative side effects except for large bowel movements. Whole fruits are safe to consume in any amount; however, for optimal health, it’s a good idea to vary one’s diet as outlined by the Daily Dozen.

      I have linked a couple videos for you to refer to on the topic.
      I hope this helps.

      Matt

      Fructose vs. Fruit: https://nutritionfacts.org/video/if-fructose-is-bad-what-about-fruit/
      Too Much Fruit?: https://nutritionfacts.org/video/how-much-fruit-is-too-much/

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