Macrobiotic Diet Benefits, Foods to Eat vs. Avoid - Dr. Axe

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What Is the Macrobiotic Diet? Learn About Benefits & Top Foods


Macrobiotic diet

The meaning of macrobiotic is “great life.” The core concepts central to the macrobiotic diet, including the Traditional Chinese Medicine belief balancing yin and yang both within the body and one’s environment, date back many centuries in ancient Eastern traditions. Proponents of macrobiotic eating approaches have long encouraged people to eat natural, whole foods that not only support the health of their bodies, but also the ecosystem and natural order of life.

As a “counter-culture” eating approach, macrobiotic diets became trendy in the U.S. during the 1960s because they encouraged living with more harmony, practicing a positive mind-set, and viewing food as much more than just simply calories or fuel.

Although every person reacts differently to different dietary approaches, evidence shows that macrobiotic-style diets can help improve heart health, lower inflammation and support a healthy body weight well into old age.

What Is a Macrobiotic Diet?

The macrobiotic diet is a plant-based diet rooted in yin-yang theory that stems from Asia. According to macrobiotic theory, balancing yin and yang is accomplished through eating a mostly vegetarian, low-fat diet with a balance of different macronutrients (proteins, carbs and fats), foods that have different energetic qualities, and a wide range of vitamins and minerals from plants. This approach to eating is believed to best support agriculture, local farming, digestion and even mental well-being.

Other recommendations for eating a macrobiotic include buying locally grown produce, purchasing organic foods that are not treated with chemical pesticides, eating foods that are in-season, consuming mostly fresh and raw foods, and emphasizing plant foods over meat, dairy and other animal products.


Most macrobiotic diets emphasize consumption of a wide variety of plant foods, which means these diets tend to be relatively high in carbohydrates (such as the SCD diet). However, because refined sugar and processed/packaged foods are not part of the macrobiotic plan, these carbohydrates are “complex,” great sources of dietary fiber, and chock-full of antioxidants and other nutrients.

Although there are many different varieties of macrobiotic diets eaten around the world, most have roughly the following breakdown:

  • 50+ percent of calories coming from complex carbohydrates (sometimes even up to 80 percent), 15 percent to 30 percent healthy fats, and 10 percent to 20 percent proteins. Even though carbs are eaten in high quantities, refined carbs like processed grains and sugar are avoided.
  • A high proportion of the carbs in macrobiotic diets (around 25 percent to 30 percent of total calories) comes from fresh or cooked vegetables. This is a very high percentage considering how low-calorie vegetables naturally are.
  • Complex carbs, such as brown rice, barley, millet, oats and organic (non-GMO) corn are also frequently eaten, making up about 30 percent to 40 percent of total calories.
  • Many also get about 5 percent to 10 percent of their calories from legumes or beans, often the types that are fermented like tempeh, miso or tofu.
  • Sea vegetables are a staple in most macrobiotic diets, making up about 5 percent to 10 percent of total calories.
  • A small percentage, about 5 percent of calories, tend to come from fish or seafood (usually consumed several times per week on average).

You might notice that macrobiotic diets have a lot in common with the famous Okinawa Diet, which isn’t surprising considering both have similar roots in Asian cultures. The Okinawa Diet is named after the largest island in the Ryukyu Islands in Japan and is consumed by some of the healthiest, longest-living people in the world.

In fact, Okinawa has been coined one of the world’s Blue Zones, where people have the highest odds of living past 100 years. The average life expectancy in the United States is 76.4 years, but it’s 84.6 years in Japan (higher for women compared to men).

Health Benefits

1. High in Essential Nutrients and Shown to Help Reduce Inflammation

In 2015, the School of Public Health at the University of Memphis released findings from a study investigating the anti-inflammatory and anti-cancer potential of macrobiotic diets. The study compared the nutrient composition of a macrobiotic diet plan compared to national dietary recommendations (RDA) based on the National Health and Nutrition Examination Survey (NHANES).

A key comparison was assessing which approach scored high on the dietary inflammatory index (DII), in addition to comparing levels of total calories, macronutrients and 28 micronutrients.

Findings showed that the macrobiotic diet plan had a lower percentage of energy from fat, higher intake of dietary fiber and higher amounts of most micronutrients. Nutrients in the macrobiotic diet often met or exceeded RDA recommendations, with the exception of vitamin D, vitamin B12 and calcium.

Based on DII scores, the macrobiotic diet was found to be “more anti-inflammatory compared to NHANES data,” and the researchers concluded that overall findings indicated potential for disease prevention when following a macrobiotic eating approach.

2. May Help Improve Heart Health

Certain studies have found evidence for macrobiotic-style diets supporting cardiovascular health — in particular lowering serum lipid levels and lowering blood pressure levels. This isn’t surprising considering how many high-antioxidant, anti-inflammatory foods are encouraged in a macrobiotic diet.

For example, the macrobiotic diet is rich in dietary fiber, including all sorts of high-fiber foods, such as veggies, beans and unprocessed ancient grains. Eating plenty of fiber has been correlated with improvements in cardiovascular disease risk factors through multiple mechanisms, including lipid reduction, body weight regulation, improved glucose metabolism, blood pressure control and reduction of chronic inflammation.

3. Can Help Support a Healthy Weight and Relationship to Eating

Much like those eating the Okinawa way, proponents of the macrobiotic diet focus not only on eating the right foods, but also eating them in the right amounts. Eating mindfully, slowing down and savoring meals, paying attention to physical sensations (also called biofeedback), and thoroughly chewing food are all emphasized in the macrobiotic diet.

This approach can help you better manage how much you eat, give you more enjoyment from having less, teach you to avoid emotional eating out of boredom or other negative feelings, and achieve satiety more easily. Rather than trying to lose weight just by eliminating many foods or consuming less, which can lead you to feel overly hungry and deprived, eating mindfully and choosing foods wisely can help you feel more in touch with your body’s needs.

4. Very Low in Sugar, Gluten and Packaged Foods

Like other whole food-based diets that eliminate junk foods, packaged products, bottled drinks, fried foods and fast foods, the macrobiotic diet is very low in sugar, empty calories and artificial ingredients. This makes it a very nutrient-dense diet, high in things like vitamin C, vitamin E and fiber but overall low in calories.

It can also be potentially beneficial for those with food allergies since it eliminates common allergens that can cause indigestion, such as dairy products, almost all gluten and nightshades. However, one drawback and point of critique is that macrobiotic diets tend to include lots of salty, high-sodium foods, mostly from things like soy sauce, fermented soy products and sea veggies.

5. May Be Able to Help Prevent Cancer

Although diet is only one piece of the total puzzle when it comes to preventing cancer, and results vary from person to person, research suggests that consuming a macrobiotic diet can help lower the risk for cancer partly by providing high levels of antioxidants and phytoestrogens.


A 2011 report published in the Journal of Nutrition stated, “On the basis of available evidence and its similarity to dietary recommendations for chronic disease prevention, the macrobiotic diet probably carries a reduced cancer risk.” Women consuming macrobiotic diets tend to have modestly lower circulating estrogen levels, which has been tied to a lowered risk of breast cancer.

Macrobiotic diets provide high amounts of phytoestrogens from foods like fermented soy products and sesame seeds, and these may help regulate production of natural estrogen by binding to estrogen receptor sites. While too much estrogen comes with its own risks, in the case of women over the age of 50 who naturally experience decreased levels during menopause, extra estrogen from their diets might help decrease cancer risk, among other benefits.

Macrobiotic diet foods - Dr. Axe

Foods to Eat

Foods that are considered macrobiotic include:

  • All sorts of fresh vegetables other than nightshades, especially daikon radishes, cooked or fresh leafy greens like bok choy, cabbage, mushrooms, scallions, leeks, broccoli, carrots, beets, various squash varieties, watercress, and cauliflower
  • Fresh herbs, including ginger, garlic, cilantro, etc., plus soy sauce, tamari, fish sauce, brown rice syrup, and honey for sweetening or flavoring
  • Sea vegetables/seaweeds
  • Beans and legumes, tofu, tempeh, adzuki beans, black beans, and edamame
  • Nuts and seeds, including sesame, pumpkin, almonds and cashews
  • Ancient, unprocessed grains — this includes all types of rice (especially brown), millet, barley, buckwheat, amaranth, quinoa, rye, oats and organically grown corn
  • Noodles made from brown rice, soba and other grains
  • Miso or fermented soy condiments (and miso soup)
  • Unrefined oils made from things like sesame or pumpkin seeds
  • Tea, such as green, black, jasmine, white, oolong, bancha, dandelion, herbal, etc.

Foods to Avoid

Here are the foods to steer clear of on a macrobiotic diet:

  • Packaged and processed foods
  • Diary products
  • Meat
  • Eggs
  • Refined sugar and sweeteners
  • Chocolate or cocoa products
  • Most fruits, especially tropical fruits
  • Coffee
  • Strong or hot spices
  • Nightshade vegetables: This includes avoiding dark-colored veggies, such as eggplant, tomatoes, potatoes and peppers. How come, you might be wondering? Although nightshades are not a problem for a high percentage of people, some experience digestive symptoms when consuming these foods, including allergies, leaky gut symptoms and autoimmune reactions. However, eliminating these veggies across the board is one common critique of the macrobiotic diet since many feel this isn’t necessary for most otherwise healthy people.

Diet Plan Tips

  • Cook fresh foods at home more often, especially over a gas stove, reducing the amount of leftovers and microwaved, frozen or canned food you consume.
  • Make plants the center of your meals, only consuming fresh, wild seafood (and especially meat or dairy) in limited quantities.
  • Aim to eat a variety of colored fruits and veggies every day, since different colors indicate different antioxidants.
  • Drink plenty of clean water and tea, avoiding sweetened drinks, alcohol and caffeine.
  • Try to thoroughly chew foods in order to improve digestion and also slow down during meal times. You should ideally aim for up to 25–50 chews according to macrobiotic diet theory.
  • Use glass to store food and water instead of plastic products.

Recipe Ideas

  • For breakfast: a green smoothie, brown rice porridge with nuts and seeds, or a savory, traditional breakfast of miso soup, veggies and legumes.
  • For lunch: miso soup with sea vegetables, a small amount of wild fish, sautéd vegetables and a serving of unprocessed grains, such as brown rice. Tea can also be consumed throughout the day.
  • For dinner: similar to lunch, such as soup with soba noodles and veggies, fermented beans or tempeh for protein with seaweed salad, or a stir-fry made with veggies, grains, nuts and seeds.

Macrobiotic Diet vs. Paleo Diet

  • The Paleo diet is modeled after what our ancient ancestors are believed to have eaten thousands of years ago, meaning only natural foods that could have been found within their local environments.
  • Because both the macrobiotic diet and paleo diet emphasize eating organic, non-processed, local and seasonal foods, the two diets have some underlying principles in common — however, certain foods also differ between the two approaches.
  • One of the biggest differences between macrobiotic and paleo diets is that macrobiotic diets are plant-based, sometimes even completely vegetarian or vegan. People eating a macrobiotic diet get their protein from plant foods like tofu, legumes, beans, whole grains, nuts, seeds and occasionally some seafood.
  • The Paleo diet tends to include more animal proteins, including meat, fish, eggs and poultry. Both approaches, however, avoid dairy products and all processed vegetarian proteins (such as soy isolate or synthetic protein powders).
  • The Paleo diet also eliminates all beans, legumes and grains for the most part, while the macrobiotic diet encourages these foods. However, both diets reduce or eliminate added sugar, synthetic additives, artificial ingredients, refined oils, fried foods, and sometimes common allergens like nightshade veggies and gluten.
Macrobiotic diet vs. paleo diet - Dr. Axe

Risks and Side Effects

Although the macrobiotic diet is considered one of the most popular alternative or complementary dietary approaches to treating chronic diseases, including cancer, few studies have been able to actually prove its effectiveness in disease prevention or management. Therefore, more research is still needed before drawing conclusions about this diet’s healing benefits. According to some experts, there are concerns regarding the treatment of cancer with dietary approaches, such as macrobiotics, including:

  • Patients potentially delaying conventional treatments and doctor visits
  • Possibly developing nutritional deficiencies that hinder immune function, such as consuming too little vitamin D, calcium and protein
  • Consuming too little calories in general, which can cause muscle loss and fatigue — these can be worsened due to low iron and B vitamin levels

Some also find that macrobiotic diets have social limitations (due to strict adherence to this diet) that make them hard to follow. In addition, macrobiotic ingredients can be difficult to source, and salt intake on this diet plan is considered too high by some. There’s also disagreement about over the need to eliminate most fruits, including all tropical fruits.

These are all valid arguments and should be weighed against your personal preferences, beliefs and the state of your overall health. If you have an existing condition, such as heart disease or cancer, or you take medications, it’s a good idea to get a professional opinion if you start any new way of eating and experience any negative signs or symptoms.

Final Thoughts

  • A macrobiotic diet is an eating approach that stems from Asian traditions that emphasize consuming mostly plant-based (vegetarian) proteins, low amounts of animal foods and fats, and a balance of different micro- and macronutrients that support yin-yang energy balance in the body.
  • Macrobiotics hold true that foods that have different energetic qualities and a mostly plant-based diet are good for health (especially the digestive system) and also the ecosystem. Emphasizing local, seasonal, fresh plant foods is believed to support agriculture, local farming and mental well-being. It might also support heart health, promote longevity and offer protection against cancer.
  • Important practices when eating a macrobiotic eating include buying locally grown organic produce, cooking often at home, avoiding packaged foods, eating fermented and raw foods, and limiting dairy and animal products.
  • While a macrobiotic diet has been shown to have anti-inflammatory effects, some concerns are that macrobiotic diets are high in salt but relatively low in protein, antioxidants from fruit, vitamin D, calcium and sometimes B vitamins.

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