Macrobiotic Medical Research

By Alex Jack[1], Denny Waxman[2], and Aaron Shenhar[3]

Scientific and medical research on the macrobiotic way of life, dietary approach, and key foods has influenced and shaped national and international dietary guidelines and medical treatment. It has also led to the prevention and relief of chronic disease and improved the quality of life of thousands of people. The Smithsonian Institution recognized the contribution of macrobiotics to “healthy diet, our increasingly global culture, alternative healing, peace studies, and traditions of grassroots activism” with the creation of a permanent Michio and Aveline Kushi Collection at the National Museum of American History in Washington, D.C. in 1998.[4] Peer-reviewed research over the years has focused on heart values and cardiovascular disease, nutrition, children’s health, cancer, AIDS, diabetes, exposure to nuclear radiation, environmental illness, geriatric and psychiatric illness, and macrobiotic-quality foods. This brief listing summarizes the major studies.

In the early 1970s, Frank Sachs, a student at Harvard Medical School, was inspired by Michio Kushi’s lectures on macrobiotics in Boston and arranged with his professors at Channing Laboratory to begin the first medical studies on macrobiotics. They focused on blood pressure, cholesterol levels, and other basic blood values. Several hundred members of the macrobiotic community volunteered for what turned out to be a series of studies that were published in the New England Journal of Medicine, Journal of the American Medical Association, Atheroclerosis, and other major journals. The scientists concluded that the low cholesterol, triglyceride levels, and lower blood pressure in the macrobiotic group “resemble those reported for populations in non-industrialized societies” where heart disease, cancer, and other degenerative illnesses are unknown.[5]

Dr. Castelli, director of the Framingham Heart Study, the nation’s oldest continuing epidemiological study, also conducted studies of the macrobiotic community, and further studies noted their heart health exceeded that of marathon runners.[6] The Harvard and Framingham studies convincingly linked diet and heart disease and led to the first national dietary guidelines on the number one cause of death in modern society. They also influenced the landmark report of the United States Congress, Senate Select Committee on Nutrition and Human Needs: Dietary Goals for the United States in 1977. Two years later, the U.S. Surgeon General cited the macrobiotic studies and reported for the first time that coronary heart disease could be relieved by dietary measures.[7]

In 1987, Physicians at Columbia Presbyterian Hospital in New York City reported that patients with angina pectoris, showed improved blood pressure values and lowered coronary risk factors after ten weeks on a macrobiotic diet and treatment with biofeedback. Dr. Kenneth Greenspan of the hospital’s Laboratory and Center for Stress Related Disorders, reported that cholesterol dropped from an average 300 to 220, levels of blood pressure also dropped, patients could walk about 20 percent farther in stress tests, and three patients with severe angina showed no symptoms at the end of the study.[8]

Studies focusing on the nutritional adequacy of the macrobiotic way of eating were conducted by researchers at the University of Rhode Island (1980), University of London (1985), University of Memphis and University of South Carolina (2015) and found they met or exceeded medical and nutritional guidelines for all major nutrients and mean blood values, including hemoglobin, hematocrit, serum iron, and transferrin saturation, serum ascorbic acid, vitamin A, beta carotene, riboflavin, vitamin B-12, and folate.[9]

Research on the health and well-being of children in macrobiotic households in the 1970s and early 1980s found selected cases of rickets and underweight. The Kushis attributed these negative results to narrow dietary practice associated with the “Zen Macrobiotic” diet of George Ohsawa. They encouraged families to adhere to the Standard Macrobiotic Diet that they popularized, which offered a much wider and more balanced variety of foods and beverages. Since then, research on macrobiotic kids has found that they meet medical dietary, energy, and nutrient standards and that the children’s anthropometric measurements including weight, height, and skinfold thicknesses were normal. A study in the Journal of the American Dietetic Association found that macrobiotic children were brighter and more intelligent than youngsters their age eating conventionally or following a vegetarian diet. Their mean IQ was 116 or 16% above average.[10]

In the late 1970s and early 1980s, the East West Journal published case histories of individuals that had recovered from cancer with the help of macrobiotics and the Kushis organized the first Diet & Cancer Conference at Pine Manor Junior College in Brookline, Massachusetts.[11] The case of Anthony Sattilaro, M.D., attracted national and international attention. Dr. Sattilaro was president of Methodist Hospital in Philadelphia and had metastatic prostate cancer that spread to his bones, testicles, and other internal organs. Within a few weeks of starting a macrobiotic diet, the back pain he suffered for years eased, and after several months of counseling with macrobiotic teacher Denny Waxman his tumors went away. One-year and four-year follow up medical scans at his own hospital confirmed that the cancer had completely disappeared. Dr. Sattilaro was profiled in East West Journal, Saturday Evening Post and Life magazines and went on to write a bestselling book with Tom Monte Recalled by Life.[12]

  • Researchers at New England Medical Center in Boston reported in 1981 that macrobiotic women were less likely to develop breast cancer. The scientists found that macrobiotic and vegetarian women process estrogen differently from other women and eliminate it more quickly from their body.[13]
  • Researchers at Tulane University reported in the American Journal of Clinical Nutrition that the 1-year survival rate among patients with pancreatic cancer was significantly higher among those who adopted a macrobiotic diet than among those who did not (17 months versus 6 months). Tulane University researchers also found that patients with metastatic prostate cancer who followed a macrobiotic diet lived longer (177 months compared to 91 months) and enjoyed an improved quality of life than controls and published their findings in American Journal of Nutrition.[14] 
  • In a statement on alternative therapies in 1996, the American CancerSociety (ACS) observed, “Today’s most popular anticancer diet is probably” While no diet has yet been shown to be able to reverseexisting tumors, the ACS went on: “Like other fat-reducing diets, macrobioticsmay help prevent some cancers. It may reduce the risk of developingcancers that appear related to higher fat intake, such as coloncancer and possibly some breast cancers. The macrobiotic diet, like otherfat-free diets, can lower blood pressure and perhaps reduce thechance of heart disease. Taking part in a macrobiotics program may providesome sense of balance with nature and harmony with the total universeand as such promote a sense of calmness and reduced stress.”[15] In 2003, the ACS stated that the macrobiotic way of eating could be beneficial for cancer survivors. “Macrobiotic diets may be used as an adjuvant to conventional treatment to ensure nutritional variety and adequacy.”[16] In 2012, the ACS recommended a plant-based diet for treating cancer. The American Cancer Society’s Guidelines on Nutrition and Physical Activity for Cancer-Prevention stated that one-third of malignancies were due to diet and physical activity habits. Among its key recommendations were “Consume a healthy diet, with an emphasis on plant foods,” “Choose whole grains instead of refined grain products,” “Limit consumption of processed meat and red meat.”[17] The ACS Guidelines were composed by a committee of experts chaired by Dr. Lawrence Kushi, son of Michio and Aveline Kushi, who was a noted epidemiologist, and who was macrobiotic from birth. 
  • The collection of cases histories by East West Journal, East West Foundation, and Kushi Foundation culminated in the National Institutes of Health’s Best Case Series of 77 Macrobiotic Cancer Recoveries. Undertaken by researchers at the University of Minnesota in the 1990s, the series documented the medical histories of 77 individuals who recovered from cancer with the help of macrobiotics. These included cancers of the prostate (20 cases), breast (12 cases), malignant melanoma (8), lymphoma (8), leukemia (6), astrocytoma (5), colorectal (4), endometrium (3), ovary (3), pancreas (3), kidney (2), liver (1), small cell lung (1), multiple myeloma (1), nose plasmacytoma (1), parotic gland (1), sarcoma (1), and small intestine (1).[18]
  • The Cancer Advisory Panel on Complementary and Alternative Medicine (CAPCAM), an expert committee of oncologists from the National Institute of Cancer (NCI), in 2003 reviewed the cases of six persons who had been diagnosed with IVth stage metastasized cancer and were part of the NIH Best Cases Series. The review included viewing patient slides and records, hearing expert testimony from a radiologist and pathologist, and listening to an explanation on macrobiotic theory and practice by Michio Kushi. The panel of 15 physicians and scientists voted unanimously to recommend to the NCI that governmental funding should be provided for a prospective and full clinical study on macrobiotics and cancer.[19]
  • The Centers for Disease Control and Disease Prevention (CDC), the public health arm of the United States, cancer researchers at the School of Public Health, University of South Carolina, investigated the macrobiotic way of life from 2000-2002.[20]
  • Cancer researchers at M.D. Anderson Cancer Center at the University of Texas in Houston posted a historical overview of macrobiotics as a therapy for cancer patients and the public on their web site in early 2003.[21]
  • In a review of complementary and alternative therapies for cancer in American Family Physician, a researcher reported in 2003 that a macrobiotic diet may positively alter drug metabolism and that in well-nourished patients who do not have breast or endometrial cancer, “a macrobiotic diet can be accepted by the physician as an adjunct of conventional treatment.”[22]
  • At Moores Cancer Center, University of California, San Diego, researchers undertook two intervention studies of patients with recurrent prostate cancer. In a 6-month pilot clinical trial to investigate whether adoption of a modified macrobiotic diet reinforced by stress management training could attenuate the rate of further rise of PSA [prostate-specific antigen, a risk factor], 14 patients with recurrent prostate cancer experienced a significant decrease in the rate of PSA rise and other benefits. Results were published in Integrative Cancer Therapies in 2006.[23]
  • DIANA: From 2001 through 2021, oncologists at the Tumor Institute in Milan, Italy, have conducted the ongoing Diet and Androgen Trials (DIANA) documenting the benefits of a Mediterranean diet based on macrobiotic principles in reducing the risk of breast cancer in post-menopausal women. The case control studies, involving up to 1300 women in a trial, have consistently reported that a macrobiotic diet could substantially reduce hormonal levels and result in other greater anthropometric and metabolic improvements. Results were published in Cancer Epidemiology, Biomarkers, & Prevention; European Journal of Clinical Nutrition; Nutrition, Metabolism, and Cardiovascular Diseases; International Journal of Cancer; Breast Cancer Research & Treatment; and[24]

In 1983, Michio Kushi began counseling men with HIV in New York City and a team of researchers from Boston and New York who worked with him reported in Lancet, the British medical journal, that the men with AIDS were stabilizing on the macrobiotic diet. “Survival in these men who have received little or no medical treatment appears to compare very favorably with that of KS [Kaposi’s sarcoma] patients in general,” the physicians reported.[25]

Italian macrobiotic educator Mario Pianesi developed an effective, alternative approach to the care of diabetes patients known as the Ma-Pi 2 Diet and inspired several ongoing medical studies around the world. A 2006 study of 44 patients with Type 2 diabetes by the Ministry of Public Health in Thailand found that patients on insulin were able to maintain their blood sugar levels without an insulin injection and all subjects were free of any adverse effects. In a 6-month macrobiotic dietary intervention study of the Ma-Pi 2 Diet carried out on 16 adults with Type 2 diabetes at the Diabetic Care Center in Colon, Cuban physicians reported in 2009 that all participants were able to eliminate insulin treatment, and only 25 percent needed to continue other diabetic medicine. Cardiovascular risk was also considerably reduced, nutrient levels maintained, and no adverse events.[26]

After healing herself of a severe case of Environmental Illness, including ugly red eczema over the lower half of her face, periodic asthma, recurrent sinus problems, wicked migraines, chronic back pain from an old riding injury, and unwarranted exhaustion and Depression, Sherry A. Rogers, M.D., a 31-year-old physician from Syracuse, N.Y., organized a study of 160 patients suffering from chemical sensitivity. Those who followed a macrobiotic diet for at least one year reported an average decrease in chemical sensitivity of 76 percent, according to an article in the Journal of Applied Nutrition.[27] 

Jonathan Lieff, Chief of Psychiatry and Geriatric Services at the Shattuck Hospital in Boston, and researchers at Tufts University School of Nutrition, designed a double-blind experiment in 1982 to test the effect of macrobiotic food on a ward of 16 long-term psychiatric and geriatric patients. Some of these people had been confined in the hospital for 30 years or more. During the test, the researchers noted medically significant reductions in psychosis and agitation among the patients. The scientists found significant improvement in experimental group cooperativeness when compared to the control group, as well as less irritability and improvement upon manifest psychosis.[28]

Following the atomic bombing of Nagasaki on August 9, 1945, Tatsuichiro Akizuki, M.D., director of the Department of Internal Medicine at St. Francis’s Hospital, saved all his patients and staff from radiation sickness by giving them a strict macrobiotic diet and prohibiting the consumption of sugar and sweets. Meanwhile, at another hospital in the city, nearly all the physicians, nurses, and patients died following exposure to severe radioactivity. Dr. Akizuki described his experience in his book Nagasaki 1945 and inspired many medical studies on the healing properties of miso (see below).[29]

  • Miso: Dr. Akizuki’s experience healing his patients in Nagasaki with a macrobiotic diet led to many scientific and medical studies on the possible therapeutic effects of miso and sea vegetables, two foods that helped strengthen natural immunity. In laboratory studies, researchers at Hiroshima University Medical Center found that there was only half the amount of radioactive iodine 131 in the blood of the group of rats fed with miso in contrast to the control group three and six hours after the injections. Lower amounts of radioactive particles were also measured in the kidneys, liver, and spleen. Although there was no difference in the amount of radioactive cesium in the blood, a high amount of cesium was eliminated from the muscles of the group eating miso.[30] During the Cold War, scientists at the Gastro-Intestinal Research Laboratory at McGill University in Montreal, Canada, reported that a substance derived from the sea vegetable kelp could reduce by 50 to 80 percent the amount of radioactive strontium absorbed through the intestine. In a series of articles in the Canadian Medical Journal in 1964, the researchers reported that in animal experiments sodium alginate obtained from brown algae permitted calcium to be normally absorbed through the intestinal wall while binding most of the strontium. The sodium alginate and strontium were subsequently excreted from the body.[31] Following nuclear accidents in the Soviet Union, Russian and Ukrainian physicians reported in the early 1990s that a macrobiotic diet and acupuncture could help their patients with leukemia, lymphoma, thyroid cancer, and other disorders associated with exposure to nuclear radiation.[32]
  • Kombu: Inspired by Michio Kushi and the macrobiotic community in Boston, Jane Teas, Ph.D., a researcher at Harvard University, and her colleagues found that kombu, a thick green seaweed that is a part of the regular macrobiotic way of eating, protected against breast cancer in laboratory studies. The study was reported in Cancer Research in 1984.[33]
  • Shiitake Mushrooms: Japanese scientists at the National Cancer Center Research Institute reported in Cancer Research that shiitake mushrooms had a strong anti-tumor effect. In experiments with mice, polysaccharide preparations from various natural sources, including the common shiitake mushroom available in Tokyo, markedly inhibited the growth of induced sarcomas resulting in “almost complete regression of tumors with no sign of toxicity.”[34]
  • Umeboshi Plums: Umeboshi, an aged, salted, pickled plum and staple in macrobiotic cooking, contain a substance that can suppress the growth of the H1N1 virus, researchers at the Wakayama Medical University in Japan reported. When applied to the affected cells, the growth of the virus was suppressed by roughly 90 percent after about seven hours. Ume-Sho-Bancha and Ume-Sho-Kuzu medicinal drinks are two of the main macrobiotic home remedies for preventing or relieving influenza and other infectious conditions.[35]
  • Agar agar: Kanten, the traditional Japanese gelatin, made from agar-agar seaweed and an important part of the macrobiotic way of eating, is a key food to reduce obesity and chronic disease. In a 2005 study of 76 overweight patients given a balanced weight-loss diet, scientists reported in the Journal of Diabetes, Obesity, and Metabolism that those given a small serving of kanten before their dinner lost 4.4 percent of their body weight over 12 weeks compared to 2.2 percent by controls.[36]
  • Natto: In a 2006 study published in the Journal of Nutrition on the effect of consuming natto on bone density, scientists found that total hipbone mineral density increased with increasing habitual natto intake in postmenopausal women. There was also improvement at the femoral neck and at the radius in older women.[37]
  • Brown Rice: Researchers from the Harvard School of Public Health (HSPH) reported in the British Medical Journal in 2012 that eating five or more servings of white rice per week was associated with an increased risk of type 2 diabetes. In contrast, eating two or more servings of brown rice per week was associated with a lower risk of the disease. The researchers estimated that replacing 50 grams of white rice (just one third of a typical daily serving) with the same amount of brown rice would lower risk of type 2 diabetes by 16%. The same replacement with other whole grains, such as whole wheat and barley, was associated with a 36% reduced risk.[38]

© 2022 by Planetary Health, Inc. www.planetaryhealth.com

Future Studies

Continuing research on the macrobiotic diet is being carried out on diabetic patients by educator Mario Pianesi in Italy and on women at high risk for cancer by the DIANA project at the Tumor Institute of Milan. Planetary Health Institute, a nonprofit educational organization, has been approved by the IRB of Berkshire Medical Center, the largest hospital in western Massachusetts, to undertake a macrobiotic dietary intervention study on patients with Type 2 diabetes.

Affiliations

Alex Jack

Alex Jack is founder and president of Planetary Health, Inc., the nonprofit sponsor of the Amberwaves grassroots food network, Macrobiotic Summer Conference, and other educational activities. He is co-author with Michio Kushi of Diet for a Strong Heart, The Cancer-Prevention Diet, and The Macrobiotic Path to Total Health. Email: shenwa26@yahoo.com

Denny Waxman

Denny Waxman is the founder and president of The Strengthening health Institute (SHI) and the author of The Ultimate Guide to Eating for Longevity: The macrobiotic way to live a long, healthy, and happy life, which he co-wrote with his wife Susan. He is founder of Philadelphia’s first health store, Essene Market.

dennywaxman@dennywaxman.com

Aaron Shenhar

Dr. Aaron Shenhar was in his first career an engineer and executive in the aerospace industry. In his second career in academia he was a business professor of technological leadership. In 2019 he adopted a macrobiotics diet and lifestyle.

aaron.shenhar@gmail.com

Footnotes

[1] Planetary Health, Inc., Becket, Massachusetts

[2] Strengthening Health Institute, Philadelphia, Pennsylvania

[3] Rutgers University, New Brunswick, New Jersey

[4] Smithsonian Institution Archives. http://siris-archives.si.edu/ipac20/ipac.jsp?profile=all&source.

[5] Sacks, F. M.; Rosner, Bernard; Kass, Edward H. “Blood Pressure in Vegetarians,” American Journal of Epidemiology 100:390-98, 1974. Sacks, F. M. et al. “Plasma Lipids and Lipoproteins in Vegetarians and Controls,” New England Journal of Medicine 292:1148-51, 1975. Sacks, F. M. et al. “Effects of Ingestion of Meat on Plasma Cholesterol of Vegetarians,” Journal of the American Medical Association 246:640-44, 1981.

[6] Castelli, William P. “Summary of Lessons from the Framingham Heart Study,” Framingham, Mass., September 1983.

[7] Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention. Government Printing Office, 1979.

[8] Kushi, Michio; Jack, Alex (1985). Diet for a Strong Heart. St. Martin’s Press, p. 131.

[9] Bergan, J. G.; Brown, P. T. “Nutritional Status of ‘New’ Vegetarians,” Journal of the American Dietetic Association 76:151-55, 1980. Hinds, Alison, BSc. “A Short Study of the Macrobiotic Diet.” Queen Elizabeth College, University of London, 1985. Harmon, Brook E. et al. (2015). “Nutrient Composition and Anti-inflammatory Potential of a Prescribed Macrobiotic Diet,” Nutrition and Cancer, DOI: 10.1080/01635581.2015. 1055369 Smith, Michael, M.D. (2017). “Macrobiotic Diet,” Web MD, www.webmd.com. Retrieved March 27, 2017.

[10] Ventura, Valerie. “A Comparative Study of the Meals Provided for Pre-School Children by Two Day Nurseries,” Department of Nutrition, Queen Elizabeth College, 1980. Shull, M. W. et al. “Velocities of Growth in Vegetarian Preschool Children,” Pediatrics 60:410-17, 1977. Dwyer, J. T. et al. “Mental Age and I.Q. of Predominantly Vegetarian Children,” Journal of the American Dietetic Association 76:142-47, 1980.

[11] Kohler, Jean; Kohler, Marie Ann (1979). Healing Miracles from Macrobiotics. Parker Publishing. Kushi, Michio and Jack, Alex (1986) The Cancer Prevention Diet. St. Martin’s Press. pp. 403–404. Dobic, Milenka (2000). My Beautiful Life. Avery Publishing. Benedict, Dirk (1991). Confessions of a Kamikaze Cowboy. Avery. Nussbaum, Elaine (1992). Recovery: From Cancer to Health Through Macrobiotics. Japan Publications.

[12] Satillaro, Anthony J., M.D.; Monte, Tom (1982). Recalled by Life: The Story of My Recovery from Cancer, Houghton-Mifflin, 1982.

[13] B. R. Goldin et al. “Effect of Diet on Excretion of Estrogens in Pre- and Postmenopausal Incidence of Breast Cancer in Vegetarian Women,” Cancer Research 41:3771-73, 1981.

[14] Carter, James P. et al. “Hypothesis: Dietary Management May Improve Survival from Nutritionally Linked Cancers Based on Analysis of Representative Cases,” Journal of the American College of Nutrition 12:209-226, 1993.

[15] Complementary and Alternative Therapies, American Cancer Society Internet Site, 1997; “Alternative and Complementary Therapies,” Cancer 77(6), 1996.

[16] “Guide for Nutrition and Physical Activity for Cancer Survivors,” CA: A Cancer Journal for Clinicians, Sept-Oct. 2003.

[17]American Cancer Society guidelines on nutrition and physical activity for cancer prevention (2012), Lawrence H. Kushi ScD. CA: A Cancer Journal for Clinicians Volume 62, Issue 1 January/February 2012. Pages 30–67.

[18] NIH Best Cases Study. University of South Carolina, Prevention Research Center, 2002.

[19] Minutes of the Fifth Meeting, Cancer Advisory Panel for Complementary and Alternative Medicine (CAPCAM), Bethesda, Maryland, February 25, 2002; Ralph Moss, Ph.D., “The Olive Branch Bears Fruit,” The Moss Reports, February 27, 2002. www.cancerdecisions. com/022702.html

[20] Macrobiotic Research Project,” Jane Teas, Ph.D., principal investigator; Joan Cunningham, Ph.D., coprincipal investigator, sponsored by the Centers for Disease Control, October 2000 to September 2002, University of South Carolina, Prevention Research Center, School of Public Health, Charleston, S.C. www.macrobiotics.sph.sc.edu/project.htm.

[21] “Nutrition and Special Diet: Macrobiotics,” M.D. Anderson Cancer Center, the University of Texas, www.mdanderson.org/departments/cims, 2003-2006.n

[22] Sadovsky, Richard. “Complementary and Alternative Medical Therapies for Cancer,” American Family Physician, May 1, 2003.

[23] Saxe, G.A. et al. “Potential Attenuation of Disease Progression in Recurrent Prostate Cancer with Plant-Based Diet and Stress Reduction,” Integr Cancer Ther 5(3)206-13, 2006.

[24] Berrino, Franco et al. “Reducing Bioavailable Sex Hormones through a Comprehensive Change in Diet: the Diet and Androgens (DIANA) Randomized Trial,” Cancer Epidemiology, Biomarkers, & Prevention 10: 25-33, January 2001. Kaaks R., Bellati C., Venturelli E., Rinaldi S., Secreto G., Biessy C., Pala V., Sieri S., Berrino F. Effects of dietary intervention on IGF-I and IGF-binding proteins, and related alterations in sex steroid metabolism: The Diet and Androgens (DIANA) Randomised Trial. Eur. J. Clin. Nutr. 2003;57:1079–1088. doi: 10.1038/sj.ejcn.1601647. Agnoli C., Berrino F., Abagnato C.A., Muti P., Panico S., Crosignani P., Krogh V. Metabolic syndrome and postmenopausal breast cancer in the ORDET cohort: A nested case-control study. Nutr. Metab. Cardiovasc. Dis. 2010;20:41–48. doi: 10.1016/j.numecd.2009.02.006. Berrino F., Pasanisi P., Bellati C., Venturelli E., Krogh V., Mastroianni A., Berselli E., Muti P., Secreto G. Serum testosterone levels and breast cancer recurrence. Int. J. Cancer. 2005;113:499–502. doi: 10.1002/ijc.20582. Villarini A., Pasanisi P., Traina A., Mano M.P., Bonanni B., Panico S., Scipioni C., Galasso R., Paduos A., Simeoni M., et al. Lifestyle and breast cancer recurrences: The DIANA-5 trial. Tumori J. 2012;98:1–18. doi: 10.1177/030089161209800101. Berrino F., Villarini A., Traina A., Bonanni B., Panico S., Mano M.P., Mercandino A., Galasso R., Barbero M., Simeoni M., et al. Metabolic syndrome and breast cancer prognosis. Breast Cancer Res. Treat. 2014;147:159–165.

[25] “Patients with Kaposi Sarcoma Who Opt for No Treatment,” Letter. Lancet, July 1985. Kushi, Michio; Jack (1995). AIDS and Beyond: Dietary and Lifestyle Guidelines for New Viral and Bacterial Disease. One Peaceful World Press. (1997) Humanity at the Crossroads. One Peaceful Word Press. (2003).

[26] Bhjumisawasdi, J. et al. “The Self-Reliant System for Alternative Care of Diabetes Mellitus Patients—Experience Macrobiotic Management in Trad Province,” Journal of the Medical Association of Thailand 89(12):2104-15, 2006. Porrata, Carmen, M.D., PhD., et al. “Ma-Pi 2 Macrobiotic Diet Intervention in Adults with Type 2 Diabetes Mellitus,” MEDICC Review, Fall 2009, 11(4):29-35. Soare A. et al. “A 6-month follow-up study of the randomized controlled Ma-Pi macrobiotic dietary intervention (MADIAB trial) in type 2 diabetes.” Nutr Diabetes. 2016 Aug 15;6(8):e222.

[27] Rogers, Sherry A. M.D. “From HEAL’s Advisory Board: The Cure Is in the Kitchen—One Case History,” The Human Ecologist, Fall 1990, pp. 19-21. Rogers, Sherry A., M.D. “Improvement in Chemical Sensitivity with the Macrobiotic Diet,” Journal of Applied Nutrition 48: 85-92, 1996.

[28] Lieff, Jonathan et al. (1987). “Study Results of Dietary Change in Shattuck Hospital Geropsychiatric Wards, 5 North and 6 North,” in Michio Kushi, Crime and Diet (1987), Japan Publications, pp. 229-34.

[29] Akizuki, Tatsuichiro, M.D. Nagasaki 1945 (1980). Quartet Books, 1981. Akizuki, Tatsuichiro, M.D., “How We Survived Nagasaki,” East West Journal, December 1980. Furo, Hiroko, Ph.D. “Dietary Practices of Hiroshima/Nagasaki Atomic Bomb Survivors,” Illinois Wesleyan University, 2006.

[30] “Miso Shows Promise as Treatment for Radiation,” Japan Times, September 27, 1988.

[31] Skoryna, S.C. et al. “Studies on Inhibition of Intestinal Absorption of Radioactive Strontium,” Canadian Medical Association Journal 91: 285-88, 1964.

[32] Jack, Alex. “Soviets Embrace Macrobiotics,” One Peaceful World 6:1 Autumn/Winter, 1990.

[33] Teas, J; Harbison, M. L.; Gelman, R.S. (1984). “Dietary Seaweed [Laminaria] and Mammary Carcinogenesis in Rats, Cancer Research 44:2758-61. Yamamoto; Ichiro; et al. (1987). “The Effect of Dietary Seaweeds on 7,12-Dimethyl-Benz[a]Anthracene- Induced Mammary Tumorigenesis in Rats,” Cancer Letters 35:109–18.

[34] Chihara, G. et al. “Fractionation and Purification of the Polysaccharides with Marked Antitumor Activity, Especially Lentinan, from Lentinus edodes (Berk.) Sing. (An Edible Mushroom), Cancer Research 30: 2776–81.

[35] Umeboshi Have H1N1 Suppressant,” Japan Times, June 3, 2010.

[36] “Effects of agar (kanten) diet on obese patients with impaired glucose tolerance and type 2 diabetes,” Diabetes, Obesity, and Metabolism, 7(1):40–46, 2005.

[37] Ikeda, Y. et al. “Intake of Fermented Soybeans, Natto, Is Associated with Reduced Bone Loss in Postmenopausal Women: Japanese Population-Based Osteoporosis (JPOS) Study,” J Nutri 136(5):1323-8, 2006.

[38] Hu, Emily A. et al. “White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review, BMJ 2012; 344.