
soy. These can be converted into more highly unsatur-
ated fatty acids, with linoleic acid producing arachi-
donic acid, and a-linolenic acid being converted to
eicosapentaenoic acid (EPA) and docosahexaenoic
acid (DHA). Arachidonic acid is found in animal
foods such as meat, poultry, and eggs. EPA and
DHA are largely found in fish and seafood. Arachi-
donic acid and EPA serve as precursors for the
eicosanoids. Recommended intakes for these poly-
unsaturated fatty acids range from 3 to 10% of total
energy intakes. Vegan vegetarians have no direct
sources of long-chain o-3 fatty acids EPA and DHA
in their diets, and thus must convert a-linolenic acid
to them. There is concern that pregnant women who
are vegan-vegetarians, or macrobiotics who consume
little or no fish or other animal foods, may not obtain
enough of these fatty acids, especially during preg-
nancy and in early infancy, especially if the infants
are premature, and their conversion capacity of a-
linolenic acid to DHA is very limited. Such individ-
uals may need DHA supplements, either from fish oils
or from cultured microalgae. However, they should
only be dispensed under a physician’s direction, since
they are also anticoagulants. o-3 fatty acids are rich in
flaxseeds and flaxseed oil, hemp seed oil, purslane, a
dark green leafy vegetable, canola, walnut, and soy
oil. Flaxseed oil is also rich in a-linolenic acid.
Carbohydrate and Fiber
0015 Raw fruits, especially berries, vegetables, legumes
such as beans and peas, nuts, seeds, whole-grain
products, and seaweed provide relatively high
amounts of dietary fiber in the macrobiotic diet,
helping to promote laxation and perhaps lessening
symptoms of asymptomatic diverticular disease. It is
possible, but not yet proven, that high intakes of
dietary fiber reduce the risks of colon cancer; there
is no evidence that macrobiotic diets are especially
efficacious in these respects. The macrobiotic diet is
high in soluble sources of dietary fiber, such as
legumes, whole grain rice, barley, oats, and raw fruits
and vegetables. Soluble fiber may enhance glycemic
control and also lower serum cholesterol, contribut-
ing the low total and low-density-lipoprotein choles-
terol levels often evident in macrobiotics. Fiber
increases the dietary bulk and lowers the energy
density per gram of food consumed. The ill effects
of dietary fiber arise if very large amounts are fed to
young infants and weanlings under 2 years of age.
Macrobiotics sieve cereals, pulses, and vegetables
that are fed to infants to increase their digestibility,
but fiber intakes and bulk may still be rather high,
and the nutrient density of such feeds may still be
quite low. The partial replacement of whole-grain
cereals with more highly refined cereals that are
lower in fiber increases energy intakes and decreases
bulk in feeding infants.
0016Macrobiotics’ intakes of refined sugar are very low,
but other fermentable carbohydrates, such as sugars
found in fruits and starches, are consumed, so the risk
of dental caries is still present, especially if these are
consumed in forms that are retained in the oral cavity,
and oral hygiene is poor. (See Carbohydrates: Re-
quirements and Dietary Importance; Glucose: Glu-
cose Tolerance and the Glycemic (Glycaemic) Index.)
Vitamins
0017Vitamins B
12
and D may be in particularly short
supply in macrobiotic diets fed to rapidly growing
infants and children.
0018Vitamin B
12
Reliable plant sources of vitamin B
12
are vitamin B
12
-fortified soyamilk and formulas,
yeast grown on, and mixed with, vitamin B
12
-
enriched media, highly fortified breakfast cereals,
and vitamin B
12
supplements. Vitamin B
12
-containing
foods that are sometimes acceptable to those who
practice macrobiotics include fish such as sardines,
pilchard, mackerel, herring, salmon, and tuna. In
amounts of about an ounce a day, they may be suffi-
cient to avoid deficiencies in young children.
0019Animal foods have a high content of vitamin B
12
because they ingest vitamin B
12
-containing micro-
organisms or because the microflora in their guts
synthesize the vitamin. The richest sources of vitamin
B
12
provide over 19 mg per 100 g. They are lamb or
beef organ meats such as kidney and liver, bivalves
such as clams and oysters, which extract many micro-
organisms containing vitamin B
12
from sea water,
soyamilk that is fortified with vitamin B
12
, and vita-
min supplements. Other types of red meats, eggs, and
milk products are also good sources. Macrobiotics
rarely eat large amounts of any of these products on
a regular basis. Therefore, inadequate intakes of vita-
min B
12
may be a problem. Moderately good sources,
providing 3–10 mg per 100 g of vitamin B
12
include
seafood, such as lobster, scallops, haddock, tuna,
swordfish, and flounder, and egg yolks, fermented
cheeses, such as Camembert or Limburger, and non-
fat milk solids. Most other red meats and fish provide
less than this amount. Grains, fruits, and vegetables
are virtually devoid of B
12
, except for tiny amounts
present in root nodules of some legumes. Seaweed is
sometimes contaminated by plankton rich in vitamin
B
12
, but these are unreliable sources of the vitamin.
‘Sea vegetables’ such as wakame, arame, and kombu
and a seaweed known as spirulina contain very few
corrinoids that are available to humans. Other plant
foods such as certain fermented soya products like
miso (which is often served as a soup) and tempeh
MACROBIOTIC DIETS 3635