Make A Date with Health November 29, 2008

Due to demand, we will now schedule cooking classes and Introduction to Macrobiotics sessions. This will enable better planning for our counsellors and for class participants.

Our other courses are on-going. Please click on the Courses tab above for a complete list of courses at Lusher Than Life.

Seats are limited – bookings are a must. Sessions by appointment (outside of the scheduled times are still possible – call Simone on +65 9004 2645 to enquire).

Every meal is Thanksgiving at Lusher Than Life

‘Life is Delicious’ cooking classes (9.30am – 3.30pm)

Fee: $250-00 (A 10% discounts applies for group bookings of at least 3)

Every Sunday; classes by special arrangement possible.

By the end of each class, students will understand the basics of food energetics, and nutrition, and be able to plan and cook a macrobiotic meal. As students books their classes, they will be asked about any health issues they might have and the menus for classes will be tailored to specific needs and issues as much as possible. Classes begin with hands-on cooking. Lunch is followed by a dialogue on macrobiotic food theory, and how to prepare a meal with ingredients already in students’ refrigerators. Students will receive a binder with a macrobiotic food pyramid, food nutrition tables, recipes and other relevant articles.

Using a pickle press for yang energy - photo courtesy of Palate Sensations

Introductory Macrobiotics Education Session (Every Saturday – 10am – 12 noon)

Fee: $120-00 (A 10% discounts applies for group bookings of at least 3)

Every Saturday. Classes by special arrangement possible.

Each lecture will teach the basics of the macrobiotic approach to eating and the effects of the practice on lifestyle. We will also cover various testimonials from people who have been helped by macrobiotics, and look at views from the medical fraternity on food and healing. Each student will receive an information pack on macrobiotic basics, what it takes to get started, resources needed, and a selection of background reading.

Journey to Health

Fee: 2-day course $370-00, 3-day course $520-00 (A 10% discounts applies for group bookings of at least 3)

Bookings for Journey to Health courses is by by special arrangement only.

This is a series of seminars and cooking classes for those who would like to seriously transition to the macrobiotic diet. The Journey to Health course lasts 2-3 days depending on the needs of participants. The two-day session comprises an introduction to macrobiotics and the macrobiotic lifestyle and a hands-on cooking class. The two-day session covers topics such as: What  is Macrobiotics, Science and Macrobiotics, Epidemioloical Research on Health and Nutrition,  The Energy of Food, Menu Planning for Health, and a Hands-on Cooking Class.

The three day session covers: What  is Macrobiotics, Science and Macrobiotics, Epidemioloical Research on Health and Nutrition, The Energy of Food,  Menu Planning for Health, a Hands-on Cooking Class and a Transitioning to Macrobiotics Counselling Package for those who feel they would like the extra support as they transition  to the macrobiotic way of life. The Transitioning to Macrobiotics Counselling Package comprises a macrobiotic consultation, a 30-page booklet outlining macrobiotic eating practices for your particular health issues and lifestyle, as well as 3 follow-up phone calls to tweak the diet further to your body’s needs.

In all classes, students will receive an information pack comprising PowerPoint slides used during the class, background reading, nutritional tables as well as recipes for the cooking classes.

Enquiries/bookings on +65 9004 2645.

For information on our other classes, please click on the Courses tab above.

Just what does ‘cheating’ mean? June 10, 2009

IN A previous post, I wrote that it was possible to ‘cheat’ on the diet, if it was well planned. Well, I’m afraid it is now time for me to eat my words.

First of all, let’s think about the word: cheating. It implies that something is verboten, forbidden. It implies that we are out of bounds if we reach for that something. For the macrobiotic practitioner, you might think it would be that 400g steak, or that triple chocolate cake. And you would be wrong – just a little bit.

One of the things I love about macrobiotics is its flexibility. You want a steak? Go for it! Macrobiotics doesn’t forbid – it just asks you to balance things out. But it will take some doing to balance such big yang as a steak.

But now, putting on my macrobiotic counsellor hat and say this – have that steak as long as it is with the full awareness of what toll it will take on your body and ultimately, your health. One steak a year won’t kill you. But if that one steak turns into the monthly steak, and if that steak leads to sticky gooey super sweet desert to balance out its strong yang energy, and then a roast leg of lamb to balance that out…well, you see what might happen. That first decision to cheat could be a slippery  slope, the thin end of the wedge. Pretty soon, your body will start to signal that it feels rotten – something small first – heart burn, then the see-saw between a lack of energy and a trigger temper, increased weight, shortness of breath…and so the spiral begins.

But that’s an obvious ‘cheat’ – the big fall off the straight and narrow path, as it were. It’s the little ‘cheats’ that are more dangerous because we hardly notice them. Very often, people eat the odd small bite off the macrobiotic diet – and excuse themselves because it’s, well, just one curry puff. Or one cream biscuit. Or just a scoop of icecream. Maybe just a couple of French fries.

In my experience, it takes an extraordinary person to just have that one curry puff, then get back on the path. Usually, that one ‘cheat’, if it results in no physical reaction, will lead to another, then another, and when you do start to feel out of sorts, it is when the damage within has been done and your body  feels that it has to signal you.

If you are in good health, it might take a little longer for your body to signal you that all is not well, with symptoms such as weight gain. Or zits. Or a sore throat. But if you are on a healing diet and want to eat outside the recommendations, my sincere advice to you if you want to cheat is: resist.

The fact is, the more I understand macrobiotics, the less I think I know. There is so much we do not know about the workings of the body. It is a huge and remarkably complex topic, and there are so many areas that baffle even the experts. Think of all the illnesses that we cannot heal or predict with any accuracy – cancer being one of them. All I know is that over time, science has begun to recommend dietary practices that are increasingly  closer to the macrobiotic recomendations that originated thousands of years ago. So, just because science has not proven macrobiotics conclusively, it has proven enough of its precepts that makes me think that there is more to this than meets the eye. And so, I eat within the guidelines.

In working with people with illness, and in navigating my own health journey with a macrobiotic compass, I have to say that if you believe in macrobiotics enough to want to try making the changes, don’t shortchange  yourself, your health, and your chances of a recovery by eating food that is not recommended. Persistent cheaters who are on the healing diet need to ask themselves why they are sabotaging their recovery. The healing phase is about 4-6 months. Isn’t  your continued good health for the long years in front of you worth eating well and strictly for an initial 6 months?

Because that’s what ‘cheating’ really means. You are not just rebelling against the counsellor. Or against macrobiotics. You are rebelling, ultimately, against the idea of good health.

And why on earth would you want to do that?

Beating Rheumatoid Arthritis Macrobiotically! June 10, 2009

I was diagnosed with rheumatoid arthritis 26 years ago as a young girl and over the years the condition  worsened. When I first saw Simone Vaz at Lusher Than Life, I had had surgery on two fingers as well as my right wrist, was lacking in energy and had accepted that pain would be a  part of my life. After my consultation, I went cold turkey into macrobiotics  with nothing but hope and the loving support of my family. After 2 weeks of  eating macrobiotically, I  found I could make a fist when I woke up, and  that my energy levels were increasing. After 5 weeks of macrobiotics, I found  I could hold that fist. I also had greater mental clarity. Where before my  workload meant that I had to leave the office at 8pm, I found myself getting  home in time for dinner with my family at 7pm. And I was able to extend my  cardio workouts on the stationary  bicycle.

The improvement in my  condition has surpassed all my expectations. My friends and colleagues notice  the change in me. My family rejoice with me. I now feel like a different  person, and I know that as I continue with the macrobiotic diet, my condition  will continue to improve. I am embarking on a new adventure, taking charge of  my health and growing into a whole new me!

- Juliana Rajam, Ang Mo Kio,  Singapore.

Thanks from a bladder cancer survivor June 10, 2009

From YW Cheong, 54-year -old bladder cancer survivor, who came to see Simone Vaz with his wife, Grace, for help in transitioning to a healing macrobiotic diet to help support him as he took chemotherapy. During chemotherapy, after starting to eat macrobiotically, he saw some of his key health parameters improve. He sent in this lovely note to Simone Vaz at Lusher Than Life.

“For now, I feel my health and energy level have improved, thanks in part to the macrobiotic diet that Grace and I learned from you!

We found you are a very patience and nice lady without air. It has been our pleasure talking to you during those phone consultations when you made the efforts to answer our queries or explain things.

Take care of yr health and have sufficient rest too!”

Best Regards
Cheong & Grace

Macrobiotics in the Medical Community February 19, 2009

Macrobiotics and Cancer We now recognise that the incidence of cancer is on the rise globally. Governments and the medical community worldwide is devoting considerable resources to developing more innovative and less debilitating treatments for cancer. One corollary of this focus is the increasing attention being paid to the macrobiotic approach to eating and the many studies on the link between diet and cancer. The studies review the effects on a range of cancers and are being conducted by some of the most well known research centres in the world, such MD Anderson Cancer Centre. The medicine behind whole foods 1. National Cancer Institute Approves Clinical Trials on Macrobiotic Approach...“After this week’s meeting I could definitely say there is real gold in macrobiotics… “ 2. Annals of Internal Medicine Study on Alternative Approaches to Cancer…“it seems reasonable to accept macrobiotics as an adjunct to conventional treatment” for most types of cancer.” 3. Italian Breast Cancer Study on the Benefits of Macrobiotics...”We suggest that these favorable changes are to be attributed to the cumulative effects of a comprehensive dietary strateg…” 4. Study on Macrobiotics by the University of South Carolina…” Fifty-one people recounted personal healing stories in which macrobiotic practice reversed a serious health condition.” 5. M.D. Anderson Cancer Center, University of Texas, Houston Scientific Review of Macrobiotics…”63% of cancer patients who received some form of dietary therapy received or were exposed to the macrobiotic diet. “ 6. Macrobiotic and Vegetarian Women Are at Less Risk for Breast Cancer…“The difference in estrogen metabolism may explain the lower incidence of breast cancer in [macrobiotic] and vegetarian women…” 7. Sea Vegetables Can Reduce the Risk of Induced Breast Cancer in Laboratory Animals...”kombu resulted in delayed onset of tumors, less tumors, slower spread, and longer life span.” 8. Miso Protects Against Stomach Cancer…”those who ate miso soup daily were 33 percent less likely to contract stomach cancer and 10 percent less likely to develop cancer at other sites compared to those who never ate miso soup.” 9. A Diet High in Soy Products, Especially Miso Soup, Protects Against Cancer.…”genistein, the active ingredient in the soy foods, retarded the multiplication of cancer cells and choked off the small blood vessels that feed tumors.” 10. Macrobiotics Benefits Pancreatic Patients…”Survival rates among pancreatic cancer patients who followed a macrobiotic diet were significantly higher than usual patients.” 11. Whole Grains Protect Against Cancer…”high intake of whole grain foods protected again cancers of the oral cavity, larynx, pharynx, esophagus, stomach, colon, rectum, liver, gallbladder, pancreas, breast, endometrium, ovary, prostate, bladder, kidney, lymphatic system, and multiple myelomas. Reduced risk ranged from 10 to 80 percent depending on the type of malignancy.” Excerpted from: http://macrobioticpath.com/cancer.html 1

Leukemia Recovery – Christina Pirello February 19, 2009

There are many moving stories of how a switch to a macrobiotic lifestyle has overcome the ravages of cancer. Each is an inspiration and encouragement to those who face serious health issues and chronic conditions, but who have taken charge of their health by embarking on the healing macrobiotic journey. Macrobiotic cook Christina Pirello  tells a moving story so many cancer patients and survivors are familiar with – the death of a loved one of cancer, the horror of their own diagnosis, the debilitating treatment that is usually the main route of cure from the medical community and then – the first step out of the darkness that is created by the cancer diagnosis, into the sunshine.

A diet based on whole grains, land and sea vegetables, roots, beans and nuts gave her body back its life. Eschewing mainstream medical  treatment, Christina found life and love. Today, Christina is a leading light in the macrobiotic community and the author of creative vegetarian cookbooks.

Read her wonderful personal account here:

http://www.kushiinstitute.org/waytohealth/macrobiotics/stories/leukemia2.htm

The More you Want It, The More You Will Commit February 1, 2009

Good changes require a strong commitment

IN recent months, with the election of the first African American President, the word CHANGE has never been more pregnant with significance. It has come to mean the dawn of a new era of hope, of home-and-hearth values, of ‘right-ness’. Going back to basics and fundamentals underline this movement of CHANGE.

For people who are embarking on a macrobiotic journey, I speak of change as well. For when we begin to eat macrobiotically, and practice the macrobiotic lifestyle, we begin see positive change emerging in our lives. We feel lighter, more full of energy and vitality. Old aches, pains and sniffles we had come to take for granted suddenly just aren’t there anymore. Our skin takes an a firmness and a glow. And the well-being spreads, from feeling good in our bodies, to feeling good about ourselves and our lives and our relationships.

Why do people seek change? Mostly because they realise that the current practice simply does not work anymore. Whatever brought on this realisation – illness, fatigue, or just an inner prompting – they come to macrobiotics because they are at a watershed and want change for the better. Or because they have been diagnosed with a dread disease. The reasons are varied and many, and they are all valid.

Quite a few do not stay the course. Some eat macrobiotically, then fall off the bandwagon. Some do come back to macrobiotics because they recognise its benefits. But – as with most changes – macrobiotics does require a commitment of time and effort. We must give the diet a chance to work on the body. We must commit to eating well, and within the framework of the diet. Constantly eating outside the diet dilutes and even undermines the goodness of macrobiotics. So, if you are eating macrobiotically only 50% of the time, I would say that it is better than nothing in terms of overall health. But I would also say that you are not getting any of the benefits of the diet, if at all, because your body is not being given the chance take the goodness from the food and heal itself before the onslaught from the next ‘questionable’ meal.

What you don’t eat is as powerful as what you do

Many people then say – yes I ate in a restaurant but I made good food choices. I only ate the vegetables and brought my own brown rice.

People sometimes forget it is the unseen factor in the food that can cause as much damage – the Teflon coated non-stick pans, the salts and other seasonings used. In Chinese restaurants, even simple stirfried  vegtetables are laced with monosodium glutamate and the special XO sauce.

In macrobiotics, one has to remember that it is as much about what  you don’t put into your mouth as it is about what you do. Sometimes it is better to eat sparingly, rather than to eat everything at the table.If you have just begun eating macrobiotics, I would advise strict adherence to the tenets of the practice for the first  6 months to begin the process of re-educating your body and boost your immunity. After this period, some eating is possible but also within the tenets of the diet.

There is a story told about George Ohsawa,the grandfather of modern macrobiotics. He healed himself of tuberculosis by eating scraps of vegetables from restuarants because he was destitute at the end of the Second World War, having spent much of it imprisoned in Japan for being a pacifist. This would be unthinkable for most of us. And most of us think that to be in good health, we have to eat lots of food and in the absence of macrobiotic food, we eat whatever is there because we have feed our bodies. But macrobiotics also tells us that the body is better off having simple plain food – even vegetable scraps – because it is able to utilise almost all the scraps. But if we ate well cooked but (what our body might consider) poor quality food  -  fois gras, cream sauces, rare Wagyu beef, fpor example -  the body would probably be able to use only a fraction of the intake and the rest has to be processed out of the body. This taxes the digestive system and eventually the heavy duty elimination required takes its toll.

As a PR practitioner, I am obliged to eat out alot. But I have devised some coping mechanisms. For example, I make sure I have eaten a bowl of brown rice before going out so that I am comfortably full and will not leap at the food the minute it arrives at the table. I try to bring my own brown rice and eat only at Chinese restaurants where I can trust the quality of the vegetarian fare.  I eat stir fried vegetables, steamed fish, and vegetable soups – in other words, the plainest food I can find on the menu. And I drink copious amounts of hot tea!

How badly do you want it?

CHANGE also asks for a commitment from all of us. Barack Obama asked for a vote and time for him to make the change work. This is also what we need to give our bodies when we make the change and switch to macrobiotics.

When people tell me that macrobiotics is hard, is anti-social, and time-consuming, I ask them – how badly do you want the change? How much do you want to give yourself a chance at better health? Nothing worthwhile is ever easy. If you really want it, you can and will make it work. HOW MUCH DO YOU WANT IT?

The commitment from Lusher Than Life is that we will work with you to help you make it work. Together, so many good things are possible. But that first step – well, that courageous undertaking is yours alone to make.

Genes Can Be Changed by Foods February 1, 2009

Nutrients may switch different genes on and of

(From BBC News, International Edition, Thursday, 17 November 2005, 00:07 GMT)

Several studies in rodents have shown that nutrients and supplements can change the genetics of animals by switching on or off certain genes.

It is not clear whether foods do the same in humans, but an article in New Scientist says there is good reason to believe they do.

In the future, diseases might be reversed by diet in this way, it says.

Modifying DNA

While many disorders in humans are caused by mutations to DNA, a few, including some cancers, occur when genes are switched on or off.

There are thousands of genes in the body, but not all of them are active.

Scientists have been looking at what factors might control gene activity and have found some evidence to suggest that diet is important.

In a recent animal experiment, adult rats were made to behave differently by injecting them with a specific amino acid called L-methionine.

Researchers are studying DNA methylation

After the injections, the animals were less confident when exploring new environments and produced higher levels of stress hormones.

The change to their behaviour occurred because the amino acid altered the way the rat’s genes were expressed.

L-methionine altered a gene for glucocorticoid that helps control the animal’s response to stress, Moshe Szyf and his team from McGill University in Montreal, Canada, told a meeting on environmental epigenomics in November in Durham, North Carolina.

It added chemical tags, known as methyl groups, to the gene by a process called methylation.

The researchers are now looking to see if they can cause a positive rather than a negative behavioural change in animals using a naturally-occurring chemical called trichostatin A (TSA).

It’s quite a strong possibility that nutrients might cause DNA changes Professor Ian Johnson at the Institute of Food Research

TSA causes the opposite effect to L-methionine on genes, stripping them of methyl groups.

Dr Szyf said his work showed how important subtle nutrients and supplements can be.

Animal research has also shown that a mother’s diet can affect the level of DNA methylation and hence gene expression in offspring.

Professor Ian Johnson at the Institute of Food Research is investigating whether colon cancer in humans might be triggered by diet through DNA methylation. His team is studying healthy people before this cancer starts.

He said: “It’s quite a strong possibility that nutrients might cause DNA changes. We think diet may have a role to play as a regulator in genes.

“Ultimately one would want to chose diets that would give you the most beneficial pattern of DNA methylation in the gut. But it is too early to say that we know the dietary strategy to do that.

“We need much more research.

“Genes regulate all the processes in the body and things that change gene expression, therefore, may be linked to a number of health issues other than cancer too.”

He said one nutrient that scientists believe might influence methylation is folate or folic acid.

A deficiency in folate levels has been linked to an increased risk of developing some adult cancers, including breast and colon.

The Role of Nurtition in Cancer Prevention and Treatment February 1, 2009

The Role of Nutrition in Cancer Prevention and Treatment

by Sandra Goodman PhD (more info)
listed in cancer, originally published in issue 66 – July 2001

Nutrition ought to be an integral part of conventional cancer care

This chapter explaining the role of nutrition in relation to cancer prevention and treatment does not rightfully belong in a book devoted to complementary approaches to cancer care; it should be part of mainstream medical care for cancer patients. Health-promoting nutrition, recognized by leading epidemiologists, oncologists, and molecular biologists alike to be a factor in reducing cancer risk by some 30-40% (WCRF 1997), should form a major part of the curriculum for medical students, should be taught to all children from primary school age, practised within our daily lives, and should form an integral part of cancer treatment for all cancer patients.

Yet perversely the opposite situation prevails. The commercial messages beamed out via the media promote the consumption of manifestly unhealthy foods high in fats, sugar, and salt, and the ’sexy’ consumption of alcoholic, caffeinated, sugary, and carbonated beverages. Negative messages pervade the media, criticizing and ridiculing the consumption of healthy and organic foods, dietary supplements and natural remedies, while physicians and holistic centres for cancer patients recommending dietary regimens fight desperately for survival, let alone for professional legitimacy.

I didn’t always feel this stridently. Until the mid 1980s I was a molecular biology scientist working in the field of agricultural biotechnology, endeavouring to find ways to increase agricultural yields of crops such as soybeans. Since I moved from that field to explore the health-enhancing benefits of nutrition, I have written books and scientific articles, (Goodman, 1988, 1991, 1994, 1995, 1997; Goodman and Daniel 1994; Goodman et al. 1994) compiled databases relating to cancer and nutrition (BCHC 1993) as well as many aspects of complementary medicine (Positive Health).

During the past 15 years, I have witnessed the almost total marginalization of nutrition in cancer treatment, despite the existence of many thousands of high quality published research papers in the most highly respected scholarly journals attesting to the important role of nutrition in all stages of cancer aetiology and development (WCRF 1997). Furthermore, having read widely from the huge literature attesting to the massive environmental contributions to cancer (Epstein 1998), I have realized that there has also been an almost total separation of the knowledge bases of these three integrally-linked disciplines – nutritional research, environmental research, and oncology care.

It is incomprehensible to me as a research scientist, as well as a scandal to the medical profession, that nutrition does not play a central role in cancer care, given the massive body of published literature documenting the important role played by nutrition both in the prevention and the treatment of cancer (BCHC 1993; Goodman 1998; CRC 1999; WCRF 1997; Wheatley 1998).

The wider general public has become much more aware than have physicians of the role of environmental carcinogens as well as the benefits of healthful nutrition in the fight against cancer. It is my hope to attempt to activate an acute interest in nutrition among physicians by providing a flavour of the findings of this research and in directing the reader to the massive body of research within the literature sources appended.

Nutrition’s vital role in cancer prevention and treatment

The extent of the published scientific evidence regarding the role of food and nutrition in cancer prevention and treatment is considerable. The initial database compiled for the Bristol Cancer Help Centre (BCHC, 1993) consisted of 5000 records during the previous decade alone! The database compiled for Positive Health numbers some 1000 references since 1993 and the World Cancer Research Fund’s epic tome (WCRF 1997) cites more than 3000 references covering:

* patterns of diet and cancer;
* diet and the cancer process, including the genetic and molecular processes of cancer initiation, promotion, and progression;
* types of scientific evidence published;
* 18 distinct types of cancer and how they are affected by food and nutrition;
* dietary constituents, i.e. carbohydrates, energy factors, fats, proteins, alcohol, vitamins, minerals;
* foods and drinks, i.e. grains, vegetables and fruits, pulses, nuts and seeds, meat, poultry, fish, eggs, milk, coffee, tea, and other drinks;
* food preparation, including contaminants, additives, processes such as curing, salting, and other cooking methods.

The evidence is graphically illustrated with charts, colour drawings, and tables listing, in great detail, the scientific literature from which the text is drawn.

Some 15 distinguished international scientists assembled this massive amount of evidence which, in short, concluded the following with regard to cancer prevention:

* That 30%-40% of all cancers, representing the prevention of some 3-4 million cancer cases each year, could be prevented using appropriate diet, physical activity, and maintaining proper body weight;
* That diets with substantial and varied amounts of fruits and vegetables could prevent 20% or greater of all cancer cases;
* That if alcohol consumption were maintained within recommended limits, up to 20% of aerodigestive tract, colon, rectal, and breast cancer cases could be prevented;
* That appropriate diet could prevent most stomach cancers and that colon and rectal cancers are mainly preventable by diet, physical activity, and appropriate body weight.

Given the paltry attention and resources currently expended upon nutritional methods for the prevention and treatment of cancer, and considering the mammoth implications of the above projections, along with its respectable documentation of scientific literature, a great deal needs to change in order to accommodate nutritional methodologies into cancer care.

However, very few physicians can afford the luxury of reading the entire research literature for cancer, or neoplasms as it is categorized within MedLine. Hence, here are a few examples of published research from the literature illustrating the extent of progress in nutritional cancer research.

Evidence from epidemiological and clinical trials

Although there is a vast literature on nutrition and cancer, few studies addressed supplemental nutrients directly. Patterson et al. (1997) compared the results of 7 clinical trials, 16 cohort and 36 case-control studies and demonstrated the effects of nutrients which are distinguishable from the effects of biologically active compounds in foods.

Randomized clinical trials have not demonstrated significant protective effects of beta-carotene, but have found protective effects of vitamin E against prostate cancer, vitamin A, zinc, beta-carotene, vitamin E, and selenium against stomach cancer, and selenium against total, lung, and prostate cancers.

Cohort studies provide scant evidence that vitamin supplements are associated with cancer. Case-control studies have demonstrated an inverse association between vitamin C and bladder cancer, several supplemental vitamins and oral/pharyngeal cancer and vitamin E and several cancers. Inverse associations between vitamin E and colon cancer have been found by a randomized clinical trial, a cohort study, and a case-control study.

In conclusion, there is, overall, modest evidence regarding the protective effects of nutrients from supplements against a number of cancers. Future studies of vitamin supplement use and cancer are justified, however methodological problems which impede the ability to assess supplement use, and statistical modelling of the relation between cancer risk and supplement use, require ironing out.

Zhang et al. (1999) studied the associations between dietary intakes of carotenoids, vitamins A, C, and E, consumption of fruits and vegetables and breast cancer risk. The authors conducted a large, prospective study to evaluate long-term intakes of these nutrients and breast cancer risk, in a cohort of 83,234 women, aged 33-60 years in 1980, who were participants in the Nurses’ Health study. During 1994, the authors identified 2697 incident cases of invasive breast cancer (784 premenopausal; 1913 postmenopausal).

There was a weak, inverse association between intakes of beta-carotene from food and supplements, lutein/zeaxanthin and vitamin A from foods and breast cancer risk in premenopausal women. There were strong inverse associations for increasing quintiles of alpha-carotene, beta-carotene, lutein/zeaxanthin, total vitamin C from foods and total vitamin A in premenopausal women with a positive family history of breast cancer. There was also an inverse association for increasing quintile of beta-carotene in premenopausal women who consumed 15 g or more of alcohol daily. Additionally, premenopausal women consuming 5 or more servings per day of fruits and vegetables had modestly lower risk of breast cancer than women who consumed fewer than 2 servings per day (relative risk (RR) = 0.77). The latter association was stronger in premenopausal women with a positive family history of breast cancer (RR = 0.29) or those women consuming 15 g or more of alcohol per day (RR = 0.53). The authors concluded that the consumption of fruits and vegetables high in specific carotenoids and vitamins may reduce the risk of breast cancer in premenopausal women.

La-Vecchia and Decarli (1996) noted that following early increases, mortality rates from oesophageal cancer have levelled off in Italy over the past two decades and are now intermediate on a European scale: 4.7/100,000 men; 0.8/100,000 women. The authors say that this reflects trends in consumption of tobacco and alcohol, major risk factors for this type of cancer. Within Italy there is considerable variation in rates of oesophageal cancer, with high mortality areas in the North-East. The relative risk (RR) of oesophageal cancer was 4.3 in heavy smokers and 3.5 in heavy drinkers, based upon a case-control study in northern Italy. A diet poor in fresh fruit and vegetables was also related to risk (RR = 2.5).

Regarding population attributable risk, 71% of cases in men and 32% in women were accounted for by tobacco smoking, 45% in men and 10% in women by alcohol drinking, 40% in men and 29% in women by a diet poor in fresh fruit and vegetables. Altogether, these 3 factors – tobacco, alcohol and poor diet – accounted for 90% of cases in Italian men and 58% in women (83% in both sexes combined).

A case-control study of lung cancer incidence among women in Shenyang, China explored the relationship between diet and lung cancer risk, with emphasis upon the potential effects of specific dietary nutrients in being able to modify lung cancer risk (Zhou et al. 1999) Dietary information regarding 290 cases and population-matched controls was obtained using personal interviews. There was a significant difference between cases and controls with respect to intake of beta-carotene, vitamin C, and fibre, all of which reduced the risk for lung cancer in a dose-dependent manner, with calculated odds ratio (OR) of 0.84, 0.75, and 0.46, respectively. The apparent effects of these nutrients persisted after adjusting for cigarette smoking. The authors’ conclusions were that beta-carotene, vitamin C, and fibre may function as protective factors to reduce the risk of lung cancer in women in China.

Breast cancer is a serious health problem, accounting for almost one-third of cancer-related deaths in women in America (Kimmick et al. (1997). As the prevention of breast cancer using dietary modification is an active area of clinical and epidemiological research, it has been proposed that vitamin E supplementation may reduce a woman’s risk of developing breast cancer. The authors review (60 references) the available evidence regarding vitamin E and breast cancer.

Vitamin E has decreased incidence of carcinogen-induced breast tumours in animal studies. However, there have been conflicting results in human epidemiological research. Further study is warranted, particularly regarding its interactions with other antioxidants and to the duration and timing – pre- vs postmenopausal – of vitamin E use to determine its use in the treatment and prevention of breast cancer.

Nutritional evidence at the cell and molecular level

The potential antiproliferative effects of tocotrienols, the vitamin E component in palm oil, upon human breast cancer cell growth have been studied by Nesaretnam et al. (1998). Both oestrogen-responsive (ER+) MCF7 and oestrogen- unresponsive (ER-) MDA-MB-231 human breast cancer cells were used in this study. The effects of the tocotrienol-rich fraction (TRF) of palm oil were compared with those of alpha-tocopherol (alphaT).

TRF inhibited growth of MCF7 cells (ER+) both in the presence and absence of oestradiol; the dose-response was nonlinear, and complete suppression of growth was achieved at 8 µg/ml. MDA-MB-231 (ER-) cells were also inhibited by TRF; there was a linear dose-response and complete growth suppression was achieved with 20 µg/ml. Fractionation of the TRF into individual tocotrienols revealed that all the fractions inhibited the growth of both ER+ and ER- cells, and of ER+ cells both in the presence and absence of oestradiol. The most highly inhibitory were the gamma- and delta-fractions; complete inhibition of MCF7 cell growth was achieved at 6 µg/ml of gamma-tocotrienol/delta-tocotrienol (gammaT3/deltaT3) in the absence of oestradiol and 10 µg/ml of deltaT3 in the presence of oestradiol. Complete suppression of growth of MDA-MB-231 (ER-) cells was not achieved even at concentrations of 10 µg/ml deltaT3. In contrast to the inhibitory effects of tocotrienols, alphaT had no inhibitory effect upon MCF7 nor on MDA-MB-231 cell growth either in the presence or absence of oestradiol.

These data confirm results from other studies using other sublines of human breast cancer cells and demonstrate that tocotrienols exert direct inhibitory effects upon breast cancer cell growth. Studies of the effects of the tocotrienol-rich fraction (TRF) upon oestrogen-regulated pS2 gene expression in MCF7 showed that tocotrienols do not act via an oestrogen receptor-mediated pathway and must therefore act differently from oestrogen antagonists. Also, tocotrienols did not increase levels of growth-inhibitory insulin-like growth factor binding proteins (IGFBP) in MCF7 cells, implying a different mechanism from the one proposed for retinoic acid inhibition of oestrogen-responsive breast cancer cell growth.

The inhibition of breast cancer cell growth by tocotrienols may have important clinical implications not only because tocotrienols inhibit the growth of both ER+ and ER- cell types, but also because ER+ cells could be growth-inhibited in the presence as well as in the absence of oestradiol. Future clinical applications of TRF may arise from potential growth suppression of ER+ breast cancer cells which are resistant to growth inhibition by antioestrogens and retinoic acid.

The antitumour effect of the herbal medicine sho-saiko-to and its mechanism of action upon a murine malignant melanoma cell line (Mel-ret) was studied by Liu et al. (1998). Sho-saiko-to induced apoptotic cell death of Mel-ret cells with a definite increase of cell surface Fas antigen and Fas ligand (FasL). [Fas is a protein recognition / signalling pathway.] Sho-saiko-to arrested Mel-ret cells in G1 phase (a phase during cell division) by decreasing the expression of cyclin-dependent kinase (cdk) 4 and its homologue cdk6. Kinase activities of cdk4 and cdk6 were shown to be downregulated by sho-saiko-to. Ingredient analysis revealed that baicalin is likely to be the main active constituent in the upregulation of Fas antigen and Fas ligand, while glycyrrhizin is the main constituent in the inhibition of cyclin-dependent kinases.

Zheng et al. (1997) recognized that various naturally occurring substances from vegetables and herbs exert chemopreventive properties against cancer. The authors reviewed two such compounds, isolated from garlic and from a traditional Chinese medicinal herb, elemene, isolated from the herb Rhizoma zedoariae.

Elemene was shown to exhibit antitumour activity in human and murine tumour cells both in vitro and in vivo and has shown substantial clinical activity against various tumours. Analysis by MTT assay of the effect of elemene upon the growth of leukaemia cells showed that the IC50 for promyelocytic leukaemia HL-60 cells and erythroleukaemia K562 cells were 27.5 µg/ml and 81 µg/ml respectively, and the IC50 for peripheral blood leukocytes PBL) was 254.3 µg/ml. Inhibition of elemene upon the proliferation of HL-60 cells was associated with cell cycle arrest from S to G2M phase transition, and with the induction of apoptosis. The apoptosis of tumour cells was confirmed by DNA ladder formation using gel electrophoresis and ultrastructural alterations.

The results also demonstrated that the inhibitory effects of allicin, a natural organosulphide from garlic, upon the proliferation of tumours cells were associated with the cell cycle blockage of S/G2M boundary phase and the induction of apoptosis.

These results suggest that the induction of apoptosis may contribute to the mechanisms of antitumour activity of elemene and allicin, which deserve further investigation as potential chemoprevention agents in humans.

The mechanism by which vitamin A prevents or delays carcinogenesis is still unclear (Maziere et al. 1997). Vitamin A, in addition to antimutagenic and antiproliferative properties, also appears to be able to induce programmed cell death (apoptosis). The authors studied the role of vitamin A regarding in vitro apoptosis induction in a rat colon tumour cell line. Retinyl palmitate in varying concentrations was added to the culture media. Cell proliferation was measured via (3H)thymidine incorporation, cell differentiation via intestinal alkaline phosphatase expression and apoptosis induction by DNA fragmentation and morphological evolution of adherent and floating cells.

Vitamin A decreased (3H)thymidine incorporation following 1 day of treatment, induced alkaline phosphatase expression and increased cells undergoing apoptosis. This study confirms the role of vitamin A regarding proliferation and demonstrates the capacity of vitamin A to induce apoptosis. These results may be useful to prevent development of colon cancer by supplementation of the diet with vitamin A.

Roles of individual nutrients and foods

Proposed mechanisms of vitamin C (ascorbic acid, ascorbate) for cancer treatment and prevention were reviewed by Head (1998). They include immune system enhancement, stimulation of collagen formation for ‘walling off’ tumours, inhibition of hyaluronidase to keep intact the ground substance around the tumour and prevent metastasis, prevention of oncogenic viruses, correction of ascorbate deficiency frequently observed in cancer patients, speeding up of wound healing following cancer surgery, enhancement of various chemotherapy drugs, reduction of toxicity of chemotherapeutic agents such as Adriamycin, prevention of damage from free radicals, and neutralization of carcinogenic substances.

Published studies from Scotland and Japan have reported the potential benefit of high dosages of vitamin C in the treatment of terminal cancer. Studies from the Mayo Clinic disputed those findings, resulting in acrimonious accusations of methodological flaws from both sides. Numerous epidemiological studies have demonstrated the importance of dietary and supplemental vitamin C in the prevention of numerous cancers, including bladder, breast, cervical, colorectal, oesophageal, lung, pancreatic, prostate, salivary gland, stomach, leukaemia and non-Hodgkin’s lymphoma.

Animal research studies

The effect of diet treatments with soy flour and rye bran upon prostate tumour development was investigated by Landstrom et al. (1998). 125 rats with transplanted R3327 PAP prostate tumours were divided into five groups. Tumour development was studied for 24 weeks during treatment with diets containing: 1) 33% soy flour (SD); 2) rye bran (RB); 3) heat-treated rye bran (HRB); 4) rye endosperm (RE); 5) control, fibre-free dietary (FF).

Compared with the control (FF), there were significantly fewer palpable tumours and lower tumour volume detected 14 and 16 weeks following transplantation in the SD (soy), RB (rye bran), and HRB (heat-treated rye bran) groups. Compared with the control, body weight was lower 16 weeks after transplantation in the RB and HRB groups. There was a significantly lower energy intake in the RB and HRB groups, compared with the controls during the 3-6 weeks following tumour transplantation, whereas energy intake was the same in all groups 13-16 weeks following transplantation. Even following adjustment of tumour volume for body weight, there were still significantly lower tumour volumes in the SD, RB, and HRB groups compared with the FF controls. There was a significant increase in daily urinary excretion of the isoflavonoids daidzein, O-desmethylangolensin, equol and Genistein in the SD group, and of the ligands enterolactone and enterodiol in the RB and HRB groups. There were no differences in testosterone levels between the groups.

These data show that soy flour inhibits implanted prostate cancer growth. Rye bran and heat-treated rye bran had a protective effect; however further studies are required to exclude the possibility that a low energy intake may have played a role in this regard. These results also suggest that phytoestrogens, isoflavonoids, and ligands may be responsible for the delayed prostate tumour growth.

Kishimoto et al. (1998) studied the effectiveness of vitamin E in the prevention of lung cancer in mice. NNK (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone was the chemical agent used to induce lung tumours. High doses of vitamin E suppressed NNK-induced increased activity of ornithine decarboxylase, a key enzyme of polyamine biosynthesis, in the lungs of mice 4 weeks following injection. Vitamin E, in contrast, increased the NNK-induced decrease of spermidine/spermine N1-acetyltransferase activity, a key enzyme of polyamine biodegradation. Vitamin E treatment suppressed NNK-increased levels of proliferating nuclear cell antigen, a marker of cell proliferation, and high doses of vitamin E suppressed NNK-induced lung tumourigenesis, i.e. inhibiting the development of lung tumours. The mechanism of inhibition is in part due to the regulation of polyamine metabolism.

Beta-carotene (BC) has been found to possess potent antitumour activity in liver carcinogenesis chemically induced by diethylnitrosamine (DEN) in rats Sarkar et al. (1997). The authors studied the basic cytogenetic and molecular mechanisms of the antitumour effects of beta-carotene. They monitored the effect of beta-carotene upon rat liver chromosomal aberrations (CAs) and DNA chain breaks in the early precancerous stage of liver cancer in rats. Even one DNA strand break per chromosome can be detected. A BC supplement, 120 mg/kg was fed to rats 15 days prior to challenge with a carcinogenic chemical.

Beta-carotene provided a unique protection against chromosomal strand breaks 96 hours following injection of DEN. Long-term treatment also afforded a protective effect on induction of CAs 15, 30 and 45 days following DEN treatment. Beta-carotene treatment for 15 days prior to DEN injection offered significant protection in the generation of single-strand breaks compared with DEN control. Beta-carotene ranks as a potential chemopreventive agent regarding rat liver carcinogenesis.

Human research studies

A cross-sectional study of postoperative non-small cell lung cancer (NSCLC) patients looked at the possible effects of vitamin intake and folate status upon disease-free survival Jatoi et al. (1998). Supplemental vitamin usage, dietary vitamin intake, red blood cell (RBC) folate, and serum folate concentrations were assessed in 36 patients with a history of NSCLC. Exclusion criteria included factors altering folate status or associated with altered nutritional habits: 1) evidence of cancer on history, physical, or chest radiograph; 2) tobacco, alcohol ingestion (>2 drinks/day) or cancer treatment within 3 months; 3) the use of folate antagonists; and 4) age <60 years.

The median disease-free censored survival was 24 months (range 4-41 months). 19 of 36 patients (53%) reported vitamin supplementation. Compared with non vitamin supplement users, vitamin users had a longer median censored survival (41 months versus 11 months, P = 0.002). Following adjustment for stage of cancer, the association between RBC folate and censored survival (r = 0.35) and serum folate and censored survival (r = 0.32) approached statistical significance. Thus those patients with NSCLC who took vitamin supplements were more likely to be long-term survivors. A similar trend toward long-term survival was seen in patients with higher circulating folate concentrations.

Sixty cancer patients with secondary lymphoedema, with particular reference to the development of the incidence of erysipelas (acute, streptococcal inflammation of the skin and subcutaneous tissues, infection accompanied by fever and constitutional disturbances) took part in a randomized, double-blind study to determine the efficacy of sodium selenite in combination with physical therapy to relieve congestion (Kasseroller 1998). All the patients in this study had erysipelas infection of the skin. Selenium was administered in pharmacological doses. Physical therapy was for 3 weeks and patients were observed for a further 3 months.

The incidence of erysipelas among the patients was 11%. During the 3-week period of intensive treatment, there was not a single case of erysipelas in the treatment, compared with a single case in the placebo group. During the follow-up period of 3 months, there was not a single case of erysipelas in the treatment group, compared with 50% of the patients in the placebo group. Despite the higher doses, the selenium level did not rise above normal values. Patients under long-term antibiotic therapy suffered no relapse when the antibiotic therapy was stopped and selenium was administered instead. Additionally, the administration of a single high-dose of sodium selenite could immediately bring the inflammation under control.

In another trial, 974 men with a history of either basal cell or squamous cell cancer were randomized to receive a daily supplement of 200 µg of selenium or a placebo to test whether supplemental dietary selenium is associated with changed incidence of prostate cancer. The men were treated for a mean of 4.5 years and followed for a mean of 6.5 years (Clark et al. 1998).

Selenium treatment was associated with a significant (63%) reduction in the secondary endpoint of prostate cancer incidence during 1983-93. There were 13 prostate cancer cases in the selenium-treated compared with 35 in the placebo group (relative risk RR = 0.37). If the analysis is restricted to the 843 patients with initially normal levels of prostate-specific antigen (PSA), there were only 4 cases diagnosed in the selenium-treated group compared with 16 in the placebo group following a 2-year treatment lag (RR = 0.26). Other significant health benefits were observed for the secondary endpoints of total cancer mortality and incidence of total, lung and colorectal cancer. There were no significant changes in incidence for primary endpoints of basal and squamous cell skin cancer. In the light of these results, the ‘blinded’ phase of this trial was stopped early. In conclusion, selenium treatment was associated with substantial reductions in the incidence of prostate cancer and total cancer incidence and mortality. Selenium did not show a protective effect against squamous and basal skin cancers.

Peng et al. (1998) analysed the plasma concentrations of 10 micronutrients in cervical tissue from cancerous, precancerous, and noncancerous women. Paired blood and cervical tissue samples were taken from 87 patients, aged from 21-86 years who had a hysterectomy or biopsy due to cervical cancer, precancer (cervical intraepithelial neoplasia I, II and III), or noncancerous diseases. The samples were analysed for 10 micronutrients (lutein, zeaxanthin, beta-cryptoxanthin, lycopene, alpha-carotene, beta-carotene, cis-beta-carotene, alpha-tocopherol, gamma-tocopherol and retinol).

In the three patient groups, the mean plasma concentrations of all micronutrients except gamma-tocopherol were lowest in the cancer patients; however, the mean tissue concentrations of the two tocopherols and certain carotenoids were highest in the cancerous tissue. Among the 10 micronutrients, only the concentrations of beta-carotene and cis-beta-carotene were lower in both the plasma and tissue of cancer and precancer patients than in those of noncancer controls. These data suggest that not all the micronutrient concentrations in plasma reflect the micronutrient concentrations in cervical tissue. In some cases, it may be necessary to measure the tissue micronutrient concentrations in order to define the role of the micronutrients in cervical cancer. An adequate plasma and tissue concentration of beta-carotene should be maintained for the prevention of cervical cancer and precancer.

To investigate whether dietary supplements of selenium (Se) reduce the risk of cancer 1312 patients with histories of basal/ squamous cell carcinomas, recruited from 1983-1990 were randomly assigned in double-blind fashion to daily oral supplements of either Se-enriched yeast (200 µg/Se/day) or a low-Se yeast placebo (Combs et al. 1997). Patients were followed with regular dermatological examinations through to 1993, representing 8269 person-years of observation. Skin cancer diagnoses were confirmed histologically, plasma selenium concentrations were determined at 6-12 month intervals, and deaths and patient illnesses were recorded, confirmed, and documented in consultation with medical care providers. Although selenium did not significantly affect the primary endpoints, incidence of recurrent basal/squamous cell skin cancer, selenium treatment was associated with reduction in a number of secondary endpoints: total mortality from all cancers, combined incidence of all cancers, combined lung cancer, colorectal cancer and prostate cancer.

These results strongly demonstrated the benefits of Se-supplementation, supporting the hypothesis that supplemental Se can reduce cancer risk. Despite the lack of protective effects against non-melanoma skin cancer, the reductions in risk of other frequent cancers demand further evaluation in controlled clinical intervention trials.

Conclusions

There is no doubt from the few examples cited above that much research has already been conducted and is ongoing regarding the application of nutrition in both the prevention and treatment of cancer. However, more concerning is the virtual non-translation of these findings into either medical or people’s lifestyle practices. Considering the ageing of the developed world’s population and the rising incidence of cancer, associated with lifestyle, environmental and dietary factors, and the human and monetary costs of cancer, social, environmental, and lifestyle issues need to be addressed. It would help if the medical profession appeared to be cognisant of the huge body of evidence already amassed, rather than always attempting to deride and denigrate the use of nutritional approaches to cancer treatment.

Today there are also a variety of non-mainstream nutritional therapeutic practices – various dietary regimes such as Gerson, macrobiotics, Vries, wheat grass, fasting, colon cleansing, herbal regimes – espoused by a variety of practitioners which may be scorned by the general medical community, but which, if subjected to serious and concerted research, may reveal significant therapeutic efficacy. Today’s marginal practice may become tomorrow’s mainstream clinical protocol. There is an urgent requirement for research regarding the efficacy of these nutritional and dietary cancer regimes in treatment of cancer patients, and the decriminalization of nutrition as a cancer treatment methodology.

A few selected areas of education, policy and research requiring urgent attention include:

* The addition of nutrition into the medical school curriculum;
* The improved communication of published research to physicians and the systemic and comprehensive integration of published findings into clinical practice;
* The requirement of open and vigorous debate about fundamental precepts such as RDAs (recommended daily allowances), balanced diet, and the use of supplements;
* The necessity for serious research about the many and varied dietary regimes currently being advocated and used by many tens of thousands of people, who claim efficacy, particularly for cancer – vegetarian, frugivore, raw food, macrobiotic, Gerson diet, fasting;
* The identification and research of components within vegetables and other foods which appear to protect against cancer;
* Research of anti-oestrogen foods such as soybeans and their preventive effects in cancer.

References

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Getting Started – What You Will Need January 31, 2009

THE basic starter kit for someone wanting to begin eating macrobiotically is not different from what you would need in any kitchen – the usual round of pots and pans, and cooking utensils. The main difference, though, is that for macrobiotics, we ask that the utensils be ‘clean’ ie, that they are not treated chemically, as are, for example, teflon coated pots and pans.

Apart from the cooking utensils, you will also need some foods which are not part of the average Asian diet.

Here is a list of things you will needs to get started:

Utensils:

Stainless steel or cast iron pots and a skillet

Claypots

Pressure cooker

Steamer – for cooking and for re-heating food.

Chef’s knife and a paring knife

Bancha twig tea is the aqua vitae of the macrobiotic world!

Foundation foods:

Kombu & Wakame

Other sea vegetables – arame, hijiki, agar agar (or kanten)

Sea salt (as dirty-looking as possible, for these contain the highest content of natural minerals)

Shoyu or tamari

Bancha twig tea

Medium or long-grain brown rice

And that’s it. You will probably add to this as you begin to cook different foods. And if you are already an avid cook, then you would probably already have most of the tools you need.

One last thing. Macrobiotics is about TRUTH – being true to your body and yourself. Don’t feed yourself food which is not ‘true’ – ie overfertilised, over-hormonised, over-chemicalised food. While our bodies were built to last, the assumption is that we would co-operate and feed them with fuel that they know and understand.

Chemicals which are not naturally occuring in the ground, but which have been added to it to increase crop yield, are not something our bodies ever thought they would have to deal with. And so, they may react in ways unanticipated – for example, through uncontrolled, abnormal cellular growth.

I recommend trying to eat organically as much as possible. And if not, try to get the best quality possible (ie, grown with good, reliable farming practices). It might cost a little more – but ultimately, it is still alot cheaper than any medical bills you might have to pay for chronic illnesses which arise out of poor eating habits.

I will say now that I avoid all foods from China, as much as possible. But the farming practices there are not reliable. And given the number of food scares coming out of China over the past years, TRUTH is something that is not yet established in its farming industry.

Having said that, I also acknowledge that it is cheaper, generally, to buy from China. So, if you must buy your food from China, I encourage you to soak all your vegetables (from China and elsewhere) for 20 minutes before use to leech out any chemicals. If you wish, you can add a few drops of apple cider vinegar to the soaking water to strengthen the leeching process. But beware, not too much or you might end up with a pickle!

The Macrobiotic Diagnosis January 31, 2009

When I speak to people of macrobiotics and its ability to help support the body as it heals itself, I find they zoom right to the last chapter and say: so, what should I eat to heal my diabetes/cholesterol problem/cancer/asthma…and so on.

The fact is that macrobiotics is not just an easy fix for health issues. It takes more than popping a few ume plums, and calling me in the morning. The typical macrobiotic diagnostic process is an fairly extensive one, where I seek to understand my clients in their various contexts – work, family, friendships, lovers, enemies. Their loves, their hates. Their dreams and their nightmares. Their highest aspirations. Their deepest fears. The extensive questionnaire which takes at least 2 hours to complete looks at:

1. The emotional state, current and potential

2. The personality, – his ideals, views of life, his character

3. The constitution – both physical and mental

4.  History of ailments suffered, past and present

5. Recommendations – what changes must be made (diet, lifestyle, outlook) to bring the person back to health

6. What highest aspirations (physical, emotional, mental, spiritual) can be aimed for to achieve happiness

7. Encouragement – what support is required for the person to develop his or her endless possibility to achieve happiness

So you see, it is never just a matter of the physical with macrobiotics. It is a holistic view of health that the macrobiotic counsellor strives for, for the benefit of the client. And because it is such an involved process, I feel that it is important to cultivate in the client a sense of excitement and interest about the journey they are about to embark on when they begin macrobiotics. So I work with the whole person, not just with their pancreas, or their liver, or their spleen. Everything the person is and everything they want to be is in the frame and must be considered for a proper diagnosis.

This is why, when macrobiotics is applied well, words such as ‘hope’ and ‘empowerement’ and ‘healing’ come to be associated with the practice.And also why when I talk to my patients, I sometimes simply ask: how do you feel? The field is open for a response – unhappy, depressed, fantastic, full of energy. All of these are the symptoms that have to be considered. And sometimes, I don’t recommend food. I simply ask people to wake up earlier, and take a walk just as the sun is rising, breathing deeply and slowly of the fresh morning air, as they move through the early morning silence. Sometimes just eating the food is not enough and one needs to access other healing aids, such as simple nature.

As I practice macrobiotics, I am continually being made to feel awe at the wonder of the human body and its ability to find  what it needs to heal itself. The body is hard wired to heal itself and if we just gave it half a chance, it could do just that. The trick is to be able to understand what your body needs, and why.

This is the other part of the counselling process – to help people understand enough of macrobiotic theory to be able to adapt elements of macrobiotics to suit their needs as they heal, and their bodies become stronger. To empower and equip them to work with their own bodies for the rest of their lives for better health – and stronger living, on every level.