In this follow up to my article,
first of all I wish to thank very much all the friends and
teachers that contributed with their comments, and then to
respond to the principal questions and remarks that I received.
At the end, I will add some considerations.
ANSWERS TO QUESTIONS AND REMARKS
1. B12 deficiency in vegans
does not exist, it is a myth created by the meat and dairy
Carlo: Unfortunately, B12 deficiency
in vegans is a documented fact: please see references in my
article. Vegetarian institutions emphasize the importance
of vegetarians and especially vegans taking vitamin. B12 supplements.
As a very authoritative example of a dedicated vegan doctor
recommending vitamin B12 supplementation, please refer to
Neal Barnard and the Physicians Committee for Responsible
Macrobiotic people, also if not vegan in principle,
may eat such a little amount of animal food so as to be at
risk of Vitamin. B12 deficiency.
At least two studies document this fact. The
first one, Vitamin B12 status in a macrobiotic community,
published in 1991, has been conducted within the macrobiotic
communities of Boston, MA, and Middletown, CT.
The study showed that many of the macrobiotic individuals
tested were lacking vitamin B12 to a certain extent, and probably,
with the more sensitive tests available today, the results
would have been even worse. At that time no test for Homocysteine
was conducted, for example. Everybody can download for free
and check by himself the study here:
The second study, while not specifically speaking
of macrobiotic people, checked and compared the vitamin B12
(and anti oxidants) status of people that:
1. ate no animal food at all.
2. ate only fish / meat once a week (and this is roughly
3. ate eggs and milk / dairy frequently.
4. ate an omnivore diet rich in meat.
The study gave similar results employing a
wider range of tests, included the one for homocysteine concentration
in blood. The less animal food that was eaten, the worse was
the vitamin B12 status, and higher was the level of Homocysteine
in blood, so the approach similar to the macrobiotic one fared
worse than the lacto ovo vegetarian one, from this point of
The study is Total Homocysteine, Vitamin B12,
and Total Antioxidant Status in Vegetarians,
freely downloadable here:
It is true that we must be aware of the meat
and dairy industry interest in this topic. However, it is
not impossible to discriminate when a specific study or research
is nothing more than an advertisement for these industries,
or a good and honest one. The studies cited in the references
are all of very high quality and solidly based on facts. Of
course, it is necessary to read them thoroughly in order to
verify my affirmation.
2. It is demonstrated that vegans are far
more healthy than omnivores, so there is no reason to worry
about vitamin B12 deficiency.
Carlo: Eating a lot of vegetables and
fruits, and reducing or avoiding animal foods, sugar and chemicals,
definitely improves one's health conditions. Nevertheless,
in this way it is still possible to slowly determine a lack
of Vitamin B12 and other substances, and it can create problems
at a later time, even decades later.
3. My affirmations and concerns about B12
are groundless, and that is demonstrated from a
study cited here:
(the study is Staging B12 status in Vegetarians,
and it is freely downloadable here:
Carlo: Actually this study confirms
my affirmations and concerns. In the very first page it says
that dietary deficiency of vitamin B12 results from
a strict vegan (all plant food) diet, while vegetarians
who are not vegans (...) ingest adequate amounts of vitamin
B12 in animal (e.g., egg, milk, and other) products.
The author then says that Vitamin B12 is reabsorbed
from the intestine and recycled, so that an healthy and adult
vegan can avoid B12 deficiency for many years, even 20
30 years (page 1217 S). But this only means that, when all
organ conditions are perfect, deficiency can be delayed.
In fact (page 1215 S): If daily vitamin
B- 12 absorption continues to be less than daily vitamin B-12
loss, negative balance will progress to Stage II, depletion
of stores. At this point, many vegetarians stabilize for years
with depleted stores, because depleted stores trigger upregulation
of healthy machinery for absorption, making more efficient
the absorption of the trace amount of vitamin B-12 from bacterial
contamination of the small intestine and vitamin B- 12 secreted
in the bile.
Eventually, however, continuing slight negative balance will
deplete vitamin B-12 stores, after which Stage III negative
balance occurs (biochemical deficiency, i.e., inadequate vitamin
B-12 for normal vitamin B-12-dependent biochemical reactions,
sometimes called preclinical deficiency).
Moreover, if the gastric or intestinal efficiency
is not perfect, deficiency can occur far earlier, because
B12 is not adequately absorbed, the same study states. This
is a rather common situation both for omnivores and vegetarians
but, according to the author, it is a more frequent occurrence
in vegetarians, due to a less efficient utilization of iron
from vegetable sources.
In fact (page 1215 S): iron from plant
foods averages 3% absorbable; iron from animal foods averages
15% absorbable. Therefore, iron deficiency is twice as common
in vegetarians as in omnivores. Because some vegetarians,
especially those consuming restrictive diets, are at greater
risk for deficiencies than omnivores, all vegetarians should
be tested for iron disorders. Prolonged iron deficiency damages
the gastric mucosa and promotes atrophic gastritis and gastric
atrophy, including loss of gastric acid and IF secretion,
and therefore diminished vitamin B-12 absorption. This would
cause vitamin B-12 deficiency in twice as many vegetarians
The study also states that the situation is
even worse if one individual becomes vegan without large Vitamin
B12 stores in the liver, a not infrequent possibility, or
for children of vegan mothers.
Actually this study is aimed to identify the
best laboratory tests to detect vitamin B12 deficiency, not
to demonstrate the possibility to thrive on a strict vegan
diet, and its affirmations clearly sustain, complete and precise
the ones from the other references I reported in my article.
4. Many vegan groups and populations have
demonstrated, through-out human history, that vegan nutrition
Carlo: Actually there are no data to
support this thesis. It is possible that vegan monks stay
healthy for a long time because they start their diet when
adults, but probably many of them actually suffered in the
past and suffer now for vitamin deficiency. They did not necessarily
live a long time, or were healthy.
Moreover, monks have a very different way
of life from common people, and practice powerful techniques
that probably can help in optimizing the resources from food.
In Daoism, practices are known that can help you to live almost
without food, but of course this is very far from what common
people regard living a normal life.
No population in the world has been vegan for
generations: animal food has always been enjoyed if only available.
Of course, specific religious groups may be vegan, and this
is more common in India.
The only study of which I am aware on vegetarians
living in India finds a very widespread B12 deficiency, even
if the authors report that this situation cannot be completely
attributed to a vegetarian diet but also to other factors.
In any case, deficiency is there, not an adequate level of
(Please refer to this free downloadable article:
Hyperhomocysteinemia and elevated methylmalonic acid
indicate a high prevalence of cobalamin deficiency in Asian
Indians, available here:
and the comment to the same study available here:).
It may be helpful to remember here the Ohsawa's
book Zen Macrobiotics, in which ten eating patterns
are proposed as ways to health, and where the
most wide one includes only 10% of grains and 30 % of animal
foods, plus vegetables and fruits, while the most strict one
is totally vegan and based only on grains. Apart from the
details and proportions, the general idea is a good, flexible
and realistic one.
Vegan diets, as well as animal food based ones
like the chetogenic diet, are both legitimate, because a human
being is able to sustain himself only on vegetables or animal
foods for a pretty long time, if necessary. Otherwise, we
could not explain some good results obtained with the Atkins
diet, for example in rebalancing blood risk factors for cardiovascular
diseases or metabolic syndrome.
This comes from the fact that humans have been
able to survive on many different foods during their evolution,
thanks to the development of specific abilities to optimize
the use of the available nutrients (as vitamin B12).
However, those diets are at the limits of the human ability
for survival, and humans usually sustained themselves on diets
in which both vegetables and animal foods were present in
different proportions according to climate.
(For a very balanced view on this subject,
please refer to Hunter-gatherers diets: a different
perspective, freely downloadable here:).
Extreme diets such as vegan or semi-vegan ones, as well as
highly carnivorous ones, are clearly sustainable only for
a imitate period of time, even if vegan ones may be continued
far longer than the ones that include a lot of animal foods.
How much animal food is necessary in our present
way of living, and for each individual, is something that
we must still discover, and experiment with, but starting
from the fact that it represents a legitimate part of the
human way of eating.
5. If both scientific conclusions and the
ones based on yin-yang are not absolutes, why should we trust
only those coming from science?
Carlo: I completely agree that it would
be foolish. Science is absolutely blind with regard to many
realms of our existence. I am speaking about a dialogue. We
have much to learn and much to teach, but if we only stay
within the limits of our philosophy, we end in making mistakes.
The data from science are very interesting for us because
we can evaluate them according to our yin-yang principle,
so expanding our understanding of reality.
And if the data suggest that a substantial
number of macrobiotic friends may be lacking B12 and presenting
high levels of a toxic substance as homocysteine in the blood,
there is no profit in trying to nullify this truth.
In any case, the way to clear this quarrel
is very simple: anyone interested can have his own blood tests
done and check the results. It seems that the best test for
screening an early negative Vitamin B12 balance is the test
for serum Holotranscobalamin II, while the test for Homocysteine
is important in order to show the presence of an unnoticed
but already existing even if not clinically evident
yet metabolical damage. Of course, this is a matter
to be discussed with a qualified Physician.
6. Yin-yang and science are the same thing.
If intuition is refined, it can be a tool as reliable as science
in order to understand reality.
Carlo: The yin-yang method has been
born in China around 300 B.C., as a way to organize the data
from senses, and the daily experience of living, in a coherent
way. The underlying paradigm, at that time, was that humanity
has to adapt to an harmonious and cyclically changing nature.
According to this view of the world, people can stay healthy,
and can even reach superhuman states, if they are able to
find their right place in the order of the universe, and flow
with its law.
Actually, not only ordinary senses were used
in order to reach that goal, but also superhuman senses and
abilities developed through special practices. It is also
important to note that this method was originally based on
Chinese language, which is far less definite and far more
open to paradox than western languages, and that it never
developed a clear concept of cause and effect, relying more
on the idea of influence and attunement with the natural order.
Modern science springs, around the fifteenth
and sixteenth centuries, from a very strict interplay between
ordinary senses, intellect working on the basis of non-contradiction
principle, mathematics and technology. Cause and effect is
the cornerstone of this way to consider the reality, at least
until the development of quantum mechanics. The paradigm in
which modern science is born is an individualistic one, aimed
to free man from dependency on nature.
So yin-yang and modern science are both in
contact with reality, but approach it from different perspectives
and using different tools. As I understand it, the greatness
of George Ohsawa stays in his efforts to start a dialogue
between these two paradigms, and I believe that his vision
is still an inspiring one for our present times. Hopefully,
it could lead to integrate these two approaches in one higher
order future approach. But we are still not able to do that
well, and sometimes we are not rigorous enough even in applying
yin-yang itself, so we must learn more from the other side.
An example of how lightly yin-yang is often
applied can be offered by referring to a classical question
in macrobiotic lessons: why water expands when heat is applied
to it (which is no surprise) and also when it freezes? The
usual macrobiotic answer is: because Oxygen is
yin and Hydrogen is yang. When cold is applied, the more yang
Hydrogen attracts it and becomes more yin. Necessarily, the
attraction between Oxygen and this yinnized Hydrogen diminishes,
so the molecule expands, making ice light and able to float
It is an attractive answer, and correct under
the yin-yang point of view, but it is not true.
What actually happens is that, when freezing,
the water molecules (and not the atoms within the molecules)
arrange themselves at the vertex and in the center of a tetrahedron
(a pyramid-like shape), with Oxygen and Hydrogen atoms of
different molecules united by hydrogen bonds, so that ice
becomes structured in an expanded way compared to water. All
this is still in perfect harmony with yin-yang principles,
but it is completely different from what is stated in the
classical answer above.
It must also be said that it is absurd to think
that the water molecules themselves can expand under the weak
influence of a few degrees difference in temperature, because
the Oxygen and Hydrogen atoms in the water molecule are united
by very strong covalent bonds that differently from
the weaker hydrogen bonds that link together water molecules
in ice - do not allow for that. If something like this could
happen it would subvert modern Physics.
Now, it seems that nobody ever had the desire
to check if this affirmation actually corresponds to reality,
and I believe that the same is true for many assertions taken
for granted in this field.
So, again, I am sure that yin-yang can really
help in solving many problems and suggesting new hypotheses,
but we must learn to use it rigorously. I personally experienced
some of this difficulty when I gave my contribution to the
work of one of the leading epidemiologists in Italy, who is
presently studying the risk factors for breast cancer.
He asked me to try to figure out for him,
according to yin-yang and starting from the available scientific
data on this subject, how foods influence the level of a very
important class of hormones, the Insulin-like Growth factors,
and related binding proteins.
I checked the data, interpreted them according
to yin-yang and combined them with my macrobiotic experience,
and finally proposed a few ideas that could be experimentally
checked. So I believe that it is definitely possible to reach
useful conclusions with yin-yang, even entering the scientific
ground, but I know that it is not so easy to do.
(I've written a book that tries to carry the
dialogue between yin-yang and science a little further on.
The book is titled Il grande libro dell'Ecodieta,
and it is published in Italian by Edizioni Mediterranean.
The first third of the book presents the scientific
data that we have about the food that human beings did eat
during the last couple of millions years of their evolution,
plus the principal data about the favourable and unfavourable
effects on the health of the main groups of modern foods.
From this first section, a general indication of the best
eating pattern for the human being comes out, and it is very
in tune with the macrobiotic approach.
I decided to start with the scientific approach
because this is the language of our modern society, and I
wanted to reach not only macrobiotic people but the widest
audience. The second part of the book is dedicated to yin-yang
and its use, and shows how this method can confirm, pinpoint
and make more practically and flexibly usable the data from
science, beyond supplying new information by itself. The third
part is about how to address specific sicknesses with food
7. Cancer in macrobiotic people comes from
eating every day pressure cooked brown rice or other grains.
This creates a too contracted condition, that makes people
overeat and eat in a disorderly way.
Carlo: I agree that eating everyday
pressure cooked brown rice makes people too yang in the long
run, and that this contributes to overeating and attraction
to sweets, so leading to several kinds of problems. A wider
range of cooking methods and preparation should be routinely
used. However, I believe that some stronger factors
as the ones proposed in my article - are at the core of such
a big problem as cancer, even if overeating and sweets can
8. I am deadly allergic to fish and fish
oils, and dislike meat. How can I get adequate amounts of
B12 and Omega-3 Fats?
Carlo: Any individual health problem
has its own particularities, and must be discussed with a
qualified therapist. However, in general it can be said that
free range eggs and poultry contain a certain amount of both
long chain omega-3 fatty acids and vitamin B12.
Milk contains B12. It is better to learn how
to introduce these foods in a balanced way and in proper amounts,
than risking a Vitamin B12 depletion. An alternative, or in
addition, supplements are there.
However, supplements only supply some definite
nutrients that we are aware of, while a lack of B12 may indicate
a lack of many other nutrients contained in animal foods such
as zinc, Vitamin B6, and more. A whole food is always very
different from a supplement.
Short-chain omega 3 fatty acids, from
which the long-chain ones can be synthesized, are also contained
in flaxseed oil and green vegetables, that should be regularly
consumed. However, the synthesis of long-chain omega 3 fatty
acids from the short-chain ones is often not sufficient to
satisfy the body needs, hence the need for the animal foods
in which they are already present.
9. Depletion of Jing is not necessarily
linked with being skinny. The classical Chinese medicine views
for depletion of Jing include: stress, over consumption of
foods, alcohol and drugs, excessive sex, excess or lack of
exercise, lack of sleep, poor breathing and natural aging.
Carlo: I don't put in connection the
fact of being lean with jing depletion, and I am aware of
the classical Chinese view on this subject , that seems very
valuable to me. However, I am referring here to an impression
of emptying, a kind of exhaustion
that some macrobiotic individuals show, and that can be easily
noticed by a trained eye, if only attention is paid to it.
Moreover, my suggestion is that vitamin B12, being so important
for correct DNA reproduction and expression, has to do with
jing depletion, even if this is something that the classical
Chinese view could not understand in ancient times.
The problem of cancer is a huge one, and I
do not pretend to have exhaustively or perfectly identified
the factors that can contribute to its manifestation in macrobiotic
people. However, the problems that I mentioned definitely
exist, derive from our current way of interpreting the macrobiotic
way of eating, ask for a solution, and probably can help us
to understand also the cancer issue.
It could even be that the present global environmental
unbalance, added to the lack of natural selection in the first
years of life, are factors too strong to be overcomed only
by a good way of eating and an active life.
And certainly the emotional problems have a
role bigger than what we usually take into account, when dealing
with this specific sickness. If things are like that, there's
nothing to hide. We know that many people succeed in healing
their cancers with macrobiotics, and very probably our way
of eating still prevents many cases of this illness. What
we have to offer is of the utmost importance for humanity,
even if we are not able to completely prevent this sickness.
In any case, the main point here does not regard
only vitamin B12 or D, Omega 3 and 6 fats, or any other specific
nutrient, but our attitude toward the facts that disturb us,
and oppose our idea of what the reality is. We just need to
look at the problems as they are, without trying to explain
them off in a simplistic way.
An example of this attitude is attributing
the problem of cancer in macrobiotic people only to minimal
mistakes within an otherwise perfect way of cooking and eating.
If we say that it is possible to get cancer
only from, say, sautéing too much our vegetables, or
eating too many cookies, or pouring too much raw oil on our
salad, or something similar as we have indeed heard, we not
only say something that it is very probably not true, but
also create an attitude of fear and rigidity in many friends
that trust our judgment and experience. This cannot be a road
to liberty and happiness.
experience to dogma
Every school of thought, or spiritual path,
starts with an enlightening experience that shows aspects
of reality that were hidden until that moment. As time passes
the experience fades, and knowledge remains. After a longer
time, even knowledge ages, loses its contact with reality,
and dogma arises.
If we wish to avoid that eventuality, or at
least to delay it as long as possible, it is essential that
we strive to keep in touch with reality. And we know very
well that the most painful experiences are the most useful
ones, with regard to keeping us aware and alert.
Believing that we know how to stay healthy,
how to prevent and cure any sickness, and that because of
that we must become leaders of the new world and save the
Humanity from the dangers in which it lives, would be a delusional
attitude. I would like to suggest another approach.
Many of us have children. From them we learnt
that we cannot really lead another persons' life to a big
extent. Our children have their way to go, their goals, limits
and experiences to live just as we have. If we believe that
we understand everything about life, and so we can guide them
to reach their happiness, we create unhappiness. We can just
help, and even that not so much. The same is true with Humanity.
We don't know what future Humanity will choose
to live, nor which future is actually the best for it. We
learned a few things from our macrobiotic practice, because
we experienced them and because we apply a method that really
helps in understanding things, but we are ignorant about many
The only attitude that we can reasonably cultivate
is the one of nourishing the future, as we nourish our children,
with good food, a little knowledge, a few dreams, and many
unanswered questions, helping the future to grow according
to its own way. We can put the little we know in the big flow
of the human evolution, and let Humanity take or reject what
it chooses to.
say that we can strive to become good ingredients of
the cosmic soup, knowing well that we are not the Cook.
If we keep ourselves open and eager to learn
from reality, also when it opposes or disappoints us, we will
be able to stay flexible and helpful to others for a long
time, putting something positive and valuable in the flow.
And this can really make a difference, especially in a deeply
transformational historical period as the one we presently
Here in the center of the spiral of history,
what we learned and can offer to others even if very
limited - can make a critical difference for everybody.