Diets for IBD, Gut Feelings, Macrobiotics

Not All “Macrobiotic” Recipes Are Truly Macrobiotic

A clear glass jar full of maple syrup or honey next to a wooden spoon.

Thanksgiving was approaching, and I’d been growing nervous. Before developing ulcerative colitis, this had been my favorite holiday, but nowadays I had a very restricted macrobiotic diet. How would I be able to enjoy a holiday that was centered around food?

To my great relief, a week or two before the big day, my sister’s girlfriend pointed out that my sister was currently on an anti-inflammatory diet, too. She suggested that the two of them, plus Ron and me, share our alternative food together at the large family meal. We could all sit near each other, our meal a subset of the group’s.

The four of us enthusiastically put together an alternative menu. The two of them would bring wild rice with lentils, mashed yams (potatoes are nightshades, and thus possibly inflammatory, but yams are not), applesauce with no added sugar, and a dairy-free, gluten-free, sugar-free gravy. Ron and I would make salmon, brussels sprouts with toasted hazelnuts, butternut squash soup, cornbread with a creamy mushroom gravy, and sugar-free cranberry sauce.

We’ll have a feast! 🙂 I wrote in an email.


As the day dawned, I felt cheerful. It made such a difference to have others with whom to share food! We four “kids” (all now in our thirties) arrived early to help set up at my parents’ house, moving furniture around, cutting flowers to make centerpieces, and laying the table with the fancy holiday dishes. Guests trickled in, bringing trays of vegetables, carafes of fatty gravy, and cranberry sauce. The kitchen and dining room grew louder and I escaped to the living room to start a puzzle with the other quieter folk. At the meal, the others asked curious questions about our alternative fare, and I explained about my illness. Afterwards we all played board games and worked more on the puzzle, and I left feeling happy.

The following day, my sister wrote me a quick email: thanksgiving was so great this year! i didn’t feel deprived at all! 🙂

I agreed.

My gut, however, was less happy.

That day I found myself hurrying to the bathroom far more than the usual two or three times a day, and with more urgency. Friday I counted twelve bowel movements, all of them bloody. The same thing happened on Saturday. Compared to my health plateau of the last couple months, this felt like something different: a flare-up within a flare-up.

It was disheartening to recognize this difference, because my last doctor in Madison had once commented that “Maybe this is your version of remission.” I had refused to accept that possibility—I knew what health felt like, and my plateau was not health. But now, after Thanksgiving, I wondered: if this was a real flare-up, what had I been in for the last few months?


The post-Thanksgiving flare was the latest piece of evidence that food had an enormous impact on my symptoms. Even though all our Thanksgiving dishes had come from macrobiotic websites, they had all contained many ingredients that I didn’t typically eat. There must have been something new in the dishes that my gut didn’t like, I thought. Possibly multiple things.

I looked back through the recipes, trying to figure out what had hurt my gut. And I realized the problem: these “macrobiotic” recipes had been written for people who didn’t have chronic illnesses. There are two camps of macrobiotic eaters, I now understood: those who eat this way to address diseases and those who’re just working on general health or weight loss.

The former group, my group, needs to be far more conservative with ingredients.

The latter group is prone to “cheating.” Recipes are often designed for people who are trying to eat healthier, but who are unwilling to give up the sweetness typical of modern American foods. They use alternative ingredients—instead of white or brown sugar, they substitute other sugars, like maple syrup, honey, and agave syrup—but the core of the recipe remains.

Take our “macrobiotic cranberry sauce,” for example. The recipe had included ¾ cups of brown rice syrup and ¼ cup of maple syrup, as well as 2 tablespoons of orange juice—with its own natural sugar—and the natural sugars in the cranberries and the pears.

It might have been labeled “macrobiotic” and found on the “Macrobiotic Chef’s” website, but reflecting on it now, this recipe simply couldn’t have been good for me or anyone with an inflammatory disease. I wasn’t even sure it was really macrobiotic. Wasn’t this kind of sugar infusion considered extremely yin in macrobiotics, rather than being balanced? I had omitted the maple syrup, but for me at least, the recipe still had far too much sugar to be downed in one sitting.

I needed recipes designed specifically to heal the gut. Taste, unfortunately, needed to be only a secondary consideration. And the ideal would be for my taste buds to adjust, so that I no longer craved such sugary-sweet foods.

Really, there probably was no such thing as macrobiotic cranberry sauce. A better idea was to scrap this food and make a real change, finding other foods altogether.


My new Portland doctor, Dr. L, had prescribed me Apriso, my first drug in months. Other similar drugs hadn’t worked in the past, but we hoped this one would, and now I was especially willing to try it. Eager to get out of my bad flare, I picked it up just after Thanksgiving and began taking it, and I asked Dr. L for some Proctofoam, too—the only drug I was certain had worked in the past, although it was for short-term use only.

It’s crazy, I wrote in my journal. 8 months have passed, and here I am taking almost the same meds as in March & April, with the same symptoms. Starting over. Except I know so much more now about diet, digestion, and health, and I’m more accepting of it all.

I also returned to my most conservative meal: whole grain brown rice, red lentils or tofu for protein, and overcooked kale, topped with toasted sesame oil and tamari. So contrite was I about expanding my diet, and so afraid about being in another bad flare, that I even began eating this meal three meals a day, every day. Anything to get back to where I’d been as quickly as possible.

Thanksgiving had distracted me from my long-term goals. I wanted to have a baby and be able to travel again, but I had risked those goals for the short-term goal of feeling “normal” on Thanksgiving. In the future, I would have to be better about keeping my eye on the prize. I wanted long-term health, even if it meant feeling left out in the short term.

A week after Thanksgiving, within two days of starting the Proctofoam, the blood in my stools began to diminish again.

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