Handbook of Psychology

602 Complementary and Alternative Therapies

cholesterol, LDL-C levels, and cardiovascular risk, the long-
term effects remain unclear.

Macrobiotic Diets

Macrobioticsstems from the Greek wordsmacro,meaning
large, andbios,meaning life. A macrobiotic diet is composed
of whole grains and cereals, vegetables (including sea veg-
etables), fruits, beans, nuts, and seeds. A macrobiotic ap-
proach underscores social interactions, climate, geographic
location, and diet as all-important lifestyle habits to promote
well-being and longevity. George Ohsawa is considered to be
the founder of the macrobiotic diet, and it was popularized
in the United States by Michio Kushi. Two early studies sup-
port the theory that a vegetarian diet results in a signi“cant re-
duction in blood pressure among patients with hypertension
(Margetts, Beilin, Vandongen, & Armstrong, 1986; Rouse,
Beilin, Armstrong, & Vandongen, 1983). The use of macrobi-
otic in treatment of other medical conditions (e.g., cancer)
remains controversial and has not been scienti“cally tested.

Atkins’Diet

In 1972, Robert Atkins published the bookDr .Atkins’ Diet
Revolution.He proposed metabolic imbalance to be the cause
of obesity and stated that many of today•s diseases, including
diabetes, hypoglycemia, and cardiac disease, are a result of
•carbohydrate intoleranceŽ (Atkins, 1972). Atkins proposed
that carbohydrates prevent our bodies from ketogenesis, a
process by which the body burns fat and turns it into fuel.
There are no scienti“c studies investigating ketogenic diets
for the previously mentioned diseases, and therefore, these
diets may be based more on theory than on scienti“c evidence.
However, ketogenic diets have been investigated for their ef-
“cacy in managing epilepsy and seizure disorder. One study
found that 54% of a group of children with intractable seizures
who remained on a ketogenic diet reported a decrease in the
frequency of their seizures by more than 50% three months
after initiating the diet (Vining et al., 1998). Despite such “nd-
ings, there is continued controversy regarding its use. Roach
(1998) argues that while there is •a clear biochemical rationale
and a well-de“ned therapeutic objectiveŽ (p. 1404), he urges
for more rigorous investigations on safety and ef“cacy.

Gerson Method

Nutrition has become increasingly used, though not necessarily
empirically supported, by individuals diagnosed with cancer.
Max Gerson was a German-born physician who believed that
•degenerativeŽ diseases such as cancer, arthritis, and multiple

sclerosis are the result of extreme body toxicity. Therefore,

he advocated a special diet in the treatment of cancer, which

included •detoxi“cationŽ of the body, a no-sodium, no-fat,

high-potassium, and high-carbohydrate diet, as well as coffee

enemas. There are few studies investigating the ef“cacy of the

Gerson Method; however, those that exist are methodologi-

cally ”awed. One study (Hildenbrand, Hildenbrand, Bradford,

& Calvin, 1995) investigated the ef“cacy of Gerson•s diet ther-

apy with 153 patients diagnosed with melanoma and found the

“ve-year survival rate to be 100% for individuals at Stage I and

II, 72% for individuals at Stage IIIA, and 41% for individuals

at Stage IVA. While there was no placebo control group in this

study, “ve-year survival rates were signi“cantly higher than the

survival rates published in other studies.

It should be noted that the Gerson Method is highly con-

troversial. The American Cancer Society (ACS) reported a

lack of evidence of the ef“cacy of the Gerson Method and

urged people with cancer not to seek treatment with the

Gerson Method (ACS, 1990). The ACS publicly acknowl-

edges that while the dietary measures may have preventive

utility, there is no scienti“c evidence than any nutritionally

related regimen is appropriate as a primary treatment for

cancer (ACS, 1993).

Ornish Lifestyle Heart Trial

Dean Ornish is well-known for his work with patients

with coronary artery disease through vegetarian diet, exer-

cise, and stress management on coronary atherosclerosis. The

Lifestyle Heart Trial (Ornish et al., 1990), a prospective, ran-

domized, controlled trial of patients with coronary artery dis-

ease, demonstrated that this prescribed lifestyle modi“cation

resulted in regression on coronary atherosclerosis as evi-

denced by a decrease in diameter stenosis. The study, how-

ever, did not investigate the individual contributions of the

various interventions (e.g., low-fat vegetarian diet, stopping

smoking, stress management training, exercise) to the out-

come measure. Later studies (Gould et al., 1995; Ornish

et al., 1998) investigated a similar lifestyle change program

in patients with coronary artery disease over “ve years and

found that the size and severity of perfusion abnormalities

on dipyridamole positron emission tomography images de-

creased (improved) after risk factor modi“cation in the

experimental group, compared with an increase (worsening)

of size and severity in the control group.

Tactile Therapies

Tactile therapies are de“ned as interventions that center on

soft tissue or energy mobilization techniques performed by a