As a follow-up of a population-based descriptive study on the nutritional status and growth of infants on macrobiotic diets (n = 53), an intervention study was carried out in 27 selected infants with clear nutritional deficiencies. This intervention program consisted of information on the nutrient content of macrobiotic foods, a regular newsletter, personal advice if needed, and reference to teachers in macrobiotics for further advice. Adaptation of the diet within the scope of current macrobiotic guidelines did not lead to an improvement in nutritional intake, growth and blood values. As a consequence of these findings, the macrobiotic community in the Netherlands and abroad has become more aware of the need for adaptation of the macrobiotic diet. It is recommended to include a source of dietary fat (minimum 20-25 g/day), fatty fish (minimum 100-150 g/wk) and dairy products (minimum 150-250 g/day).