Ma‐Pi 2 macrobiotic diet and type 2 diabetes mellitus: pooled analysis of short‐term intervention studies

Abstract

SummaryThe macrobiotic, Ma-Pi 2 diet (12% protein, 18% fat and 70% carbohydrate), has shown benefit in adults with type 2 diabetes mellitus (T2DM). This pooled analysis aims to confirm results from four, 21-day intervention studies with the Ma-Pi 2 diet, carried out in Cuba, China, Ghana and Italy. Baseline and end of study biochemical, body composition and blood pressure data, were compared using multivariate statistical methods and assessment of the Cohen effect size (d). Results showed that all measured indicators demonstrated significant changes (p < 0.001); most of them with a very high (d ≥ 1.30), or high (d = 0.80-1.29) effect size. The global effect size of the diet was Italy (1.96), China (1.79), Cuba (1.38) and Ghana (0.98). The magnitude of the individual effect on each variable by country, and the global effect by country, was independent of the sample size (p > 0.05). Similarly, glycemia and glycemic profiles in all four studies were independent of the sample size (p = 0.237). The Ma-Pi diet 2 significantly reduced glycemia, serum lipids, uremia and cardiovascular risk in adults with T2DM. These results suggest that the Ma-Pi 2 diet could be a valid alternative treatment for patients with T2DM and point to the need for further clinical studies. Mechanisms related to its benefits as a functional diet are discussed.

Recommendations for management of diabetes during Ramadan: update 2015

“…Of particular interest for Ramadan, the use of the macrobiotic Ma-Pi 2 diet may be considered. 24 This diet, conceived by Mario Pianesi, is high in dietary fibers, which is in keeping with the ADA and European nutrition recommendations. 25 It is rich in complex carbohydrates, whole grains, vegetables and legumes, and fermented products, and low in unrefined sea salt and green tea, without fat or protein from animal sources (including milk and dairy products) and no added sugars.…”

“…This diet, conceived by Mario Pianesi, is high in dietary fibers, which is in keeping with the ADA and European nutrition recommendations 25. It is rich in complex carbohydrates, whole grains, vegetables and legumes, and fermented products, and low in unrefined sea salt and green tea, without fat or protein from animal sources (including milk and dairy products) and no added sugars 24. The first RCT comparing the Ma-Pi 2 diet and a standard diet recommended for patients with type 2 diabetes—the MAcrobiotic DIABetes trial MADIAB—was reported in 2014 24.…”

“…Multivariate analysis, adjusted for age, gender, body mass index, and physical activity, showed a significant improvement in fasting blood glucose, postprandial blood glucose, HbA1c, total cholesterol, low-density lipoprotein (LDL) cholesterol, LDL–HDL (high-density lipoprotein) ratio, body weight, waist and hip circumference, and insulin resistance in the Ma-Pi 2 diet treated compared with the control diet. Furthermore, participants in the Ma-Pi 2 group achieved better fasting and postprandial glucose target levels of 6.1 mmol/L and 7.8 mmol/L (<110 mg/dL and <140 mg/dL), respectively, at the end of the 21-day dietary treatment, as well as a reduction of markers of insulin resistance and inflammation 24–26. These features are valuable in the management of type 2 diabetes during Ramadan due to a lower component of complex carbohydrate at the night meal and higher complex carbohydrate at predawn, which is eaten before the beginning of daily fasting.…”

“…Of particular interest for Ramadan, the use of the macrobiotic Ma-Pi 2 diet may be considered 24. This diet, conceived by Mario Pianesi, is high in dietary fibers, which is in keeping with the ADA and European nutrition recommendations 25.…”

“…25 It is rich in complex carbohydrates, whole grains, vegetables and legumes, and fermented products, and low in unrefined sea salt and green tea, without fat or protein from animal sources (including milk and dairy products) and no added sugars. 24 The first RCT comparing the Ma-Pi 2 diet and a standard diet recommended for patients with type 2 diabetes-the MAcrobiotic DIABetes trial MADIAB-was reported in 2014. 24 Following 21 days on the prescribed diets, administered under supervised conditions, the average daily energy intake was 1803 kcal (12% protein, 15% fat, and 73% complex carbohydrates, with 29 g/ 1000 kcal fiber) in the Ma-Pi 2 group and 1798 kcal (18% protein, 32% fat, and 49% complex carbohydrates, with 20.5 g/1000 kcal fiber) in the control group.…”