The effect of the macrobiotic Ma-Pi 2 diet vs. the recommended diet in the management of type 2 diabetes: the randomized controlled MADIAB trial.

BACKGROUND: Diet is an important component of type 2 diabetes therapy. Low adherence to current therapeutic diets points out to the need for alternative dietary approaches. This study evaluated the effect of a different dietary approach, the macrobiotic Ma-Pi 2 diet, and compared it with standard diets recommended for patients with type 2 diabetes. METHODS: A randomized, controlled, open-label, 21-day trial was undertaken in patients with type 2 diabetes comparing the Ma-Pi 2 diet with standard (control) diet recommended by professional societies for treatment of type 2 diabetes. Changes in fasting blood glucose (FBG) and post-prandial blood glucose (PPBG) were primary outcomes. HbA1c, insulin resistance (IR), lipid panel and anthropometrics were secondary outcomes. RESULTS: After correcting for age, gender, BMI at baseline, and physical activity, there was a significantly greater reduction in the primary outcomes FBG (95% CI: 1.79; 13.46) and PPBG (95% CI: 5.39; 31.44) in those patients receiving the Ma-Pi 2 diet compared with those receiving the control diet. Statistically significantly greater reductions in the secondary outcomes, HbA1c (95% CI: 1.28; 5.46), insulin resistance, total cholesterol, LDL cholesterol and LDL/HDL ratio, BMI, body weight, waist and hip circumference were also found in the Ma-Pi 2 diet group compared with the control diet group. The latter group had a significantly greater reduction of triglycerides compared with the Ma-Pi 2 diet group. CONCLUSIONS: Intervention with a short-term Ma-Pi 2 diet resulted in significantly greater improvements in metabolic control in patients with type 2 diabetes compared with intervention with standard diets recommended for these patients. TRIAL REGISTRATION: Current Controlled Trials ISRCTN10467793.

Influence of diet on gut microbiota, inflammation and type 2 diabetes mellitus. First experience with macrobiotic Ma-Pi 2 diet.

Type 2 diabetes mellitus (T2DM) is a complex disorder influenced by both genetic and environmental factors. Recent studies have suggested that an imbalance of the intestinal microbiota may be involved in the development of several human diseases, including obesity and T2DM. The main regulators of the intestinal microbiota are age, ethnicity, the immune system and diet. A high-fat diet may induce dysbiosis, which can result in a low-grade inflammatory state, obesity and other metabolic disorders. Adding prebiotics to the diet may reduce inflammation, endotoxaemia and cytokine levels as well as improving insulin resistance and glucose tolerance. The administration of prebiotics such as fermentable dietary fibres, promotes glucagon-like peptide 1 and peptide YY (anorexigenic) and decreases ghrelin (orexigenic). In a recent 21-day, intervention study in patients with T2DM, the effect of using the macrobiotic Ma-Pi 2 diet was investigated. Results suggested that it could induce a significant improvement in fasting blood glucose, plasma lipid fractions, plasma insulin and homeostasis. It is therefore possible that a diet rich in prebiotics and probiotics can play a role in T2DM management, probably due to positive intestinal microbiota modulation. However, this must be demonstrated by larger studies including randomized controlled trials that measure indicators of inflammation.

Dietary reference intakes for the cuban population, 2008.

Recommended dietary reference intakes (DRI) for energy and nutrients for the Cuban population were first established by the Nutrition and Food Hygiene Institute (INHA, its Spanish acronym) in 1996.[1] International organizations and Cuban public health research subsequently generated a considerable volume of new information on food-based energy and nutrient requirements,[2-4] resulting in the need for a revision. Updated DRIs were therefore compiled by a multidisciplinary group of specialists and published in 2008 by INHA and the Cuban Ministry of Public Health.[5,6].

Ma-pi 2 macrobiotic diet intervention in adults with type 2 diabetes mellitus.

Introduction Diet is a cornerstone of comprehensive treatment of diabetes mellitus. The macrobiotic diet is low in fat and rich in dietary fiber, vegetables and whole grains, and therefore may be a good therapeutic option. Objective Assess the influence of the Ma-Pi 2 macrobiotic diet on physical, hematologic and biochemical variables, as well as on hypoglycemic medication, in adults with type 2 diabetes mellitus. Materials and Methods A 6-month dietary intervention was carried out in 16 adults with type 2 diabetes mellitus and poor glucide metabolism control (glycosylated hemoglobin, HbA1 >8.5%) receiving treatment at the Diabetic Care Center in Colón, Matanzas province, Cuba. The diet was prepared and served daily by macrobiotic specialists. Type and amount of food consumed and nutritional content were assessed using a weighted food-consumption survey. At onset and termination of the intervention, anthropometric and body composition variables were measured, as were biochemical (glucide and lipid metabolism) and other nutritional safety variables, and hypoglycemic drug use. Results The diet provided sufficient energy and protein. It was low in fat, high in complex carbohydrates and dietary fiber, and provided adequate amounts of vitamins and minerals, except for vitamin B12. At 6 months, anthropometric variables were significantly lower, lean body mass was preserved, and glucide and lipid metabolism was controlled. All participants were able to eliminate insulin treatment, and 25% continued treatment with glibenclamide only. Mean total cholesterol, LDL cholesterol and triglyceride values dropped 16.4%, 22.7% and 37.0%, respectively, while mean HDL cholesterol rose 97.8%. Mean glycemia and HbA1 values also decreased 63.8% and 54.5%, respectively. According to lipid levels and ratios, cardiovascular risk was also considerably reduced. Hemoglobin, total protein, albumin and creatinin levels indicated that nutritional safety was maintained. There were no adverse events. Conclusions In the 6-month intervention, the Ma-Pi 2 macrobiotic diet had a positive influence on weight control, body fat, and glucide and lipid metabolism in patients with type 2 diabetes mellitus. Further research is needed to validate these encouraging results, particularly a clinical trial in which a control group receives the standard diet recommended for diabetic patients.

Ma-Pi 2 Macrobiotic Diet Intervention in Adults with Type 2 Diabetes Mellitus

ABSTRACTIntroduction Diet is a cornerstone of comprehensive treatment of diabetes mellitus. The macrobiotic diet is low in fat and rich in dietary fiber, vegetables and whole grains, and therefore may be a good therapeutic option. Assess the influence of the Ma-Pi 2 macrobiotic diet on physical, hematologic and biochemical variables, as well as on hypoglycemic medication, in adults with type 2 diabetes mellitus...(AU)

Cubans' deadly diet: a wakeup call.

Learning to live and eat differently is essential to turning back the global epidemic of chronic diseases. And Cubans are no exception. As a rule, Cubans scarcely consume whole-grain cereals, fruits, or leafy green and other vegetables. But we have a relatively high consumption of saturated fats, sugars, refined cereals, animal-origin foods, sweets of all kinds, salt, and "junk foods" loaded with chemical additives. Mealtimes tend to be irregular, we eat on-the-run, and foods are often poorly handled and elaborated.

Dietary factors in epidemic neuropathy on the Isle of Youth, Cuba

An epidemic neuropathy that broke out in late 1991 has exhibited clinical manifestations similar to those of other polyneuropathies of nutritional origin. To investigate its possible association with diet, a study was conducted on the Isle of Youth in 1993, at the start of an outbreak there. Thirthy-four subjects with cases and 65 controls were interviewed regarding their diets, measured anthropometrically, and evaluated. As a whole, the subjects with cases demonstrated greater weight loss before the onset of disease, lower body mass indexes (BMI), lower percentages of body fat, and more deficient diets than the control subjects. Analysis of individual variables found associations between occurrence of the disease and the following; weight loss, low BMI, a broad range of specific dietary deficiencies, a sugar intake exceeding 15 percent of total caloric intake, alcohol consumption, and smoking. Also protective associations were found between absence of the disease and regular consumption of certain foods at or above specified levels. Multivariate analysis indicated that while smoking and alcohol consumption reinforced the effects of the dietary deficiencies, they did not account for occurrence of the disease by themselves. Overall, the results indicate that diets which are deficient in caloric energy, protein, fat, and the micronutrients included in the study, and which reflect an imbalance resulting from a relative excess of sugar, with consequent effects on body weight, are strongly associated with, and causally related to, the occurrence of epidemic neuropathy in Cuba

Dietary factors in epidemic neuropathy on the Isle of Youth, Cuba

An epidemic neuropathy that broke out in late 1991 has exhibited clinical manifestations similar to those of other polyneuropathies of nutritional origin. To investigate its possible association with diet, a study was conducted on the Isle of Youth in 1993, at the start of an outbreak there. Thirthy-four subjects with cases and 65 controls were interviewed regarding their diets, measured anthropometrically, and evaluated. As a whole, the subjects with cases demonstrated greater weight loss before the onset of disease, lower body mass indexes (BMI), lower percentages of body fat, and more deficient diets than the control subjects. Analysis of individual variables found associations between occurrence of the disease and the following; weight loss, low BMI, a broad range of specific dietary deficiencies, a sugar intake exceeding 15 percent of total caloric intake, alcohol consumption, and smoking. Also protective associations were found between absence of the disease and regular consumption of certain foods at or above specified levels. Multivariate analysis indicated that while smoking and alcohol consumption reinforced the effects of the dietary deficiencies, they did not account for occurrence of the disease by themselves. Overall, the results indicate that diets which are deficient in caloric energy, protein, fat, and the micronutrients included in the study, and which reflect an imbalance resulting from a relative excess of sugar, with consequent effects on body weight, are strongly associated with, and causally related to, the occurrence of epidemic neuropathy in Cuba

This article was also published in Spanish in the BOSP. Vol. 117(5), Nov. 1994

Factores dietéticos de la neuropatía epidémica en la Isla de la Juventud, Cuba / Dietary factors involved in epidemic neuropathy in Isla de la Juventud, Cuba

La neuropatía epidémica que surgió en Cuba a finales de 1991 tiene manifestaciones clínicas similares a las de otras polineuropatías de origen nutricional. Con el objetivo de identificar su posible asociación con la dieta, se realizó un estudio de casos y controles al inicio de la epidemia en la Isla de la Juventud. Se evaluó la ingestion de alimentos por una encuesta semicuantitativa de frecuencia de consumo mediante entrevista individual directa, y se hicieron mediciones de peso, talla y pliegues cutáneos en 34 casos y 65 controles. En los casos se halló mayor pérdida de peso antes de enfermar, menor índice de masa corporal (IMC), menor porcentaje de grasa corporal y una dieta más deficiente que en los controles. De acuerdo con los valores de odds ratio (OR) obtenidos del análisis de cada variable por separado, se hallaron asociados a la enfermedad la pérdida de peso corporal, los valores bajos de IMC, el peso bajo para la talla, una menor ingestión de pan y arroz, una alimentación menos variada, la falta de consumo de leche,la ingestión de una cantidad de azúcar mayor del 15 por ciento de la energía total ingresada, el consumo de alcohol y el hábito de fumar; la asociación fue de protección en el caso del consumo de frijoles, tubérculos, raíces feculentas, aceite y productos cárnicos con soya. En el análisis multifactorial se hallaron valores elevadors de OR, ajustados respecto a hábito de fumar y consumo de alcohol, correspondientes a ingestion inferior al 50 por ciento de las cantidades recomendadas de proteínas, piridoxina, tiamina, energía, vitamina E, niacina, ácido fólico, grasa, riboflavina y vitamina A. Los resultados de este análisis muestran que el tabaco y el alcohol favorecen el efecto de la deficiencia alimentaria, sin explicar la asociación por sí solos. El análisis integral de estos resultados permite concluir que una dieta deficiente en energía, proteínas, grasas y los micronutrientes estudiados, y desequilibrada por un exceso relativo de azúcar, con la consecuente afectación del peso corporal, se asocia fuertemente a la neuropatía epidémica y guarda una relación causal con ella

Factores dietéticos de la neuropatía epidémica en la Isla de la Juventud, Cuba / Dietary factors involved in epidemic neuropathy in Isla de la Juventud, Cuba

La neuropatía epidémica que surgió en Cuba a finales de 1991 tiene manifestaciones clínicas similares a las de otras polineuropatías de origen nutricional. Con el objetivo de identificar su posible asociación con la dieta, se realizó un estudio de casos y controles al inicio de la epidemia en la Isla de la Juventud. Se evaluó la ingestion de alimentos por una encuesta semicuantitativa de frecuencia de consumo mediante entrevista individual directa, y se hicieron mediciones de peso, talla y pliegues cutáneos en 34 casos y 65 controles. En los casos se halló mayor pérdida de peso antes de enfermar, menor índice de masa corporal (IMC), menor porcentaje de grasa corporal y una dieta más deficiente que en los controles. De acuerdo con los valores de odds ratio (OR) obtenidos del análisis de cada variable por separado, se hallaron asociados a la enfermedad la pérdida de peso corporal, los valores bajos de IMC, el peso bajo para la talla, una menor ingestión de pan y arroz, una alimentación menos variada, la falta de consumo de leche,la ingestión de una cantidad de azúcar mayor del 15 por ciento de la energía total ingresada, el consumo de alcohol y el hábito de fumar; la asociación fue de protección en el caso del consumo de frijoles, tubérculos, raíces feculentas, aceite y productos cárnicos con soya. En el análisis multifactorial se hallaron valores elevadors de OR, ajustados respecto a hábito de fumar y consumo de alcohol, correspondientes a ingestion inferior al 50 por ciento de las cantidades recomendadas de proteínas, piridoxina, tiamina, energía, vitamina E, niacina, ácido fólico, grasa, riboflavina y vitamina A. Los resultados de este análisis muestran que el tabaco y el alcohol favorecen el efecto de la deficiencia alimentaria, sin explicar la asociación por sí solos. El análisis integral de estos resultados permite concluir que una dieta deficiente en energía, proteínas, grasas y los micronutrientes estudiados, y desequilibrada por un exceso relativo de azúcar, con la consecuente afectación del peso corporal, se asocia fuertemente a la neuropatía epidémica y guarda una relación causal con ella