Abstract
BackgroundDiet 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.MethodsA 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.ResultsAfter 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.ConclusionsIntervention 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 registrationCurrent Controlled Trials ISRCTN10467793.
Highlights
Diet is an important component of type 2 diabetes therapy
We report here on the first randomized comparative trial which compares the Ma-Pi 2 diet with the dietary guidelines for type 2 diabetes recommended by professional societies in Italy [25]
Trial design The study was a 21-day, controlled open-label trial in which participants were randomized (1:1 ratio) to the Ma-Pi 2 macrobiotic diet or to a diet based on dietary recommendations guidelines for type 2 diabetes [25]
Summary
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. The Ma-Pi 2 diet is rich in complex carbohydrates, whole grains, vegetables and legumes, fermented products, sea salt and green tea, without fat or protein from animal sources (including milk and dairy products) and no added sugars. These features are designed to achieve optimal glucose control, lower insulin requirement, prolong the time of glucose absorption, increase insulin sensitivity, reduce total cholesterol and triglyceride levels in plasma, improve body weight control and lower systemic blood pressure [16,17,18,19]. This may alter the composition of gut microbiota, which in turn may affect the glycemic control [21,22]
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