RESUMO
Background. In Cuba, the Ma-Pi 2 macrobiotic diet has shown positive results in 6-month assays with type 2 diabetic patients. The objective of this study was to assess the influence of this diet at short and medium terms. Methods. Sixty-five type 2 diabetic volunteers were included for dietary intervention, institutionally based for 21 days and followed later at home, until completing 3 months. 54 of them stayed until assay end. Before intervention, and after both assay periods, they were submitted to anthropometric records, body composition analyses and measurements of serum biochemical indicators, glycemic profile in capillary blood, blood pressure, and medication consumption; food intake was evaluated by the 3-day dietary recall. Results. During the intervention, the energy intake was 200 kcal higher at instance of more complex carbohydrates and dietary fiber and despite less fat and protein. Blood pressure and serum biochemical indicators decreased significantly in both periods; the safety nutritional indicators (hemoglobin, serum total proteins, and albumin) showed no variations. The global cardiovascular risk decreased and insulin consumption dropped by 46% and 64%, in both periods, respectively. Conclusions. The Ma-Pi 2 macrobiotic diet was a successful therapy at short term and after 3-month home-based intervention, for type 2 diabetics.
RESUMO
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.
RESUMO
Se realizó un ensayo clínico, durante 6 meses, en 25 adultos con diabetes mellitus tipo 2, tratados con antihiperglicemiantes, para estudiar el efecto terapéutico de la dieta macrobiótica vegetariana Ma-Pi 2. Se evaluaron datos de encuesta dietética, evolución clínica, estado nutricional, indicadores bioquímicos de rutina y del metabolismo glucídico y lipídico, consumo de medicamentos y eventos adversos. La dieta tuvo presencia mayoritaria de cereales integrales, verduras y hortalizas, leguminosas y té verde; fue suficiente en energía, baja en grasa y adecuada en proteínas; elevada en carbohidratos complejos, fibra dietética, ß caroteno, manganeso y magnesio. Al final del estudio la glicemia disminuyó en 53 por ciento, hemoglobina glucosilada 32 por ciento, colesterol 21 por ciento, triglicéridos 43 por ciento y la relación colesterol-LDL/colesterol-HDL 61 por ciento. El peso corporal y las circunferencias de cintura y cadera disminuyeron significativamente. Se normalizaron los valores de hemoglobina, creatinina, ácido úrico, urea, transaminasa glutámico pirúvica, frecuencia cardíaca y tensión arterial. Los niveles séricos de vitaminas A, E, C, B1, B12 y folatos resultaron adecuados. Del total de los pacientes, 88 por suprimió totalmente el tratamiento antihiperglicemiante. No se registraron eventos adversos. Mejoraron de manera notable los síntomas asociados, el bienestar y la calidad de vida. Se concluyó que la dieta Ma-Pi 2 resultó una alternativa terapéutica muy apropiada en los 25 pacientes con diabetes mellitus tipo 2 evaluados.
A clinical assay of 25 adults with type 2 diabetes mellitus, who were treated with anti-hyperglycemic drugs was conducted for six months in order to study the therapeutical effect of vegetarian macrobiotic diet Ma-Pi2. Data from dietetic surveys, clinical evolution, nutritional status, biochemical indicators, glucose and lipid metabolism indicators, drug consumption and adverse effects were evaluated. The diet mostly comprised whole grains, vegetables, leguminosae and green tea; sufficient energy, low fat and adequate protein contents, high amount of complex carbohydrates, dietetic fiber, ß carotene, manganese and magnesium. At the end of the study, glycemic levels lowered by 53 percent, glycosylated hemoglobin by 32 percent, cholesterol by 21 percent, triglycerides by 43 percent and LDL/HDL cholesterol ratio by 61 percent. Body weight, and waist and hip circumferences were significantly reduced. Hemoglobin, creatinine, uric acid, urea, piruvic glutamic transaminase, heart rate and blood pressure values stabilized. Vitamin A, E, C, B1, B12 and folates serum levels were satisfactory. Of the total number of patients, 88 percent totally ceased their antihyperglycemic treatment. No adverse effects were observed. Improvement in associated symptoms, well-being and quality of life was remarkable. It was concluded that the Ma-pi2 diet proved to be a very suitable therapeutical alternative in the 25 studied patients with type 2 diabetes mellitus.