2009, Number 4
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MEDICC Review 2009; 11 (4)
Ma-Pi 2 macrobiotic diet intervention in adults with type 2 diabetes mellitus
Porrata C, Sánchez J, Correa V, Abuín A, Hernández-Triana M, Dacosta-Calheiros RV, Díaz ME, Mirabal M, Cabrera E, Campa C, Pianesi M
Language: English
References: 47
Page: 29-35
PDF size: 145.20 Kb.
ABSTRACT
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.
REFERENCES
Federación Internacional de la Diabetes. Diabetes Atlas. 3rd ed.; 2006.
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047–53.
Pan American Health Organization/World Health Organization. Estrategia regional y plan de acción para un enfoque integrado sobre la prevención y el control de las enfermedades crónicas, incluyendo el régimen alimentario, la actividad física y la salud. Resolución CD47R9 del 47º Consejo Directivo, 58ª Sesión del Comité Regional, Washington, DC, 2006 Sep 25–29.
Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature. 2001 Dec 13;414(6865):782–7. Review.
Boyle JP, Honeycutt AA, Narayan KM, Hoerger TJ, Geiss LS, Chen H, et al. Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the U.S. Diabetes Care. 2001 Nov;24(11):1936–40.
The Economic Impact of Diabetes. In: Diabetes Atlas. 3rd ed. Brussels: International Diabetes Federation; 2006.
American Diabetes Association. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care. 2002 Jan;25(1):202–12.
The Prevention of Diabetes Mellitus and Its Complications. Geneva: World Health Organization; 2008.
American Diabetes Association. Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2008 Jan;31 Suppl 1:S61–78.
Willett WC, Koplan JP, Nugent R, Dusenbury C, Puska P, Gaziano TA. Prevention of Chronic Disease by Means of Diet and Lifestyle Changes. In: Jamison DT, et al, editors. Disease Control Priorities in Developing Countries. 2nd ed. New York: Oxford University Press; 2006. p. 833–50.
Willett W, Manson J, Liu S. Glycemix index, glucemix load, and risk of type 2 diabetes. Am J Clin Nutr. 2002 Jul;76(1):274S–80S.
Ohsawa G. Le zen macrobiotique ou l’art du rajeunissement et de la longévité. Paris: Librairie Philosophique J Vrin; 2004.
Pianesi M. Las 5 dietas Ma-Pi. Macerata (IT): L’Chi; 2007.
Porrata C, Hernández M, Abuín A, Campa C, Pianesi M. Caracterización y evaluación nutricional de las dietas macrobióticas Ma-Pi. Rev Cubana Investig Biomed. 2008;27(3–4):1–36.
Porrata C, Hernández M, Castro D, Naranjo M, Vilá R, Díaz ME, et al. Security and nutritional value of macrobiotic diet. The Cuban experience. Proceedings of Intrafood-2005; 2005 Oct 25–28; Valencia, Spain. Spain: Elsevier; 2005.
Porrata C, Abuín A, Morales A, Vilá R, Hernández M, Menéndez J, et al. Efecto terapéutico de la dieta macrobiótica Ma-Pi 2 en 25 adultos con diabetes mellitus tipo 2. Rev Cubana Invest Biomed. 2007;26(2).
Bhumisawasdi J, Vanna O, Surinpang N. The self-reliant system for alternative care of diabetes mellitus patients. Experiences macrobiotic management in Thai province. J Med Thai. 2006;89(12):2104–15.
Declaración de Helsinki de la Asamblea Médica Mundial. Principios éticos para las investigaciones médicas en seres humanos. 52a Asamblea General [monograph on the Internet]. Escocia: Asamblea Médica Mundial; 2000 [cited 2007 Feb 22]. Available from: http://www.upo.es/general/ investigar/otri/otri_docu/pn/Decl_Helsinki.pdf
U.S Department of Agriculture, Agricultural Research Service. 2004 [homepage on the Internet]. USDA National Nutrient Database for Standard reference, Release 17. Nutrient Data Laboratory Home Page. Washington: USDA; ©2008 [updated 2008 Jan 28; cited 2008 Feb 25]. Available from: http://www.ars.usda.gov/Services/ docs.htm?docid=5717
Hagiwara K. Standard Tables of Food Composition in Japan Fifth Revised Edition. J Integr Study Diet Habits. 2001;12(2):86–9.
Banca Dati di composizione degli alimenti per studi epidemiologici in Italia [database on the Internet]. Milano: Istituto Europeo di Oncologia. ©1998 [cited 2008 Feb 22]. Available from: http:// www.ieo.it/bda2008/homepage.aspx
Banca dati interativa di Composizione degli alimenti, INRAN [database on the Internet]. Italy: Istituto Nazionale di Recerca per gli alimenti e la Nutrizione, [updated 2000; [cited 2008 Feb 22]. Available from: http://www.inran.it/servizi_cittadino/ per_saperne_di_piu/tabelle_composizione_ alimenti
Manual on Human Nutritional Requirements. Report of a Joint FAO/WHO Expert Consultation. Rome: FAO/WHO; 2002.
Panel on Macronutrients, Subcommittees on Upper Reference Levels of Nutrients and Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine of the National Academies. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: National Academies Press; 2005.
Sarwar G. Analytical issues related to food composition and protein quality. In: Protein and Amino Acid Requirements in Human Nutrition. Report of a Joint WHO/FAO/UNU Expert Consultation. WHO Technical Report Series 935. Geneva: WHO; 2007.
Lohman TG, Roche AF, Martorell R. Anthropometric Standardization Reference Manual. Illinois: Human Kinetics Books Champaign; 1988.
Durnin JVGA, Womersly J. Body fat assessed from total body density and its estimation from skinfolds thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr. 1974 Jul;32(1):72–97.
Siri WE. Body composition from fluid spaces and density. Analysis of methods. In: Techniques for measuring body composition. National Research Council, Washington DC; 1961. p. 223–44.
Burtis CA, Ashwood ER, Bruns DE, editors. In: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th ed. St. Louis (US): Elsevier Saunders; 2006.
Burstein M, Scholnick HR, Morfin R. Rapid method for the isolation of lipoproteins from human serum by precipitation with polyanions. J Lipid Res. 1970 Nov;11(6):583–95.
Lopes-Virella MF, Stone P, Ellis S, Colwell JA. Cholesterol determination in high density lipoproteins separated by three different methods. Clin Chem. 1977 May;23(5):882–4.
American Diabetes Association. Clinical practice recommendations. Diabetes Care. 2000;23 Suppl 1:S32–60.
Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Bethesda (US): National Institutes of Health; 2002.
Porrata C. Cubans’ deadly diet: a wakeup call. MEDICC Review. 2008 Spring;10(2):52.
Connor H, Annan F, Bunn E, Frost G, McGouth N, Sarwar T, et al. The implementation of nutritional advice for people with diabetes. Diabetes Med. 2003 Oct;20(10):786–807.
Guillausseau PJ, Meas T, Virally M, Laloi-Michelin M, Médeau V, Kevorkian JP. Abnormalities in insulin secretion in type 2 diabetes mellitus. Diabetes Metab. 2008;34 Suppl 2:S43–8.
Beylot M. Effects of inulin-type fructans on lipid metabolism in man and in animal models. Br J Nutr. 2005;93 Suppl 1:S163–8.
Slavin JL. Plausible mechanism for the protectiveness of whole grains. Am J Clin Nutr. 1999;70 Suppl:S459–63.
Schwartz MW. Porte D Jr. Diabetes, obesity and the brain. Science. 2005 Jan 21;307(5708):375–9.
Sales CH, Pedrosa L de F. Magnesium and diabetes mellitus: their relation. Clin Nutr. 2006 Aug;25(4):554–62. Epub 2006 May 11.
Lee SJ, Choi MG. Association of manganese superoxide dismutase gene polymorphism (V16A) with diabetic macular edema in Korean type 2 diabetic patients. Metabolism. 2006 Dec;55(12):1681–8.
Bellomo A, Mancinella M, Troisi G, Ettorre E, Marigliano V. Diabetes and metabolic syndrome (MS). Arch Gerontol Geriatr. 2007;44 Suppl:S61–7.
Palmer JP, Fleming GA, Greenbaum CJ, Herold KC, Jansa LD, Kolb H, et al. C-Peptide is the appropriate outcome measure for type 1 diabetes clinical trials to preserve β-cell function: report of an ADA workshop, 21–22 October 2001. Diabetes. 2004 Jan;53(1):250–64.
Promintzer M, Krebs M. Effects of dietary protein on glucose homeostasis. Curr Opin Clin Nutr Metab Care. 2006 Jul;9(4):463–8.
Demigné C, Sabboh H, Puel C, Rémésy C, Coxam V. Organic anions and potassium salts in nutrition and metabolism. Nutr Res Rev. 2004 Dec;17(2):249–58.
O’Driscoll L, Gammell P, Clynes M. Mechanisms associated with loss of glucose responsiveness in beta cells. Transplant Proc. 2004 May;36(4):1159–62.
González Montesino D. Capacidad antioxidante y aporte de polifenoles de las dietas macrobióticas Ma-Pi implementadas en el Instituto Finlay [master’s thesis]. Havana (CU): University of Havana; 2009.