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Wednesday, April 2, 2014

Macrobiotic Diet Used to treat Diabetes in Cuba


Medium- and Short-Term Interventions with Ma-Pi 2 Macrobiotic Diet in Type 2 Diabetic Adults of Bauta, Havana
1Clinical Assay Direction, Finlay Institute, Avenue 27, No. 19805, La Coronela, La Lisa, Havana 11600, Cuba
2Latin American Nutrition Society, Iberoamerican Nutrition Foundation, and Department of Biochemistry and Physiology, Institute of Nutrition, Infanta 1158, Havana 10300, Cuba
3Direction, Diabetic Care Center, Carretera Central km 29.5, Bauta 32400, Artemisa, Cuba
4Lipid Metabolism Laboratory, Department of Biochemistry and Physiology, Institute of Nutrition, Infanta 1158, Havana 10300, Cuba
5Presidency, Finlay Institute, Avenue 27, No. 19805, La Coronela, La Lisa, Havana 11600, Cuba
6Presidency, UPM Un Punto Macrobiotico, Viale San Nicola, 62029 Tolentino, Italy
Received 30 May 2012; Revised 1 September 2012; Accepted 2 September 2012
Academic Editor: H. Boeing
Copyright © 2012 Carmen Porrata-Maury et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.

1. Introduction

Between 2010 and 2030, there will be a 69% increase of adults with diabetes in the developing countries [1]. The Italian International Association Un Punto Macrobiotico, UPM, founded and presided by Mario Pianesi, in collaboration with the Finlay Institute in Havana have shown positive results after 6 months of dietary institutional interventions with macrobiotic Ma-Pi 2 diet in adults affected with type 2 diabetes mellitus [2, 3]. The objective of this study was to prove those dietary effects at short term (after 21 days of controlled institutional administration) and also at medium term following 3 months during which patients remained incorporated to their daily life and were responsible for their own feeding.

2. Materials and Methods

The study was carried out at the Diabetic Care Center (DCC) of the municipality of Bauta, Havana, it was not a randomized double-blind trial. Instead of including a control group, which may be a limitation, a prospective cohort study was designed in 65 adult volunteers been evaluated at onset, 21 days and at 3 months at the end of the intervention.
2.1. Sample Size
According to previous results [2, 3], for a power of 85% and a significance level of α = 0.05, a sample size of 40 individuals should be enough for detecting reductions of 26% in glycemia, 8% in total cholesterol, 12% in LDL cholesterol, and 18% in triglycerides.






2.2. Ethical Considerations
The study followed the recommendations of the 2000 Declaration of Helsinki [4], all participants were informed about the study procedures, patients’ information was recorded in data collection charts, and the study protocol was approved by the Scientific Councils and Ethics Committees of the Finlay Institute and the Nutrition and Food Hygiene Institute (INHA, its Spanish acronym).
2.3. Inclusion Criteria
Confirmed diagnosis of type 2 diabetes [5]; age between 20 and 80 years; pharmacological treatment with insulin, hypoglycemic drugs, or both; dietotherapy regimen established by the Cuban Institute of Endocrinology received; periodical DCC medical controls fulfilled and written consent of participation provided.
2.4. Exclusion Criteria
Presence of concomitant factors able to modify the carbohydrates or lipid metabolism parameters (illnesses, drugs consumption), mental inability, addictions, hemoglobin <10 mg/dL, and BMI <18.5.
2.5. Exit Criteria
Dietary intolerance or non-acceptance of the diet, unfulfillment of the dietary medical protocol, occurence of serious events, and voluntary abandonment of the study.
2.6. Adverse Events
Any medical manifestation during the intervention, related or not to the diet. Anemia, low body weight, and signs or symptoms of nutritional deficiencies or excesses, were considered as events related to diet.
2.7. Intervention Diet
Macrobiotic vegetarian Ma-Pi 2 diet [6, 7], designed for diseases considered with acid metabolic course. Total volume of the Ma-Pi 2 diet consisted of 40–50% whole grains (rice, millet, and barley), 40–50% vegetables (carrots, kale, cabbage, broccoli, chicory, onions, red and white radish, and parsley), and 8–10% legumes (adzuki beans, chickpeas, lentils, and black beans); all foods derived from organic cultivations with no chemical additives. Gomasio (roasted ground sesame seeds with unrefined sea salt), fermented products (miso, tamari, and umeboshi), and seaweeds (kombu, wakame, and nori) were used as complements of the diet’s nutritional value. Bancha tea (theine-free green tea) was the main source of liquid.

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