Article Text

The effect of macrobiotic Ma-Pi 2 diet on systemic inflammation in patients with type 2 diabetes: a post hoc analysis of the MADIAB trial
  1. Andreea Soare1,
  2. Rossella Del Toro1,
  3. Elena Roncella1,
  4. Yeganeh Manon Khazrai1,
  5. Silvia Angeletti2,
  6. Laura Dugo3,
  7. Sara Fallucca1,
  8. Lucia Fontana4,
  9. Maria Altomare4,
  10. Valeria Formisano1,
  11. Francesca Capata1,
  12. Rosaria Gesuita5,
  13. Silvia Manfrini1,
  14. Francesco Fallucca6,
  15. Mario Pianesi7,
  16. Paolo Pozzilli1,8,
  17. for the MADIAB Group
  1. 1Area of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
  2. 2Laboratory Medicine, University Campus Bio-Medico of Rome, Rome, Italy
  3. 3Center of Integrated Research, University Campus Bio-Medico of Rome, Rome, Italy
  4. 4Unit of Dietology and Diabetology, Sandro Pertini Hospital, Rome, Italy
  5. 5Center of Epidemiology, Biostatistics and Medical Information Technology, Polytechnic Marche University, Ancona, Italy
  6. 6In Unam Sapientiam, La Sapienza University, Rome, Italy
  7. 7International Study Center for Environment, Agriculture, Food, Health and Economics, Tolentino, Italy
  8. 8Centre of Diabetes, St. Bartholomew's and The London School of Medicine, Queen Mary University of London, London, UK
  1. Correspondence to Professor Paolo Pozzilli; p.pozzilli{at}


Introduction Current guidelines for the management of type 2 diabetes (T2D) emphasize diet as essential therapy. However, the effect of diet on systemic inflammation remains unclear. We investigated the effects of consuming a macrobiotic Ma-Pi 2 diet versus a standard recommended diet (control diet) on markers of inflammation in patients with T2D.

Methods This was a post hoc analysis of the MADIAB trial, a 21-day randomized controlled trial conducted in 51 patients (25 males and 26 females) with T2D. Patients were randomized 1:1 to the Ma-Pi 2 macrobiotic diet or a control diet based on dietary guidelines for T2D. Biological antioxidant potential of plasma and circulating levels of high-sensitivity C reactive protein, interleukin-6, tumor necrosis factor-α, and insulin-like growth factor-1 were assessed.

Results After 21 days on the Ma-Pi 2 or control diet, markers of inflammation were reduced in both groups. The antioxidant potential of plasma improved significantly in the Ma-Pi group. A significant reduction in insulin growth factor-1 was observed in the Ma-Pi group versus control group (p<0.001).

Conclusions Findings of this post hoc analysis demonstrated that the Ma-Pi 2 diet is a safe dietary strategy to reduce levels of the markers of insulin resistance and inflammation, compared with baseline values, in the short term. Furthermore, the Ma-Pi 2 diet was superior to the control diet in reducing insulin growth factor-1 and may be beneficial for patients with T2D.

Trial registration number Current Controlled Trials ISRCTN10467793.

  • Inflammatory Markers
  • Type 2 Diabetes
  • Dietary Intervention
  • Insulin Resistance

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