Ma-Pi 2 macrobiotic diet and type 2 diabetes mellitus: pooled analysis of short-term intervention studies

Diabetes Metab Res Rev. 2014 Mar:30 Suppl 1:55-66. doi: 10.1002/dmrr.2519.


The macrobiotic, Ma-Pi 2 diet (12% protein, 18% fat and 70% carbohydrate), has shown benefit in adults with type 2 diabetes mellitus (T2DM). This pooled analysis aims to confirm results from four, 21-day intervention studies with the Ma-Pi 2 diet, carried out in Cuba, China, Ghana and Italy. Baseline and end of study biochemical, body composition and blood pressure data, were compared using multivariate statistical methods and assessment of the Cohen effect size (d). Results showed that all measured indicators demonstrated significant changes (p < 0.001); most of them with a very high (d ≥ 1.30), or high (d = 0.80-1.29) effect size. The global effect size of the diet was Italy (1.96), China (1.79), Cuba (1.38) and Ghana (0.98). The magnitude of the individual effect on each variable by country, and the global effect by country, was independent of the sample size (p > 0.05). Similarly, glycemia and glycemic profiles in all four studies were independent of the sample size (p = 0.237). The Ma-Pi diet 2 significantly reduced glycemia, serum lipids, uremia and cardiovascular risk in adults with T2DM. These results suggest that the Ma-Pi 2 diet could be a valid alternative treatment for patients with T2DM and point to the need for further clinical studies. Mechanisms related to its benefits as a functional diet are discussed.

Keywords: Ma-Pi 2 macrobiotic diet; adults; type 2 diabetes; vegetarian diets; whole-grain cereals.

Publication types

  • Review

MeSH terms

  • Blood Glucose / metabolism
  • Cardiovascular Diseases / prevention & control
  • China
  • Cuba
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Diet, Macrobiotic*
  • Dietary Carbohydrates
  • Dietary Fats
  • Ghana
  • Humans
  • Italy
  • Lipids / blood
  • Risk Factors


  • Blood Glucose
  • Dietary Carbohydrates
  • Dietary Fats
  • Lipids