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Br J Nutr. 2016 Jul;116(1):80-93. doi: 10.1017/S0007114516001045. Epub 2016 May 6.

Modulation of gut microbiota dysbioses in type 2 diabetic patients by macrobiotic Ma-Pi 2 diet.

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1Department of Pharmacy and Biotechnology,University of Bologna,40126 Bologna,Italy.
2Institute of Biomedical Technologies,Italian National Research Council,20090 Segrate,Milan,Italy.
3Department of Endocrinology and Diabetes,University Campus Bio-Medico,00128 Rome,Italy.
4International Study Center for Environment,Agriculture, Food, Health and Economics,62029 Tolentino,Italy.
5In Unam Sapientiam,La Sapienza University,00161 Rome,Italy.


The gut microbiota exerts a role in type 2 diabetes (T2D), and deviations from a mutualistic ecosystem layout are considered a key environmental factor contributing to the disease. Thus, the possibility of improving metabolic control in T2D by correcting gut microbiome dysbioses through diet has been evaluated. Here, we explore the potential of two different energy-restricted dietary approaches - the fibre-rich macrobiotic Ma-Pi 2 diet or a control diet recommended by Italian professional societies for T2D treatment - to correct gut microbiota dysbioses in T2D patients. In a previous 21-d open-label MADIAB trial, fifty-six overweight T2D patients were randomised to the Ma-Pi 2 or the control diet. For the present study, stools were collected before and after intervention from a subset of forty MADIAB participants, allowing us to characterise the gut microbiota by 16S rRNA sequencing and imputed metagenomics. To highlight microbiota dysbioses in T2D, the gut microbiota of thirteen normal-weight healthy controls were characterised. According to our findings, both diets were effective in modulating gut microbiome dysbioses in T2D, resulting in an increase of the ecosystem diversity and supporting the recovery of a balanced community of health-promoting SCFA producers, such as Faecalibacterium, Roseburia, Lachnospira, Bacteroides and Akkermansia. The Ma-Pi 2 diet, but not the control diet, was also effective in counteracting the increase of possible pro-inflammatory groups, such as Collinsella and Streptococcus, in the gut ecosystem, showing the potential to reverse pro-inflammatory dysbioses in T2D, and possibly explaining the greater efficacy in improving the metabolic control.


CTR control diet; Dysbiosis; FBG fasting blood glucose; Fibre-rich diets; GM gut microbiota; Gut microbiota; KO KEGG Orthology; Macrobiotic diets; PCoA principal coordinates analysis; T2D type 2 diabetes; Type 2 diabetes

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