BACKGROUND
The implications of diet in the prevention/management of metabolic diseases are widely recognized, with the most recent evidence provided by macrobiotic Ma- Pi diets in the treatment of type-2 diabetes (T2D) and reactive hypoglycemia. Ma-Pi diets, whose complex carbohydrate and dietary fiber content is remarkably higher than that of Mediterranean diet, proved to be more effective compared with standard, recommended diets (1-3). The Diabetes Risk Score (DRS) is one of the most widely used tools to evaluate the risk of developing T2D in the general population due to its ease of use and reliability (4).
AIMS
In order to explore whether and to what extent consumption of a Ma-Pi dietary lifestyle is related to T2D risk compared to other diets, we administered the DRS questionnaire during the 2016 World Diabetes Day in local activities affiliated to UPM – Un Punto Macrobiotico Association, an international charity/no-profit organization throughout the city of Rome, Italy.
SUBJECTS AND METHODS
Subjects (n=476) were individually interviewed by a team of doctors/nutritionists belonging to Campus Bio- Medico University of Rome who supervised data collection and administered the DRS questionnaire. They were asked to point out their dietary habits among Macrobiotic, Mediterranean, or Other.
RESULTS
Subjects following Ma-Pi lifestyle showed a significantly lower DRS value compared with Mediterranean and Other diet groups (1.1% vs 12.7% and 20.4%, respectively, p<0.0001). 
CONCLUSIONS
In addition to what seen in previous studies concerning treatment purposes (1-2), Ma-Pi dietary lifestyle appears to exert beneficial effects regarding T2D prevention. To this end, Ma-Pi ingredients such as wholegrains and legumes may elicit protective effects for glycemic homeostasis (5).
The administration of simple yet validated tools such as the DRS is of importance for screening the general population, which ultimately results in better prevention and lower healthcare costs related to T2D.

Use of diabetes risk score in the evaluation of type-2 diabetes risk following Ma-Pi macrobiotic and other diets