Object to Obesity’s Demands
With cinnamon you can be safer and less vulnerable while you . . .
To say that obesity is caused by merely consuming too many calories is like saying that the only cause of the American Revolution was the Boston Tea Party. — Adelle Davis
How fat are we as a nation? Very recent estimates claim the prevalence of obesity in the U.S. to be 32.2% in adult men and 35.5% in adult women.1 Can you believe it? On top of that, 57 million American adults (20 years of age or older) have impaired glucose tolerance, suggesting that at least 57 million American adults have prediabetes.2 Additionally, 23.6 million people, or 7.8%, of the population are believed to have diabetes. These mind-boggling numbers clearly suggest that multiple dietary strategies need to be implemented to help treat these diseases. What about you? What are you willing to do to make a difference in your life?
There are no convincing arguments coming from the main streams of advice. Otherwise, the problems would be solved. Exercise … diet … you’ve heard it all before. One might just as well pray to Apollo, the God of Moderation, or take up a new religion! As good as any of these answers might be for some (such as the permanent placebo responders who can be “saved”), for the rest of us there needs to be something more.
Cinnamon Preserves, Protects, and …
One approach might involve the use of cinnamon. Truly a “spice of life,” the supplemental use of cinnamon is now backed by a growing body of scientific literature demonstrating its use as an insulin sensitizer, a possible cholesterol reducer, and an antioxidant. This last is of interest because oxidative stress has been linked as a contributing factor in obesity-related diseases such as type 2 diabetes and cardiovascular diseases.3 Giving substance to this, several in vitro, as well as in vivo, studies have shown cinnamon to have a positive effect on insulin
While that may be so, in humans, cinnamon’s effect on glucose control and lipids in type 2 diabetic patients is far from clear, with some finding value,10 and others not.11-14 With that kind of a line-up, why bother? Well, researchers at the University of Pittsburgh’s Physical Activity and Weight Management Research Center had some ideas of their own, so they chose to investigate the use of cinnamon as a supplemental treatment in the areas of obesity, diabetes, and cardiovascular disease.15 We have written about this paper before and reported some interesting findings, including new evidence that cinnamon could be useful for preventing obesity’s oxidative damage as measured by markers for oxidative stress and antioxidant status. The former was down while the latter was up, establishing a preserve and protect role for cinnamon with regard to these aspects of blood chemistry.
What Was Not Reported
However, what was not reported by the University of Pittsburgh researchers were the effects of cinnamon treatment in the area of obesity, diabetes, and cardiovascular disease. So a recent paper has revisited some of the unpublished findings, and found evidence that they lend support to the use of cinnamon for glucose and lipid control.16
The goal of the study was to examine the effect of a water extract of cinnamon on oxidative stress in individuals with impaired glucose tolerance, who were also overweight or obese. Employing a double-blind placebo-controlled structure, the study enlisted 22 subjects with impaired glucose tolerance (mean fasting blood glucose at 114.3 mg/dL), a mean age of 46.0, and a mean body mass index of 33.2 kg/m2 (the threshold for obesity is 30). The subjects were randomly assigned to take either a placebo or 250 mg of aqueous extract of cinnamon twice daily for 12 weeks. At the beginning of the study, blood was collected following an overnight fast. This was done again at 6 weeks, and at the end of the study to measure various markers for plasma protein oxidation, lipid antioxidant status, and ferric-reducing antioxidant status. Also measured was the activity of copper-zinc superoxide (an antioxidant enzyme detoxifying oxygen radical species), and erythrocyte glutathione peroxidase (an antioxidant that protects against hydrogen peroxide), along with the levels of fasting glucose, and fasting insulin.
Decreased Fasting Glucose and Improved Stress Markers
While there were no significant changes observed in the placebo group at any time over the course of the study, in the cinnamon group at the end of the 12 weeks, fasting glucose decreased significantly from 114.3 to 102 mg/dL (an 11 percent drop), fasting insulin was unchanged. Also, the plasma oxidative stress markers were all significantly improved, with markers for antioxidant status and plasma protein oxidation protection increasing, and the marker for lipid oxidation decreasing.
As well, there was a positive correlation between lipid peroxidation and plasma glucose. Nonetheless, cinnamon supplementation did not change the antioxidant enzymes, copper-zinc superoxide or glutatione peroxidase, but 5 out of 7 measurements were improved. That’s pretty good. Importantly, these effects were not apparent at 6 weeks, but became significant at the end of the trial at 12 weeks.
Reemphasizing a More Fruitful Direction
So finally we have a double-blind, placebo-controlled study providing evidence that the use of cinnamon extract may reduce the risk factors associated with diabetes and cardiovascular disease. This is fruitful and bound to direct future studies to go beyond examining just the insulin-empowering benefits of cinnamon, and as well to look more thoroughly at the additive impact that cinnamon can have for inhibiting and preventing type 2 diabetes and cardiovascular disease.
For the obese subjects in this study who suffer from diabetes and cardiovascular disease, cinnamon provided the added benefits of decreasing lipid and protein oxidation, thereby avoiding oxidative damage and its complications. And indeed, this was evidenced in the group taking cinnamon after 12 weeks, with clear indications of reduced peroxidation and improved protection against oxidation.
Furthermore, there was an increase in total antioxidant capacity in plasma at the end of the study (after 12 weeks), offering support for cinnamon’s protective effects in individuals with impaired glucose tolerance. On the other hand, a recent meta-analysis of randomized placebo-controlled trials of cinnamon in type 1 and type 2 diabetes revealed that cinnamon use apparently only goes so far, and that it does not significantly affect hemoglobin A1c, fasting blood glucose, or lipid parameters.12
However, it is entirely possible that this meta-analysis may have been without sufficient power, given that there have been so few studies to date and that most of these were too short in duration. It is interesting to note that this meta-analysis reported that differences in ethnic or cultural differences in diet, dose, aroma, and publication bias could potentially play a role in the determining cinnamon’s effects on glucose and lipid parameters. Finally, the meta-analysis didn’t include individuals with prediabetes.
So even if the results of cinnamon as a dietary approach are somewhat inconclusive at this point, it is important to state that there are few adverse effects from taking cinnamon. Given that there are so few alternatives in the pharmaceutical world—and all of which have significant associated risks—it is certainly worth considering the use of cinnamon, which can be readily incorporated into a variety of lifestyles and could prove beneficial to many individuals.
As Part of a Comprehensive Lifestyle Program
Certainly, larger and longer randomized placebo controlled trials will prove to be valuable to assess the effect of cinnamon on glucose and lipid parameters in type 2 diabetes and prediabetes. But in the interim, as per the author, Amy D. Otto, Ph.D., also of the University of Pittsburgh, “the recommendation of cinnamon supplementation as part of a comprehensive lifestyle program may be warranted for individuals with impaired glucose tolerance or who have type 2 diabetes.”
A new study has reported that cinnamon supplementation may decrease blood sugar levels and offer other benefits to people with insulin resistance.1 Insulin resistance occurs when cells become less sensitive to the glucose-lowering effects of insulin. This results in an abnormal increase in levels of glucose in the blood. When sustained, a person has hyperglycemia, which is frequently the prelude to type-2 diabetes.
The study was presented at a poster session at the Federation of American Societies for Experimental Biology (FASEB) Annual Meeting in Anaheim, California this spring. Involving 137 hyperglycemic participants, the study was a double-blind placebo-control trial conducted in China with American collaboration. Based on the insulin-potentiating activity of cinnamon, researchers tested the effects of a water extract of cinnamon over the course of a 2-month period. The subjects had a mean age of 61.3 years, and a mean body mass index (BMI) of 25.3 (they were slightly overweight). There were 65 men and 72 women enrolled, each of whom was given either a placebo or a 250-mg dried water-extract cinnamon capsule twice per day. As the investigation began, insulin resistance was significantly correlated with diastolic blood pressure, postprandial glucose, insulin, triglycerides, fructosamine, and BMI, but negatively correlated with HDL cholesterol.
At the end of the study, fasting glucose decreased in the group receiving the cinnamon from 8.85 to 8.19 mmol/L (down 7.5 percent). In the placebo group, fasting glucose was only reduced from 8.57 to 8.44 mmol/L (down 1.6 percent). When glucose levels were measured 2 hours after a 75 g carbohydrate load, a decrease was found in those taking the cinnamon (15.09 to 13.30 mmol/L, a 12 percent decrease), compared to those taking placebo (14.18 to 13.74 mmol/L, a mere 3.1 percent). Also, insulin concentrations along with an assessment for insulin resistance tended to be improved by cinnamon supplements, but differences were not significant. In summary, supplementation of a water extract of cinnamon had beneficial effects in subjects with hyperglycemia.
“This clinical trial adds to the growing evidence that aqueous cinnamon extract may be beneficial for insulin-resistant populations,” pronounced the study’s senior researcher Dr. Barbara Stoecker of Oklahoma State University.2
With huge numbers of people affected by diabetes in every developed country, and with projected increases spiraling upwards to hundreds of millions in the not too distance future, approaches to reduce the risk of diabetes are becoming increasing attractive.
Here in the U.S. the figures are even more startling, where almost 24 million people live with diabetes, equal to 8 per cent of the population. The total costs are thought to be as much as $174 billion, with $116 billion being direct costs from medication, according to 2005-2007 American Diabetes Association figures.
- Flegal KM, Carroll MD, Ogden CL, Curtain LR: Prevalence and trends in obesity among US adults, 1999–2008. JAMA 2010;303:235–41.
- Centers for Disease Control and Prevention. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2007. Atlanta GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2008.
- Yu Y, Lyon TJ: A lethal trend in diabetes: hyperglycemia, dyslipidemia, oxidative stress, and endothelial dysfunction. Am J Med Sci 2005;330:227–32.
- Imparl-Radosevich J, Deas S, Polansky MM, et al.: Regulation of phosphorylase phosphatase (PTP-1) and insulin receptor kinase by fractions from cinnamon: implications for cinnamon regulation of insulin signaling. Horm Res 1998, 50:177–82.
- Jarvill-Taylor KJ, Anderson RA, Graves DJ: A hydroxy-chalcone derivative from cinnamon functions as a mimetic for insulin in 3T3-L1 dipocytes. J Am Coll Nutr 2001, 20: 327–36.
- Qin B, Nagasaki M, Ren M, et al.: Cinnamon extract (traditional herb) potentiates in vivo insulin-regulated glucose utilization via enhanced insulin signaling in rats. Diabetes Res Clin Pract 2003, 62:139–48.
- Broadhurst CL, Polansky MM, Anderson RA: Insulin-like biological activity of culinary and medicinal plant aqueous extracts in vitro. J Agric Food Chem 2000, 48:849–52.
- Anderson RA, Broadhurst CL, Polansky MM, et al.: Isolation and characterization of polyphenol type-A polymers from cinnamon and insulin-like activity. J Agric Food Chem 2004, 52:65–70.
- Peng X, Ma J, Chao J, Sun Z, Chang RC, Tse I, Li ET, Chen F, Wang M. Beneficial effects of cinnamon proanthocyanidins on the formation of specific advanced glycation endproducts and methylglyoxal-induced impairment on glucose consumption. J Agric Food Chem 2010 May 17. [Epub ahead of print]
- Khan A, Safdar M, Khan MM, et al.: Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003, 26:3215–8.
- Blevins SM, Leyva MJ, Brown J, et al.: Effect of cinnamon on glucose and lipid levels in non-insulin-dependent type 2 diabetes. Diabetes Care 2007, 30:2236–7.
- Baker WL, Gutierrez-Williams G, White CM, et al.: Effect of cinnamon on glucose control and lipid parameters. Diabetes Care 2008, 31:41–3.
- Vanchoonbeek K, Thomassen BJ, Senden JM, et al.: Cinnamon supplementation does not improve glycemic control in postmenopausal type 2 diabetes patients. J Nutr 2006, 136:977–80.
- Mang B, Wolters M, Schmitt B, Kelb K, Lichtinghagen R, Stichtenoth DO, Hahn A. Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest 2006 May;36(5):340-4.
- Roussel AM, Hininger I, Benaraba R, Ziegenfuss TN, Anderson RA. Antioxidant effects of a cinnamon extract in people with impaired fasting glucose that are overweight or obese. J Am Coll Nutr 2009 Feb;28(1):16-21.
- Otto AD. Cinnamon as a supplemental treatment for impaired glucose tolerance and type 2 diabetes. Curr Diab Rep 2010 Jun;10(3):170-2.
Cinnamon Blocks AGE Formation
It’s the tragedy of the AGEs; that’s an acronym for advanced glycation endproducts, about which you have heard before in the pages of this magazine. The aptly named AGEs are implicated in many degenerative diseases, and they’re believed to be an important feature of the aging process itself, in part because of the oxidative stress they induce throughout our bodies. (Conversely, an oxidative environment is known to accelerate the formation of AGEs.) Naturally, we want to combat them in every way possible.
Unfortunately, AGEs are formed inside your body through normal metabolism and aging, and outside your body during the preparation of some foods you eat. They’re implicated in the development or exacerbation of numerous degenerative diseases associated with aging, notably atherosclerosis, cardiovascular disease, Alzheimer’s and other dementias, cataracts, retinal dysfunction, kidney failure, nerve damage, arthritis, cancer, and type 2 diabetes.
There’s the rub. The accumulation of AGEs in vivo has been implicated as a major pathogenic process in diabetic complications, and in a recent study, the inhibitory effects of cinnamon bark proanthocyanidins, along with other compounds that it contains, were investigated.
The other compounds included catechin, epicatechin, and procyanidin B2 and the scientists examined their effects on the formation of specific AGEs including pentosidine, Nε-(carboxymethyl)lysine, and methylglyoxal derived AGEs. Indeed, these compounds displayed evident inhibitory effects on the specific AGEs, which were attributed to both their antioxidant activities and carbonyl scavenging capacities.
Another finding was that cinnamon, through its potent methylglyoxal scavenging capacities, exerted protective effects on glucose consumption impaired by methylglyoxal in 3T3-L1 fat cells. Methylglyoxals are known to interfere with the insulin signaling pathways, so for yet another reason cinnamon could prove extremely beneficial as an another AGEless agent.