Add Some Spice to Your Life
Controlling Blood Sugar with Cinnamon
Water-soluble cinnamon extract lowers glucose
levels and improves lipid profile in diabetic mice
By Dr. Hyla Cass
f you attend any parties this holiday season, you’ll probably encounter some of the traditional delicacies we all enjoy so much: spice cake or pumpkin pie, baked apples or mulled cider—perhaps even one of those fruitcakes that get sent as gifts but are never actually eaten. And what do these goodies have in common besides being trotted out at this time of year? They usually contain cinnamon in one form or another. So unless you regularly eat cinnamon buns, cinnamon toast, or some other cinnamon-containing product, chances are you’ll be getting more cinnamon during the holidays than you usually do.
That’s a good thing, because a particular component of cinnamon helps keep blood sugar under control, and during the holiday season, we tend to eat more than the usual amounts of sugary and fatty foods, especially at parties. Controlling blood sugar is important all year round, though, so it would be good to have cinnamon on a regular basis. In the course of one year, the average person in our society consumes about 150 pounds of sugar, or about half a cup daily (teenage boys are the champions in this department, downing about twice as much sugar as any other age or gender group).*
Spice Is Nice, but . . .
Now, if you were interested in controlling your blood sugar (glucose) with cinnamon, you could eat a lot of cinnamon every day. That, however, would probably wear thin pretty quickly—spice is nice, but not as a steady diet. It would not be a good idea in any case, because that much cinnamon might give you too much of a certain compound, coumarin, which is a natural anticoagulant (blood thinner). So what should you do?
Fortunately, Mother Nature has solved this problem nicely, by making coumarin fat-soluble, not water-soluble. That means that an aqueous (water) extract of cinnamon will not contain coumarin or any other fat-soluble components. However, the beneficial, glucose-regulating component of cinnamon mentioned above is water-soluble, so to get that, you can take a powdered cinnamon extract containing only the water-soluble components.
. . . It’s the Procyanidins (Type A) We Want Most
And what is this mystery component we’re talking about? It’s actually a class of closely related compounds called procyanidins (type A); these are polyphenolic compounds in the very large class of compounds called bioflavonoids. [Also among the water-soluble components of cinnamon is MHCP (methylhydroxychalcone polymer), which until recently was thought to be the substance primarily responsible for cinnamon’s remarkable ability to regulate glucose levels.]
The procyanidins (type A) are insulin mimetics, i.e., they mimic the physiological effects of insulin, a protein hormone produced by the pancreas. Insulin’s principal role in our bodies is to remove excess glucose from our blood, which it accomplishes in two ways. First, it facilitates the transport of glucose molecules into our cells, which need glucose as fuel. Then, if there’s still too much glucose in the blood after the cells have absorbed all they need for the moment, insulin facilitates the conversion of the remainder to glycogen, a polymeric form of glucose that’s stored primarily in the muscles and liver, where it can be converted back to glucose on demand.
Why is glucose control so important? Because excessive glucose levels can cause serious damage. Acute (short-term) excesses lead to the formation and accumulation of insoluble sugar-protein complexes called advanced glycation end products (AGEs), which are implicated in the premature aging of many organs and tissues. Chronic (long-term) excesses do the same, of course, but they can also lead to type 2 diabetes, which, in turn, can lead to heart disease, kidney failure, nerve damage, blindness, and dementia, among other things.
Cinnamon Lowers Blood Sugar Levels
Previous issues of Life Enhancement have reported on various studies of the substantial antidiabetic—as well as anticholesterol—benefits of cinnamon, including a clinical trial with human diabetic patients in Pakistan. (See
“Cinnamon Reduces Blood Sugar and Cholesterol Levels” in the February 2004 issue.) Most studies, however, have been on laboratory animals, and a new one has just been published by Korean researchers, who used diabetic mice to evaluate the effects of a water-soluble cinnamon extract on blood levels of glucose, cholesterol, and triglycerides (fats).
The mice—of a strain that is genetically predisposed to become diabetic—received either cinnamon extract or placebo orally every day for 6 weeks. The cinnamon doses ranged from 50 to 200 mg per kg of body weight; thus, a mouse weighing 30 g (1.1 oz) would have received from 1.5 to 6 mg/day of the extract. On the same 200-mg/kg basis, a 75-kg (165-lb) human, weighing 2500 times more than the mouse, would receive the exceedingly large doses of 3.75 to 15 g/day.
Comparing mouse dosages to human dosages based on body weight is misleading, however, because mice have a much higher metabolic rate than humans. A more meaningful comparison is based on daily energy (food) intake. When this calculation is done (we’ll spare you the details), it turns out that equivalent dosages of cinnamon extract for humans would be about 250 to 1000 mg/day (0.25 to 1.0 g/day). As we will see below, that’s in the right ballpark.
In the mouse study, total food intake and increases in body weight did not differ significantly among the cinnamon and control groups after 6 weeks, but blood glucose levels in the cinnamon groups were dramatically lower (about 2-to-3-fold) than in the controls. The effects were dose-dependent, with the 200-mg/kg dose being the most effective. It took only 2 weeks to reach maximum efficacy, after which the levels remained relatively steady.
Cinnamon Boosts Insulin Levels and Improves Lipid Profile
Significantly, the 200-mg/kg dose of cinnamon raised the serum insulin levels of the mice by about 150% (i.e., 2.5-fold) compared with the controls. This accords with evidence from other studies indicating that cinnamon’s antidiabetic action is probably due not just to its insulin-mimetic effect but also to its insulin-stimulating effect. Yet another factor may be its ability to inhibit the action of intestinal enzymes that convert carbohydrates to glucose. By so doing, it slows down the absorption of glucose from the intestines. This effect was observed with the 200-mg/kg dose of cinnamon in the present study.
The 200-mg/kg dose also had strongly beneficial effects on the lipid profile of the mice: compared with the controls, total cholesterol was reduced by 16%, HDL-cholesterol (the “good cholesterol”) was increased by 55%, and triglycerides were reduced by 45%. Aggressive control of cholesterol and triglycerides is particularly important in diabetic individuals, in whom they are typically elevated; as we all know, that condition invites the onset of cardiovascular and cerebrovascular disease.
Chromium Proves Its Mettle
Chromium isn’t just for making hard, shiny things. In the form of certain chemical compounds, chromium is one of the nine vital trace minerals—the ones without which good health, and life itself, would not be possible (the other eight are cobalt, copper, iodine, iron, manganese, molybdenum, selenium, and zinc). In the human body, chromium’s principal role is in the regulation of carbohydrate metabolism, the end product of which is glucose. It is believed that chromium enhances the action of insulin.
Dietary deficiencies of chromium, which are common in people who don’t take vitamin and mineral supplements, can cause impaired glucose tolerance. This means that blood glucose levels after a carbohydrate-rich meal are excessive—an unhealthy condition that can lead to type 2 diabetes. People with this disease, in fact, generally have serum chromium levels about 40% lower than normal. For that reason, chromium (usually as chromium picolinate) has long been used in the treatment of diabetes, to help improve glucose tolerance (the typical dosage is 50 to 200 mcg per day, expressed as elemental chromium).
Diabetes is pernicious in part because it’s associated with various other diseases, often in ways that are still poorly understood. One such disease is clinical depression. Depression is itself linked with a variety of other diseases because, in addition to abnormalities of mood, it involves disruptions in a number of bodily systems (most notably the cardiovascular system). Diabetes and depression are reciprocally linked: people suffering from either of these conditions are at increased risk of developing the other. This has prompted some researchers to investigate whether medications used for diabetes might be useful for depression as well.
A recent pilot study looked at the possibility that chromium might help patients with atypical depression, a disorder that, despite its name, is quite common. It is characterized primarily by excessive eating and excessive sleeping, along with mood reactivity (i.e., a brightening of mood in response to positive events) and heavy, leaden feelings in the arms or legs.
In the 8-week trial, 75 adult outpatients with atypical depression, most of whom were overweight or obese, received either placebo or 600 mcg/day of chromium, in the form of chromium picolinate, and their depressive symptoms were monitored by means of standardized rating systems. The chromium supplementation had no effect on the overall ratings, but examination of the data showed that it did produce improvements in four specific areas: appetite increase, increased eating, carbohydrate craving, and daily variation of feelings.
The researchers concluded that chromium’s main effect was on carbohydrate craving and appetite regulation and that supplementation with chromium might be beneficial for patients with atypical depression who also have severe carbohydrate craving.
- Ludman EJ, Katon W, Russo J, Von Korff M, Simon G, Ciechanowski P, Lin E, Bush T, Walker E, Young B. Depression and diabetes symptom burden. Gen Hosp Psychiatry 2004;26:430-6.
- Musselman DL, Betan E, Larsen H, Phillips LS. Relationship of depression to diabetes types 1 and 2: epidemiology, biology, and treatment. Biol Psychiatry 2003;54:317-29.
- Docherty JP, Sack DA, Roffman M, Finch M, Komorowski JR. A double-blind, placebo-controlled, exploratory trial of chromium picolinate in atypical depression: effect on carbohydrate craving. J Psychiatr Pract 2005;11(5):302-14.
Of Mice and Men
The results of the human study cited earlier were similar to those of the mouse study, the main exceptions being that the cinnamon had a much smaller (but still significant) effect on blood glucose levels, and no effect on HDL-cholesterol levels.
Another difference is that in the mouse study, the response to the cinnamon extract was dose-dependent, whereas in the human study, it was not. The Pakistani researchers found that 1 g was just as effective as the two higher doses they used (3 g and 6 g). This suggests that even 1 g might have been more than enough. Furthermore, the material they used was a whole-cinnamon extract, so the water-soluble portion of that extract would have constituted considerably less than 1 g. This fits reasonably well with our earlier estimate of 0.25 to 1.0 g as an effective dose range for humans.
Why Supplements Are Preferable to Drugs
These studies illustrate that, for all their biological similarities, there are still many differences between mice and men. For the latter, in any case, it’s much more desirable to control blood sugar with nutritional supplements than with prescription drugs, which not only cost much more than supplements but are much more likely to come with unwanted side effects. For example, the TV commercial for an antidiabetic drug (Avandia) currently being heavily advertised warns of potentially serious heart problems, potentially serious liver problems, weight gain, and an increased risk of pregnancy, among other side effects. Cinnamon, by contrast, has no harmful side effects (and it tastes better).
Live Well, and Long, with Cinnamon
The best advice for controlling blood sugar levels and avoiding diabetes is to eat a healthy diet, watch your weight, and get regular exercise. Obesity is by far the leading risk factor for type 2 diabetes, making this terrible disease easy to prevent in most cases. It can’t hurt, though, to give your healthy lifestyle a helping hand with cinnamon. It will add spice to your life and, by helping you avoid diabetes, it may even add years as well.
What Diabetes Can Do to Women
"Sugar and spice, and everything nice; that’s what little girls are made of." Unfortunately, too many little girls—big girls too, and their moms and grandmas—are made of too much sugar, and perhaps not enough spice (especially cinnamon). It’s not so much that they eat too much sugar (although they do) as it is that they eat too much of everything and thus become overweight or obese. If they compound this problem with inadequate exercise, they’re well on the road to insulin resistance and type 2 diabetes.
That’s a road that no one—girls or boys, women or men—should ever take. Here we’ll look at some of the consequences for women.
Congestive heart failure (CHF, a weakening of the heart’s ability to pump blood forcefully enough to maintain good circulation) is a devastating disease that was long thought to be primarily the province of men. We now know, however, that it afflicts women to the same extent—the lifetime risk for both sexes is about 20%. Coronary disease is the major risk factor for CHF, but the strongest independent predictors are different for men and women. That fact emerged from a recent study conducted at the University of California’s San Francisco and San Diego medical schools.
The UC researchers tracked the cardiovascular health of 2391 postmenopausal women (average age 67) for an average duration of 6.3 years. All the women had coronary disease but not CHF at baseline, and 237 (10%) subsequently developed CHF. The strongest risk factor for this disease, it turned out, was diabetes—it tripled the risk. For men, by contrast, the strongest predictor of CHF appears to be multiple heart attacks.
In an interview with Reuters Health, the research team leader, Dr. Kirsten Bibbins-Domingo, said, “Not much was known about what predisposes women to heart failure, except that they seemed less likely to have a preceding heart attack than men. . . . Many of the risk factors we uncovered are, of course, the same ones seen in men, but what was particularly striking was the risk seen with diabetes. In our analysis, it was a stronger risk factor than having multiple heart attacks.” The risk was greatest in women whose diabetes was poorly controlled or who had impaired kidney function or obesity.
Diabetes also increases the risk for an ailment that afflicts many more women than men: urinary tract infection (UTI). In a study conducted at the University of Washington in Seattle, researchers tracked the health of 218 diabetic and 799 nondiabetic postmenopausal women (aged 55 to 75) for 4 years. They found that the incidence of UTI per 100 person-years was 12.2 for diabetic women and 6.7 for nondiabetic women. In other words, diabetes increased the risk of UTI by 80%. Analysis of the data showed that the increased risk occurred mainly in women who were taking insulin and in those whose diabetes was of long duration (10 years or more).
In a separate paper, the same research group reported that diabetes increases the risk for a problem that is highly prevalent in postmenopausal women, but one that many are loath to talk about, even with their doctors: urinary incontinence (UI). Analyzing data from the same 1017 women as in the previous study, the researchers found that UTI is a major risk factor for UI and that women with diabetes were about twice as likely to experience severe incontinence as those who were nondiabetic.
Overall, 60% of the women reported at least one episode of UI in the prior month, and of these women, 8% had severe incontinence. The diabetic women reported not just disproportionately more severe incontinence, but also more of the following: difficulty in controlling urination, mixed forms of incontinence (stress and urge), use of pads, inability to empty the bladder completely, unawareness of leakage, and discomfort with urination.
Moral: Avoid diabetes like the plague that it is!
- Bibbins-Domingo K, Lin F, Vittinghoff E, Barrett-Connor E, Hulley SB, Grady D, Shlipak MG. Predictors of heart failure among women with coronary disease. Circulation 2004;110:1424-30.
- Anon. Diabetes triples risk of heart failure for women. Reuters Health report, Sept. 7, 2004.
- Boyko EJ, Fihn SD, Scholes D, Abraham L, Monsey B. Risk of urinary tract infection and asymptomatic bacteriuria among diabetic and nondiabetic postmenopausal women. Am J Epidemiol 2005;161(6):557-64.
- Jackson SL, Scholes D, Boyko EJ, Abraham L, Fihn SD. Urinary incontinence and diabetes in postmenopausal women. Diabetes Care 2005;28:1730-8.
- Anderson RA, Broadhurst CL, Polansky MM, Schmidt WF, Khan A, Flanagan VP, Schoene NW, Graves DJ. Isolation and characterization of polyphenol type-A polymers from cinnamon with insulin-like biological activity. J Agric Food Chem 2004;52:65-70.
- Khan A, Safdar M, Khan MMA, Khattak KN, Anderson RA. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003 Dec;26(12):3215-8.
- Kim SH, Hyun SH, Choung SY. Anti-diabetic effect of cinnamon extract on blood glucose in db/db mice. J Ethnopharmacol 2005 [online preprint].
- Rucker R, Storms D. Interspecies comparisons of micronutrient requirements: metabolic vs. absolute body size. J Nutr 2002;132:2999-3000.
- Jarvill-Taylor KJ, Anderson RA, Graves DJ. A hydroxychalcone derived from cinnamon functions as a mimetic for insulin in 3T3-L1 adipocytes. J Am Coll Nutr 2001 Aug;20(4):327-36.
Caution: If you have diabetes, do not take any supplement that may affect your blood sugar levels without first consulting your physician. Diabetes is a serious disease requiring careful professional management.
Hyla Cass, M.D., is assistant clinical professor of psychiatry at UCLA and chair of the Dept. of Complementary and Alternative Medicine at the American University of Complementary Medicine. She has written several books on herbal supplements.