Cinnamon Gets an Early Start

The recorded history of cinnamon began at least as far back as 2700 B.C., when a Chinese herbalist wrote of its usefulness for fever, diarrhea, and menstrual problems. Down through the centuries—in Pharaonic Egypt, in ancient Rome, during the Middle Ages—cinnamon has been used as a medicinal herb as well as a seasoning. In the Middle Ages, it was thought to be an aphrodisiac. The spice was so esteemed in Europe that commerce in cinnamon contributed toward making Venice a wealthy city-state, and even centuries later, the persistent demand for it touched off warfare, conquests, and the occasional massacre.

In modern times, cinnamon lost favor (but not flavor) as an appetite stimulant, digestant, antispasmodic, and antidiarrheal, at least in Western countries. In America it was relegated to the spice rack as a tasty ingredient for sweet desserts, such as apple pie, and as something to sprinkle on toast or outrageously costly cups of coffee.

More Apple Pie, Mom!

Then, in 1990, lightning struck when Dr. Richard Anderson, a chemist at the U.S. Department of Agriculture’s Beltsville Human Nutrition Research Center in Maryland, was searching for foods that might mimic the action of insulin in controlling blood sugar (glucose) levels. Dr. Anderson and his colleagues discovered their prime candidate in a most unlikely source: apple pie. The spice mix typically used in making the quintessential American dessert boosted insulin’s glucose-regulating activity more than threefold. Subsequent research narrowed the focus to the cinnamon in the spice mix, and finally to a class of water-soluble compounds in cinnamon called procyanidins (type A), which boost insulin’s activity about 20-fold.1

The procyanidins (type A)* are natural polymers, each unit of which is a type of molecule called a polyphenol; there are innumerable kinds of polyphenols, many of which are strong antioxidants. And many polyphenols, including the procyanidins (type A) belong to a broad class of beneficial, biologically active compounds called bioflavonoids.

*Type A” refers to a particular feature of the chemical bonding that links the polyphenol units in the polymeric structure; there are also type B procyanidins, but they’re of no concern to us.

And a Cinnamon Role!

It’s fortunate that the procyanidins (type A) are found in the water-soluble portion of cinnamon powder, because the fat-soluble portion contains coumarin, an anticoagulant that’s potentially harmful in large amounts, as well as cinnamaldehyde, which is potentially allergenic. By extracting and using only the water-soluble portion, therefore, the risk from these compounds is eliminated.

The strong insulin-mimetic properties of the procyanidins (type A) explain why there’s a cinnamon role (no pun intended) in diabetes. It’s useful to think of cinnamon as a sort of “Hamburger Helper®” for insulin: it makes this vital hormone go further. Several other herbs also potentiate insulin, including cloves, turmeric, bay leaves, and fenugreek, as do the minerals chromium and vanadium. However, cinnamon is by far the best of the lot. (OK, the pun was intended.)

The Looming Diabetes Crisis

We are in the grip of a worldwide diabetes epidemic, fueled by sedentary habits and calorie-rich junk foods, which lead to the primary risk factor for the disease: obesity. This situation is not getting better—it’s getting worse. Right now, about 16 million Americans have diabetes (overwhelmingly type 2), and nearly as many are estimated to be at risk for it. A dire prediction by the World Health Organization and the International Diabetes Foundation sets the worldwide tally of diabetics in the year 2030 at more than twice the current number. Many future citizens will likely be blind or lame owing to diabetes, and healthcare systems throughout the world will be overwhelmed.

Diabetes is characterized by high levels of blood glucose. This condition is harmful because the excess glucose causes chemical reactions that lead to the formation of deleterious, cross-linked protein complexes aptly called AGEs (advanced glycation end products), whose prevalence in our tissues increases with age. High glucose levels also wreck blood vessels, trash kidneys, and erode cognitive function, among other things.

Beware of Insulin Resistance

In healthy individuals, blood glucose is controlled by insulin, a protein produced in the pancreas and the brain.* Insulin molecules “dock” with insulin receptors (which are also proteins) on the surface of cells. This causes the molecular structure of the receptor complex to change so that a channel is opened, selectively allowing glucose molecules to enter the cells. Thus, blood glucose levels are reduced, and the cells are nourished.

*The dramatic implications of the fact that our brains produce insulin (a recent discovery) are discussed in “Is Alzheimer’s Disease a Type of Diabetes?” and “More Evidence that Alzheimer’s Is Type 3 Diabetes” in the May 2005 and February 2006 issues, respectively.

When this system goes seriously awry, the result is diabetes, of which there are two main kinds, boringly called type 1 and type 2. They once bore the more descriptive names juvenile-onset and adult-onset, but because more and more children are now developing “adult” diabetes, owing to their atrocious diet and lack of exercise, those names no longer fit.

In type 1 diabetes, there’s not enough insulin to do the job, because an inflammatory process has destroyed the pancreatic cells that produce it. Type 2 diabetes is very different: here the problem is not a lack of insulin, but rather a reduced sensitivity of the cells’ insulin receptors to insulin. This reduces insulin’s effectiveness, causing the pancreas to produce more and more of it in an increasingly futile attempt to compensate. In its early stages, this pernicious condition is called insulin resistance. If uncontrolled, it can evolve to full-fledged diabetes. The various therapies for the disease (drugs, exercise, diet, and nutritional supplements) are directed at increasing insulin sensitivity, i.e., reducing insulin resistance.

A Cinnamon Study in Pakistan . . .

As an insulin “extender,” cinnamon offers hope for millions of diabetics worldwide, especially in poor countries where drugs are unavailable or unaffordable. This was first verified in a human clinical trial conducted in Pakistan 13 years after Anderson’s original report.2 The study’s lead author, Dr. Alam Khan, was a longtime associate of Anderson, who was a coauthor.

The researchers divided 60 middle-aged men and women with diabetes into groups treated with 1, 3, or 6 g of whole cinnamon powder daily, or placebo. After 40 days, all three of the cinnamon groups showed reductions (from 18% to 29%) in fasting blood glucose levels, whereas the control group showed no change. The cinnamon groups also had significant reductions in blood levels of LDL-cholesterol, total cholesterol, and triglycerides. Moreover, their improvements persisted for 20 days after the treatment was stopped. Thus it appeared that as little as 1 g/day of cinnamon, and perhaps less, could help control undesirably high levels of glucose and lipids in diabetics.

As dramatic as those results were, however, their broader relevance has been questioned. The Pakistani patients’ genetic background and dietary habits were quite different from those of most Westerners. More tellingly, their diabetes was not under what we would consider good control: their blood glucose levels were higher than those ordinarily attained (or at least targeted) in diabetic patients in the West. It’s not surprising that they had high lipid levels, which are a common complication of diabetes, especially when it’s poorly controlled.

. . . Sets the Stage for Further Success in Germany

A German research team in Hannover has now published a human study that seems to remove any doubts about cinnamon’s effectiveness in diabetes.3 In a randomized, placebo-controlled, double-blind trial, they assigned 65 men and women with type 2 diabetes to either a treatment group or a placebo group. The former received an aqueous extract of cinnamon (in capsule form) equivalent to 3 g of whole cinnamon powder, daily, for 4 months.

Fasting blood glucose levels in the cinnamon group were reduced by 10%, vs. 3.4% in the control group. The authors speculated that the lower percentage reduction seen here than in the Pakistani study was probably because the baseline levels in the German patients were substantially lower than those in the Pakistani patients; the German baseline levels were, in fact, comparable to the Pakistani post-treatment levels.

In contrast to the Pakistani study, the German study showed no significant changes in cholesterol or triglyceride levels, nor were there any changes in the levels of glycosylated hemoglobin (a measure of the extent to which high glucose levels are causing the formation of AGEs), probably because the decline in blood glucose levels was insufficient to cause this.

From all the results obtained, the researchers concluded that the more poorly controlled the diabetes is in any given case, the more effective cinnamon supplementation is likely to be. They also concluded that the lower percentage reduction in their study was probably not attributable to their having used an aqueous extract of cinnamon rather than whole cinnamon powder (as in the Pakistani study), because laboratory studies have shown that aqueous extracts of cinnamon do have insulin-mimetic activity, and the substances thought to be responsible—the procyanidins (type A)—are indeed water-soluble.


  1. 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.
  2. Khan A, Safdar M, Khan MMA, Khattak KN, Anderson RA. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003;26(12):3215-8.
  3. Mang B, Wolters M, Schmitt B, Kelb K, Lichtinghagen R, Stichtenoth DO, Hahn A. Effects of a cinnamon extract on plasma glucose, HbA1c, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest 2006;36:340-4.

Also see “Supplements We Take with Our Meals to Enhance Health and Healthy Weight Management” by Durk Pearson & Sandy Shaw

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