Cinnamon enhances insulin sensitivity, lowers glucose,
improves lipid profiles, and now helps to . . .

Preserve and Protect
Your Hemoglobin

From ancient Egypt to your cupboard, a long journey for an amazing spice
By Will Block

The hemoglobin molecule, with its striking color
and its property of combining reversibly with
dioxygen, seemed to me to be especially interesting.

— Linus Pauling

C

innamon is among the earliest known spices used by mankind. According to ancient Egyptian texts engraved on the walls of the Temple of Queen Hatshepsut (pronounced hat-shep-SOOT) 3,500 years ago, cinnamon was considered valuable and used as an item of trade along with ebony, ivory, gold, incense and myrrh. Indeed, Hatshepsut had entered into exchange with the Land of Punt, the exact location of which remains a mystery.

Nevertheless, commerce with this trading outpost is commemorated in hieroglyphics and this lends credence to the early use of cinnamon in Egypt for medicinal purposes and for embalming, where body cavities were filled with spiced preservatives. This stands to reason because we now know that cinnamon is a superb antioxidant (see sidebar, “Preventing Obesity’s Oxidative Damage”). By the way, Hatshepsut was obese and, according to computed tomography analysis, it is likely that she died from a blood infection caused by an abscessed tooth, with complications from advanced bone cancer and possibly diabetes, while she was in her fifties.1 Queen Hatshepsut had reigned for 22 years, and ironically was a true “blue blood,” meaning that she had a biological link to the royal blood line.

New evidence that cinnamon is useful for . . .
Preventing Obesity’s Oxidative Damage

In a new study,1 designed to determine the effects of cinnamon extract on the antioxidant status of overweight or obese people with impaired fasting glucose, it was found that two of the principal risk factors associated with diabetes and cardiovascular disease could be reduced. Employing 22 subjects with impaired fasting blood glucose, with BMI* ranging from 25 to 45, the double-blind placebo-controlled trial entailed giving either 250 mg of an aqueous extract of cinnamon, two times per day for 12 weeks, or placebo.


* To compute your BMI, divide your weight in pounds by the square of your height in inches, and multiply the result by 703. (In metric units, divide your weight in kilograms by the square of your height in meters.) The ideal BMI range is about 19–22, and 23–24 is good. If your BMI is in the 25–29 range, you’re considered overweight—a moderate threat to your health and longevity. If it’s 30 or more, you’re obese, and you could be at serious risk of life-threatening diseases. These ranges are provided by The National Institutes of Health, so beware: this is after all only a guide.


Among the measurements evaluated were plasma concentrations of malondialdehyde (MDA), a marker for oxidative stress, using high performance liquid chromatography and plasma, and antioxidant status, using ferric reducing antioxidant power (FRAP) assay. A number of other activities were measured.

What was found: FRAP and plasma thiol (a compound composed of a sulfur atom and a hydrogen atom) groups increased, while plasma MDA levels decreased in subjects receiving the cinnamon extract. These effects were magnified at 12 weeks compared to 6 weeks signifying further improvement of antioxidant status. Also noted was a positive correlation between MDA and plasma glucose, meaning that as MDA declined, so did glucose levels.

  1. 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.

“Bad Blood” Is at the Root of Diabetes

In terms of our own blood—in the process of mummification, ancient Egyptians discarded it as if it were unessential to life!—a recent paper has found that cinnamon can help maintain the integrity of hemoglobin (Hgb), an important component of blood.2 Hgb is the iron-containing oxygen-transport protein found in red blood cells, a protein that transports oxygen from the lungs to the rest of the body where it releases the oxygen for cell use, among other roles. But Hgb can turn bad!

When blood sugar levels are too high, glycated hemoglobin (Hgb A1c, or HbA1c) is created. HbA1c is a degraded form of hemoglobin, the measurement of which is used primarily to identify the average plasma glucose concentration over prolonged periods of time in diabetes. (See sidebar “Glycated Hemoglobins are AGEs.”) It is formed in a non-enzymatic pathway by hemoglobin’s excessive exposure to high plasma levels of glucose. In the order of events, first comes insulin resistance, then continuously high levels of glucose (hyperglycemia), and finally type 2 diabetes.

Glycated Hemoglobins are AGEs

To understand glycated hemoglobin, we must first understand advanced glycation endproducts (AGEs), and we need to go back a century, to prewar Paris. In 1912, a young French physician and chemist named Louis Camille Maillard (Mah·YAHR) began investigating the chemical reactions between nutrient sugars (such as glucose and fructose) and amino acids, the building blocks of proteins.

When Maillard heated aqueous solutions of sugars and amino acids for a few hours, they turned a yellow-brown color, the result of a series of reactions that yielded a witches’ brew of products. Significantly, the same phenomenon occurred, albeit much more slowly, when he simply allowed the solutions to sit for a few weeks under physiological conditions (37ºC, pH 7.4).

Maillard had discovered a series of complex and important chemical reactions that now bear his name: Maillard reactions. He predicted that they would occur in the human body, especially in diabetic patients because of their chronically high glucose (blood sugar) levels. This prophetic insight went unnoticed for half a century, however, and he did not live to see it realized.

In 1971, scientists investigating the blood of diabetic patients discovered that some of the hemoglobin was glycated.

Glycation—the first step in the Maillard reactions—is the chemical attachment of a sugar molecule (either free or bound in a polysaccharide, such as starch) to an amino acid (either free or bound in a protein, such as hemoglobin). As the ensuing reactions advance through numerous complex stages, they can lead to a great variety of endproducts, most of which are harmful to us. These are the “advanced glycation endproducts” we now call AGEs.

In essence, diabetes is a condition in which the body has trouble turning food into energy. After you eat, digested food is broken down into a sugar known as glucose, the main source of cellular fuel. When you are healthy, the hormone insulin assists glucose to enter your cells and nourish them. However, in diabetes the pancreas does not produce enough insulin, or the body becomes resistant to it (making it less effective). Or both! In effect, cells go hungry for energy and starve while glucose mounts up in the blood. Then, that unused glucose tends to connect together with Hgb proteins, producing HbA1c, and now another problem arises. Namely, the transport of oxygen becomes less effective.


Queen Hatshepsut was obese and,
according to computed tomography
analysis, it is likely that
she died from a blood infection
caused by an abscessed tooth.
She probably had diabetes too.


Glycated Hemoglobin is Detrimental to Life

Once a hemoglobin molecule is glycated, it remains that way. A buildup of glycated hemoglobin within the red cells consequently reflects the average level of glucose to which the cell has been exposed during its life cycle. Altogether, the long-term buildup of glycated hemoglobin is at the root of diabetes, and its complications affect macro- and micro-vasculature, brain, heart, kidneys, eye, and nerves. Glycation of hemoglobin has been directly implicated in nephropathy and retinopathy in diabetes mellitus.

Glycated Hemoglobin May Be Preventable

In the recent study referenced above,2 Paul Crawford, M.D., a researcher at the Eglin Air Force Base Regional Hospital in Florida, set out to determine in a randomized, controlled trial whether daily cinnamon plus usual care, versus usual care alone, lowers HbA1c in patients with type 2 diabetes. Multiple trials in the past have shown conflicting results about whether cinnamon lowers glucose or hemoglobin HbA1c. However, the seeming conflict with the former has been resolved. Cinnamon does lower glucose (see “The Antidiabetes Trigger” in the March 2009 issue and “More Evidence for Cinnamon’s Effect on Blood Sugar” in the August 2008 issue). What has not been resolved is whether cinnamon can help prevent hemoglobin damage. To date, of two studies, neither has shown any effect from cinnamon on HbA1c levels. Chromium, by the way, has been found to lower HbA1c.3

Drawing upon 109 type 2 diabetics (with HbA1c >7.0) enlisted from 3 primary care clinics caring for pediatric, adult, and geriatric patients at a United States military base, the participants were randomly allocated to one of two groups: Either usual care with management changes by their primary care physician, or usual care with management changes plus cinnamon capsules, 500 mg twice daily (for a total of 1 g) for 90 days with food along with their normal medications. All subjects were categorized as having poorly controlled type 2 diabetes. There were 55 receiving treatment and 54 who acted as controls.

This trial tried to replicate the conditions typically found in primary care, where patients undergo medication changes, comorbid conditions, and dietary changes. Thus, wrote the researchers, “it was not an efficacy trial with every variable controlled. . . . Effectiveness trials such as this are critical in determining if the interventions that we recommend to patients are effective in the practical world in which patients live.”


Glycated hemoglobin is at the root of
diabetes and its complications affect
macro- and micro-vasculature, brain,
heart, kidneys, eye, and nerves.


In the recruitment process, participants were queried if they were currently using cinnamon in whatever amount and whatever forms, i.e., capsules, powder, syrup. Participants were told to continue taking their pretrial level of cinnamon intake. However, there were only 3 participants (2 in treatment and 1 in control) with high levels of supplementary cinnamon. Compliance was greater than 75% in the treatment group. Also important, neither participants nor investigators were blinded, but the true outcome assessor (in the laboratory) was blinded to who got what in the group allocation.

HbA1c was drawn at baseline and 90 days and compared with intention-to-treat analysis. There was no significant change in medication use—usual care typically involves doctor-made decisions—in either group during the intervention. And when “hierarchical analysis” was employed, comparing the effects of the primary physician being “faculty” versus “resident,” the difference was “0”; meaning that the experience level of the primary physician had no impact on HbA1c. An institutional review board had approved the study.

At the end point, cinnamon lowered HbA1c by 0.83% compared with usual care alone lowering HbA1c by 0.37%. This was clinically significant! It can be concluded that taking cinnamon can be useful for lowering serum HbA1c in type 2 diabetics with HbA1c >7.0, in addition to usual care.


At the end point, cinnamon lowered
HbA1c by 0.83% compared with usual
care alone lowering Hb
A1c by 0.37%.
This was clinically significant!


Strengths and Weaknesses of the Trial

The fact that the trial was an effectiveness trial—with described community clinical practice and measured outcomes that are important to diabetes care providers—strengthened the results. Efficacy trials are of value to identify whether an intervention works. However, without effectiveness data in the types of patients who will receive the intervention, it is difficult for clinicians to determine whether to incorporate it into their practice. The cinnamon used was off the shelf and not an extract, and no placebo was used because of the strong taste of the spice. Unfortunately, the absence of placebo weakened the study results.


In the United Kingdom Prospective
Diabetes Study, when HbA1c dropped
from 7.9% to 7% a number of risks
were lowered, including the risk of
macrovascular disease (by 16%),
retinopathy (by 17% to 21%), and
nephropathy (by 24% to 33%).


A meta-analysis of other trials done with cinnamon found that there were weaknesses with all of them.4 Nevertheless, the current trial may have shown benefit that earlier trials did not because this is the largest randomized cinnamon trial to date in type 2 diabetics, and because Dr. Crawford et al. studied only patients with poorly controlled type 2 diabetes. It is possible that because patients using insulin and with comorbid conditions were included, these circumstances may have potentiated the effect of cinnamon, but this is unlikely because the groups were quite similar. There is also the possibility that diabetics in the United States may have different characteristics than those in other countries.

A last word: In the United Kingdom Prospective Diabetes Study,5 when HbA1c dropped from 7.9% to 7% a number of risks were lowered, including the risk of macrovascular disease (by 16%), retinopathy (by 17% to 21%), and nephropathy (by 24% to 33%). Therefore, the 0.83% drop in HbA1c in the current study might be expected to live up to expectations of similar reductions in morbidity.


Among areas in the inner cities
where diabetes is prevalent,
it is often described casually as
“getting the sugar” or
having “the sweet blood.”


Cinnamon for Sweet Blood

Among areas in the inner cities where diabetes is prevalent, it is often described casually as “getting the sugar” or having “the sweet blood.” I remember my own father, softening the blow of his disease, by saying that he had “sugar.”

In ancient Rome, cinnamon was widely used by perfume merchants who were revered and given the same status as doctors, and Romans, enraptured by perfume, referred to their sweethearts as “my cinnamon,” in much the same way that we say “sweetie pie” and “honey” today. If the use of cinnamon for diabetes is as successful as the implications of the studies indicate—to mix metaphors—perhaps we will end up referring to those benefiting from the spicy remedy as “cinnamon bloods.”

References

  1. Brown C. The king herself. National Geographic Magazine, April 2009.
  2. Crawford P. Effectiveness of cinnamon for lowering hemoglobin A1C in patients with type 2 diabetes: a randomized, controlled trial. J Am Board Fam Med 2009 Sep-Oct;22(5):507-12.
  3. Anderson RA. Chromium and polyphenols from cinnamon improve insulin sensitivity. Proc Nutr Soc 2008 Feb;67(1):48-53.
  4. Baker WL, Gutierrez-Williams G, White CM, Kluger J, Coleman CI. Effect of cinnamon on glucose control and lipid parameters. Diabetes Care 2008;31:41–3.
  5. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998;352:837–53.


Will Block is the publisher and editorial director of Life Enhancement magazine.

Featured Product

  • Learn more about Chromium benefits and implementation strategies.

FREE Subscription

  • You're just getting started! We have published thousands of scientific health articles. Stay updated and maintain your health.

    It's free to your e-mail inbox and you can unsubscribe at any time.
    Loading Indicator