Cinnamon

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Cinnamon is a spice used frequently across the world that exerts numerous biological effects in the body that can be seen as 'anti-diabetic'.

It reduces the rate glucose enters the body (thus avoiding spikes of blood sugar) and aids with the usage of glucose on the cell. Over time, it can reduce fasting blood glucose and potentially cholesterol levels as well.

It is a farily well researched compound that does not need to be bought as a supplement per se, but can be used as cinnamon from grocery stores.

It does possess a liver toxin, called coumarin, which can be harmful in high doses. Discussed below are methods to avoid excessive coumarin levels, of which includes ingesting Ceylon cinnamon (a species) that has low coumarin levels.

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Doses for diabetic effects range from 1-6g cinnamon daily, taken with carbohydrate containing meals. Some studies use more than this amount with no acute harms.

Ceylon cinnamon should always be preferentially used over Cassia due to Coumarin content.

Edit1. Cinnamon components and species

Cinnamon is a spice that contains several bioactive agents. Cinnamaldehydes give cinnamon its aroma^[1], Coumarins (a toxin) contribute to taste^[2], and several compounds including MethylHydroxyChalcone polymers (MHCPs) contribute to its systemic insulin sensitizing benefits.^[3] Beyond the three unique compounds listed, cinnamon also contains tannins, flavonoids, glycosides, terpenoids and anthraquinones.^[4]

Edit2. Cinnamon and blood sugar; anti-diabetic effects

Cinnamon exerts beneficial control effects against pro-diabetic diets in a number of ways.

Cinnamon can inhibit numerous digestive enzymes, such as alpha-glucosidase^[4], sucrase^[5] and potentially pancreatic amylase (although the only results were confounded with acarbose).^[5] Via inhibition of these enzymes, cinnamon can decrease the influx of glucose into systemic circulation and avoid overly significant insulin spikes.

In systemic circulation (beyond the liver) cinnamon also possesses anti-diabetic effects. A compound in cinnamon, methylhydroxychalcone polymer (MHCP), acts as an insulin mimetic on adipocytes.^[6][7][8] MHCP's effects as an insulin mimetic are dose depend, and act by transphosphorlyating the insulin receptor on the cytoplasmic membrance (the same mechanism as the insulin molecule itself). Its effects on glucose uptake and glycogen, however dose-dependent, seem to be time-delayed (When insulin acts within 10 minutes of reaching the cell, MHCPs take 30-60, suggesting an intra-cellular time delay).^[9]

Cinnamon has also been implicating in aiding insulin function, potentiating its effects more than 20-fold in vitro.^[10]

When ingested in human trials, cinnamon shows much promise in reducing blood glucose levels^[11][12][13] and sometimes markers of lipid metabolism (LDL, Triglycerides, Total cholesterol).^[14] There are also intervention studies noting improved insulin sensitivity with cinnamon extract, possibly vicariously through the reduced blood glucose levels.^[15][16]

Edit3. Dosing and Coumarin avoidance

Coumarin is a hepatotoxic and carcinogenic phytochemical found in some plants, of which cinnamon is a high source of. It is not the active compound that reduces blood sugar, but one that exists alongside the active ingredient(s). It initially had a TDI (Tolerable Daily Intake) of 2mg/kg bodyweight max, but was lowered to 0.5 and currently stands at 0.1mg/kg bodyweight.^[2] Although a safety buffer in included in this last recommendation, some subsets of the human population seem more susceptible due to less of a capacity to metabolize it.^[2]

This is relevant since most anti-diabetic benefits come in a dose dependent manner, in the range of 300mg/kg bodyweight^[5]. In these doses, coumarin above the TDI can easily be ingested.

The best method of coumarin avoidance appears to be through the original source of cinnamon. Ceylon cinnamon has the lowest levels of coumarin with below 190mg/kg (some samples being below detection levels) whereas Cassia contains between 700 (at best) and 12,230mg/kg (at worst).^[17]. Ceylon can be detected in stick form via its numerous thin folds, whereas Cassia has less folds and a thicker appearance. They cannot be distinguished in powder form, and Cassia is more frequently used in production and manufacturing.^[2][18]

Via the above numbers, a 200lb human can ingest 4.78g of Ceylon Cinnamon and arrive at the 0.1mg/kg bodyweight TDI for coumarin at worst (using the highest recorded dose of coumarin in cinnamon). Using Cassia cinnamon with a coumarin will invariably place somebody above the TDI.

There seems to be little variance on coumarin absorption depending on form of cinnamon ingested. Similar serum levels and excreted levels were achieved with isolated coumarin, pill form cinnamon, tea and rice pudding (solid food).^[19] These results were standardized to X dose of coumarin, so source of cinnamon is irrelevant.

The above study, however, did note a 38.5% extraction rate of coumarin from powder to liquid when steeped (just boiling for 30 minutes); suggesting that one can tip the scales more in favor of water-soluble polyphenols and MHCPs relative to coumarins if steeped and served in tea or using said cinnamon water to mix protein shakes with, as the water-soluble components have a much higher extraction rate.

References

1. Characterization of antioxidant and antimicrobial compounds of cinnamon and ginger essential oils
2. Abraham K, et al. Toxicology and risk assessment of coumarin: focus on human data. Mol Nutr Food Res. (2010)
3. A Hydroxychalcone Derived from Cinnamon Functions as a Mimetic for Insulin in 3T3-L1 Adipocytes
4. Mohamed Sham Shihabudeen H, Hansi Priscilla D, Thirumurugan K. Cinnamon extract inhibits α-glucosidase activity and dampens postprandial glucose excursion in diabetic rats. Nutr Metab (Lond). (2011)
5. Adisakwattana S, et al. Inhibitory activity of cinnamon bark species and their combination effect with acarbose against intestinal α-glucosidase and pancreatic α-amylase. Plant Foods Hum Nutr. (2011)
6. A Hydroxychalcone Derived from Cinnamon Functions as a Mimetic for Insulin in 3T3-L1 Adipocytes
7. Isolation and Characterization of Chalcone Polymers from Cinnamon with Insulin-Like Biological Activity
8. Imparl-Radosevich J, et al. Regulation of PTP-1 and insulin receptor kinase by fractions from cinnamon: implications for cinnamon regulation of insulin signalling. Horm Res. (1998)
9. A Hydroxychalcone Derived from Cinnamon Functions as a Mimetic for Insulin in 3T3-L1 Adipocytes
10. Broadhurst CL, Polansky MM, Anderson RA. Insulin-like biological activity of culinary and medicinal plant aqueous extracts in vitro. J Agric Food Chem. (2000)
11. Kirkham S, et al. The potential of cinnamon to reduce blood glucose levels in patients with type 2 diabetes and insulin resistance. Diabetes Obes Metab. (2009)
12. Pham AQ, Kourlas H, Pham DQ. Cinnamon supplementation in patients with type 2 diabetes mellitus. Pharmacotherapy. (2007)
13. Mang B, et al. Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest. (2006)
14. Khan A, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care. (2003)
15. Anderson RA. Chromium and polyphenols from cinnamon improve insulin sensitivity. Proc Nutr Soc. (2008)
16. Qin B, Panickar KS, Anderson RA. Cinnamon: potential role in the prevention of insulin resistance, metabolic syndrome, and type 2 diabetes. J Diabetes Sci Technol. (2010)
17. Solvent-assisted supercritical fluid extraction for the isolation of semivolatile flavor compounds from the cinnamons of commerce and their separation by series-coupled column gas chromatography
18. Woehrlin F, et al. Quantification of flavoring constituents in cinnamon: high variation of coumarin in cassia bark from the German retail market and in authentic samples from indonesia. J Agric Food Chem. (2010)
19. Abraham K, et al. Relative bioavailability of coumarin from cinnamon and cinnamon-containing foods compared to isolated coumarin: a four-way crossover study in human volunteers. Mol Nutr Food Res. (2011)

(Common misspellings for Cinnamon include cinamon, cinnamin, cinnomon, cinnomin, cinomin, cinamin, sinnamon, sinamon)

(Common phrases used by users for this page include recommended cinnamon daily intake, original source of cinnamon, cinnamon methylhydroxychalcone polymer supplement best for diabetes, cinnamon examine, cinnamon carcinogenic, MHCPs supplements)

(Users who contributed to this page include tiago, Sol, KurtisFrank, jgordos)