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Moreira FD, Reis CEG, Gallassi AD, Moreira DC, Welker AF. Suppression of the postprandial hyperglycemia in patients with type 2 diabetes by a raw medicinal herb powder is weakened when consumed in ordinary hard gelatin capsules: A randomized crossover clinical trial. PLoS One 2024; 19:e0311501. [PMID: 39383145 PMCID: PMC11463819 DOI: 10.1371/journal.pone.0311501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 09/16/2024] [Indexed: 10/11/2024] Open
Abstract
INTRODUCTION Contradictory claims about the efficacy of several medicinal plants to promote glycemic control in patients with type 2 diabetes mellitus (T2DM) have been explained by divergences in the administration form and by extrapolation of data obtained from healthy individuals. It is not known whether the antidiabetic effects of traditional herbal medicines are influenced by gelatin capsules. This randomized crossover trial aimed to evaluate the acute effect of a single dose of raw cinnamon consumed orally either dissolved in water as a beverage or as ordinary hard gelatin capsules on postprandial hyperglycemia (>140 mg/dL; >7.8 mmol/L) in T2DM patients elicited by a nutritionally-balanced meal providing 50 g of complex carbohydrates. METHODS Fasting T2DM patients (n = 19) randomly ingested a standardized meal in five experimental sessions, one alone (Control) and the other after prior intake of 3 or 6 g of crude cinnamon in the form of hard gelatin capsules or powder dissolved in water. Blood glucose was measured at fasting and at 0.25, 0.5, 0.75, 1, 1.5 and 2 hours postprandially. After each breakfast, its palatability scores for visual appeal, smell and pleasantness of taste were assessed, as well as the taste intensity sweetness, saltiness, bitterness, sourness and creaminess. RESULTS The intake of raw cinnamon dissolved in water, independently of the dose, decreased the meal-induced large glucose spike (peak-rise of +87 mg/dL and Δ1-hour glycemia of +79 mg/dL) and the hyperglycemic blood glucose peak. When cinnamon was taken as capsules, these anti-hyperglycemic effects were lost or significantly diminished. Raw cinnamon intake did not change time-to-peak or the 2-h post-meal glycaemia, but flattened the glycemic curve (lower iAUC) without changing the shape that is typical of T2DM patients. CONCLUSIONS This cinnamon's antihyperglycemic action confirms its acarbose-like property to inhibit the activities of the carbohydrate-digesting enzymes α-amylases/α-glucosidases, which is in accordance with its exceptionally high content of raw insoluble fiber. The efficacy of using raw cinnamon as a diabetes treatment strategy seems to require its intake at a specific time before/concomitantly the main hyperglycemic daily meals. Trial registration: Registro Brasileiro de Ensaios Clínicos (ReBEC), number RBR-98tx28b.
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Affiliation(s)
- Fernanda Duarte Moreira
- Ministério da Saúde, Brasília, Brazil
- Secretaria de Estado de Saúde do Distrito Federal, Brasília, Brazil
- Programa de Pós-Graduação em Ciências e Tecnologias em Saúde, Universidade de Brasília, Brasília, Brazil
| | | | - Andrea Donatti Gallassi
- Programa de Pós-Graduação em Ciências e Tecnologias em Saúde, Universidade de Brasília, Brasília, Brazil
| | | | - Alexis Fonseca Welker
- Programa de Pós-Graduação em Ciências e Tecnologias em Saúde, Universidade de Brasília, Brasília, Brazil
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Bakhach H, Nuffer M, Tall Bull S, Nuffer W. A Systematic Review Evaluating Cinnamon's Effects on Glucose Utilizing a Ranking System to Assess Bias and Study Quality. J Med Food 2024; 27:814-823. [PMID: 38466959 DOI: 10.1089/jmf.2023.0277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
In the context of diabetes, the use of cinnamon continues to be among the most popular supplements taken by patients for glucose control. To strategically evaluate the available literature comparing various cinnamon species and statistically significant glucose effects after ranking studies based on two tools to assess bias and overall study quality, to clarify cinnamon's role in glucose control. The authors performed a systematic search based upon PRISMA guidelines. The search was conducted utilizing PubMed, AMED, CINAHL, EMBASE, Cochrane, and Medline databases, with the final search performed in September 2022 with restrictions to human subjects and English language. Electronic searches were conducted utilizing the keywords "diabetes mellitus" combined with Cinnamomum zeylanicum/Cinnamomum cassia/Cinnamomum verum combined with blood glucose (BG). A second search utilized "cinnamomum zeylanicum/cinnamomum cassia/cinnamomum verum" combined with "blood glucose," and a final search utilized "diabetes mellitus" combined with "cinnamon." Data extraction and ranking of included studies utilizing the risk of bias 2 tool and modified Heyland Methodological Quality Scoring tool were performed independently by two review authors. These authors compared their results and reconciled any differences in scoring to generate a final ranking of studies. A third author was available for any discrepancies that could not be resolved but was not needed. Forty-five studies were included in the review and were scored for bias and quality. Overall 62% demonstrated statistical significance for positive effects in at least one parameter around BG control. Applying the ranking systems reduced the percentage closer to 50%. Safety was extremely well documented across studies with few adverse effects. Results are limited by heterogeneity of glucose parameters, leading to studies being ranked individually and not synthesized. Cinnamon supplementation likely has a modest positive effect on BG. Based upon the strong safety profile, utilization of this spice as an adjunct to pharmacologic therapy is reasonable.
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Affiliation(s)
- Hebat Bakhach
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA
| | - Monika Nuffer
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA
| | - Shasta Tall Bull
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA
| | - Wesley Nuffer
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA
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Moreira LDSG, Brum IDSDC, de Vargas Reis DCM, Trugilho L, Chermut TR, Esgalhado M, Cardozo LFMF, Stenvinkel P, Shiels PG, Mafra D. Cinnamon: an aromatic condiment applicable to chronic kidney disease. Kidney Res Clin Pract 2023; 42:4-26. [PMID: 36747357 PMCID: PMC9902738 DOI: 10.23876/j.krcp.22.111] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/14/2022] [Indexed: 02/01/2023] Open
Abstract
Cinnamon, a member of the Lauraceae family, has been widely used as a spice and traditional herbal medicine for centuries and has shown beneficial effects in cardiovascular disease, obesity, and diabetes. However, its effectiveness as a therapeutic intervention for chronic kidney disease (CKD) remains unproven. The bioactive compounds within cinnamon, such as cinnamaldehyde, cinnamic acid, and cinnamate, can mitigate oxidative stress, inflammation, hyperglycemia, gut dysbiosis, and dyslipidemia, which are common complications in patients with CKD. In this narrative review, we assess the mechanisms by which cinnamon may alleviate complications observed in CKD and the possible role of this spice as an additional nutritional strategy for this patient group.
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Affiliation(s)
| | | | | | - Liana Trugilho
- Graduate Program in Medical Sciences, Fluminense Federal University, Niterói, Brazil
| | - Tuany R. Chermut
- Graduate Program in Nutrition Sciences, Fluminense Federal University, Niterói, Brazil
| | - Marta Esgalhado
- Graduate Program in Cardiovascular Sciences, Fluminense Federal University, Niterói, Brazil
| | | | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden,Correspondence: Peter Stenvinkel Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska University Hospital M99, 141 86 Stockholm, Sweden. E-mail:
| | - Paul G. Shiels
- Institute of Cancer Sciences, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Denise Mafra
- Graduate Program in Medical Sciences, Fluminense Federal University, Niterói, Brazil,Graduate Program in Nutrition Sciences, Fluminense Federal University, Niterói, Brazil,Graduate Program in Biological Sciences – Physiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Woźniak-Budych M, Bajek A, Kowalczyk O, Giamberini M, Montornes JM, Staszak K, Tylkowski B. The Pragmatism of Polyphenols and Flavonoids Application as Drugs, from an Academic Lab to a Pharmacy Shelf. Curr Pharm Des 2023; 29:3421-3427. [PMID: 38083888 DOI: 10.2174/0113816128273103231204064507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/26/2023] [Indexed: 01/26/2024]
Abstract
Polyphenols and flavonoids, naturally occurring compounds found abundantly in plants, have gained considerable attention in recent years due to their potential health benefits. Research exploring their bioactive properties has revealed promising therapeutic applications in various diseases. This article aims to provide a comprehensive overview of the intricate journey from academic laboratory discoveries to the availability of polyphenols and flavonoids as drugs on pharmacy shelves. It was shown that the transformation of these natural compounds into effective therapies is a promising avenue for enhancing human health. Yet, fully realizing this potential necessitates sustained scientific exploration, cross-disciplinary collaboration, and continued investment in research and development. This article underscores the importance of sustained collaboration and investment as key pillars of progress towards innovative and effective therapies.
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Affiliation(s)
| | - Anna Bajek
- Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | - Oliwia Kowalczyk
- Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | - Marta Giamberini
- Departament d' Enginyeria Química, Universitat Rovira i Virgili, Tarragona, Spain
| | - Josep M Montornes
- Unitat de Tecnologia Química, Eurecat - Centre Tecnològic de Catalunya, Tarragona, Spain
| | - Katarzyna Staszak
- Institute of Technology and Chemical Engineering, Poznan University of Technology, Poznan, Poland
| | - Bartosz Tylkowski
- Unitat de Tecnologia Química, Eurecat - Centre Tecnològic de Catalunya, Tarragona, Spain
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Ong YQ, Harith S, Shahril MR, Shahidan N, Hapidin H. Acute effect of Melon Manis Terengganu peel powder on glycemic response, perceived satiety, and food intake: a randomized, placebo-controlled crossover trial in adults at risk of type 2 diabetes. BMC Nutr 2022; 8:75. [PMID: 35941609 PMCID: PMC9358903 DOI: 10.1186/s40795-022-00572-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Melon Manis Terengganu (MMT) peel has a high dietary fiber content, but there is no data examining its health benefits in adults at risk of type 2 diabetes. The objective of the study was to evaluate whether consumption of MMT peel powder improves glycemic response, satiety, and food intake in adults at risk of type 2 diabetes. METHODS An open-label, randomized, placebo-controlled, crossover design trial was conducted among adults (n = 30, ages 18-59 y) at risk of type 2 diabetes. They consumed Formulation 3 (formulated MMT peel powder) [A] and control (glucose) [B] with study breakfast based on randomly assigned treatment sequences (AB, BA) established by Research Randomizer ( www.randomizer.org ). Capillary blood glucose and perceived satiety were determined at baseline (0 min), 30, 60, 90 and 120 min, followed by a post-intervention food intake measurement. RESULTS The repeated measures analysis of variance (ANOVA) revealed significant time (F = 84.37, p < 0.001, ηp2 = 0.744), condition (F = 22.89, p < 0.001, ηp2 = 0.441), and time*condition effects (F = 24.40, p < 0.001, ηp2 = 0.457) in blood glucose levels. Respondents (n = 30) who consumed Formulation 3 also had a significantly lower blood glucose 2-hour incremental area under the curve (iAUC) of 134.65 ± 44.51 mmol/L*min and maximum concentration (CMax) of 7.20 (7.10, 8.20) mmol/L with relative reduction of 26.8 and 13.3% respectively, when compared with control (p < 0.001). Besides, significantly greater perceived satiety, lower energy and fat intake as well as higher dietary fiber intake were also observed in the intervention group compared with the placebo group (p < 0.05). There were no marked side effects associated with the ingestion of the test products. CONCLUSIONS Short-term consumption of formulated MMT peel powder may improve glycemic response, increase perceived satiety and reduce food intake in adults at risk of type 2 diabetes with the potential to be utilized as a functional beverage. Medium-to long-term clinical trial is warranted to determine whether taking this formulated MMT peel powder on a daily basis has an influence on health outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05298111. Registered 28/03/2022.
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Affiliation(s)
- Ying Qian Ong
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, 21300, Kuala Nerus, Terengganu, Malaysia
| | - Sakinah Harith
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, 21300, Kuala Nerus, Terengganu, Malaysia.
| | - Mohd Razif Shahril
- Nutrition Program, Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Norshazila Shahidan
- Faculty of Bioresources and Food Industry, Universiti Sultan Zainal Abidin, Tembila Campus, 22200, Besut, Terengganu, Malaysia
| | - Hermizi Hapidin
- Biomedicine Programme, School of Health Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
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