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Cinnamon as a Complementary Therapeutic Approach for Dysglycemia and Dyslipidemia Control in Type 2 Diabetes Mellitus and Its Molecular Mechanism of Action: A Review.
Silva, ML, Bernardo, MA, Singh, J, de Mesquita, MF
Nutrients. 2022;14(13)
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Diabetes is a metabolic disorder resulting from defects in insulin secretion and/or action, leading to chronic hyperglycaemia, which has an adverse impact on health. The aim of this study was to provide an overview of the beneficial effects of cinnamon in exerting dysglycemia and dyslipidaemia control in type 2 diabetic patients and a summary of its mechanisms of action. This study is a narrative review of twenty-three articles. Results showed that: - in diabetic patients with dyslipidaemia, the lipid profile could be modulated with cinnamon supplementation as it seems to decrease serum triglycerides, total cholesterol and low-density lipoprotein levels. - cinnamon seems to exert beneficial and protective anti-inflammatory and antioxidant effects. - cinnamon seems to be effective as an antihyperlipidemic agent – through the regulation of lipid metabolism in enterocyte [a cell of the intestinal lining]. Authors conclude that targeted cinnamon-based therapy can provide an opportunity to modulate glucose and lipid dysregulation to avoid the progression of T2DM. Thus, future research studies should investigate the effect of cinnamon by employing a larger number of standardized randomized clinical trials to provide a comprehensive impact of cinnamon on diabetic patients.
Abstract
The scientific evidence that cinnamon may exert beneficial effects on type 2 diabetes mellitus due to the biological activity of its bioactive compounds has been increasing in recent years. This review provides an overview of the effects of cinnamon on clinical parameters of diabetes and summarizes the molecular mechanisms of action of cinnamon on glucose and lipid metabolism. Search criteria include an electronic search using PubMed, Medline, and Cochrane Library databases. English literature references from 2000 up to 2022 were included. Following title and abstract review, full articles that met the inclusion criteria were included. The results from the available evidence revealed that cinnamon improved glycemic and lipidemic indicators. Clinical trials clarified that cinnamon also possesses an anti-inflammatory effect, which may act beneficially in diabetes. Based on in vitro and in vivo studies, cinnamon seems to elicit the regulation of glucose metabolism in tissues by insulin-mimetic effect and enzyme activity improvement. Furthermore, cinnamon seems to decrease cholesterol and fatty acid absorption in the gut. The current literature search showed a considerable number of studies on diabetic subjects. Some limitations in comparing published data should be highlighted, including variability in doses, extracts and species of cinnamon, administration forms, and antidiabetic therapy.
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Safety of Cinnamon: An Umbrella Review of Meta-Analyses and Systematic Reviews of Randomized Clinical Trials.
Gu, DT, Tung, TH, Jiesisibieke, ZL, Chien, CW, Liu, WY
Frontiers in pharmacology. 2021;12:790901
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Cinnamon is a common spice that contains manganese, iron, dietary fibre, calcium, their derivatives, and other related compounds. Despite the several clinical benefits afforded by cinnamon, concerns about its safety persist. The aim of this study was to elucidate the safety of cinnamon which may facilitate a better understanding of the side effects of cinnamon among healthcare workers and policy makers. This study is an umbrella review of four systematic reviews and meta-analysis. Results show that there was no significant difference in adverse events between cinnamon and placebo. Furthermore, it has benefits in the treatment of a variety of diseases, such as type 2 diabetes and cancer. Authors conclude that cinnamon can be used as an adjunctive compound in clinical practice and appears safe in terms of side effects.
Abstract
Purpose: Many evidence-based studies have indicated that cinnamon has therapeutic effects. However, it may not be entirely safe and its adverse effects may be ignored. The present umbrella review was conducted to elucidate the safety of cinnamon. Methods: Pertinent meta-analyses and systematic reviews of randomized controlled trials on cinnamon use in humans were identified by searching PubMed, EMBASE, and the Cochrane Library from their inception to September 15, 2021. All meta-analyses and systematic reviews on the safety or adverse effects of cinnamon were considered. PRISMA 2020 was used as the standard of reporting (PRISMA registration ID: 286746). Results: We identified three meta-analyses and one systematic review that described the safety of cinnamon. The quality of the meta-analysis and systematic reviews was evaluated using "Assessing the Methodological Quality of Systematic Reviews." Their quality was rated as low in two (50%) instances and moderate in two (50%). There were no significant toxic- or side effects between cinnamon group and placebo group regardless of dose and duration. Conclusion: There is evidence to support that the use of cinnamon has no adverse reactions. It can improve the health status of patients as an adjuvant treatment. Future studies exploring better profile risks and protective factors for cinnamon use-related adverse effect are needed, in order that preventive approaches can be developed.
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The effect of cinnamon supplementation on liver enzymes in adults: A systematic review and meta-analysis of randomized controlled trials.
Shekarchizadeh-Esfahani, P, Heydarpour, F, Izadi, F, Jalili, C
Complementary therapies in medicine. 2021;58:102699
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Non-alcoholic fatty liver disease (NAFLD) is known to be the most prevalent hepatic disorder that is characterised by the accumulation of lipids within the hepatocytes exceeding 5% of the liver weight in the absence of excessive alcohol intake and secondary causes of liver diseases. Currently, the primary treatment for NAFLD is weight loss by lifestyle therapy involving diet and exercise. The aim of this study was to summarise the available evidence of randomised controlled trials to establish the effect of cinnamon supplementation on changes in liver enzymes among adults. This study is a meta-analysis of seven randomised controlled trials with nine treatment arms. In total, 266 participants were enrolled in selected articles, of which 133 individuals allocated to cinnamon supplementation group and 133 subjects to the control group. Results show that cinnamon cannot effectively reduce the liver enzymes - aspartate aminotransferase, alanine aminotransferase (ALT) and alkaline phosphatase levels. However, subgroup analyses showed that the effect of cinnamon supplementation on ALT levels was significant at dosages of <1500 mg/day, in trials lasting >12 weeks and in trials conducted of both genders. Authors conclude that due to limited availability of studies with NAFLD participants and relatively small sample sizes, well designed trials with adequate sample sizes aimed at NAFLD patients are recommended.
Abstract
AIMS: The aim of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effect of cinnamon supplementation on liver enzymes. METHODS A systematic search was performed in electronic databases including PubMed-Medline, Scopus, and ISI Web of Science up to November 2020. We used a random effects model to estimate pooled effect size of alanine aminotransferase (ALT), alkaline phosphatase (ALP), and aspartate aminotransferase (AST) levels. RESULTS Seven RCTs (9 treatment arms) fulfilled the eligibility criteria of the present meta-analysis. Overall, meta-analysis could not show any beneficial effect of cinnamon supplementation on AST, ALT, and ALP. Subgroup analyses showed that the effect of cinnamon supplementation on ALT was significant at the dosages of <1500 mg/day (Hedges's: -0.61; 95 % CI: -1.11, -0.10; P = 0.002), in trials lasting>12 weeks (Hedges's: -0.83; 95 % CI: -1.36, -0.30; P = 0.01), and in trials conducted of both gender (Hedges's: -0.72; 95 % CI: -1.45, -0.01; P = 0.04). CONCLUSION In summary, cinnamon supplementation had no significant effect on liver enzymes in adults. However, the effect of cinnamon on ALT levels was significant at the dosages of <1500 mg/day, in trials lasting>12 weeks, and in trials conducted of both gender. Nevertheless, further studies should be performed to confirm our results.
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Spices and Atherosclerosis.
Tsui, PF, Lin, CS, Ho, LJ, Lai, JH
Nutrients. 2018;10(11)
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Cardiovascular disease (CVD) is one of the leading causes of death and disability in the world. Atherosclerosis, characterised by the accumulation of fat and inflammation in blood vessels, is the main feature of CVD. Common spices such as pepper, ginger, garlic, onion, cinnamon and chilli may have effects on the initiation and development of atherosclerosis. In this review, the authors focused on the potential protective effects of spices, in atherosclerosis and CVD. Most studies to date have been carried out either in cell culture or in animals. These have revealed various potential mechanisms by which spices exert their beneficial effects, including anti-oxidant, anti-atherogenic, anti-coagulant, anti-inflammatory and cholesterol-lowering properties. There are some human studies evaluating the effects of spices on high blood pressure. Although saffron, turmeric, and chilli pepper had no effect on blood pressure, cinnamon demonstrated significant blood pressure lowering effects in patients with diabetes. Garlic has been shown to have the potential to reduce blood pressure in patients with high blood pressure. These studies provide information on the beneficial roles of spices in reducing cardiovascular risk factors. The types of spices consumed vary across cultures, and currently there are no available population studies showing that consumption of spices is associated with reduction of CVD nor any recommendations for the amounts of spices to be consumed. The authors conclude that the consumption of spices should be encouraged across countries to promote good health.
Abstract
Cardiovascular disease is one of the leading causes of death and disability in the world. Atherosclerosis, characterized by lipid accumulation and chronic inflammation in the vessel wall, is the main feature of cardiovascular disease. Although the amounts of fruits and vegetables present in the diets vary by country, diets, worldwide, contain large amounts of spices; this may have positive or negative effects on the initiation and development of atherosclerosis. In this review, we focused on the potential protective effects of specific nutrients from spices, such as pepper, ginger, garlic, onion, cinnamon and chili, in atherosclerosis and atherosclerotic cardiovascular disease. The mechanisms, epidemiological analysis, and clinical studies focusing on a variety of spices are covered in this review. Based on the integrated information, we aimed to raise specific recommendations for people with different dietary styles for the prevention of atherosclerotic cardiovascular disease through dietary habit adjustments.