Cinnamon hope for heart

New Delhi, June 23: Three grams of hand-powdered cinnamon a day may help reverse metabolic syndrome, a state of health that raises the risk of heart disease, diabetes and strokes, medical researchers said today.

A clinical trial in India has shown improvements in blood pressure, fasting blood sugar, cholesterol, triglycerides and high-density lipoprotein (HDL) or the "good" cholesterol after four months of this daily cinnamon intake.

A team of doctors and nutrition scientists at the Fortis Centre for Diabetes Obesity and Cholesterol (C-DOC), New Delhi, has offered the cinnamon option to patients with metabolic syndrome and people at risk of diabetes or heart disease - but not those already being treated for diabetes.

Metabolic syndrome is a clinical state marked by abnormal measurements of three of five health parameters: blood pressure, blood glucose, cholesterol, triglycerides and waist circumference.

"Cinnamon is a commonly used spice in India and there have been suggestions in the past that it has medical benefits - but not with the rigorous scientific evidence needed to back claims," said Anoop Misra, a C-DOC director and lead investigator of the trial.

The findings have just been published in the journal Lipids in Health and Disease.

Misra and his colleagues carried out the trial following multiple hints from earlier studies, including a landmark trial from Pakistan over 14 year ago, that cinnamon may help combat metabolic syndrome.

In 2003, Mahpara Safdar, a human nutrition scientist at the University of Agriculture in Peshawar, and her colleagues had shown that cinnamon could reduce blood glucose, triglycerides and cholesterol in diabetes patients.

They found that three doses of cinnamon - 1 gram, 3 grams and 6 grams a day -- had similar effects on these biochemical measurements after 40 days of treatment.

Now, the C-DOC researchers have conducted the first double-blind placebo-controlled trial with cinnamon in patients with metabolic syndrome. Such trials, where neither the researchers nor the patients know who received the drug and who the placebo, are the most rigorous way of evaluating a drug's effectiveness.

The researchers divided 116 patients with metabolic syndrome into two groups. Members of one of the groups received 3 grams cinnamon a day: two capsules of 500mg each after breakfast, lunch and dinner.

The other group was offered placebo capsules: of whole wheat powdered and roasted with cinnamon flavour to make it indistinguishable in taste from real cinnamon.

Those patients who received cinnamon showed significantly improved reductions in fasting blood glucose, total cholesterol, triglycerides and low-density lipoprotein (LDL) or "bad" cholesterol compared with those who received the placebo capsules. ( See chart)

The first group also showed a 6 per cent rise in HDL.

"This is a bit of a surprise. There is no pharmacological therapy known that increases HDL - nothing except exercise," Misra said.

Seema Puri, an associate professor of nutrition at the Institute of Home Economics, New Delhi, and a co-author of the study, said: "The significance of these results lies in the robust scientific design of the study with a simple dietary intervention."

Puri said the findings would justify recommending 2 grams of cinnamon (lowering the amount from 3 grams to accommodate fears of possible side-effects) - about a level teaspoonful of powdered cinnamon - per day to patients with metabolic syndrome.

"It should be hand-powdered cinnamon: grinding it in an electric mixer would heat it and weaken the effects of its ingredients," Puri said.

She said one needn't gulp down the powdered cinnamon off a spoon - it could be sprinkled on food (but not hot meals) such as curd, cold milk or porridge and eaten.

The scientists believe that cinnamon's ingredients stimulate the release and activity of insulin and decrease glucose production by the liver.

They have, however, cautioned that while their results are promising, they need follow-up studies on much larger samples of patients over longer periods of time.

"Long-term studies will be critical," Safdar, who is now at the Allama Iqbal Open University, Islamabad, told The Telegraph over the phone.

"We need to rule out the possibility of any side-effects associated with cinnamon, particularly on the liver," she said.

Cinnamon, the inner bark of the cinnamon tree, has been used as a spice for centuries in a dry form --- as sticks or as a powder. But the Pakistani study kicked off its marketing as an anti-diabetic food supplement in many countries, stirring concern among health agencies about possible side-effects of its long-term use.

Germany's Federal Institute for Risk Assessment said in 2006 that there was "no toxicological data on the long-term daily administration of high levels of cinnamon".

It recommended that cinnamon products to reduce blood sugar be viewed as "medical products" --- subject to a rigorous approval process by the drug regulator ---- rather than food supplements.

"We're not recommending the daily cinnamon to pregnant women, nor to patients already diagnosed with diabetes who are on medical therapy," said Seema Gulati, a nutritionist who was part of the study team.

"We tested it only in a group of people at risk of developing diabetes and other health disorders."