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The effects of cinnamon supplementation on blood lipid concentrations: A systematic review and meta-analysis

Published:August 11, 2017DOI:https://doi.org/10.1016/j.jacl.2017.08.004

      Highlights

      • Cinnamon supplementation reduced total plasma cholesterol and triglycerides.
      • Effect is correlated with duration of treatment, but not with dose administered.
      • High-density lipoprotein was also significantly increased after removing 1 study from the analysis.

      Background

      Cinnamon is a rich botanical source of polyphenols, whose positive effects on blood lipid concentrations have been hypothesized, but have not been conclusively studied.

      Objective

      The objective of the study was to systematically review and evaluate the effect of administration of cinnamon on blood lipid concentrations.

      Methods

      We assessed 13 randomized controlled trials with 750 participants investigating the effect of cinnamon supplementation on blood lipid concentrations. A meta-analysis was performed using random effect models, with weighted mean differences (WMDs; with 95% confidence interval [CI]) for endpoints calculated using a random effects model.

      Results

      No statistically significant effect of cinnamon was observed on blood low-density lipoprotein cholesterol (LDL-C; WMD: −0.16 mmol/L [−6.19 mg/dL], 95% CI: −0.35, 0.03 [−13.53, 1.16], P = .10) and high-density lipoprotein cholesterol (HDL-C; WMD: 0.05 mmol/L [1.92 mg/dL], 95% CI: −0.03, 0.12 [−0.03, 4.64], P = .21) concentrations. However, a statistically significant reduction in blood triglycerides (WMD: −0.27 mmol/L [−23.91 mg/dL], 95% CI: −0.39, −0.14 [−34.54, −12.40], P < .01) and total cholesterol concentrations (WMD: −0.36 mmol/L [−13.92 mg/dL], 95% CI: −0.63, −0.09 [−24.36, −3.48], P < .01) was observed. HDL-C was significantly elevated after the omission of 1 study (WMD: 0.04 mmol/L [1.54 mg/dL], 95% CI: 0.03, 0.06 [1.16, 2.32], P < .01) during our sensitivity analysis. A meta-regression analysis was conducted, and no significant association was found between changes in lipid parameters and cinnamon dose. In contrast, changes in blood levels of total cholesterol (slope: 0.09; 95% CI: 0.02, 0.16; P < .01), LDL-C (slope: 0.05; 95% CI: 0.001, 0.10; P = .05) and triglycerides (slope: 0.06; 95% CI: 0.04, 0.09; P < .01) were significantly and positively associated with the duration of supplementation. No statistically significant association was found between blood HDL-C changes and duration of supplementation.

      Conclusion

      Cinnamon supplementation significantly reduced blood triglycerides and total cholesterol concentrations without any significant effect on LDL-C and HDL-C.

      Keywords

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      References

        • Chait A.
        • Eckel R.H.
        Lipids, lipoproteins, and cardiovascular disease: clinical pharmacology now and in the future.
        J Clin Endocrinol Metab. 2016; 101: 804-814
        • Cicero A.F.
        • Tartagni E.
        • Ertek S.
        Nutraceuticals for metabolic syndrome management: from laboratory to benchside.
        Curr Vasc Pharmacol. 2014; 12: 565-571
        • Pirro M.
        • Mannarino M.R.
        • Bianconi V.
        • et al.
        The effects of a nutraceutical combination on plasma lipids and glucose: a systematic review and meta-analysis of randomized controlled trials.
        Pharmacol Res. 2016; 110: 76-88
        • Food and Drug Administration
        Withdrawal of approval of indications related to the coadministration with statins in applications for niacin extended-release tablets and fenofibric acid delayed-release capsules.
        Fed Regist. 2016; (FDA Notice No. 2016-08887, effective date: 04/18/2016, pp. 22612-22613)
        • Ranasinghe P.
        • Pigera S.
        • Premakumara G.A.
        • et al.
        Medicinal properties of 'true' cinnamon (Cinnamomum zeylanicum): a systematic review.
        BMC Complement Altern Med. 2013; 13: 275
        • Ranasinghe P.
        • Galappaththy P.
        Health benefits of Ceylon cinnamon (Cinnamomum zeylanicum): a summary of the current evidence.
        Ceylon Med J. 2016; 61: 1-5
        • Kumar K.
        • Issac A.
        • Ninan E.
        • Kuttan R.
        • Maliakel B.
        Enhanced anti-diabetic activity of polyphenol-rich de-coumarinated extracts of Cinnamomum cassia.
        J Funct Foods. 2014; 10: 10
        • Kawatra P.
        • Rajagopalan R.
        Cinnamon: mystic powers of a minute ingredient.
        Pharmacognosy Res. 2015; 7: S1-S6
        • Archer A.W.
        Determination of cinnamaldehyde, coumarin and cinnamyl alcohol in cinnamon and cassia by high-performance liquid chromatography.
        J Chromatogr. 1988; 447: 5
        • Gruenwald J.
        • Freder J.
        • Armbruester N.
        Cinnamon and health.
        Crit Rev Food Sci Nutr. 2010; 50: 822-834
        • Jayaprakasha G.K.
        • Rao L.J.
        Chemistry, biogenesis, and biological activities of Cinnamomum zeylanicum.
        Crit Rev Food Sci Nutr. 2011; 51: 547-562
        • Medagama A.B.
        The glycaemic outcomes of Cinnamon, a review of the experimental evidence and clinical trials.
        Nutr J. 2015; 14: 108
      1. Higgins JPT and Green S, (Eds.), Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available at: http://handbook.cochrane.org.

        • Borenstein M.
        • Hedges L.
        • Higgins J.
        • Rothstein H.
        Comprehensive Meta-Analysis, Version 2.
        Biostat, Englewood, NJ2005 (104)
        • Akilen R.
        • Tsiami A.
        • Devendra D.
        • Robinson N.
        Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial.
        Diabet Med. 2010; 27: 1159-1167
        • Anderson R.A.
        • Zhan Z.
        • Luo R.
        • et al.
        Cinnamon extract lowers glucose, insulin and cholesterol in people with elevated serum glucose.
        J Tradit Complement Med. 2015; 30: 5
        • Askari F.
        • Rashidkhani B.
        • Hekmatdoost A.
        Cinnamon may have therapeutic benefits on lipid profile, liver enzymes, insulin resistance, and high-sensitivity C-reactive protein in nonalcoholic fatty liver disease patients.
        Nutr Res. 2014; 34: 143-148
        • Blevins S.M.
        • Leyva M.J.
        • Brown J.
        • Wright J.
        • Scofield R.H.
        • Aston C.E.
        Effect of cinnamon on glucose and lipid levels in non insulin-dependent type 2 diabetes.
        Diabetes Care. 2007; 30: 2236-2237
        • Khan A.
        • Safdar M.
        • Ali Khan M.M.
        • Khattak K.N.
        • Anderson R.A.
        Cinnamon improves glucose and lipids of people with type 2 diabetes.
        Diabetes Care. 2003; 26: 3215-3218
        • Lu T.
        • Sheng H.
        • Wu J.
        • Cheng Y.
        • Zhu J.
        • Chen Y.
        Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes.
        Nutr Res. 2012; 32: 408-412
        • Mang B.
        • Wolters M.
        • Schmitt B.
        • et al.
        Effects of a cinnamon extract on blood glucose, HbA, and serum lipids in diabetes mellitus type 2.
        Eur J Clin Invest. 2006; 36: 340-344
        • Sengsuk C.
        • Sanguanwong S.
        • Tangvarasittichai O.
        • Tangvarasittichai S.
        Effect of cinnamon supplementation on glucose, lipids levels, glomerular filtration rate, and blood pressure of subjects with type 2 diabetes mellitus.
        Diabetol Int. 2015; 7: 124-132
        • Vafa M.
        • Mohammadi F.
        • Shidfar F.
        • et al.
        Effects of cinnamon consumption on glycemic status, lipid profile and body composition in type 2 diabetic patients.
        Int J Prev Med. 2012; 3: 531-536
        • Vanschoonbeek K.
        • Thomassen B.J.
        • Senden J.M.
        • Wodzig W.K.
        • van Loon L.J.
        Cinnamon supplementation does not improve glycemic control in postmenopausal type 2 diabetes patients.
        J Nutr. 2006; 136: 977-980
        • Wickenberg J.
        • Lindstedt S.
        • Berntorp K.
        • Nilsson J.
        • Hlebowicz J.
        Ceylon cinnamon does not affect postprandial blood glucose or insulin in subjects with impaired glucose tolerance.
        Br J Nutr. 2012; 107: 1845-1849
        • Zahmatkesh M.
        • Fallah Huseini H.
        • Hajiaghaee R.
        • Heidari M.
        • Mehrafarin A.
        • Tavakoli-Far B.
        The effects of Cinnamomum zeylancium on blood glucose level in patients with type 2 diabetes, a double-blind clinical trial.
        J Med Plants. 2012; 1: 6
        • Ziegenfuss T.N.
        • Hofheins J.E.
        • Mendel R.W.
        • Landis J.
        • Anderson R.A.
        Effects of a water-soluble cinnamon extract on body composition and features of the metabolic syndrome in pre-diabetic men and women.
        J Int Soc Sports Nutr. 2006; 3: 45-53
        • Banach M.
        • Rizzo M.
        • Toth P.P.
        • et al.
        Statin intolerance - an attempt at a unified definition. Position paper from an International Lipid Expert Panel.
        Arch Med Sci. 2015; 11: 1-23
        • Finegold J.A.
        • Manisty C.H.
        • Goldacre B.
        • Barron A.J.
        • Francis D.P.
        What proportion of symptomatic side effects in patients taking statins are genuinely caused by the drug? Systematic review of randomized placebo-controlled trials to aid individual patient choice.
        Eur J Prev Cardiol. 2014; 21: 464-474
        • Reith C.
        • Armitage J.
        Management of residual risk after statin therapy.
        Atherosclerosis. 2016; 245: 161-170
        • Mancini G.B.
        • Tashakkor A.Y.
        • Baker S.
        • et al.
        Diagnosis, prevention, and management of statin adverse effects and intolerance: Canadian Working Group Consensus update.
        Can J Cardiol. 2013; 29: 1553-1568
        • Banach M.
        • Aronow W.S.
        • Serban M.C.
        • Rysz J.
        • Voroneanu L.
        • Covic A.
        Lipids, blood pressure and kidney update 2015.
        Lipids Health Dis. 2015; 14: 167
        • Sahebkar A.
        • Serban M.C.
        • Gluba-Brzózka A.
        • et al.
        Lipid-modifying effects of nutraceuticals: an evidence-based approach.
        Nutrition. 2016; 32: 1179-1192
        • Serban M.C.
        • Sahebkar A.
        • Dragan S.
        • et al.
        A systematic review and meta-analysis of the impact of Spirulina supplementation on blood lipid concentrations.
        Clin Nutr. 2015; 35: 842-851
        • Ursoniu S.
        • Sahabkar A.
        • Serban M.C.
        • et al.
        Lipid profile and glucose changes after supplementation with astaxanthin: a systematic review and meta-analysis of randomized controlled trials.
        Arch Med Sci. 2015; 11: 253-266
        • Baker W.L.
        • Gutierrez-Williams G.
        • White C.M.
        • Kluger J.
        • Coleman C.I.
        Effect of cinnamon on glucose control and lipid parameters.
        Diabetes Care. 2008; 31: 41-43
        • Allen R.W.
        • Schwartzman E.
        • Baker W.L.
        • Coleman C.I.
        • Phung O.J.
        Cinnamon use in type 2 diabetes: an updated systematic review and meta-analysis.
        Ann Fam Med. 2013; 11: 452-459
        • Solomon T.P.
        • Blannin A.K.
        Effects of short-term cinnamon ingestion on in vivo glucose tolerance.
        Diabetes Obes Metab. 2007; 9: 895-901
        • Kim S.H.
        • Choung S.Y.
        Antihyperglycemic and antihyperlipidemic action of Cinnamomi Cassiae (Cinnamon bark) extract in C57BL/Ks db/db mice.
        Arch Pharm Res. 2010; 33: 325-333
        • Ranasinghe P.
        • Jayawardana R.
        • Galappaththy P.
        • Constantine G.R.
        • de Vas Gunawardana N.
        • Katulanda P.
        Efficacy and safety of 'true' cinnamon (Cinnamomum zeylanicum) as a pharmaceutical agent in diabetes: a systematic review and meta-analysis.
        Diabet Med. 2012; 29: 1480-1492
        • Konig B.
        • Koch A.
        • Spielmann J.
        • Hilgenfeld C.
        • Stangl G.I.
        • Eder K.
        Activation of PPARalpha lowers synthesis and concentration of cholesterol by reduction of nuclear SREBP-2.
        Biochem Pharmacol. 2007; 73: 574-585
        • Abraham K.
        • Wöhrlin F.
        • Lindtner O.
        • Heinemeyer G.
        • Lampen A.
        Toxicology and risk assessment of coumarin: focus on human data.
        Mol Nutr Food Res. 2010; 54: 228-239
        • Blahova J.
        • Svobodova Z.
        Assessment of coumarin levels in ground cinnamon available in the Czech retail market.
        ScientificWorldJournal. 2012; 2012: 263851
        • Brancheau D.
        • Patel B.
        • Zughaib M.
        Do cinnamon supplements cause acute hepatitis?.
        Am J Case Rep. 2015; 16: 250-254