DOI QR코드

DOI QR Code

Effects of Cinnamon Supplementation on Lipid Profile: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Hawal Lateef Fateh (Nursing Department, Kalar Technical College, Garmian Polytechnic University) ;
  • Saman M. Amin (Garmian Health Directorate, Ministry of Health)
  • Received : 2023.11.11
  • Accepted : 2024.01.18
  • Published : 2024.01.31

Abstract

Since the effects of cinnamon supplementation on lipid profiles are still controversial, this study conducted a meta-analysis of randomized controlled trials to assess the effect of cinnamon supplementation on lipid profiles. The study was designed and conducted according to the guidelines of the 2020 preferred reporting items for systematic reviews and meta-analysis (PRISMA) statements. A systematic and comprehensive search was performed in several databases from inception up to 11 November 2023. The meta-analysis on the impact of Cinnamon on lipid profiles indicates a non-significant overall effect on low-density lipoprotein (weighted mean differences [WMD], -2.48; 95% confidence interval [CI], -9.70, 4.72). However, significant reductions are seen with doses < 500 mg/day (-10.26), and non-significant increases with doses ≥ 500 mg/day (1.18). The overall effect on high-density lipoprotein is non-significant (WMD, 3.97; 95% CI, -7.877, 15.831), showing varying responses at different doses. Triglycerides exhibit a significant overall reduction (WMD, -6.88; 95% CI, -12.62, -1.15), particularly in the < 500 mg/day group. The overall effect on cholesterol is non-significant (WMD, -4.314; 95% CI, -15.011, 6.384), with diverse responses at different doses. High heterogeneity underlines the importance of standardized study designs and further exploration of dosage-specific effects. Findings from this study suggest that cinnamon supplements might be beneficial to modulate the blood lipid profile.

Keywords

Acknowledgement

Thanks to reviewers for their valuable comments on this manuscript.

References

  1. Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study. J Am Coll Cardiol 2020;76:2982-3021. https://doi.org/10.1016/j.jacc.2020.11.010
  2. Ribeiro-Santos R, Andrade M, Madella D, Martinazzo AP, de Aquino Garcia Moura L, de Melo NR, Sanches-Silva A. Revisiting an ancient spice with medicinal purposes: Cinnamon. Trends Food Sci Technol 2017;62:154-69. https://doi.org/10.1016/j.tifs.2017.02.011
  3. Jamali N, Kazemi A, Saffari-Chaleshtori J, Samare-Najaf M, Mohammadi V, Clark CC. The effect of cinnamon supplementation on lipid profiles in patients with type 2 diabetes: a systematic review and meta-analysis of clinical trials. Complement Ther Med 2020;55:102571.
  4. Kirtikar KR, Basu BB. Indian medicinal plants. Dehra Dun: Bishen Singh Mahendra Pal Singh; 1975.
  5. Cao H, Urban JF Jr, Anderson RA. Cinnamon polyphenol extract affects immune responses by regulating anti- and proinflammatory and glucose transporter gene expression in mouse macrophages. J Nutr 2008;138:833-40. https://doi.org/10.1093/jn/138.5.833
  6. Vijayan KK. ATR. Pharmacology and toxicology of cinnamon and cassia. In: Ravindran PN, Nirmal-Babu K, Shylaja M, editors. Cinnamon and cassia: the genus Cinnamomum. Boca Raton (FL): CRC Press; 2005.
  7. Redd AM, Seo JH, Ryu SY, Kim YS, Kim YS, Min KR, Kim Y. Cinnamaldehyde and 2-methoxycinnamaldehyde as NF-kappaB inhibitors from Cinnamomum cassia. Planta Med 2004;70:823-7. https://doi.org/10.1055/s-2004-827230
  8. Wu SJ, Ng LT, Lin CC. Cinnamaldehyde-induced apoptosis in human PLC/PRF/5 cells through activation of the proapoptotic Bcl-2 family proteins and MAPK pathway. Life Sci 2005;77:938-51. https://doi.org/10.1016/j.lfs.2005.02.005
  9. Maierean SM, Serban MC, Sahebkar A, Ursoniu S, Serban A, Penson P, Banach M; Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. The effects of cinnamon supplementation on blood lipid concentrations: a systematic review and meta-analysis. J Clin Lipidol 2017;11:1393-406. https://doi.org/10.1016/j.jacl.2017.08.004
  10. Vafa M, Mohammadi F, Shidfar F, Sormaghi MS, Heidari I, Golestan B, Amiri F. Effects of cinnamon consumption on glycemic status, lipid profile and body composition in type 2 diabetic patients. Int J Prev Med 2012;3:531-6.
  11. Wu T, Huang W, He M, Yue R. Effects of cinnamon supplementation on lipid profiles among patients with metabolic syndrome and related disorders: a systematic review and meta-analysis. Complement Ther Clin Pract 2022;49:101625.
  12. Khan A, Safdar M, Ali Khan MM, Khattak KN, Anderson RA. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003;26:3215-8. https://doi.org/10.2337/diacare.26.12.3215
  13. Anderson RA, Broadhurst CL, Polansky MM, Schmidt WF, Khan A, Flanagan VP, Schoene NW, Graves DJ. Isolation and characterization of polyphenol type-A polymers from cinnamon with insulin-like biological activity. J Agric Food Chem 2004;52:65-70. https://doi.org/10.1021/jf034916b
  14. Solomon TP, Blannin AK. Effects of short-term cinnamon ingestion on in vivo glucose tolerance. Diabetes Obes Metab 2007;9:895-901.
  15. Wang JG, Anderson RA, Graham GM 3rd, Chu MC, Sauer MV, Guarnaccia MM, Lobo RA. The effect of cinnamon extract on insulin resistance parameters in polycystic ovary syndrome: a pilot study. Fertil Steril 2007;88:240-3. https://doi.org/10.1016/j.fertnstert.2006.11.082
  16. Anderson RA, Zhan Z, Luo R, Guo X, Guo Q, Zhou J, Kong J, Davis PA, Stoecker BJ. Cinnamon extract lowers glucose, insulin and cholesterol in people with elevated serum glucose. J Tradit Complement Med 2015;6:332-6. https://doi.org/10.1016/j.jtcme.2015.03.005
  17. Hlebowicz J, Darwiche G, Bjorgell O, Almer LO. Effect of cinnamon on postprandial blood glucose, gastric emptying, and satiety in healthy subjects. Am J Clin Nutr 2007;85:1552-6. https://doi.org/10.1093/ajcn/85.6.1552
  18. Crawford P. Effectiveness of cinnamon for lowering hemoglobin A1C in patients with type 2 diabetes: a randomized, controlled trial. J Am Board Fam Med 2009;22:507-12. https://doi.org/10.3122/jabfm.2009.05.080093
  19. Ziegenfuss TN, Hofheins JE, Mendel RW, Landis J, Anderson RA. 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. https://doi.org/10.1186/1550-2783-3-2-45
  20. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T. Cochrane handbook for systematic reviews of interventions version 6.3 (updated February 2022). Hoboken (NJ): John Wiley & Sons; 2022.
  21. Shishehbor F, Rezaeyan Safar M, Rajaei E, Haghighizadeh MH. Cinnamon consumption improves clinical symptoms and inflammatory markers in women with rheumatoid arthritis. J Am Coll Nutr 2018;37:1-6. https://doi.org/10.1080/07315724.2017.1392765
  22. Wickenberg J, Lindstedt S, Nilsson J, Hlebowicz J. Cassia cinnamon does not change the insulin sensitivity or the liver enzymes in subjects with impaired glucose tolerance. Nutr J 2014;13:96.
  23. 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;34:143-8. https://doi.org/10.1016/j.nutres.2013.11.005
  24. Farooq F, Hussain Z, Hanief MI, Fida Z. Safety and efficacy of cinnamomum zeylanicum Blume in nonalcoholic fatty liver disease: a single-blind randomized standard controlled trial. World J Pharm Res 2023;12:540-56.
  25. Gupta Jain S, Puri S, Misra A, Gulati S, Mani K. Effect of oral cinnamon intervention on metabolic profile and body composition of Asian Indians with metabolic syndrome: a randomized double -blind control trial. Lipids Health Dis 2017;16:113.
  26. Zare R, Nadjarzadeh A, Zarshenas MM, Shams M, Heydari M. Efficacy of cinnamon in patients with type II diabetes mellitus: a randomized controlled clinical trial. Clin Nutr 2019;38:549-56. https://doi.org/10.1016/j.clnu.2018.03.003
  27. Fateh HL, Muhammad SS, Kamari N. Associations between adherence to MIND diet and general obesity and lipid profile: a cross-sectional study. Front Nutr 2023;10:1078961.
  28. Gaggini M, Gorini F, Vassalle C. Lipids in atherosclerosis: pathophysiology and the role of calculated lipid indices in assessing cardiovascular risk in patients with hyperlipidemia. Int J Mol Sci 2022;24:75.
  29. 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;4:685-93. https://doi.org/10.1177/193229681000400324
  30. Sarmadi B, Musazadeh V, Dehghan P, Karimi E. The effect of cinnamon consumption on lipid profile, oxidative stress, and inflammation biomarkers in adults: An umbrella meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 2023;33:1821-35. https://doi.org/10.1016/j.numecd.2023.03.010
  31. Allen RW, Schwartzman E, Baker WL, Coleman CI, Phung OJ. Cinnamon use in type 2 diabetes: an updated systematic review and meta-analysis. Ann Fam Med 2013;11:452-9. https://doi.org/10.1370/afm.1517
  32. Miah MA, Himel MH, Sujan KM, Mustari A, Haque MI. Protective effects of cinnamon powder against hyperlipidemia and hepatotoxicity in butter fed female albino mice. Saudi J Biol Sci 2022;29:3069-74. https://doi.org/10.1016/j.sjbs.2022.01.047
  33. Hajimonfarednejad M, Nimrouzi M, Heydari M, Zarshenas MM, Raee MJ, Jahromi BN. Insulin resistance improvement by cinnamon powder in polycystic ovary syndrome: a randomized double-blind placebo controlled clinical trial. Phytother Res 2018;32:276-83. https://doi.org/10.1002/ptr.5970