How Sweet It Is! Cinnamon, Spices and Diabetes

1. How Sweet It Is!Cinnamon, Spices and Diabetes Catherine M. Champagne, PhD, RD Pennington Biomedical Research Center

2. Focus of presentation: • Cinnamon • Health benefits of cinnamon • Research • A little is good, is more better? • How to incorporate cinnamon in your diet • Additional foods of interest (spices, herbs, other) • Summary

3. Cinnamon • Native to Sri Lanka • Dried inner bark of a variety of evergreen tree • In ancient times, more precious than gold • Stick or powdered

4. Benefits of cinnamon • Can decrease high fasting glucose by making body cells more sensitive to insulin • As little at ¼ teaspoon can reduce blood sugar significantly • Evidence that cinnamon slows digestion, which can affect the blood sugar rise after a meal • May also reduce: • heart rate • blood pressure • body temperature

5. 1 tsp cinnamon = 2.6 grams • Study of subjects taking 2-6 grams per day: • Nearly all with diabetes showed substantial improvement • Connection between cinnamon & diabetes was there because when cinnamon stopped, blood sugar levels began rising • So cinnamon can be regular part of lifestyle and with additional benefits: • Response to insulin more efficient • Contains polyphenols, powerful antioxidants • Anti-inflammatory and can help to prevent cancer

6. How much is too much? • May be dangerous if taken in large quantities over a long period of time • Some cinnamon (Chinese or cassia cinnamon) contains a compound, coumarin. In excess, this can harm the liver of sensitive people. It also may interact with blood thinners such as Coumadin (warfarin) to increase the risk of bleeding. • Two tablespoons of cinnamon daily is a very big dose. You should have your liver enzymes checked when you see your doctor. People who use cinnamon to help lower blood sugar take one-quarter to one-half of a teaspoon before meals. • Cassia cinnamon is not labeled with the amount of coumarin it contains, making it hard to know what dose one is getting. • Consuming ¼ - ½ teaspoons per day is not harmful

7. Adding cinnamon to your diet • Add a cinnamon stick to: • Tea • Coffee • Apple cider or juice • Cocoa • Sprinkle cinnamon on: • Oatmeal • Yogurt • Baked apples or applesauce • Toast (cinnamon toast) • Pudding

8. More recipes and information on cinnamon research • For additional recipes, make sure you get a handout with these. • And for more information about cinnamon, visit the following website: • http://care.diabetesjournals.org/cgi/content/full/26/12/3215 <-- has really good, understandable information.

9. Other spices and foods that have been studied for diabetes • Russian tarragon • Ginseng • Fenugreek seed • Gymnema sylvestre • Garlic • Nopal or prickly pear cactus • Ivy gourd • Aloe vera

10. Russian Tarragon(Artemisia dracunculus) • Common medicinal and culinary herb. • An extract, Tarralin, may work by blocking an enzyme which would improve insulin efficiency. • Studies in mice have been promising. • This is just beginning to be investigated in humans, so it cannot now be recommended….stay tuned!!!

11. Ginseng (Panaxquinquefolius or Panax ginseng) • Used in traditional Chinese medicine for thousands of years. • May have possible hypoglycemic effects: • Decreasing rate of carbohydrate absorption • Increasing blood sugar transport and storage • Increasing insulin secretion • Clinical trials with American ginseng but short term and few subjects.

12. Ginseng (Panaxquinquefolius) • Known side effects of large doses and long-term use • Diarrhea • Insomnia • Nervousness • Nausea and vomiting • Until longer-term studies are conducted, cannot firmly recommend its use at this time.

13. Fenugreek Seed(Trigonellafoenum-graecum) • Member of pea family. • Traditionally used in India to treat diabetes – insulin like effect. • Widely cultivated in other parts of the world for treatment of diabetes. • To date, trials with humans have been small and are inconclusive. • Common problems: • diarrhea and gas • may absorb oral medications • blood thinning potential

14. GymnemaSylvestre • Herb from tree native to Africa and India, long used to treat diabetes. • May improve blood sugar uptake in tissues, increase insulin secretion and increase the number of cells in the pancreas that make insulin. • Limited research on poorly controlled scientific studies make it hard to recommend this herb!!

15. Garlic (Alliumsativum) • Used as a medicinal herb for centuries. • Compounds in garlic (allicins) may increase secretion or slow degradation of insulin or improve glucose storage ability in the body. • For diabetes, there are few studies and findings are conflicting. • Safety not an issue, but jury is still out on the true benefits!!

16. Bitter melon (Momordicacharantia)aka “vegetable insulin” • Grows in tropical and subtropical climates (Asia, Africa, South America); widely used in folk medicine as a remedy for diabetes • Clinical trials have shown a moderate blood sugar-lowering effect. Small studies, perhaps dubious value • But… hard to find and bitter! May have gastrointestinal discomfort.

17. Nopal or Prickly Pear Cactus(Opuntiastreptacantha) • Commonly used by people of Mexican descent for glucose control. • Part of soups, salads, sandwiches and blended in drinks in traditional Mexican diet. • High pectin may regulate blood glucose. • May have potential, but longer-term clinical trials needed. • Some mild gastrointestinal upset, but appears to be well tolerated.

18. Ivy Gourd (Cocciniagrandis) • Used in India to treat diabetes, long history of use; has low glycemic index. • May mimic insulin and may suppress activity of enzymes in glucose production. • While some studies have been promising, they are few. • There is a need for more studies with more subjects before we can recommend supplementation.

19. Aloe Vera • Aloe juice widely used in India and on the Arabian peninsula to treat diabetes. • Contains a fiber that may drive down blood sugar and make cells more sensitive to insulin. • Do not take if you have any sort of intestinal condition (Crohn’s, ulcerative colitis, etc.). • More information needed before recommendations can be made (i.e., clinical trials with scientific integrity).

20. For more information…….

21. So what have we learned? • It’s all about science and finding the science to back up the claims. • What does it take? Long term studies, lots of subjects, strictly controlled. • Can we try any of these options presented? Sure, just make certain that the amounts consumed are not going to harm you in any way!! • Any other ideas? • Move to India, China, Africa, or somewhere else where these have been used traditionally to treat diabetes!!

22. MERCI BEAUCOUP