Cinnamon can no longer be considered a safe and effective treatment for diabetes.
Update on Cinnamon for Blood Sugar Control
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
The use of cinnamon to help treat diabetes remains controversial. We know that cinnamon is so good at controlling one’s blood sugar that you can cheat on a diabetes test by consuming two teaspoons of cinnamon the night before your glucose tolerance test. Basically, they make you drink some sugar water, and see how well your body can keep your blood sugar levels under control. And, if you eat those two teaspoons right when the test starts, or 12 hours before, you can significantly blunt the spike. A half teaspoon of cinnamon does not seem to be enough, but about a teaspoon a day does appear to make a significant difference. A review of the best studies done to date found that the intake of cinnamon by type 2 diabetics or prediabetics does lower their blood glucose significantly.
So, what’s the controversy? Well, as I described before, cassia cinnamon, also known as Chinese cinnamon—or probably what you’re getting at the store, if it just says cinnamon—contains a compound called coumarin, which may be toxic to the liver in high-enough doses.
Originally, the concern was mainly for kids during Christmas time, where they might get an above-average exposure. But, more recently, some researchers suggest that the kids just sprinkling some cassia cinnamon on their oatmeal a few times a week might exceed the recommended safety limit. The bold values here are above the recommended upper limit. For little kids, just a quarter-teaspoon of cinnamon a few times a week may be too much. And, if you’re eating that cinnamon sprinkled on oatmeal more than like every day, even adults can bump up against the limit. So, a teaspoon a day of cassia cinnamon might be too much for anyone.
But, no problem; just switch from cassia cinnamon to Ceylon cinnamon, and you can get the benefits without the potential risks—right? Well, without the risks, yes; but we’re not sure about the benefits.
Nearly all of the studies showing blood sugar benefits of cinnamon have been done on cassia. We’ve just assumed that the same would apply for the safer cinnamon, Ceylon. But, only recently was it put to the test. “Owing to the presence of [that] toxic [compound], the Federal Institute for Risk Assessment…in Europe has warned against consuming large amounts of” the cassia cinnamon—suggesting a switch from cassia cinnamon to Ceylon cinnamon (also known as true cinnamon). But we don’t know whether or not the true cinnamon had similar benefits, until now.
We saw that nice blunting of blood sugars in response to cassia cinnamon, but in response to Ceylon cinnamon—nothing. Bummer. In fact, they’re thinking maybe that potentially toxic coumarin stuff was the active ingredient in the cassia cinnamon all along. So, take out the toxin; you take out the benefit.
So, they conclude, yeah, it’s great that health authorities are recommending the switch. However, the positive effects seen with cassia could then be lost. So, should we just give up on going out of our way to add cinnamon to our diet? No, I think it’s still a good idea to shoot for about teaspoon of Ceylon cinnamon a day, since there’s a bunch of other benefits linked to cinnamon besides blood sugar control—not the least of which is its potent antioxidant content.
In fact, one of the cheapest food sources of antioxidants—beating out cloves, and coming in just under purple cabbage. But, cinnamon can no longer considered a safe and effective treatment for diabetes. Either you’re using cassia cinnamon, and it’s effective, but may not be safe; or you’re using Ceylon cinnamon, which is safe, but does not appear effective.
But look, even the cassia cinnamon only brought down blood sugars modestly. In other words, only as good as the leading diabetes drug in the world, metformin, sold as Glucophage. Yeah, it may work as good as the leading drug, but that’s not saying much. The best way to treat diabetes is to attempt to cure it completely— reversing diabetes with a healthy diet.
Please consider volunteering to help out on the site.
- Trapp CB, Barnard ND. Usefulness of vegetarian and vegan diets for treating type 2 diabetes. Curr Diab Rep. 2010 Apr;10(2):152-8. doi: 10.1007/s11892-010-0093-7.
- Hlebowicz J, Hlebowicz A, Lindstedt S, Björgell O, Höglund P, Holst JJ, Darwiche G, Almér LO. Effects of 1 and 3 g cinnamon on gastric emptying, satiety, and postprandial blood glucose, insulin, glucose-dependent insulinotropic polypeptide, glucagon-like peptide 1, and ghrelin concentrations in healthy subjects. Am J Clin Nutr. 2009 Mar;89(3):815-21. Epub 2009 Jan 21.
- Solomon TP, Blannin AK. Changes in glucose tolerance and insulin sensitivity following 2 weeks of daily cinnamon ingestion in healthy humans. Eur J Appl Physiol. 2009 Apr;105(6):969-76. Epub 2009 Jan 22.
- Solomon TP, Blannin AK. Effects of short-term cinnamon ingestion on in vivo glucose tolerance. Diabetes Obes Metab. 2007 Nov;9(6):895-901.
- Davis PA, Yokoyama W. Cinnamon intake lowers fasting blood glucose: meta-analysis. J Med Food. 2011 Sep;14(9):884-9. doi: 10.1089/jmf.2010.0180.
- Rafehi H, Ververis K, Karagiannis TC. Controversies surrounding the clinical potential of cinnamon for the management of diabetes. Diabetes Obes Metab. 2012;14(6):493-499.
- 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(2):228-239.
- Fotland TØ, Paulsen JE, Sanner T, Alexander J, Husøy T. Risk assessment of coumarin using the bench mark dose (Bmd) approach: children in Norway which regularly eat oatmeal porridge with cinnamon may exceed the TDI for coumarin with several folds. Food Chem Toxicol. 2012;50(3-4):903-912.
- Wickenberg J, Lindstedt S, Berntorp K, Nilsson J, Hlebowicz J. Ceylon cinnamon does not affect postprandial plasma glucose or insulin in subjects with impaired glucose tolerance. Br J Nutr. 2012;107(12):1845-1849.
- Bandara T, Uluwaduge I, Jansz ER. Bioactivity of cinnamon with special emphasis on diabetes mellitus: a review. Int J Food Sci Nutr. 2012;63(3):380-386.
Image thanks to Cinnamon Vogue via flickr. Image has been modified.
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
The use of cinnamon to help treat diabetes remains controversial. We know that cinnamon is so good at controlling one’s blood sugar that you can cheat on a diabetes test by consuming two teaspoons of cinnamon the night before your glucose tolerance test. Basically, they make you drink some sugar water, and see how well your body can keep your blood sugar levels under control. And, if you eat those two teaspoons right when the test starts, or 12 hours before, you can significantly blunt the spike. A half teaspoon of cinnamon does not seem to be enough, but about a teaspoon a day does appear to make a significant difference. A review of the best studies done to date found that the intake of cinnamon by type 2 diabetics or prediabetics does lower their blood glucose significantly.
So, what’s the controversy? Well, as I described before, cassia cinnamon, also known as Chinese cinnamon—or probably what you’re getting at the store, if it just says cinnamon—contains a compound called coumarin, which may be toxic to the liver in high-enough doses.
Originally, the concern was mainly for kids during Christmas time, where they might get an above-average exposure. But, more recently, some researchers suggest that the kids just sprinkling some cassia cinnamon on their oatmeal a few times a week might exceed the recommended safety limit. The bold values here are above the recommended upper limit. For little kids, just a quarter-teaspoon of cinnamon a few times a week may be too much. And, if you’re eating that cinnamon sprinkled on oatmeal more than like every day, even adults can bump up against the limit. So, a teaspoon a day of cassia cinnamon might be too much for anyone.
But, no problem; just switch from cassia cinnamon to Ceylon cinnamon, and you can get the benefits without the potential risks—right? Well, without the risks, yes; but we’re not sure about the benefits.
Nearly all of the studies showing blood sugar benefits of cinnamon have been done on cassia. We’ve just assumed that the same would apply for the safer cinnamon, Ceylon. But, only recently was it put to the test. “Owing to the presence of [that] toxic [compound], the Federal Institute for Risk Assessment…in Europe has warned against consuming large amounts of” the cassia cinnamon—suggesting a switch from cassia cinnamon to Ceylon cinnamon (also known as true cinnamon). But we don’t know whether or not the true cinnamon had similar benefits, until now.
We saw that nice blunting of blood sugars in response to cassia cinnamon, but in response to Ceylon cinnamon—nothing. Bummer. In fact, they’re thinking maybe that potentially toxic coumarin stuff was the active ingredient in the cassia cinnamon all along. So, take out the toxin; you take out the benefit.
So, they conclude, yeah, it’s great that health authorities are recommending the switch. However, the positive effects seen with cassia could then be lost. So, should we just give up on going out of our way to add cinnamon to our diet? No, I think it’s still a good idea to shoot for about teaspoon of Ceylon cinnamon a day, since there’s a bunch of other benefits linked to cinnamon besides blood sugar control—not the least of which is its potent antioxidant content.
In fact, one of the cheapest food sources of antioxidants—beating out cloves, and coming in just under purple cabbage. But, cinnamon can no longer considered a safe and effective treatment for diabetes. Either you’re using cassia cinnamon, and it’s effective, but may not be safe; or you’re using Ceylon cinnamon, which is safe, but does not appear effective.
But look, even the cassia cinnamon only brought down blood sugars modestly. In other words, only as good as the leading diabetes drug in the world, metformin, sold as Glucophage. Yeah, it may work as good as the leading drug, but that’s not saying much. The best way to treat diabetes is to attempt to cure it completely— reversing diabetes with a healthy diet.
Please consider volunteering to help out on the site.
- Trapp CB, Barnard ND. Usefulness of vegetarian and vegan diets for treating type 2 diabetes. Curr Diab Rep. 2010 Apr;10(2):152-8. doi: 10.1007/s11892-010-0093-7.
- Hlebowicz J, Hlebowicz A, Lindstedt S, Björgell O, Höglund P, Holst JJ, Darwiche G, Almér LO. Effects of 1 and 3 g cinnamon on gastric emptying, satiety, and postprandial blood glucose, insulin, glucose-dependent insulinotropic polypeptide, glucagon-like peptide 1, and ghrelin concentrations in healthy subjects. Am J Clin Nutr. 2009 Mar;89(3):815-21. Epub 2009 Jan 21.
- Solomon TP, Blannin AK. Changes in glucose tolerance and insulin sensitivity following 2 weeks of daily cinnamon ingestion in healthy humans. Eur J Appl Physiol. 2009 Apr;105(6):969-76. Epub 2009 Jan 22.
- Solomon TP, Blannin AK. Effects of short-term cinnamon ingestion on in vivo glucose tolerance. Diabetes Obes Metab. 2007 Nov;9(6):895-901.
- Davis PA, Yokoyama W. Cinnamon intake lowers fasting blood glucose: meta-analysis. J Med Food. 2011 Sep;14(9):884-9. doi: 10.1089/jmf.2010.0180.
- Rafehi H, Ververis K, Karagiannis TC. Controversies surrounding the clinical potential of cinnamon for the management of diabetes. Diabetes Obes Metab. 2012;14(6):493-499.
- 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(2):228-239.
- Fotland TØ, Paulsen JE, Sanner T, Alexander J, Husøy T. Risk assessment of coumarin using the bench mark dose (Bmd) approach: children in Norway which regularly eat oatmeal porridge with cinnamon may exceed the TDI for coumarin with several folds. Food Chem Toxicol. 2012;50(3-4):903-912.
- Wickenberg J, Lindstedt S, Berntorp K, Nilsson J, Hlebowicz J. Ceylon cinnamon does not affect postprandial plasma glucose or insulin in subjects with impaired glucose tolerance. Br J Nutr. 2012;107(12):1845-1849.
- Bandara T, Uluwaduge I, Jansz ER. Bioactivity of cinnamon with special emphasis on diabetes mellitus: a review. Int J Food Sci Nutr. 2012;63(3):380-386.
Image thanks to Cinnamon Vogue via flickr. Image has been modified.
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Update on Cinnamon for Blood Sugar Control
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URLNota del Doctor
Check out the Antioxidants in a Pinch video I’m so proud of. The Safer Cinnamon is where I originally brought up the coumarin issue. The oxalates in too much turmeric may be a concern.
I talk more about the potential potency of plants in general in Power Plants, and more about spices in particular in videos such as these:
- Benefits of Fenugreek Seeds
- Saffron for the Treatment of Alzheimer’s
- Saffron for the Treatment of PMS
- Garden Variety Anti-Inflammation
Amla vs. Diabetes explores the use of Indian gooseberries as a way to help control blood sugar—though the best way to deal with diabetes is to prevent it and treat it with a healthy diet. Books I would recommend on this topic (in order of publication) are Defeating Diabetes, Dr. Neal Barnard’s Program for Reversing Diabetes, and The End of Diabetes.
For further context, check out my associated blog posts: Cinnamon for Diabetes, Nutmeg Toxicity, and Tarragon Toxicity?
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