Current Diabetes Reports

, Volume 11, Issue 3, pp 173–178 | Cite as

Alternative and Complementary Treatments for Metabolic Syndrome

  • Mariya Power
  • Richard Pratley


Metabolic syndrome is defined by a cluster of cardiovascular disease risk factors that are associated with insulin resistance. In recent years, a number of innovative nutritional strategies have been proposed as safe alternative treatments to reduce the morbidity as well as the cost of treating metabolic syndrome. Of these, dietary supplementation with chromium picolinate or cinnamon extract has been studied most extensively. These interventions may attenuate insulin resistance and reduce the cardiovascular risk factors that together comprise the metabolic syndrome. However, more clinical trials are needed to determine the dose and duration of such treatments to make specific recommendations for populations with metabolic syndrome.


Metabolic syndrome Chromium Cinnamon Insulin resistance 



No potential conflicts of interest relevant to this article were reported.


Papers of particular interest, published recently, have been highlighted as: •   Of importance

  1. 1.
    Pratley RE. Metabolic syndrome: why the controversy? Curr Diab Rep. 2007;7:56–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adults Treatment Panel III) [no authors listed]. JAMA 2001, 285:2486–2497.Google Scholar
  3. 3.
    Jeejeebhoy KN, Chu RC, Marliss EB, et al. Chromium deficiency, glucose intolerance, and neuropathy reversed by chromium supplementation, in a patient receiving long-term total parenteral nutrition. Am J Clin Nutr. 1977;30:531–8.PubMedGoogle Scholar
  4. 4.
    Via M, Scurlock C, Raikhelkar J, et al. Chromium infusion reverses extreme insulin resistance in a cardiothoracic ICU patient. Nutr Clin Pract. 2008;23:325–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Anderson RA. Chromium and parenteral nutrition. Nutrition. 1995;11:83–6.PubMedGoogle Scholar
  6. 6.
    Anderson RA. Nutritional factors influencing the glucose/insulin system: chromium. J Am Coll Nutr. 1997;16:404–10.PubMedGoogle Scholar
  7. 7.
    Anderson RA. Chromium, glucose intolerance and diabetes. J Am Coll Nutr. 1998;17:548–55.PubMedGoogle Scholar
  8. 8.
    National Research Counsil, Food and Nutrition Board. Recommended dietary allowances. 10th ed. Washington: National Academy Press; 1989.Google Scholar
  9. 9.
    Anderson RA, Polansky MM, Bryden NA, et al. Effects of chromium supplementation on urinary Cr excretion of human subjects and correlation of Cr excretion with selected clinical parameters. J Nutr. 1983;113:276–81.PubMedGoogle Scholar
  10. 10.
    Bunker VW, Lawson MS, Delves HT, Clayton BE. The uptake and excretion of chromium by the elderly. Am J Clin Nutr. 1984;39:797–802.PubMedGoogle Scholar
  11. 11.
    Anderson RA, Kozlovsky AS. Chromium intake, absorption and excretion of subjects consuming self-selected diets. Am J Clin Nutr. 1985;41:1177–83.PubMedGoogle Scholar
  12. 12.
    Offenbacher EG. Promotion of chromium absorptionby ascorbic acid. Trace Elem Electrolytes. 1994;11:178.Google Scholar
  13. 13.
    Lim TH, Sargent 3rd T. Kusubov N: Kinetics of trace element chromium(III) in the human body. Am J Physiol. 1983;244:R445–54.PubMedGoogle Scholar
  14. 14.
    Schwarz K, Mertz W. Chromium(III) and the glucose tolerance factor. Arch Biochem Biophys. 1959;85:292–5.PubMedCrossRefGoogle Scholar
  15. 15.
    Vincent JB. Elucidating a biological role for chromium at a molecular level. Acc Chem Res. 2000;33:503–10.PubMedCrossRefGoogle Scholar
  16. 16.
    Hummel M, Standl E, Schnell O. Chromium in metabolic and cardiovascular disease. Horm Metab Res. 2007;39:743–51.PubMedCrossRefGoogle Scholar
  17. 17.
    Cefalu WT, Hu FB. Role of chromium in human health and in diabetes. Diab Care. 2004;27:2741–51.CrossRefGoogle Scholar
  18. 18.
    Cefalu WT, Wang ZQ, Zhang XH, et al. Oral chromium picolinate improves carbohydrate and lipid metabolism and enhances skeletal muscle Glut-4 translocation in obese, hyperinsulinemic (JCR-LA corpulent) rats. J Nutr. 2002;132:1107–14.PubMedGoogle Scholar
  19. 19.
    Sherman L, Glennon JA, Brech WJ, et al. Failure of trivalent chromium to improve hyperglycemia in diabetes mellitus. Metabolism. 1968;17:439–42.PubMedCrossRefGoogle Scholar
  20. 20.
    Rabinowitz MB, Gonick HC, Levin SR, Davidson MB. Effects of chromium and yeast supplements on carbohydrate and lipid metabolism in diabetic men. Diab Care. 1983;6:319–27.CrossRefGoogle Scholar
  21. 21.
    Lee NA, Reasner CA. Beneficial effect of chromium supplementation on serum triglyceride levels in NIDDM. Diab Care. 1994;17:1449–52.CrossRefGoogle Scholar
  22. 22.
    Thomas VL, Gropper SS. Effect of chromium nicotinic acid supplementation on selected cardiovascular disease risk factors. Biol Trace Elem Res. 1996;55:297–305.PubMedCrossRefGoogle Scholar
  23. 23.
    Trow LG, Lewis J, Greenwood RH, et al. Lack of effect of dietary chromium supplementation on glucose tolerance, plasma insulin and lipoprotein levels in patients with type 2 diabetes. Int J Vitam Nutr Res. 2000;70:14–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Gunton JE, Cheung NW, Hitchman R, et al. Chromium supplementation does not improve glucose tolerance, insulin sensitivity, or lipid profile: a randomized, placebo-controlled, double-blind trial of supplementation in subjects with impaired glucose tolerance. Diab Care. 2005;28:712–3.CrossRefGoogle Scholar
  25. 25.
    Anderson RA, Cheng N, Bryden NA, et al. Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes. 1997;46:1786–91.PubMedCrossRefGoogle Scholar
  26. 26.
    Cefalu WT, Bell-Farrow AD, Stegner J, Wang ZQ, King T, Morgan T, et al. Effect of chromium picolinate on insulin sensitivity in vivo. J Trace Elem Exp Med. 1999;12:71–83.CrossRefGoogle Scholar
  27. 27.
    Iqbal N, Cardillo S, Volger S, et al.: Chromium Picolinate Does Not Improve Key Features of Metabolic Syndrome in Obese Nondiabetic Adults. Metab Syndr Relat Disord 2009.Google Scholar
  28. 28.
    Lukaski HC, Bolonchuk WW, Siders WA, Milne DB. Chromium supplementation and resistance training: effects on body composition, strength, and trace element status of men. Am J Clin Nutr. 1996;63:954–65.PubMedGoogle Scholar
  29. 29.
    Grant KE, Chandler RM, Castle AL, Ivy JL. Chromium and exercise training: effect on obese women. Med Sci Sports Exerc. 1997;29:992–8.PubMedGoogle Scholar
  30. 30.
    Martin J, Wang ZQ, Zhang XH, et al. Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes. Diab Care. 2006;29:1826–32.CrossRefGoogle Scholar
  31. 31.
    Proctor SD, Kelly SE, Stanhope KL, et al. Synergistic effects of conjugated linoleic acid and chromium picolinate improve vascular function and renal pathophysiology in the insulin-resistant JCR:LA-cp rat. Diab Obes Metab. 2007;9:87–95.CrossRefGoogle Scholar
  32. 32.
    Roeback Jr JR, Hla KM, Chambless LE, Fletcher RH. Effects of chromium supplementation on serum high-density lipoprotein cholesterol levels in men taking beta-blockers. A randomized, controlled trial. Ann Intern Med. 1991;115:917–24.PubMedGoogle Scholar
  33. 33.
    Abraham AS, Brooks BA, Eylath U. The effects of chromium supplementation on serum glucose and lipids in patients with and without non-insulin-dependent diabetes. Metabolism. 1992;41:768–71.PubMedCrossRefGoogle Scholar
  34. 34.
    Padmavathi IJ, Rao KR, Venu L, et al. Chronic maternal dietary chromium restriction modulates visceral adiposity: probable underlying mechanisms. Diabetes. 2010;59:98–104.PubMedCrossRefGoogle Scholar
  35. 35.
    Dugoua JJ, Seely D, Perri D, et al. From type 2 diabetes to antioxidant activity: a systematic review of the safety and efficacy of common and cassia cinnamon bark. Can J Physiol Pharmacol. 2007;85:837–47.PubMedCrossRefGoogle Scholar
  36. 36.
    Anderson RA, Broadhurst CL, Polansky MM, et al. Isolation and characterization of polyphenol type-A polymers from cinnamon with insulin-like biological activity. J Agric Food Chem. 2004;52:65–70.PubMedCrossRefGoogle Scholar
  37. 37.
    Imparl-Radosevich J, Deas S, Polansky MM, et al. Regulation of PTP-1 and insulin receptor kinase by fractions from cinnamon: implications for cinnamon regulation of insulin signalling. Horm Res. 1998;50:177–82.PubMedCrossRefGoogle Scholar
  38. 38.
    Qin B, Nagasaki M, Ren M, et al. Cinnamon extract (traditional herb) potentiates in vivo insulin-regulated glucose utilization via enhancing insulin signaling in rats. Diab Res Clin Pract. 2003;62:139–48.CrossRefGoogle Scholar
  39. 39.
    Qin B, Nagasaki M, Ren M, et al. Cinnamon extract prevents the insulin resistance induced by a high-fructose diet. Horm Metab Res. 2004;36:119–25.PubMedCrossRefGoogle Scholar
  40. 40.
    Sheng X, Zhang Y, Gong Z, et al. Improved insulin resistance and lipid metabolism by cinnamon extract through activation of peroxisome proliferator-activated receptors. PPAR Res. 2008;2008:581348.PubMedGoogle Scholar
  41. 41.
    Khan A, Safdar M, Ali Khan MM, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diab Care. 2003;26:3215–8.CrossRefGoogle Scholar
  42. 42.
    Vanschoonbeek K, Thomassen BJ, Senden JM, et al. Cinnamon supplementation does not improve glycemic control in postmenopausal type 2 diabetes patients. J Nutr. 2006;136:977–80.PubMedGoogle Scholar
  43. 43.
    • 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, 22:507–512. This is a recent clinical trial demonstrating positive effect of cinnamon extract on HbA 1c levels in people with type 2 diabetes.PubMedCrossRefGoogle Scholar
  44. 44.
    Ziegenfuss TN, Hofheins JE, Mendel RW, et al. 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.PubMedCrossRefGoogle Scholar
  45. 45.
    Feiner JJ, McNurlan MA, Ferris RE, et al. Chromium picolinate for insulin resistance in subjects with HIV disease: a pilot study. Diab Obes Metab. 2008;10:151–8.Google Scholar
  46. 46.
    Wang JG, Anderson RA, Graham 3rd GM, et al. The effect of cinnamon extract on insulin resistance parameters in polycystic ovary syndrome: a pilot study. Fertil Steril. 2007;88:240–3.PubMedCrossRefGoogle Scholar
  47. 47.
    Solomon TP, Blannin AK. Effects of short-term cinnamon ingestion on in vivo glucose tolerance. Diab Obes Metab. 2007;9:895–901.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Nutrition and Food Science DepartmentUniversity of VermontColchesterUSA
  2. 2.College of Medicine, Endocrinology, Diabetes and Metabolism UnitUniversity of VermontColchesterUSA

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