Effects of cinnamon supplementation on body weight and composition in adults: A systematic review and meta-analysis of controlled clinical trials
Zeinab Yazdanpanah
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Search for more papers by this authorMaryam Azadi-Yazdi
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Search for more papers by this authorHadis Hooshmandi
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Search for more papers by this authorNahid Ramezani-Jolfaie
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Search for more papers by this authorCorresponding Author
Amin Salehi-Abargouei
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Correspondence
Amin Salehi-Abargouei, Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Email: [email protected]; [email protected]
Search for more papers by this authorZeinab Yazdanpanah
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Search for more papers by this authorMaryam Azadi-Yazdi
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Search for more papers by this authorHadis Hooshmandi
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Search for more papers by this authorNahid Ramezani-Jolfaie
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Search for more papers by this authorCorresponding Author
Amin Salehi-Abargouei
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Correspondence
Amin Salehi-Abargouei, Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Email: [email protected]; [email protected]
Search for more papers by this authorAbstract
Background
This systematic review and meta-analysis aimed to investigate the effect of cinnamon on body weight, body mass index (BMI), waist circumference (WC), waist–hip ratio (WHR), and body fat mass including the maximum number of studies.
Methods
Medline, ISI Web of Science, Scopus, Google Scholar, and Cochrane library were searched with no limitation from inception up to August 2019 for relevant randomized controlled clinical trials (RCTs). The RCTs' risk of bias was assessed using the Cochrane collaboration's tool. Random-effects model was used for meta-analysis.
Results
Twenty-one RCTs with 1,480 participants were included. The meta-analysis showed that cinnamon supplementation significantly reduces BMI [weighted mean difference (WMD) = −0.40 kg/m2, 95% confidence interval (CI): −0.57, −0.22 kg/m2, p < .001, I2 = 78.9%], body weight (WMD = −0.92 kg; 95% CI: −1.51, −0.33 kg; p = .002; I2 = 84.2%), and WHR (WMD = −0.02, 95% CI: −0.038, −0.018; p < 0.001; I2 = 0%). Cinnamon supplementation did not significantly affect the WC (WMD = −1.76 cm, 95% CI: −3.57, −0.045 cm; p = .056; I2 = 90.8%) and body fat mass (WMD = −0.87%, 95% CI: −1.87, 0.025%; p = .057; I2 = 78.6%).
Conclusion
Cinnamon supplementation significantly reduces body weight, BMI, and WHR. Future high-quality long-term RCTs are recommended to confirm these results.
CONFLICT OF INTEREST
There is no conflict of interest to report for this study.
Supporting Information
Filename | Description |
---|---|
ptr6539-supp 0001-Supporting_Information.docxWord 2007 document , 157.7 KB |
Table S1 The strategy used for online database search Table S2 Excluded studies with reasons |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
REFERENCES
- Afshin, A., Forouzanfar, M. H., Reitsma, M. B., Sur, P., Estep, K., Lee, A., … Murray, C. J. L. (2017). Health effects of overweight and obesity in 195 countries over 25 years. The New England Journal of Medicine, 377(1), 13–27. https://doi.org/10.1056/NEJMoa1614362
- Akilen, R., Pimlott, Z., Tsiami, A., & Robinson, N. (2013). Effect of short-term administration of cinnamon on blood pressure in patients with prediabetes and type 2 diabetes. Nutrition, 29(10), 1192–1196. https://doi.org/10.1016/j.nut.2013.03.007
- Akilen, R., Tsiami, A., Devendra, D., & Robinson, N. (2010). 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. Diabetic Medicine, 27(10), 1159–1167. https://doi.org/10.1111/j.1464-5491.2010.03079.x
- Aldayel, T. S. (2016). Health Benefits of Cinnamon Supplement: In Vitro and In Vivo. (Doctoral), University of Surrey, Retrieved from http://epubs.surrey.ac.uk/810443/
- Allen, R. W., Schwartzman, E., Baker, W. L., Coleman, C. I., & Phung, O. J. (2013). Cinnamon use in type 2 diabetes: An updated systematic review and meta-analysis. Annals of Family Medicine, 11(5), 452–459. https://doi.org/10.1370/afm.1517
- Anderson, R. A., Zhan, Z., Luo, R., Guo, X., Guo, Q., Zhou, J., … Stoecker, B. J. (2016). Cinnamon extract lowers glucose, insulin, and cholesterol in people with elevated serum glucose. Journal of Traditional and Complementary Medicine, 6(4), 332–336. https://doi.org/10.1016/j.jtcme.2015.03.005
- Askari, F., Rashidkhani, B., & Hekmatdoost, A. (2014). Cinnamon may have therapeutic benefits on lipid profile, liver enzymes, insulin resistance, and high-sensitivity C-reactive protein in nonalcoholic fatty liver disease patients. Nutrition Research, 34(2), 143–148. https://doi.org/10.1016/j.nutres.2013.11.005
- Azimi, P., Ghiasvand, R., Feizi, A., Hariri, M., & Abbasi, B. (2014). Effects of Cinnamon, Cardamom, Saffron, and Ginger Consumption on Markers of Glycemic Control, Lipid Profile, Oxidative Stress, and Inflammation in Type 2 Diabetes Patients. The Review of Diabetic Studies, 11(3-4), 258–266. https://doi.org/10.1900/rds.2014.11.258
- Balijepalli, M. K., Buru, A. S., Sakirolla, R., & Pichika, M. (2017). Cinnamomum genus: A review on its biological activities. International Journal of Pharmacy and Pharmaceutical Sciences, 9, 1–11.
10.22159/ijpps.2017v9i2.11156 Google Scholar
- Bandell, M., Story, G. M., Hwang, S. W., Viswanath, V., Eid, S. R., Petrus, M. J., … Patapoutian, A. (2004). Noxious cold ion channel TRPA1 is activated by pungent compounds and bradykinin. Neuron, 41(6), 849–857. https://doi.org/10.1016/s0896-6273(04)00150-3
- Blevins, S. M., Leyva, M. J., Brown, J., Wright, J., Scofield, R. H., & Aston, C. E. (2007). Effect of cinnamon on glucose and lipid levels in non-insulin-dependent type 2 diabetes. Diabetes Care, 30, 2236–2237. https://doi.org/10.2337/dc07-0098
- Borzoei, A., Rafraf, M., & Asghari-Jafarabadi, M. (2018). Cinnamon improves metabolic factors without detectable effects on adiponectin in women with polycystic ovary syndrome. Asia Pacific Journal of Clinical Nutrition, 27(3), 556–563. https://doi.org/10.6133/apjcn.062017.02
- Camacho, S., Michlig, S., de Senarclens-Bezencon, C., Meylan, J., Meystre, J., Pezzoli, M., … le Coutre, J. (2015). Anti-obesity and antihyperglycemic effects of cinnamaldehyde via altered ghrelin secretion and functional impact on food intake and gastric emptying. Scientific Reports, 5, 7919-7928. https://doi.org/10.1038/srep07919
- Cao, H., Polansky, M. M., & Anderson, R. A. (2007). Cinnamon extract and polyphenols affect the expression of tristetraprolin, insulin receptor, and glucose transporter 4 in mouse 3T3-L1 adipocytes. Archives of Biochemistry and Biophysics, 459(2), 214–222. https://doi.org/10.1016/j.abb.2006.12.034
- Cho, H. J., Callaghan, B., Bron, R., Bravo, D. M., & Furness, J. B. (2014). Identification of enteroendocrine cells that express TRPA1 channels in the mouse intestine. Cell and Tissue Research, 356(1), 77–82. https://doi.org/10.1007/s00441-013-1780-x
- DerSimonian, R., & Laird, N. (1986). Meta-analysis in clinical trials. Controlled Clinical Trials, 7(3), 177–188. https://doi.org/10.1016/0197-2456(86)90046-2
- Doihara, H., Nozawa, K., Kawabata-Shoda, E., Kojima, R., Yokoyama, T., & Ito, H. (2009a). Molecular cloning and characterization of dog TRPA1 and AITC stimulate the gastrointestinal motility through TRPA1 in conscious dogs. European Journal of Pharmacology, 617(1-3), 124–129. https://doi.org/10.1016/j.ejphar.2009.06.038
- Doihara, H., Nozawa, K., Kawabata-Shoda, E., Kojima, R., Yokoyama, T., & Ito, H. (2009b). TRPA1 agonists delay gastric emptying in rats through serotonergic pathways. Naunyn-Schmiedeberg's Archives of Pharmacology, 380(4), 353–357. https://doi.org/10.1007/s00210-009-0435-7
- Ebrahimzadeh Attari, V., Ostadrahimi, A., Asghari Jafarabadi, M., Mehralizadeh, S., & Mahluji, S. (2016). Changes of serum adipocytokines and body weight following Zingiber officinale supplementation in obese women: A RCT. European Journal of Nutrition, 55(6), 2129–2136. https://doi.org/10.1007/s00394-015-1027-6
- Egger, M., Davey Smith, G., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109), 629–634. https://doi.org/10.1136/bmj.315.7109.629
- Egger, M., Davey-Smith, G., & Altman, D. (2008). Systematic Reviews in Health Care: Meta-analysis in Context. John Wiley & Sons: London, UK.
- Field, A. E., Coakley, E. H., Must, A., Spadano, J. L., Laird, N., Dietz, W. H., … Colditz, G. A. (2001). Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Archives of Internal Medicine, 161(13), 1581–1586. https://doi.org/10.1001/archinte.161.13.1581
- Geng, S., Cui, Z., Huang, X., Chen, Y., Xu, D., & Xiong, P. (2011). Variations in essential oil yield and composition during Cinnamomum cassia bark growth. Industrial Crops and Products, 33(1), 248–252. https://doi.org/10.1016/j.indcrop.2010.10.018
- Gupta Jain, S., Puri, S., Misra, A., Gulati, S., & Mani, K. (2017). Effect of oral cinnamon intervention on metabolic profile and body composition of Asian Indians with metabolic syndrome: A randomized double-blind control trial. Journal of the Science of Food and Agriculture, 16(1), 113-123. https://doi.org/10.1002/jsfa.849010.1186/s12944-017-0504-8
- Haghighian, H. K., Naimi, A. F., Gargari, B. P., Ali-Asgharzadeh, A., & Nemati, A. (2011). Effect of cinnamon supplementation on blood glucose and lipid levels in type 2 diabetic patients. JPS, 2(1), 2008–4978.
- Hajimonfarednejad, M., Nimrouzi, M., Heydari, M., Zarshenas, M. M., Raee, M. J., & Jahromi, B. N. (2018). Insulin resistance improvement by cinnamon powder in polycystic ovary syndrome: A randomized double-blind placebo controlled clinical trial. Phytotherapy Research, 32(2), 276–283. https://doi.org/10.1002/ptr.5970
- Higgins, J. P., & Thompson, S. G. (2002). Quantifying heterogeneity in a meta-analysis. Statistics in Medicine, 21(11), 1539–1558. https://doi.org/10.1002/sim.1186
- Higgins, JPT, & Green, S (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration, London, UK. Available from: www.handbook.cochrane.org
- Iwasaki, Y., Tanabe, M., Kobata, K., & Watanabe, T. (2008). TRPA1 agonists—Allyl isothiocyanate and cinnamaldehyde—Induce adrenaline secretion. Bioscience, Biotechnology, and Biochemistry, 72(10), 2608–2614. https://doi.org/10.1271/bbb.80289
- Jayaprakasha, G. K., & Rao, L. J. (2011). Chemistry, biogenesis, and biological activities of Cinnamomum zeylanicum. Critical Reviews in Food Science and Nutrition, 51(6), 547–562. https://doi.org/10.1080/10408391003699550
- Khare, P., Jagtap, S., Jain, Y., Baboota, R. K., Mangal, P., Boparai, R. K., … Bishnoi, M. (2016). Cinnamaldehyde supplementation prevents fasting-induced hyperphagia, lipid accumulation, and inflammation in high-fat diet-fed mice. BioFactors, 42(2), 201–211. https://doi.org/10.1002/biof.1265
- Lee, S. G., Siaw, J. A., & Kang, H. W. (2016). Stimulatory effects of cinnamon extract (Cinnamomum cassia) during the initiation stage of 3T3-L1 adipocyte differentiation. Food, 5(4), 83-91. https://doi.org/10.3390/foods5040083
- Li, Y. Q., Kong, D. X., & Wu, H. (2013). Analysis and evaluation of essential oil components of cinnamon barks using GC–MS and FTIR spectroscopy. Industrial Crops and Products, 41, 269–278. https://doi.org/10.1016/j.indcrop.2012.04.056
- Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P., … Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Medicine, 6(7), 1-2 e1000100. https://doi.org/10.1371/journal.pmed.1000100
- Lopes, B. P., Gaique, T. G., Souza, L. L., Paula, G. S., Kluck, G. E., Atella, G. C., … Oliveira, K. J. (2015). Cinnamon extract improves the body composition and attenuates lipogenic processes in the liver and adipose tissue of rats. Food & Function, 6(10), 3257–3265. https://doi.org/10.1039/c5fo00569h
- Maierean, S. M., Serban, M. C., Sahebkar, A., Ursoniu, S., Serban, A., Penson, P., & Banach, M. (2017). The effects of cinnamon supplementation on blood lipid concentrations: A systematic review and meta-analysis. Journal of Clinical Lipidology, 11(6), 1393–1406. https://doi.org/10.1016/j.jacl.2017.08.004
- Masamoto, Y., Kawabata, F., & Fushiki, T. (2009). Intragastric administration of TRPV1, TRPV3, TRPM8, and TRPA1 agonists modulates autonomic thermoregulation in different manners in mice. Bioscience, Biotechnology, and Biochemistry, 73(5), 1021–1027. https://doi.org/10.1271/bbb.80796
- Mechanick, J. I., Hurley, D. L., & Garvey, W. T. (2017). Adiposity-based chronic disease as a new diagnostic term: the American Association of Clinical Endocrinologists and American College of Endocrinology position statement. Endocrine Practice, 23(3), 372–378. https://doi.org/10.4158/ep161688.ps
- Mirfeizi, M., Mehdizadeh Tourzani, Z., Mirfeizi, S. Z., Asghari Jafarabadi, M., Rezvani, H. R., & Afzali, M. (2016). Controlling type 2 diabetes mellitus with herbal medicines: A triple-blind randomized clinical trial of efficacy and safety. Journal of Diabetes, 8(5), 647–656. https://doi.org/10.1111/1753-0407.12342
- Mousavi, S. M., Rahmani, J., Kord-Varkaneh, H., Sheikhi, A., Larijani, B., & Esmaillzadeh, A. (2019). Cinnamon supplementation positively affects obesity: A systematic review and dose-response meta-analysis of randomized controlled trials. Clinical Nutrition, S0261-5614(19), 30071–30078. https://doi.org/10.1016/j.clnu.2019.02.017
- Nakhaei, K., Ghofrani, M., Bakhsheshi, M. F., & Nakhaei, H. (2018). Effect of circuit resistance training and cinnamon supplement on body composition and omentin-1 in overweight women. Iranian Journal of Obstetrics, Gynecology and Infertility, 20(11), 74–82. https://doi.org/10.22038/IJOGI.2018.10230
- Namazi, N., Khodamoradi, K., Khamechi, S. P., Heshmati, J., Ayati, M. H., & Larijani, B. (2019). The impact of Cinnamon on anthropometric indices and glycemic status in patients with type 2 diabetes: A systematic review and meta-analysis of clinical trial. Complementary Therapies in Medicine, 43(2019), 92–101.
- Nozawa, K., Kawabata-Shoda, E., Doihara, H., Kojima, R., Okada, H., Mochizuki, S., … Ito, H. (2009). TRPA1 regulates gastrointestinal motility through serotonin release from enterochromaffin cells. Proceedings of the National Academy of Sciences of the United States of America, 106(9), 3408–3413. https://doi.org/10.1073/pnas.0805323106
- Pittman, S. (2011). Cinnamon: It's not just for making cinnamon rolls. Ethnobotanical Leaflets, 2000(2), 11-15.
- Ravindran, P. N., Nirmal-Babu, K., & Shylaja, M. (2003: 318). Cinnamon and Cassia: The Genus Cinnamomum: CRC Press.
- Shatwan, I. A., Ahmed, L. A., & Badkook, M. M. (2013). Effect of barley flour, crude cinnamon, and their combination on glycemia, dyslipidemia, and adipose tissue hormones in type 2 diabetic rats. Journal of Medicinal Food, 16(7), 656–662. https://doi.org/10.1089/jmf.2012.0083
- Shishehbor, F., Rezaeyan Safar, M., Rajaei, E., & Haghighizadeh, M. H. (2018). Cinnamon consumption improves clinical symptoms and inflammatory markers in women with rheumatoid arthritis. Journal of the American College of Nutrition, 1–6. https://doi.org/10.1080/07315724.2018.1460733
- Soni, R., & Bhatnagar, V. (2015). Effect of cinnamoN (Cinnamomum cassia) intervention on metabolic features of adult male with type 2 diabetes. International Journal of Pharma and Bio Sciences, 6(4), 772–P776.
- Swift, D. L., Johannsen, N. M., Lavie, C. J., Earnest, C. P., & Church, T. S. (2014). The role of exercise and physical activity in weight loss and maintenance. Progress in Cardiovascular Diseases, 56(4), 441–447. https://doi.org/10.1016/j.pcad.2013.09.012
- Szulinska, M., Kregielska-Narozna, M., Swiatek, J., Stys, P., Kuznar-Kaminska, B., Jakubowski, H., … Bogdanski, P. (2018). Garlic extract favorably modifies markers of endothelial function in obese patients-randomized double blind placebo-controlled nutritional intervention. Biomedicine & Pharmacotherapy, 102, 792–797. https://doi.org/10.1016/j.biopha.2018.03.131
- Talaat, B., & Ammar, I. M. M. (2018). The added value of cinnamon to metformin in controlling symptoms of polycystic ovary syndrome, A randomized controlled trial. Middle East Fertility Society Journal, 23, 440–445. https://doi.org/10.1016/j.mefs.2018.03.005
- Tamura, Y., Iwasaki, Y., Narukawa, M., & Watanabe, T. (2012). Ingestion of cinnamaldehyde, A TRPA1 agonist, reduces visceral fats in mice fed a high-fat and high-sucrose diet. Journal of Nutritional Science and Vitaminology (Tokyo), 58(1), 9–13.
- Torabi, S., Asad, M. R., & Tabrizi, A. (2016). The effect of endurance training with cinnamon supplementation on plasma concentrations of liver enzymes (ALT, AST) in women with type II diabetes. Tehran University Medical Journal, 74(6), 433–441.
- Vafa, M., Mohammadi, F., Shidfar, F., Sormaghi, M. S., Heidari, I., Golestan, B., & Amiri, F. (2012). Effects of cinnamon consumption on glycemic status, lipid profile and body composition in type 2 diabetic patients. International Journal of Preventive Medicine, 3(8), 531–536.
- Van Hul, M., Geurts, L., Plovier, H., Druart, C., Everard, A., Stahlman, M., … Gerard, P. (2018). Reduced obesity, diabetes, and steatosis upon cinnamon and grape pomace are associated with changes in gut microbiota and markers of gut barrier. 314(4), E334–e352. https://doi.org/10.1152/ajpendo.00107.2017
- Wainstein, J., Stern, N., Heller, S., & Boaz, M. (2011). Dietary cinnamon supplementation and changes in systolic blood pressure in subjects with type 2 diabetes. Journal of Medicinal Food, 14(12), 1505–1510. https://doi.org/10.1089/jmf.2010.0300
- Weitgasser, R., Pfutzner, A., Kerschgens, B., Drexel, H., Prager, R., Ludvik, B., … Grafinger, P. (2007). Impact of cinnamon vs. placebo on surrogate markers of metabolic control in patients with type 2 diabetes mellitus. Diabetologia, 50, S378–S379.
- Zare, R., Heshmati, F., Fallahzadeh, H., & Nadjarzadeh, A. (2014). Effect of cumin powder on body composition and lipid profile in overweight and obese women. Complementary Therapies in Clinical Practice, 20(4), 297–301. https://doi.org/10.1016/j.ctcp.2014.10.001
- Zare, R., Nadjarzadeh, A., Zarshenas, M. M., Shams, M., & Heydari, M. (2018). Efficacy of cinnamon in patients with type II diabetes mellitus: A randomized controlled clinical trial. Clinical Nutrition, 38, 549–556. https://doi.org/10.1016/j.clnu.2018.03.003
- Zheng, J., Zheng, S., Feng, Q., Zhang, Q., & Xiao, X. (2017). Dietary capsaicin and its anti-obesity potency: From mechanism to clinical implications. Bioscience Reports, 37(3), 1-9. https://doi.org/10.1042/bsr20170286
- Ziegenfuss, T. N., Hofheins, J. E., Mendel, R. W., Landis, J., & Anderson, R. A. (2006). Effects of a water-soluble cinnamon extract on body composition and features of the metabolic syndrome in pre-diabetic men and women. Journal of the International Society of Sports Nutrition, 3, 45–53. https://doi.org/10.1186/1550-2783-3-2-45