Start With Chromium and Skip the Carbs
TYPE 2 DIABETES is a chronic condition in which the body’s ability to metabolize sugar is impaired. Though it was once known as “adult-onset diabetes,” it has been showing up in younger and younger people over the past two decades. Each year, according to the Centers for Disease Control and Prevention (CDC), more than 13,000 young people are diagnosed with it, a number likely to grow even larger over the next few decades.
It’s impossible to talk about diabetes—and its relative, metabolic syndrome (also known as pre-diabetes)—without discussing a hormone called insulin.
In a nutshell, here’s what happens: When you eat, your blood sugar goes up. In response to this elevated blood sugar, the pancreas makes a hormone called insulin, whose many jobs in the body include whisking that extra sugar out of the bloodstream and into the cells where it can be burned for energy.
In at least one in four people (much more by some estimates), this mechanism doesn’t work properly. The cells stop paying attention to insulin, becoming resistant to its effects. This condition, called “insulin resistance,” is a prominent feature of type 2 diabetes as well as metabolic syndrome—a collection of symptoms like abdominal obesity and high blood pressure that together significantly increase the risk for heart disease. The vast majority of individuals with cardiovascular disease and/or type 2 diabetes are also insulin resistant.
Because diabetics and people who are insulin resistant have trouble clearing sugar from their bloodstream, it makes sense that a low-sugar (also known as low-glycemic) diet would be helpful as it would lessen the load on an already dysfunctional system. This is precisely the thinking that led many researchers to investigate the effects of low-carbohydrate diets on both insulin resistance and “glucose control,” which is the ability of the body to keep blood sugar levels in a reasonable range. The overwhelming majority of such studies show great improvement in insulin levels and blood sugar control. My friend Barry Sears, Ph.D., often says that insulin resistance can be reversed within three days with proper diet, and the research has backed him up.
I am a huge proponent of low-carb diets, especially for anyone with insulin resistance, diabetes or metabolic syndrome (see my book, Living Low Carb: Controlled Carbohydrate Eating for Long-Term Weight Loss). A low-carb diet should be the first thing you try if you’ve got abdominal obesity, insulin resistance, or even full-blown diabetes. Many risk factors for heart disease, like high triglycerides, come plummeting down with a low-carb diet, and you will be much more able to keep blood sugar and insulin levels in control.
Chromium: Insulin’s Little Helper
Chromium is a trace mineral that is directly involved in carbohydrate, fat, and protein metabolism. It’s also known to enhance the action of insulin, helping it to do its job better (and therefore reducing the amount needed to get the job done).
In this way, insulin works much like certain “insulin-sensitizing” medications, such as glucophage. It literally helps open the doors of the cells so that insulin (and sugar) can get in, thus reducing the burden on the body of having high amounts of both blood sugar and insulin. According to Georgetown University Medical Center professor Harry Preuss, M.D., C.N.S., chromium activates the enzyme tyrosine kinase, which helps insulin attach to insulin receptors. It’s like a key to the cell door.
The leading chromium researcher in the world is Richard Anderson, Ph.D., at the U.S. Department of Agriculture. Anderson has done a number of studies on diabetics that show their blood sugar levels dropping with chromium supplementation, particularly at the higher doses (800 to 1,000 mcg per day). Chromium has also been shown to be helpful in the treatment of gestational diabetes and may even be of some help in type 1 diabetes. In one study, even 200 mcg of chromium given to people with type 1 diabetes allowed them to reduce their average insulin dosage by almost one-third.
Simply put, chromium is “insulin’s little helper.”
Just one year after a typically behind-the-curve statement by the American Diabetes Association, which stated that “chromium supplementation has no known benefit in patients who are not chromium deficient,” a study published in the journal Diabetes reached the opposite conclusion.
Researchers divided 180 people with type 2 diabetes into three groups—one group received 200 mcg of chromium picolinate a day, one group received 1,000 mcg, and the third group got a placebo. Supplemental chromium was shown to have dramatic effects on glucose and insulin variables and “significant, sustained reductions in diabetic symptoms were especially noted in those who received 1,000 mcg per day.”
Remember that we don’t absorb chromium very well and we don’t get a lot of it in our diet (the main source is brewer’s yeast, liver, and of course, beer—not the way you’d want to get it if you struggle with blood sugar and weight issues). Some studies have shown no effect of chromium on blood sugar or other diabetic measures, but Anderson and other experts have pointed out that this is probably because researchers have not always used the most effective forms of chromium, or the right dosages. Anderson himself is partial to chromium picolinate, while other experts, like Preuss, favor niacin-bound chromium (chromium polynicotinate or chromium nicotinate, sold under the brand name ChromeMate). There’s also GTF chromium (GTF stands for glucose tolerance factor), but this is a mislabeling and a misconception; no such substance exists.
Interestingly, a diet high in sugar and processed foods actually drains chromium from the body, so the paradox is that those who need it the most have the least of it. Infection, pregnancy, and stress may also reduce levels. Even those eating a lot of healthy foods like seeds, nuts, and grains may be low in chromium because many of these foods, especially soy, contain phytic acid, which decreases the absorption of chromium (and other minerals).
The main thing we can hang our hat on is chromium’s ability to help lower blood sugar and make insulin work more effectively. That alone makes it a hugely important addition to the regime of anyone trying to regulate his or her blood sugar and reduce insulin resistance.
Don’t confuse chromium the supplement with the dangerous form of metal that was poisoning the town in the movie Erin Brockovich. That was hexavalent chromium, and it is indeed a poison. Trivalent chromium, the kind in food and supplements, is amazingly safe. So few adverse effects have been reported that the Institute of Medicine has never established a tolerable upper intake level for it. According to Preuss, rats fed trivalent chromium at levels thousands of times higher than the reference dose for humans, based on body weight, didn’t show any toxic effects.
Magnesium plays a crucial role in carbohydrate metabolism. It also plays a critical role in the secretion and action of insulin, thereby helping to control blood sugar. Magnesium supplements are absolutely essential for anyone with type 2 diabetes or anyone at risk for it.
In two of the most respected, long-range studies of health ever done, the Nurses’ Health Study and the Health Professionals Follow-Up Study, more than 125,000 participants with no history of diabetes, cardiovascular disease, or cancer were investigated specifically for the purpose of examining risk factors for type 2 diabetes. Over time, the risk for developing type 2 diabetes was significantly greater in both men and women with a lower intake of magnesium.
This relationship between low magnesium and diabetes has been confirmed in other research as well. In the Women’s Health Study, researchers looked at the association between magnesium intake and the incidence of type 2 diabetes over an average of six years. Among overweight women, the risk of developing the disease was significantly greater among those with lower intakes of magnesium.
The Iowa Women’s Study followed 40,000 women for more than six years and also examined the relationship between diabetes and magnesium. The findings suggest that a greater intake of whole grains, dietary fiber, and yes, magnesium, decreased the risk of developing type 2 diabetes in older women.
And a number of studies have looked at the potential benefits of magnesium supplements for helping to control type 2 diabetes. In one study, sixty-three subjects with below normal blood levels of magnesium received either 300 mg of elemental magnesium a day or a placebo. At the end of only sixteen weeks, those who received the magnesium had improved metabolic control of diabetes (i.e., lower levels of hemoglobin A1c, an important marker for diabetes).
Alpha Lipoic Acid: The Superstar Antioxidant
Alpha lipoic acid (ALA) is a naturally occurring compound that is made in tiny amounts in the human body. It’s one of the most potent antioxidants on the planet, with two special properties that make it unique. One, it is both fat soluble and water soluble, which makes it more effective against a wide range of free radicals than say vitamin C (water-soluble only) or vitamin E (fat-soluble only). Two, it helps “recycle” those potent antioxidants (vitamins C and E).
Its activity as a super-antioxidant is part of what makes it of great interest to type 2 diabetics. Research has shown that oxidative stress (damage from free radicals) can significantly contribute to insulin resistance. ALA, in addition to its power as an antioxidant, also helps lower blood sugar and improve insulin sensitivity.
In at least four studies, ALA used orally or intravenously improved insulin sensitivity and glucose disposal in patients with type 2 diabetes. Patients who took 600 to 1,800 mg orally or 500 to 1,000 mg intravenously of ALA daily had significant improvement in insulin resistance and glucose effectiveness after four weeks of oral treatment (or after one to ten days of intravenous administration). It’s also good for peripheral neuropathy, a common complication of diabetes that causes painful sensations, especially in the feet and legs. Giving ALA orally or intravenously in 600 to 1,200 mg doses each day seems to reduce symptoms such as burning, pain, numbness, and prickling of the feet and legs.
Controversy exists over which type of ALA supplements are most effective. ALA comes in two forms, the “S” form and the “R” form; the “S” form is the chemical mirror image of the “R” form. Preliminary evidence indicates that the R form is much better absorbed. R-ALA supplements are said to be as effective as or more effective than the traditional ALA supplement (which is a mix of the two forms), based on data from animal studies.
Several other natural supplements that may have positive effects on diabetes have received an “A” for “good scientific evidence” by the rigorous Natural Standard, the Authority on Integrative Medicine, an international research collaboration that systematically reviews scientific evidence on complementary and alternative medicine. These include:
• Beta-Glucan: Beta-glucan is a soluble fiber that has gotten a lot of attention recently for its ability to lower cholesterol. But there are now several human trials that support the use of beta-glucan for controlling blood sugar. In general, fiber slows the entrance of sugar into the blood stream, so high-fiber diets are always a good idea for people with diabetes (as well as for everyone else).
• Ginseng: American ginseng (panax quinquefolium) has been found in studies to lower both fasting blood sugar and post-prandial (after-eating) blood sugar.
• Gymnema: Gymnema sylvestre is an herb that grows in the tropical forests of India, and has long been used as a natural treatment for diabetes. There is good scientific evidence that gymnema can be useful in helping control blood sugar levels especially when used in conjunction with other oral medications.
If you are diabetic or have metabolic syndrome, you might consider looking into these other supplements:
• Biotin: A member of the B-vitamin family, biotin has been found to decrease insulin resistance and improve glucose tolerance. Biotin enhances insulin sensitivity and increases the activity of an enzyme called gluckinase, which is responsible for helping the liver use sugar. One study that used 9 milligrams a day of biotin reduced significant decreases in fasting blood-sugar levels in type 2 diabetics, and another did the same by using 8 to 6 grams a day. Most B-vitamin formulas include less than a milligram of biotin, but for its blood sugar lowering effect you need a lot more than that. (I have high-dose biotin on my website, www.jonnybowden.com.)
• Fish Oil: Though there are currently no studies showing that omega-3s (fish oil) have any significant long-term effects on glucose control or insulin resistance, fish oil can lower both blood pressure (modestly) and triglycerides, an independent risk factor for heart disease. And because diabetes, like all major degenerative diseases, has a huge inflammatory component, the fact that omega-3 fats are so highly anti-inflammatory makes them an important part of any good supplement program for diabetes.
• Cinnamon: Several studies support the use of cinnamon in treating diabetes. The active ingredient in cinnamon—methylhydroxychalcone polymer, or MHCP—seems to mimic insulin function, increasing the uptake of sugar by the cells and signaling certain kinds of cells to turn glucose (plain blood sugar) into glycogen (the storage form of sugar). In 2003, the Beltsville Human Nutrition Research Center worked with researchers in Pakistan to test the effects of cinnamon on blood glucose (as well as triglycerides and cholesterol) in type 2 diabetics. They found that even one gram a day of cinnamon reduced blood sugar by 18 to 29 percent and reduced triglycerides by 23 to 30 percent.