When we talk about diabetes, people usually mention Type 1 and Type 2. Very few are aware of the term ‘Intermediate Diabetes’, which can be cured by an old spice. Dr Anoop Mishra and team share details with Surabhi Jajodia
The prevalence of metabolic syndrome and diseases like diabetes are potential health threats in India. Moreover, Indian spices like cinnamon do not have a scientific validation which could help us use it as a curative or preventive aid. Inspired by this, Dr Anoop Mishra, Director, National Diabetes, Obesity and Cholesterol Foundation and Chairman, Fortis CDOC Hospital, Dr Seema Puri, Associate Professor at Institute of Home Economics, Dr Sonal Gupta Jain, Assistant Professor at Institute of Home Economics and Dr Seema Gulati, conducted a study to assess the value of cinnamon in managing and preventing metabolic syndrome, diabetes, cardiovascular diseases and so on.
Talking about their research study on Promising Effects of Oral Cinnamon on Weight and Multiple Metabolic Parameters in High Risk Individuals, which has been published in an acclaimed international medical journal, they emphasised the importance of diagnosing intermediate diabetes. It’s the stage which involves the high risk of diabetes and if adverse, even leads to heart diseases. “The only difference is that diabetes is irreversible while the intermediate stage, if addressed with healthy diet and exercise, can lead to a normal condition with no risks involved. In our research, we have taken people who are half way down the intermediate stage and are prone to acquire diabetes. In order to pull them back to normal stage, we experimented with their diet. We increased and decreased several ingredients and noted the change. After the process, we came to our conclusion that the components which are associated with metabolic syndrome, that is fasting blood glucose, triglycerides, obesity, particularly abdominal obesity, were reduced to a significant amount. Also, there was a reduction in blood pressure — post systolic and diastolic blood pressure. The most important change was increase of HDl which is good cholesterol. We could reverse the condition of 34 of our patients to normal with our experiment,” said Dr Sonal.
Nutritional modulation remains central to the management of metabolic syndrome. The team investigated the effect of oral cinnamon consumption on body composition and metabolic parameters of Asian Indians with metabolic syndrome. In the 16-week double blind randomised control trial, 116 individuals with metabolic syndrome were randomised to two dietary intervention groups, cinnamon [6 capsules (3 g) daily] or wheat flour [6 capsules (2.5 g) daily]. Body composition, blood pressure and metabolic parameters were assessed.
Significantly greater decrease [difference between means, (95% CI)] in fasting blood glucose (mmol/l) [0.3 (0.2, 0.5) p = 0.001], glycosylated haemoglobin (mmol/mol) [2.6 (0.4, 4.9) p = 0.023], waist circumference (cm) [4.8 (1.9, 7.7) p = 0.002] and body mass index (kg/m2 ) [1.3 (0.9, 1.5) p = 0.001] was observed in the cinnamon group compared to the placebo group. Other parameters which showed significantly greater improvement were: waist-hip ratio, blood pressure, serum total cholesterol, low-density lipoprotein cholesterol, serum triglycerides and high-density lipoprotein cholesterol. Prevalence of defined metabolic syndrome was significantly reduced in the intervention group (34.5%) vs. the placebo group (5.2%).
A single supplement intervention with 3 g cinnamon for 16 weeks resulted in significant improvements in all components of metabolic syndrome in a sample of Asian Indians in north India. So imagine the effects of sustained use.
Dr Sonal talked about the basic factors they kept in mind while carrying out the research on people. “While performing the research, one thing we observed that even though patients are aware of the importance of diet and exercise, the actual problem lies in applying a regimen to their daily routine. Discipline and adherence to a diet is the first step to a healthy life. But in India, people usually cover up by giving excuses like they had to go to parties and so on. Proper motivation and discipline help one to carry out the diet regime honestly while happiness on seeing it work on their body and health keeps them loyal to it.”
In order to cure people from intermediate condition, it’s very important to create awareness among them to go through regular body check-ups and most importantly follow a strict and healthy diet. “People did not know that they had certain conditions like high lipids, low HDl and so on until they were asked to undergo a test. We went to a lot of screenings and conferences where we were able to figure out certain conditions by merely looking at the subjects’ physique. The strangest part was that they were completely unaware of it. Compelled to undergo tests, they discovered that they suffered from conditions like blood sugar and high blood pressure. We can arrest so many cases of full blown diabetes just by following discipline,” Dr Sonal added.
Significant self-referral symptoms and signs which call for consulting a dietician include an elevated BMI (body mass index) count, which should not be more than 23, waist circumference higher than 80 cm for Indians, family history of diabetes and heart disease, birth weight higher than 4 kg (which makes one prone to acquiring diabetes) and existence of a polycystic ovarian syndrome.
Dr Seema Gulati said that educating people is the first step towards creating awareness. “People who have metabolic syndrome are one step away from diabetes and two steps away from heart diseases. left on their own, they keep following a faulty lifestyle which aggravates their latent condition. But if they are educated about the importance of a healthy lifestyle, there can be complete reversal to normal stage. Our research paper has been published in international journals and has gone through a lot of revisions after responses from there. We are trying our best to create a mass awareness campaign.”
Dr Mishra said diet was such a delicate and personalised issue that no amount of internet aids could help you decide what foods are good for you. “Nowadays, everybody searches Google for an answer. We even find people searching emergency medicines on it. If we get all the answers on the net, then why go to a doctor for dietary suggestionsIJ Google provides answers for the general public. But what we fail to understand is that every individual has his own problems and dynamics. A dietician will prescribe the diet based on his or her family history, gene tree, weight, etc. Individualising diet plans, putting emphasis on and deleting certain food items require a lot of detailed study which can be possible via human interaction. That’s the difference between a dietician and internet”, said Dr Mishra.
Talking about the type of awareness created in the field of nutrition and diabetes, Dr Mishra felt that these were the most neglected fields of study and research. The most important step has to be taken by the government. “Unfortunately, nutrition, diabetes and proper diet are not receiving the same status as HIV, polio and AIDS. What we as doctors can do is just a small bit. The Government can do public awareness campaigns,” he added.