Cinnamon effects on metabolic syndrome: a review based on its mechanisms

Document Type: Review Article


1 Department of Physiology and Pharmacology, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran

2 Department of Pharmacodynamic and Toxicology, Pharmaceutical Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran


Objective(s): Nowadays, cardiovascular diseases (CVDs) are the major risk factors of death globally. One of the most undeniable reasons of CVDs is metabolic syndrome (MetS). MetS is defined as a complex of diseases including insulin resistance, hyperglycemia, obesity, high blood pressure and dyslipidemia. The use of complementary medicine such as traditional herbal species can be effective in treatment of MetS`s complications.  Cinnamomum verum (family Lauraceae) is a medicinal global plant which has been used daily by people all over the world. Positive effects of cinnamon in reducing blood pressure, plasma glucose, obesity and ameliorating dyslipidemia which represented in traditional medicine introduced it as probable decreasing MetS`s complications agent. The aim of this review was to investigate the mechanisms of C. verum in reducing the MetS`s complications and CVDs risk factors.
Materials and Methods: Various databases such as PubMed, Science Direct, Scopus, Web of Science, Google Scholar and Persian Websites such as with keywords search of cinnamon, cinnamomum, cinnamaldehyde, atherogenic, hypertension, hyperglycemia, insulin resistance, obesity and dyslipidemia have been included in this search.
Results: Clinical data and mechanisms of action of C. verum and its active ingredients that have been shown in this review indicated that cinnamon has protective effects against MetS`s aspects in various ways.
Conclusion: The use of this plant can be effective in reducing MetS`s complications and its morbidity and mortality.


1. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005; 365:1415–1428.

2. JAMA, 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 (Adult Treatment Panel III). 2001; 285:2486–2497.

3. Bener A, Yousafzai MT, Darwish S, Al-Hamaq AO, Nasralla EA, Abdul ghani M. Obesity inde.x that better predict metabolic syndrome: body mass index, waist circumference, waist hip ratio, or waist height ratio. J Obes 2013; 269038.

4. Srikanthan P, Seeman TE, Karlamangla AS. Waist-hip-ratio as a predictor of all-cause mortality in high-functioning older adults. Annals Epidemiol 2009; 19:724-731.

5. Razavi BM, Hosseinzadeh H. A review of the effects of Nigella sativa L. and its constituent, thymoquinone, in metabolic syndrome.  J Endocrinol Invest 2014; 37:1031-40.

6. Tabatabai SM, Dashti S, Doosti F,  Hosseinzadeh H. Phytotherapy of opioid dependence and withdrawal syndrome: a review. Phytother Res 2014; 28:811-830.

7. Hosseinzadeh H, Nassiri-Asl M. Review of the protective effects of rutin on the metabolic function as an important dietary flavonoid. J Endocrinol Invest 2014; 37:783-788.

8. Hassani FV, Shirani K, Hosseinzadeh H. Rosemary (Rosmarinus officinalis) as a potential therapeutic plant in metabolic syndrome: a review. Naunyn Schmiedebergs Arch Pharmacol. 2016; 389:931-949.

9. Hosseini A, Hosseinzadeh H. A review on the effects of Allium sativum (Garlic) in metabolic syndrome. J Endocrinol Invest 2015; 38:1147-1157.

10. Razavi BM, Hosseinzadeh H. Saffron: a promising natural medicine in the treatment of metabolic syndrome. J Sci Food Agric. 2016; In Press.

11. Akaberi M, and Hosseinzadeh H. Grapes (Vitis vinifera) as a potential candidate for the therapy of the metabolic syndrome. Phytother Res 2016; 30:540-556.

12. Hosseini A, Hosseinzadeh H. A review on the effects of Allium sativum (Garlic) in metabolic syndrome. J Endocrinol Invest 2015; 38:1147-57.

13. Shu Z, Xiwen L, Jie L, Van der Werff H. CINNAMOMUM Schaeffer, Bot. Exped. 74. 1760, nom. cons. Flora. China. 2008; 7:166–187.

14. Jayaprakasha GK, Rao LJ. Chemistry, biogenesis, and biological activities of Cinnamomum zeylanicum. Crit Rev Food Sci Nutr 2011; 51: 547-562.

15. Singh G, Maurya S, DeLampasona MP, Catalan CA. A comparison of chemical, antioxidant and antimicrobial studies of cinnamon leaf and bark volatile oils, oleoresins and their constituents. Food Chem Toxicol 2007; 45:1650–1661.

16. Senanayake UM, Lee TH, Wills RBH. Volatile constituents of cinnamon (Cinnamomum zeylanicum) oils. J Agric Food Chem 1978; 26:822–824.

17. Rao PV, Gan SH. Cinnamon: a multifaceted medicinal plant. Evid Based Complement Alternat Med 2014; 642942.

18. Ranasinghe P, Pigera S, Premakumara GA, Galappaththy P, Constantine GR, Katulanda P. Medicinal properties of 'true' cinnamon (Cinnamomum zeylanicum): a systematic review. BMC Complement Altern Med 2013; 13:275.

19. Aneja K, Joshi R, Sharma C. Antimicrobial activity of dalchini (Cinnamomum zeyancum bark) extracts on some dental caries pathogens. J Pharm Res 2009; 2:1387–1390.

20. Mathew S, Abraham TE. In vitro antioxidant activity and scavenging effects of Cinnamomum verum leaf extract assayed by different methodologies. Food Cheml Toxcol 2006; 44:198–206.

21. Miranda PJ, De Fronzo RA, Califf RM, Guyton JR. Metabolic syndrome: Definition, pathophysiology, and mechanisms. Am Heart J 2005; 149:33-45.

22. Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissén M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24:683-689.

23. Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al The metabolic syndrome and cardiovascular risk, a systemic reviewe and meta-analysis. J Am Coll Cardiol 2010; 56:1113-1138.

24. Ziegenfuss TM, Hofheins JE, Mendel RW. Effects of water soluble cinnamon extracts on body composition and features of the metabolic syndrome in prediabetic men and women. J Int Soc Sports Nutr 2006; 3:45-53.

25. Couturier K, Batandier C, Awada M, Hininger-Favier I, Canini F, Anderson RA, et al. Cinnamon improves insulin sensitivity and alters the body composition in an animal model of the metabolic syndrome. Arch Biochem Biophys 2010; 501:158-161.

26. Shen Y, Jia LN, Honma N, Hosono T, Ariga T, Seki T. Beneficial effects of cinnamon on the metabolic syndrome, inflammation, and pain, and mechanisms underlying these effects-a review. Tradit Complement Med 2012; 2:27-32.

27. Khan A, Bryden NA, Polansky MM, Anderson RA. Insulin potentiating factor and chromium content of selected foods and spices. Biol Trace Elem Res 1990; 24:183–188.

28. Sangal A. Role of cinnamon as beneficial antidiabetic food adjunct: a review. Adv Appl Sci Res 2011; 2:440-450.

29. Couturier K, Qin B, Batandier C, Awada M, Hininger-Favier I, Canini F, et al Cinnamon increases liver glycogen in an animal model of insulin resistance. Metabolism 2011; 60:1590-1597.

30. Adisakwattana S, Lerdsuwankij O, Poputtachai U, Minipun A, Suparpprom C. Inhibitory activity of cinnamon bark species and their combination effect with acarbose against intestinal α-glucosidase and pancreatic α-amylase. Plant Foods Hum Nutr 2011; 66:143-148.

31. Kreydiyyeh SI, Usta J, Copti R. Effect of cinnamon, clove and some of their constituents on the Na(+)-K(+)-ATPase activity and alanine absorption in the rat jejunum. Food Chem Toxicol 2000; 38:755-762.

32. Anderson RA, Broadhurst CL, Polansky MM, Schmidt WF, Khan A, Flanagan VP, 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.

33. Qin B, Nagasaki M, Ren M, Bajotto G, Oshida Y, Sato Y. Cinnamon extract (traditional herb) potentiates in vivo insulin-regulated glucose utilization via enhancing insulin signaling in rats. Diabetes Res Clin Pract 2003; 62:139-148.

34. Anderson RA, Broadhurst CL, Polansky MM, Schmidt WF, Khan A. Isolation and characterization of polyphenol type-A polymers from cinnamon with insulin-like biological activity. J Agric Food Chem 2004; 52:65–70.

35. Im K, Issac A, Ninan E, Maliakel B, Kuttan R. Effects of the polyphenol content on the anti-diabetic activity of Cinnamomum zeylanicum extracts. Food Funct 2014; 5:2208-2220.

36. Blevins SM, Leyva MJ, Brown J, Wright J, Scofield RH, Aston CE. Effect of cinnamon on glucose and lipid levels in non-insulin-dependent type 2 diabetes.  Diabetes Care 2007; 30:2236–2237.

37. Hafizur RM, Hameed A, Shukrana M, Raza SA, Chishti S, Kabir N, et al Cinnamic acid exerts anti-diabetic activity by improving glucose tolerance in vivo and by stimulating insulin secretion in vitro. Phytomedicine 2015; 22:297-300.

38. Camacho S, Michlig S, De Senarclens-Bezençon C, Meylan J, Meystre J, Pezzoli M, et al. Antiobesity and anti-hyperglycemic effects of cinnamaldehyde via altered ghrelin secretion and functional impact on food intake and gastric emptying. Sci Rep 2015;  21:7919.

39. Mang B, Wolters M, Schmitt B, Kelb K, Lichtinghagen R, Stichtenoth DO, et al Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest 2006; 36:340-344.

40. Huang B, Yuan HD, Kimdo Y, Quan HY, Chung SH. Cinnamaldehyde prevents adipocyte differentiation and adipogenesis via regulation of peroxisome proliferator-activated receptor-gamma (PPARgamma) and AMP-activated protein kinase (AMPK) pathways. J Agric Food Chem 2011; 59:3666–3673.

41. Sheng X, Zhang Y, Gong Z, Huang C, Zang YQ. Improved insulin resistance and lipid metabolism by cinnamon extract through activation of peroxisome proliferator-activated receptors. PPAR Res 2008; 581348.

42. Takasao N, Tsuji-Naito K, Ishikura S, Tamura A, Akagawa M. Cinnamon extract promotes type I collagen biosynthesis via activation of IGF-I signaling in human dermal fibroblasts. J Agric Food Chem 2012; 60:1193-200.

43. Usta J, Kreydiyyeh S, Bajakian K, Nakkash-Chmaisse H. In vitro effect of eugenol and cinnamaldehyde on membrane potential and respiratory chain complexes in isolated rat liver mitochondria. Food Chem Toxicol 2002; 40:935-940.

44. Schriner SE, Kuramada S, Lopez TE, Truong S, Pham A, Jafari M. Extension of Drosophila lifespan by cinnamon through a sex-specific dependence on the insulin receptor substrate chico. Exp Gerontol 2014; 60:220-230.

45. Beejmohun V, Peytavy-Izard M, Mignon C, Muscente-Paque D, Deplanque X, Ripoll C, et al. Acute effect of Ceylon cinnamon extract on postprandial glycemia: alpha-amylase inhibition, starch tolerance test in rats, and randomized crossover clinical trial in healthy volunteers. BMC Complement Altern Med 2014; 14:351-359.

46. Shen Y, Honma N, Kobayashi K, Jia LN, Hosono T, Shindo K, et al. Cinnamon extract enhances glucose uptake in 3T3-L1 adipocytes and C2C12 myocytes by inducing LKB1-AMP-activated protein kinase signaling. PLoS One 2014; 9:e87894.

47. Peng X, Ma J, Chao J, Sun Z, Chang RC, Tse I, et al Beneficial effects of cinnamon proanthocyanidins on the formation of specific advanced glycation endproducts and methylglyoxal-induced impairment on glucose consumption. J Agric Food Chem 2010; 58:6692–6696.

48. Ranasinghe P, Jayawardana R, Galappaththy P, Constantine GR, Gunawardana DV, Katulanda P. Efficacy and safety of 'true' cinnamon (Cinnamomum zeylanicum) as a pharmaceutical agent in diabetes: a systematic review and metaanalysis. Diabet Med Dec 2012; 29:1480–1492.

49. 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.

50. Cao H, Polansky MM, Anderson RA. Cinnamon extract and polyphenols affect the expression of tristetraprolin, insulin receptor, and glucose transporter 4 in mouse 3T3-L1 adipocytes.  Arch Biochem Biophys 2007; 459:214–222.

51. Vanschoonbeek K, Thomassen BJ, Senden JM, Wodzig WK, van Loon LJ. Cinnamon supplementation does not improve glycemic control in postmenopausal type 2 diabetes patients. J Nutr 2006; 136:977–980.

52. Valko M, Leibfritz D, Moncola J, Cronin MTD, Mazura M, Telser J. Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell Biol 2007; 39:44-84.

53. Mu T, Gori T, Bruno RM, Taddei S. Is oxidative stress a therapeutic target in cardiovascular disease? Eur Heart J 2010; 31:2741–2749.

54. Bashan N, Kovsan J, Kachko I, Ovadia H, Rudich A. Positive and negative regulation of insulin signaling by reactive oxygen and nitrogen species. Physiol Rev 2009; 89:27–71.

55. Cadenas E. Basic mechanisms of antioxidant activity. Biofactors 2009; 6:391–397.

56. Halliwell B. Free radicals and antioxidants—quo vadis? Trends Pharmacol Sci 2011; 32:125–130.

57. Dhuley JN. Anti-oxidant effects of cinnamon (Cinnamomum verum) bark and greater cardamon (Amomumsubulatum) seeds in rats fed high fat diet. Indian J Exp Biol 1999; 37:238-242.

58. Mancini-Filho J, van-Koiij A, Mancini DAP, Cozzolino F, Torres RP. Antioxidant activity of cinnamon (Cinnamomum zeylanicum, breyne) extracts. Bollettino Chimico Farmaceutico 1998; 137:443–447.

59. Boğa M, Hacıbekiroğlu I, Kolak U.  Antioxidant and anticholinesterase activities of eleven edible plants. Pharm Biol 2011; 49:290-295.

60. Aravind R, Aneesh T, Bindu A, Bindu K. Estimation of phenolics and evaluation of antioxidant activity of Cinnamomum malabatrum (Burm. F). Blume Asian J Res Chem 2012; 5:628–632.

61. Chericoni S, Prieto JM, Iacopini P, Cioni P, Morelli I. In vitro activity of the essential oil of Cinnamomum zeylanicum and eugenol in peroxynitrite-induced oxidative processes. J Agric Food Chem 2005; 53:4762–4765.

62. Khaki A. Effect of Cinnamomum zeylanicumon on Spermatogenesis. Iran Red Crescent Med J 2015; 17:e18668.

63. Keshvari M, Asgary S, Jafarian-dehkordi A, Najafi S, Ghoreyshi-Yazdi S.M. Preventive effect of cinnamon essential oil on lipid oxidation of vegetable oil. ARYA Atheroscler 2013; 9:280–286.

64. Okawa M, Kinjo J, Nohara T, Ono M. DPPH (1,1-diphenyl-2-Picrylhydrazyl) radical scavenging activity of flavonoids obtained fromsomemedicinal plants. Biol Pharm Bullet 2001; 24:1202–1205.

65. Kim SJ, Han D, Moon KD, Rhee JS. Measurement of superoxide dismutase-like activity of natural antioxidants. Biosci Biotechnol Biochem 1995; 59:822-826.

66. Kumar S, Vasudeva N, Sharma S. GC-MS analysis and screening of antidiabetic, antioxidant and hypolipidemic potential of Cinnamomum tamala oil in streptozotocin induced diabetes mellitus in rats. Cardiovasc Diabetol 2012; 11:1–11.

67. Lee HS, Kim BS, Kim MK. Suppression effect of Cinnamomum cassia bark-derived component on nitric oxide synthase. J Agric Food Chem 2002; 50:7700–7703.

68. Roussel AM, Hininger I, Benaraba R, Ziegenfuss TN, Anderson RA. Antioxidant effects of a cinnamon extract in people with impaired fasting glucose that are overweight or obese. J Am Coll Nutr 2009; 28:16-21.

69. Pandey M, Chandra DR. Evaluation of Ethanol and Aqueous extracts of Cinnamomum verum Leaf Galls for Potential Antioxidant and Analgesic activity. Indian J Pharm Sci 2015; 77:243-247.

70. Moselhy SS, Ali HK. Hepatoprotective effect of cinnamon extracts against carbon tetrachloride induced oxidative stress and liver injury in rats. Biol Res 2009; 42:993-998.

71. Villela NR, Kramer-Aguiar LG, Bottino DA, Wiernsperger N, Bouskela E. Metabolic disturbances linked to obesity: the role of impaired tissue perfusion. Arq Bras Endocrinol Metab 2009; 53:238-245.

72. Mancia G, Bousquet P,  Elghozi JL, Esler M, Grassi G, Julius S, et al. The sympathetic nervous system and the metabolic syndrome. J Hypertens 2007; 25:909-920.

73. Akilen R, Pimlott Z, Tsiami A, Robinson N. Effect of short-term administration of cinnamon on blood pressure in patients with prediabetes and type 2 diabetes. Nutrition 2013; 29:1192-1196.

74. Akilen R, Tsiami A, Devendra D, Robinson N. 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. Diabet Med 2010; 27:1159-1167.

75. Alvarez-Collazo J, Alonso-Carbajo L, López-Medina AI, Alpizar YA, Tajada S, Voetes T, et al. Cinnamaldehyde inhibits L-type calcium channels in mouse ventricular cardiomyocytes and vascular smooth muscle cells. Pflugers Arch 2014; 466:2089-2099.

76. Nyadjeu P, Dongmo A, Nguelefack TB, Kamanyi A. Antihypertensive and vasorelaxant effects of Cinnamomum zeylanicum stem bark aqueous extract in rats. J Complement Integr Med 2011; doi: 10.2202/1553-3840.1490

77. Earley S. TRPA1 channels in the vasculature. Br J Pharmacol 2012; 167:13-22.

78. Nyadjeu P, Nguelefack-Mbuyo EP, Atsamo AD, Nguelefack TB, Dongmo AB, Kamanyi A. Acute and chronic antihypertensive effects of Cinnamomum zeylanicum stem bark methanol extract in L-NAME-induced hypertensive rats. BMC Complement Altern Med 2013; 31:13-27.

79. Kaffash Elahi R. The effect of the cinnamon on dog's heart performance by focus on Kortkoff sounds. J Animal Veterinary 2012; 11:3604-3608.

80. El-Bassossy HM, Fahmy A, Badawy D. Cinnamaldehyde protects from the hypertension associated with diabetes. Food Chem Toxicol 2011; 49:3007-3012.

81. Grayson PC, Kim SY, LaValley M, Choi HK. Hyperuricemia and incident hypertension: a systematic review and meta-analysis.  Arthritis Care Res (Hoboken) 2011; 63:102-110.

82. Rao A, Pandya V, Whaley-Connell A. Obesity and insulin resistance in resistant hypertension: implications for the kidney. Adv Chronic Kidney Dis 2015; 22:211-217.

83. Badalzadeh R, Shaghaghi M, Mohammadi M, Dehghan G, Mohammadi Z. The effect of cinnamon extract and long-term aerobic training on heart function, biochemical alterations and lipid profile following exhaustive exercise in male rats. Adv Pharm Bull 2014; 4:515-520.

84. Ko FN, Yu SM, Kang YF, Teng CM. Characterization of the thromboxane (TP-) receptor subtype involved in proliferation in cultured vascular smooth muscle cells of rat. Br J Pharmacol 1995; 116:1801-1808.

85. Yu SM, Wu TS, Teng CM. Pharmacological characterization of cinnamophilin, a novel dual inhibitor of thromboxane synthase and thromboxane A2 receptor. Br J Pharmacol 1994; 111:906-912.

86. Hwa JS, Jin YC, Lee YS, Ko YS, Kim YM, Shi LY, HJ Kim, JH Lee, TM Ngoc, YS Kim, KC, et al. Chang, 2-Methoxycinnamaldehyde from Cinnamomum cassia reduces ratmyocardial ischemia and reperfusion injury in vivo due to HO-1 induction. J Ethnopharmacol 2012; 139:605-615.

87. Song F, Li H, Sun J, Wang S. Protective effects of cinnamic acid and cinnamic aldehyde on isoproterenol-induced acute myocardial ischemia in rats. J Ethnopharmacol 2013; 150:125-130.

88. Badalzadeh R, Shaghaghi M, Mohammadi M, Dehghan G, Mohammadi Z. The effect of cinnamon extract and long-term aerobic training on heart function, biochemical alterations and lipid profile following exhaustive exercise in male rats. Adv Pharm Bull 2014; 4:515-520.

89. Rega G, Kaun C, Demyanets S, Pfaffenberger S, Rychli K, Kastl SP, et al. Vascular endothelial growth factor Is induced by the inflammatory cytokines interleukin-6 and oncostatin M in human adipose tissue In vitro and in murine adipose tissue In vivo. Arterioscler Thromb Vasc Biol 2007; 27:1587-1595.

90. Muhammad JS, Zaidi SF, Shaharyar S, Refaat A, Usmanghani K, Saiki I, et al. Anti-inflammatory effect of cinnamaldehyde in Helicobacter pylori induced gastric inflammation. Biol Pharm Bull 2015; 38:109-115.

91. Mashhadi NS, Ghiasvand R, Askari G, Feizi A, Hariri M, Darvishi L, et al. Influence of ginger and cinnamon intake on inflammation and muscle soreness endued by exercise in Iranian female athletes. Int J Prev Med 2013; 4:11-15.

92. Lee SH, Lee SY, Son DJ, Lee H, Yoo HS, Song S, et al. Inhibitory effect of 2`- hydroxycinnamaldehyde on nitric oxide production through inhibition of NF-𝜅B activation inRAW264.7 cells. Biochem Pharmacol 2005; 69:791-799.

93. Muhammad JS, Zaidi SF, Shaharyar S, Refaat A, Usmanghani K, Saiki I, et al. Anti-inflammatory effect of cinnamaldehyde in Helicobacter pylori induced gastric inflammation. Biol Pharm Bull 2015; 38:109-115.

94. Yu T, Lee S, Yang WS, Jang HJ, Lee YJ, Cho NY. The ability of an ethanol extract of Cinnamomum cassia to inhibit Src and spleen tyrosine kinase activity contributes to its anti-inflammatory action. J Ethnopharmacol 2012; 139:566-573.

95. Lee BJ, Kim YJ, Cho DH, Sohn NW, Kang H. Immunomodulatory effect of water extract of cinnamon on anti-CD3-induced cytokine responses and p38, JNK, ERK1/2, and STAT4 activation. Immunopharmacol Immunotoxicol 2011; 33:714-722.

96. Hong JW, Yang GE, Kim YB, Eom SH, Lew JH, Kang H. Anti-inflammatory activity of cinnamon water extract in vivo and in vitro LPS-inducedmodels. BMC Complement  Altern Med 2012; 12:237.

97. Bolin Q, Anderson R. Cinnamon polyphenols increase oxygen-glucose deprivation of decreased PGE2 production by upregulation of SIRT1 and alleviation of the anti-inflammatory effects (830.11). FASEB J 2014; 28:830-841.

98. Chao LK, Hua KF, Hsu HY, Cheng SS, Lin IF, Chen CJ, et al. Cinnamaldehyde inhibits pro-inflammatory cytokines secretion from monocytes/macrophages through suppression of intracellular signaling. Food Chem Toxicol 2008; 46:220-231.

99. Huang SH, Choi YG, Jeong MY, Hong YM, Lee JH, Lim S. Microarray analysis of gene expression profile by treatment of Cinnamomi ramulus in lipopolysaccharide estimulated BV-2 cells. Gene 2009; 443:83-90.

100. Gunawardena D, Karunaweera N, Lee S, Van Der Kooy F, Harman,  DG  Raju R, et al. Anti-inflammatory activity of cinnamon (C. zeylanicum and C. cassia) extracts – identification of E-cinnamaldehyde and o-methoxy cinnamaldehyde as the most potent bioactive compounds. Food Funct 2015; 6:910-919.

101. Rathi B, Bodhankar S, Mohan V, Thakurdesai P. Ameliorative effects of a polyphenolic fraction of Cinnamomum zeylanicum L. bark in animal models of inflammation and arthritis. Sci Pharm 2013; 81:567–589.

102. Lu J, Zhang K, Nam S, Anderson RA, Jove R, Wen W. Novel angiogenesis inhibitory activity in cinnamon extract blocks VEGFR2 kinase and downstream signaling. Carcinogenesis 2010; 31:481-488.

103. Ross R, Després JP. Abdominal obesity, insulin resistance, and the metabolic syndrome: contribution of physical activity/exercise. Obesity 2009; 17:S1-S2.

104. Takemoto K, Deckelbaum RJ, Saito I, Likitmaskul S, Morandi A, Pinelli L, et al. Adiponectin/resistin levels and insulin resistance in children: a four country comparison study. Int J Pediatr Endocrinol 2015; 2015:2.

105. Rahman S, Begum H, Rahman Z, Ara F, Iqbal MJ, Abukalam MY. Effect of cinnamon (Cinnamomum cassia) as a lipid lowering agent on hypercholesterolemic rats. J  Enam Medical College 2013; 3:94-98.

106. Kim SH, Choung SY. Antihyperglycemic and antihyperlipidemic action of Cinnamomi cassiae (Cinnamon bark) extract in C57BL/Ks db/db mice. Arch Pharm Res 2010; 33:325-333.

107. Khan A, Safdar M, Ali Khan MM, Khattak KN, Anderson RA. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003; 26:3215-3218.

108. Shatwan IA, Ahmed LA, Badkook MM. Effect of barley flour, crude cinnamon, and their combination on glycemia, dyslipidemia, and adipose tissue hormones in type 2 diabetic rats. J Med Food 2013; 16:656-662.

109. Javed I, Faisal I, Rahman Z, Khan MZ, Muhammad F, Aslam B, et al. Lipid lowering effect of Cinnamomum zeylanicum in hyperlipidaemic albino rabbits. Pak J Pharm Sci 2012; 25:141-147.

110. Lee JS, Jeon SM, Park EM, Huh TL, Kwon OS, Lee MK, et al. Cinnamate supplementation enhances hepatic lipid metabolism and antioxidant defense systems in high cholesterol-fed rats. J Med Food 2003; 6:183-191.

111. Jin S, Cho KH. Water extracts of cinnamon and clove exhibits potent inhibition of protein glycation and anti-atherosclerotic activity in vitro and in vivo hypolipidemic activity in zebrafish. Food Chem Toxicol 2011; 49:1521-1529.

112. Wronkowitz N, Romacho T, Sell H, Eckel J. Adipose tissue dysfunction and inflammation in cardiovascular disease. Front Horm Res 2014; 43:79-92.

113. Arslan N, Sayin O, Tokgoz Y. Evaluation of serum xenin and ghrelin levels and their relationship with nonalcoholic fatty liver disease and insulin resistance in obese adolescents. J Endocrinol Invest 2014; 37:1091-1097.

114. Sartorius T, Peter A, Schulz N, Drescher A, Bergheim I, Machann J, et al. Cinnamon extract improves insulin sensitivity in the brain and lowers liver fat in mouse models of obesity. PLoS One 2014; 9:e92358.

115. Ogasawara J, Kitadate K, Nishioka H, Fujii H, Sakurai T, Kizaki T, et al. Oligonol, an oligomerized lychee fruit-derived polyphenol, activates the Ras/Raf-1/MEK1/2 cascade independent of the IL-6 signaling pathway in rat primary adipocytes. Biochem Biophys Res Commun 2010; 402:554-559.

116. Mercader J, Palou A, Bonet ML. Resveratrol enhances fatty acid oxidation capacity and reduces resistin and retinol-binding protein 4 expression in white adipocytes. J Nutr Biochem 2011; 22:828–834.

117. Uchiyama S, Taniguchi Y, Saka A, Yoshida A, Yajima H. Prevention of diet-induced obesity by dietary black tea polyphenols extract in vitro and in vivo. Nutrition 2011; 27:287-292.           

118. Seely KA, Levi MS, Prather PL. The dietary polyphenols trans-resveratrol and curcumin selectively bind human CB1 cannabinoid receptors with nanomolar affinities and function as antagonists/inverse agonists. J Pharmacol Exp Ther 2009; 330:31–39.

119. Overman A, Bumrungpert A, Kennedy A, Martinez K, Chuang CC, West T, et al. Polyphenol-rich grape powder extract (GPE) attenuates inflammation in human macrophages and in human adipocytes exposed to macrophage-conditioned media. Int J Obes (Lond) 2010; 34:800–808.

120. Vafa M, Mohammadi F, Shidfar F, Sormaghi MS, Heidari I, Golestan B, et al. Effects of cinnamon consumption on glycemic status, lipid profile and body composition in type 2 diabetic patients. Int J Prev Med 2012; 3:531-536.