Chromium: An Element Essential to HealthAugust 2004
By Dale Kiefer
|LE Magazine August 2004|
|Chromium: An Element Essential to Health|
By Dale Kiefer
Safe and Well Tolerated
In light of research by Dr. Anderson and other scientists, the USDA’s Food and Nutrition Board revised the dietary reference intake (formerly the recommended dietary allowance, or RDA) for chromium in 2001. Noting that there have never been any reported adverse effects from high dosages of chromium, the board declined to establish a tolerable upper intake level for chromium. By default, the government has acknowledged that there is no known dose of supplemental chromium that is too high to be safe.
The dietary reference intake level of chromium currently is 35 mcg per day for adult men and 25 mcg per day for adult women. Because pregnancy and lactation are known to deplete chromium stores, taking 30 mcg daily is recommended for pregnant women, and women who are breastfeeding should take at least 45 mcg daily. Dr. Anderson postulates that doses well above these recommended minimum levels may be necessary to treat chronic diseases. Citing a study conducted in China, he notes that patients there received up to 1,000 mcg of chromium per day, a dose that proved “highly effective” in relieving many of the symptoms of type II diabetes.36
Reiterating his conviction that chromium supplementation is safe, Dr. Anderson says, “Chromium is one of the safest nutrients we have.” As further proof, he points to the new government-issued guidelines for chromium consumption. “There’s no upper limit for chromium. At the highest levels tested there’s no toxicity . . . it’s safer than water.” That may sound like hyperbole, but there is an empirical basis for this claim. As Dr. Anderson notes, there is no discernible toxicity when one consumes 100 times the dietary reference intake of chromium. By contrast, consuming 100 times the daily requirement for water, were it physically possible to do so, would certainly be toxic.
Niacin Reinforces Positive Effects
Physicians have known for years that lowering so-called “bad” LDL cholesterol is of paramount importance if one is to avoid heart disease risk. Cholesterol is manufactured by the body and is a necessary and natural component of cell membranes and steroid hormones. It is also present in some foods we consume. But excess cholesterol promotes atherosclerosis, whether it is a genetically determined consequence of cholesterol overproduction by the liver or the result of dietary overindulgence. And atherosclerosis generally yields disastrous health consequences, ranging from heart attacks to stroke.
In 2001, the National Cholesterol Education Program (NCEP) issued NCEP-III, a series of new guidelines for the aggressive management of cholesterol and triglycerides.51 NCEP-III is a clarion call for doctors to treat elevated LDL and triglycerides more aggressively, with prescriptions for diet, exercise, and drug therapy. One of the more striking features of NCEP-III is its reclassification of the status of HDL (high-density lipoprotein). HDL is beneficial because it acts to transport cholesterol out of the arteries and back to the liver where it can be cleared from the body.52 NCEP-III raised the limit at which a person’s HDL is to be considered too low. In effect, NCEP-III placed new emphasis on the importance not only of lowering total cholesterol and LDL, but also of raising HDL.51 Physicians are slowly recognizing that low HDL may be just as unhealthy as high LDL.
The good news is that niacin and chromium both raise levels of “good” HDL while lowering “bad” LDL and triglyceride levels. Niacin alone may raise HDL by as much as 15% while lowering total cholesterol and triglycerides by up to 20% and 40%, respectively.53 While doctors have known this for more than 30 years, some have resisted prescribing therapeutic doses of niacin, probably because of side effects caused by early forms of the vitamin. Some patients have experienced flushing of the face and neck or other side effects from high-dose niacin therapy. But dosing and formulation changes have provided a form of niacin that is both effective and well tolerated.40-42, 47
In fact, the simple nutrient niacin is so good at improving one’s lipid profile that it inspired one researcher to declare: “[Niacin] is the most effective agent available for increasing HDL levels while lowering levels of LDL and triglycerides, and improving other lipid risk factors such as lipoprotein(a).”42 Expensive statin drugs are most commonly prescribed to treat lipid imbalances, but physicians are beginning to recognize that niacin is one of the most effective, inexpensive treatments available for lipid therapy.44,48,49
Chromium clearly plays an important role in normal carbohydrate and lipid metabolism. It is equally clear that many millions of people are likely to be deficient in this essential micronutrient, and would therefore benefit by adding supplemental chromium to their daily diet.
1. Anderson RA. Chromium and parenteral nutrition. Nutrition. 1995 Jan-Feb;11(1 Suppl):83-6.
2. Brown RO, Forloines-Lynn S, Cross RE, Heizer WD. Chromium deficiency after long-term total parenteral nutrition. Dig Dis Sci. 1986 Jun;31(6):661-4.
3. Freund H, Atamian S, Fischer JE. Chromium deficiency during total parenter al nutrition. JAMA. 1979 Feb 2;241(5):496-8.
4. Anderson RA, Cheng N, Bryden NA, et al. Elevated intakes of supplemental chromium improve glucose and insulin variables in indi- viduals with type 2 diabetes. Diabetes. 1997 Nov;46(11):1786-91.
5. Wilson BE, Gondy A. Effects of chromium supplementation on fasting insulin levels and lipid parameters in healthy, non-obese young subjects. Diabetes Res Clin Pract. 1995 Jun;28(3):179-84.
6. Bahijri SM. Effect of chromium supplemen- tation on glucose tolerance and lipid profile. Saudi Med J. 2000 Jan;21(1):45-50.
7. Bahijri SM, Mira SA, Mufti AM, Ajabnoor MA. The effects of inorganic chromium and brewer’s yeast supplementation on glucose tolerance, serum lipids and drug dosage in individuals with type 2 diabetes. Saudi Med J. 2000 Sep;21(9):831-7.
8. Bahijri SM, Mufti AM. Beneficial effects of chromium in people with type 2 diabetes, and urinary chromium response to glucose as a possible indicator of status. Biol Trace Elem Res. 2002 Feb;85(2):97-109.
9. Zima T, Mestek O, Tesar V, et al. Chromium levels in patients with internal diseases. Biochem Mol Biol Int. 1998 Oct;46(2):365- 74.
10. Uyanik F. The effects of dietary chromium supplementation on some blood parameters in sheep. Biol Trace Elem Res. 2001;84(1- 3):93-101.
11. Cheng HH, Lai MH, Hou WC, Huang CL. Antioxidant effects of chromium supplementation with type 2 diabetes mellitus and euglycemic subjects. J Agric Food Chem. 2004 Mar 10;52(5):1385-9.
12. Thomas VL, Gropper SS. Effect of chromium nicotinic acid supplementation on selected cardiovascular disease risk factors. Biol Trace Elem Res. 1996 Dec;55(3):297-05.
13. Morris BW, MacNeil S, Hardisty CA, Heller S, Burgin C, Gray TA. Chromium homeostasis in patients with type II (NIDDM) diabetes. J Trace Elem Med Biol. 1999 Jul;13(1-2):57-61.
14. Ekmekcioglu C, Prohaska C, Pomazal K, Steffan I, Schernthaner G, Marktl W. Concentrations of seven trace elements in different hematological matrices in patients with type 2 diabetes as compared to healthy controls. Biol Trace Elem Res. 2001 Mar;79(3):205-19.
15. Anderson RA. Effects of chromium on body composition and weight loss. Nutr Rev. 1998 Sep;56(9):266-70.
16. Crawford V, Scheckenbach R, Preuss HG. Effects of niacin-bound chromium supplementation on body composition in over- weight African-American women. Diabetes Obes Metab. 1999 Nov;1(6):331-7.
17. Bahadori B, Wallner S, Schneider H, Wascher TC, Toplak H. Effect of chromium yeast and chromium picolinate on body composition of obese, non-diabetic patients during and after a formula diet. Acta Med Austriaca. 1997;24(5):185-7.
18. Kleefstra N, Bilo HJ, Bakker SJ, Houweling ST. Chromium and insulin resistance. Ned Tijdschr Geneeskd. 2004 Jan 31;148(5):217- 20.
19. Lamson DS, Plaza SM. The safety and efficacy of high-dose chromium. Altern Med Rev. 2002 Jun;7(3):218-35.
20. Anderson RA. Recent advances in the clinical and biochemical effects of chromium deficiency. Prog Clin Biol Res. 1993;380:221- 34.
21. Anderson RA. Essentiality of chromium in humans. Sci Total Environ. 1989 Oct 1;86(1- 2):75-81.
22. Anderson RA. Nutritional role of chromium. Sci Total Environ. 1981 Jan;17(1):13-29.
23. Anderson RA. Chromium metabolism and its role in disease processes in man. Clin Physiol Biochem. 1986;4(1):31-41.
24. Anderson RA. Chromium in the prevention and control of diabetes. Diabetes Metab. 2000 Feb;26(1):22-7.
25. Racek J. Chromium as an essential element. Cas Lek Cesk. 2003;142(6):335-9.
26. Appleton DJ, Rand JS, Sunvold GD, Priest J. Dietary chromium tripicolinate supplementation reduces glucose concentrations and improves glucose tolerance in normal-weight cats. J Feline Med Surg. 2002 Mar;4(1):13-25.
27. Shinde Urmila A, Sharma G, Xu YJ, Dhalla NS, Goyal R K. Anti-diabetic activity and mechanism of action of chromium chloride. Exp Clin Endocrinol Diabetes. 2004 May;112(5):248-52.
28. Guan X, Matte JJ, Ku PK, Snow JL, Burton JL, Trottier NL. High chromium yeast supplementation improves glucose tolerance in pigs by decreasing hepatic extraction of insulin. J Nutr. 2000 May;130(5):1274-9.
29. Shigeta A, Ratanamaneechat S, Srisukho S, et al. Epidemiological correlation between chromium content in gallstones and choles- terol in blood. J Med Assoc Thai. 2002 Feb;85(2):183-94.
30. Turkoski BB. An ounce of prevention. Drugs used to treat hyperlipidemia (Part 1). Orthop Nurs. 2004 Jan;23(1):58-61.
31. Brunzell JD, Ayyobi AF. Dyslipidemia in the metabolic syndrome and type 2 diabetes mel- litus. Am J Med. 2003 Dec 8;115 Suppl 8A:24S-8S.
32. Kuvin JT, Karas RH. The effects of LDL reduction and HDL augmentation on physiologic and inflammatory markers. Curr Opin Cardiol. 2003 Jul;18(4):295-300.
33. Preuss HG. Effects of glucose/insulin perturbations on aging and chronic disorders of aging: the evidence. J Am Coll Nutr. 1997 Oct;16(5):397-403.
34. Wierzbicki AS, Mikhailidis DP. Beyond LDL-C — the importance of raising HDL-C. Curr Med Res Opin. 2002;18(1):36-44.
35. Atkins RC. Dr. Atkins’ Vita-Nutrient Solution. New York, NY: Simon & Schuster; 1999:145-8.
36. Preuss HG, Anderson RA. Chromium update: examining recent literature 1997- 1998. Curr Opin Clin Nutr Metab Care. 1998 Nov;1(6):509-12.
37. Streja D. Combination therapy for the treatment of dyslipidemia. Curr Opin Investig Drugs. 2004 Mar;5(3):306-12.
38. McKenney J. New perspectives on the use of niacin in the treatment of lipid disorders. Arch Intern Med. 2004 Apr 12;164(7):697-705.
39. Rosenson RS. Antiatherothrombotic effects of nicotinic acid. Atherosclerosis. 2003 Nov;171(1):87-96.
40. Wink J, Giacoppe G, King J. Effect of very- low-dose niacin on high-density lipoprotein in patients undergoing long-term statin ther- apy. Am Heart J. 2002 Mar;143(3):514-8.
41. Malik S, Kashyap ML. Niacin, lipids, and heart disease. Curr Cardiol Rep. 2003 Nov;5(6):470-6.
42. Miller M. Niacin as a component of combination therapy for dyslipidemia. Mayo Clin Proc. 2003 Jun;78(6):735-42.
43. Rindone JP, Achacoso S. Effect of low-dose niacin on glucose control in patients with non-insulin-dependent diabetes mellitus and hyperlipidemia. Am J Ther. 1996 Sep;3(9):637-9.
44. Ganji SH, Kamanna VS, Kashyap ML. Niacin and cholesterol: role in cardiovascular disease (review). J Nutr Biochem. 2003 Jun;14(6):298-305.
45. McKenney J. Niacin for dyslipidemia: considerations in product selection. Am J Health Syst Pharm. 2003 May 15;60(10):995-1005.
46. Kruse W, Kruse W, Raetzer H, et al. Nocturnal inhibition of lipolysis in man by nicotinic acid and derivatives. Eur J Clin Pharmacol. 1979 Aug;16(1):11-5.
47. Bays HE, McGovern ME. Once-daily niacin extended release/lovastatin combination tablet has more favorable effects on lipoprotein particle size and subclass distribution than atorvastatin and simvastatin. Prev Cardiol. 2003 Fall;6(4):179-88.
48. Stein EA, Davidson MH, Dujovne CA, et al. Efficacy and tolerability of low-dose Simvastatin and niacin, alone and in combination, in patients with combined hyperlipi- demia: A prospective trial. J Cardiovasc Pharmacol Ther. 1996 Apr;1(2):107-16.
49. Luria MH. Effect of low-dose niacin on high-density lipoprotein cholesterol and total cholesterol/high-density lipoprotein cholesterol ratio. Arch Intern Med. 1988 Nov;148(11):2493-5.
50. Chong PH, Bachenheimer BS. Current, new and future treatments in dyslipidaemia and atherosclerosis. Drugs. 2000 Jul;60(1):55-93.
51. Executive Summary of the Third Report of the Expert Panel on the Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001 May 16;285(19):2486-97.
52. McKenney J. Dyslipidemias. In: Young LY, Koda-Kimble MA, eds. Applied Therapeutics:The Clinical Use of Drugs. 6th ed. Vancouver, WA: Applied Therapeutics Inc; 1995.
53. Available at: http://www.medscape.com/ viewarticle/438573. Accessed June 2, 2004.
54. Vinson JA, Mandarano MA, Shuta DL, Bagchi M, Bagchi D. Beneficial effects of a novel IH636 grape seed proanthocyanidin extract and a niacin-bound chromium in a hamster atherosclerosis model. Mol Cell Biochem. 2002 Nov;240(1-2):99-103.
55. Preuss HG, Wallerstedt D, Talpur N, et al Effects of niacin-bound chromium and grape seed proanthocyanidin extract on the lipid profile of hypercholesterolemic subjects: a pilot study. J Med. 2000;31(5-6):227-46.
56. Leonard SS, Xia C, Jiang BH, et al. Resveratrol scavenges reactive oxygen species and effects radical-induced cellular responses. Biochem Biophys Res Commun. 2003 Oct 3;309(4):1017-26.
57. Geetha S, Sai Ram M, Mongia SS, Singh V, Ilavazhagan G, Sawhney RC. Evaluation of antioxidant activity of leaf extract of Seabuckthorn (Hippophae rhamnoides L.) on chromium(VI) induced oxidative stress in albino rats. J Ethnopharmacol. 2003 Aug;87(2-3):247-51.
58. Lopez-Burillo S, Tan DX, Mayo JC, Sainz RM, Manchester LC, Reiter RJ. Melatonin, xanthurenic acid, resveratrol, EGCG, vita- min C and alpha-lipoic acid differentially reduce oxidative DNA damage induced by Fenton reagents: a study of their individual and synergistic actions. J Pineal Res. 2003 May;34(4):269-77.
59. McCarty MF. Longevity effect of chromium picolinate – ‘rejuvenation’ of hypothalamic function? Med Hypotheses. 1994 Oct;43(4):253-65.
60. Franklin M, Odontiadis J. Effects of treat- ment with chromium picolinate on peripheral amino acid availability and brain monoamine function in the rat. Pharmacopsychiatry. 2003 Sep;36(5):176-80.