Patrick Holford and the Chromium Review: We Need Your Help

Patrick Holford may have been a touch disappointed when Dr. Sarah Jarvis failed to be intimidated by the wealth of evidence that he implied in the photocopy of the paper that he had touchingly brought with him as a sort of talisman. The paper completely failed if it was, QLink-like, somehow intended to ward off evil atmospheres or waves of scepticism.

What is this paper of dubious magical properties? Does it have better scientific qualities? Please help us to find out. We believe that the paper is:

C. L Broadhurst & P. Domenico (2006). Clinical Studies on Chromium Picolinate Supplementation in Diabetes Mellitus—A Review. Diabetes Technology & Therapeutics Volume 8 (6): 677-87.

Unfortunately, the paper has some oddities and quirks that it is difficult to understand without knowing more about some of the source documents that were included in the review. Some of these papers are not available on Entrez PubMed: if you or somebody you know has access to some of them, or you know about them, or you can spare 10 minutes as you are passing by some particularly dusty stacks, then we would be very grateful if you could look something up for us and let us know.

References for chromium picolinate supplementation for Type 2 Diabetes

Anderson RA, Cheng N, Bryden NA, Polansky MM, Cheng N, Chi J, Feng J: Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes, 1997; 46:1786–1791

Holford claims:

120 chinese patients with type 2 diabetes, 60 of whom were given 200ug chromium per day and 60 of whom were given 1000ug/day. After just 2 months, significant improvements were seen in glucose control, in both groups. After 4 months, there was almost a 30% reduction in glucose levels in the higher dosage group.

However, in the abstract, the improvements aren’t quantified and there are no p values, ORs, RRs etc., and no mention of the 30% reduction. What does this paper say, and are there any significance values etc.?

Bahadori B, Wallner S, Hacker C, Boes U, Komorowski JR, Wascher TC: Effects of chromium picolinate on insulin levels and glucose control in obese patients with Type-II diabetes mellitus [abstract]. Diabetes 1999; 48:A349.
I can find the citation on Google Scholar but no abstract.

Cheng N, Zhu X, Hongli S, Wo W, Chi J, Cheng J, Anderson R: Follow-up survey of people in China with type 2 diabetes mellitus consuming supplemental chromium. J Trace Elem Med Biol 1999; 12:55–60
The only study with a substantial number of participants was open-label and uncontrolled. It seems to be the written-up version of a paper to a symposium (it was received and accepted the same day).
Holford refers to the improved fasting and post-prandial glucose levels. Again, no p values, RRs or ORs. I don’t know if these differences are significant and to what degree.

Evans GW: The effect of chromium picolinate on insulin controlled parameters in humans. Int J BiosocialMed Res 1989; 11:163–180.
I can find the citation on Google Scholar but no abstract. Said to be an RCT with 17 participants. Althuis et al. characterise it as an “uncontrolled investigation” rather than an RCT.

Feng J, Lin D, Zheng A, Cheng N: Chromium picolinate reduces insulin requirement in people with type 2 diabetes mellitus [abstract]. Diabetes 2002;51:A469
I can find the citation on Google Scholar but no abstract. Said to be an RCT with 237 participants.

Morris BW, Kouta S, Robinson R, MacNeil S, Heller S: Chromium supplementation improves insulin resistance in patients with Type 2 diabetes mellitus. Diabet Med 2000; 17:684–685.
From its length, it seems like a letter/comment. It’s supposed to be an RCT with either 5 or 10 participants.

Rabinovitz H, Friedensohn A, Leibovitz A, Gabay G, Rocas C, Habot B: Effect of chromium supplementation on blood glucose and lipid levels in type 2 diabetes mellitus elderly patients. Int J Vitam Nutr Res 2004;74:178–182.
Very odd. The review describes this as an RCT. From the abstract, it reads as if the authors recruited their study group and then the control group; if so, this isn’t an RCT.
I’m further puzzled because Holford claims:

chromium has been shown to dramatically decrease the need for medication in many diabetics and in some cases eliminate the need for drugs completely.

He uses this reference to support this; however, there is nothing about eliminating medication in the abstract (possibly in the body of the paper). It is only a 3 week study, and it involves a 1500 Kcal diet which might itself have an impact on blood glucose levels, unless that isn’t particularly restrictive for this elderly study group.

Ravina A, Slezak L, Mirsky N, Bryden NA, Anderson RA: Reversal of corticosteroid-induced diabetes mellitus with supplemental chromium. Diabet Med 1999;16:164–167.
I’m puzzled by this paper. In the review, it is said to have 99 subjects (55/44) but in the abstract, they only mention 13. I’m sure the other numbers are buried in the paper, it is just a remarkably poor abstract. I have no idea what the clinical outcomes are.

Ravina A, Slezak L, Rubal A, Mirsky N: Clinical use of the trace element chromium (III) in the treatment of diabetes mellitus. J Trace Elem Med Biol 1995;8:183–190.
I found the citation on Google Scholar but no abstract. Review describes this as an RCT with 172/162 participants. However, Althuis et al. characterise this as an “uncontrolled investigation” and refers to it having 10 participants.

If you have seen any of these papers or know something about their whereabouts or their contents, please don’t keep the news to yourself: let us know.

For a fuller discussion of a meta-analysis of chromium supplementation for diabetes see: Patrick Holford and Cinnachrome for Natural Blood Sugar Balance.

Update September 18: For readers who don’t consult the full paper, the author information on the PubMed extract for the Broadhurst & Domenico review did not include the information that the authors’ affilition, Department of Technical Services and Scientific Affairs, belongs to Nutrition 21 which is a nutritional bioscience company.

Advertisements

11 Comments

Filed under Althuis, Broadhurst, chromium, chromium picolinate, Domenico, Holford, Jarvis, patrick holford, Sarah Jarvis, supplements

11 responses to “Patrick Holford and the Chromium Review: We Need Your Help

  1. James Fallon

    Been through the full text Diabetes via ProQuest and had a quick search on PubMed and couldn’t find them there either. Google Scholar did show the one you mentioned but as you say no link to abstract.

    Strange because Feng has written papers on Chromium and diabetes in Diabetes a couple of times, just not the ones listed.

  2. profnick

    Sorry can’t help with the details but the Broadhurst and Domenico abstract does say, rather worryingly, “The beneficial effects of chromium in individuals with diabetes were observed at levels higher than the upper limit of the Estimated Safe and Adequate Daily Dietary Intake.”

  3. Anonymous

    There’s another trial that involved chromium that I believe Patrick Holford has quoted

    Effectiveness of chromium in atypical depression: a placebo-controlled trial. (Biological Psychiatry, Volume 53, Issue 3, Pages 261-264 J. Davidson, K. Abraham, K. Connor, M. McLeod)

    Which may bear some scrutiny as well!

    See also Patricks paper on nutrition and mood – which , to be fair I’ve not fully read but was struck by fascinating but unreferenced statements such as “This is because oestrogen blocks the breakdown of serotonin.” or “About 98% of the chromium present in sugarcane is lost in
    turning it into sugar. This mineral is vital for keeping the blood sugar level stable.” See http://www.ingentaconnect.com/content/rmp/pcmh/2003/00000001/00000001/art00003 but full text available.

    A
    There is also a paper at
    http://www.practicalpsychiatry.com/pt/re/jpsychpract/abstract.00131746-200509000-00004.htm;jsessionid=GyXLMn1g7ZcPHgTjTd1DTZppbfJLpPhWQnXgVgT4ytm1M6Y31hQQ!-1804036389!-949856145!8091!-1

    with the title A Double-Blind, Placebo-Controlled, Exploratory Trial of Chromium Picolinate in Atypical Depression: Effect on Carbohydrate Craving. (Journal of Psychiatric Practice. 11(5):302-314, September 2005.
    DOCHERTY, JOHN P. MD; SACK, DAVID A. MD; ROFFMAN, MARK PhD; FINCH, MANLEY; KOMOROWSKI, JAMES R. MS) if link fails. Which appears to be a link between mood, weight and chromium………

  4. Shinga

    It is strange, isn’t it, James. It is one of the most rag-bag collection of unverifiable sources that I have ever seen let through in a peer-review journal.

    I’m truly stuck as to how to proceed without obtaining this sources but I doubt the value of an abstract anyway…

  5. Shinga

    Prof Nick – it is a strange thing to admit with. However, scarcely less strange than this section: “Given that virtually all studies employing CrPic supplementation for T2DM subjects showed improved glucose or insulin control,an attempt was made to express the combined effects of these changes. This analysis was conducted despite the diversity of demographics,doses, and durations in these studies”. There was, of course, no defence as to why this was acceptable or even vaguely reasonable.

    All in all – an odd duck of a paper.

  6. Shinga

    Davidson et al. seems to have a participant pool of 15 and it ran for 8 weeks, so it might seem a tad premature to use that as persuasive evidence for a particular application.

    Is the Igenta link to a particular paper because it dropped me into Primary Care, Mental Health? I do find the number of unreferenced claims to be irritating because they tend to be the most interesting.

    Well, the Practical Psychiatry paper was interesting in its acknowledged limitations.

  7. Anonymous

    I m stunned. Isnt it illegal to give nutritional medical advice unless your a dietetian? I have just looked at the GMTV link, Holford link..surely if you are diagnosed with diabetes..you are asssigned a dietitian..recomended Low GI, more exercise if necessary. Are people being let down by the NHS? Are diabetics not given any dietary advice? I thought the glycemic load was examined and documented years ago to specifically help people with diabetes? Whys he making out its his idea?

  8. Shinga

    I don’t know, is the short answer. The term ‘dietitian’ is protected but I think that it is legal to consult one and follow the advice, as long as the GP is informed/consulted/in agreement.

    As far as I know, people are usually referred to a dietitian or a specialist nurse within a Diabetes Clinic if the GP offers one.

    As for the ownership of ‘glycaemic load’, Patrick Holford puts me in mind of the cat from Red Dwarf. He reads about something, and suddenly, he owns it: “Hey, this is mine. That’s mine. All of this is mine. Except that bit. I don’t want that bit. But all the rest of this is mine. Hey, this has been a really good day. I’ve eaten five times, I’ve slept six times, and I’ve made a lot of things mine”.

    Regards – Shinga

  9. Pingback: Patrick Holford and the ASA: Advertising Must Be Legal, Decent, Honest and Truthful « Holford Watch: Patrick Holford, nutritionism and bad science

  10. Pingback: Patrick Holford and Cinnachrome for Natural Blood Sugar Balance « Holford Watch: Patrick Holford, nutritionism and bad science

  11. Pingback: Does Patrick Holford Lack Generosity of Spirit As Well As Scholarly Accuracy? « Holford Watch: Patrick Holford, nutritionism and bad science

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s