Chromium deficiency

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Chromium deficiency
Classification and external resources
Cr-TableImage.png
ICD-10 E61.4
DiseasesDB 2625

Chromium deficiency is a proposed disorder that results from an insufficient dietary intake of chromium. It is an unlikely condition.[1][2] Clear cases of deficiency have only been observed in hospital patients who were fed defined liquid diets intravenously for long periods of time.[3]

Dietary guidelines[edit]

The US dietary guidelines for adequate daily chromium intake were lowered in 2001 from 50–200 µg for an adult to 30–35 µg (adult male) and to 20–25 µg (adult female).[4] These amounts were set to be the same as the average amounts consumed by healthy individuals. Consequently, it is thought that few Americans are chromium deficient.[5]

Chromium may fall in the same category as manganese, where it is likely that many people get too much.

Approximately 2% of ingested chromium(III) is absorbed, with the remainder being excreted in the feces. Amino acids, vitamin C and niacin may enhance the uptake of chromium from the intestinal tract.[6] After absorption, this metal accumulates in the liver, bone, and spleen.

Trivalent chromium is found in a wide range of foods, including: whole-grain products, processed meats, high-bran breakfast cereals, coffee, nuts, green beans, broccoli, spices, and some brands of wine and beer.[6] Most fruits and vegetables and dairy products only contain low amounts.[3] Most of the chromium in people's diet comes from processing or storing food in pans and cans made of stainless steel, which can contain up to 18% chromium.[3]

The amount of chromium in the body can be decreased as a result of a diet high in simple sugars, which increases the excretion of the metal through urine.[citation needed] Because of the high excretion rates and the very low absorption rates of most forms of chromium, acute toxicity is uncommon.

Symptoms[edit]

The symptoms of chromium deficiency caused by long-term total parenteral nutrition are severely impaired glucose tolerance, a loss of weight, and confusion.[7] However, the validity of these findings is questioned in later studies.[5]

Supplementation[edit]

In a mouse model, Glucose Tolerance Factor (GTF) was found to exert remarkable beneficial insulin-mimetic and insulin-potentiating effects, both in vivo and in vitro. It was seen to produce an insulin-like effect by acting on cellular signals downstream of the insulin receptor. These beneficial results suggest Glucose Tolerance Factor as a potential source for a novel oral medication for diabetes.[8]

Although it is controversial whether supplements should be taken by healthy adults eating a normal diet,[2] chromium is needed as a component of the defined liquid diet that is given to patients receiving total parenteral nutrition (TPN), since deficiency can occur after many months of this highly restricted diet.[7] As a result chromium is added to normal TPN solutions,[9] although the trace amounts from even in "chromium free" preparations may be enough to prevent deficiency in some individuals.[citation needed] Recent studies have challenged the methodology of earlier studies, concluding that chromium should not be regarded as an essential element.[5]

The mechanism by which this complex enters the cells in the body differs from that for the introduction of trivalent chromium found naturally in food does, and for this reason the safety of this supplement is debatable, since chromium is toxic at high levels.[10] Moreover, recent studies "have concluded that chromium supplements have no demonstrated effects on healthy individuals" and chromium picolinate in particular is described as a "poor choice" as a supplement.[5] A meta-analysis in 2002 found no effect on blood glucose or insulin in healthy people, and the data were inconclusive for diabetics.[11] Subsequent trials gave mixed results, with one finding no effect in people with impaired glucose tolerance,[citation needed] but another seeing a small improvement in glucose resistance.[citation needed] A 2007 review again concluded that chromium supplements had no beneficial effect on healthy people, but that there might be an improvement in glucose metabolism in diabetics, although the authors stated that the evidence for this effect remains weak.[12]

References[edit]

  1. ^ Jeejeebhoy, Khursheed N. (1999). "The role of chromium in nutrition and therapeutics and as a potential toxin". Nutrition Reviews 57 (11): 329–335. doi:10.1111/j.1753-4887.1999.tb06909.x. PMID 10628183. 
  2. ^ a b Porter, David J.; Raymond, Lawrence W.; Anastasio, Geraldine D. (1999). "Chromium: friend or foe?". Archives of Family Medicine 8 (5): 386–390. doi:10.1001/archfami.8.5.386. PMID 10500510. Archived from the original on 9 January 2005. Retrieved 24 February 2013. 
  3. ^ a b c Expert group on Vitamins and Minerals (August 2002). "Review of Chromium". Retrieved 24 February 2013. 
  4. ^ Trumbo, Paula; Yates, Allison A.; Schlicker, Sandra; Poos, Mary (March 2001). "Dietary reference intakes: vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc". Journal of the American Dietetic Association 101 (3): 294–301. doi:10.1016/S0002-8223(01)00078-5. PMID 11269606. 
  5. ^ a b c d Vincent, John B. (2010). "Chromium: celebrating 50 years as an essential element?". Dalton Transactions 39 (16): 3787–3794. doi:10.1039/B920480F. PMID 20372701. 
  6. ^ a b Lukaski, Henry C. (1999). "Chromium as a supplement". Annual Review of Nutrition 19 (1): 279–302. doi:10.1146/annurev.nutr.19.1.279. PMID 10448525. 
  7. ^ a b Freund, Herbert; Atamian, Susan; Fischer, Josef E. (February 1979). "Chromium deficiency during total parenteral nutrition". JAMA 241 (5): 496–498. doi:10.1001/jama.1979.03290310036012. PMID 104057. 
  8. ^ Weksler-Zangen, Sarah; Mizrahi, Tal; Raz, Itamar; Mirsky, Nitsa (September 2012). "Glucose tolerance factor extracted from yeast: oral insulin-mimetic and insulin-potentiating agent: in vivo and in vitro studies". British Journal of Nutrition 108 (5): 875–882. doi:10.1017/S0007114511006167. PMID 22172158. 
  9. ^ Anderson, R. A. (1995). "Chromium and parenteral nutrition". Nutrition 11 (1 Suppl): 83–86. PMID 7749258. 
  10. ^ Bagchi, Debasis; Stohs, Sidney J.; Downs, Bernard W.; Bagchi, Manashi; Preuss, Harry G. (2002). "Cytotoxicity and oxidative mechanisms of different forms of chromium". Toxicology 180 (1): 5–22. doi:10.1016/S0300-483X(02)00378-5. PMID 12324196. 
  11. ^ Althuis, Michelle D.; Jordan, Nicole E.; Ludington, Elizabeth A.; Wittes, Janet T. (July 2002). "Glucose and insulin responses to dietary chromium supplements: a meta-analysis". The American Journal of Clinical Nutrition 76 (1): 148–155. PMID 12081828. Retrieved 24 February 2013. 
  12. ^ Balk, Ethan M.; Tatsioni, Athina; Lichtenstein, Alice H.; Lau, Joseph; Pittas, Anastassios G. (2007). "Effect of chromium supplementation on glucose metabolism and lipids: a systematic review of randomized controlled trials". Diabetes Care 30 (8): 2154–63. doi:10.2337/dc06-0996. PMID 17519436. Retrieved 24 February 2013. 

Further reading[edit]

External links[edit]