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Background: Several authors, mostly on the basis of nonrandomized studies, have suggested dietary trivalent chromium supplementation as an attractive option for the management of type 2 diabetes and for glycemic control in persons at high risk of type 2 diabetes., Objective: The study aimed to determine the effect of chromium on glucose and insulin responses in healthy subjects and in individuals with glucose intolerance or type 2 diabetes., Design: The study design was a systematic review and meta-analysis of randomized clinical trials (RCTs)., Results: The authors identified 20 reports of RCTs assessing the effect of chromium on glucose, insulin, or glycated hemoglobin (Hb A(1c)). This review summarizes data on 618 participants from the 15 trials that reported adequate data: 193 participants had type 2 diabetes and 425 were in good health or had impaired glucose tolerance. The meta-analysis showed no association between chromium and glucose or insulin concentrations among nondiabetic subjects. A study of 155 diabetic subjects in China showed that chromium reduced glucose and insulin concentrations; the combined data from the 38 diabetic subjects in the other studies did not. Three trials reported data on Hb A(1c): one study each of persons with type 2 diabetes, persons with impaired glucose tolerance, and healthy subjects. The study of diabetic subjects in China was the only one to report that chromium significantly reduced Hb A(1c)., Conclusions: Data from RCTs show no effect of chromium on glucose or insulin concentrations in nondiabetic subjects. The data for persons with diabetes are inconclusive. RCTs in well-characterized, at-risk populations are necessary to determine the effects of chromium on glucose, insulin, and Hb A(1c).

Magnesium, zinc, and chromium are mineral elements required in modest amounts to maintain health and optimal physiologic function. For physically active persons, adequate amounts of these micronutrients are needed in the diet to ensure the capacity for increased energy expenditure and work performance. Most physically active individuals consume diets that provide amounts of magnesium and zinc sufficient to meet population standards. Women tend to consume less of these minerals than is recommended, in part because they eat less food than men. Inadequate intakes of magnesium and zinc have been reported for participants in activities requiring restriction of body weight. Dietary chromium is difficult to estimate because of a lack of appropriate reference databases. Acute, intense activity results in short-term increases in both urine and sweat losses of minerals that apparently diminish during recovery in the days after exercise. Supplemental magnesium and zinc apparently improve strength and muscle metabolism. However, evidence is lacking as to whether these observations relate to impaired nutritional status or a pharmacologic effect. Chromium supplementation of young men and women does not promote muscle accretion, fat loss, or gains in strength. Physically active individuals with concerns about meeting guidelines for nutrient intake should be counseled to select and consume foods with high nutrient densities rather than to rely on nutritional supplements. The indiscriminate use of mineral supplements can adversely affect physiologic function and impair health.

The effects of 8 wk of daily chromium supplementation (3.3-3.5 mumol as chromium chloride or chromium picolinate) or placebo (0.1 mumol Cr) and weight training were examined in 36 men in a double-blind design. Strength, mesomorphy, fat-free mass, and muscle mass increased with resistance training independently of chromium supplementation (P < 0.0001). Protein, magnesium, zinc, copper, and iron intakes equalled or exceeded the recommended dietary allowance (RDA) or estimated safe and adequate daily dietary intake (ESADDI) during training and did not change significantly from pretraining intakes (P > 0.05). Chromium supplementation increased the serum chromium concentration and urinary chromium excretion without a difference as a result of the chemical form of chromium (P < 0.05). Resistance training was associated with a significant decrease (P < 0.05) in serum ferritin, total-iron-binding capacity, transferrin saturation, the ratio of enzymatic to immunoreactive ceruloplasmin, and plasma copper, independently of chromium supplementation. However, transferrin saturation was decreased more with chromium picolinate supplementation (24%) than with chromium chloride or placebo (10-13%). Compared with pretraining values, urinary magnesium excretion increased (P < 0.05) and urinary zinc output tended to decrease during the first 4 wk of resistance training and then returned to baseline values for the final 4 wk, which suggests an adaptation in mineral excretion in response to weight training. These findings suggest that routine chromium supplementation has no beneficial effects on body- composition change or strength gain in men. Whether chromium supplementation of individuals with diminished chromium nutriture facilitates propitious changes in body structure and function remains to be determined.

The effects of low-chromium diets containing chromium in the lowest quartile of normal intake on glucose tolerance and related variables in 11 females and 6 male subjects were evaluated. Subjects with glucose concentration greater than 5.56 mmol/L but less than 11.1 mmol/L 90 min after an oral-glucose challenge were designated as the hyperglycemic group and the remainder, the control group. Glucose tolerance and circulating insulin and glucagon of the hyperglycemic group all improved during chromium supplementation (200 micrograms/d) whereas those of the control group were unchanged. Glucose and insulin concentrations 60 min after the oral-glucose challenge and the sum of the 0-90 min and 0-240 min glucose values were all significantly lower after chromium supplementation in the hyperglycemic group. These data demonstrate that consumption of diets in the lowest 25% of normal chromium intake lead to detrimental effects on glucose tolerance, insulin, and glucagon in subjects with mildly impaired glucose tolerance.

This study of chromium (Cr) exchange in the rat combined measurements of 51Cr distribution and tissue Cr content to permit an assessment of tissue Cr exchange under control conditions and during varied Cr intakes. Liver Cr was found to be 50 to 100% exchangeable whereas pancreas Cr was only 34% exchangeable. In kidney, the specific activity of 51Cr exceeded that of serum by more than 100%, indicating a complex type of exchange involving both a rapidly exchanging Cr pool and an "inner" Cr pool with "sink-like" characteristics. Chromium deprivation of moderate degree reduced serum Cr and tissue exchangeable Cr pools but did not change total tissue Cr, 51Cr distribution, or glucose tolerance. Chromium supplementation and Cr overload increased serum Cr and total, exchangeable, and nonexchangeable tissue Cr pools but did not alter 51Cr distribution. These results indicate that the merging of tracer techniques with tissue Cr analyses yields a more complete view of Cr exchange than 51Cr distribution alone. The data support the hypothesis that specific transport characteristics exist in tissues that may regulate the biological role of Cr.

Chromium (Cr) content of the self-selected diets of 10 adult males and 22 females was determined. Each subject collected duplicate food and beverage samples on a daily basis for seven consecutive days. The 7-day average intake for males was 33 +/- 3 micrograms (mean +/- SEM), range 22-48 micrograms, and intake for females was 25 +/- 1, range 13-36. Mean Cr intake per 1000 cal was approximately 15 micrograms. Approximately 90% of the diets analyzed were below the minimum suggested safe and adequate daily intake for Cr of 50 micrograms. Chromium absorption was inversely related to dietary intake; absorption at a dietary Cr intake of 10 micrograms was approximately 2% and, with increasing intake to 40 micrograms, Cr absorption decreased to 0.5%. These data demonstrate that the average daily intake of chromium from self-selected diets is well below the minimum suggested safe and adequate intake and that Cr absorption, at levels found in typical US diets, is inversely related to dietary intake.

Seventy-six adult subjects, 48 males and 28 females, were given placebo or 200 micrograms Cr in the form of chromic chloride in a double-blind crossover study, with 3-month experimental periods, to determine basal serum Cr levels and the effects of Cr supplementation on serum Cr and related variables. Basal serum Cr determined by graphite furnace atomic absorption for all subjects was 0.13 +/- 0.02 ng/ml (mean +/- SEM), and increased significantly to 0.38 +/- 0.02 ng/ml following 3 months of Cr supplementation. There were no significant differences in the serum Cr values for males and females. Serum Cr 90 min following a glucose load (1 g per kg body wt) was not significantly different from fasting during either the placebo or Cr supplementation periods. These data demonstrate that serum Cr increased significantly following Cr supplementation and is a reflection of Cr intake, but serum Cr concentration, even that following a glucose load, does not appear to be a meaningful indicator of Cr status.

The utilization of inorganic chromium by free-living human subjects was studied in 76 volunteers (male, 48; female, 28) who were supplemented with 200 micrograms of inorganic chromium as chromic chloride or a placebo tablet for 3 months in a double-blind, cross-over experiment. For all subjects, initial mean +/- SEM urinary chromium (Cr) level was 0.20 +/- 0.01 (range, 0.05 to 0.58) ng/ml and did not differ by sex. Initial chromium/creatinine ratio (Cr/Ct) was 0.15 +/- 0.01 (range 0.03 to 0.36) ng Cr/mg creatinine for females and was significantly lower, 0.10 +/- 0.01 (range 0.03 to 0.36) for males. Mean urinary Cr level increased to 1.0 +/- 0.12 after 2 and to 1.13 +/- 0.08 ng/ml after 3 months' supplementation. The Cr/Ct ratio increased to 0.69 +/- 0.10 for females and to 0.50 +/- 0.04 for males after 2 months' supplementation; values were similar after 3 months. An increase in urinary Cr excretion in response to a glucose load was demonstrated for nonsupplemented normal free-living subjects but not for subjects supplemented daily with trivalent chromium. Urinary Cr excretion after a glucose challenge was not predictable and did not depend on Cr status.

A chromium (Cr) balance study was conducted on a metabolic unit for 12 days in two normal males, ages 62 and 66, ingesting a nutritionally adequate, constant diet. Complete urine and stool collections were obtained daily. The diet, stool, and urine were analyzed for chromium by Zeeman atomic absorption spectrometry. On dietary Cr intakes of 36.9 and 36.7 micrograms/day, only a small fraction of the ingested Cr, 0.9 microgram and 0.5 microgram/day, was absorbed. Most of the dietary Cr, 36.0 micrograms and 36.2 micrograms/day, was excreted in the stool. Urinary Cr was constant from day to day with a mean of 0.30 microgram/day +/- 0.03 SD and 0.28 microgram/day +/- 0.05 SD. The Cr balances (apparent net retention) were positive, 0.6 and 0.2 microgram/day, indicating equilibrium. The average apparent net absorption of Cr for the two subjects was 1.8%.