Nutrient Reference Values

Chromium

Download as PDF

Background

Chromium is involved in potentiating the action of insulin in vivo and in vitro (Mertz 1969, 1993, Mertz et al 1961) and several studies have shown beneficial effects of chromium on circulating glucose, insulin and lipids in humans, although not all studies were positive. These studies have been reviewed by Anderson (1997), Mertz (1993), Offenbacher et al (1997) and Stoecker (1996).

In man, chromium accumulates in liver, spleen, soft tissue and bone (Lim et al 1983). Research on chromium metabolism is limited by the lack of a good measure for establishing deficiency states in man. However, data from metabolic balance and urinary excretion studies suggest that only 0.4-2.5% of chromium is absorbed, the actual amount being determined by the environment of the gastrointestinal tract and ligands provided by foods (Clydesdale 1998).

Chromium is widely distributed through the food supply but the content within a given type of food can vary widely because of geochemical factors (Welch & Carey 1975).

Most ingested chromium is excreted unabsorbed in the faeces (Mertz 1969, Offenbacher et al 1986) whilst absorbed chromium is excreted mainly in the urine (Anderson et al 1983). Vitamin C appears to increase absorption (Davis et al 1995, Offenbacher 1994, Seaborn & Stoecker 1990). Animal experiments have shown that high phytate levels can reduce absorption (Chen et al 1973) although lower levels appear to have no effect (Keim et al 1987). There are no systematic data for humans. Animal experiments have shown that long-term consumption of some medicines can affect chromium absorption through affecting stomach acidity or gastrointestinal prostaglandins (Davis et al 1995, Kamath et al 1997). It has also been suggested that absorption may increase with chronic resistive exercise (Rubin et al 1998).

In man, diets very high in simple sugars (35% energy) have been shown to increase urinary chromium excretion (Kozlovsky et al 1986) which may be related to the insulinogenic actions of carbohydrates (Anderson et al 1990). Urinary excretion also appears to be increased by aerobic exercise (Anderson et al 1982, 1984, 1988).

Chromium deficiency is relatively rare but has been reported in patients on total parenteral nutrition (Brown et al 1986, Freund et al 1979, Jeejeebhoy et al 1977). It has been hypothesised that poor chromium status contributes to the incidence of impaired glucose tolerance and type II diabetes which has led to interest in a potential role for chromium supplements in type II diabetes. One Chinese study involved 180 subjects with type II diabetes being given placebo, 200 µg or 1,000 µg chromium as chromium picolinate for 4 months. The subjects showed decreased fasting and 2-hour insulins at two months at both supplement levels, with glycosylated haemoglobin and fasting and 2-hour glucose concentrations being lower in the higher supplement group only. The reduced glucose and insulin concentrations were maintained to 4 months and glycosylated haemoglobin in both dosage groups was also reduced (Anderson et al 1997).

Approaches to the estimation of chromium requirements have included balance studies (Bunker et al 1984, Offenbacher et al 1986), urinary chromium excretion (Anderson et al 1982, 1983, 1991, Anderson & Kozlovsky 1985, Paschal et al 1998), plasma chromium concentration (Anderson 1987, Veillon 1989) and blood glucose and insulin concentrations (Anderson et al 1991). However, none of these approaches has been found to be satisfactory (FNB:IOM 2001).

1 mmol chromium = 52 mg chromium

Recommendations by life stage and gender

Infants

Rationale: The AI for 0-6 months was calculated by multiplying the average intake of breast milk (0.78 L/day) by the average concentration of chromium in breast milk, and rounding. The figure for breast milk used was 0.25 µg/L based on the studies of Anderson et al (1993), Casey & Hambidge (1984), Casey et al (1985), Engelhardt et al (1990), and Mohamedshah et al (1998). The AI for 7-12 months was derived from consideration of the overall energy intake of infants of this age (3,530 kJ), the estimated contribution from breast milk (0.6 L/day at 0.25 µg/L = 0.15 µg chromium and 1,880 kJ), plus chromium from the amount of complementary foods needed to provide the additional 1,670 kJ using a chromium concentration of 3.2 µg/1,000 kJ (Anderson et al 1992). This gives a total chromium of 5.5 µg/day (0.15 µg from milk + 5.36 µg from foods).

Children & adolescents

Rationale: As there are limited data to set an EAR, AIs were set for children. In the absence of any data, the children's AIs were derived from the adult AIs on a body weight basis.

Adults

Rationale: As there are limited data to set an EAR, an AI was set for adults. As there are no national intake data or food composition data available either for Australia or New Zealand for chromium, data from the FNB:IOM review (2001) were used to derive the AIs. The US estimates were based on analytical studies of 22 well-balanced adult diets designed by US nutritionists (Anderson et al 1992). These studies gave an average chromium concentration of 3.21 µg/1,000 kJ food (range 2-5.7 µg/1,000 kJ). As there is some evidence that dietary intake data may have a tendency to underestimate actual intake (Mertz et al 1991), the average concentration in food was applied to the highest median intakes of energy for a given age group within the adult men or women, using intake data from the Australian (ABS 1998) and New Zealand (MOH 1999) National Nutrition Surveys.

Pregnancy

Rationale: Because of lack of data to establish the additional needs in pregnancy, the AI was extrapolated from the AIs for adolescent girls and women on the basis of an average weight gain of 16 kg in pregnancy for pregnancies with good outcomes (Carmichael et al 1997).

Lactation

Rationale: The AI for lactation was estimated from the intake necessary to replace chromium secreted in milk plus the AI for women. The amount needed to be absorbed is 0.252 µg/L x 0.78 L/day (200 µg/day). With absorption at 1%, an additional 20 µg/day is needed.

Upper level of intake

The ULs for chromium are unknown as there are insufficient data.

A number of potential adverse effects of high chromium intakes in relation to renal failure, genotoxicity, carcinogenicity, hepatic dysfunction and reproductive function have been seen either in animal studies or in humans (Al-Hamood et al 1998, Bagchi et al 1997, Bataineh et al 1997, Cerulli et al 1988, Elbetieha & Al-Hamood 1997, Fristedt et al 1965, Kaufman et al 1970, Kusiak et al 1995, Loubieres et al 1999, Speetjens et al 1999, Stearns et al 1995, Wasser et al 1997). However, adequate human data on trivalent chromium are limited.

No adverse side effects were reported in a number of supplementation trials in which subjects received up to 1 mg chromium/day, mostly as picolinate, for several months (Flodin 1990, Hathcock 1997). These trials, however, were mainly studies of efficacy and not designed to find potential toxic effects. The limited data from all studies on subchronic, chronic and reproductive toxicity on soluble trivalent chromium salts do not give clear information on the dose-response relationship. Therefore, ULs cannot be derived.

References

Al-Hamood MH, Elbetieha A, Bataineh H. Sexual maturation and fertility of male and female mice exposed prenatally and postnatally to trivalent and hexavalent chromium compounds. Reprod Fertil Dev 1998;10:179-83.

Anderson RA, Bryden NA, Patterson KY, Veillon C, Andon MB, Moser-Veillon PB. Breast milk chromium and its association with chromium intake, chromium excretion and serum chromium. Am J Clin Nutr 1993;57:519-23.

Anderson RA, Bryden NA, Polansky MM, Reiser S. Urinary chromium excretion and insulinogenic properties of carbohydrates. Am J Clin Nutr 1990;51:864-68.

Anderson RA, Bryden NA, Polansky MM. Dietary chromium intake. Freely chosen diets, institutional diets and individual foods. Biol Trace Elem Res 1992;32:117-21.

Anderson RA, Bryden RA, Polansky MM, Deuster PA. Exercise effects on chromium excretion of trained and untrained men consuming a constant diet. J Appl Physiol 1988 64:249-52.

Anderson RA, Cheng N, Bryden NA, Polansky MM, Cheng N, Chi J, Feng J. Elevated intakes of supplemental chromium improves glucose and insulin variables in individuals with type 2 diabetes. Diabetes 1997;46:1786-91.

Anderson RA, Kozlovsky AS. Chromium intake, absorption and excretion of subjects consuming self-selected diets. Am J Clin Nutr 1985;41:1177-83.

Anderson RA, Polansky MM, Bryden NA, Canary JJ. Supplemental chromium effects on glucose, insulin, glucagon and urinary chromium losses in subjects consuming controlled low-chromium diets. Am J Clin Nutr 1991;54:909-16.

Anderson RA, Polansky MM, Bryden NA, Patterson KY, Veillon C, Glinsmann WH. Effects of chromium supplementation on urinary Cr excretion of human subjects and correlation of Cr excretion with selected clinical parameters. J Nutr 1983;113:276-81.

Anderson RA, Polansky MM, Bryden RA, Roginski EE, Patterson KY, Reamer D. Effect of exercise (running) on serum glucose, insulin, glucagon and chromium excretion. Diabetes 1982;31:212-16.

Anderson RA, Polansky MM, Bryden RA. Strenuous running: Acute effects on chromium, copper, zinc and selectee clinical variables in urine and serum of male runners. Biol Trace Elem Res 1984;6:327-36.

Anderson RA. Chromium as an essential nutrient for humans. Regul Toxicol Pharmacol 1997;26:S35-S41.

Anderson RA. Chromium. In: Mertz W, ed. Trace elements in human and animal nutrition, Vol 1.San Diego: Academic Press, 1987. Pp 225-44.

Australian Bureau of Statistics: Department of Health and Aged Care; National Nutrition Survey. Nutrient intakes and physical measurements. Australia, 1995. Canberra: Australian Bureau of Statistics, 1998.

Bagchi D, Bagchi M, Balmoori J, Ye X, Stohs SJ. Comparative induction of oxidative stress in cultured J774A.1 macrophage cells by chromium picolinate and chromium nicotinate. Res Comm Mol Pathol Pharmacol 1997;97:335-46.

Bataineh H, Al-Hamood MH, Elbetieha A, Bani Hani I. Effect of long term ingestion of chromium compounds on aggression, sex behaviour and fertility in adult male rats. Drug Chem Toxicol 1997;20:133-49.

Brown RO, Forloines-Lynn S, Cross RE, Heizer WD. Chromium deficiency after long-term parenteral nutrition. Dig Dis Sci 1986;39:661-64.

Bunker VW, Lawson MS, Delves HT, Clayton BE. The uptake and excretion of chromium by the elderly. Am J Clin Nutr 1984;39:797-802.

Carmichael S, Abrams B, Selvin S. The pattern of maternal weight gain in women with good pregnancy outcomes. Am J Pub Health 1997;87:1984-88.

Casey CE, Hambidge KM, Neville MC. Studies in human lactation: Zinc, copper, manganese and chromium in human milk in the first month of lactation. Am J Clin Nutr 1985;41:1193-200.

Casey CE, Hambidge KM. Chromium in human milk from American mothers. Br J Nutr 1984;52:73-7.

Cerulli J, Grabe DW, Gauthier I, Malone M, McGoldrick MD. Chromium picolinate toxicity. Ann Pharmacotherapy 1988;32:428-31.

Chen NSC, Tsai A, Dyer IA. Effects of chelating agents on chromium absorption in rats. J Nutr 1973;103:1182-6.

Clydesdale FM. Mineral interactions in foods. In :Bodwell CE, Erdman JW, eds. Nutrition interactions. New York: Marcel Dekker, 1998. Pp 73-113.

Davis Ml, Seaborn CD, Stoecker BJ. Effects of over-the-counter drugs on 51chromium retention and urinary excretion in rats. Nutr Res 1995;15:201-10.

Elbetieha A, Al-Hamood MH. Long-term exposure of male and female mice to trivalent and hexavalent chromium compounds: Effect on fertility. Toxicology 1997;116:39-47.

Engelhardt S, Moser-Veillon PB, Mangels AR, Patterson KL, Veillon C. Appearance of an oral dose of chromium (53Cr) in breast milk. In: Atkinson SA, Hanson LA, Chandra RK, eds. Human lactation 4. Breastfeeding, nutrition, infection and infant growth in developed and emerging countries. St Johns, Newfoundland: ARTS Biomedical, 1990. Pp 485-7.

Food and Nutrition Board: Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium and Zinc. Washington DC: National Academy Press, 2001.

Flodin NW. Micronutrient supplements: toxicity and drug interactions. Prog Food Nutr Sci 1990;14:277-331.

Freund H, Atamian S, Fischer JE. Chromium deficiency during total parenteral nutrition. JAMA 1979;241:496-8.

Fristedt B, Lindqvist B, Schutz A, Ovrum P. Survival in a case of acute oral chromic acid poisoning with acute renal failure treated by haemodialysis. Acta Med Scand 1965;177:153-9.

Hathcock JN. Vitamins and minerals: efficacy and safety. Am J Clin Nutr 1997;66:427-37.

Jeejeebhoy KN, Chu RC, Marliss EB, Greenberg GR, Bruce-Robertson A. Chromium deficiency, glucose intolerance and neuropathy reversed by chromium supplementation in a patient receiving long-term total parenteral nutrition. Am J Clin Nutr 1977;30:
531-8.

Kamath SM, Stoecker BJ, Davis-Whitenack ML, Smith MM, Adeleye BO, Sangiah S. Absorption, retention and urinary excretion of chromium-51 in rats pretreated with indomethacin and dosed with dimethylprostaglandin E2, misoprostol or prostacyclin. J Nutr 1997;127:478-82.

Kaufman DB, DiNicola W, McIntosh R. Acute potassium dichromate poisoning. Treated by periodontal dialysis. Am J Dis Child 1970;119:374-6.

Keim KS, Stoecker BJ, Henley S. Chromium status of the rat as affected by phytate. Nutr Res 1987;7:253-63.

Kozlovsky A, Moser PB, Reiser S, Anderson RA. Effects of diets high in simple sugars on urinary chromium losses. Metabolism 1986;35:515-8.

Kusiak RA, Ritchie AC, Springer J, Muller J. Mortality from stomach cancer in Ontario miners. Br J Ind Med 1995;590:117-26.

Lim TH, Sargent T III, Kusubov N. Kinetics of trace element chromium (III) in the human body. Am J Physiol 1983;244:R445-R454.

Loubieres Y, de Lassence A, Bernier M, Veillard-Baron A, Schmitt JM, Page B, Jardin F. Acute, fatal, oral chromic acid poisoning. J Toxicol Clin Toxicol 1999;37:333-6.

Mertz W, Roginski EE, Schwartz K. Effect of trivalent chromium complexes on glucose uptake by epididymal fat tissues of rats. J. Biol Chem 1961;236:489-94.

Mertz W, Tsui JC, Judd J, Reiser S, Hallfrisch J, Morris EER, Steele PD, Lashley E. What are people really eating? The relationship between energy intake derived from estimated diet records and intake determined to maintain body weight. Am J Clin Nutr 1991;534:291-5.

Mertz W. Chromium occurrence and function in biological systems. Physiol Rev 1969;49:163-239.

Mertz W. Chromium, in human nutrition: A review. J Nutr 1993;123:626-33.

Ministry of Health. NZ Food: NZ people. Key results of the National Nutrition Survey. Wellington; Ministry of Health, 1999.

Mohamedshah FY, Moser-Veillon PB, Yamini S, Douglass LW, Anderson RA, Veillon C. Distribution of a stable isotope of chromium (53Cr) in serum, urine and breast milk in lactating women. Am J Clin Nutr 1998;67:1250-5.

Offenbacher EG, Pi-Sunyer FX, Stoecker BJ. Chromium. In: O'Dell BL, Sunde RA, eds. Handbook of nutritionally essential mineral elements. New York: Marcel Dekker,1997. Pp 389-411.

Offenbacher EG, Spencer H, Dowling HJ, Pi-Sunyer FX. Metabolic chromium balances in men. Am J Clin Nutr 1986;44:77-82.

Offenbacher EG. Promotion of chromium absorption by ascorbic acid. Trace Elem Elect 1994;11:178-81.

Paschal DC, Ting BG, Morrow JC, Pirkle JL, Jackson RJ, Sampson EJ, Miller DT, Caldwell KL. Trace metals in the urine of United States residents: reference range concentrations. Environ Res 1998;76:53-9.

Rubin MA, Miller JP, Ryan AS, Trueth MS, Patterson KY, Pratley RE, Hurley BF, Veillon C, Moser-Veillon PB, Anderson RA. Acute and chronic resistive exercise increase urinary chromium excretion in men as measured with an enriched chromium stable isotope. J Nutr 1998;128:73-8.

Seaborn CD, Stoecker BJ. Effects of antacid or ascorbic acid on tissue accumulation and urinary excretion of 51chromium. Nutr Res 1990;10:1401-7.

Speetjens JK, Collins RA, Vincent JB, Woski SA The nutritional supplement chromium (III) tris (picolate) cleaves DNA. Chem Res Toxicol 1999;12:483-7.

Stearns DM, Wise JP, Patierno SR, Wetterhahn KE. Chromium (III) picolinate produces chromosome damage in Chinese hamster ovary cells. FASEB 1995;9:1643-8.

Stoecker BJ. Chromium. In: Ziegler EE, Filer LJ Jr, eds. Present knowledge in nutrition, 7th edition. Washington, DC: ILSI Press, 1996. Pp 344-52.

Veillon C. Analytical chemistry of chromium. Sci Total Environ 1989;86:65-8.

Wasser WG, Feldman NS, D'Agati VD. Chronic renal failure after ingestion of over-the-counter chromium picolinate. Ann Intern Med 1997;126:410.

Welch RM, Carey EE. Concentration of chromium, nickel and vanadium in plant materials. J Agric Food Chem 1975;23:479-82.