Apple Cider Vinegar anyone?

BMC Gastroenterol. 2007 Dec 20;7:46.
Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study.
Hlebowicz J1, Darwiche G, Björgell O, Almér LO.
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Abstract
BACKGROUND:
Previous studies on healthy people show that vinegar delays gastric emptying and lowers postprandial blood glucose and insulin levels. The aim of this study was to investigate the effect of apple cider vinegar on delayed gastric emptying rate on diabetes mellitus patients.

METHODS:
Ten patients with type 1 diabetes and diabetic gastroparesis, including one patient who had undergone vagotomy, were included and completed the investigator blinded crossover trial. The gastric emptying rate (GER) was measured using standardized real-time ultrasonography. The GER was calculated as the percentage change in the antral cross-sectional area 15 and 90 minutes after ingestion of 300 g rice pudding and 200 ml water (GER1), or 300 g rice pudding and 200 ml water with 30 ml apple cider vinegar (GER2). The subjects drank 200 ml water daily before breakfast one week before the measurement of GER1. The same subjects drank 200 ml water with 30 ml vinegar daily before breakfast for two weeks before the measurement of GER2.

RESULTS:
The median values of GER1 and GER2 were 27% and 17%, respectively. The effect of vinegar on the rate of gastric emptying was statistically significant (p < 0.05).

CONCLUSION:
This study shows that vinegar affects insulin-dependent diabetes mellitus patients with diabetic gastroparesis by reducing the gastric emptying rate even further, and this might be a disadvantage regarding to their glycaemic control.

“Regular ingestion of cider vinegar is becoming an increasingly popular habit in Austria and Germany. Cider vinegar is described as a prophylaxis and cure for almost any disease or complaint. Doses from one teaspoon to six soupspoons per day have been recommended. A local bookshop offered nine different specialist books on the benefits of cider vinegar. Here we describe the case of a woman, in whom chronic ingestion of excessive amounts of cider vinegar caused serious health problems.” What kind of health problems? Well, the article is entitled ‘Hypokalemia, Hyperreninemia and Osteoporosis in a Patient Ingesting Large Amounts of Cider Vinegar’. Authors: Karl Lhotta, Günther Höfle, Rudolf Gasser, Gerd Finkenstedt. Ref: Nephron 1998;80:242-243 (DOI: 10.1159/000045180).

Apple cider vinegar products are advertised in the popular press and over the Internet for treatment of a variety of conditions. After an adverse event was reported to the authors, eight apple cider vinegar tablet products were tested for pH, component acid content, and microbial growth. Considerable variability was found between the brands in tablet size, pH, component acid content, and label claims. Doubt remains as to whether apple cider vinegar was in fact an ingredient in the evaluated products. The inconsistency and inaccuracy in labelling, recommended dosages, and unsubstantiated health claims make it easy to question the quality of the products.
Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products.
J Am Diet Assoc. 2005 Jul;105(7):1141-4.
PMID: 15983536 [PubMed - indexed for MEDLINE]

Vinegar lacks antiglycemic action on enteral carbohydrate absorption in human subjects.
Salbe AD1, Johnston CS, Buyukbese MA, Tsitouras PD, Harman SM.
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Abstract
The antiglycemic effects of vinegar have been known for more than a century and have been demonstrated in animal as well as human studies. Although the exact mechanism of vinegar action is not known, several possibilities have been proposed including suppression of disaccharidase activity, delayed gastric emptying, enhanced glucose uptake in the periphery and conversion to glycogen, and increased satiety. We hypothesized that by suppressing endogenous insulin secretion, we could estimate the glucose absorption rate from an oral carbohydrate load and determine the effects of vinegar ingestion on this rate. To do so, 5 subjects had 4 studies at 1-week intervals, randomly receiving placebo twice (60 mL water) and vinegar twice (20 mL apple cider vinegar, 40 mL water), followed 2 minutes later by a meal of mashed potatoes (0.75 g carbohydrate per kilogram body weight) that was consumed over 20 minutes. At the beginning of the meal, an oral octreotide/insulin suppression test (25-microg bolus octreotide; 180 minute infusion 5 mU/m(2) body surface area per minute regular human insulin, and 0.5 microg/min octreotide) was begun. Blood samples for insulin and glucose were drawn at 20-minute intervals. The oral octreotide/insulin suppression test suppressed endogenous insulin secretion for the first 100 minutes of the study. During this time, the rate of rise of glucose was modestly but significantly (P = .01) greater after vinegar ingestion compared to placebo, suggesting that vinegar does not act to decrease glycemia by interference with enteral carbohydrate absorption.

PMID: 19963157 [PubMed - indexed for MEDLINE]