Apple Vinegar Associated with Improved Glycemic Indices in Diabetics with Dyslipidemia

by | Oct 26, 2020 | 2019, Blood Lipids, Cardiovascular Health, Diabetes, Pancreatic Health

Written by Angeline A. De Leon, Staff Writer. Apple vinegar consumption significantly decreased insulin resistance, oxidative stress, blood pressure and homocysteine levels in participating type 2 diabetics with dyslipidemia.

apple vinegarThe prevalence of diabetes has steadily increased since 1980 1, with estimates projecting over 500 million incident cases of diabetes by 2030 2. Dietary-based interventions are becoming an increasingly popular therapeutic approach to diabetes treatment 3, the adoption of plant-based diets, for example, being known to offer key benefits for hypoglycemic factors and antioxidant capacity 4. Epidemiological research supports the prescription of polyphenol-rich foods and beverages to successfully lower the incidence of diabetes as well 5. Apple vinegar is one of the most popular functional foods today, its profile of polyphenols and acetic acid associated with strong protective effects against oxidative stress 6. Experimental research has shown that apple vinegar can improve serum triglycerides (TG) and glycated hemoglobin (HbA1c) levels in a mouse model of diabetes 7, and epidemiological work in humans has associated vinegar intake with improved fasting blood sugar (FBS) levels 8. Contrary research, however, also exists, suggesting that vinegar intake actually shows no significant effects on insulin resistance, HbA1c, or FBS 9. In an effort to reconcile current disparities in the literature, a recent study 10 in Clinical Nutrition ESPEN (2019) evaluated the impact of apple vinegar on glucose regulation and oxidative stress, as well as blood pressure and homocysteine (atherogenic risk factor) levels, in patients with diabetes and dyslipidemia.

A total of 62 patients with type 2 diabetes and dyslipidemia (mean age = 50.8 years) were enrolled in a randomized, placebo-controlled, parallel-group trial in which they were randomly assigned to receive 20 ml of apple vinegar (concentration of 5% acetic acid) dissolved in a glass of water or identical placebo daily for 4 weeks before being switched to the alternate arm of the study. At baseline and at the end of the study, anthropometric and blood pressure measurements were taken, and fasting blood samples were collected to determine FBS, insulin resistance (homeostatic model assessment of insulin resistance, HOMA-IR), b-cell function (HOMA-B), insulin sensitivity (quantitative insulin sensitivity check index, QUICKI) and biomarkers of oxidative stress and antioxidant capacity (malondialdehyde, MDA; 2,20-Diphenyl-1- picrylhydrazyl, DPPH; and homocysteine).

From baseline to the end of the study, subjects in the apple vinegar group demonstrated a significant decrease in insulin (p < 0.001), HOMA-IR (p < 0.001), HOMA-B (p < 0.001), QUICKI (p < 0.001), and FBS (p = 0.006). DPPH levels were also seen to significantly increase in the apple vinegar over the course of the study (mean change = 16.58 +/- 11.56, p < 0.001). Moreover, between-group analyses revealed that there were significant differences between patients receiving apple vinegar and control subjects regarding FBS levels, as well as DPPH and MDA concentrations (p < 0.001 for all).

Evidence from the current study supports the beneficial role of apple vinegar on glycemic indices and oxidative stress levels in patients with type 2 diabetes and dyslipidemia. Intake at a dose approximately equivalent to 4 teaspoons daily for a period of only 4 weeks was associated with significant within-group improvements on all measured glycemic parameters, including HOMA-IR and QUICKI, as well as significant improvement on FBS, compared to controls. Apple vinegar also showed the ability to significantly increase DPPH (used here as an indicator of total antioxidant capacity), while producing a lower increase in MDA levels, relative to controls. In sum, evidence suggests that apple vinegar supplementation should be considered a potential adjunct to current treatment procedures for patients with diabetes and dyslipidemia, although further exploration of the biological mechanisms associated with apple vinegar’s major components is warranted. Key study limitations pertain to the lack of blinding in the trial design, a relatively short treatment duration, and the failure to assess polyphenol content in the treatment product.

Source: Gheflati A, Bashiri R, Ghadiri-Anari A, et al. The effect of apple vinegar consumption on glycemic indices, blood pressure, oxidative stress, and homocysteine in patients with type 2 diabetes and dyslipidemia: a randomized controlled clinical trial. Clinical Nutrition ESPEN. 2019; 33: 132-138. DOI: 10.1016/j.clnesp.2019.06.006.

© 2019 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Posted October 26, 2020.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

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