Vinegar reduces postprandial hyperglycaemia in patients with type II diabetes when added to a high, but not to a low, glycaemic index meal

Abstract

Background/Objectives: Earlier studies have shown that the addition of vinegar in a carbohydrate-rich meal lowers glucose and insulin response in healthy individuals. The mechanism of how this is accomplished, however, remains unclear. The aim of this study is to examine the effect of vinegar on glucose and insulin response in patients with type II diabetes (T2D) in relation to the type of carbohydrates consumed in a meal. Subjects/Methods: Sixteen patients with T2D were divided into two groups, matched for age, gender and HbA 1c . Patients in the first group (group A) were given a high-glycaemic index (GI) meal (mashed potatoes and low-fat milk) on two different days, with and without the addition of vinegar, respectively. In the second group (group B), patients were given an isocaloric meal with the same nutrient composition, but low GI (whole grain bread, lettuce and low-fat cheese). Postprandial plasma glucose and insulin values were measured every 30 min for 2 h. Results: In group A, the incremental area under the curve of glucose (GiAUC 120 ) was lower after the addition of vinegar (181 ± 78 mmol Á min/l vs 311 ± 124 mmol Á min/l, P ¼ 0.04). The iAUC of insulin (IiAUC 120 ) was also reduced, but the difference was of marginal statistical significance (2368±1061 mU Á min/ml vs 3545±2586 mU Á min/ml, P ¼ 0.056). In group B, the addition of vinegar did not affect either the GiAUC 120 (229 ± 38 mmol Á min/l vs 238 ± 25 mmol Á min/l, P ¼ 0.56) or the IiAUC 120 (2996±1302 mU Á min/ml vs 3007±1255 mU Á min/ml, P ¼ 0.98). Conclusions: We conclude that the addition of vinegar reduces postprandial glycaemia in patients with T2D only when it is added to a high-GI meal.

Impact of Diet Composition on Blood Glucose Regulation

“…Several years ago, organic acids such as acetic and propionic acids were shown to lower the glucose and insulin responses when added to white bread meals in healthy subjects (Liljeberg and Bjorck, 1998;Darwiche et al, 2001;€ Ostman et al, 2005). More recently, addition of vinegar in a carbohydrate rich meal decreased significantly the glycemic and insulin responses in T2DM subjects only after a high GI meal (Liatis et al, 2010). The blood glucose and insulin kinetics were not modified after the low GI meal.…”

Is Vinegar an Effective Treatment for Glycemic Control or Weight Loss?

“…9 Other theories equate vinegar's antiglycemic effects to the suppression of disaccharidase activity, thereby influencing carbohydrate absorption. [2][3][4][5]9 Vinegar's effects on glucose production in the liver, glucose uptake in skeletal muscle, and insulin secretion are also being explored. 4,5 Although there is a lack of evidence at this time to recommend vinegar as an adjuvant treatment for diabetes, vinegar is considered to be safe when consumed in reasonable amounts.…”

“…6 While some studies have included acetic acid in pill form, the supplements available to consumers have varied greatly in their "contents and acidity." 9 Although vinegar's specific influence on metabolism has yet to be determined, it has been proposed that vinegar may delay gastric emptying, [2][3][4]6,9 and has been shown to worsen this condition in people with gastroparesis and type 1 diabetes mellitus. 9 Other theories equate vinegar's antiglycemic effects to the suppression of disaccharidase activity, thereby influencing carbohydrate absorption.…”

“…Vinegar as a weight-loss aid was reported as early as the 1820s, 1 and more recently it has received attention for its possible role in lowering blood glucose levels. [2][3][4][5][6] Vinegar can be derived from beer or wine-or in the case of apple cider vinegar, cider-and is a result of bacterial fermentation that yields acetic acid. 7 Although "no standards of identity" exist for vinegar, the US Food and Drug Administration (FDA) has defined the amount of acetic acid for a product to be labeled as vinegar to be 4 g of acetic acid per 100 mL.…”

Minimizing Postprandial Oxidative Stress in Type 2 Diabetes: The Role of Exercise and Selected Nutrients

“…In patients with T2DM, 20g of wine vinegar has been shown to reduce postprandial glucose and insulin AUC when added to a high, but not to a low, glycemic index meal (Liatis et al, 2010). In a four part investigation, the anti-glycemic properties of vinegar were investigated (Johnston et al, 2010).…”