Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials

  • Farideh Shishehbor
    Affiliations
    Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
    Search for articles by this author
  • Anahita Mansoori
    Correspondence
    Corresponding author at: Department of Nutrition, Para-Medical School, Ahvaz Jundishapur University of Medical Sciences, P.O. BOX: 61357-15794, Ahvaz, Khuzestan, Iran. Fax: +98 61 33738330.
    Affiliations
    Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
    Search for articles by this author
  • Fatemeh Shirani
    Affiliations
    Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
    Search for articles by this author

      Highlights

      • Vinegar consumption can reduce the postprandial glucose response in both healthy, and participants with glucose disorder.
      • Vinegar consumption can reduce the postprandial insulin response.
      • Type of vinegar and disorders of glucose homeostasis could influence the heterogeneity of studies.

      Abstract

      Objective

      Postprandial hyperglycemia plays a decisive role in the development of chronic metabolic disorders. The effect of vinegar intake with a meal on postprandial glucose has been studied in several trials with conflicting results.

      Research methods and procedures

      The purpose of the current study was to systematically review control trials that report on the effect of vinegar intake on postprandial glucose response. Postprandial insulin response was considered as secondary outcome.

      Results

      The pooled analysis of studies revealed a significant mean glucose and insulin area under the curve (AUC) reduction in participants who consumed vinegar compared with the control group (standard mean difference = −0.60, 95%CI −1.08 to −0.11, p = 0.01 and −1.30, 95%CI −1.98 to −0.62, p < 0.001, respectively).

      Conclusions

      The findings suggest that vinegar can be effective in reducing postprandial glucose and insulin levels, indicating it could be considered as an adjunctive tool for improving glycemic control.

      Keywords

      To read this article in full you will need to make a payment

      References

        • Rizza R.A.
        Pathogenesis of fasting and postprandial hyperglycemia in type 2 diabetes: implications for therapy.
        Diabetes. 2010; 59: 2697-2707
        • Standl E.
        • Schnell O.
        • Ceriello A.
        Postprandial hyperglycemia and glycemic variability should we care?.
        Diabetes Care. 2011; 34: S120-S127
        • O’Keefe J.H.
        • Gheewala N.M.
        • O’Keefe J.O.
        Dietary strategies for improving post-prandial glucose, lipids, inflammation, and cardiovascular health.
        J Am Coll Cardiol. 2008; 51: 249-255
        • Johnston C.S.
        • Gaas C.A.
        Vinegar: medicinal uses and antiglycemic effect.
        Medscape General Med. 2006; 8: 61
        • Johnston C.S.
        • White A.M.
        • Kent S.M.
        Preliminary evidence that regular vinegar ingestion favorably influences hemoglobin A1c values in individuals with type 2 diabetes mellitus.
        Diabetes Res Clin Pract. 2009; 84: e15-e17
        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • Altman D.G.
        Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        Ann Intern Med. 2009; 151: 264-269
        • Brouns F.
        • Brouns F.
        • Bjorck I.
        • Frayn K.
        • Gibbs A.
        • Lang V.
        • et al.
        Glycaemic index methodology.
        Nutr Res Rev. 2005; 18: 145
        • Matthews J.
        • Altman D.G.
        • Campbell M.
        • Royston P.
        Analysis of serial measurements in medical research.
        BMJ (Clin Res Ed). 1990; 300: 230-235
        • Lau J.
        • Ioannidis J.P.
        • Schmid C.H.
        Quantitative synthesis in systematic reviews.
        Ann Intern Med. 1997; 127: 820-826
        • Egger M.
        • Davey Smith G.
        • Schneider M.
        • Minder C.
        Bias in meta-analysis detected by a simple, graphical test.
        BMJ (Clin Res Ed). 1997; 315: 629-634
        • Jadad A.R.
        • Moore R.A.
        • Carroll D.
        • Jenkinson C.
        • Reynolds D.J.M.
        • Gavaghan D.J.
        • et al.
        Assessing the quality of reports of randomized clinical trials: is blinding necessary?.
        Control Clin Trials. 1996; 17: 1-12
        • Kohn J.B.
        Is vinegar an effective treatment for glycemic control or weight Loss?.
        J Acad Nutr Dietet. 2015; 115: 1188
        • Petsiou E.I.
        • Mitrou P.I.
        • Raptis S.A.
        • Dimitriadis G.D.
        Effect and mechanisms of action of vinegar on glucose metabolism, lipid profile, and body weight.
        Nutr Rev. 2014; 72: 651-661
        • Li J.
        • Yu G.
        • Fan J.
        Alditols and monosaccharides from sorghum vinegar can attenuate platelet aggregation by inhibiting cyclooxygenase-1 and thromboxane-A2 synthase.
        J Ethnopharmacol. 2014; 155: 285-292
        • Beheshti Z.
        • Chan Y.H.
        • Nia H.S.
        • Hajihosseini F.
        • Nazari R.
        • Shaabani M.
        Influence of apple cider vinegar on blood lipids.
        Life Sci J. 2012; 9: 2431-2440
        • Derakhshandeh-Rishehri S.M.
        • Heidari-Beni M.
        • Feizi A.
        • Askari G.R.
        • Entezari M.H.
        Int J Prev Med. 2014; 5: 1608-1615
        • Tanaka H.
        • Watanabe K.
        • Ma M.L.
        • Hirayama M.
        • Kobayashi T.
        • Oyama H.
        • et al.
        The effects of gamma-aminobutyric acid, vinegar, and dried bonito on blood pressure in normotensive and mildly or moderately hypertensive volunteers.
        J Clin Biochem Nutr. 2009; 45: 93-100
        • Chung Y.C.
        • Chen H.H.
        • Yeh M.L.
        Vinegar for decreasing catheter-associated bacteriuria in long-term catheterized patients: a randomized controlled trial.
        Biolog Res Nurs. 2012; 14: 294-301
        • Darzi J.
        • Frost G.S.
        • Montaser R.
        • Yap J.
        • Robertson M.D.
        Influence of the tolerability of vinegar as an oral source of short-chain fatty acids on appetite control and food intake.
        Int J Obes. 2014; 38: 675-681
        • Johnston C.S.
        • White A.M.
        • Kent S.M.
        A preliminary evaluation of the safety and tolerance of medicinally ingested vinegar in individuals with type 2 diabetes.
        J Med Food. 2008; 11: 179-183
        • Nakhaee S.
        • Nasiri A.
        • Waghei Y.
        • Morshedi J.
        Comparison of Avena Sativa, vinegar, and hydroxyzine for uremic pruritus of hemodialysis patients a crossover randomized clinical trial.
        Iran J Kidney Dis. 2015; 9: 316-322
      1. Panetta CJ, Jonk YC, Shapiro AC. Prospective randomized clinical trial evaluating the impact of vinegar on lipids in non-diabetics. 2013.

        • Yoon J.W.
        • Kang S.M.
        • Vassy J.L.
        • Shin H.
        • Lee Y.H.
        • Ahn H.Y.
        • et al.
        Efficacy and safety of ginsam, a vinegar extract from Panax ginseng, in type 2 diabetic patients: Results of a double-blind, placebo-controlled study.
        J Diabetes Invest. 2012; 3: 309-317
        • Mettler S.
        • Schwarz I.
        • Colombani P.C.
        Additive postprandial blood glucose-attenuating and satiety-enhancing effect of cinnamon and acetic acid.
        Nutr Res. 2009; 29: 723-727
        • Kondo T.
        • Kishi M.
        • Fushimi T.
        • Ugajin S.
        • Kaga T.
        Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects.
        Biosci Biotechnol Biochem. 2009; 73: 1837-1843
        • Wolever T.M.
        • Spadafora P.J.
        • Cunnane S.C.
        • Pencharz P.B.
        Propionate inhibits incorporation of colonic [1,2–13C]acetate into plasma lipids in humans.
        Am J Clin Nutr. 1995; 61: 1241-1247
        • Liatist S.
        • Grammatikou S.
        • Poulia K.A.
        • Perrea D.
        • Makrilakis K.
        • Diakoumopoulou E.
        • et al.
        Vinegar reduces postprandial hyperglycaemia in patients with type II diabetes when added to a high, but not to a low, glycaemic index meal.
        Eur J Clin Nutr. 2010; 64: 727-732
        • Johnston C.S.
        • Buller A.J.
        Vinegar and peanut products as complementary foods to reduce postprandial glycemia.
        J Am Diet Assoc. 2005; 105: 1939-1942
        • Johnston C.S.
        • Steplewska I.
        • Long C.A.
        • Harris L.N.
        • Ryals R.H.
        Examination of the antiglycemic properties of vinegar in healthy adults.
        Ann Nutr Metab. 2010; 56: 74-79
        • Ostman E.
        • Granfeldt Y.
        • Persson L.
        • Bjorck I.
        Vinegar supplementation lowers glucose and insulin responses and increases satiety after a bread meal in healthy subjects.
        Eur J Clin Nutr. 2005; 59: 983-988
        • Johnston C.S.
        • Kim C.M.
        • Buller A.J.
        Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes.
        Diabetes Care. 2004; 27: 281-282
        • Kahramani N.K.
        • Mesci B.
        • Oguz A.
        • Tamer G.
        • Kahraman C.
        • Sagun G.
        • et al.
        The effect of vinegar on postprandial glycemia: does the amount matter?.
        Acta Endocrinol-Bucharest. 2011; 7: 577-584
        • van Dijk J.W.
        • Tummers K.
        • Hamer H.M.
        • van Loon L.J.
        Vinegar co-ingestion does not improve oral glucose tolerance in patients with type 2 diabetes.
        J Diabetes Complications. 2012; 26: 460-461
        • Mitrou P.
        • Petsiou E.
        • Papakonstantinou E.
        • Maratou E.
        • Lambadiari V.
        • Dimitriadis P.
        • et al.
        Vinegar consumption increases insulin-stimulated glucose uptake by the forearm muscle in humans with type 2 diabetes.
        J Diabetes Res. 2015;
        • Salbe A.D.
        • Johnston C.S.
        • Buyukbese M.A.
        • Tsitouras P.D.
        • Harman S.M.
        Vinegar lacks antiglycemic action on enteral carbohydrate absorption in human subjects.
        Nutr Res. 2009; 29: 846-849
        • Ebihara K.
        • Nakajima A.
        Effect of acetic acid and vinegar on blood glucose and insulin responses to orally administered sucrose and starch.
        Agric Biol Chem. 1988; 52: 1311-1312
        • Mitrou P.
        • Raptis A.E.
        • Lambadiari V.
        • Boutati E.
        • Petsiou E.
        • Spanoudi F.
        • et al.
        Vinegar decreases postprandial hyperglycemia in patients with type 1 diabetes.
        Diabetes Care. 2010; 33 (e27-e27): e27-e
        • Mitrou P.
        • Petsiou E.
        • Papakonstantinou E.
        • Maratou E.
        • Lambadiari V.
        • Dimitriadis P.
        • et al.
        The role of acetic acid on glucose uptake and blood flow rates in the skeletal muscle in humans with impaired glucose tolerance.
        Eur J Clin Nutr. 2015; 69: 734-739
        • Hlebowicz J.
        • Darwiche G.
        • Björgell O.
        • Almér L.-O.
        Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study.
        BMC Gastroenterol. 2007; 7: 1
        • Liljeberg H.
        • Björck I.
        Delayed gastric emptying rate may explain improved glycaemia in healthy subjects to a starchy meal with added vinegar.
        Eur J Clin Nutr. 1998; 52: 368-371
        • Ogawa N.
        • Satsu H.
        • Watanabe H.
        • Fukaya M.
        • Tsukamoto Y.
        • Miyamoto Y.
        • et al.
        Acetic acid suppresses the increase in disaccharidase activity that occurs during culture of Caco-2 cells.
        J Nutr. 2000; 130: 507-513
        • Fushimi T.
        • Tayama K.
        • Fukaya M.
        • Kitakoshi K.
        • Nakai N.
        • Tsukamoto Y.
        • et al.
        Acetic acid feeding enhances glycogen repletion in liver and skeletal muscle of rats.
        J Nutr. 2001; 131: 1973-1977
        • Brighenti F.
        • Castellani G.
        • Benini L.
        • Casiraghi M.
        • Leopardi E.
        • Crovetti R.
        • et al.
        Effect of neutralized and native vinegar on blood glucose and acetate responses to a mixed meal in healthy subjects.
        Eur J Clin Nutr. 1995; 49: 242-247
        • Brighenti F.
        • Castellani G.
        • Benini L.
        • Casiraghi M.C.
        • Leopardi E.
        • Crovetti R.
        • et al.
        Effect of neutralized and native vinegar on blood-glucose and acetate responses to a mixed meal in healthy-subjects.
        Eur J Clin Nutr. 1995; 49: 242-247
        • Östman E.M.
        • Elmståhl H.G.L.
        • Björck I.M.
        Inconsistency between glycemic and insulinemic responses to regular and fermented milk products.
        Am J Clin Nutr. 2001; 74: 96-100
        • Sugiyama M.
        • Tang A.C.
        • Wakaki Y.
        • Koyama W.
        Glycemic index of single and mixed meal foods among common Japanese foods with white rice as a reference food.
        Eur J Clin Nutr. 2003; 57: 743-752