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 HbA1c. 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 (GiAUC120) was lower after the addition of vinegar (181±78 mmol·min/l vs 311±124 mmol·min/l, P=0.04). The iAUC of insulin (IiAUC120) was also reduced, but the difference was of marginal statistical significance (2368±1061 μU·min/ml vs 3545±2586 μU·min/ml, P=0.056). In group B, the addition of vinegar did not affect either the GiAUC120 (229±38 mmol·min/l vs 238±25 mmol·min/l, P=0.56) or the IiAUC120 (2996±1302 μU·min/ml vs 3007±1255 μU·min/ml, P=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.
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References
AACE Diabetes Mellitus Clinical Practice Guidelines Task Force (2007). American Association of Clinical Endocrinologists medical guidelines for clinical practice for the management of diabetes mellitus. Endocr Pract 13 (Suppl 1), 1–68.
American Diabetes Association (2008). Standards of medical care in diabetes. Diabetes Care 31 (Suppl 1), S12–S54.
Brighenti F, Castellani G, Benini L, Casiraghi MC, Leopardi E, Crovetti R et al. (1995). Effect of neutralized and native vinegar on blood glucose and acetate responses to a mixed meal in healthy subjects. Eur J Clin Nutr 49, 242–247.
Donahue RP, Abbott RD, Reed DM, Yano K (1987). Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry: honolulu heart program. Diabetes 36, 689–692.
Foster-Powell K, Holt SH, Brand-Miller JC . (2002) International table of glycemic index and glycemic load values: 2002. Am J Clin Nutr 76, 5–56.
Hlebowicz J, Darwiche G, Björgell O, Almér LO (2007). Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC Gastroenterol 7, 46.
Hunt JN, Knox MT (1969). The slowing of gastric emptying by nine acids. J Physiol 201, 161–179.
Hunt JN, Knox MT (1972). The slowing of gastric acid by four strong acids and three weak acids. J Physiol 222, 187–208.
Johnston CS, Buller AJ (2005). Vinegar and peanut products as complementary foods to reduce postprandial glycemia. J Am Diet Assoc 105, 1939–1942.
Johnston CS, Kim CM, Buller AJ (2004). Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes. Diabetes Care 27, 281–282.
Katsilambros N, Liatis S, Makrilakis K (2006). Critical review of the international guidelines: what is agreed upon—what is not? Nestle Nutr Workshop Ser Clin Perform Programme 11, 207–218.
Leeman M, Ostman E, Björck I (2005). Vinegar dressing and cold storage of potatoes lowers postprandial glycaemic and insulinaemic responses in healthy subjects. Eur J Clin Nutr 59, 1266–1271.
Liljeberg H, Björck I (1998). Delayed gastric emptying rate may explain improved glycaemia in healthy subjects to a starchy meal with added vinegar. Eur J Clin Nutr 52, 368–371.
Lin HC, Doty JE, Reedy TJ, Meyer JH (1990). Inhibition of gastric emptying by acids depends on pH, titratable acidity, and length of intestine exposed to acid. Am J Physiol 259, 1025–1030.
Mitrou P, Raptis AE, Lambadiari V, Boutati E, Petsiou E, Spanoudi F et al. (2010). Vinegar decreases postprandial hyperglycemia in patients with type 1 diabetes. Diabetes Care 33, e27.
Monnier L, Lapinski H, Colette C (2003). Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients: variations with increasing levels of HbA(1c). Diabetes Care 26, 881–885.
Ogawa N, Satsu H, Watanabe H, Fukaya M, Tsukamoto Y, Miyamoto Y et al. (2000). Acetic acid suppresses the increase in disaccharidase activity that occurs during culture of caco-2 cells. J Nutr 130, 507–513.
Ostman E, Granfeldt Y, Persson L, Björck I (2005). Vinegar supplementation lowers glucose and insulin responses and increases satiety after a bread meal in healthy subjects. Eur J Clin Nutr 59, 983–988.
Sugiyama M, Tang AC, Wakaki Y, Koyama W (2003). Glycemic index of single and mixed meal foods among common Japanese foods with white rice as a reference food. Eur J Clin Nutr 57, 743–752.
The DECODE Study Group, the European Diabetes Epidemiology Group (1999). Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. Lancet 354, 617–621.
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We thank Mr Elias Kourpas for his assistance to write the article in proper English.
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Liatis, S., Grammatikou, S., Poulia, KA. 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 64, 727–732 (2010). https://doi.org/10.1038/ejcn.2010.89
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DOI: https://doi.org/10.1038/ejcn.2010.89
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