KLC and NLC diets were equally effective in reducing body weight and insulin resistance, but the KLC diet was associated with several adverse metabolic and emotional effects. The use of ketogenic diets for weight loss is not warranted.

Given the importance of maintaining acceptable blood glucose concentrations, there is much interest in identifying foods and diet patterns that will help individuals with diabetes manage their condition. Based on previous data indicating that vinegar ingestion at mealtime reduces postprandial glycemia (1-4), the aim of this pilot study was to examine whether vinegar ingestion at bedtime reduces the next-morning fasting glucose concentration in individuals with type 2 diabetes.RESEARCH DESIGN AND METHODS -Four men and seven women (aged 40 -72 years) diagnosed with type 2 diabetes (by a physician) who were not taking insulin completed the study. Participants provided a clinically determined A1C reading from a recent (Ͻ2 months) blood analysis. All participants gave written informed consent, and the study was approved by the institutional review board at Arizona State University.Participants maintained 24-h diet records for 3 days and measured fasting glucose at 0700 h for 3 consecutive days with a calibrated glucometer before the start of the study. Participants were instructed to continue usual prescription medication use during the study. Utilizing a randomized crossover design with a 3-to 5-day washout period between treatments, participants followed a standardized meal plan for 2 days, consuming either 2 Tbsp apple cider vinegar or water at bedtime with 1 oz cheese (8 g protein, 1 g carbohydrate, and 1.5 g fat). The standardized meal plan was designed to reflect the individual's typical diet. Participants were instructed to record all foods and beverages ingested during each 2-day treatment period.Fasting glucose was recorded with a calibrated glucometer by each participant during the trial: at baseline (day 0) and day 2 at 0700 h. These results were downloaded by the research staff from each participant's glucometer memory. A multivariate repeated-measures ANOVA test with body weight as a covariate was used to determine a significant time-bytreatment effect using SPSS (version 14 for Windows; SPSS, Chicago, IL).RESULTS -The duration of diabetes averaged 4.9 Ϯ 1.0 years for the participants, and 73% of participants (8 of 11) used prescription hypoglycemic agents during the study. Before the initiation of the study, a BMI of 29.1 Ϯ 1.2 kg/m 2 , a typical fasting glucose of 7.6 Ϯ 0.3 mmol/l, and an A1C of 6.7 Ϯ 0.2% were recorded for the participants. Participants complied with the dietary protocol as indicated by the diet records maintained during the study; hence, food intake for the two treatment periods was identical within subjects. Fasting glucose was reduced 0.15 mmol/l (2%) and 0.26 mmol/l (4%) for the placebo and vinegar treatments, respectively (time-by-treatment effect, P ϭ 0.033) (Fig. 1). Closer examination of the data revealed that the vinegar treatment was particularly effective for the participants with a typical fasting glucose Ͼ7.2 mmol/l; in these individuals (n ϭ 6), fasting glucose was reduced 6% compared with a reduction of 0.7% in those participants with a typical fasting glucose Ͻ7.2 mmol...

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