A Preliminary Evaluation of the Safety and Tolerance of Medicinally Ingested Vinegar in Individuals with Type 2 Diabetes

Abstract

Vinegar (VIN) ingestion at mealtime reduces postprandial glycemia and may benefit individuals with diabetes; hence, the medicinal use of VIN has increased in recent years. This study examined the safety and tolerance of medicinally ingested VIN in type 2 diabetics. Participants (n = 27) were stratified by gender, age, and body mass and randomized into three groups: commercial VIN pills (the reference treatment [REF] (30 mg of acetic acid daily), pickles (PCK) (approximately 1,400 mg of acetic acid daily), or VIN (2,800 mg of acetic acid daily). Participants continued their normal eating habits during the 12-week trial. At baseline and weeks 6 and 12, fasting blood and urine samples were collected, and adverse changes in bowel movements, frequency of burping or flatulence, and episodes of acid reflux were recorded. Reporting frequency for adverse events did not vary significantly by group during the trial; however, 50-56% of PCK and VIN participants reported at least one treatment-emergent adverse event at week 6 as compared to 11% of REF participants (P = .110). Urinary pH was significantly reduced in VIN participants at week 12 as compared to the other groups (-9% vs. +3% and +2% for the PCK and REF groups, respectively, P = .023). At week 6 there was a tendency for aspartate aminotransferase concentrations to increase in the VIN group as compared to the other groups (+17% vs. +8% and -8% for VIN, PCK, and REF, respectively; P = .090). These data indicate that chronic VIN ingestion may influence hepatic function and metabolic pathways aside from glucose metabolism.

Dietary Supplements for Diabetes Are Decidedly Popular: Help Your Patients Decide

“…80 Most side effects from vinegar are gastrointestinal in nature. 81 However, hypoglycemia has been reported in type 1 diabetes patients with gastroparesis. 82 Oropharyngeal inflammation and caustic esophageal injury have also been reported.…”

Diabetes Control: Is Vinegar a Promising Candidate to Help Achieve Targets?

“…The only 2 non-English articles were in Persian. 14 , 22 Five were parallel group randomized controlled trials, 14 , 17 , 18 , 21 , 24 5 were crossover randomized controlled trials, 12 , 16 , 22 , 23 , 25 1 was a nonrandomized controlled trial, 20 and 1 was a single-arm before-and-after study. 19 The subjects were treated with diet, oral hypoglycemic agents, or insulin.…”

“…Five studies reported PPG levels at 30 minutes, 16 , 17 , 19 , 21 , 25 4 studies at 60 minutes, 16 , 17 , 19 , 25 and 3 studies at 90 and 120 minutes. 17 , 19 , 25 Pooled mean difference of PPG levels between control and vinegar groups were 0.88 mmol/L (95% confidence interval [CI] = 0.51, 1.25) at 30 minutes (n = 102), 0.45 mmol/L (95% CI = −0.31, 1.21) at 60 minutes (n = 92), 0.10 mmol/L (95% CI = −0.52, 0.73) at 90 minutes (n = 74), and 0.05 mmol/L (95% CI = −1.11, 1.20) at 120 minutes (n = 74). Three studies reported FPI at 30 and 60 minutes 17 , 19 , 25 and 2 studies at 90 and 120 minutes.…”

“… 17 , 19 , 25 Pooled mean difference of PPG levels between control and vinegar groups were 0.88 mmol/L (95% confidence interval [CI] = 0.51, 1.25) at 30 minutes (n = 102), 0.45 mmol/L (95% CI = −0.31, 1.21) at 60 minutes (n = 92), 0.10 mmol/L (95% CI = −0.52, 0.73) at 90 minutes (n = 74), and 0.05 mmol/L (95% CI = −1.11, 1.20) at 120 minutes (n = 74). Three studies reported FPI at 30 and 60 minutes 17 , 19 , 25 and 2 studies at 90 and 120 minutes. 19 , 25 Pooled mean difference of FPI between control and vinegar groups were 13.62 mU/L (95% CI = −63.81, 91.03) at 30 minutes (n = 74), −53.57 mU/L (95% CI = −157.93, 50.80) at 60 minutes (n = 74), −24.77 mU/L (95% CI = −114.07, 64.52) at 90 minutes (n = 56), and −20.06 mU/L (95% CI = −124.02, 83.89) at 120 minutes (n = 56).…”

Influence of the tolerability of vinegar as an oral source of short-chain fatty acids on appetite control and food intake

“…However, this raises concerns about the appropriateness and safety of this advice, as ingestion of vinegar products have been reported to be linked with oesophageal injury, 7,8 biochemical disturbances, 9 dental erosion 10 and acute pancreatitis 11 and symptoms such as acid reflux, burping/ flatulence and changes in bowel habit. 12 It could further be argued that the scientific evidence currently available is not sufficient to warrant such health claims.…”