Tag Archives: Glycemic index

Glycaemic Index

Definition:
The glycemic index or glycaemic index (GI) is a number associated with a particular type of food that indicates the food’s effect on a person’s blood glucose (also called blood sugar) level. The number typically ranges between 50 and 100, where 100 represents the standard, an equivalent amount of pure glucose.

The GI represents the total rise in a person’s blood sugar level following consumption of the food; it may or may not represent the rapidity of the rise in blood sugar. The steepness of the rise can be influenced by a number of other factors, such as the quantity of fat eaten with the food. The GI is useful for understanding how the body breaks down carbohydrates  and only takes into account the available carbohydrate (total carbohydrate minus fiber) in a food. Although the food may contain fats and other components that contribute to the total rise in blood sugar, these effects are not reflected in the GI.

The glycemic index is usually applied in the context of the quantity of the food and the amount of carbohydrate in the food that is actually consumed. A related measure, the glycemic load (GL), factors this in by multiplying the glycemic index of the food in question by the carbohydrate content of the actual serving. Watermelon has a high glycemic index, but a low glycemic load for the quantity typically consumed. Fructose, by contrast, has a low glycemic index, but can have a high glycemic load if a large quantity is consumed.

GI tables are available that list many types of foods and their GIs. Some tables also include the serving size and the glycemic load of the food per serving.

A practical limitation of the glycemic index is that it does not measure insulin production due to rises in blood sugar. As a result, two foods could have the same glycemic index, but produce different amounts of insulin. Likewise, two foods could have the same glycemic load, but cause different insulin responses. Furthermore, both the glycemic index and glycemic load measurements are defined by the carbohydrate content of food. For example when eating steak, which has no carbohydrate content but provides a high protein intake, up to 50% of that protein can be converted to glucose when there is little to no carbohydrate consumed with it.  But because it contains no carbohydrate itself, steak cannot have a glycemic index. For some food comparisons, the “insulin index” may be more useful.

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Glycemic index charts often give only one value per food, but variations are possible due to variety, ripeness (riper fruits contain more sugars increasing GI), cooking methods (the more cooked, or over cooked, a food the more its cellular structure is broken with a tendency for it to digest quickly and raise GI more), processing (e.g., flour has a higher GI than the whole grain from which it is ground as grinding breaks the grain’s protective layers) and the length of storage. Potatoes are a notable example, ranging from moderate to very high GI even within the same variety.

The glycemic response is different from one person to another, and also in the same person from day to day, depending on blood glucose levels, insulin resistance, and other factors.

Most of the values on the glycemic index do not show the impact on glucose levels after two hours. Some people with diabetes may have elevated levels after four hours.

Why  GI is so Important?
Over the past 15 years, low-GI diets have been associated with decreased risk of cardiovascular disease, type 2 diabetes, metabolic syndrome, stroke, depression, chronic kidney disease, formation of gall stones, neural tube defects, formation of uterine fibroids, and cancers of the breast, colon, prostate, and pancreas. Taking advantage of these potential health benefits can be as simple as sticking with whole, natural foods that are either low or very low in their GI value.

Determination of GI of a food:
Foods with carbohydrates that break down quickly during digestion and release glucose rapidly into the bloodstream tend to have a high GI; foods with carbohydrates that break down more slowly, releasing glucose more gradually into the bloodstream, tend to have a low GI. The concept was developed by Dr. David J. Jenkins and colleagues  in 1980–1981 at the University of Toronto in their research to find out which foods were best for people with diabetes. A lower glycemic index suggests slower rates of digestion and absorption of the foods’ carbohydrates and may also indicate greater extraction from the liver and periphery of the products of carbohydrate digestion. A lower glycemic response usually equates to a lower insulin demand but not always, and may improve long-term blood glucose control   and blood lipids. The insulin index is also useful for providing a direct measure of the insulin response to a food.

The glycemic index of a food is defined as the incremental area under the two-hour blood glucose response curve (AUC) following a 12-hour fast and ingestion of a food with a certain quantity of available carbohydrate (usually 50 g). The AUC of the test food is divided by the AUC of the standard (either glucose or white bread, giving two different definitions) and multiplied by 100. The average GI value is calculated from data collected in 10 human subjects. Both the standard and test food must contain an equal amount of available carbohydrate. The result gives a relative ranking for each tested food.

The current validated methods use glucose as the reference food, giving it a glycemic index value of 100 by definition. This has the advantages of being universal and producing maximum GI values of approximately 100. White bread can also be used as a reference food, giving a different set of GI values (if white bread = 100, then glucose ? 140). For people whose staple carbohydrate source is white bread, this has the advantage of conveying directly whether replacement of the dietary staple with a different food would result in faster or slower blood glucose response. A disadvantage with this system is that the reference food is not well-defined.

Classification:
GI values can be interpreted intuitively as percentages on an absolute scale and are commonly interpreted as follows:

Low GI…..(55 or less fructose;) …….Examples:beans (white, black, pink, kidney, lentil, soy, almond, peanut, walnut, chickpea); small seeds (sunflower, flax, pumpkin, poppy, sesame, hemp); most whole intact grains (durum/spelt/kamut wheat, millet, oat, rye, rice, barley); most vegetables, most sweet fruits (peaches, strawberries, mangos); tagatose; mushrooms; chilis.

Medium GI…..(56–69 Examples: white sugar or sucrose, not intact whole wheat or enriched wheat, pita bread, basmati rice, unpeeled boiled potato, grape juice, raisins, prunes, pumpernickel bread, cranberry juice,[10] regular ice cream, banana.

High GI….….(70 and above) Examples: glucose (dextrose, grape sugar), high fructose corn syrup, white bread (only wheat endosperm), most white rice (only rice endosperm), corn flakes, extruded breakfast cereals, maltose, maltodextrins, sweet potato , white potato , pretzels, bagels.

A low-GI food will release glucose more slowly and steadily, which leads to more suitable postprandial (after meal) blood glucose readings. A high-GI food causes a more rapid rise in blood glucose levels and is suitable for energy recovery after exercise or for a person experiencing hypoglycemia.

The glycemic effect of foods depends on a number of factors, such as the type of starch (amylose versus amylopectin), physical entrapment of the starch molecules within the food, fat and protein content of the food and organic acids or their salts in the meal — adding vinegar, for example, will lower the GI. The presence of fat or soluble dietary fiber can slow the gastric emptying rate, thus lowering the GI. In general, coarse, grainy breads with higher amounts of fiber have a lower GI value than white breads.  However, most breads made with 100% whole wheat or wholemeal flour have a GI not very different from endosperm only (white) bread.  Many brown breads are treated with enzymes to soften the crust, which makes the starch more accessible (high GI).

While adding fat or protein will lower the glycemic response to a meal, the relative differences remain. That is, with or without additions, there is still a higher blood glucose curve after a high-GI bread than after a low-GI bread such as pumpernickel.

Fruits and vegetables tend to have a low glycemic index. The glycemic index can be applied only to foods where the test relies on subjects consuming an amount of food containing 50 g of available carbohydrate.[citation needed] But many fruits and vegetables (not potatoes, sweet potatoes, corn) contain less than 50 g of available carbohydrate per typical serving. Carrots were originally and incorrectly reported as having a high GI.  Alcoholic beverages have been reported to have low GI values; however, beer was initially reported to have a moderate GI due to the presence of maltose. This has been refuted by brewing industry professionals, who say that all maltose sugar is consumed in the brewing process and that packaged beer has little to no maltose present. Recent studies have shown that the consumption of an alcoholic drink prior to a meal reduces the GI of the meal by approximately 15%.  Moderate alcohol consumption more than 12 hours prior to a test does not affect the GI.

Many modern diets rely on the glycemic index, including the South Beach Diet, Transitions by Market America and NutriSystem Nourish Diet. However, others have pointed out that foods generally considered to be unhealthy can have a low glycemic index, for instance, chocolate cake (GI 38), ice cream (37), or pure fructose (19), whereas foods like potatoes and rice have GIs around 100 but are commonly eaten in some countries with low rates of diabetes.

The GI Symbol Program is an independent worldwide GI certification program that helps consumers identify low-GI foods and drinks. The symbol is only on foods or beverages that have had their GI values tested according to standard and meet the GI Foundation’s certification criteria as a healthy choice within their food group, so they are also lower in kilojoules, fat and/or salt.

Weight control:
Recent animal research provides compelling evidence that high-GI carbohydrate is associated with increased risk of obesity. In one study,  male rats were split into high- and low-GI groups over 18 weeks while mean body weight was maintained. Rats fed the high-GI diet were 71% fatter and had 8% less lean body mass than the low-GI group. Postmeal glycemia and insulin levels were significantly higher, and plasma triglycerides were threefold greater in the high-GI-fed rats. Furthermore, pancreatic islet cells suffered “severely disorganized architecture and extensive fibrosis.” However, the GI of these diets was not experimentally determined. In a well controlled feeding study no improvement in weight loss was observed with a low glycemic index diet over calorie restriction.  Because high-amylose cornstarch (the major component of the assumed low-GI diet) contains large amounts of resistant starch, which is not digested and absorbed as glucose, the lower glycemic response and possibly the beneficial effects can be attributed to lower energy density and fermentation products of the resistant starch, rather than the GI.

In humans, a 2012 study shows that, after weight loss, the energy expenditure is higher on a low-glycemic index diet than on a low-fat diet (but lower than on the Atkins diet).

 Prevention of Diseases:
Several lines of recent [1999] scientific evidence have shown that individuals who followed a low-GI diet over many years were at a significantly lower risk for developing both type 2 diabetes, coronary heart disease, and age-related macular degeneration than others.  High blood glucose levels or repeated glycemic “spikes” following a meal may promote these diseases by increasing systemic glycative stress, other oxidative stress to the vasculature, and also by the direct increase in insulin levels.  The glycative stress sets up a vicious cycle of systemic protein glycation, compromised protein editing capacity involving the ubiquitin proteolytic pathway and autophagic pathways, leading to enhanced accumulation of glycated and other obsolete proteins.

In the past, postprandial hyperglycemia has been considered a risk factor associated mainly with diabetes. However, more recent evidence shows that it also presents an increased risk for atherosclerosis in the non-diabetic population   and that high GI diets,  high blood-sugar levels more generally,  and diabetes  are related to kidney disease as well.

Conversely, there are areas such as Peru and Asia where people eat high-glycemic index foods such as potatoes and high-GI rice without a high level of obesity or diabetes.  The high consumption of legumes in South America and fresh fruit and vegetables in Asia likely lowers the glycemic effect in these individuals. The mixing of high- and low-GI carbohydrates produces moderate GI values.

A study from the University of Sydney in Australia suggests that having a breakfast of white bread and sugar-rich cereals, over time, may make a person susceptible to diabetes, heart disease, and even cancer.

A study published in the American Journal of Clinical Nutrition found that age-related adult macular degeneration (AMD), which leads to blindness, is 42% higher among people with a high-GI diet, and concluded that eating a lower-GI diet would eliminate 20% of AMD cases.

The American Diabetes Association supports glycemic index but warns that the total amount of carbohydrate in the food is still the strongest and most important indicator, and that everyone should make their own custom method that works best for them.

The International Life Sciences Institute concluded in 2011 that because there are many different ways of lowering glycemic response, not all of which have the same effects on health, “It is becoming evident that modifying the glycemic response of the diet should not be seen as a stand-alone strategy but rather as an element of an overall balanced diet and lifestyle.”

A systematic review of few human trials examined the potential of low GI diet to improve pregnancy outcomes. Potential benefits were still seen despite no ground breaking findings in maternal glycemia or pregnancy outcomes. In this regard, more women under low GI diet achieved the target treatment goal for the postprandial glycemic level and reduced their need for insulin treatment. A low GI diet may also provide greater benefits to overweight and obese women. Interestingly, intervention at an early stage of pregnancy has shown a tendency to lower birth weight and birth centile in infants born to women with GDM.

Other factors:
The number of grams of carbohydrate can have a bigger impact than glycemic index on blood sugar levels, depending on quantities. Consuming fewer calories, losing weight, and carbohydrate counting can be better for lowering the blood sugar level. Carbohydrates impact glucose levels most profoundly,  and two foods with the same carbohydrate content are, in general, comparable in their effects on blood sugar.  A food with a low glycemic index may have a high carbohydrate content or vice versa; this can be accounted for with the glycemic load (GL). Consuming carbohydrates with a low glycemic index and calculating carbohydrate intake would produce the most stable blood sugar levels.

Criticism and alternatives:
The glycemic index does not take into account other factors besides glycemic response, such as insulin response, which is measured by the insulin index and can be more appropriate in representing the effects from some food contents other than carbohydrates. In particular, since it is based on the area under the curve of the glucose response over time from ingesting a subject food, the shape of the curve has no bearing on the corresponding GI value. The glucose response can rise to a high level and fall quickly, or rise less high but remain there for a longer time, and have the same area under the curve. For subjects with type 1 diabetes who do not have an insulin response, the rate of appearance of glucose after ingestion represents the absorption of the food itself. This glycemic response has been modeled, where the model parameters for the food enable prediction of the continuous effect of the food over time on glucose values, and not merely the ultimate effect that the GI represents.

Although the glycemic index provides some insights into the relative diabetic risk within specific food groups, it contains many counter-intuitive ratings. These include suggestions that bread generally has a higher glycemic ranking than sugar and that some potatoes are more glycemic than glucose. More significantly, studies such as that by Bazzano et al.  demonstrate a significant beneficial diabetic effect for fruit compared to a substantial detrimental impact for fruit juice despite these having similar “low GI” ratings.

From blood glucose curves presented by Brand-Miller et al.  the main distinguishing feature between average fruit and fruit juice blood glucose curves is the maximum slope of the leading edge of 4.38 mmol·L-1·h-1 for fruit and 6.71 mmol·L-1·h-1 for fruit juice. This raises the concept that the rate of increase in blood glucose may be a significant determinant particularly when comparing liquids to solids which release carbohydrates over time and therefore have an inherently greater area under the blood glucose curve.

If you were to restrict yourself to eating only low GI foods, your diet is likely to be unbalanced and may be high in fat and calories, leading to weight gain and increasing your risk of heart disease. It is important not to focus exclusively on GI and to think about the balance of your meals, which should be low in fat, salt and sugar and contain plenty of fruit and vegetables.

There are books that give a long list of GI values for many different foods. This kind of list does have its limitations. The GI value relates to the food eaten on its own and in practice we usually eat foods in combination as meals. Bread, for example is usually eaten with butter or margarine, and potatoes could be eaten with meat and vegetables.

An additional problem is that GI compares the glycaemic effect of an amount of food containing 50g of carbohydrate but in real life we eat different amounts of food containing different amounts of carbohydrate.

Note: The amount of carbohydrate you eat has a bigger effect on blood glucose levels than GI alone.

How to have lower GI?
*Choose basmati or easy cook rice, pasta or noodles.
*Switch baked or mashed potato for sweet potato or boiled new potatoes.
*Instead of white and wholemeal bread, choose granary, pumpernickel or rye bread.
*Swap frozen microwaveable French fries for pasta or noodles.
*Try porridge, natural muesli or wholegrain breakfast cereals.
*You can maximise the benefit of GI by switching to a low GI option food with each meal or snack

Resources:
http://en.wikipedia.org/wiki/Glycemic_index
https://www.diabetes.org.uk/Guide-to-diabetes/Managing-your-diabetes/Glycaemic-Index-GI/
http://www.whfoods.com/genpage.php?tname=faq&dbid=32

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Boil and Bubble, Rice is the Trouble

Refined carbohydrates in white rice and white bread are more harmful than a fatty diet. Hari Pulakkat reports

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Cheese burgers are bad for health, nutritionists have always said. Cheese and red meat, according to conventional medical wisdom, are not the healthiest of foods. Current research supports this statement but with a twist. It now turns out that it’s not just the cheese or meat that is the cause of worry but also the bread.

Saturated fat has been implicated in cardiovascular disease for a long time now, and with good reason. Too much fat in the diet increases triglycerides and LDL (low-density lipoprotein or bad cholesterol), and both raise your chances of falling prey to a heart attack. A fatty diet also reduces HDL (high-density lipoprotein or good cholesterol) levels, and low HDL is a risk factor for cardiovascular disease. But then if you cut saturated fat in your diet and substitute it with refined carbohydrates, you are actually worse off.

Many recent studies have shown that refined carbohydrates are some of the worst things you can eat. They can lead to type 2 diabetes if eaten consistently in large quantities. This applies not only to sugar but also staple items such as white rice and white bread. In fact, a recent study at the Harvard School of Public Health (HSPH) showed that by just substituting white rice with brown rice, you can cut the risk of getting type 2 diabetes by 16 per cent. According to Qi Sun of the department of nutrition at the HSPH, “White rice is eaten in large quantities in many parts of Asia. It is not good for health.”

In white rice, the germ and bran of the grain are removed. What remains is the endosperm, the least nutritive part of rice. The bran and germ contain dietary fibre and magnesium, both important in controlling diabetes. They also contain vitamins and other important minerals. Lack of nutrition, however, is not the only reason why white rice is unhealthy.

“White rice has a high glycemic index and glycemic load,” says Sun. “High glycemic index foods are known to increase the risk for diabetes.” Glycemic index is a measure of how quickly the food raises glucose levels. White rice has a glycemic index of around 65 while it’s 55 in the case of brown rice.

It is well known that high glycemic index foods are bad, and the Harvard study showed just how bad. Eating just 150 grams of white rice per week increased your chances of getting type 2 diabetes by 17 per cent, while eating just two servings of brown rice a month lowered the same by 11 per cent. Introducing a variety of whole grains in the diet lowered the risk of diabetes by as much as 36 per cent.

The link between saturated fat and cardiovascular disease is more complex, but it is becoming clear that fat is not as bad as scientists once thought. Research findings in this regard, however, are somewhat contradictory. Several studies have shown no increase in risk for cardiovascular disease with moderate fat consumption, while some others show an increased risk. A recent meta-analysis by the Children’s Hospital Oakland Research Institute in California found no link at all between fat consumption and heart disease.

A meta-analysis is an analysis of all large amounts of research in the field. The Oakland meta-analysis looked at the dietary habits of 3,50,000 people between five and 23 years, for which data was already published.

It found no evidence of increased cardiovascular risk with fat consumption, but it of course does not mean there was no risk. As the authors argued in a paper published recently in the American Journal of Clinical Nutrition, what is eaten with the fat was very important in how the diet influenced health.

The argument against fat was based on the fact that it raised total cholesterol levels. Total cholesterol level is not a useful indicator of cardiovascular health. Fat increases LDL and HDL levels at the same time, and one cancels the negative effect of the other. “More data are needed to elucidate whether cardiovascular disease risks are likely to be influenced by specific nutrients used to replace saturated fat,” the authors wrote in the paper. The authors also saw a publication bias against results that showed no link between fat and heart disease – that is, papers that showed fat was bad were more likely to get published in journals.

A few studies used in the analysis strongly reject a fat-heart disease link. One study two years ago, again from the HSPH and conducted on 322 individuals, was particularly striking. It looked at the lipid profiles of people on three different kinds of diet: a low-fat, low-calorie diet; an unrestricted diet; and a low-calorie but otherwise unrestricted diet. Those who were on the third regime had the healthiest lipid profile in their blood, although they ate the maximum fat. Of course, they ate the least amount of carbohydrates.

So, rice lovers, make that change. Be it a Sunday lunch or a family feast, keep that familiar mound of white off your plate.

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carbohydrates in rice

Source : The Telegraph ( Kolkata, India)

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Tuna ‘Prevents Macular Degeneration’

Omega-3 fatty acids found in fatty fish such as tuna and salmon may help prevent age-related macular degeneration (AMD) progression,  depending upon the stage of the disease, suggest researchers.
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AMD is a progressive disease that attacks central vision, resulting in a gradual loss of eyesight and, in some cases, blindness

During the study, the research team from Laboratory for Nutrition and Vision Research (LNVR) and Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University calculated the intakes of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) among 2,924 patients aged 55 to 80 years.

The findings revealed that taking supplements of antioxidants plus zinc prevents progression of late-stage AMD.

“In our study, we observed participants with early stages of AMD in the placebo group benefited from higher intake of DHA, but it appears that the high-dose supplements of the antioxidants and/or the minerals somehow interfered with the benefits of DHA against early AMD progression,” said senior author Dr Allen Taylor, director of the LNVR at the USDA HNRCA.

The antioxidant supplements did not seem to interfere with the protective effects of DHA and EPA against progression to advanced stages of AMD.

The study also showed that participants who consumed higher amounts of DHA and EPA appeared to have lower risk of progression to both wet and dry forms of advanced AMD.

“Data from the present study also shows the supplements and omega-3 fatty acids collaborate with low-dietary glycemic index (dGI) diets against progression to advanced AMD,” said corresponding author Chung-Jung Chiu, DDS, PhD, a scientist in the LNVR and an assistant professor at TUSM.

“Our previous research suggests a low-GI diet may prevent AMD from progressing to the advanced stage,” Chiu added.

The researchers suggest that eating two to three servings of fatty fish such as salmon, tuna, mackerel, shellfish, and herring every week would achieve the recommended daily intake of DHA and EPA, however, further research is required to conclude dietary recommendations for people with AMD.

Source:The study appears in the British Journal of Ophthalmology.

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High Fibre Diets Bad for Diabetes

DHA Molecule

DHA Molecule (Photo credit: Wikipedia)

A new Canadian study has found that beans, peas, pasta, lentils and boiled rice are better for controlling type-2 diabetes and heart disease risks than high-fibre diets like cereals and whole grain bread.

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The study “Effect of a Low Glycemic Index or a High Cereal Fibre Diet on Type-2 Diabetes: A Randomised Trial” has found that these foods are better at managing glycemic control for type-2 diabetes and risk factors for coronary heart disease than high-fibre diets. Click to see:->Low Glycemic Index Foods

Professor David Jenkins of Toronto-based St. Michael’s Hospital, who led the study, said their research assumes significance as the incidence of type-2 diabetes is likely to double in the next 20 years.

“Our study shows that a low GI (glycemic index) diet can also minimise the risk factors associated with cardiovascular disease. It does this better than a diet high in fibre, but with a higher GI,” he said.

GI is a measure for calculating the glucose level of the blood. A low GI diet contains foods that have a low glucose level.

“Pharmaceuticals used to control type-2 diabetes have not shown the expected benefits in terms of reducing cardiovascular disease. Our hope is that the low GI diet may help all the complications of diabetes,” he added.

As part of their study, Jenkins and his team picked up 210 patients with type-2 daibetes and divided them into two groups for diet treatment.

They compared the effects of a low GI diet versus a high-fibre diet on glycemic control and cardiovascular risk factors for these patients for a period of six months.

After the six-month diet treatment, the researchers found that the haemoglobin level (blood glucose level) decreased by -0.50 percent in the group that was served the low glycemic index diet.

On the other hand, it decreased by only -0.18 percent in the group that was served the high cereal fibre diet, clearly indicating that high-fibre diets were not good for type-2 diabetes patients.

In relation to the effects of these two set of diets in heart stroke control, the researchers observed the ratio of high-density lipoprotein cholesterol (HDL-C) and the low-density lipoprotein cholesterol (LDL-C).

They found that the ratio showed a greater reduction in the low glycemic index diet group compared with the high-fibre diet group, showing the latter group was at higher risk of heart stroke.

The findings have been published in the Dec 17 issue of Journal of the American Medical Association.

Sources: The Times Of India

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Apple Cider Vinegar

Other names: cider vinegar, ACV, acetic acid

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Apple cider vinegar is a type of vinegar made by the fermentation of apple cider. During this process, sugar in the apple cider is broken down by bacteria and yeast into alcohol and then into vinegar. Apple cider vinegar contains acetic acid (like other types of vinegar) and some lactic, citric and malic acids.

Unlike white vinegar, apple cider vinegar is a light yellow-brown color and is often sold unfiltered and unpasteurized with a dark, cloudy sediment called mother of vinegar (consisting mainly of acetic acid bacteria) settled at the bottom of the bottle.

Unfiltered and unpasteurized apple cider vinegar is sold in health food stores, online and in some grocery stores.

Although other types of vinegar — such as white vinegar, balsamic vinegar, red wine vinegar and rice wine vinegar — are used mainly in cooking, apple cider vinegar is used primarily for health purposes. Hippocrates was said to have used it as a health tonic and American soldiers are said to have used it to combat indigestion, pneumonia and scurvy.

But it wasn’t until the book Folk Medicine: A Vermont Doctor’s Guide to Good Health, written by D.C. Jarvis, M.D., was published in 1958 that the medicinal use of apple cider vinegar took off. Jarvis recommended apple cider vinegar as a cure-all, explaining that it was unusually rich in potassium (compared to other food sources, it is not). He said that mixing the apple cider vinegar with honey, a mixture he called “honegar,” enhanced the healing power of the vinegar. Jarvis also wrote that apple cider vinegar could destroy harmful bacteria in the digestive tract and recommended as a digestive tonic to be consumed with meals.

Although the year it was released it didn’t attract much attention, the following year, Folk Medicine became a bestseller and stayed on the bestseller list for months. According to Time magazine, it sold more than 245,000 copies in a single week and received many testimonials by people who felt they benefited from the apple cider vinegar and honey mixture.

In the 1970s, apple cider vinegar became popular once again, this time by proponents who had read Jarvis’ book and suggested that apple cider vinegar along with kelp, vitamin B6 and lecithin could help people lose weight by speeding metabolism and burning fat at a faster rate.

Why Do People Use Apple Cider Vinegar

Diabetes
Perhaps the most intriguing aspect of apple cider vinegar’s possible health benefits is its effect on blood glucose levels. Several small studies suggest that vinegar (both apple cider vinegar and other types) may help to lower glucose levels.

For example, a preliminary study by researchers at Arizona State University, published in the journal Diabetes Care, examined people with type 2 diabetes. Study participants took either two tablespoons of apple cider vinegar or water with one ounce of cheese at bedtime for two days. The researchers found taking two tablespoons of apple cider vinegar at bedtime had a favorable impact on blood glucose levels the next morning. Prior to the study, the average fasting blood glucose level was 137 mg/dL. It decreased by 2% with the cheese and by 4% with the vinegar, a statistically significant difference. In people with a fasting glucose level above 130 mg/dL prior to the study, the vinegar reduced glucose levels by as much as 6%. The study was very small and the duration was short, so more research is needed.

Other studies have found that vinegar can lower the post-meal rise in glucose. The acetic acid in vinegar is thought to slow starch digestion and reduce the glycemic index of starchy foods. For example, a small study compared the effect of vinegar with white bread on blood glucose and insulin levels. Researchers found that those who took vinegar with white bread had lower post-meal blood glucose and insulin levels and it also appeared to increase satiety ratings.

Weight Loss
Apple cider vinegar has become popular as a “fat-burner” and as a natural appetite suppressant. In fact, there’s even an apple cider vinegar diet, which involves taking one to three teaspoons of apple cider vinegar or apple cider vinegar pills before each meal.

The earliest proponent of apple cider vinegar for weight loss was Jarvis, who wrote that people who consumed apple cider vinegar regularly would burn fat instead of store it. Although some say that the pectin, enzymes, vitamins, or potassium may help with weight loss, there is no reliable research showing that either apple cider vinegar or the combination of apple cider vinegar, kelp, vitamin B6 and lecithin can influence metabolic rate or the help us “burn fat” faster than we normally would.

One small study in 2005 found that those who ate a piece of bread with a small amount of white vinegar felt more full and satisfied than those who ate the bread alone. It’s possible that vinegar may affect satiety by lowering the glycemic index of carbohydrates eaten at a meal. More research is needed.

Alkaline Acid Balance
Some alternative practitioners suggest apple cider vinegar as part of a diet to restore alkaline acid balance. The theory behind the alkaline diet is our blood is slightly alkaline, with a normal pH level of between 7.35 and 7.45. Our diet should reflect this pH level and be slightly alkaline. All foods we eat, after being digested and metabolized, release either an acid or alkaline base (bicarbonate) into blood. The foods that people tend to overeat –- grains, meat, dairy products — all produce acid.

Proponents of the alkaline-acid theory believe that a diet high in acid-producing foods leads to lack of energy, excessive mucous production, infections, anxiety, irritability, headache, sore throat, nasal and sinus congestion, allergic reactions and makes people prone to conditions such as arthritis and gout. Despite being an acidic solution, some proponents of apple cider vinegar believe it has an alkalinizing effect on the body, which is why one to two teaspoons of apple cider vinegar in water is recommended as a daily health tonic. Although it’s a popular remedy, the effectiveness of the remedy and the theory haven’t been researched.

Dandruff
A home remedy for dandruff is to mix 1/4 cup apple cider vinegar with 1/4 cup water. The vinegar solution is thought to restore the restore the pH balance of the scalp and discourage the overgrowth of malassezia furfur, the yeast-like fungus thought to trigger dandruff.

The vinegar mixture is usually poured into a spray bottle and spritzed on the hair and scalp, avoiding the eye and ear area. A towel is then wrapped around the head and left on 15 minutes to an hour. After that, the vinegar can be washed from the hair. Alternative practitioners often recommend it once to twice a week for dandruff.

High Cholesterol
A 2006 study found that rats fed acetic acid (the main ingredient in vinegar) had significantly lower total cholesterol and triglyceride levels. Large, human trials are needed to see if the same results occur in humans.

Acid Reflux
Apple cider vinegar in water is a popular home remedy for acid reflux. It’s based on a theory by some alternative medicine practitioners that heartburn and reflux are actually symptoms of insufficient stomach acid caused by aging, poor diet or overusing antacids or other medications. Alternative practitioners usually rely on laboratories that conduct alternative tests to assess stomach acidity prior to any treatment. Critics say that insufficient stomach acid, or hypochlorhydria, isn’t a common condition and that it isn’t a known cause of acid reflux or heartburn.

Apple cider vinegar isn’t recommended as a home remedy for acid reflux or heartburn, because it may damage the delicate lining of the digestive tract and it could possibly worsen the problem. If you have acid reflux or heartburn, see a qualified health practitioner for a proper diagnosis and treatment.

Acne
Apple cider vinegar is a home remedy for acne. A typical application is one part apple cider vinegar to three parts water and the solution is dabbed onto the pimple. Although some people swear by it, caution should be used because there have been case reports of skin damage and burns from using full-strength vinegar on the face.

Blood Pressure
Preliminary studies suggest that the acetic acid in vinegar may help to lower blood pressure. How it might work is unclear, although studies suggest that it may increase levels of nitric oxide, a compound in the body that relaxes blood vessels, or it might inhibit an enzyme called angiotensin-converting enzyme from producing angiotensin II, a hormone that causes blood vessels to constrict or narrow.

Side Effects and Safety Concerns:
Undiluted apple cider vinegar, in liquid or pill form, may damage the esophagus and other parts of the digestive tract. Apple cider vinegar drinks may damage tooth enamel if sipped.

One case report linked excessive apple cider vinegar consumption with low blood potassium levels (hypokalemia) and low bone mineral density. People with osteoporosis, low potassium levels and those taking potassium-lowering medications should use caution.

People with allergies to apples should avoid apple cider vinegar.

Apple cider vinegar tablets may become lodged in the throat or esophagus and cause serious damage to those tissues.

Vinegar applied to the skin may cause burns and scarring.

Excessive doses of apple cider vinegar have been found to cause damage to the stomach, duodenum and liver in animals.

The quality of apple cider vinegar tablets varies. A 2005 study compared eight brands of apple cider vinegar supplements and found that the ingredients didn’t correspond with the ingredients listed on the packaging, and that the chemical analysis of the samples led researchers to question whether any of the products were actually apple cider vinegar or whether they were just acetic acid.

Possible Drug Interactions:
Theoretically, prolonged use of apple cider vinegar could lead to lower potassium levels, which could increase the risk of toxicity of cardiac glycoside drugs such as Lanoxin (digoxin), insulin, laxatives and diuretics such as Lasix (furosemide).

Because apple cider vinegar may affect blood glucose and insulin levels, it could theoretically have an additive effect if combined with diabetes medications. Apple cider vinegar may also lower blood pressure, so it may have an additive effect if combined with high blood pressure medications.

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Resources:Fushimi T, Suruga K, Oshima Y, Fukiharu M, Tsukamoto Y, Goda T. Dietary acetic acid reduces serum cholesterol and triacylglycerols in rats fed a cholesterol-rich diet. Br J Nutr. (2006) 95.5: 916-924.

Ostman E, Granfeldt Y, Persson L, Björck I. Vinegar supplementation lowers glucose and insulin responses and increases satiety after a bread meal in healthy subjects. Eur J Clin Nutr. (2005) 59.9: 983-988.

White AM, Johnston CS. Vinegar ingestion at bedtime moderates waking glucose concentrations in adults with well-controlled type 2 diabetes. Diabetes Care. (2007) 30.11: 2814-2815.

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