Apple cider vinegar (Gabriela Gmyrek, Purdue College of Pharmacy/BSPS

DIETARY SUPPLEMENT REVIEW Apple Cider Vinegar

Gabriella Gmyrek Purdue University College of Pharmacy Student Spring 2022

GENERAL INFORAMTION

Scientific Name of Supplement Malus Pumila Mill Common Name of Supplement Apple Cider Vinegar (ACV) Typical Serving 1-2 tbs when liquid or up to 1000mg

Toxicity There is limited information on the toxicity of apple cider vinegar. For that reason it is important to use ACV in moderation and while monitoring potassium levels should they drop too low. Available Forms Liquid Tablet Gummies Capsules Dehydrated Powder

Safety Concerns

Skin and Throat Burns Lowered Potassium Levels

Side Effects When Taken in Large Doses:

Nausea/indigestion Tooth decay Increased gastroparesis

Interactions

Apple cider vinegar, in conjunction with digoxin or insulin-stimulating medications, ACV can cause decreased potassium levels in the body. Those taking diuretics that cause potassium excretion should limit ACV uses

Purported Uses

1. 2. 3. 4. 5. 6.

7. Blood Pressure Stabilizer Blood Sugar Control Lowered Cholesterol Cold/Flu Aid Increased Weight Loss Anti-Inflammatory Benefits Improved Digestion

Apple cider vinegar is made in a similar fashion to regular vinegar. It is produced during the fermentation of apple cores and peels in sugar water. While the history of vinegar dates back to the Babylonians in 5000 BC, the oldest known documentation of apple cider vinegar is with Hippocrates in 400 BC. It has been used as a traditional “cure-all” remedy in Asia, Africa, and Europe.

The complete mechanism of action for apple cider vinegar is unknown. It is believed that ACV can improve digestion and act antilipidemic due to the increased acidity allowing the easier breakdown of foods and lipolysis, By delaying gastric emptying and inhibiting enzyme activity, ACV is believed to help boost digestion and decrease glucose levels. Finally, acidity is thought to create an antibacterial environment in the throat and GI tract.

PHARMACOLOGY

EFFECTIVENESS

According to research, the use of apple cider vinegar can be beneficial in reducing blood sugar spikes after meals, increasing weight loss, and acting as an inflammatory measure. There have been no results supporting blood pressure aid in humans (the research on rats found the benefits negligible). The use of ACV during cold and flu is theoretically plausible due to its antiinflammatory and antibacterial properties but has not been adequately studied. There have been no definitive reports of ACV lowering cholesterol in humans (but positive results from animal research were present). In large amounts, ACV can actually slow digestion but in standard amounts improve it.

RESULTS OF OXIDATIVE STRESS/OBESITY STUDY

In 2018, a study was conducted by the University of Tunis El Manar on male Wistar rats. These rats were fed a high-fat diet and, after six weeks, were started on doses of ACV. By nine weeks, the rats showed a decrease in obesity and a decreased triglyceride, LDL, and total cholesterol levels. Moreover, the oxidative stress that developed after six weeks on the high-fat diet decreased with doses of ACV. An additional finding was that ACV increases the production of antioxidants in the body which causes a positive metabolic change.

RESOURCES

1. Hoover, Andi. “Apple Cider Vinegar Myths & Facts.” WVU Community Education Outreach Service, https://extension.wvu.edu/foodhealth/cooking/apple-cider-vinegar-myths-facts. 2.“Health Benefits of Apple Cider Vinegar and Other Common Vinegars: A Review.” Relias Media Continuing Medical Education Publishing, https://www.reliasmedia.com/articles/140790-health-benefits-of-applecider-vinegar-and-other-common-vinegars-a-review. 3. Edwin McDonald IV, MD. “Debunking the Health Benefits of Apple Cider Vinegar.” UChicago Medicine, UChicago Medicine, 23 Aug. 2018,https://www.uchicagomedicine.org/forefront/health-and-wellnessarticles/debunking-the-health-benefits-of-apple-cider-vinegar. 4. Halima BH;Sonia G;Sarra K;Houda BJ;Fethi BS;Abdallah A; “Apple Cider Vinegar Attenuates Oxidative Stress and Reduces the Risk of Obesity in High-Fat-Fed Male Wistar Rats.” Journal of Medicinal Food, U.S. National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/29091513/#affiliation-1.

PROFESSIONAL OPINION

When used in moderate amounts not exceeding a safe dose, Apple Cider Vinegar can benefit its purported uses. However, the results appear more minimal, and the use of ACV does not replace proper medication, diet, and exercise. ~G. Gmyrek 10