Comparison of Apple Cider Vinegar and Metformin Combination with Metformin Alone in Newly Diagnosed Type 2 Diabetic Patients: A Randomized Controlled Trial

Objective: This study aims to compare the effect of metformin monotherapy with the combination therapy of metformin and apple cider vinegar on the parameters of Body Mass Index and glycemic control of recently diagnosed type 2 diabetes mellitus patients. Methods: A total of 126 patients were enrolled in this open-label randomized controlled trial, divided into two parallel arms: Group I (Metformin 750 mg alone per day) and Group II (Metformin 750 mg+Apple Cider Vinegar 2 tablespoons per day) and assessed for weight, Body Mass Index, Fasting Blood Sugar and Hemoglobin A1c after which the post-treatment values of the aforementioned parameters were compared between the two groups. Informed consent from all patients and ethical approval from the institutional ethics board was obtained. A p-value of <0.05 was considered significant. Results: All the parameters underwent a significant reduction in the pre and post intra group comparison of each group (p-value<0.001). Moreover, a significant difference was found in the post-treatment comparisons of the Fasting Blood Sugar (p-value<0.001) and HbA1c (p-value=0.04) in between the two groups. However, no significant difference was obtained in the post-treatment comparisons of weight and Body Mass Index in between the two groups. Conclusion: Apple Cider Vinegar in combination with Metformin appears to be more effective in improving glycemic control versus Metformin monotherapy.

Effect of 2-week bedtime ingestion of apple cider vinegar on the blood glucose concentration (fasting blood sugar and second hour blood sugar) of Gravidas with Gestational Diabetes Mellitus in a tertiary hospital / Philippine Journal of Obstetrics and Gynecology

Background@#Gestational Diabetes Mellitus (GDM) is a common condition that complicates a substantial number of pregnancies. Currently, the first line management for patients with GDM is dietary modification and exercise. Recent evidence suggest that there may be a complimentary hypoglycemic effect of substances such as vinegar. @*Objectives@#This study is a randomized, crossover trial, aiming to determine the effect of 2-week bedtime ingestion of apple cider vinegar (ACV) on the blood glucose concentration of gravidas diagnosed with GDM in a tertiary hospital. Specifically, it aims to describe the patients’ general profile, to determine the effect of ACV on the 75 grams OGTT levels of the subjects, to correlate the change in blood glucose levels with ingestion of the same amount of ACV with the patient’s BMI, and to determine the acceptability of ACV ingestion in pregnant patients.@*Methods@#There were 32 patients included in the study. Upon diagnosis of GDM, subjects were randomized into two groups. Group A had a sequence of Medical Nutrition Therapy (MNT) for 2 weeks followed by MNT plus ingestion of 2 tablespoons of ACV diluted in a cup of water for another 2 weeks. Group B had the reverse sequence. A 75g OGTT was taken on Day 0, Day 14, and Day 28 of treatment, in which the values were compared. The data were analyzed using SPSS 16.0.@*Results@#Results showed that there is a marginally significant increase in the fasting blood sugar (FBS) and 2nd hour blood sugar at the moment when ACV was withdrawn. A greater reduction in the blood sugar level was noted in patients with higher BMI during the period when patients were given the ACV. The Likert scale response was also done showing that ACV is acceptable, affordable and well-tolerated among pregnant patients.

Population dynamics of mixed cultures of yeast and lactic acid bacteria in cider conditions

The objective of this work was to study the malolactic bioconversion in low acidity cider, according Brazilian conditions. The apple must was inoculated with Saccharomyces cerevisiae or S. cerevisiae with Oenococcus oeni. The control contained the indigenous microorganisms. Fermentation assays were carried out with clarified apple must from the Gala variety. At the beginning of fermentation, there was a fast growth of the non-Saccharomyces yeast population. Competitive inhibition occurred in all the assays, either with inoculated or indigenous populations of the yeast. The lactic acid bacteria count was ca. 1.41·10²CFU/mL at the beginning and 10(6)CFU/mL after yeast cells autolysis. The lactic bacteria O. oeni reached the highest population (10(7)CFU/mL) when added to the apple must after the decline of the yeast. The malic acid was totally consumed during the alcoholic fermentation period (80.0 to 95.5 %) and lactic acid was still synthesized during the 35 days of malolactic fermentation. These results could be important in order to achieve a high quality brut, or sec cider obtained from the dessert apple must.

An assessor-blind, randomized controlled trial on the efficacy and safety of apple cider vinegar vs. salicylic-lactic acid solution in the treatment of common warts (verruca vulgaris)

BACKGROUND: Common warts are among the top causes of dermatologic consultations. Apple cider vinegar is an old time home remedy for various ailments including common warts.Objectives: To compare the safety and efficacy of apple cider vinegar with salicylic-lactic acid solution in the treatment of common warts.METHODS: Twenty-seven patients clinically diagnosed with a total of 88 common warts were assigned randomly for topical application of either apple cider vinegar or salicylic-lactic acid solution which were applied and occluded for 3 consecutive days. Clinical evaluation and curettage were conducted on day 3 and every 3 days thereafter until complete resolution of the lesion for a maximum of 4 weeks. The primary outcome measured in this study was complete clinical cure of the treated wart. One week post-treatment evaluation assessment was also graded as clinical cure, clinical improvement, clinical failure and side effect failure. Adverse events were monitored.RESULTS: In the ACV group, 33 out of 44 (75%) common warts were completely cleared while in the salicylic-lactic acid (SA/LA) group, 26 common warts were completely cleared (59%). There was no significant difference in the cure rates between the two groups (p=0.112, chi-square test). There was no significant difference in the mean time to cure between the two groups, 11 days and 12 days in the apple cider vinegar and salicylic-lactic acid groups, respectively (p=0.090; log rank test). There was no significant difference in the incidence of adverse reactions between the two groups (p=0.676; Fisher's exact test).CONCLUSION: Apple cider vinegar is a safe and effective topical treatment that was comparable to salicylic-lactic acid solution in the treatment of common warts.

Apple wine processing with different nitrogen contents

The aim of this work was to evaluate the nitrogen content in different varieties of apple musts and to study the effect of different nitrogen concentrations in apple wine fermentation. The average total nitrogen content in 51 different apples juices was 155.81 mg/L, with 86.28 percent of the values above 100 mg/L. The apple must with 59.0, 122.0 and 163.0 mg/L of total nitrogen content showed the maximum population of 2.05x 10(7); 4.42 x 10(7) and 8.66 x 10(7) cell/mL, respectively. Therefore, the maximum fermentation rates were dependent on the initial nitrogen level, corresponding to 1.4, 5.1 and 9.2 g/L.day, respectively. The nitrogen content in the apple musts was an important factor of growth and fermentation velocity.

Effect of alcoholic fermentation in the content of phenolic compounds in cider processing

The objective of this work was to study the effect of alcoholic fermentation on the content of phenol compounds of five cider apple varieties. The initial content in the apple juice samples, as determined by HPLC, varied from 188.4 to 2776.17 m mg.L-1. In three of them (DC, PJ, GU), the total phenol compounds remained unaffected by fermentation. However, in two (DM, KE), the final values were lower (55 and 313 mg.L-1). In these apple cider, the values of caffeic acid increased from 6.6 mg.L-1 to 41.8 mg.L-1. The catechin content increased during the process, approximately 13 mg.L-1 independent of the variety. The other phenols class did not present any modifications due to the alcoholic fermentation, maintaining the phenolic compounds of original clarified apple juice in the cider.

O objetivo deste trabalho foi estudar o efeito da fermentação alcoólica no teor de compostos fenólicos de cinco mostos de maçãs industriais. Os compostos fenólicos foram analisados por HPLC. Os mostos apresentaram fenóis totais entre 188,4 a 2776,17 mg.L-1. Os teores de fenóis durante a fermentação permaneceram os mesmos para as variedades DC, PJ e GU, entretanto, em DM e KE foi observada uma diminuição dos teores de fenóis (55 e 313 mg.L-1, respectivamente). Em KE o teor do ácido caféico aumentou de 6,6 mg.L-1 para 41,8 mg.L-1. O teor de catequinas aumentou cerca de 13 mg.L-1 durante o processo, independente da variedade. As outras classes de fenóis não apresentaram modificações com a fermentação alcoólica, permanecendo na sidra os compostos fenólicos do suco de maçã clarificado.

Effect of biomass reduction on the fermentation of cider

The aim of this work was to determine the influence of biomass reduction in the cider processing and the quality of the fermented product made on laboratory scale, but in the same conditions usually found in factory units. The must, made with apples of the Gala variety, depectinized and transferred to 500 mL-fermenters, was inoculated with 2.0x10(6) cfu/mL of natural or commercial yeast, and at each 12 hours biomass was removed by centrifugation in one flask of the experimental set, and the must was left to ferment. All seven flasks of the fermented beverage were analyzed for 20-26 days after the inoculation, and the results showed that the best moment for biomass removal was 1.5-2.0 days of fermentation, leading to a product with significant residual sugars content, a low alcoholic degree, and with a fruity flavor. In addition, it was possible to practically eliminate all nitrogen, which was important to control the natural gasification. It was quite clear that biomass removal could be a very efficient treatment in order to obtain a sweeter and more pleasant alcoholic beverage, a better cider.

O trabalho objetivou caracterizar a influência da eliminação de biomassa no processamento da sidra e na qualidade do produto fermentado em bancada de laboratório utilizando condições observadas na indústria. O mosto da cultivar Gala foi despectinizado e transferido para fermentadores de 500 mL e inoculado com 2,0x10(6) ufc/mL de leveduras naturais ou comerciais. A cada 12 horas em um dos fermentadores a biomassa foi reduzida por centrifugação, em seguida o mosto era deixado fermentar. Os sete fermentados de maçãs foram analisados após 20-26 dias de fermentação, mantendo açúcar residual na bebida, um baixo grau alcoólico e aroma frutado. Além disso, foi possível eliminar todo o nitrogênio assimilável, importante no controle da gaseificação natural. Desta forma, a redução de biomassa pode ser um tratamento eficiente para obter uma sidra suave e de baixo grau alcoólico com uma melhor qualidade.