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Vinegar: Medicinal Uses and Antiglycemic Effect

Keywords: vinegar, acetic acid, diabetes mellitus, control, systematic review, meta-analysis, meta-regression, HbA1c, insulin, vinegar, phenolics, flavonoids, organic acids, health effects, orange vinegar, antioxidant activity, bioactive compound, curcumin, turmeric, anti diabetes, Apple cider vinegar, Hyperlipidemia, Atherosclerosis, apple, grape, antioxidant, polyphenol, HT29, IC50, DPPH, MTT, functional properties, functional ingredients, blood glucose control, lipid metabolism regulation, anti

Summary of Abstracts:

Vinegar: Medicinal Uses and Antiglycemic Effect Vinegar folklore is as colorful as it is practical. Legend states that a courtier in Babylonia (c. 5000 BC) “discovered” wine, formed from unattended grape juice, leading to the eventual discovery of vinegar and its use as a food preservative. Hippocrates (c. 420 BC) used vinegar medicinally to manage wounds. Hannibal of Carthage (c. 200 BC), the great military leader and strategist, used vinegar to dissolve boulders that blocked his army's path. Cleopatra (c. 50 BC) dissolved precious pearls in vinegar and offered her love potion to Anthony. Sung Tse, the 10th century creator of forensic medicine, advocated hand washing with sulfur and vinegar to avoid infection during autopsies. Based on the writings of US medical practitioners dating to the late 18th century, many ailments, from dropsy to poison ivy, croup, and stomachache, were treated with vinegar,[1] and, before the production and marketing of hypoglycemic agents, vinegar teas were commonly consumed by diabetics to help manage their chronic aliment. Vinegar, from the French vin aigre, meaning “sour wine,” can be made from almost any fermentable carbohydrate source, including wine, molasses, dates, sorghum, apples, pears, grapes, berries, melons, coconut, honey, beer, maple syrup, potatoes, beets, malt, grains, and whey. Initially, yeasts ferment the natural food sugars to alcohol. Next, acetic acid bacteria (Acetobacter) convert the alcohol to acetic acid. Commercial vinegar is produced by either fast or slow fermentation processes. For the quick methods, the liquid is oxygenated by agitation and the bacteria culture is submerged permitting rapid fermentation.

Anti-obesity and anti-inflammatory effects of synthetic acetic acid vinegar and Nipa vinegar on high-fat-diet-induced obese mice Recently, food-based bioactive ingredients, such as vinegar, have been proposed as a potential solution to overcome the global obesity epidemic. Although acetic acid has been identified as the main component in vinegar that contributes to its anti-obesity effect, reports have shown that vinegar produced from different starting materials possess different degrees of bioactivity. Although both synthetic acetic acid vinegar and Nipa vinegar effectively reduced food intake and body weight, a high dose of Nipa vinegar more effectively reduced lipid deposition, improved the serum lipid profile, increased adipokine expression and suppressed inflammation in the obese mice. Thus, a high dose of Nipa vinegar may potentially alleviate obesity by altering the lipid metabolism, inflammation and gut microbe composition in high-fat-diet-induced obese mice.

Pineapple Vinegar Regulates Obesity-Related Genes and Alters the Gut Microbiota in High-Fat Diet (HFD) C57BL/6 Obese Mice Obesity is a pandemic metabolic syndrome with increasing incidences every year. Among the significant factors that lead to obesity, overconsumption of high-fat food in daily intake is always the main contributor. Functional foods have shown a positive effect on disease prevention and provide health benefits, including counteracting obesity problem. Vinegar is one of the fermented functional beverages that have been consumed for many years, and different types of vinegar showed different bioactivities and efficacies. Collectively, these data established the mechanism of pineapple vinegar as antiobesity in mice and revealed the potential of pineapple vinegar as a functional food for obesity.

Diabetes Control: Is Vinegar a Promising Candidate to Help Achieve Targets? Small significant reduction in mean HbA1c was observed after 8 to 12 weeks of vinegar administration: −0.39% (95% confidence interval = −0.59, −0.18; I 2 = 0%). Other long-term outcomes favored vinegar but were not significant. Short-term outcomes showed significantly lower pooled mean difference in glucose levels at 30 minutes in the vinegar group. Readings at 60, 90, and 120 minutes were lower in the vinegar group but not statistically significant. Adverse effects profile also favored the vinegar group.

Antimicrobial activity of apple cider vinegar against Escherichia coli, Staphylococcus aureus and Candida albicans; downregulating cytokine and microbial protein expression Proteomic analyses of microbes demonstrated that ACV impaired cell integrity, organelles and protein expression. ACV treatment resulted in an absence in expression of DNA starvation protein, citrate synthase, isocitrate and malate dehydrogenases in E-coli; chaperone protein DNak and ftsz in S. aureus and pyruvate kinase, 6-phosphogluconate dehydrogenase, fructose bisphosphate were among the enzymes absent in C.albican cultures. The results demonstrate ACV has multiple antimicrobial potential with clinical therapeutic implications. The Old Testament and Hippocrates reported on the use of ACV in combination with honey to combat infection and protect open skin wounds. Historically, vinegar has been produced and sold as a commercial commodity for over 5000 years. In fact up until the sixth century BC, the Babylonians were making vinegars for consumption as well as for use in healing. ACV also decreased blood triglyceride and very low density lipoprotein levels in rats which had induced cholesterol induced hepatic steatosis.

The Effect of External Apple Vinegar Application on Varicosity Symptoms, Pain, and Social Appearance Anxiety: A Randomized Controlled Trial We aimed to determine the effect of external apple vinegar application on the symptoms and social appearance anxiety of varicosity patients who were suggested conservative treatment. Conclusion. We determined that the external application of apple vinegar on varicosity patients, which is a very easy application, increased the positive effects of conservative treatment.

Effect of apple cider Vinegar on blood glucose level in diabetic mice Therefore, in this study it has been revealed that apple cider vinegar has considerable reducing effect on blood glucose levels in diabetic mice. The mechanism of this action and its significance remain to be elucidated in future investigations.

Apple Cider Vinegar Modulates Serum Lipid Profile, Erythrocyte, Kidney, and Liver Membrane Oxidative Stress in Ovariectomized Mice Fed High Cholesterol, In conclusion, ACV induced a protective effect against erythrocyte, kidney, and liver oxidative injury, and lowered the serum lipid levels in mice fed high cholesterol, suggesting that it possesses oxidative stress scavenging effects, inhibits lipid peroxidation, and increases the levels of antioxidant enzymes and vitamin.

Phytochemicals of foods, beverages and fruit vinegars: chemistry and health effects Plant-based foods and food ingredients provide a wide range of phytochemicals and antioxidants that render their beneficial health effects through a number of mechanisms. The presence of phenolics in different plant materials and beverages depends on the source material which dictates the type and quantity present. In addition, processing of raw materials, including fermentation, may alter the chemical nature and efficacy of their phenolic constituents. While vinegar has traditionally been used for food preservation and as a seasoning, more recently, fruit vinegars with different sensory characteristics have appeared in the marketplace. In addition to acetic acid, fruit vinegars often contain citric, malic, lactic, and tartaric acids and may also include phenolics, some of which are produced as a result of fermentaion. The beneficial health effects of fruit vinegars may in part be related to the process-induced changes in their phenolics and generation of new antioxidative phenolics during fermentation.

Bioactive compounds and antioxidant activity analysis during orange vinegar production Ascorbic acid is the major component in citrus fruits with interesting antioxidant properties, but its content in juices may vary (20-100 mg/100 mL) depending on variety or species. Despite the important role as enzymatic cofactor and antioxidant, humans cannot synthesize or store ascorbic acid in the body (Bernardi et al., 2014). Therefore, it is of great importance to provide it in the daily intake. Besides the numerous ascorbic acid benefits, loss due to heat, air and light exposure must be taken into account during processing (Passaro Carvalho and Londono-Londono, 2012; Bernardi et al., 2014). In general, antioxidant compounds and their associated AA decreased along orange vinegar processing. As expected, total carotenoid content showed a 46% decrease during biooxidative period caused by their high susceptibility to the air contact (Damodaran et al., 2010) and particularly during this process, characterized by a constant air supply to the system. However, no concentration changes were observed during the aging stage (Vn0-Vn6). Ascorbic acid significantly decreased along orange vinegar processing. The highest reduction (49.2%) occurred during SNA acetification period probably due to continuous air flow to the system, as vitamin C is easily degraded in contact with oxygen. Drange vinegar bioactive compounds as well as their associated antioxidant activity decreased along the whole process studied, but total phenolics and carotenoids remained constant during aging period. The highest reduction was recorded during acetification stage, possibly due to component oxidation caused by continuous air flow to the system. A higher contribution to antioxidant activity was associated to ascorbic acid and phenolic compounds concentration.

STUDY ABOUT THE NUTRITIONAL AND MEDICINAL PROPERTIES OF APPLE CIDER VINEGAR ARTICLE INFO ABSTRACT Apple cider vinegar otherwise known as cider vinegar or ACV, Is a type of vinegar made from cider or apple must and has a pale medium color. Unpasteurized or organic ACV contains mother of vinegar. Apple cider vinegar is fermented juice from crushed apples. Like apple juice , it likely contain some pectin, vitamin b1, vitamin b2, and vitamin b6, biotin, folic acid, niacin pantothenic acid and vitamin c.Using apple cider vinegar (ACV) diabetes significantly reduces haemoglobin A1C (HbA1C), lower density lipoprotein (LDL), cholesterol and triglycerides and increase high density lipoprotein (HDL) cholesterol. In another patient model, ―apple cider vinegar‖ decreased triglycerides and very low density lipoprotein (VLDL) cholesterol. it’s nutrient- rich, especially in unfiltered and organic verities, and contains acetic acid, pectin, potassium and calcium. It also controls the blood levels, loss weight, improves cardio-vascular health, regulate body pH & detoxify body. Two spoonfuls of Apple Cider Vinegar‖ and mix it glass of water. Take this regularly before having a meal.

Apple Cider Vinegar; Health Benefits and unwanted effects Apple cider vinegar has a long history as a home remedy, used to treat everything from a sore throatto varicose veins. But there’s not much science to support the claims. Still, in recent years, some researchers have been taking a closer look at apple cider vinegar and its possible benefits. It’s mostly apple juice, but adding yeast turns the fruit sugar into alcohol -- this is fermentation. Bacteria turn the alcohol into acetic acid. That’s what gives vinegar its sour taste and strong smell.

Effect of Apple Cider Vinegar on Glycemic Control, Hyperlipidemia and Control on Body Weight in Type 2 Diabetes Patients The objective of the current review study was to investigate the effect of apple cider vinegar on glycemic control, hyperlipidemia and control on body weight in type 2 diabetes patients and other therapeutic and commercial effect of apple cider vinegar. Diabetes mellitus (DM) has been considered as one of the most universal endocrine, metabolic disorders which is characterized by the irregular metabolism of fat, protein, and carbohydrate due to decreased efficacy of insulin secretion or altered insulin activity. Curcumin is a popular spice used in all over the Asian cuisine. Curcumin known as curcuminoid found in turmeric (Curcuma longa Linn) has anti-inflammatory and anti-diabetes effects [16]. A study was conducted on uses of curcumin extract for prevention of the diabetes type 2, this study shows that curcumin extract delay type 2 diabetes development and improve beta cell functions, reduce insulin resistance and also reduced the numbers of pre-diabetes individual who are going to develop type 2 diabetes [17]. A double-blind placebo randomized cohort trial for 9-months show that 16.4% diabetic individual was diagnosed in placebo group significantly and none were diagnosed with type 2 diabetes in the curcumin treatment group, also better improvement in beta cell functions in the curcumin-treated group was observed as compared to the placebo group [18]. Polyphenols dietary plants and polyphenol-rich products attenuate hyperglycemia, insulin resistance, and dyslipidemia, improve adipose tissue metabolism and modulate carbohydrate, and alleviate oxidative stress. Long term diabetes complications like retinopathy, cardiovascular diseases nephropathy and neuropathy can be prevented by polyphenol compounds [19]. A single-blind randomized cross over study indicated that fiber-rich and polyphenol (PFRF) containing food have potential to effect on the glycemic index by lowering glucose absorption and also decreasing the glycemic response of polyphenol and fiber-rich food. The mechanism of PFRF inhibited alpha-amylase (strawberry, green tea, blackberry, and black currant) and activities of alpha-glycosidase (green tea) in vitro [21]. Fruits and vegetables that contain bioactive compound have been consider for the prevention of diabetes, cancer, cardiovascular diseases and is also used as an antibacterial, anti-aging and anti-inflammation agent [22]. A double-blind randomized control trial showed that cinnamon extracts water soluble for the prevention of pre- diabetes and diabetes as lowering glucose level, blood pressure, lipids and also decreases inflammatory markers and work as an insulin sensitizer in type 2 diabetes patients [23]. Water extract of cinnamon (insulin) 250 mg/capsules twice a day of spray dried have insulin potentiating activity lowering blood glucose, decreasing total cholesterol, LDL and enhanced insulin sensitivity in subjects with elevated blood glucose plasma in double-blind placebo randomized control trial [24]. Fenugreek is a natural herb used widely for the prevention of diabetes showed hypoglycemic, lowering effects of total cholesterol. Fenugreek significantly reduced fasting blood glucose, HbA1C, total cholesterol but results for low- density lipoprotein, high-density lipoprotein, and triglyceride of fenugreek were controversial in many randomized controlled trials (RTC) showed by meta-analysis of 10 studies due to low quality of studies because no renal and liver efficacy were checked, side-effect of fenugreek is discomfort for gastrointestinal tracts and further clinical trials are needed [29]. Uses of garlic as food spices are very popular all over the world it’s very helpful for the prevention of diabetic dyslipidemia in patients with raised lipid profile. The finding of this study suggested that the uses of vinegar not only improve the insulin sensitivity but also improve the ovarian functions in PCOS patients. Vinegar reduced the cost and time of medical treatment in insulin resistance and polycystic ovaries syndrome. Apple cider vinegar is a nutraceutical which can be used for the management of diabetes,whole apple cider vinegar is more effective than alone acetic acid. Mother of vinegarconsumption may be more effective than without this component. Meal oxidative stress is not only improved by vinegar addition in standard meal but it also reduced post- prandial glucose level, and satiety period also prolonged which should be helpful to reduced food cravings and lowering the intake of calories by intake of 1 to 2 spoons of vinegar with high glycaemic index foods like white bread, white rice, etc. which lower the random blood glucose by 25% to 30% in diabetic patients. Apple cider vinegar is a nutraceutical which can be used for the management of diabetes, whole apple cider vinegar is more effective than alone acetic acid. Mother of vinegar consumption may be more effective than without this component. Addition of vinegar in diet can reduce the postprandial glucose level in healthy individual but it is more effective in high glycaemic index meal (low-fat milk and mashed potato) than in low glycaemic index meal (low-fat cheese, whole grain, lettuce, etc) with the same composition of nutrients in isocaloric meal when random blood sugar and insulin values measured after 2 hours of meal intake [50]. Apple cider vinegar has beneficial properties for decreasing LDL-C, total cholesterol concentration, and blood glucose have also increased HDL-C in diabetic rats significantly. Studies of the comprehensive review indicate that apple cider vinegar can reduce obesity, hyperglycemia, hyperlipidemia, and hyperinsulinemia in many clinical trials. The current review study concluded that the results of many clinical trials showed an active component of apple cider vinegar which has the potential for lowering hyperglycemia, hyperlipidemia, and reduced body weight. Hypertension should be control with the intervention of apple cider vinegar. Results of many studies also showed the anti-microbial effect of apple cider vinegar. Several mechanisms have been reported for mechanism action of glucose metabolisms such as delayed gastric emptying and enteral absorption, increased utilization of glucose, suppression of production of hepatic glucose, up-regulation of flow-mediated vasodilatation, increase in lipolysis and reduction in lipogenesis, insulin secretion facilitation. Other mechanisms are reported including fecal acid bile excretion facilitation, enhanced energy uses and increased satiety.

Influence of apple cider vinegar on blood lipids Consumption of apple cider vinegar over a 8 week period had a beneficial effect in significant reductions in harmful blood lipids and is recommended as a simple and cost-effective treatment for hyperlipidemia.

Total phenolics and antioxidant properties of cider apple cultivars The results indicated an approximate 55% relation between total phenolics and radical scavenging. Pasteurization of all samples caused a small but significant decrease in the total phenolic content and antioxidant capacity; however, Malus sieversii accessions were high in both and were less affected by pasteurization.

Fruit Antioxidants during Vinegar Processing: Changes in Content and in Vitro Bio-Accessibility Vinegars based on fruit juices could conserve part of the health-associated compounds present in the fruits. However, in general very limited knowledge exists on the consequences of vinegar-making on different antioxidant compounds from fruit. The major conclusion of this work is that major changes occur in phenolic compounds during vinegar making. An untargeted metabolite analysis should be used to reveal these changes in more detail. In addition, the effect of vinegar processing on bio-accessibility of phenolic compounds was investigated by mimicking the digestive tract in an in vitro set up. This study is meant to provide insight into the potential of vinegar as a source of health-related compounds from fruit.

EVALUATION OF ANTIOXIDANT, ANTIPROLIFERATIVE AND CHEMOPROPHYLACTIC EFFECT OF APPLE CIDER VINEGAR AGAINST COLON CANCER CELL LINES Colon cancer is the most threatening cases in the contemporary world due to sedentary lifestyles, changes in eating habits, genetics and etiological factors. The latest statistics proves that it is expected to cause about 50,630 deaths every year. Apple Cider Vinegar (ACV) has been proved to be a very constructive and effective therapy for cancer, hyperlipidemia, hyperglycemia, urolithiasis and skin infections. The HT-29 cancer cell line subjected to various concentrations of apple cider vinegar, resulted in cell viability of 48.90% at 62.5μg/ml. From the graph IC50 value was calculated to be around 50-60μg/ml. Conclusion: It was concluded ACV is biologically active and effective against colon cancer.

Vinegar Functions on Health: Constituents, Sources, and Formation Mechanisms Regarding anticancer activities, several grain vinegars strongly inhibit the growth of some cancer cells in vivo or in vitro, but related functional ingredients remain largely unknown, except tryptophol in Japanese black soybean vinegar. Considering the discovering of various functional ingredients and clarifying their mechanisms, some vinegars could be functional foods or even medicines, depending on a number of proofs that demonstrate these constituents can cure chronic diseases such as diabetes or cardiovascular problems.

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