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Objective: Vinegar consumption studies have demonstrated possible therapeutic effects in reducing HbA1c and postprandial glycemia. The purpose of the study was to closely examine the effects of a commercial vinegar drink on daily fluctuations in fasting glucose concentrations and postprandial glycemia, and on HbA1c, in individuals at risk for Type

Objective: Vinegar consumption studies have demonstrated possible therapeutic effects in reducing HbA1c and postprandial glycemia. The purpose of the study was to closely examine the effects of a commercial vinegar drink on daily fluctuations in fasting glucose concentrations and postprandial glycemia, and on HbA1c, in individuals at risk for Type 2 Diabetes Mellitus (T2D). Design: Thirteen women and one man (21-62 y; mean, 46.0±3.9 y) participated in this 12-week parallel-arm trial. Participants were recruited from a campus community and were healthy and not diabetic by self-report. Participants were not prescribed oral hypoglycemic medications or insulin; other medications were allowed if use was stable for > 3 months. Subjects were randomized to one of two groups: VIN (8 ounces vinegar drink providing 1.5 g acetic acid) or CON (1 vinegar pill providing 0.04 g acetic acid). Treatments were taken twice daily immediately prior to the lunch and dinner meals. Venous blood samples were drawn at trial weeks 0 and 12 to measure insulin, fasting glucose, and HbA1c. Subjects recorded fasting glucose and 2-h postprandial glycemia concentrations daily using a glucometer. Results: The VIN group showed significant reductions in fasting capillary blood glucose concentrations (p=0.05) that were immediate and sustained throughout the duration of the study. The VIN group had reductions in 2-h postprandial glucose (mean change of −7.6±6.8 mg/dL over the 12-week trial), but this value was not significantly different than that for the CON group (mean change of 3.3±5.3 mg/dL over the 12-week trial, p=0.232). HbA1c did not significantly change (p=0.702), but the reduction in HbA1c in the VIN group, −0.14±0.1%, may have physiological relevance. Conclusions: Significant reductions in HbA1c were not observed after daily consumption of a vinegar drink containing 1.5 g acetic acid in non-diabetic individuals. However, the vinegar drink did significantly reduce fasting capillary blood glucose concentrations in these individuals as compared to a vinegar pill containing 0.04 g acetic acid. These results support a therapeutic effect for vinegar in T2D prevention and progression, specifically in high-risk populations.
ContributorsQuagliano, Samantha (Author) / Johnston, Carol (Thesis advisor) / Appel, Christy (Committee member) / Dixon, Kathleen (Committee member) / Arizona State University (Publisher)
Created2013
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Description
Many people with or at risk for diabetes have difficulty maintaining normal postprandial blood glucose levels (120-140 mg/dl). Research has shown that vinegar decreases postprandial glycemia. The purpose of this study was to examine a possible mechanism by which vinegar decreases postprandial glycemia, particularly the effect of vinegar ingestion on

Many people with or at risk for diabetes have difficulty maintaining normal postprandial blood glucose levels (120-140 mg/dl). Research has shown that vinegar decreases postprandial glycemia. The purpose of this study was to examine a possible mechanism by which vinegar decreases postprandial glycemia, particularly the effect of vinegar ingestion on gut fermentation. In this parallel arm randomized control trial, the effects of daily ingestion of vinegar on gut fermentation markers were observed among adults at risk for type 2 diabetes in Phoenix, Arizona. Subjects (n=14) were randomly assigned to treatments consisting of a vinegar drink (1.5g acetic acid) or a placebo (2 vinegar pills containing 40mg acetic acid each). All participants were required to consume the vinegar drink (16 oz) or 2 placebo pills every day for 12 weeks. At week 12, participants filled out a questionnaire to report gastrointestinal (GI) symptoms and three consecutive breath samples were taken from each subject to measure fasting breath hydrogen (BH2) with a breath analyzer. Fasting BH2 measures for the vinegar drink group (16.1+11.8 ppm) were significantly different than those from the pill group (3.6+1.4) with a partial eta squared of 0.39 (p=0.023). After adjusting for age as a confounding factor (r=0.406) and removing an outlier, fasting BH2 measures for the vinegar drink group (4.3+1.1 ppm) were still significantly different than those from the pill group (3.6+1.4) with a partial eta squared of 0.35 (p=0.045). Participants in both groups reported mild changes in GI symptoms. In conclusion, adults at risk for type 2 diabetes that consume 2 tablespoons of vinegar a day may have increased gut fermentation compared to those who do not consume vinegar.
ContributorsWhite, Serena (Author) / Johnston, Carol (Thesis advisor) / Appel, Christy (Committee member) / Martin, Keith (Committee member) / Arizona State University (Publisher)
Created2013
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ABSTRACT This randomized, controlled, double-blind crossover study examined the effects of a preprandial, 20g oral dose of apple cider vinegar (ACV) on colonic fermentation and glycemia in a normal population, with the ultimate intention of identifying the mechanisms by which vinegar has been shown to reduce postprandial glycemia and insulinemia.

ABSTRACT This randomized, controlled, double-blind crossover study examined the effects of a preprandial, 20g oral dose of apple cider vinegar (ACV) on colonic fermentation and glycemia in a normal population, with the ultimate intention of identifying the mechanisms by which vinegar has been shown to reduce postprandial glycemia and insulinemia. Fifteen male and female subjects were recruited, ages 20-60y, who had no prior history of gastrointestinal (GI) disease or resections impacting normal GI function, were non-smokers, were non-vegetarian/vegan, were not taking any medications known to alter (glucose) metabolism, and were free of chronic disease including diabetes. Subjects were instructed to avoid exercise, alcohol and smoking the day prior to their trials and to consume a standardized, high-carbohydrate dinner meal the eve prior. There was a one-week washout period per subject between appointments. Breath hydrogen, serum insulin and capillary glucose were assessed over 3 hours after a high-starch breakfast meal to evaluate the impact of preprandial supplementation with ACV or placebo (water). Findings confirmed the antiglycemic effects of ACV as documented in previous studies, with significantly lower mean blood glucose concentrations observed during ACV treatment compared to the placebo at 30 min (p=0.003) and 60 min (p=0.005), and significantly higher mean blood glucose concentrations at 180 min (p=0.045) postprandial. No significant differences in insulin concentrations between treatments. No significant differences were found between treatments (p>0.05) for breath hydrogen; however, a trend was observed between the treatments at 180 min postprandial where breath hydrogen concentration was visually perceived as being higher with ACV treatment compared to the placebo. Therefore, this study failed to support the hypothesis that preprandial ACV ingestion produces a higher rate of colonic fermentation within a 3 hour time period following a high-carbohydrate meal. Due to variations in experiment duration noted in other literature, an additional study of similar nature with an expanded specimen collections period, well beyond 3 hours, is warranted.
ContributorsMedved, Emily M (Author) / Johnston, Carol (Thesis advisor) / Sweazea, Karen (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Water makes up about 45-70% of a human body's total weight. It is estimated that 80% of the human brain's tissue is composed of water. Cognitive productivity is altered when the body is in a mere 2% dehydrated state. Several cognitive functions impacted by dehydration include: visual motor tracing, short-term

Water makes up about 45-70% of a human body's total weight. It is estimated that 80% of the human brain's tissue is composed of water. Cognitive productivity is altered when the body is in a mere 2% dehydrated state. Several cognitive functions impacted by dehydration include: visual motor tracing, short-term recall, attentiveness, and mathematic efficiency. It is estimated that 80% of the U.S. adult population endures the majority of their day in a mildly dehydrated state.

Participants were employees working full-time jobs with Arizona State University or Tri Star Motor Company. Employees had to be 18 or older were invited to join the study. Employees participating in the study lived within the the greater Phoenix area. Participants of all races, genders, activity statuses, and BMIs were encouraged to join.

A one-arm, pre-test, post-test study design was utilized. We examined whether the hydration status of participants in the intervention improved or worsened during the course of the intervention, and then attributed any such improvement or deterioration to the intervention. Urine collections from an afternoon sample were gathered before and after the one-week intervention. For the intervention, the participating offices received a water dispensing system in close proximity to employee desk spaces. A reusable water bottle was also given to each participant. Urine specific gravity (USG) was assessed in all urine samples to indicate hydration status, and all participants completed water intake surveys before and after the intervention.

From this study, the overall change in water intake over the course of the one-week intervention was 143 ounces/day. This is an average of adding two and a half 8 oz glasses of water each day of the week per participant. USG also decreased significantly at the end of the intervention in comparison to the baseline value. In the greater body of research, this study strengthens the viability of inputting a hydration station and offering reusable water bottles to employees. This cost-effective method is an easy way to incorporate employee wellness in the workplace. The benefit of employees to drink more water is numerous, including increased focus, mental reactivity, and overall mood and wellness.
ContributorsWildermuth, Kelsi (Author) / Johnston, Carol (Thesis advisor) / Dixon, Kathleen (Committee member) / Levinson, Simin (Committee member) / Arizona State University (Publisher)
Created2018
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To date, there have not been any studies in a human population that explore the potential of vinegar ingestion in reducing visceral fat, a common yet serious metabolic disease risk factor. However, previous research in animal models exhibit promising findings, showing that vinegar is effective at reducing visceral fat. This

To date, there have not been any studies in a human population that explore the potential of vinegar ingestion in reducing visceral fat, a common yet serious metabolic disease risk factor. However, previous research in animal models exhibit promising findings, showing that vinegar is effective at reducing visceral fat. This is thought to be due to the activation of AMPK (adenosine monophosphate protein kinase) by acetic acid, the active ingredient in vinegar. The purpose of this study was to identify if this potentially groundbreaking relationship exists in human subjects. Healthy, nonsmoking, sedentary adults between the ages 18-45 y and a waist circumference measurement greater than or equal to 33 inches for women and 38 inches for men were recruited for this study. Twenty-three participants completed this 8-week, parallel arm, randomized control trial that tested the efficacy of red wine vinegar consumption (2 tablespoons red wine vinegar, twice per day, before a meal; providing 3.6 g acetic acid) against a placebo (1 apple cider vinegar pill, twice per day, before a meal; providing 0.0225 g acetic acid) for 8 weeks. Participants were randomized into either the vinegar (VIN) or control (CON) group after being stratified by age, gender, waist circumference, and weight. Results found that the VIN group experienced a 2% decrease in visceral fat (cm3, quantified by a DXA scan), but this change did not differ significantly from that of the CON group (p=0.256). The VIN group also experienced a slight decrease in insulin compared to the CON group, but this change was not significantly different than the control change (p=0.125). However, the change in HOMA-IR trended downward in the VIN group (-16%) as compared to the CON group (+9%) (p=0.079) with a large effect size, 0.153. Other parameters did not show statistically significant results between the groups. Further research is indicated in order to examine the potential of vinegar to reduce visceral fat.
ContributorsBaker, Olivia (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2018
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Description
Exposure to sun radiation (SUR) with ambient temperature may be an influencer on athletes’ sweat loss in different environments, but the results are not currently known. The purpose of this study was to determine the effects of SUR on fluid balance (FB) and hydration status (HS) in athletes exercising indoors

Exposure to sun radiation (SUR) with ambient temperature may be an influencer on athletes’ sweat loss in different environments, but the results are not currently known. The purpose of this study was to determine the effects of SUR on fluid balance (FB) and hydration status (HS) in athletes exercising indoors and outdoors.

Initial FB and HS were assessed in NCAA-DI female soccer athletes (n=10) of a single team in temperate, dry conditions (55-68°F, 18-48% humidity) who were monitored during 3 practices of equal estimated energy expenditure (EE): two outdoors in direct SUR (cold/moderate temperatures) and one indoors without SUR (moderate temperatures). Humidity, temperature, and wet bulb globe temperature (WBGT – a measurement partly based on SUR, including ambient temperature/relative humidity) were recorded using Heat Stress Meters placed in the direct sun or in the shade. Each athlete’s semi-nude dry body weight was recorded before and after exercise. Urine samples were taken before, after, and the morning after. Urine specific gravity (USG) was tested to assess HS. Athletes wore combined heart rate and activity monitors to estimate EE and were provided ad libitum water and/or a zero-calorie sports drink. Their total intake included weights of consumed food and drink. Sweat rate was calculated using body weight change and intakes of liquids minus urine losses/hour.

Two-way repeated measures ANOVA analyzed group-level differences. No significance was found in total FB (1.01±0.32 L/hr) or EE/hr (444±97.1 kcal/hr) across all days (p>0.05). In analyzing individual athlete results, 40% had consistent USG >1.025 (p=0.001) suggesting potential dehydration. These 4 athletes selected water as their beverage, of which is known that consuming only water does not stimulate drinking behavior as does electrolyte drinks. The remaining 60% were overall not dehydrated (USG <1.025) but must be aware of incidental dehydration in hotter temperatures.

The conclusion is that in low-moderate temperatures, athletes self-regulate drinking habits and achieve fluid balance during exercise with or without sun radiation. However, athletes with average USG >1.025 are likely to remain dehydrated in moderate temperatures. The findings suggest that more education would benefit these athletes by ensuring hydration in any environment.
ContributorsOlzinski, Stephanie (Author) / Wardenaar, Floris (Thesis advisor) / Johnston, Carol (Committee member) / Yudell, Amber (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Background: Acetic acid in vinegar has demonstrated antiglycemic effects in previous studies; however, the mechanism is unknown.

Objective: To determine whether acetic acid dissociates in the addition of sodium chloride and describe a flavorful vinaigrette that maintains the functional properties of acetic acid.

Design: Phase I - Ten healthy subjects

Background: Acetic acid in vinegar has demonstrated antiglycemic effects in previous studies; however, the mechanism is unknown.

Objective: To determine whether acetic acid dissociates in the addition of sodium chloride and describe a flavorful vinaigrette that maintains the functional properties of acetic acid.

Design: Phase I - Ten healthy subjects (23-40 years) taste tested five homemade vinaigrette and five commercial dressings. Perceived saltiness, sweetness, tartness, and overall tasted were scored using a modified labeled affective magnitude scale. Each dressing was tested three times for pH with a calibrated meter. Phase II – Randomized crossover trial testing six dressings against a control dressing two groups of nine healthy adult subjects (18-52 years). Height, weight and calculated body mass index (BMI) were performed at baseline. Subjects participated in four test sessions each, at least seven days apart. After a 10-hour fast, participants consumed 38g of the test drink, followed by a bagel meal. Capillary blood glucose was obtained at fasting, and every 30 minutes over a 2-hour period the test meal.

Results: Dressing pH reduced as sodium content increased. In the intervention trials, no significant differences were observed between groups (p >0.05). The greatest reduction in postprandial glycemia (~21%) was observed in the dressing containing 200 mg of sodium. Effect size was large in both group 1 (η2=0.161) and group 2 (η2=0.577).

Conclusion: The inclusion of sodium into acetic acid may impair its ability to attenuate blood glucose after a meal.
ContributorsBonsall, Amber K (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2017
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It is widely documented and accepted that athletes have difficulty maintaining adequate hydration status and that dehydration is a key risk factor for the heat-related illnesses commonly observed among athletes. Research has also suggested that hydration status can influence cognitive performance. Educational interventions focused on rehydration strategies have had

It is widely documented and accepted that athletes have difficulty maintaining adequate hydration status and that dehydration is a key risk factor for the heat-related illnesses commonly observed among athletes. Research has also suggested that hydration status can influence cognitive performance. Educational interventions focused on rehydration strategies have had minimal success reducing dehydration rates; hence, alternative interventions promoting adequate hydration status in athletes should be explored. This trial examined the efficacy of a commercial hydration mobile application (app) for reducing dehydration rates in campus athletes. Fifty-eight college students aged 18-40 y, who participated in club-level collegiate athletics were recruited from a large Southwestern university and randomized by team to one of two study arms, the Standard of Care – Education (EDU) or the hydration mobile app (APP), to determine if app technology improved hydration status as compared to traditional education messaging. Twenty-three (79%) in the EDU group and twenty (69%) in the APP group were mildly-dehydrated at baseline based on the three-day averages of hydration assessment (USG 1.010). Moreover, 31% (n=9) and 28% (n=8) of the EDU and APP groups, respectively, were dehydrated (USG 1.020). No significant differences were found between the EDU and APP groups following the intervention. Three-day average post-intervention USG testing showed 76% (n=22) and 72% (n=21) of the EDU and APP groups respectively were at best mildly-dehydrated. Additionally, 28% (n=8) and 17% (n=5) were considered dehydrated. Neither intervention improved hydration status after four weeks of treatment. Further analyses of cognitive measures were conducted by hydration assessment groups at baseline and post-intervention: hydrated (HYD) (USG < 1.020) or dehydrated (DEH) (USG 1.020). No significant differences between hydration status were found between intervention groups. Additionally, no significant improvements were seen for either group, which indicates there is still a need for a novel way to improve hydration status in this population. Multi-dimensional interventions and individualized interventions to improve hydration status in this at-risk population may be more effective. Additional research should be conducted to determine if there is any cognitive performance enhancement associated with dehydration or mild-dehydration by reassessing previous data and conducting future trials.
ContributorsZemek, Kate A (Author) / Johnston, Carol (Thesis advisor) / Hekler, Eric (Committee member) / Mayol-Kreiser, Sandra (Committee member) / Ransdell, Lynda (Committee member) / Swan, Pamela (Committee member) / Arizona State University (Publisher)
Created2017
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Description
Water is an essential nutrient that is often overlooked. As a result of this hydration status is often forgotten as well. Becoming hypohydrated puts athletes at risk of decreased performance and potentially life-threatening heat illness. Being able to self-assess hydration status is may be instrumental in helping athletes safely optimize

Water is an essential nutrient that is often overlooked. As a result of this hydration status is often forgotten as well. Becoming hypohydrated puts athletes at risk of decreased performance and potentially life-threatening heat illness. Being able to self-assess hydration status is may be instrumental in helping athletes safely optimize performance. Therefore, this study investigated, 1) the ability of an athletic population vs. trained investigators to self-diagnose underhydration, 2) the diagnostic ability of urine color (Ucol) charts as a method for diagnosing underhydration, and 3) the accuracy of participant and investigator assessments. Members of an athletic population each provided a urine sample and scored samples using both the traditional 8-color and newly developed 7-color Ucol chart. Investigators then scored the samples using the same methods. To determine the diagnostic value of the Ucol charts, Ucol scores were compared to concentration measures of Urine Specific Gravity (USG) and Urine Osmolality (Uosm). Differences in participant and investigator scores were compared using Mann-Whitney U and Spearman’s Correlation. Bland-Altman plots were drawn to assess individual differences in reporting against the mean of the two methods. Receiver Operating Characteristic (ROC) analysis was used to both determine the ability of both charts to diagnose underhydration and to determine how well participants and investigators can determine their level of hydration. Athletes reported Ucol significantly lighter compared to investigators. Investigators showed no difference in reporting between the two charts but, athletes reported less than a color shade difference. The charts performed fair (8-color) to good (7-color) at diagnosing hypohydration. Athletes reported with less accuracy compared to investigators, and Ucol classification was found to be more accurate when compared to USG. Ucol charts are a practical tool to determine hydration status. Ucol scoring is similar regardless of the type of chart used. Trained investigators reported with slightly higher accuracy on both charts compared to untrained athletes. Athletes score Ucol fair to good in comparison to investigators. Ucol scoring is similar regardless of the type of chart used. The diagnostic ability of both Ucol charts is good in relation to USG. With education, athletes may be able to improve scores.
ContributorsPesek, Kathryn Margaret (Author) / Wardenaar, Floris (Thesis advisor) / Johnston, Carol (Committee member) / Yudell, Amber (Committee member) / Arizona State University (Publisher)
Created2022