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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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Dietary protein is known to increase postprandial thermogenesis more so than carbohydrates or fats, probably related to the fact that amino acids have no immediate form of storage in the body and can become toxic if not readily incorporated into body tissues or excreted. It is also well documented that

Dietary protein is known to increase postprandial thermogenesis more so than carbohydrates or fats, probably related to the fact that amino acids have no immediate form of storage in the body and can become toxic if not readily incorporated into body tissues or excreted. It is also well documented that subjects report greater satiety on high- versus low-protein diets and that subject compliance tends to be greater on high-protein diets, thus contributing to their popularity. What is not as well known is how a high-protein diet affects resting metabolic rate over time, and what is even less well known is if resting metabolic rate changes significantly when a person consuming an omnivorous diet suddenly adopts a vegetarian one. This pilot study sought to determine whether subjects adopting a vegetarian diet would report decreased satiety or demonstrate a decreased metabolic rate due to a change in protein intake and possible increase in carbohydrates. Further, this study sought to validate a new device called the SenseWear Armband (SWA) to determine if it might be sensitive enough to detect subtle changes in metabolic rate related to diet. Subjects were tested twice on all variables, at baseline and post-test. Independent and related samples tests revealed no significant differences between or within groups for any variable at any time point in the study. The SWA had a strong positive correlation to the Oxycon Mobile metabolic cart but due to a lack of change in metabolic rate, its sensitivity was undetermined. These data do not support the theory that adopting a vegetarian diet results in a long-term change in metabolic rate.
ContributorsMoore, Amy (Author) / Johnston, Carol (Thesis advisor) / Appel, Christy (Thesis advisor) / Gaesser, Glenn (Committee member) / Arizona State University (Publisher)
Created2012
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In 2002, a scientifically derived food guide pyramid for vegetarians, the Modified Food Guide for Lacto-ovo-vegetarians and Vegans was published and well received. Now that 10 years have passed, new scientific literature regarding the bioavailability of the nutrients of key concern in vegetarian diets has been published, and the graphical

In 2002, a scientifically derived food guide pyramid for vegetarians, the Modified Food Guide for Lacto-ovo-vegetarians and Vegans was published and well received. Now that 10 years have passed, new scientific literature regarding the bioavailability of the nutrients of key concern in vegetarian diets has been published, and the graphical format of the nation's food guide has evolved from a pyramid shape into a circular plate. The objective of this research was to examine the post-2002 literature regarding the bioavailability of key nutrients in vegetarian diets; to use this information to update the recommendations made in the 2002 Modified Food Guide Pyramid for Lacto-ovo-vegetarians and Vegans; and to adapt this revised food plan to the new USDA MyPlate format. This process involved reviewing the scientific literature to determine if the DRIs for the nutrients of key concern in vegetarian diets are adequate for the vegetarian population and using this information to develop new recommendations for vegetarians if necessary, analyzing the nutrient content of representative foods in different food groups, reconfiguring the food groups so that foods with like nutrient components were grouped together, determining the number of servings of each food group required to meet vegetarians' nutrient requirements at three caloric levels, and developing sample menus. A circular plate graphic, the Vegetarian Plate, was designed to illustrate the recommendations of this updated food guide. This updated, scientifically derived food guide provides a sound base for diet planning for lacto-ovo-vegetarians and vegans. Further research is needed to assess the Vegetarian Plate's adequacy for children, pregnant and lactating women, athletes, and individuals with medical conditions or chronic diseases.
ContributorsFladell, Lauren (Author) / Johnston, Carol (Thesis advisor) / Vaughan, Linda (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2013
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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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The various health benefits of vinegar ingestion have been studied extensively in the<br/>literature. Moreover, emerging research suggests vinegar may also have an effect on mental<br/>health. Beneficial effects of certain diets on mood have been reported, however, the mechanisms<br/>are unknown. The current study aimed to determine if vinegar ingestion positively affects

The various health benefits of vinegar ingestion have been studied extensively in the<br/>literature. Moreover, emerging research suggests vinegar may also have an effect on mental<br/>health. Beneficial effects of certain diets on mood have been reported, however, the mechanisms<br/>are unknown. The current study aimed to determine if vinegar ingestion positively affects mood<br/>state in healthy young adults. This was a randomized, single blinded controlled trial consisting of<br/>25 subjects. Participants were randomly assigned to either the vinegar group (consumed 2<br/>tablespoons of liquid vinegar diluted in one cup water twice daily with meals) or the control<br/>group (consumed one vinegar pill daily with a meal), and the intervention lasted 4 weeks.<br/>Subjects completed mood questionnaires pre- and post-intervention. Results showed a significant<br/>improvement in CES-D and POMS-Depression scores for the vinegar group compared to the<br/>control. This study suggests that vinegar ingestion may improve depressive symptoms in healthy<br/>young adults.

ContributorsWilliams, Susanna (Author) / Johnston, Carol (Thesis director) / Whisner, Corrie (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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Depression is a worldwide public health problem that affects millions of people every year. Due to recent reports that depressed individuals have an altered gut microbiome composition, there is speculation that treatments that influence microorganisms in the gut could potentially lead to alleviation of depressive symptoms. Apple cider vinegar has

Depression is a worldwide public health problem that affects millions of people every year. Due to recent reports that depressed individuals have an altered gut microbiome composition, there is speculation that treatments that influence microorganisms in the gut could potentially lead to alleviation of depressive symptoms. Apple cider vinegar has been studied extensively for its health-promoting properties and benefits. Apple cider vinegar’s main ingredient is the short chain fatty acid, acetic acid. Short chain fatty acids have been shown to improve mood state and depressive symptoms, as well as amplify the effect of prebiotics in restoring the gut microbiome. This experimental design study examined the effects of ingesting 2 tbsp. apple cider vinegar (1 g acetic acid) twice daily with a meal on the levels of urinary metabolites in 14 college students compared to a control group of 11 college students that took one vinegar supplement tablet (0.015 g of acetic acid) daily for 28 days. All participants were healthy, normal to underactive (< 300 minutes of moderate exercise a week), and free of chronic or acute illnesses. Urinary metabolite analysis revealed a significant production of enzymes involved in the hexosamine pathway in the liquid vinegar group compared to baseline levels. However, anticipation of an alteration in tryptophan metabolites, a possible consequence of altered metabolism of gut microflora, was not observed. These data suggest that apple cider vinegar might be a potential treatment for depression through the production of hexosamine pathway enzymes.

ContributorsBauer, Shayna Dru (Author) / Johnston, Carol (Thesis director) / Sweazea, Karen (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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The objective of this randomized, single-blind crossover study was to examine the effect of vinegar on the blood glucose response to meal ingestion. This study was associated with a companion study Is Apple Cider Vinegar Effective for Reducing Heartburn Symptoms Related to Gastroesophageal Reflux Disease. Glucose meters were

The objective of this randomized, single-blind crossover study was to examine the effect of vinegar on the blood glucose response to meal ingestion. This study was associated with a companion study Is Apple Cider Vinegar Effective for Reducing Heartburn Symptoms Related to Gastroesophageal Reflux Disease. Glucose meters were utilized to measure blood glucose levels immediately prior to, and at four ½ hour intervals following meal ingestion. Previous studies have demonstrated that vinegar modulates the meal-time glucose response. Hence an alternative hypothesis was used: that a significant difference will be observed between the control and the vinegar groups. The results from the study were not significant likely due to a small sample size. The test meal eaten with a drink composed of vinegar diluted in water appeared to be most effective at decreasing the overall change in postprandial blood glucose. The vinegar drink also played a role in decreasing the peak glucose level at 30 minutes post-meal.
ContributorsPadgitt-Cobb, Lillian Katelyn (Author) / Johnston, Carol (Thesis director) / Redding, Kevin (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor)
Created2015-05
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A recent meta-analysis concluded that vinegar consumption could be considered effective adjunct therapy for improving glycemic control. Glycemic control strategies are useful for diabetic and pre-diabetic patients as a way of managing the symptoms of disease. However, liquid vinegar consumption is often poorly tolerated and ingestion can invoke nausea. This

A recent meta-analysis concluded that vinegar consumption could be considered effective adjunct therapy for improving glycemic control. Glycemic control strategies are useful for diabetic and pre-diabetic patients as a way of managing the symptoms of disease. However, liquid vinegar consumption is often poorly tolerated and ingestion can invoke nausea. This pilot study examined the effect of liquid vinegar versus commercial vinegar pills on postprandial glycemia in 12 healthy adults. All participants were healthy with fasting blood glucose averaging 91mg/dl. This study examined the efficacy of liquid vinegar ingestion (25 g apple cider vinegar [1.25 g acetic acid]) versus vinegar pill ingestion (4 vinegar tablets [1.5 g acetic acid] either consumed whole or crushed and then dissolved in water) on postprandial glycemia. At 30 minutes following a standard test meal (bagel + jelly + juice; 106 g carbohydrate), blood glucose concentrations were reduced 12% in comparison to the pill groups or to a no vinegar control (135.6±15.8, 154.3±22.2, 152.7±30.6, and 157.7±22.8 mg/dl for the liquid vinegar, whole pill, crushed pill, and control groups respectively; p=0.023). These data suggest that in healthy adults, four commercial vinegar pills with a reported acetic acid content of 1.5 g acetic acid are not effective for improving glycemic control.
ContributorsFeise, Natasha Kristine (Author) / Johnston, Carol (Thesis director) / Kingsbury, Jeffrey (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
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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