Beneficial effects of Apple Cider Vinegar on weight management, Visceral Adiposity Index and lipid profile in overweight or obese subjects receiving restricted calorie diet: A randomized clinical trial (original) (raw)

Highlights

•
Co-administration of apple cider vinegar (ACV) and restricted calorie diet (RCD) decrease body weight and BMI.
•
Co-administration of ACV and RCD decrease hip circumference and VAI.
•
Co-administration of ACV and RCD reduced plasma triglyceride concentration and also increase in HDL-c level.
•
Co-administration of ACV and RCD has a beneficial effect on appetite reduction.

Abstract

A randomized, clinical trial was performed to examine whether Apple cider vinegar (ACV) can result in dietary modifications that provides beneficial effects on the management of body weight and serum metabolic profiles in overweight or obese individuals. The participants (n = 39) were randomly allocated into the ACV (subjected to a restricted calorie diet (RCD) with 250 kcal/day energy deficit and 30 mL/d of ACV)) or the control group (RCD only) for 12 weeks. The ACV significantly reduced body weight, BMI, Hip circumference, visceral adiposity index (VAI) and appetite score (P ≤ 0.00). Furthermore, Plasma triglyceride (TG) and total cholesterol (TC) levels significantly decreased and high density lipoprotein cholesterol (HDL-C) concentration significantly increased in the ACV group in comparison to the control group (P ≤ 0.05). Thus, ACV along with RCD can be considered as an effective strategy for reducing anthropometric parameters, TG and TC level, VAI, appetite and increasing HDL-C concentration in overweight or obese individuals.

Introduction

Obesity has become a critical challenge worldwide in the recent decades and is associated with many public health problems such as dyslipidemia, cardiovascular disease, and type 2 diabetes (Al-Kuraishy and Al-Gareeb, 2016, Health, 2000). The most effective strategies for the management of obesity are energy intake restriction, increased physical activity, behavioral modifications, pharmacotherapy, and bariatric surgery (Health, 2000). Unfortunately, these treatments have had a maximum success rate of only 21% (Wing & Hill, 2001).

Traditional and complementary medicine is becoming more popular worldwide generally due to fewer side effects (Ajaykumar, Anandarajagopal, Jainaf, Venkateshan, & Ananth, 2012). Apple cider vinegar (ACV) is widely used as a flavoring (or dressing) and preservative in foods. In addition, ACV is a traditional natural treatment that has two main active constituents including acetic acid (Kondo, Kishi, Fushimi, Ugajin, & Kaga, 2009) and polyphenolic compounds (Denis et al., 2013). Recently ACV has attracted a lot of interest for its beneficial effects on controlling body weight and visceral fat accumulation (Kondo et al., 2009). So far, a few animal studies and clinical trials have been performed investigating the effects of ACV on anthropometric measurements, body composition and plasma lipids. Some of these studies show that vinegar administration has favorable effects on anthropometric parameters especially body weight regulation (Kondo et al., 2009, Lim et al., 2009, Ok et al., 2013, Seo et al., 2014), whereas others did not find these effects (Lee et al., 2013, Park et al., 2014). In addition, the effects of vinegar on lipid parameters were contradictory in the previous studies (Kondo et al., 2009, Ok et al., 2013, Park et al., 2014, Seo et al., 2014). Furthermore, based on the current evidence, there is a general lack of research investigating the effects of ACV on plasma concentrations of neuropeptide-Y (NPY) which is the most potent orexigenic peptide, regulating food intake (Tatemoto, 2004). Moreover, it seems that evaluating the visceral adiposity index (VAI) is a beneficial marker determining adipose tissue dysfunction, in regards to subcutaneous and visceral adipose tissue in the abdominal region (Al-Kuraishy & Al-Gareeb, 2016). Therefore, the present study aimed to evaluate the impact of ACV along with restricted calorie diet (RCD) on the anthropometric measurements, body composition, VAI, plasma lipids, NPY, and appetite in overweight or obese individuals.

Section snippets

Subjects and ethical aspects

A randomized, controlled trial conducted from October to December 2014, this study was not blinded as the subjects in the ACV group were aware of the nature of the samples due to the strong odor and taste. No odor masking techniques were used as the control group were only subjected to the RCD. In this two-arm parallel study with 9 kg difference detection and a pooled standard deviation of 9.8 kg (Kondo et al., 2009), the minimum sample size was estimated 19 at a power (1 − β) of 80%

Results

Of the 44 obese and overweight subjects eligible for this trial, 2 subjects in the ACV group (inability to cooperate or medical treatments) and 3 subjects in the control group (using medical treatments) were excluded (Fig. 1).

Discussion

In the present study, oral administration of ACV along with RCD significantly decreased body weight, BMI, hip circumference and Visceral Adiposity Index (VAI) in comparison to the control. No clinical trials have investigated the effects of ACV and RCD together on anthropometric parameters in overweight or obese subjects. However, few animal studies (Lee et al., 2013, Lim et al., 2009, Ok et al., 2013, Seo et al., 2014) and clinical trials (Kondo et al., 2009, Park et al., 2014) have been

Conclusion

This study indicates that apple cider vinegar consumption along with restricted calorie diet can decrease appetite, body weight, BMI, hip circumference, VAI, plasma triglyceride, total cholesterol concentration and also increase HDL-C level in overweight or obese subjects. An implication of this is the possibility that ACV could be used as an adjunctive therapy in concomitant with RCD or other standard way of weight management therapy through appetite controlling or increasing thermic effect of

Conflict of interest

The authors declare that they have no conflict of interest.

Author Contribution

SKH and AS had full access to all of the data in the study and took responsibility for the integrity of the data and the accuracy of data analysis. NH, ZA and AS conceived and designed the study and provided administrative support. SKH, NH, ZA, and AS conducted the study. SKH and AS wrote the manuscript

Funding support

This project was supported by the National Nutrition and Food Technology Research Institute of Iran.

Acknowledgments

The authors thank the staff of Specialized Clinic of Nutrition & Diet Therapy located at the Faculty of Nutrition Sciences and Food Technology of Shahid Beheshti University of Medical Sciences in Tehran, Iran, for their invaluable assistance, and the staff of the research laboratory of Research Institute for Endocrine Sciences and the Nutrition research laboratory of the Faculty of Nutrition and Food Technology for their technical assistance.

Cited by (31)

View full text