Abstract
BackgroundElevated lipid profiles and impaired glucose homeostasis are risk factors for several cardiovascular diseases (CVDs), which, subsequently, represent a leading cause of early mortality, worldwide. The aim of the current study was to conduct a systematic review and meta-analysis of the effect of apple cider vinegar (ACV) on lipid profiles and glycemic parameters in adults.MethodsA systematic search was conducted in electronic databases, including Medline, Scopus, Cochrane Library, and Web of Knowledge, from database inception to January 2020. All clinical trials which investigated the effect of ACV on lipid profiles and glycemic indicators were included. Studies were excluded if ACV was used in combination with other interventions or when the duration of intervention was < 2 weeks. To account for between-study heterogeneity, we performed meta-analysis using a random-effects model.ResultsOverall, nine studies, including 10 study arms, were included in this meta-analysis. We found that ACV consumption significantly decreased serum total cholesterol (− 6.06 mg/dL; 95% CI: − 10.95, − 1.17; I2: 39%), fasting plasma glucose (− 7.97 mg/dL; 95% CI: − 13.74, − 2.21; I2: 75%), and HbA1C concentrations (− 0.50; 95% CI: − 0.90, − 0.09; I2: 91%). No significant effect of ACV consumption was found on serum LDL-C, HDL-C, fasting insulin concentrations, or HOMA-IR. The stratified analysis revealed a significant reduction of serum TC and TG in a subgroup of patients with type 2 diabetes, those who took ≤15 mL/day of ACV, and those who consumed ACV for > 8-weeks, respectively. Furthermore, ACV consumption significantly decreased FPG levels in a subgroup of studies that administered ACV for > 8-weeks. Further, ACV intake appeared to elicit an increase in FPG and HDL-C concentrations in apparently healthy participants.ConclusionWe found a significant favorable effect of ACV consumption on FPG and blood lipid levels.
Highlights
Elevated lipid profiles and impaired glucose homeostasis are risk factors for several cardiovascular diseases (CVDs), which, subsequently, represent a leading cause of early mortality, worldwide
Participants’ clinical conditions were different across the included studies; where five trials had enrolled diabetic patients [12, 16, 20, 27, 28], 2 studies had included obese and/or overweight participants [22, 23], one study had recruited type 2 diabetic patients with dyslipidemia [4], and one study did not report the condition of subjects [33]
We found that our findings about serum TG was influenced by 3 studies, and when we removed each of these studies from the analysis, the findings did change [excluding Panetta et al [33] WMD: − 39.38 mg/dL; 95% confidence intervals (CI): − 73.18, − 5.59; excluding Mahmoodi et al [27] WMD: − 39.46 mg/dL; 95% CI: − 75.37, − 3.55; and excluding Khezri et al [22] WMD: − 20.76 mg/dL; 95% CI: − 36.86, − 4.65]
Summary
Elevated lipid profiles and impaired glucose homeostasis are risk factors for several cardiovascular diseases (CVDs), which, subsequently, represent a leading cause of early mortality, worldwide. Cardiovascular diseases (CVDs), collectively, are regarded as the number one cause of early mortality, worldwide [30]. Low adherence to lifestyle recommendations and reported adverse reactions of synthetic agents [38, 41] highlights the necessity of discerning novel and efficacious approaches. In this line, the benefical effect of nutraceutics and fuctional foods on human health have been welldocumented [8, 36]. In contemporary research and practice, plants and their derivatives have attracted a lot of interest for their beneficial effects in controlling lipid profile and glycemic status [5, 15, 37]. One of the most popular plant derivatives in this regard is vinegar
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