June 19

Flashback Friday: Optimal Vinegar Dose


Consuming vinegar with a meal reduces the spike in blood sugar, insulin, and triglycerides. And it appears to work particularly well in those who are insulin resistant, on their way to type 2 diabetes; no wonder the consumption of vinegar with meals was used as a folk medicine for the treatment of diabetes before diabetes drugs were invented.

Many cultures have taken advantage of this fact, mixing vinegar with high glycemic foods like white rice—in Japan, for example, to make sushi; dipping bread into balsamic in the Mediterranean; a variety of sourdough breads throughout Europe, which cause lower blood sugar and insulin spikes. And you can do the same with boiled white potatoes by adding vinegar, and cooling them to make potato salad.

Adding vinegar to white bread doesn’t just lower blood sugar and insulin responses, but increases satiety—the feeling of being full after a meal. If you eat three slices of white bread, it may fill you up a little, but in less than two hours, not only are you as hungry as you started, but actually hungrier—less satiated than when you began. But if you eat that same amount of bread with some vinegar, you feel twice as full. And even two hours later, you’re still feeling nearly just as full as if you just ate the three pieces of bread plain. But this remarkable increase and prolongation of satiety took nearly two tablespoons of vinegar. That’s a lot of vinegar.

It turns out even just small amounts of vinegar—two teaspoons with a meal—can significantly cut down on the blood sugar spike of a refined carb meal—a bagel and juice in this case. So, you could have a little side salad or even just add it to some tea with lemon—it’s only two teaspoons. Or scrap the bagel with juice, and just have some oatmeal with berries instead.

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What if you consume vinegar every day for months? Researchers at Arizona State randomized prediabetics to drink a daily bottle of apple cider vinegar drink—a half bottle at lunch, a half bottle at supper—or, take an apple cider vinegar tablet, which they pretty much considered a placebo control, since while the bottle contains two tablespoons of vinegar, two tablets would add up to only about a third of a teaspoon a day. So, they were, in effect, comparing about 40 spoonfuls of vinegar a week, to 2 for 12 weeks.

This is what happened. On the vinegar drink, fasting blood sugars dropped within one week. How significant is a drop of 16 points? A simple dietary tweak—a tablespoon of vinegar twice a day—worked better than the leading drugs, like Glucophage and Avandia. This effect of vinegar is particularly noteworthy when the cost, access, and toxicities that are associated with pharmaceutical medications are considered. So, safer, cheaper, and more effective. No wonder it’s been used medicinally since antiquity. Interestingly, even the tiny amount of vinegar in pill form seemed to help a bit. That’s astonishing. And no, the study was not funded by the vinegar company.

What about long-term vinegar use where it really counts: in diabetics? They were randomized into one of three groups. Two tablespoons of vinegar twice a day, with lunch and supper; two dill pickles a day, which each contained about a half tablespoon’s worth of vinegar; or an even smaller vinegar pill twice a day, each containing only 1/16th of a teaspoon’s worth of vinegar. So, I wasn’t surprised the pill didn’t work, but neither did the pickles. Maybe the tablespoon a day isn’t enough for diabetics? Regardless, the vinegar did work: all the more impressive, because the diabetics were mostly well-controlled on medication, and still saw an additional benefit from the vinegar.

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To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

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