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Background: Apple cider vinegar (ACV) is a naturally fermented beverage with potential metabolic health benefits; however, its effects on weight loss remain controversial. This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to assess the effect of ACV on anthropometric measurements in adults. Methods: We performed a systematic search of PubMed, Web of Science, Scopus, and CENTRAL up to March 2025 for randomized controlled trials (RCTs) in adults (≥18 years) evaluating the effects of ACV for ≥4 weeks on body composition parameters. Primary outcomes included changes in body weight, BMI, waist circumference, and other anthropometric measures. Risk of bias was assessed using the Revised Cochrane Risk-of-bias tool. Results: Out of 2961 reports screened, 10 RCTs comprising a total of 789 participants were eligible for inclusion in this meta-analysis. The pooled results using a random-effects model showed that daily ACV intake significantly reduced body weight [SMD: -0.39; 95% CI: -0.63, -0.15; p = 0.001; I2 = 62%], BMI [SMD: -0.65; 95% CI: -1.05, -0.26; p = 0.001; I2 = 83%], and WC [SMD: -0.34; 95% CI: -0.67, -0.02; p = 0.04; I2 = 61%]. However, no significant effects of ACV were observed on the other body composition parameters analyzed. Sensitivity analyses excluding high-risk-of-bias studies confirmed the robustness of ACV's beneficial effects on body weight and BMI. Subgroup analyses suggested that ACV consumption significantly improved anthropometric parameters when administered for up to 12 weeks, at a dose of 30 mL/day, and in adults who were overweight, obese, or had type 2 diabetes. Conclusions: Overall, this meta-analysis suggests that ACV supplementation may be a promising and accessible adjunctive strategy for short-term weight management in adults with excess body weight or metabolic complications.

BACKGROUND: SCFAs have immune-modulating effects in animal models of disease. However, there is limited evidence that this may occur in humans. OBJECTIVES: This study aimed to determine the effects of increased exposure to SCFAs via dietary manipulation on colonic fermentation and adaptive immune cells. METHODS: Twenty healthy young adults (18-45 y of age) underwent a blinded randomized crossover dietary intervention, consuming a high-SCFA diet and a matched low-SCFA diet for 21-d with a 21-d washout in between. SCFAs were provided through resistant starch, inulin, and apple cider vinegar. Blood and 3-d total fecal output were collected at baseline and at the end of each diet. GC was used to measure fecal and plasma SCFA. Flow cytometry was used for peripheral blood immunophenotyping. RESULTS: According to a paired samples Wilcoxon test, the high-SCFA diet was associated with significantly higher fecal SCFA concentrations [median (IQR); 86.6 (59.0) compared with 75.4 (56.2) µmol/g, P = 0.02] and lower fecal ammonia concentrations [26.2 (14.7) compared with 33.4 (18.5) µmol/g, P = 0.04] than the low-SCFA diet. Plasma propionate [9.87 (12.3) compared with 4.72 (7.6) µmol/L, P = 0.049] and butyrate [2.85 (1.35) compared with 2.02 (1.29) µmol/L, P = 0.03] were significantly higher after the high-SCFA diet than after the low-SCFA diet. Blood total B cells [184 (112) compared with 199 (143) cells/µL, P = 0.04], naive B cells [83 (66) compared with 95 (89) cells/µL, P = 0.02], Th1 cells [22 (19) compared with 29 (16) cells/µL, P = 0.03], and mucosal-associated invariant T cells [62 (83) compared with 69 (114) cells/µL, P = 0.02] were significantly lower after the high-SCFA diet than the low-SCFA diet. CONCLUSIONS: Increasing colonic and peripheral blood SCFA has discrete effects on circulating immune cells in healthy humans following 3-wk intervention. Further studies (e.g., in patients with inflammatory disease) are necessary to determine whether 1) these changes have immunomodulatory effects, 2) they are therapeutically beneficial, and 3) prolonged intake might be required. This trial is registered at the Australian New Zealand Clinical Trials Registry as ACTRN126180

INTRODUCTION: Atopic dermatitis is a common skin disease characterized by altered cutaneous immunity in which patients often exhibit lower skin microbiota diversity compared to healthy skin and are prone to colonization by Staphylococcus aureus. Apple cider vinegar has been shown to have antibacterial effects; however, its effects on the skin microbiome have not previously been well-described. OBJECTIVES: We aimed to examine the effects of topical dilute apple cider vinegar soaks on Staphylococcus aureus abundance, skin bacterial microbiome composition, and skin bacterial microbiome diversity in atopic dermatitis participants compared to healthy skin. METHODS: Eleven subjects with atopic dermatitis and 11 healthy controls were enrolled in this randomized, non-blinded, single-institution, split-arm pilot study. Subjects soaked one forearm in dilute apple cider vinegar (0.5% acetic acid) and the other forearm in tap water for 10 minutes daily. Skin bacteria samples were collected from subjects' volar forearms before and after 14 days of treatment. 16S sequencing was used to analyze Staphylococcus aureus abundance and skin bacterial microbiome composition, and alpha diversity of microbiota were determined using Shannon diversity index. RESULTS: There was no difference in skin bacterial microbiome in atopic dermatitis subjects after 2 weeks of daily water or apple cider vinegar treatments (p = 0.056 and p = 0.22, respectively), or in mean abundance of S. aureus on apple cider vinegar-treated forearms (p = 0.60). At 2 weeks, the skin bacterial microbiomes of healthy control subjects were not significantly different from the skin bacterial microbiome of atopic dermatitis subjects (p = 0.14, 0.21, 0.12, and 0.05). CONCLUSIONS: Our results suggest that daily soaks in 0.5% apple cider vinegar are not an effective method of altering the skin bacterial microbiome in atopic dermatitis. Further studies are needed to explore the effects of different concentrations of apple cider vinegar on skin microflora and disease severity. TRIAL NUMBER: UVA IRB-HSR #19906.

The present study was conducted to evaluate the combination effect of apple cider vinegar (ACV) and metformin against letrozole-induced polycystic ovary syndrome (PCOS). Female Wistar rats were administered letrozole (1 mg/kg/day, p.o) for 21 days, except for the control group of animals. On the 22nd day, PCOS-induced animals were segregated into 4 groups and administered with CMC, ACV, metformin, and a combination of ACV and metformin, respectively. The treatments were continued for 15 days, and on the 36th day, all the animals were sacrificed for biochemical (blood glucose, lipid profile), hormonal (sex hormones and adiponectin), and pro-inflammatory mediator estimations in blood samples. The ovarian tissue samples were used for oxidative stress parameters and histological alterations. The PCOS control animals showed a significant alteration in the estrous cycle. The administration of letrozole resulted in the alteration of hormonal balance and elevation of body weights, glycemic state, lipid profile, pro-inflammatory mediators in serum, and oxidative stress in ovarian samples. Individual treatment groups and combination treatment groups reversed the letrozole-induced alterations in PCOS animals, and more promising results were observed with combination therapy than with individual treatment groups. Further, the therapeutic potential of the combination treatment group was also confirmed by the histological observations in the ovarian samples. The study showed that the combination of ACV and metformin significantly alleviated letrozole-induced PCOS complications in rats. This might have been achieved by mitigating the hormonal imbalance, pro-inflammatory, hyperglycemic, and hyperlipidemic states in serum, and oxidative stress in the ovary samples. © 2024. The Author(s), under exclusive licence to Society for Reproductive Investigation.

This systematic review aims to provide preclinical evidence of the antimicrobial efficacy of natural endodontic solutions (NES) compared to sodium hypochlorite (NaOCl) and chlorhexidine (CHX) against Enterococcus faecalis. The study followed the PRISMA guidelines and had a registered protocol (PROSPERO - CRD42021224022). The inclusion criteria comprised ex vivo studies simulating root canal irrigation to assess the standardized mean difference of colony-forming units (CFUs). Records were systematically identified in PubMed, Scopus, EMBASE, SciELO, Web of Science, LILACS, DANS Easy, and BDTD databases in January 2024. The RoBDEMAT tool helped determine the risk of bias. As for the network meta-analysis, CFU data were collected pre- and post-irrigation protocols as an effect measure. Thirty-five studies met the eligibility criteria and were included in the qualitative analysis, and seven studies were eligible for the network meta-analysis. The total sample consisted of 1,504 root canals. Among the tested solutions, apple cider vinegar combined with 2.5% NaOCl showed the highest probability of reducing CFUs after root canal irrigation (95%CI: -0.76-0.20), followed by 2% CHX and NaOCl (considering the different concentrations [95%CI: -0.32-0.17]). The bias assessment revealed significant omissions in reporting, particularly regarding sample size calculation, sample randomization, and operator blinding. The obtained evidence demonstrated that, even though NES did not overcome NaOCl, they have antimicrobial potential against Enterococcus faecalis.

BACKGROUND: Cardiometabolic syndrome (CMS) is a set of metabolic abnormalities that are risk factors for cardiovascular disease (CVD). Apple cider vinegar (ACV) has been used in several studies as a natural agent to improve CMS risk factors. The present study aimed to perform a systematic review and meta-analysis of the effects of ACV consumption on lipid and glycemic parameters. METHODS: PubMed, Scopus, and ISI Web of Science databases were systematically searched to find clinical trials evaluating the effects of ACV consumption on CMS risk factors. RESULTS: Overall, 25 clinical trials (33 arms) comprising 1320 adults were entered in this study. ACV consumption could significantly improve the levels of FBG (-21.20 mg/dl; 95% CI: -32.31 to -2.21; I2: 95.8%), HbA1c (-0.91mg/dl; 95% CI: -1.62 to -0.21; I2: 98.9%), and TC (-6.72 mg/dl; 95% CI: -12.91 to -0.53; I2:50.8%). No significant results were observed for BMI, HOMA-IR, serum insulin, TG, LDL-C, and HDL-C. Subgroup analysis showed a significant decrease in FBG, HbA1c, TC, and TG in diabetic patients. In this type of analysis, ACV consumption significantly reduced FBG levels when administered for both duration subgroups (≥12 and <12 weeks). Moreover, in the subgroup analysis based on duration, TG concentration was significantly decreased following ACV consumption for ≥ 12 weeks. CONCLUSION: This meta-analysis showed that consumption of ACV has a favorable effect in decreasing some CMS risk factors including FBG, HbA1c, and TC.

BACKGROUND AND AIMS: There are several herbal formulations for type 2 diabetes (T2D), but many of them have never been directly compared to establish the most effective methods. Therefore, the present systematic review and network meta-analysis aimed to compare and rank the effects of herbal formulations by combining direct and indirect evidence on the management of type 2 diabetes. METHODS: From five electronic databases, relevant studies on the effectiveness of herbal formulations for glycemic status for people with type 2 diabetes were retrieved. Only randomized controlled trials that were published in English and looked at how herbal formulations affected adults' (>18-year-old) glycemic levels were included. A systematic review and network meta-analysis design with the random-effects model was used. RESULTS: A total of 44 trials included 3130 participants on six herbs were included in the final analysis. Apple cider vinegar (ACV) (standardized mean difference (SMD) = -28.99), cinnamon (-9.73), curcumin (-13.15), and fenugreek (-19.64) significantly reduced fasting blood glucose (FBG) compared with placebo (all p < 0.05). Notably, only ACV (SMD = -2.10) and fenugreek seeds (0.84) were found significantly effective in reducing HbA1C. ACV was most effective herb to reduce FBG comparison with other herbs. CONCLUSIONS: Several herbs could be considered as a valuable adjuvant therapy regarding glycemic control of type 2 diabetes patients. Health professionals should be encouraged to incorporate these herbs for the management of type 2 diabetes as part of their standard care.

BACKGROUND: 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. 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. METHODS: A 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. RESULTS: Overall, 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. CONCLUSION: We found a significant favorable effect of ACV consumption on FPG and blood lipid levels.

BACKGROUND: This study evaluates a herbal shampoo containing Gharaghorot, vinegar, and Ajwain for managing head lice, particularly in resource-limited settings. METHODS: The herbal shampoo formulation constituted 100% final solution, composed of: 28.85% Gharaghorot extract (prepared from sour yogurt juice), 67.31% apple cider vinegar, 2.88% Ajwain (Trachyspermum ammi) essential oil, and 0.96% xanthan gum (a biocompatible thickening agent). Cell toxicity and sterility were assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and fluid thioglycollate and soybean casein digest media, respectively. Irritation and sensitization tests were conducted on rabbits and guinea pigs, respectively. A randomized controlled trial with 114 patients compared the herbal shampoo to standard Permethrin treatment (Permethrin shampoo 1%). Participants applied the shampoo daily for one hour over seven days, with efficacy evaluated by counting live lice and nits before treatment, three days in, and seven days post-treatment. RESULTS: The herbal shampoo exhibited no significant cytotoxicity at concentrations of 10% or lower. The shampoo did not cause sensitization, edema, or erythema. Microbial contamination analysis showed no detectable levels of aerobic or anaerobic bacteria or fungal spores. In the human study, the intervention group showed a 0% prevalence of live lice by the seventh day, compared to 50% in the permethrin group (P= 0.021), and a significant reduction in lice eggs to 42% versus 100% in the permethrin group (P= 0.025). CONCLUSION: The herbal shampoo demonstrated safety, microbiological purity, and notable efficacy in reducing live head lice and partial effectiveness against nits (42% egg viability post-treatment).

This study evaluated the effect of apple cider vinegar (ACV) on the carcass characteristics and meat quality of broiler chickens. A total of 300 broilers (Arbor Acre) were randomized to six treatments replicated 5 times (50 birds/treatment and 10 birds/replicate) from 2 days old till the sixth week of age in a 2 by 3 factorial layout consisting of dosages (5.0 mL/L and 10.0 mL/L ACV) and administration frequency (antibiotics following standard schedule, twice/week ACV and thrice/week ACV). At the sixth week, sixty birds (10 birds/treatment) were selected for carcass yield, cut part yield, organ weight, meat technological properties, lipid profiles, and malondialdehyde (MDA) level evaluation. Data obtained were subjected to two-way ANOVA followed by Tukey's test at a P < 0.05 significant level. Birds administered 5.0 mL/L ACV thrice weekly presented a significantly (P < 0.05) higher plucked, eviscerated, dressed, thigh and breast weight compared with the other treatments. The spleen of birds in the control group was significantly (P < 0.05) heavier than those administered ACV. The meat from the 5.0 mL/L ACV group had significantly higher (P < 0.05) water absorptive power and lower refrigeration loss, as depicted in the main effect table. Meat cholesterol, phospholipids, and MDA levels did not differ across the treatments except triglyceride, which was significantly (P < 0.05) lower in the 5.0 mL/L ACV thrice-weekly group. This study concludes that ACV administration could improve carcass yield and meat quality indices. Thus, its use as an alternative to conventional antibiotics for broiler chickens might be beneficial. © 2021. The Author(s), under exclusive licence to Springer Nature B.V.

Chewing gum alleviates symptoms of gastro-esophageal reflux (GER) following a refluxogenic meal. GutsyGum(tm), a chewing gum developed to alleviate the symptoms of GER contains calcium carbonate, with a proprietary blend of licorice extract, papain, and apple cider vinegar (GiGs®). The efficacy of GutsyGum(tm) was determined in alleviating the symptoms of GER after a refluxogenic meal compared to placebo gum. This double-blind, placebo-controlled-crossover trial with a one-week washout between treatments had 24 participants with a history of GER consume a refluxogenic meal and then chew GutsyGum(tm) or placebo gum. Participants completed GER symptom questionnaires, consisting of symptom based 10 cm Visual Analogue Scales, immediately following the meal and then at regular intervals out to four hours postmeal. Adjusted mean ± SEM heartburn score (15-min postmeal to 240 min) was significantly lower in GutsyGum(tm) than in placebo gum treatment (0.81 ± 0.20 vs. 1.45 ± 0.20 cm; p = 0.034). Mean acid reflux score was significantly lower in GutsyGum(tm) than in placebo treatment (0.72 ± 0.19 vs. 1.46 ± 0.19 cm; p = 0.013). There were no significant differences for any of the secondary outcomes. However, pain approached significance with less pain reported in GutsyGum(tm) versus placebo treatment (0.4 ± 0.2 vs. 0.9 ± 0.2 cm; p = 0.081). Although nausea (p = 0.114) and belching (p = 0.154) were lower following GutsyGum(tm), the difference was not statistically significant. GutsyGum(tm) is more effective than a placebo gum in alleviating primary symptoms of heartburn and acid reflux (Clinical Trial Registration: ACTRN12612000973819).