{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T17:53:50Z","timestamp":1782410030244,"version":"3.54.5"},"reference-count":66,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>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 (\u226518 years) evaluating the effects of ACV for \u22654 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: \u22120.39; 95% CI: \u22120.63, \u22120.15; p = 0.001; I2 = 62%], BMI [SMD: \u22120.65; 95% CI: \u22121.05, \u22120.26; p = 0.001; I2 = 83%], and WC [SMD: \u22120.34; 95% CI: \u22120.67, \u22120.02; 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\u2019s 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.<\/jats:p>","DOI":"10.3390\/nu17183000","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T12:33:32Z","timestamp":1758285212000},"page":"3000","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of Apple Cider Vinegar Intake on Body Composition in Humans with Type 2 Diabetes and\/or Overweight: A Systematic Review and Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9136-2055","authenticated-orcid":false,"given":"Alberto","family":"Castagna","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences, University \u201cMagna Gr\u00e6cia\u201d, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7503-6188","authenticated-orcid":false,"given":"Yvelise","family":"Ferro","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University \u201cMagna Gr\u00e6cia\u201d, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9293-1433","authenticated-orcid":false,"given":"Francesca Rita","family":"Noto","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University \u201cMagna Gr\u00e6cia\u201d, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1439-7103","authenticated-orcid":false,"given":"Rossella","family":"Bruno","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University \u201cMagna Gr\u00e6cia\u201d, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Analucia","family":"Aragao Guimaraes","sequence":"additional","affiliation":[{"name":"O.U. Clinical Nutrition, \u201cRenato Dulbecco\u201d Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8854-5854","authenticated-orcid":false,"given":"Carmelo","family":"Pujia","sequence":"additional","affiliation":[{"name":"O.U. Clinical Nutrition, \u201cRenato Dulbecco\u201d Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3198-7090","authenticated-orcid":false,"given":"Elisa","family":"Mazza","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University \u201cMagna Gr\u00e6cia\u201d, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7644-1337","authenticated-orcid":false,"given":"Samantha","family":"Maurotti","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University \u201cMagna Gr\u00e6cia\u201d, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7048-5830","authenticated-orcid":false,"given":"Tiziana","family":"Montalcini","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University \u201cMagna Gr\u00e6cia\u201d, 88100 Catanzaro, Italy"},{"name":"Research Center for the Prevention and Treatment of Metabolic Diseases, University \u201cMagna Gr\u00e6cia\u201d, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Pujia","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University \u201cMagna Gr\u00e6cia\u201d, 88100 Catanzaro, Italy"},{"name":"Research Center for the Prevention and Treatment of Metabolic Diseases, University \u201cMagna Gr\u00e6cia\u201d, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/S0140-6736(22)02576-4","article-title":"The Lancet Commission on 21st-Century Global Health Threats","volume":"401","author":"Kanem","year":"2023","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/S2213-8587(23)00129-8","article-title":"Disparities in Diabetes Prevalence and Management by Race and Ethnicity in the USA: Defining a Path Forward","volume":"11","author":"Hassan","year":"2023","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_3","unstructured":"Lobstein, T., Jackson-Leach, R., Powis, J., and Brinsden, H. (2025, May 16). World_Obesity_Atlas_2023_Report. Available online: https:\/\/www.worldobesityday.org\/assets\/downloads\/World_Obesity_Atlas_2023_Report.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s10198-021-01358-1","article-title":"The Economic Burden of Obesity in Italy: A Cost-of-Illness Study","volume":"23","author":"Pavlova","year":"2022","journal-title":"Eur. J. Health. Econ."},{"key":"ref_5","unstructured":"GBD 2021 Diabetes Collaborators (2023). Global, Regional, and National Burden of Diabetes from 1990 to 2021, with Projections of Prevalence to 2050: A Systematic Analysis for the Global Burden of Disease Study 2021. Lancet, 402, 203\u2013234."},{"key":"ref_6","unstructured":"NCD Risk Factor Collaboration (NCD-RisC) (2024). Worldwide Trends in Underweight and Obesity from 1990 to 2022: A Pooled Analysis of 3663 Population-Representative Studies with 222 Million Children, Adolescents, and Adults. Lancet, 403, 1027\u20131050."},{"key":"ref_7","unstructured":"GBD 2021 Adolescent BMI Collaborators (2025). Global, Regional, and National Prevalence of Child and Adolescent Overweight and Obesity, 1990-2021, with Forecasts to 2050: A Forecasting Study for the Global Burden of Disease Study 2021. Lancet, 405, 785\u2013812."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Lin, X., and Li, H. (2021). Obesity: Epidemiology, Pathophysiology, and Therapeutics. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.706978"},{"key":"ref_9","unstructured":"Lopez-Jimenez, F., Cesare, M.D., Powis, J., Shrikhande, S., Codato, E., Zhou, B., Bixby, H., Adeoye, M., Evans, N., and Lara-Breitinger, K. (2025, May 16). World_Heart_Report_2025_Online Version. Available online: https:\/\/world-heart-federation.org\/wp-content\/uploads\/World_Heart_Report_2025_Online-Version.pdf."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1038\/s41571-021-00514-z","article-title":"Planning for Tomorrow: Global Cancer Incidence and the Role of Prevention 2020\u20132070","volume":"18","author":"Soerjomataram","year":"2021","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S288","DOI":"10.37765\/ajmc.2022.89292","article-title":"A Review of Current Guidelines for the Treatment of Obesity","volume":"28","author":"Cornier","year":"2022","journal-title":"Am. J. Manag. Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"101882","DOI":"10.1016\/j.eclinm.2023.101882","article-title":"Pharmacotherapy of Obesity: An Update on the Available Medications and Drugs Under Investigation","volume":"58","author":"Chakhtoura","year":"2023","journal-title":"EClinicalMedicine"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1093\/ajcn\/74.5.579","article-title":"Long-Term Weight-Loss Maintenance: A Meta-Analysis of US Studies","volume":"74","author":"Anderson","year":"2001","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"g2646","DOI":"10.1136\/bmj.g2646","article-title":"Long Term Maintenance of Weight Loss with Non-Surgical Interventions in Obese Adults: Systematic Review and Meta-Analyses of Randomised Controlled Trials","volume":"348","author":"Dombrowski","year":"2014","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"47","DOI":"10.9778\/cmajo.20140050","article-title":"Strategies for Weight Maintenance in Adult Populations Treated for Overweight and Obesity: A Systematic Review and Meta-Analysis","volume":"3","author":"Peirson","year":"2015","journal-title":"CMAJ Open"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Kosmalski, M., Deska, K., Bak, B., Rozycka-Kosmalska, M., and Pietras, T. (2023). Pharmacological Support for the Treatment of Obesity-Present and Future. Healthcare, 11.","DOI":"10.3390\/healthcare11030433"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3199","DOI":"10.2147\/DMSO.S311359","article-title":"Cardiovascular Safety and Superiority of Anti-Obesity Medications","volume":"14","author":"Alobaida","year":"2021","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"bvad016","DOI":"10.1210\/jendso\/bvad016","article-title":"Adverse Events Related to Tirzepatide","volume":"7","author":"Mishra","year":"2023","journal-title":"J. Endocr. Soc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.ajem.2024.10.050","article-title":"High Risk and Low Incidence Diseases: Bariatric Surgery Complications","volume":"87","author":"Farooqi","year":"2025","journal-title":"Am. J. Emerg. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S2213-8587(24)00316-4","article-title":"Definition and Diagnostic Criteria of Clinical Obesity","volume":"13","author":"Rubino","year":"2025","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Narain, K., and Scannell, C. (2024). Exploring Racial and Ethnic Differences in Utilization of Medications for Obesity Management in a Nationally Representative Survey. J. Racial Ethn. Health Disparities.","DOI":"10.1007\/s40615-024-02248-x"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.gtc.2023.02.003","article-title":"Disparities in Access and Quality of Obesity Care","volume":"52","author":"Washington","year":"2023","journal-title":"Gastroenterol. Clin. N. Am."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Hidalgo-Lozada, G.M., Villarruel-Lopez, A., Nuno, K., Garcia-Garcia, A., Sanchez-Nuno, Y.A., and Ramos-Garcia, C.O. (2024). Clinically Effective Molecules of Natural Origin for Obesity Prevention or Treatment. Int. J. Mol. Sci., 25.","DOI":"10.20944\/preprints202401.2175.v1"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Park, J., Nurkolis, F., Won, H., Yang, J., Oh, D., Jo, H., Choi, J., Chung, S., Kurniawan, R., and Kim, B. (2023). Could Natural Products Help in the Control of Obesity? Current Insights and Future Perspectives. Molecules, 28.","DOI":"10.3390\/molecules28186604"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e13493","DOI":"10.1016\/j.heliyon.2023.e13493","article-title":"A Comprehensive Review on Clinically Proven Medicinal Plants in the Treatment of Overweight and Obesity, with Mechanistic Insights","volume":"9","author":"Aziz","year":"2023","journal-title":"Heliyon"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1080\/10408398.2023.2277353","article-title":"Polyphenolic Profile, Processing Impact, and Bioaccessibility of Apple Fermented Products","volume":"65","author":"Kucukgoz","year":"2025","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1093\/jn\/132.2.172","article-title":"Polyphenols from Alcoholic Apple Cider are Absorbed, Metabolized and Excreted by Humans","volume":"132","author":"DuPont","year":"2002","journal-title":"J. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Arjmandfard, D., Behzadi, M., Sohrabi, Z., and Mohammadi Sartang, M. (2025). Effects of Apple Cider Vinegar on Glycemic Control and Insulin Sensitivity in Patients with Type 2 Diabetes: A GRADE-Assessed Systematic Review and Dose-Response Meta-Analysis of Controlled Clinical Trials. Front. Nutr., 12.","DOI":"10.3389\/fnut.2025.1528383"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"102176","DOI":"10.1016\/j.eujim.2022.102176","article-title":"Effects of Vinegar Consumption on Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"55","author":"Sohouli","year":"2022","journal-title":"Eur. J. Integr. Med."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Hadi, A., Pourmasoumi, M., Najafgholizadeh, A., Clark, C.C.T., and Esmaillzadeh, A. (2021). The Effect of Apple Cider Vinegar on Lipid Profiles and Glycemic Parameters: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. BMC Complement. Med. Ther., 21.","DOI":"10.1186\/s12906-021-03351-w"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1089\/jmf.2017.0039","article-title":"Apple Cider Vinegar Attenuates Oxidative Stress and Reduces the Risk of Obesity in High-Fat-Fed Male Wistar Rats","volume":"21","author":"Halima","year":"2018","journal-title":"J. Med. Food"},{"key":"ref_32","first-page":"e373","article-title":"Modulation of the Intestinal Microbiota by Apple Cider Vinegar in Rats Subjected to Cafeteria Diet","volume":"11","author":"Bouderbala","year":"2019","journal-title":"Arch. Cardiovasc. Dis. Suppl."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2273","DOI":"10.1007\/s00394-020-02214-3","article-title":"Safety and Side Effects of Apple Vinegar Intake and its Effect on Metabolic Parameters and Body Weight: A Systematic Review","volume":"59","author":"Launholt","year":"2020","journal-title":"Eur. J. Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.2174\/0929867331666230822102021","article-title":"The Effects of Apple Cider Vinegar on Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis of Clinical Trials","volume":"32","author":"Tehrani","year":"2025","journal-title":"Curr. Med. Chem."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2019). Cochrane Handbook for Systematic Reviews of Interventions, Wiley.","DOI":"10.1002\/9781119536604"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane Collaboration\u2019s Tool for Assessing Risk of Bias in Randomised Trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e66887","DOI":"10.2196\/66887","article-title":"The Role of Mobile Apps in Obesity Management: Systematic Review and Meta-Analysis","volume":"27","author":"Pujia","year":"2025","journal-title":"J. Med. Internet Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"38","DOI":"10.9734\/afsj\/2024\/v23i3705","article-title":"Apple Cider Vinegar Effervescent Tablets on Gut Health, Obesity and User Experience: An Observation","volume":"23","author":"Kannan","year":"2024","journal-title":"AFSJ"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.1271\/bbb.90231","article-title":"Vinegar Intake Reduces Body Weight, Body Fat Mass, and Serum Triglyceride Levels in Obese Japanese Subjects","volume":"73","author":"Kondo","year":"2009","journal-title":"Biosci. Biotechnol. Biochem."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Mahdavi-Roshan, M., Salari, A., Emaminejad, S., Parvinroo, S., Ashouri, A., Alizadeh, I., and Medicine, I. (2021). The Effect of Oxymel Syrup on some Cardiovascular Risk Factors in Overweight and Obese People: A Randomized Controlled Trial Study. Tradit. Integr. Med., 6.","DOI":"10.18502\/tim.v6i3.7307"},{"key":"ref_42","first-page":"1","article-title":"Comparison of Apple Cider Vinegar and Metformin Combination with Metformin Alone in Newly Diagnosed Type 2 Diabetic Patients: A Randomized Controlled Trial","volume":"9","author":"Abid","year":"2020","journal-title":"Int. J. Med. Res. Health Sci."},{"key":"ref_43","first-page":"206","article-title":"Assessment of hypoglycemic effects of apple cider vinegar in type 2 diabets","volume":"4","author":"Nazni","year":"2015","journal-title":"Int. J. Food Nutr. Sci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1136\/bmjnph-2023-000823","article-title":"Apple Cider Vinegar for Weight Management in Lebanese Adolescents and Young Adults with Overweight and Obesity: A Randomised, Double-Blind, Placebo-Controlled Study","volume":"7","author":"Andary","year":"2024","journal-title":"BMJ Nutr. Prev. Health."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Jafarirad, S., Elahi, M., Mansoori, A., Khanzadeh, A., and Haghighizadeh, M. (2023). The Improvement Effect of Apple Cider Vinegar as a Functional Food on Anthropometric Indices, Blood Glucose and Lipid Profile in Diabetic Patients: A Randomized Controlled Clinical Trial. Front. Clin. Diabetes Healthc., 4.","DOI":"10.3389\/fcdhc.2023.1288786"},{"key":"ref_46","first-page":"149","article-title":"Effect of Apple Cider Vinegar in Type 2 Diabetic Patients with Poor Glycemic Control: A Randomized Placebo Controlled Design \u00ae","volume":"8","author":"Kausar","year":"2019","journal-title":"Int. J. Med. Res. Health Sci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jff.2018.02.003","article-title":"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","volume":"43","author":"Khezri","year":"2018","journal-title":"J. Funct. Foods"},{"key":"ref_48","first-page":"1453","article-title":"Apple Cider Vinegar Ameliorates Hyperglycemia and Hyperlipidemia in Tunisian Type 2 Diabetic Patients","volume":"5","author":"Sarra","year":"2017","journal-title":"Int. J. Multidiscip. Curr. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"286","DOI":"10.53350\/pjmhs22167286","article-title":"Effect of the Apple Cider Vinegar on Weight Management, Blood Glucose Levels and Lipid Profile among Obese\/Overweight Adults: A Randomised Control Trial","volume":"16","author":"Khalid","year":"2022","journal-title":"Pak. J. Med. Health Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1","DOI":"10.9734\/jpri\/2019\/v31i630376","article-title":"Evaluating the Synergistic Activity of Metformin and Apple Cider Vinegar in Type 2 Diabetics","volume":"31","author":"Abid","year":"2020","journal-title":"J. Pharm. Res. Int."},{"key":"ref_51","first-page":"723","article-title":"Apple Cider Vinegar Effect on Lipid Profile in Prediabetics","volume":"49","author":"Junejo","year":"2024","journal-title":"Rawal Med. J."},{"key":"ref_52","first-page":"968","article-title":"Effects of Apple Cider Vinegar on Diabetic and Obese Patients","volume":"12","author":"Pusparatha","year":"2019","journal-title":"Drug Invent. Today"},{"key":"ref_53","first-page":"277","article-title":"Investigation of Medicinal Properties and Chemical and Biochemical Characterization of Apple Cider Vinegar for Anti-Hyperuricemia in Female Human Subjects in Controlled Randomized Trial","volume":"36","author":"Shahzad","year":"2023","journal-title":"Pak. J. Pharm. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.clnesp.2019.06.006","article-title":"The Effect of Apple Vinegar Consumption on Glycemic Indices, Blood Pressure, Oxidative Stress, and Homocysteine in Patients with Type 2 Diabetes and Dyslipidemia: A Randomized Controlled Clinical Trial","volume":"33","author":"Gheflati","year":"2019","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_55","first-page":"1543","article-title":"The Effect of Apple Vinegar on Lipid Profiles and Anthropometric Indices in Type 2 Diabetes Patients with Dyslipidemia: A Randomized Clinical Trial","volume":"22","author":"Bashiri","year":"2014","journal-title":"J. Shahid Sadoughi Univ. Med. Sci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2319","DOI":"10.1002\/oby.21358","article-title":"Is 5% Weight Loss a Satisfactory Criterion to Define Clinically Significant Weight Loss?","volume":"23","author":"Williamson","year":"2015","journal-title":"Obesity"},{"key":"ref_57","first-page":"2141","article-title":"Antidiabetic and Hypocholesrolemic Effect of Different Types of Vinegar in Rats","volume":"9","author":"Sahar","year":"2012","journal-title":"Life Sci. J."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Hlebowicz, J., Darwiche, G., Bjorgell, O., and Almer, L. (2007). Effect of Apple Cider Vinegar on Delayed Gastric Emptying in Patients with Type 1 Diabetes Mellitus: A Pilot Study. BMC Gastroenterol., 7.","DOI":"10.1186\/1471-230X-7-46"},{"key":"ref_59","first-page":"1025","article-title":"Inhibition of Gastric Emptying by Acids Depends on pH, Titratable Acidity, and Length of Intestine Exposed to Acid","volume":"259","author":"Lin","year":"1990","journal-title":"Am. J. Physiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"275","DOI":"10.4093\/dmj.2012.36.4.275","article-title":"Balsamic Vinegar Improves High Fat-Induced Beta Cell Dysfunction Via Beta Cell ABCA1","volume":"36","author":"Seok","year":"2012","journal-title":"Diabetes Metab. J."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s00592-010-0184-6","article-title":"White Rice Vinegar Improves Pancreatic Beta-Cell Function and Fatty Liver in Streptozotocin-Induced Diabetic Rats","volume":"49","author":"Gu","year":"2010","journal-title":"Acta Diabetol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1271\/bbb.80634","article-title":"Effects of Acetate on Lipid Metabolism in Muscles and Adipose Tissues of Type 2 Diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) Rats","volume":"73","author":"Yamashita","year":"2009","journal-title":"Biosci. Biotechnol. Biochem."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1271\/bbb.60668","article-title":"Improvement of Obesity and Glucose Tolerance by Acetate in Type 2 Diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) Rats","volume":"71","author":"Yamashita","year":"2007","journal-title":"Biosci. Biotechnol. Biochem."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1023\/B:REMD.0000021433.63915.bb","article-title":"AMP-Activated Protein Kinase: A Master Switch in Glucose and Lipid Metabolism","volume":"5","year":"2004","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"100566","DOI":"10.1016\/j.crfs.2023.100566","article-title":"Beneficial Effect of Vinegar Consumption Associated with Regulating Gut Microbiome and Metabolome","volume":"8","author":"Xia","year":"2023","journal-title":"Curr. Res. Food Sci."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1093\/nutrit\/nuad163","article-title":"Anthropometric and Cardiometabolic Effects of Polyphenols in People with Overweight and Obesity: An Umbrella Review","volume":"82","author":"Chew","year":"2024","journal-title":"Nutr. 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