Effect of apple vinegar intake on metabolic parameters and constipation in patients with schizophrenia treated with clozapine: a pilot study.

PURPOSE: Clozapine is one of the drugs that cause the highest level of weight gain. Additionally, obese patients are at higher risk of developing various physical co-morbidities, such as type 2 diabetes and cardiovascular diseases. Forty-nine percent of patients on clozapine suffer from constipation. Apple vinegar (AV) had been assigned health benefits, such as weight loss, laxative properties, blood glucose lowering effects, and reducing the risk of heart disease. Our hypothesis was that AV would lower the mean glycated haemoglobin level and reduce the level of constipation. MATERIAL AND METHODS: Pilot intervention study with a 12-week follow-up. All patients receiving clozapine treatment for schizophrenia at one outpatient clinic were eligible for inclusion. Intervention: Ten millilitres of AV diluted in 200 ml drinking water with breakfast and dinner. RESULTS: Forty patients were suitable for inclusion and nine completed the intervention. Women had much higher-than-recommended body mass index. Scores for constipation were high. The reduction in constipation was of clinical interest (2.6 (p = 0.017)). However, there were no statistically significant differences in glycated haemoglobin, cholesterol, HDL, LDL or triglyceride levels. Patients with problems of constipation prior to the intervention experienced much better bowel habits and relief of their constipation. CONCLUSION: AV lower the constipation problems faced by patients with schizophrenia treated with clozapine. Further research, repeating this pilot study with a meaningfully larger sample size and randomized with placebo, is needed.

Safety and side effects of apple vinegar intake and its effect on metabolic parameters and body weight: a systematic review.

INTRODUCTION: Apple vinegar (AV) has been proclaimed to have different health benefits, such as a weight loss, the ability to lower blood glucose levels, and reducing the risk of heart diseases. Studies on animals have demonstrated effects of AV consumption, deepening our knowledge of the beneficial effects and side effects. AIM: The aims of this study were to evaluate the evidence of the effect of AV on metabolic parameters and body weight in humans, furthermore, to evaluate the safety and side effects of ingesting AV, and additionally to evaluate the evidence of the effect of AV on metabolic parameters, safety, and side effects of AV from studies performed on animals (mammals). METHODS: A systematic literature search was performed. The databases PubMed (MEDLINE), PsycInfo (Ebsco), CINAHL (Ebsco), and Embase (Ovid) were searched for relevant articles. Primary outcomes were glycated hemoglobin, postprandial glucose, and synonyms for blood glucose. Secondary outcomes were waist circumference, visceral fat, high-density lipoprotein, low-density lipoprotein, triglycerides, and total cholesterol. Studies performed on humans and animals were included. The included studies performed on humans were quality assessed for risk of bias using a version of the Cochrane Collaboration's tool. RESULTS: A total of 487 papers were identified in the literature search. Of these, 13 studies performed on humans and 12 studies performed on animals were included. There may be beneficial health effects from the consumption of AV. The risk of side effects when ingested in recommended quantities and in recommended ways seems inconsiderable. CONCLUSION: Due to inadequate research of high quality, the evidence for the health effects of AV is insufficient. Therefore, more large-scale, long-term clinical studies with a low risk of bias are needed before definitive conclusions can be made.