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DK Garden's avatar

I’m wondering the same thing as Heather: how could/should we use ACV in a healthy diet to gain blood sugar benefits?

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DevonshireDozer's avatar

I do intermittent fasting, avoiding much carb intake, either;

1. A couple of days a week when I might have (<500C total within a 36h period) an egg, maybe a slice of ham, tomatoes & spiralised courgette with a bit of curry powder to spice it up

OR

2. Maybe once a month a 72h fast when I only drink sparkling mineral water with a few spoonsful of apple cider vinegar to give it some flavour.

There is no real science behind this, no blood tests or other objective measures. I just do it because I feel better for it - which, of course, could all be in the mind - and it seems to stabilise my weight. I'm a 72 year old male, about 150lb.

Presently 19 days post op THR, so decided fasting was trumped by the need to help healing with some fuel energy. Consequently pigging out on fish & chips, pasties & full English breakfasts. The only vinegar I'm consuming is sprinkled on my fish & chips - enough to dissolve the ample shakings of salt. I'm planning to return to my usual routine 6 weeks post op, probably with a 72h fast. Again - no science, just an arbitrary choice.

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Elisabeth Donati's avatar

I so wish I understood this. LOL

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Chris Masterjohn, PhD's avatar

4-17 tbsp ACV can induce ketosis, more is too much, you can add 1/4 tsp baking soda per tbsp ACV to neutralize acidity, cut back if glucose rises, ketones don't rise, or any lighteheadedness low blood pressure or flushing occur.

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Sandra J's avatar

Just to say that Mercola is now saying that if you eat much more than roughly 30% of your calories as fat/oil, then your cells will have to burn fat rather than carbs. In this case it's not too many carbs preventing ketosis but too much fat/oil preventing glycolysis (I mean burning glucose). It also means, presumably, that if you eat over 60% of your calories as glucose, then you won't burn fat. So there is this kind of exclusion factor. He has also changed his mind on the benefit of ketosis because (e.g. the work of Peat) it seems certain that burning fat is both inefficient and inflammatory and will deteriorate the body/metabolism. Consequently he has stopped ketosis.

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Heather B's avatar

If someone is not on a strictly ketogenic diet, can ACV be used in these doses to lower blood sugar? Should the ACV be taken with food or apart from food?

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Chris Masterjohn, PhD's avatar

Taking ACV with food has been shown to lower the blood sugar response.

This is probably related to the digestive process and unrelated to the additional fact that generating ketones lowers blood sugar by suppressing hepatic glucose output.

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kobreeding's avatar

Me too. I am not trying to be ketogenic but to just keep blood sugar within a healthy range. My A1c tends to be higher than it should be (almost pre-diabetic range). Being low-carb didn't seem to help me much. I'm still trying to figure out how to get my body to use the carbs for energy and efficient metabolism. So understanding if ACV can possibly help maintain blood sugar levels would be great. Thank you

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Ministry of Truth's avatar

Is there a way to use this practically? Say I for some reason want to "switch" from glucose to ketones can I make the transition easier by getting some ketones through vinegar while the body switches from drawing down glycogen to producing ketones?

I know some people take exogenous ketones (which taste like half-digested vomit) for cognitive benefits.

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Chris Masterjohn, PhD's avatar

I'm going to write about the practical aspects of why you would want to use it as one of the five ways to get into ketosis.

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Susan F.'s avatar

Oh well no one else seems here. I got to the point of trying the Braggs ACV mixed with baking soda up to half a tsp. Baking soda for Each tbls. Of vinegar. I’m not convinced taking more than 3 tbls. a day of this concoction would be safe - maybe too much B.S. ( a pun?). Would it raise blood pressure? Would it despite the supposed neutrality erode esophagus? I’m waiting for some better ph strips as my hot tub strips ph wasn’t low enough to register the acidity with 1/4 tsp. B.S. Also my glucose seems rather high and ketones not affected yet. But how long is it supposed to take ( assuming this “low” of dose does anything which it is supposed to according to general literature). Immediately, days, weeks? And would anyone consider drinking more than this in the long term? Sustainable or would it subtly start screwing blood chemistry? I’m watching my resting heart rate but it normally bounces around. I also take it with DAO enzyme for what that is worth and sometimes throw in Zyrtec because I’m concerned about histamine. Actually Braggs is on the low side for histamine but vinegar is a histamine liberator and I’m not sure if DAO can do anything about that if it liberates histamine elsewhere in the body. Anyone? Chris? Thanks!

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Chris Masterjohn, PhD's avatar

Hi Susan,

If concerned about a blood pressure response, you could use half or all potassium bicarbonate:

https://www.amazon.com/Potassium-Bicarbonate-Powder-Plants-Cookies/dp/B0CKXJFLTJ/ref=sr_1_2?crid=3KNHCISVSC7JZ&dib=eyJ2IjoiMSJ9.nt-7cU9F5Ww6PGOR8VnKMqziKG0B5xcwrHEYa9N6kMgSvB3Wd1nCx8WyUyJd8bcaU0kjYJs80-r2GwCiaYYeFTnMhnUIep8y3U4AAwlo1SJDXBNkp20ufXH3EXmIaBTh2yoEcXZ6ecvezvDi30VS0xnER_l-zL_x2kTkMrU2pO7edehJjkRPvFrO3yWUrX9kDJu4B0bbXcxpKR3hbJqSUePe-gLQ42vbnXBfLSJWnn8.NuzorICxR0Tz7PhtrtX-t4he-1vsXG5qhmG9KWBwHWU&dib_tag=se&keywords=potassium+bicarbonate&qid=1716853572&sprefix=potassium+bicarbonat%2Caps%2C96&sr=8-2

Neutrality is neutrality. Once the bicarbonate reacts with the H+ it makes water and there is no acidity. There's nothing supposed about it. It can't possibly erode the esophagus if the solution is neutral.

I think it would be within days to see a rise in ketones. I also think if your glucose is rising and it's clearly driven by the ACV you should back off of it.

However, it might be hard to figure out what it's doing if it's creating a histamine response and you're taking antihistamines at the same time.

There's a new supplement out that achieves a similar goal through different means and you might want to try it instead of the vinegar:

https://idealabs.ecwid.com/Pyrucet-p130023750

Some diabetics have tried this and reported it helping their blood sugar. It wouldn't have any histamine so it might work better for you.

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Energetica's avatar

Another random thought. 1ml of ethanol is converted into 1 ml of acetate in the blood.

In other words. Instead of say eating 2 tablespoons of acetate with every meal (6 tbsp a day).

Eating 2 tablespoons of "beer" with every meal will have the same effect on your blood acetate levels...

So is drinking microdoses of alcohol with every meal not very ketogenic then?

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Chris Masterjohn, PhD's avatar

Alcohol is ketogenic. This is why alcoholic ketoacidosis exists.

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Energetica's avatar

Pectin gets metabolized into acetic acid in the colon. I wonder if we could raise acetic acid significantly by supplementing pectin.

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Chris Masterjohn, PhD's avatar

Maybe but the acetate in the colon is probably getting entirely metabolized by colonocytes to the extent it is left over after cross-feeding between microbes and most likely most of it is actually converted to butyrate before reaching the colon cells.

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Energetica's avatar

I found a 1985 study, that answers this question in great detail:

https://dm5migu4zj3pb.cloudfront.net/manuscripts/111000/111847/cache/111847.1-20201218131445-covered-e0fd13ba177f913fd3156f593ead4cfd.pdf

A 30 mmol dose acetate (2.4 table spoons of ACV) raised fasting blood acetate from 54 umol/L to a peak of 194 umol/L at 45 min and returned to fasting level at 2h.

Blood acetate also rose in response to 20g lactulose, peak levels occurring 2-4 h after the dose at 181 umol/liter. After 6 hours it was still around 100 umol/L still.

Pectin fermentation (20 gram) was much slower, with blood acetate levels starting to rise after 6 h and remaining elevated at about twice fasting levels for the subsequent 18 h. However, areas under the blood acetate curves were closely related whatever the source of acetate.

20 gram lactulose reaches a similar peak as 30mmol acetate, but it sustains it 3 times longer, so might be similar to 90mmol (7.2 tbsp ACV) slowly released acetate.

And then to answer my question:

20 gram of pectin will be similar to 7.2 tbsp of very slowly released ACV

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Chris Masterjohn, PhD's avatar

Nice find!

If this is the human study you mentioned in your other comment I hadn't seen this post till now.

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Energetica's avatar

Yes this is the one!

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Energetica's avatar

Another study showing that most butyrate and propionate are used in the liver, but acetate is leaving the liver in high concentrations and ends up in the blood:

https://sci-hub.se/10.1136/gut.28.10.1221

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Chris Masterjohn, PhD's avatar

It's something around 70% in the gut, 29% in the liver.

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Energetica's avatar

Actually I found a study that a high fiber diet doubles (!) the blood serum levels of acetate:

https://www.nature.com/articles/ncomms8320

Here is the specific graph:

https://media.springernature.com/full/springer-static/image/art%3A10.1038%2Fncomms8320/MediaObjects/41467_2015_Article_BFncomms8320_Fig1_HTML.jpg

Also another interesting study:

https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.116.024545

Showing that acetate supplementation has similar effects as a high fiber diet. The mechanism proposed is that one of the key beneficial effects of a high-fiber diet is having a constant acetic acid supply:

"A diet high in fiber led to changes in the gut microbiota

that played a protective role in the development of cardiovascular

disease. The favorable effects of fiber may be explained by the

generation and distribution of one of the main metabolites of the gut

microbiota, the short-chain fatty acid acetate. Acetate effected several

molecular changes associated with improved cardiovascular health and

function."

"We found that high consumption of fiber modified the gut

microbiota populations and increased the abundance of acetate-producing

bacteria independently of mineralocorticoid excess. Both fiber and

acetate decreased gut dysbiosis, measured by the ratio of Firmicutes to

Bacteroidetes, and increased the prevalence of Bacteroides acidifaciens.

Compared with mineralocorticoid-excess mice fed a control diet, both

high-fiber diet and acetate supplementation significantly reduced systolic

and diastolic blood pressures, cardiac fibrosis, and left ventricular

hypertrophy. Acetate had similar effects and markedly reduced renal

fibrosis. Transcriptome analyses showed that the protective effects

of high fiber and acetate were accompanied by the downregulation of

cardiac and renal Egr1, a master cardiovascular regulator involved in

cardiac hypertrophy, cardiorenal fibrosis, and inflammation. We also

observed the upregulation of a network of genes involved in circadian

rhythm in both tissues and downregulation of the renin-angiotensin

system in the kidney and mitogen-activated protein kinase signaling in the

heart."

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Chris Masterjohn, PhD's avatar

Interesting. The mouse study abstract says "high fiber/acetate" did they feed fiber without acetate? Unclear from abstract.

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Energetica's avatar

Yes, a placebo group, high fiber group and a seperate acetate group (200mMol/L). So around 60mg a day. Which might translate to around 6g for humans or 8 tbsp ACV. (Scaled to human dose as calories).

The acetate was more effective than the high-fiber diet in some remarks, for example, it prevented kidney fibrosis which the high fiber diet didn't. Both prevented high blood pressure and cardiac fibrosis.

The acetic acid prevented gut dysbiosis, similarly to the high fiber diet. But it was more effective in preventing the overgrowth of Enterobacteriaceae, a gamma-proteobacteria.

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Chris Masterjohn, PhD's avatar

Got it. Well, unfortunately this doesn't provide any utility because rats and mice eat their feces:

https://chrismasterjohnphd.substack.com/p/the-greatest-error-in-microbiome

So you'd need either a human study or a rodent study where measures were taken to eliminate coprophagy.

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Energetica's avatar

Fascinating. The other study I posted a hour ago was in humans though. And shows that 20g pectin is comparable with around 7 tbsp of slowly released ACV (6 hour delay and released then in around 12 hours)

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