Made from fermented apples and naturally high in acetic acid, apple cider vinegar has been popular in recent years for its purported health benefits – from antibacterial properties to antioxidant effects and potential for helping manage blood sugars.

Its origins as a health tonic stretch much further back. Hippocrates used it to treat wounds, fever and skin sores.

An experimental study, released today, looks into whether apple cider vinegar could be effective for weight loss, reduce blood glucose levels and reduce blood lipids (cholesterol and triglycerides).

The results suggest it could reduce all three – but it might not be as simple as downing an apple cider vinegar drink a day.

What did they do?

A group of scientists in Lebanon did a double-blinded, randomised, clinical trial in a group of overweight and obese young people aged from 12–25 years.

Researchers randomly placed 30 participants in one of four groups. The participants were instructed to consume either 5, 10 or 15ml of apple cider vinegar diluted into 250ml of water each morning before they ate anything for 12 weeks. A control group consumed an inactive drink (a placebo) made (from lactic acid added to water) to look and taste the same.

Typically this sort of study provides high quality evidence as it can show cause and effect – that is the intervention (apple cider vinegar in this case) leads to a certain outcome. The study was also double-blinded, which means neither the participants or the scientists involved with collecting the data knew who was in which group.

So, what did they find?

After a period of three months apple cider vinegar consumption was linked with significant falls in body weight and body mass index (BMI). On average, those who drank apple cider vinegar during that period lost 6–8kg in weight and reduced their BMI by 2.7–3 points, depending on the dose. They also showed significant decreases in the waist and hip circumference.

The authors also report significant decreases in levels of blood glucose, triglycerides, and cholesterol in the apple cider groups. This finding echoes previous studies. The placebo group, who were given water with lactic acid, had much smaller decreases in weight and BMI. There were also no significant decreases in blood glucose and blood lipids.

From animal studies, it is thought the acetic acid in apple cider vinegar may affect the expression of genes involved in burning fats for energy. The new study did not explore whether this mechanism was involved in any weight loss.

Is this good news?

While the study appears promising, there are also reasons for caution.

Firstly, study participants were aged from 12 to 25, so we can’t say whether the results could apply to everyone.

The statistical methods used in the study don’t allow us to confidently say the same amount of weight loss would occur again if the study was done again.

And while the researchers kept records of the participants’ diet and exercise during the study, these were not published in the paper. This makes it difficult to determine if diet or exercise may have had an impact. We don’t know whether participants changed the amount they ate or the types of food they ate, or whether they changed their exercise levels.

The study used a placebo which they tried to make identical in appearance and taste to the active treatment. But people may still be able to determine differences. Researchers may ask participants at the end of a study to guess which group they were in to test the integrity of the placebo. Unfortunately this was not done in this study, so we can’t be certain if the participants knew or not.

Finally, the authors do not report whether anyone dropped out of the study. This could be important and influence results if people who did not lose weight quit due to lack of motivation.

Any other concerns?

Apple cider vinegar is acidic and there are concerns it may erode tooth enamel. This can be a problem with any acidic beverages, including fizzy drinks, lemon water and orange juice.

To minimise the risk of acid erosion some dentists recommend the following after drinking acidic drinks:

• rinsing out your mouth with tap water afterwards
• chewing sugar-free gum afterwards to stimulate saliva production
• avoiding brushing your teeth immediately after drinking because it might damage the teeth’s softened top layer
• drink with a straw to minimise contact with the teeth.

Down the hatch?

This study provides us with some evidence of a link between apple cider vinegar and weight loss. But before health professionals can recommend this as a weight loss strategy we need bigger and better conducted studies across a wider age range.

Such research would need to be done alongside a controlled background diet and exercise across all the participants. This would provide more robust evidence that apple cider vinegar could be a useful aid for weight loss.

Still, if you don’t mind the taste of apple cider vinegar then you could try drinking some for weight loss, alongside a healthy balanced and varied dietary intake. This study does not suggest people can eat whatever they like and drink apple cider vinegar as a way to control weight.

Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Iron deficiency is common and can be debilitating. It mainly affects women. One in three premenopausal women are low in iron compared to just 5% of Australian men. Iron deficiency particularly affects teenage girls, women who do a lot of exercise and those who are pregnant.

The body needs iron to make new red blood cells, and to support energy production, the immune system and cognitive function. If you’re low, you may experience a range of symptoms including fatigue, weakness, shortness of breath, headache, irregular heartbeat and reduced concentration.

If a blood test shows you’re iron deficient, your doctor may recommend you start taking an oral iron supplement. But should you take a tablet or a liquid? With food or not? And when is the best time of day?

Here are some tips to help you work out how, when and what iron supplement to take.

How do I pick the right iron supplement?

The iron in your body is called “elemental iron”. Choosing the right oral supplement and dose will depend on how much elemental iron it has – your doctor will advise exactly how much you need.

The sweet spot is between 60-120 mg of elemental iron. Any less and the supplement won’t be effective in topping up your iron levels. Any higher and you risk gastrointestinal symptoms such as diarrhoea, cramping and stomach pain.

In Australia, iron salts are the most common oral supplements because they are cheap, effective and come in different delivery methods (tablets, capsules, liquid formulas). The iron salts you are most likely to find in your local chemist are ferrous sulfate (~20% elemental iron), ferrous gluconate (~12%) and ferrous fumarate (~33%).

These formulations all work similarly, so your choice should come down to dose and cost.

Many multivitamins may look like an iron supplement, but it’s important to note they usually have too little iron – usually less than 20 mg – to correct an iron deficiency.

Should I take tablets or liquid formulas?

Iron contained within a tablet is just as well absorbed as iron found in a liquid supplement. Choosing the right one usually comes down to personal preference.

The main difference is that liquid formulas tend to contain less iron than tablets. That means you might need to take more of the product to get the right dose, so using a liquid supplement could work out to be more expensive in the long term.

What should I eat with my iron supplement?

Research has shown you will absorb more of the iron in your supplement if you take it on an empty stomach. But this can cause more gastrointestinal issues, so might not be practical for everyone.

If you do take your supplement with meals, it’s important to think about what types of food will boost – rather than limit – iron absorption. For example, taking the supplement alongside vitamin C improves your body’s ability to absorb it.

Some supplements already contain vitamin C. Otherwise you could take the supplement along with a glass of orange juice, or other vitamin C-rich foods.

On the other hand, tea, coffee and calcium all decrease the body’s ability to absorb iron. So you should try to limit these close to the time you take your supplement.

Should I take my supplement in the morning or evening?

The best time of day to take your supplement is in the morning. The body can absorb significantly more iron earlier in the day, when concentrations of hepcidin (the main hormone that regulates iron) are at their lowest.

Exercise also affects the hormone that regulates iron. That means taking your iron supplement after exercising can limit your ability to absorb it. Taking your supplement in the hours following exercise will mean significantly poorer absorption, especially if you take it between two and five hours after you stop.

Our research has shown if you exercise every day, the best time to take your supplement is in the morning before training, or immediately after (within 30 minutes).

My supplements are upsetting my stomach. What should I do?

If you experience gastrointestinal side effects such as diarrhoea or cramps when you take iron supplements, you may want to consider taking your supplement every second day, rather than daily.

Taking a supplement every day is still the fastest way to restore your iron levels. But a recent study has shown taking the same total dose can be just as effective when it’s taken on alternate days. For example, taking a supplement every day for three months works as well as every second day for six months. This results in fewer side effects.

Oral iron supplements can be a cheap and easy way to correct an iron deficiency. But ensuring you are taking the right product, under the right conditions, is crucial for their success.

It’s also important to check your iron levels prior to commencing iron supplementation and do so only under medical advice. In large amounts, iron can be toxic, so you don’t want to be consuming additional iron if your body doesn’t need it.

If you think you may be low on iron, talk to your GP to find out your best options.

Alannah McKay, Postdoctoral Research Fellow, Sports Nutrition, Australian Catholic University

This article is republished from The Conversation under a Creative Commons license. Read the original article.