***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The purpose of this study was to examine the effects of γ-aminobutyric acid ( GABA ) in fermented drinking water prepared from sodium glutamate , vinegar , and dried bonito ( FDWG ) compared with placebo [ vinegar and dried bonito without GABA ( FDW ) ] and its safety in normotensive and mildly or moderately hypertensive volunteers . A double-blind , placebo-controlled , r and omized study was conducted involving volunteers with normal ( group-N ) and mildly or moderately high ( group-H ) blood pressure ( BP ) . After a pretreatment period of 2 weeks ( weeks –2 ) , the subjects received FDWG or FDW for 12 weeks followed by 4 weeks of no intake ( weeks 16 ) . In group-H , both FDWG and FDW significantly decreased systolic ( SBP , −7.6 ± 4.0 and −5.5 ± 1.5 mmHg , p<0.05 , respectively ) and diastolic ( DBP , −10.6 ± 4.0 and −7.6 ± 1.7 mmHg , p<0.01 , respectively ) BP compared to the baseline ( 0-week ) value at 12 weeks , respectively . There were no abnormal changes in hematological or blood chemistry variables , urinalysis , heart rate , or body weight in the study groups . These findings indicated that vinegar and dried bonito with or without GABA might have an effect on BP in mildly or moderately hypertensive patients Abstract Aims / Introduction : The efficacy , dose – response relationship and safety of ginsam , a vinegar extract from Panax ginseng , were evaluated in an 8‐week , double‐blind , r and omized , placebo‐controlled study in drug‐naïve patients with type 2 diabetes . Material s and Methods : A total of 72 diabetic patients were r and omized to receive 1500 , 2000 or 3000 mg of ginsam , or placebo daily for 8 weeks ( n = 18 in each group ) . The primary end‐point was the changes from the baseline HbA1c level . The secondary end‐points were the changes of fasting and postpr and ial 2‐h glucose concentration , and the proportion of patients achieving a reduction in HbA1c > 0.5 % . Results : In the intention‐to‐treat analysis , ginsam treatment reduced HbA1c level significantly : −0.56 ± 0.25 % in the 1500 mg group , −0.31 ± 0.12 % in the 2000 mg group , and −0.29 ± 0.11 % in the 3000 mg group ( all P < 0.05 ) , with a significant difference between the 1500 mg ginsam and the placebo group ( −0.02 ± 0.12 % , P = 0.021 ) . The changes in fasting glucose concentration followed the same pattern : −21.40 , −14.27 and −6.76 mg/dL for 1500 , 2000 , and 3000 mg , respectively , vs −2.25 mg/dL for the placebo . The percentage of patients whose HbA1c level decreased by > 0.5 % differed significantly between the placebo group ( 11.1 % ) and the 1500 mg ( 27.8 % ) and 2000 mg ( 27.8 % ) groups . No severe adverse events were observed in any group . Conclusions : An 8‐week treatment with ginsam , a vinegar extract from P. ginseng , moderately improved HbA1c level and was well tolerated in type 2 diabetic patients with inadequate glycemic control . This trial was registered with Clinical Trial . Gov ( no. NCT01008163 ) . ( J Diabetes Invest , doi : 10.1111/j.2040‐1124.2011.00185.x , 2011 Vinegar ( VIN ) ingestion at mealtime reduces postpr and ial glycemia and may benefit individuals with diabetes ; hence , the medicinal use of VIN has increased in recent years . This study examined the safety and tolerance of medicinally ingested VIN in type 2 diabetics . Participants ( n = 27 ) were stratified by gender , age , and body mass and r and omized into three groups : commercial VIN pills ( the reference treatment [ REF ] ( 30 mg of acetic acid daily ) , pickles ( PCK ) ( approximately 1,400 mg of acetic acid daily ) , or VIN ( 2,800 mg of acetic acid daily ) . Participants continued their normal eating habits during the 12-week trial . At baseline and weeks 6 and 12 , fasting blood and urine sample s were collected , and adverse changes in bowel movements , frequency of burping or flatulence , and episodes of acid reflux were recorded . Reporting frequency for adverse events did not vary significantly by group during the trial ; however , 50 - 56 % of PCK and VIN participants reported at least one treatment-emergent adverse event at week 6 as compared to 11 % of REF participants ( P = .110 ) . Urinary pH was significantly reduced in VIN participants at week 12 as compared to the other groups ( -9 % vs. + 3 % and + 2 % for the PCK and REF groups , respectively , P = .023 ) . At week 6 there was a tendency for aspartate aminotransferase concentrations to increase in the VIN group as compared to the other groups ( + 17 % vs. + 8 % and -8 % for VIN , PCK , and REF , respectively ; P = .090 ) . These data indicate that chronic VIN ingestion may influence hepatic function and metabolic pathways aside from glucose metabolism Acetate and propionate , produced during colonic fermentation of unabsorbed carbohydrate , may influence systemic lipid metabolism . As a preliminary study to see whether colonic acetate is incorporated into plasma lipids and whether propionate inhibits this process , 5 healthy males were studied after fasting overnight . They were given , in r and om order , 12.5 mmol ( 1.05 g ) [1,2 - 13C]sodium acetate by intravenous or rectal infusion , and the rectal infusion was given with or without 6 mmol ( 0.58 g ) sodium propionate . Two hours after rectal acetate , 13C recoveries in plasma cholesterol ( 0.59 + /- 0.22 % ) and triglycerides ( 1.24 + /- 0.69 % ) were significantly greater than after intravenous acetate ( 0.09 + /- 0.12 % and 0.29 + /- 0.18 % , respectively ) . Addition of propionate reduced 13C recovery in triglycerides ( 0.19 + /- 0.06 % , P = 0.024 ) compared with rectal acetate alone , but the effect on cholesterol ( 0.26 + /- 0.05 % ) was not significant . These data suggest that incorporation of colonic acetate into plasma triglycerides is inhibited by propionate . Further studies are required to quantify the effects of colonic acetate and propionate on lipid synthesis The glycaemic index ( GI ) concept was originally introduced to classify different sources of carbohydrate (CHO)-rich foods , usually having an energy content of > 80 % from CHO , to their effect on post-meal glycaemia . It was assumed to apply to foods that primarily deliver available CHO , causing hyperglycaemia . Low-GI foods were classified as being digested and absorbed slowly and high-GI foods as being rapidly digested and absorbed , result ing in different glycaemic responses . Low-GI foods were found to induce benefits on certain risk factors for CVD and diabetes . Accordingly it has been proposed that GI classification of foods and drinks could be useful to help consumers make ' healthy food choices ' within specific food groups . Classification of foods according to their impact on blood glucose responses requires a st and ardised way of measuring such responses . The present review discusses the most relevant method ological considerations and highlights specific recommendations regarding number of subjects , sex , subject status , inclusion and exclusion criteria , pre-test conditions , CHO test dose , blood sampling procedures , sampling times , test r and omisation and calculation of glycaemic response area under the curve . All together , these technical recommendations will help to implement or reinforce measurement of GI in laboratories and help to ensure quality of results . Since there is current international interest in alternative ways of expressing glycaemic responses to foods , some of these methods are discussed Acetic acid ( AcOH ) , a main component of vinegar , recently was found to suppress body fat accumulation in animal studies . Hence we investigated the effects of vinegar intake on the reduction of body fat mass in obese Japanese in a double-blind trial . The subjects were r and omly assigned to three groups of similar body weight , body mass index ( BMI ) , and waist circumference . During the 12-week treatment period , the subjects in each group ingested 500 ml daily of a beverage containing either 15 ml of vinegar ( 750 mg AcOH ) , 30 ml of vinegar ( 1,500 mg AcOH ) , or 0 ml of vinegar ( 0 mg AcOH , placebo ) . Body weight , BMI , visceral fat area , waist circumference , and serum triglyceride levels were significantly lower in both vinegar intake groups than in the placebo group . In conclusion , daily intake of vinegar might be useful in the prevention of metabolic syndrome by reducing obesity Background / Objectives : Previous studies support the glucose-lowering effect of vinegar . However , the effect of vinegar on muscle glucose metabolism and endothelial function has not been studied in humans . This open , r and omized , crossover , placebo-controlled study aims to investigate the effects of vinegar on muscle glucose metabolism , endothelial function and circulating lipid levels in subjects with impaired glucose tolerance ( IGT ) using the arteriovenous difference technique . Subjects/ Methods : Eight subjects with IGT ( 4 males , age 46±10 years , body mass index 30±5 ) were r and omised to consume 0.50 mmol vinegar ( 6 % acetic acid ) or placebo before a mixed meal . Plasma sample s were taken for 300 min from the radial artery and the forearm vein for measurements of glucose , insulin , triglycerides , non-esterified fatty acids ( NEFAs ) and glycerol . Muscle blood flow was measured with strain gauge plethysmography . Glucose flux was calculated as the arteriovenous difference of glucose multiplied by the blood flow rates . Results : Vinegar compared with placebo : ( 1 ) decreased arterial plasma insulin ( Poverall<0.001 ; P75 min=0.014 , β=−42 ) , ( 2 ) increased forearm blood flow ( Poverall<0.001 ; P240 min=0.011 , β=1.53 ; P300 min=0.023 , β=1.37 ) , ( 3 ) increased muscle glucose uptake ( Poverall<0.001 ; P60 min=0.029 , β=2.78 ) and ( 4 ) decreased arterial plasma triglycerides ( Poverall=0.005 ; P240 min<0.001 , β=−344 ; P300 min<0.001 , β=−373 ) , without changing NEFA and glycerol . Conclusions : In individuals with IGT , vinegar ingestion before a mixed meal results in an enhancement of muscle blood flow , an improvement of glucose uptake by the forearm muscle and a reduction of postpr and ial hyperinsulinaemia and hypertriglyceridaemia . From this point of view , vinegar may be considered beneficial for improving insulin resistance and metabolic abnormalities in the atherogenic prediabetic state Objectives : The aim of the study was to evaluate the possible influence of acetic acid ( administered as vinegar ) on the postpr and ial glucose and insulin responses , and the potential involvement of a modified gastric emptying rate was studied by use of paracetamol as a marker . Design : The white bread reference meal as well as the corresponding meal supplemented with vinegar had the same content of starch , protein and fat . The meals were served in the morning after an over-night fast and in r and om order . Capillary blood sample s for analysis of glucose , insulin and paracetamol were collected postpr and ially . Setting : The study was performed at the Department of Applied Nutrition and Food Chemistry , Lund University , Sweden . Subjects : Ten healthy volunteers , seven women and three men , aged 22–51 y , with normal body mass indices were recruited . Results : The presence of acetic acid , given as vinegar , significantly reduced the postpr and ial glucose ( GI=64 ) and insulin responses ( II=65 ) to a starchy meal . As judged from lowered paracetamol levels after the test meal with vinegar , the mechanism is probably a delayed gastric emptying rate . Conclusions : Fermented foods or food products with added organic acids should preferably be included in the diet in order to reduce glycaemia and insulin dem 
    Output:
    
The findings suggest that vinegar can be effective in reducing postpr and ial glucose and insulin levels , indicating it could be considered as an adjunctive tool for improving glycemic control