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Post-mealWalking vs. Pre-meal Vinegar Ingestion: Strategies to Reduce Postprandial Hyperglycemia    
University of Florida
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Postprandial hyperglycemia is a risk factor for cardiovascular events. Independent of fasting blood glucose, impaired glucose tolerance predicts mortality. Lifestyle interventions that blunt the postprandial glucose spike are healthy overall and may  reduce diabetic and CVD risk in at-risk populations. Apple cider vinegar has been shown to attenuate the rise in glucose following a meal. Similarly, aerobic exercise (walking) reduces blood glucose levels when performed before or following a high-glycemic meal. This study aimed to compare these interventions in terms of their ability to reduce postprandial glucose (BG) in older adults. Furthermore, we investigated whether this population would self-select a walking speed sufficient to reduce their postprandial BG spike. All participants (n=12) reported for testing on 2 occasions. A subset (n=5) completed a third visit. Participants arrived following a 3 hour fast. Baseline glucose was measured upon arrival, after which participants completed on 1 of the following 2 conditions in a randomized, crossover order: (1) Consumption of standard meal with either (1) addition of apple cider vinegar (V) (.3g/kg BW) or (2) 15 minutes of self-paced walking following the meal (W). The subset engaged in a third condition (C) (3) Consumption of meal followed by 2 hours of little to no activity to highlight the efficacy of the meal to induce a spike in glucose. BG was taken by finger stick at 30, 60, 90, and 120 minutes following meal consumption. The meal was designed to be high glycemic-index (GI) and included a bagel, butter, and orange juice. Total energy content of the meal was 470kcal (79g CHO [28gsugar], 12g FAT, 1g PRO). The control trial confirmed the ability of the meal to spike BG as levels rose following the meal at 30 (167.8±6.1 vs. 91.8±2.4; p<.005) and 60 minutes (172.8±11.8 vs. 91.8± 2.4; p<.05). There was no difference in BG area under the curve (AUC) at any time point between conditions. However, following both vinegar and walking, the absolute increase in BG at 30 minutes following the meal was significantly reduced compared to control (∆30BG in C 76.1±7.0 vs. V 46.8±9.2 vs. W 44.3±7.5; p<.05 for all). Speed was found to be correlated with glucose AUC, such that an increase in walking speed was associated with a greater reduction in 2-hour glucose AUC (R=.590, p<.05). Lifestyle interventions such as walking and vinegar ingestion may be effective in acutely lowering spikes in glucose following a meal. For older adults, these represent alternative therapies to aid in glucose management and improve metabolic health.