Side Effects of Apple Cider Vinegar Diet Pills.

Apple cider vinegar diet pills may help you lose weight in the same manor as drinking apple cider vinegar, only without the tart taste or overpowering smell of the vinegar. Unfortunately, these pills also lead to increased side effects due to their ease of consumption. Consult your physician prior to taking apple cider vinegar diet pills.

Potassium Levels:

Katherine Zeratsky, a nutritionist for the Mayo Clinic, warns that the intake of apple cider vinegar may interact with certain prescription medications, especially insulin and diuretics, lowering your potassium levels. This effect may increase with apple cider vinegar pills, because their ease of use may cause you to consume more throughout the day. Low potassium levels may cause constipation, muscle weakness, fatigue, abnormal heart rhythms and paralysis.

Glucose Control

A study published online in May of 2006 by the journal “Medscape General Medicine” showed that the acetic acid in apple cider vinegar has an antiglycemic effect, meaning it lowers glucose levels in the blood. If you have type 2 diabetes or insulin resistance, this effect may decrease your blood sugar levels to the point of hypoglycemia. Hypoglycemia can cause shakiness, dizziness, hunger, headache, pale skin, jerky movements, seizures and loss of consciousness.

Throat Irritation

The acidity level of apple cider vinegar may cause throat irritation, according to Zeratsky. Apple cider vinegar pills do not have the acidic taste of liquid vinegar, but they still have a high acid content. The use of apple cider vinegar pills may cause throat pain, difficulty swallowing or throat burns, according to a study published in the July 2005 issue of the “Journal of the American Dietetic Association.” Reduce these risks by taking apple cider vinegar pills with a full glass of water while in an upright position. Use extreme caution taking these pills if you have problems swallowing or have a narrow esophagus.

Salicylate or Sulfite Sensitivity:

Apple cider vinegar contains both salicylates and sulfites — natural compounds found in plants, according to the Cleveland Clinic. Pills made from apple cider vinegar or with apple cider vinegar may also contain these compounds. If you experience symptoms of an allergy after taking apple cider vinegar diet pills, discontinue their use. Signs of an allergic reaction may include difficulty breathing, watery eyes, itchy eyes, stuffy nose, runny nose and hives.

The FDA does not regulate the sale of dietary supplements and only intervenes when a supplement makes false claims or has shown dangerous effects after sale. Considerable variability exists between apple cider vinegar pill brands in pH levels, tablet size, acid content and label claims. The July 2005 study published in the “Journal of the American Dietetic Association” indicated that many apple cider vinegar tablets might not contain any apple cider vinegar at all.


References; Apple Cider Vinegar for Weight Loss: Effective?; Katherine Zeratsky, R.D., L.D.; April 2010

MedlinePlus; Hypokalemia; David C. Dugdale, III, M.D.; August 2009

Medscape General Medicine”; inegar: Medicinal Uses and Antiglycemic Effect; Carol S. Johnston, PhD, RD, et al.; May 2006

American Diabetes Association: Hypoglycemia (Low Blood Glucose)

“Journal of the American Dietetic Association”; Esophageal Injury By Apple Cider Vinegar Tablets and Subsequent Evaluation of Products; Laura L. Hill, et al.; July 2005

Cleveland Clinic: Specialty Diets for Food Allergies.




FDA Panel Recommends Approval of Adjuvanted Bird Flu (H5N1) Vaccine .

An adjuvanted vaccine against the avian influenza virus (H5N1) has been recommended for approval by an FDA advisory panel, Reuters reported last week.

Another vaccine has already been licensed for H5N1, but the newer vaccine would require much less antigen to be effective because of the presence of the adjuvant. That would make it easier to produce enough doses during an epidemic, according to the report.

Source: Reuters


Infant Travel Tent Recalled Because of Suffocation Risk .

About 220,000 infant and toddler PeaPod and PeaPod Plus Travel Beds have been recalled because children can become trapped between the mattress and the side of the tent and suffocate, the U.S. Consumer Product Safety Commission announced on Friday.

A 5-month-old infant who died last year was found with his face pressed against the side of the tent.

Also, at least nine children in the U.S. and Canada have become entrapped or experienced physical distress while in the tent. Two infants were found crying underneath the inflatable air mattresses after the mattresses had not been properly secured in the zippered pocket in the tent.

Source: CPSC news

Intranasal Oxytocin Shows Promise for Alcohol Withdrawal.

In a small pilot trial, the agent lowered withdrawal symptoms, anxiety, and the need for benzodiazepines.

Oxytocin blocks the development of tolerance and attenuates withdrawal symptoms in rodents. This double-blind, randomized study examined effects of oxytocin on alcohol withdrawal symptoms in humans.

The 11 actively drinking, alcohol-dependent participants (9 men; average age, 41) with a history of withdrawal symptoms but not of alcohol withdrawal seizures or delirium tremens underwent inpatient alcohol detoxification. Seven participants received intranasal oxytocin 24 IU twice daily for 3 days, and four received matching intranasal placebo. Lorazepam was given as needed, based on withdrawal symptoms. Oxytocin recipients required almost five times less lorazepam than the placebo recipients and had significantly lower withdrawal ratings on days 1 and 2 and anxiety/tension symptom ratings on day 2.

Comment: This very preliminary study suggests that oxytocin may reduce alcohol withdrawal symptoms in humans. Oxytocin would have advantages over benzodiazepines because it does not itself cause sedative-hypnotic tolerance and instead reverses it. However, oxytocin would be unlikely to prevent alcohol withdrawal seizures or delirium tremens.

Oxytocin has already been shown to reduce anxiety, increase interpersonal trust, and improve social cognition in humans, with no adverse effects, in short-term studies. Oxytocin is currently far from routine clinical use, but it will be exciting to see whether it can reduce drinking in alcohol-dependent outpatients or treat anxiety symptoms and disorders.

Source: Journal Watch Psychiatry


Early menarche may predict overall obesity.

Cardiovascular disease is the leading cause of death in women in the United States, but little is known about the effect of reproductive factors. In a recent substudy of the Framingham Heart Study, researchers determined that earlier age of menarche is linked to overall obesity.

“The purpose of this study was to examine whether female reproductive risk factors — including onset of menarche, number of births over a lifetime (parity), onset of menopause and menopausal status — are all associated with indices of body fat composition,” researcher Caroline S. Fox, MD, MPH, of the National Heart, Lung, and Blood Institute, said in a press release.

Researchers analyzed 1,638 patients (aged 40 years or older; weighing less than 160 kg) from the multidetector CT (MDCT) substudy of the Framingham Heart Study (FHS) from 2002 to 2005. The patients were offspring of the FHS and third-generation cohorts.

Besides female reproductive risk factors measured, the researchers also looked at visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) via MDCT.

To better understand the influences of body fat and female reproductive risk factors, the researchers also adjusted for covariates such as age, smoking status, alcohol consumption, physical activity, hormone therapy use and menopausal status.

According to data, earlier age of menarche was associated with increased BMI, waist circumference, VAT and SAT (all P<.0001). The researchers wrote that for each 1-year increase in menarche age, VAT was 61 cm3 lower. However, this association of earlier menarche with adiposity measures was weakened after adjustments for BMI. Associations between adiposity and parity, besides menopausal age, were not statistically significant, they added.

Although postmenopausal women had increased BMI, waist circumference, VAT and SAT compared with premenopausal women, the researchers said this was due to increased ages among postmenopausal women.

“This research suggests that select female reproductive risk factors, specifically onset of menarche, are associated with overall adiposity, but not with specific indices of body fat distribution,” researcher Subbulaxmi Trikudanathan, MD, of Harvard Medical School, said in a press release. “Ultimately, the important question is whether female reproductive risk factors can be used to target lifestyle interventions in high-risk women to prevent the metabolic consequences of obesity and cardiovascular disease.”

The researchers suggest that further studies determine whether female reproductive factors can be used in lifestyle interventions among women at high risk for the metabolic consequences of obesity and CVD.

  • Source: Endocrine Today


Statins may lower risk for NAFLD, not linked to ALT increase.

Patients taking statins had a lower prevalence of nonalcoholic fatty liver disease than those who were not, with no impact on alanine aminotransferase as a result of treatment, in a study presented at The Liver Meeting.

Researchers assessed ultrasonography and statin prescription data on 2,578 patients (mean age 76.5 years) collected from the Rotterdam Study, a population-based cohort of elderly people. Fatty liver observed on ultrasonography without the presence of secondary causes was considered nonalcoholic fatty liver disease (NAFLD).

“Statin therapy is an effective treatment in patients with the metabolic syndrome, but the effect and safety of statins on NAFLD is not well established,” the researchers wrote. “We aimed to study the association of statin therapy with the presence of NAFLD, and elevated alanine aminotransferase (ALT) concentrations in a large cross-sectional population-based study.”

NAFLD was observed in 35% of the cohort. Statin use was more common among participants with NAFLD than those without (27% of patients compared with 23%; P=.03). Investigators determined an association between current statin use and lower NAFLD prevalence (OR=0.58; 95% CI, 0.40-0.83 compared with nonusers), but not with prior use (OR=0.96; 95% CI, 0.66-1.404), via multivariate analysis adjusting for factors including age, sex, statin dosage, metabolic syndrome, cardiovascular disease and consumption of alcohol. No association was observed between ALT levels and either prior (OR=1.39; 95% CI, 0.72-2.69) or current statin use (OR=1.05; 95% CI, 0.56-1.97).

The association between statin use and lower NAFLD prevalence grew stronger according to the duration of statin therapy (OR=0.76; 95% CI, 0.64-0.91 for 1 year of use). Researcher Edith M. Koehler,MD, gastroenterology and hepatology division, Erasmus MC University Hospital, in Rotterdam, Netherlands, told that additional analysis has since been performed in patients who had used statins for more than 2 years, and that the association persisted.

“Often there’s concern that statins may not be good for patients with NAFLD because they may elevate ALT,” Koehler said. “Our findings [show] that statin use is not associated with an elevation of ALT, which suggests it’s safe to prescribe to patients with or without NAFLD. It may even be good to prescribe statins to patients with NAFLD who don’t have cardiovascular disease, because it may lower the prevalence of NAFLD.”

Disclosure: Researcher Harry L. Janssen received consulting fees from Roche, Merck, Gilead Sciences, Bristol-Myers Squibb, Novartis, Santaris, Medtronic, Abbott, and Debio, and grant/research support from Roche, Merck, Gilead Sciences, Bristol-Myers Squibb, Novartis, Santaris, Medronic, Anadys, Innogenetics, and Kirin.

For more information:

Koehler EM. P825: Association between statin use and Nonalcoholic Fatty Liver Disease in a population-based study. Presented at: The Liver Meeting 2012; Nov. 9-13, Boston.

  • Source: Endocrine Today


Routine diabetes education in UK improved glycemic control, QOL .

When delivered through routine health care in the United Kingdom, diabetes education led to long-term glycemic control and improved quality of life in adults with type 1 diabetes.

Researchers from the UK National Institute for Health Research Dose Adjustment for Normal Eating (NIHR DAFNE) study group examined 262 patients with type 1 diabetes before and after evaluation of the DAFNE program.

DAFNE consisted of a 5-day course with a follow-up booster session at 6 weeks. The diabetes educators promoted carbohydrate counting, dose adjustments and other management techniques.

HbA1c data were collected from routine records up to 8 weeks before and 6 and 12 months after the course of the program, the researchers wrote. Before enrollment, patients (average age, 40 years) completed the Diabetes-Specific Quality of Life Scale (DSQOLS) and again at 3, 6 and 12 months after the course. The researchers said there were no differences between men and women in the study.

According to data, the mean baseline HbA1c was 8.5% and one-quarter of patients (n=65) had an HbA1c <7.5%. Patients with an HbA1c of <7.5% were ultimately excluded from an analysis of patients with suboptimal control; further improvements would have increased the risk for severe hypoglycemia.

Upon further analysis, significant improvements were noted among HbA1c levels in patients from baseline to 6 months (P<.001), continuing through 12 months (P<.001), researchers wrote.

“Each DSQOLS subscale and total score showed significant improvements by 3 months, all of which were maintained at 6 and 12 months in the total sample,” researchers said.

Based on these findings, they said it is possible to achieve sustainable improvements in HbA1c and QOL among adults with type 1 diabetes through routine diabetes education programs.



Carol Rasmussen

  • By using a structured group education format for type 1 diabetes patients, researchers found positive outcomes. The format was to provide intensive insulin therapy with flexible food choices. By teaching freedom in choosing foods without restrictions and flexible dosing, overall quality of life (QOL) will be improved. The goal was to decrease HbA1c and increase QOL. As this program is included as part of the routine diabetes care provided, it should decrease medical costs by doing group education and support. Having this education separate from the individual clinic appointments gave additional attention to their diabetes and other concerns. The HbA1c in this study decreased in relation to improved QOL.

The paradigm for diabetes care in type 1 diabetes patients has long been individual visits and care. The group setting was used more in the type 2 diabetes population. In the clinical setting, this will impact education, in teaching to a group rather than individually a support focus will be created. The format and intense education worked well in their population, which was mainly well educated and motivated. Time will tell how it works in the less educated and motivated population.

This research and following programs bear close watching to evaluate further successes or concerns. Myself, I am excited about the implications for this innovative format.

    • Carol Rasmussen, MSN, APRN, CDE, FAADE
    • Family medicine nurse practitioner at the Exodus Healthcare Network in Magna, Utah
  • Source: Endocrine Today


Diagnosed diabetes rate increasing nationwide.

Between 1995 and 2010, the prevalence of diagnosed diabetes increased by 100% or more in 18 states across the nation. Additionally, 42 states saw increases of 50% or more, and all US states, the District of Columbia and Puerto Rico reported increases during that time, according to a study from the CDC.

States with the largest increases include Oklahoma (226%), Kentucky (158%), Georgia (145%), Alabama (140%) and Washington (135%), according to a press release.

“Regionally, we saw the largest increase in diagnosed diabetes prevalence in the South, followed by the West, Midwest and Northeast,” Linda Geiss, a statistician with CDC’s Division of Diabetes Translation and report author, said in the release. “These data also reinforce findings from previous studies, which indicate that the prevalence of diagnosed diabetes is highest in the southern and Appalachian states.”

Researchers used data from the annual telephone survey of health behaviors and conditions of US adults aged 18 and older, the Behavioral Risk Factor Surveillance System. According to their data, diagnosed diabetes prevalence was 10% or more in six states and Puerto Rico in 2010.

“In 1995 only three states, the District of Columbia and Puerto Rico had a diagnosed diabetes prevalence of 6% or more. By 2010, all 50 states had a prevalence of more than 6%,” Ann Albright, PhD, RD, director of CDC’s Division of Diabetes Translation, said in the press release. “These rates will continue to increase until effective interventions and policies are implemented to prevent both diabetes and obesity.”

For more information:

Geiss LS. MMWR. 2012;61:918-921.

Source: Endocrine Today


FDA Posts Adverse Event Reports Related to Energy Drinks.

The FDA publicly released the adverse event reports for four energy drinks — 5-Hour Energy, Monster Energy, Rockstar Energy, and Red Bull. Thus far, 18 fatalities have been linked to the highly caffeinated energy drinks (5 to Monster Energy, 13 to 5-Hour).

Some of the symptoms mentioned in the reports include increased heart rate, fatigue, vomiting, loss of consciousness, and cardiac and respiratory arrest. A federal report also found that an energy drink was listed as a possible cause for over 13,000 emergency room visits in 2009, the New York Times reports.

The FDA says that important information may be missing from the adverse event reports, making it “difficult … to fully evaluate” whether the energy drinks caused the injuries reported. Nevertheless, the agency advises consumers to consult a healthcare provider before using the products.

Source: FDA

Alcohol a Major Contributor of Empty Calories to the American Diet .

Adults in the U.S. consume an average of 100 calories from alcohol per day, according to a data brief from the CDC’s National Center for Health Statistics.

Using data from NHANES 24-hour dietary recall interviews of adults from 2007 to 2010, researchers found that a third of men and 18% of women consume alcohol on a given day. Among the other findings:

  • People who regularly drink alcoholic beverages obtain about 16% of their total calories from alcohol. Dietary guidelines recommend that so-called empty calories (i.e., discretionary solid fats and added sugars) should comprise no more than 5 to 15% of a healthy diet.
  • People in the highest income categories consumed, on average, the most calories per day from alcohol.
  • Of all the demographic groups, men aged 20 to 39 years consumed the most calories (174) from alcoholic beverages.

Source: CDC