ISSN 2395-3411 Available online at www.ijpacr.com 88

______Review Article

AMAZING FACTS ABOUT APPLE CIDER VINEGAR (ACV) –A TRADITIONAL HOME REMEDY: A REVIEW

* Shilpa Shetty , Karunakar Hegde and AR. Shabaraya Department of Pharmacology, Srinivas College of Pharmacy, Valachil, Post- Farangipete, Mangalore - 574 143, Karnataka, India. ______ABSTRACT M. domestica fruits have many health beneficial effects for human health, mostly due to the presence of phytoconstituents which provide high dietary supplements. This article briefly reviews the general information about Mallus domestica fruit, description of apple cider vinegar, its chemical constituents, medicinal uses, pharmacological action. The therapeutic effects of ACV can be attributed to the bioactive constituents of the organic acids generated in ACV production, including acetic, citric, formic, lactic, malic, which have demonstrated antimicrobial, antioxidative, antidiabetic, antitumor, antiobesity, antihypertensive, and cholesterol-lowering properties in in vitro, animal, and human studies.

Keywords: Apple cider vinegar, Acetic acid, chlorogenic acid, poly phenols, anti diabetic, anti hyperlipidemic.

INTRODUCTION counterbalancing free radical activities that Traditional medicine is still the foundation of may cause cell injuries5. Apple cider vinegar is about 75-80% of world population, mainly in a home remedy which is widely taken by the the developing countries. Many countries such people in Malaysia to reduce the body weight. as Malaysia, Indonesia, India and China have The influence of apple cider vinegar has been a rich tradition of folk medicine from centuries investigated for hundreds of years. It was in and provided effective remedies to various fact first used about 5000 years ago. In the ailments using plants and plants derived year 400 B.C., Hippocrates, the father of compounds. There is no such risk factor to use modern medicine, prescribed the mixture of the plant medicine as compare with the honey and apple cider vinegar for treatment of allopathic drugs. The uses of complementary various diseases6. It has been particularly and traditional medicines have been used during the American Civil War for increasing worldwide because of fewer side disinfecting the wounds of soldiers. More effects. valuable properties of apple cider vinegar and Malus domestica is a medium sized tree its ingredients, suggesting their therapeutic belonging to the family Rosaceae. The fruit is effects, have been recently discovered7. Apple commonly known as Apple in English. Apples cider vinegar contains polyphenolic are consumed worldwide in the form of fresh compounds that have beneficial health juices and cider1 and used for curing cancer, effects8. Its antioxidant flavonoid content can cardiovascular disease, asthma, and reduce the harmful effects of high cholesterol diabetes2. M. domestica fruits have many diets. Acetic acid is the main ingredient of health beneficial effects for human health, apple cider vinegar. It is consumable at mostly due to the presence phytoconstituents concentrations of 3-5%. It is used not only as a which provide high dietary supplements such seasoning but also as a common a traditional as dietary fibre, sugars, vitamins, and phenolic medicine9. compounds3. M. domestica exhibit efficient antioxidant property owing to the presence of DESCRIPTION OF APPLE CIDER VINEGAR its phytoconstituents4. Polyphenols are common secondary metabolites of plants, with a well known putative role in protection against the infection by plant pathogens. Apples also ranked the second for total content of phenolic compounds, including quercetin, catechin, phloridzin and chlorogenic acid, all of which : are strong antioxidants, and thus capable of

International Journal of Pharma And Chemical Research I Volume 4 I Issue 2 I Apr – Jun I 2018 ISSN 2395-3411 Available online at www.ijpacr.com 89

Chemical constituentst10: problems, metabolism, nasal congestion, sore Scientists have measured ninety different throats, stiff joints, ulcers and weight loss. substances in apple cider vinegar such as Organic apple cider vinegar helps to maintain thirteen types of carbolic acids, four aldehydes, wrinkle free skin and also it corrects pH twenty ketones, eighteen types of alcohols, balance in the body. Apple juice and cider eight ethyl acetates etc. vinegar can improve memory. It also contains important minerals, trace  The presence of pectin in apple cider elements and vitamins as well acetic acid, vinegar heps to reduce bad propionic acid, lactic acid and malic acid, cholesterol in the body and in enzymes, amino acids as well as roughage in regulating blood pressure. the form of potash and apple pectin.  Due to malic acid content in apple cider vinegar, it helps in fighting fungal Minerals and trace elements: Potassium, and bacterial infection. Calcium, Magnesium, Phosphorous, Chlorine,  Beta-carotene, an oxidant present in Sodium, Sulfur, Copper, Iron, Silicon, Fluorine. organic apple cider vinegar helps to Vitamins: Vitamin C, Vitamin E, Vitamin A, maintain a wrinkle free skin. Vitamin B1, Vitamin B2, Vitamin B6  Potassium normalizes acid levels (pH) in the stomach, controls water balance Organic Components of ACV in body and maintains a healthy heart Acetic acid is the most abundant compound. rhythm. Organic acids from an analysis of a  Magnesium is a catalyst in enzyme commercially produced ACV using high activity, helping digestion and assisting resolution H NMR spectroscopy are found in the uptake of calcium from healthy Table 1. ACV is well established that various bones. types of phenolic compounds are found in  Apple cider vinegar contains beta- cider apples, particularly the hydroycinnamic carotene, which possesses antioxidant acid derivatives, oligomeric flavan-3-ols, properties that counteract damage dihydrochalcones, and flavonols11 . The caused by free radicals. phenolic content of ACV will vary with cultivar  The anti inflammatory properties of and processing12. Phenolic content of ACV apple cider vinegar work to soothe the was determined to consist of gallic acid, effects of sunburned skin when added catechin, epicatechin, chlorogenic acid, caffeic to a bath. acid and p-coumaric acid. Chlorogenic acid is  Apple cider vinegar also useful in the dominant phenolic substance in ACV13. weight loss. The total phenol content and chlorogenic acid content appear to vary significantly between PHARMACOLOGICAL ACTIVITIES different studies, possibly attributed to the  Anti-hyperlipidemic16: Abnormal different ACVs being used. metabolism of lipids leads to the elevated levels of fatty substances Table 1: Oganic acids in ACV largely cholesterol and triglycerides Compound Concentration (g/L) into blood stream leads hyperlipidemia. Acetic Acid 50.9 Apple cider vinegar was prepared and Citric Acid 0.02 evaluated for anti hyperlipidemic Formic Acid 0.28 Lactic Acid 0.38 activities in rat model. Hyperlipidemia Malic Acid 3.56 was induced by feeding high Succinic Acid 0.27 cholesterol diet. ACV (1ml/day) and Fructose 6.83 standard drug atorvastatin were Acetoin 0.21 administered to the animals in 2,3-Butanediol 0.37 Ethanol 1.03 respective groups and fed with high Ethyl acetate 0.14 cholesterol diet for 14 days except normal control rats. A significant MEDICINAL USES OF APPLE CIDER increase in reduced HDC-L level and VINEGAR14,15 significant decrease in elevated level Cider vinegar is thought to be beneficial in the of TC, TG, LDL and VLDL level were treatment of arthritis, asthma, nose bleeds, observed in ACV treated rats when osteoporosis,highcholesterol,cold,constipation, compared to cholesterol fed rats. The gallstone,kidneystones,candida,colds,hayfever, result concluded that ACV has headaches,hiccups,indigestion,insomnia,musc significant anti-hyperlipidemic activity lecramps,cancer,colitis,diabetes,diarrohea, in HCD induced hyperlipidemia. dizziness, eczema, kidney and bladder

International Journal of Pharma And Chemical Research I Volume 4 I Issue 2 I Apr – Jun I 2018 ISSN 2395-3411 Available online at www.ijpacr.com 90

 Anti oxidative17 -. ACV has a number response effect on the content of of phenolic compounds that contribute medium-sized alpha-glycans, active to its antioxidative capacity, including against tumors in experimental mice20. gallic acid, catechin, epicatechin,  Anti obesity - The anti obesity effect chlorogenic acid, caffeic acid, and p- of ACV can, from what we know, be coumaric acid13.A study was attributed to its earlier induction of conducted on fifty-four adult male satiety. Variable results have been wistar albino rats which were fed with demonstrated in studies evaluating the high cholesterol diet for 7 weeks. Rats rate of gastric emptying when were sacrificed at the end of the preceding a meal with ACV; however experiment and blood samples were some have showed a slower rate, collected. Catalase (CAT) activity, which would induce satiety sooner, malondialdehyde level (MDA), confirming the biologic plausibility of glutathione peroxidase (GSH-Px) ACV’s involvement in weight loss21. activity, superoxide dismutase (SOD)  Antifungal activity22 –In vitro activity were studied. Levels of CAT, assessment of anti fungal potential of GSH-Px, SOD were significantly apple cider vinegar and acetic acid decreased in high-cholesterol diet was carried out on 18 patients with group (CHCNT) .Levels of MDA, aural symptoms suggestive of which is the end product of lipid- otomycosis.18 samples were peroxidation was significantly examined 13(72%) of them were decreased in the apple cider vinegar positive for fungal growth, 6(46%) of administration group when compared fungal isolates were Aspergillus to the CHCNT (Pinsulin respectively. sensitivity and suppressed the drastic  Nootropic activity23: Cognitive rise in blood glucose after meals. A enhancing activity of apple cider pilot study found that two tablespoons vinegar on scopalamine induced of ACV at bedtime reduced morning memory impairment in mice was blood glucose by 4-6%, results that investigated by using elevated plus further indicate the anti glycemic maze and estimation of biochemical capacity of ACV18. Anti diabetic effect parameter in terms of acetylcholine of apple cider vinegar was performed esterase activity. Two doses (0.51 ml using streptozocin induced diabetes in /kg) and (1.02 ml/kg) of ACV were mice. The mice were divided in six subjected for the evaluation of groups. Two concentrations of 0.16% nootropic activity against the amnesia and 6% concentration of apple cider induced by scopalamine in young vinegar were used in drinking water mice. The long term administration of for 21 days. In this study it has been both lower and higher dose ACV revealed that apple cider vinegar has produced significant reduction of considerable reducing effect on blood TL(P<0.01) and( P<0.05) in EPM glucose level in diabetic mice19. model on both 19th and 27th day when  Anti tumor - Although little research compared with control and induced has been performed on ACV or acetic group.ACV at higher doses acid and their involvement in the significantly reduces the activity of inhibition of tumor growth, the AchE indicated improvement in involvement of ACV’s anti oxidative learning and retention of memory in activity inherently plays a role in early young mice. stages of tumor development. One  Cholesterol-lowering Effect24 - The study did investigate the products of polyphenol content of vinegars, most acetic acid fermentation present in the notably the high content of chlorogenic production of ACV and found a dose- acid in ACV, has suggested a potential

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inhibition of LDL oxidation in the blood  Joanna Morgan – Sapha Mosawy stream, however further research is investigated the potential apple cider warranted in this area. In animals, vinegar in management of type II acetic acid and concomitant diabetes. cholesterol, reduced serum  Ahmed saber - Abu Zaiton triglyceride levels by inhibiting investigated the effect of apple cider lipogenesis and promoting exertion of vinegar on physiological state of triglycerides in fecal bile acid excretion, pancreas in normal and alloxan further suggesting its protective effect induced diabetic rats. on risk factors of heart disease mainly  Derya A, Cem A and Celalettin K atherosclerosis. investigated the effect of external apple vinegar application on varicosity NOTABLE RESEARCH WORK ON APPLE symptoms, pain and social CIDER VINEGAR appearance anxiety: a randomized  Ajaykumar TV. et al evaluated the control trial. anti hyperlipidemic activity of apple cider vinegar in experimental rat CONCLUSION models. In the present review an attempt has been  LaszloBardos, Balazs Bender made to reveal the active constituents, investigated the effect of apple cider medicinal uses and pharmacological activities vinegar on blood and liver cholesterol, of Apple cider vinegar. It reveals that apple triglycerides and one of a marker of cider vinegar contains several anti oxidant status of blood in phytoconstituents like acetic, chlorogenic acid, laboratory mice. gallic acid and several phenolic components.  Hayder Badr Jabir M et al reported The ACV is a readily available product that is the antifungal potential of apple cider easily able to be incorporated into meals. vinegar and acetic acid to find a safer Large body of research has demonstrated its alternative to traditional antifungal beneficial properties as an entire product, as drugs in treatment of otomycosis. well as the abilities of the individual  Zahra Behshtil et al investigated the components. Literature surveys revealed that early prevention and treatment of Apple cider vinegar has a great perspective in atherosclerosis can prevent the treatment of several diseases and it complications of cardio vascular possesses anti hyperlipedemic, anti diabetic, diseases by the influence of apple nootropic, anti-oxidative, anti-fungal, anti cider vinegar consumption on obesity and anti-tumor effects . Further reducing blood lipid levels. evaluation need to be carried out in order to  Zahra Vahdat Shariatpanahi et al explore the concealed areas and their practical evaluated the effect of apple cider clinical applications, which can be used for the vinegar plusPPI- based triple therapy welfare of mankind. on eradication of helicobacter pylori(H.pylori) infection.116 patients REFERENCES with H.pylori infection were included in 1. Alberto MR, Canavosio MAR, Nadra this randomized clinical trial. MCM. Antimicrobial effect of  Amin T.Hamed et al designed to polyphenols from apple skins on determine and compare the effect of human bacterial pathogens. apple and grape vinegars on lipid Biotechnol Environ. 2006;9(3):1-5. profile in male Albino white rats. 2. Boyer J, Liu RH. Apple  Shishehbor F et al investigated the phytochemicals and their health effect of apple cider vinegar on fasting benefits. Nutr J. 2004;5 :1–5. blood glucose, glycated 3. Hagen SF, Borge GIA, Bengtsson GB, haemoglobin( HbAlc) and lipid profile Bilger W, Berge A, Haffner K, Solhaug, in a normal and diabetic rats. KA. Phenolic contents and other  Soujanya et al evaluated nootropic health and sensory related properties potential of apple cider vinegar in of apple fruit (Malus domestica Borkh., validated experimental animal model. cv. Aroma): Effect of postharvest UV-B  Nazar AA Omar et al investigated irradiation. Postharvest Biology and hepatoprotective and anti diabetic Technology. 2007; 45:1–10. properties of apple cider vinegar on 4. Fratianni FA, Sada, Cipriano L, liver of male rats. Masucci A, Nazzaro F. Biochemical characteristics, antimicrobial and

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International Journal of Pharma And Chemical Research I Volume 4 I Issue 2 I Apr – Jun I 2018