Is Apple Cider Vinegar All It Is Cracked Up To be?

Vinegar has been around for a centuries, dating back to Babylonia in 5,000 BC. Today there are numerous types of vinegars that are used for various reasons throughout the world. Trends come and go, but it seems like everywhere I look right now, apple cider vinegar (ACV) can barely stay on the shelves. Some claim that it is one of the best things sense sliced bread. This made me curious, so I decided to look into the research to see what the science has to say. This is what I have found so far:

Blood Glucose Management (Blood Sugar)

A common health claims with ACV is its effects on blood sugars. Most of the studies to date have been animal studies and very few human studies. Results of these small studies found that drinking 1-2 tablespoons of ACV mixed with water before eating a carbohydrate rich meal slightly improving post-meal glycemic response. What does this mean? Well, after we eat a high carbohydrate meal, a spike in our blood sugar (glucose) levels occur, a hormone called insulin is released by the pancreas to help move glucose into the cells from the blood steam. This process is what brings our blood sugar levels back down. Think of it this way, when your blood sugar is high, it is thicker and therefore forces your body to work harder to circulate; it is insulins job to thin back out the blood and help make circulation easier. Another study found that participants with type 2 diabetes who mixed 2 ounces of ACV with a glass of water along with eating 1 ounce of cheese helped to improve their morning fasting (before eating) blood sugar levels.

To better understand what is happening here we need to look at what ACV consist of. ACV is a type of vinegar that is made from apple must or cider that is rich in acetic acid. Acetic acid is a short-chain fatty acid that dissolves into acetate and hydrogen in the body. Through some older research, acetic acid was found to possibly have a small decreasing effect on blood sugar levels. Nevertheless, there needs to be more research to better understand just exactly how and why acetic acid affects blood sugars post-meal.

HOWEVER

Although these studies seem promising, a huge limitation is in the size of these studies. The studies reviewing ACV and post-meal blood sugars were only 10 – 30 participants. The study involving participants with type 2 diabetes only had 11 individuals, and all the studies were short term.

Lowers Cholesterol

Another health claim with ACV is that it will help to improve your cholesterol levels. A few studies have been done on diabetic and normal rats. One study found that dietary acetic acid reduced total cholesterol and triacylglycerol levels. Another study showed that ACV helped to improve the serum lipid profile (fat profile) in normal and diabetic rats by lowering triglycerides (TG), LDL “bad” cholesterol, and increasing HDL “good” cholesterol.

HOWEVER

The studies conducted so far have only been animal studies. We cannot depend on apple cider vinegar to improve your cholesterol levels by the current research.

Weight Loss

One of the most popular claims regarding ACV is in the use as a weight loss aid. Well as of right now, only ONE study in humans involved ACV and its effects on weight and body fat is commonly cited to this claim. This study had 155 obese Japanese adults consumed 1 tablespoon, 2 tablespoons, or a placebo drink mixture every day for 12 weeks. Diet and activity levels were not altered during the study; however, alcohol intake was restricted. The groups that drank ACV lost about 2.6 – 3.7 pounds along with a decrease in waist circumference and total triglycerides while the control group only lost 0.9 pounds and did not have a decrease in waist circumference.

HOWEVER

This study was larger and the results are encouraging. But, the participants gained the weight back at the 4 week follow up. To date this is the only human study that has investigated ACV in terms of a weight loss aid and cannot be generalized to the population. Another limitation is in the fact that this was not a controlled study, meaning the participants did not have a controlled diet over the course of the study and as we know very well by now, diet has a lot to do with weight loss.

Take Home Message

As a health professional, it is my job to look at what the research says and provide evidence-based recommendations off the science. We rely on large, long-term, double-blind, randomized controlled trials (RCTs) where the humans are randomly selected and administered the treatment under controlled conditions. The studies on ACV are currently small piolet studies for small amounts of time and animal studies.

I like apple cider vinegar for a lot of different things and don’t get me wrong, it can and should be a part of a balanced diet. Nevertheless, I am not quite sold on all the claims of it being the key to health and longevity. If wanting to achieve weight loss or weight management, blood sugar management, or cholesterol management, I suggest meeting and discussing lifestyle changes with a Registered Dietitian Nutritionist (RD or RDN) to help establish long term and sustainable health goals. I personally would rather go the route of adding Apple Cider Vinegar to a big salad or using it in pickling vegetables.

Note: If you would like to try ACV I strongly suggest only drinking 1-2 ounce and diluting it with water to prevent unpleasant and dangerous side effects such as burning your esophagus.

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