Apple cider vinegar has a long pedigree, shrouded in mystery; a folklore remedy found in many cultures from the Babylonians to the Aryans to Samurai warriors, who used it for strength and power. More than 2,000 years ago, Hippocrates recognised its value as an antiseptic, and latterly, apple cider vinegar was used to treat wounds in the battle fields of WW1 and the US civil war. In recent years, people have explored its use in heart health, weight loss and diabetes
What is Apple Cider Vinegar?
Apple cider vinegar is apple juice, which has undergone a double fermentation. Crushed apples are mixed with yeast and the natural sugars converted into alcohol. After a few weeks, natural bacteria and yeasts convert the alcohol into acetic acid. Acetic acid gives the vinegar its strong taste and smell.
You will notice that some apple cider vinegar is dark with wispy, floating bits. These bits are the good bits, composed of probiotic bacteria and protein, called ‘the mother’. Sometimes manufacturers filter these out to give a clear vinegar. We don’t have much data on how this affects the probiotic value of the vinegar, but we are hazarding a guess that the unfiltered product will have more rather than less good bugs!
How do I lose weight with Apple Cider Vinegar?
It has been suggested that apple cider vinegar suppresses your appetite and make you feel fuller, hence the link to weight loss. Animal studies show weight loss benefits, but there is a paucity of studies in humans proving weight loss benefits.1, 2 A detailed review of these studies was undertaken by Launholt.3 Their conclusion was that there is currently insufficient evidence to support the use of apple cider vinegar as a weight loss treatment. This does not mean that apple cider vinegar is of no value in weight loss, it means that there is no proof and more research is needed.
But all is not lost; apple cider vinegar may be a useful tool to improve your metabolism and a healthier metabolism means a healthier you.
The Effect of Apple Cider Vinegar on Insulin and Metabolism
After a sugary meal, sugar rushes into the circulation, resulting in very high blood sugar levels. High blood sugar causes a large insulin release. If this scenario is repeated constantly over prolonged periods of time, an ever-increasing amount of insulin is needed to do the same job. This is called insulin resistance. Insulin resistance is the beginning of all metabolic problems. Eventually, there is insufficient insulin to reduce blood sugar and diabetes is not far away. This is where vinegar may help.
Vinegar reduces the speed of sugar absorption, the rise of blood sugar is slowed after a meal, meaning that less insulin is needed. If you use less insulin, the likelihood of insulin resistance diminishes, and you reduce your chance of metabolic disease such as diabetes. So, this is a winner! The effect of apple cider vinegar on blood sugar is seen particularly after a sugary meal.
The mechanism of the vinegar action in reducing blood sugar, following a meal is still unknown. A theory related to gastric emptying has been discounted.4 It may be the effect on digestive enzymes or an effect on the muscles by increasing their sugar uptake from the blood.
In a trial, subjects were given 20g of apple cider vinegar, or a placebo drink. Immediately after, they were given a sugary meal, which was a buttered bagel, and orange juice, containing 87g of carbs. Insulin release and blood sugar were compared between the group who had had the apple cider vinegar and those who had not. The rise in sugar was less in the group who had the apple cider vinegar compared to the group who did not have apple cider vinegar.5
This type of study has been replicated by other scientists and a recent review confirmed that there is considerable support for the positive role of vinegar in this reducing blood sugar after a meal.6 Apple cider vinegar has been suggested as a treatment for people with diabetes to help to control blood sugar, but further research is needed.7, 8
It’s best to avoid sugary meals totally to enjoy a healthy metabolism. If you do succumb to the odd plate of chips, douse with apple cider vinegar and you will reduce the inevitable blood sugar spike. You can alternatively take the apple cider vinegar before the meal. The addition of apple cider vinegar to your food is not carte blanche to eat sugary foods, but it does mitigate your sugar response and help with your metabolism.
Other Health Benefits
Other potential health benefits of apple cider vinegar include its probiotic and antioxidant properties.
If you use live apple cider vinegar, you may help your gut bugs. Apple cider vinegar contains up to one hundred different live bacterial species (probiotics). Probiotics support healthy gut bugs, which are critical for good health. Organically grown vinegar has more species than those grown using conventional farming methods.9
There is encouraging data, based only on animal experiments. In one trial, the addition of apple cider vinegar resulted in a beneficial change to the composition of gut bugs. The ratio of Firmicutes (bad) to other bugs decreased and Firmicutes is generally regarded as a bug associated with obesity, so its god news when it decreases. But we need more research before we can extrapolate these findings to humans.
Polyphenols, natural plant antioxidants contribute to the control of inflammation, and there is mounting evidence of their role in preventing heart disease, cancer and strokes.
Apple cider vinegar is rich in polyphenols containing flavonoids, chlorogenic acid and other hydroxycinnamic acids. The double fermentation process increases bioavailability of these antioxidants, and it is this antioxidant effects which provide the health benefits.10 To date, no trials confirm the role of apple cider vinegar in disease prevention, but the abundant polyphenols present make it a likely candidate for further research and significant health benefits.
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Should I take Apple Cider Vinegar?
We believe that there is at present insufficient evidence to recommend daily apple cider vinegar as a long-term health supplement. There are compelling reasons that it may be helpful but until more research is undertaken, the benefits remain unproven. It has a small role in blunting the sugar response to a sugary meal.
How do I take it?
If you take it daily: the commonest way to incorporate apple cider vinegar into your diet is to add one or two tablespoons (10-30ml) per day to water or tea. Do not take it neat.
Apple cider vinegar can be used or added to foods such as salad dressings, sauces, or soups. You can take apple cider vinegar before a sugary meal to reduce your blood sugar spike or sprinkle on sugary food such as potato chips or fries.
If apple cider vinegar is taken in moderate amounts, it is regarded as safe. Larger amounts may be associated with low potassium and it has been reported to fall to dangerously low levels, although this is rare.11 There may be stomach upsets, throat problems and interactions with medications. Apple cider vinegar is among the most acidic foods taken and it isn’t a good idea to drink neat vinegar, as it may damage your tooth enamel.
Apple cider vinegar, a ubiquitous remedy has been taken for centuries
‘The mother’ is the clumped live bacteria and protein
Live apple cider vinegar with ‘mother’ is a probiotic
- Apple cider vinegar has been used as an antiseptic
Current scientific evidence does not support the benefit of apple cider vinegar in weight loss
Apple cider vinegar reduces the spike in blood sugar seen after sugary meals
It can be taken as a ‘get out of jail card’ if you eat a sugary meal.
Apple cider vinegar may reduce insulin resistance, a major factor in the development of metabolic diseases, including diabetes
Live apple cider vinegar is a probiotic with up to 100 bacterial species
Its use in salad dressings helps to support healthy gut bugs
Apple cider vinegar contains polyphenols, plant antioxidants
Polyphenols protect against cancer, heart disease, diabetes and other metabolic diseases
The double fermentation process increases the bioavailability of the polyphenols in apple cider vinegar
Take apple cider vinegar with other fluids-tea or water
Do not drink neat apple cider vinegar, as this may cause erosion of tooth enamel
In low doses, apple cider vinegar is regarded as safe
It may interact with some medications, causing low potassium
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Bouderbala H, Kaddouri H, Kheroua O, Saidi D. Effet anti-obésogène du vinaigre de cidre de pomme chez le rat soumis à un régime hyperlipidique [Anti-obesogenic effect of apple cider vinegar in rats subjected to a high fat diet]. Ann Cardiol Angeiol (Paris). 2016 Jun;65(3):208-13. French. doi: 10.1016/j.ancard.2016.04.004. Epub 2016 May 18. PMID: 27209492. https://pubmed.ncbi.nlm.nih.gov/27209492/
Launholt TL, Kristiansen CB, Hjorth P. Safety and side effects of apple vinegar intake and its effect on metabolic parameters and body weight: a systematic review. Eur J Nutr. 2020 Sep;59(6):2273-2289. doi: 10.1007/s00394-020-02214-3. Epub 2020 Mar 13. PMID: 32170375. https://pubmed.ncbi.nlm.nih.gov/32170375/
Brighenti F, Castellani G, Benini L, Casiraghi MC, Leopardi E, Crovetti R, Testolin G. Effect of neutralized and native vinegar on blood glucose and acetate responses to a mixed meal in healthy subjects. Eur J Clin Nutr. 1995 Apr;49(4):242-7. PMID: 7796781. https://pubmed.ncbi.nlm.nih.gov/7796781/
Johnston CS, Kim CM, Buller AJ. Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes. Diabetes Care. 2004 Jan;27(1):281-2. doi: 10.2337/diacare.27.1.281. PMID: 14694010. https://care.diabetesjournals.org/content/27/1/281
Santos HO, de Moraes WMAM, da Silva GAR, Prestes J, Schoenfeld BJ. Vinegar (acetic acid) intake on glucose metabolism: A narrative review. Clin Nutr ESPEN. 2019 Aug;32:1-7. doi: 10.1016/j.clnesp.2019.05.008. Epub 2019 May 31. PMID: 31221273. https://clinicalnutritionespen.com/article/S2405-4577(19)30305-5/fulltext
Cheng LJ, Jiang Y, Wu VX, Wang W. A systematic review and meta-analysis: Vinegar consumption on glycaemic control in adults with type 2 diabetes mellitus. J Adv Nurs. 2020 Feb;76(2):459-474. doi: 10.1111/jan.14255. Epub 2019 Nov 21. PMID: 31667860https://pubmed.ncbi.nlm.nih.gov/31667860/
Kausar, Sofia & Abbas, Muhammad & Ahmad, Hajra & Yousef, Nazia & Ahmed, Zaheer & Sheikh, Naheed & Ashfaq, Hira & Humayun, Ayesha. (2019). Effect of Apple Cider Vinegar in Type 2 Diabetic Patients with Poor Glycemic Control: A Randomized Placebo Controlled Design. https://www.researchgate.net/publication/331684757
Štornik A, Skok B, Trček J. Comparison of Cultivable Acetic Acid Bacterial Microbiota in Organic and Conventional Apple Cider Vinegar. Food Technol Biotechnol. 2016 Mar;54(1):113-119. doi: 10.17113/ftb.54.01.16.4082. PMID: 27904401; PMCID: PMC5105631 https://pubmed.ncbi.nlm.nih.gov/27904401/
Shuqing Zhang, Chingyuan Hu, Yurong Guo, Xiaoyu Wang, Yonghong Meng, Polyphenols in fermented apple juice: Beneficial effects on human health, Journal of Functional Foods, Volume 76, 2021,104294, ISSN 1756-4646, https://doi.org/10.1016/j.jff.2020.104294. https://www.sciencedirect.com/science/article/pii/S1756464620305181
Anderson S, Gonzalez LA, Jasbi P, Johnston CS. Evidence That Daily Vinegar Ingestion May Contribute to Erosive Tooth Wear in Adults. J Med Food. 2020 Dec 9. doi: 10.1089/jmf.2020.0108. Epub ahead of print. PMID: 33297831. https://pubmed.ncbi.nlm.nih.gov/33297831/