Apple Cider Vinegar, real benefits vs hype

Apple cider vinegar (ACV) has been touted for various health ailments from dandruff to diabetes to high cholesterol. Before you jump on the bandwagon it is important to understand how apple cider vinegar works, its benefits and its risks.

Apple cider vinegar is made from crushing and fermenting the apples. The sugars in the apples first turn into alcohol. Then, there is a second fermentation process when the alcohol is fermented into vinegar.  The second fermentation is done by a type of bacteria called acetobacter. The second fermentation process produces acetic acid.

Vinegar contains anywhere from 5 to 20 % acetic acid.


Many brands of natural apple cider vinegar boast that they still have live and active cultures or “the mother” in the bottle.  The live cultures look like the cloudy material in the bottle. While there has not been any research on the benefits of these cultures, many other fermented foods like yogurt, miso, and sauerkraut have been shown to have health benefits.


The specific mechanism of apple cider vinegar has yet to be completely understood. Like many other natural foods, it probably works on many pathways, not just one.  Vinegar increases the dilation of arteries. Research has also revealed that it decreased post-meal rises in glucose and insulin (which is a good thing). Insulin is an inflammatory hormone and has been linked to weight gain.


There is published literature that shows that apple cider vinegar can help with the following.

  • Diabetes – decreased the HBA1C (a measure of your blood glucose level for 3 months)
  • Metabolic syndrome – improves insulin sensitivity (which means your pancreas does not have to secrete as much insulin)
  • Atherosclerosclerosis – decreases oxidized LDL (an inflammatory type of cholesterol)
  • Obesity – decreases abdominal visceral fat (which is the dangerous fat around the organs)


While there are definite and documented benefits of apple cider vinegar. There have also been associated risks.  Some of the common risks include heartburn, esophagitis, loss of tooth enamel and a worsening of diabetic gastroparesis.


Nevertheless, many experts feel that the benefits of apple cider vinegar outweigh the risks. Here are a few things you should do to limit the risks of apple cider vinegar while enjoying its health benefits.


  1. Check with your doctor to make sure apple cider vinegar is okay for you. This is especially important to do if you have diabetes or reflux.


  1. Do not take more than 1 tablespoon or 15 ml of apple cider vinegar a day.  Also, dilute this with water when you drink it.


  1. Take apple cider vinegar 30 minutes before your meal.


  1. Rinse your mouth after taking apple cider vinegar to minimize any damage to your dental enamel.


  1. Do not sip apple cider vinegar throughout the day. This can be an acidic drink so it is better to have it once a day rather than throughout the day.


J Prosthodont. 2015 Jun;24(4):296-302. doi: 10.1111/jopr.12207. Epub 2014 Sep 14.Antifungal Activity of Apple Cider Vinegar on Candida Species Involved in Denture Stomatitis.Mota AC1, de Castro RD1, de Araújo Oliveira J1, de Oliveira Lima E1.

J Evid Based Integr Med. 2018; 23: 2156587217753004.Published online 2018 May 14. doi:  10.1177/2156587217753004 PMCID:PMC5954571 PMID: 29756472; Diabetes Control: Is Vinegar a Promising Candidate to Help Achieve Targets? Fahad Javaid Siddiqui, MSc, Pryseley Nkouibert Assam, PhD, Nurun Nisa de Souza, MPH, Rehena Sultana, MSc, Rinkoo Dalan, FRCP and Edwin Shih-Yen Chan, PhD

Journal of Medicinal Food Vol. 21, No. 1, Apple Cider Vinegar Attenuates Oxidative Stress and Reduces the Risk of Obesity in High-Fat-Fed Male Wistar Rats, Ben Hmad Halima, Gara Sonia, Khlifi Sarra, Ben Jemaa Houda, Ben Slama Fethi, and Aouidet Abdallah, Published Online:1 Jan 2018

Biosci Biotechnol Biochem. 2009 Aug;73(8):1837-43. Epub 2009 Aug 7.Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects.Kondo T1, Kishi M, Fushimi T, Ugajin S, Kaga T.

Sci Rep. 2017 Jul 27;7(1):6664. doi: 10.1038/s41598-017-06235-7.Anti-obesity and anti-inflammatory effects of synthetic acetic acid vinegar and Nipa vinegar on high-fat-diet-induced obese mice.Beh BK, Mohamad NE, Yeap SK, Ky H, Boo SY, Chua JYH, Tan SW, Ho WY, Sharifuddin SA, Long K, Alitheen NB.

Pharm Biol. 2017 Dec;55(1):43-52. Epub 2016 Sep 5.Fruit vinegars attenuate cardiac injury via anti-inflammatory and anti-adiposity actions in high-fat diet-induced obese rats.Bounihi A, Bitam A, Bouazza A, Yargui L, Koceir EA.

Pharm Biol. 2016;54(2):260-5. doi: 10.3109/13880209.2015.1031910. Epub 2015 Apr 8.Effect of fruit vinegars on liver damage and oxidative stress in high-fat-fed rats.Bouazza A, Bitam A, Amiali M, Bounihi A, Yargui L, Koceir EA.

Mol Nutr Food Res. 2016 Aug;60(8):1837-49. doi: 10.1002/mnfr.201600121. Epub 2016 Jun 27. Vinegar as a functional ingredient to improve postprandial glycemic control-human intervention findings and molecular mechanisms.Lim J, Henry CJ, Haldar S.



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