These are the days when one would go online seeking nutrition remedies for every imaginable condition and find every imaginable solution. But long before Google delivered instant suggestions on what to eat for better health and performance, apple cider vinegar (ACV) has been one of the leading word-of-mouth health remedies.
So, you’re probably wondering what science has to say. Can ACV really go the distance in helping us stay healthy for longer? Here’s the truth on whether sour has the power.
What exactly is apple cider vinegar?
While vinegar can be gleaned from various starting materials including grapes and rice, apple cider vinegar is produced by pulverizing apples into a slurry of juice and pulp that is then allowed to ferment in the presence of bacteria and yeast. This converts the fruit sugar largely into acetic acid (among other types) and produces various flavor compounds, which lends the vinegar its strong sour smell and sharp flavor.
What are the health benefits of apple cider vinegar?
Though singled out as a remedy for a laundry list of ailments, some purported health perks may hold true.
Foremost, the high levels of acetic acid in ACV may help with blood sugar control and improve certain blood lipids, according to a 2021 systematic review and meta-analysis in the Journal of the Academy of Nutrition and Dietetics. Acetic acid was also found to lower concentrations of blood triglycerides among those who were overweight or obese and in those with type 2 diabetes, which may promote better heart health. Additionally, another review study in the journal BMC Complementary Medicine and Therapies found enough evidence to suggest that apple cider vinegar used for longer than two months can improve blood sugar management and blood cholesterol levels.
An investigation in the European Journal of Clinical Nutrition found that when people consumed white bread with vinegar, there was a lower blood glucose and insulin response, as well as improved ratings of satiety, than when they consumed the same amount of bread without the vinegar. The higher the acetic acid content of the vinegar the greater the impact.
Though we often think of improved blood sugar control as something that’s only important for people with diabetes, Molly Kimball, R.D., registered dietitian with Ochsner Health in New Orleans, tells Runner’s World it’s beneficial for everyone, including runners. “Maintaining steady blood sugar levels—meaning avoiding the peaks and valleys—as much as possible is key for optimizing energy, mood, and fending off cravings, to name a few.”
The slower release of blood sugar into the bloodstream with apple cider vinegar use and the subsequent rise in hunger-reducing hormones could result in feelings of fullness and, therefore, potential weight loss over time.
ACV can improve blood sugar numbers, which Kimball says are most likely to occur when it’s paired with carb-rich foods, because it reduces the activity of an enzyme that breaks down starch and increases the uptake of glucose into tissues—including skeletal muscle—by improving insulin sensitivity and blood flow.
But keep in mind that we don’t know what impact is on people without any impaired insulin sensitivity or blood sugar control, including healthy runners. And, noticeable blood sugar improvement may only occur when apple cider vinegar is added to meals containing high glycemic index foods and drinks like white bread, juice, potatoes, and white pasta.
Kimball adds that it’s also unclear how apple cider vinegar’s metabolic effects vary from any other kinds of vinegar. Though most of the research has been conducted on apple cider vinegar, the blood sugar benefits may not differ a great deal among different varieties of vinegar like balsamic and white wine, since they also contain acetic acid.
Since apple cider vinegar is a fermented food product, Kimball says it could, in theory, supply probiotics to improve our microbiome, which is the population of microbes in our digestive tract that appear to play a big role in overall health. After analyzing blood and stool samples of healthy adult participants, Stanford School of Medicine researchers discovered that a 10-week diet high in fermented foods (6 servings daily) resulted in measurable improvements in microbiome diversity and decreases in markers of inflammation.
“However, because we’re typically consuming such small volumes, it doesn’t seem likely that apple cider vinegar would be a significant source of probiotics in our diet compared to other fermented foods,” says Kimball. “Instead, I would look at it as every bit helps.” To date, there are no studies specifically addressing apple cider vinegar’s impact on the microbiome.
It’s likely that apple cider vinegar contains small amounts of the various phytochemicals found in the apples it is produced from. These phytochemicals could give the vinegar some antioxidant activity to help reduce cell damage in the body that may offer protection from various conditions like cognitive decline.
“But, the amount of antioxidants you’d get from typical serving sizes of apple cider vinegar is likely much less than what you would get from whole apples and other fruits,” Kimball says. “I would not count on it to give us a significant impact in terms of antioxidant benefit.”
Here’s how to add apple cider vinegar to your diet
The easiest way to incorporate ACV into your diet is to use it in salad dressings. You can also toss it into cooked grains and use it in sauces and homemade condiments for some vinegary tang. Pickled vegetables can also be another source of acetic acid in your diet.
Some people will dilute the ACV in water and drink it before meals, which could improve post-meal blood sugar numbers. “I typically recommend diluting 1 ounce [of ACV] in about 4 ounces of water, herbal tea, or other types of no-sugar beverages,” Kimball says. However, she cautions that it’s essential to adequately dilute the vinegar—due to its acidic nature, it can damage the gastrointestinal tract and tooth enamel.
Ideally, you want to use an unfiltered apple cider vinegar that contains a cobweb-like floating substance referred to as the “lass” and has an amber color with a cloudy appearance. Bragg is one of the most popular brand options. Most commercial apple cider vinegar takes shortcuts from the longer fermentation process so it won’t have the same flavor nuances or probiotics.
You can also find apple cider vinegar in capsule and gummy form, but it’s not known if these are as helpful and there can be quality control issues.
The bottom line is...
Though the research holds some promise, especially related to blood sugar management when eating your higher carb meals, the quality of evidence surrounding the benefits of apple cider vinegar is not yet there and we don’t yet know if it is any better for you than other vinegar varieties. At the very least, it can make vegetables taste more exciting so you’ll want to eat more of them, which is certainly something to celebrate.