Apple Cider Vinegar (ACV) has been used for centuries as a natural remedy for ailments. It has antiseptic properties and is used in pickling and preserving. It is dated back to ancient Greece as being used by Hippocrates to treat colds. Apple cider vinegar (ACV) is produced by fermenting apples, resulting in acetic acid and polyphenols- both responsible for ACV’s health benefits. My grandfather took a shot of ACV every morning, was healthy as a horse and lived to be 92. Now of course this is anecdotal, so let’s look at the evidence and see if ACV is a cure-all, the latest snake oil, or if it falls somewhere in the middle. And is it accurate to consider ACV as probiotic?
Health benefits of Apple Cider: Fact or Myth:
1. Blood glucose control- In one study, supplemental ACV reduced total cholesterol and fasting glucose levels and A1C levels in type II diabetics- all factors contributing to the onset of the leading cause of mortality worldwide- cardiovascular disease1. The blood glucose control is likely attributed to the acetic acid lowering the rate at which carbohydrate is converted to glucose in the bloodstream. Another study showed that ACV intake lowered postprandial (or post-meal) glucose levels.2 Note: ACV will not cure diabetes but can assist in glucose control.
2. Lipid lowering-
In the same study cited above, it was found that ACV intake may also lower total cholesterol by increasing lipolysis and decreasing lipogenesis (fat breakdown and fat formation, respectively). In the meta-analysis which included 9 studies, ACV consumption significantly decreases total cholesterol.1
3. Weight loss aid- One study showed that 15ml/day supplementation of ACV reduced body weight, adiposity and lipid levels in an overweight Japanese population.3 Additionally, another study utilizing a 250-calorie per day diet deficit combined with ACV supplementation resulted in reduced body weight, BMI, hip circumference, visceral adiposity and appetite. Triglycerides and total cholesterol levels significantly decreased and high density lipoprotein cholesterol (HDL-C) concentration significantly increased in the ACV group in comparison to the control group which did not receive ACV.4
4. Increases stomach acid- Low stomach acid interferes with the body’s ability to efficiently break down food and absorb nutrients. The result? Gas, bloating, heartburn/indigestion, fatigue, GI infections, etc. Can ACV help? There is insufficient research to suggest that ACV increases stomach acid, however it has been shown anecdotally to help with GERD. Further, ACV is antimicrobial and may inhibit bad bacteria in the gut.
ACV as Probiotic :
A probiotic is defined as “live microorganisms which when administered in adequate amounts confer a health benefit on the host.”5 As mentioned, ACV is the product of fermentation. The mother, the cloudy stringy mass seen floating in a bottle of ACV, is the yeast and bacteria formed in the process. Once such bacteria is Acetobacter sp and is considered a potential probiotic.6 Bottom line, ACV should not be utilized as a sole source of probiotics. Bottles of ACV are not tested for number and strain of probiotic making it difficult to ascertain the probiotic effect if any. If considering ACV as probiotic, I recommend purchasing a raw, unfiltered product such as Bragg’s Oraganic.
How to take ACV:
There are several ways to take apple cider vinegar. Here are just a few examples:
– dilute about 1-2 tablespoons of raw ACV in an 8 ounce glass of still or sparkling water
– add a splash to salad greens
– add to warm lemon water with honey
– make an ACV vinaigrette
– add a splash to avocado toast
– in a gummy supplement -look for a brand that is third-party tested, such as this organic Digestive Health Jelly, and also be wary of brands with added sugars such as high fructose corn syrup)
ACV has very limited adverse effects including potential stomach burning and erosion of teeth enamel. For the latter it is recommended to brush teeth following a straight dose.
Will ACV cure all that ails you? Short answer- no. However taken regularly it may aid in moderate weight loss, tighter blood glucose control and a lowered lipid profile. Additionally supplementing with apple cider vinegar may provide a natural way to increase low stomach acid and/or inhibit bad microbes in the gut, therby adding to the health of the gut microbiome.
Overall, to have a functional food, such as ACV, in one’s health arsenal and as part of a healthy lifestyle can contribute to better health.
Hadi, Amir et al. “The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials.” BMC complementary medicine and therapies vol. 21,1 179. 29 Jun. 2021, doi:10.1186/s12906-021-03351-w
Shishehbor F, Mansoori A, Shirani F. Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials. Diabetes Res Clin Pract. 2017 May;127:1-9. doi: 10.1016/j.diabres.2017.01.021. Epub 2017 Mar 2. PMID: 28292654.
Tomoo KONDO, et al. “Vinegar Intake Reduces Body Weight, Body Fat Mass, and SerumTriglyceride Levels in Obese Japanese Subjects.” Bioscience, Biotechnology, and Biochemistry, 73:8, 1837-1843, 2009. DOI: 10.1271/bbb.90231
Khezri, Solaleh Sadat et al. “Beneficial effects of Apple Cider Vinegar on weight management, Visceral Adiposity Index and lipid profile in overweight or obese subjects receiving restricted calorie diet: A randomized clinical trial.” Journal of Functional Foods vol. 43, p. 95-102, Apr. 2018, https://doi.org/10.1016/j.jff.2018.02.003
Reid, Gregor et al. “Probiotics: Reiterating What They Are and What They Are Not.” Frontiers in microbiology vol. 10 424. 12 Mar. 2019, doi:10.3389/fmicb.2019.00424