By Helaine Krasner, MS, RDN, CSOWM, CDN
It’s easy to be swayed by the magic of advertising. Promoters of apple cider vinegar (ACV) would have you believe it’s the secret weapon you’ve been searching for to speed up your metabolism or detoxify your digestive system. But what does the evidence say and are there any potential dangers?
ACV, also known as acetic acid, is made by adding yeast to apple juice, which turns sugar in the juice to alcohol through a process called fermentation. ACV has many uses in cooking, baking and salad dressing and these applications are separate from its use as a dietary supplement.
What are the potential benefits?
ACV has a long history of use as a home remedy for a variety of health issues, but reliable evidence of any real benefit is lacking. Preliminary research shows that ACV consumed with meals may help lower blood sugar in those with diabetes and can help improve insulin sensitivity, meaning glucose has an easier time moving from your bloodstream into cells where it can be converted to energy. And it may help slow gastric emptying, which can promote satiety and help avoid blood sugar spikes. ACV would not be appropriate for someone with gastroparesis, the rare condition of slow gastric emptying, more common in people with diabetes. It is also recommended that those taking medication for diabetes monitor blood sugar closely if using ACV so that medication can be adjusted if needed.
There is limited evidence from one small study that one tablespoon of ACV consumed twice daily with meals combined with a calorie-restricted healthy diet and exercise may result in more weight loss than diet and exercise alone. Additional health benefit seen in this study was decreased triglyceride levels and increased HDL cholesterol (1). However, more research is needed to confirm these results.
What are the concerns?
Although ACV is considered safe by Natural Medicines research group when used orally and appropriately for short-term medicinal purposes up to 12 weeks, topical use may cause burns. Be aware that drinking ACV can erode your tooth enamel and exacerbate acid reflux. It’s recommended that you dilute no more than 1-2 tablespoons of ACV in water prior to drinking. Too much vinegar can also cause your potassium levels to drop too low, which can have a negative effect on proper muscle function. Use caution if you are taking medication that can also lower potassium levels, such as some diuretics that help lower blood pressure. Long term intake of high doses of ACV (1 cup or more per day) have been linked to increased risk of osteoporosis. There is no evidence ACV improves digestion or prevents cancer, heart disease or infections.
In spite of these possible benefits and relative safety, if you opt to use ACV as a dietary supplement for its potential health properties you will get the most benefit if you combine it with a healthy diet and lifestyle that is known to improve health. Before taking any supplement, it’s important to understand the science and how it applies to you before you jump on the bandwagon for the next “miracle cure”. Always tell your healthcare provider about any dietary supplements you are using so they can make you aware of any potential concerns related to your health or interactions with medications you are taking.
Note: There is no reliable evidence that apple cider vinegar is helpful for COVID-19.
- Khezri SS, Saidpour A, Hosseinzadeh N, Amiri Z. 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. 2018:43, 95-102.
Helaine Krasner, MS, RDN, CSOWM, CDN is a registered dietitian nutritionist who takes great pride in helping our Bariatric and Medical Weight Management patients achieve their health and weight loss goals.