Apple cider vinegar – health hero or hype?

bottle of apple cider vinegar laying on white marble counter, with whole and half apples surrounding it.

Over the past several years, apple cider vinegar (ACV) has received a lot of attention for multiple health benefits.  According to the hype, this common pantry staple can do everything from helping you lose weight to curing athlete’s foot.  And the supplement industry is making a ton of money by selling it in any form you can imagine: pill, powder, gummy…they’ve made ‘em all.

What can apple cider vinegar really do, though?  Are the amazing benefits touted by the masses legit, or is it placebo effect? 

In this article, I’ll break down the science behind apple cider vinegar from a dietitian’s lens.  Let’s answer the burning question of whether you would benefit from an ACV supplement, shall we?

Claims about apple cider vinegar

Cardiovascular health

ACV has been credited with lowering blood levels of cholesterol and triglycerides.  There is significant research to support this claim in animals.  In humans, however, the results are mixed based on the health status of the individuals studied.

Overall, studies indicate that people with type 2 diabetes can experience decreases in total cholesterol and triglyceride levels when they consume 15 ml or less of ACV daily for 8 weeks or longer.1

Non-diabetic participants, however, did not have any significant changes in total cholesterol or triglyceride levels.  That said, in some studies these individuals did experience an increase in HDL cholesterol (high-density lipoprotein), which is considered the good form of cholesterol.1

Blood sugar control

With rising rates of diabetes, the claim that ACV lowers blood sugar gets a lot of attention these days.  The hope of managing or avoiding diabetes without medication is understandably appealing. 

Results regarding changes in blood sugar with ACV supplementation, though, are variable.  Some studies indicate significant improvement in fasting blood glucose and/or HbA1c levels with use of ACV, while others indicate little to no improvement. 

The trend seems to be that individuals with type 2 diabetes see more improvements in blood sugar control with ACV supplementation than those who don’t have diabetes.1  Additionally, combining ACV supplementation with traditional medication (e.g. Metformin) may be more effective for management of type 2 diabetes.2

It should be noted that how long you take ACV also seems to matter, with supplementation for longer than 8 weeks providing greater improvements in blood sugar than shorter time periods.1

Weight loss

As a dietitian, I work with women all the time who are either taking ACV or ask me if they should take it for weight loss.  ACV loyalists make big claims of weight loss, but does it really work?

The short answer is, once again, sometimes.  Not helpful, right?  Let me elaborate.

Improved blood sugar levels tend to lead to reduced body fat, so it would logically follow that individuals with type 2 diabetes would experience weight loss from ACV supplementation.  Animal studies tend to support this hypothesis, however human studies are mixed.

Likewise, studies on animals with obesity have shown promising results for weight loss with ACV supplementation.  Human studies are less consistent.

ACV tends to suppress appetite, and it reduces production of body fat in the liver while increasing fat breakdown.1 It would make sense, therefore, that weight loss would be inevitable with ACV supplementation.  Humans are complex creatures, though.

What it really comes down to is the fact that no two people respond to nutrition the exact same way.  So many factors within the body play a role in weight loss, including stress, sleep, overall diet and exercise habits, gut health, and any underlying health conditions. 

Unfortunately, even after all these years searching and so many advances in science and medicine, there’s still no silver bullet for weight loss.

Gut health

As noted above, gut health plays a role in weight loss.  It also has a direct impact on brain health, hormone regulation, production of certain vitamins, and a multitude of other body processes that make it crucial to overall health.

ACV is produced by fermenting apples.  Fermentation is a process by which microbes like bacteria and yeast break down the different components of food to produce new substances. 

Fermented foods are known to provide benefits to gut health, as they contain probiotics which add to the population of “good” microbes that live in your gut. 

In addition to containing probiotics, ACV also contains fiber and polyphenols.  Fiber feeds the good microbes in your gut, so they can thrive and reproduce.

Polyphenols are known to improve the mucus lining of your intestines, which helps reduce inflammation throughout the body.  Polyphenols are also antioxidants, which improve immune function and aid in cancer prevention.

How does ACV make magic?

While we don’t yet know all of the specifics of what happens in your body that makes ACV so special, there are some theories.  

First, ACV decreases appetite.  This is likely due to delayed emptying of the stomach.1  For anyone who tends to overeat, this may be helpful for reducing fat and regulating blood sugar.  If, however, you do not overeat and you’re active, this isn’t going to help you and may even be detrimental to your health if you end up undereating.

Second, ACV seems to reduce the conversion of glucose to fat in your liver, and increases utilization of that glucose for energy. 

Additionally, it’s believed that ACV may increase bile excretion, which reduces total cholesterol and triglyceride levels by increasing breakdown of fat while decreasing production of fat in the liver.1

Finally, ACV provides prebiotics (fiber), probiotics (healthy bacteria and yeast), and polyphenols, all of which aid in supporting a healthy gut.  I would argue that this may be the most important benefit of all.

Potential side effects of ACV supplementation

While ACV consumption is safe for the most part, there are a few things to be aware of.

ACV is acidic, so some people experience stomach burning or reflux.  Additionally, highly acidic foods can cause erosion of tooth enamel over time. 

ACV tends to slow gastric emptying, so anyone with gastroparesis should avoid it.

ACV may also lower potassium levels in the body.  Potassium is important for body fluid regulation, bone health and muscle contraction.  Anyone taking medications or supplements that lower potassium levels should avoid taking ACV. 3

ACV supplements

Powder, capsules, gummies, liquid drops and tablets are all options available on the market for ACV supplements.  Then, there’s also the option of drinking ACV in water or including it in your daily meals.

If you do choose to take a processed supplement, always make sure you’re purchasing from a reputable manufacturer that has their products third-party tested.  Since supplements are regulated by the FDA, third-party testing is to ensure that you get exactly what the label says your getting…nothing more, nothing less.

Look for one of the following seals on the label to confirm it’s third-party tested: NSF, USP, ConsumerLab, or Informed Choice.

If you choose to dilute ACV in water, make sure it’s diluted well.  Try no more than 2 tablespoons of ACV in 8-12 ounces of water.  Ultimately, the best way to consume ACV with the least chance of effects from the acidity is in food.

So, is ACV worth it?

With rising rates of obesity, diabetes, and cardiovascular disease, more and more people are looking for alternatives to pharmaceutical interventions.  Functional foods, or foods that provide benefits beyond just standard nutrients and energy, are becoming very popular as a result.

Apple cider vinegar is one such functional food that many are turning to, both in its natural state and as a supplement, for the promise of a slimmer waistline or lower blood sugars.  But can it really do everything they say it can?

The answer truly depends on the individual and what you’re wanting it to do for you.  In the end, ACV isn’t harmful to most people (see side effects above) and has the potential to provide benefits, so add some to your soup or top your salad with apple cider vinaigrette and enjoy!

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