Episode 108 – Apple Cider Vinegar

Key Topics Covered  

Apple Cider Vinegar

Weight Loss

  • Apple Cider Vinegar (ACV) is often linked with weight loss.
  • Weight loss occurs through the principle of ‘Calories In vs Calories Out’.
    • ACV has no proposed mechanism for increasing TDEE (i.e. calories out). Even if somebody claimed increased fat oxidation, that wouldn’t necessarily translate to fat loss without a calorie deficit. 
  • The main study people refer to is a 12-week Japanese study with 155 participants involving vinegar (not ACV specifically).
    • Participants consumed 500ml of liquid ranging from 0-30ml of vinegar per day, based on their group. 
      • This resulted in a weight loss of 1.7kg over 12 weeks. 
    • This is not a significant amount of weight loss.
    • The Participant’s intake was self-reported.
    • Within 4 weeks post-trial they had regained 1.4kg.
    • Nausea is also a common symptom of ACV intake. Does this explain the small losses we see in research? 

Blood Glucose Levels 

  • ACV actually seems pretty promising for reducing BGLs.
  • The mechanism is that acetic acid helps with delaying gastric emptying.
    • Although, this mechanism requires that the ACV needs to be consumed nearer to meal times.
  • One example of this is a study that had vinegar prior to the consumption of 50g of white bread.
    • BGLs were raised 31% less with the apple cider vinegar.  
  • This could be particularly relevant to those with diabetes.

Cholesterol 

  • Cholesterol is more complex.  
  • Animal studies look promising, but this may not be relevant for humans. 
  • A systematic review found 9 studies on the topic.
    • It concluded that it could help cholesterol, but it’s a bit more nuanced than that. 
    • The impact on total cholesterol was very small. A direct quote from the study stated; “significantly decreased total cholesterol”, but the absolute change was an average of 0.16mmol/L.  

Cancer 

  • There is no direct, convincing evidence indicating that ACV reduces cancer risk.
  • The claim mostly stems from concepts related to the alkaline diet.  
    • A systematic review of the alkaline diet found no evidence that it reduces cancer risk.
  • Ultimately, there needs to be more evidence supporting the claim that ACV reduces cancer risk in any way.

Digestion 

  • Digestion is difficult to measure. Does this refer to a reduction in IBS symptoms, or something else? 
  • There is no research on this topic. But there are two proposed mechanisms. 
  • One mechanism is delayed gastric emptying.
    • But even that could be interpreted from the other angle since that could slow digestion. 
  • The other mechanism is specific to ACV and not just vinegar. This is due to the ‘mother’ which is the cloud of bacteria at the bottom of ACV. 
    • This could have a beneficial probiotic effect.
  • Currently, we only have anecdotal outcomes though. 
Dentist looking at teeth

Tooth Enamel

  • Apple cider vinegar is acidic to the point that it can negatively impact tooth enamel if not diluted. 
  • This is a very clear mechanism and would therefore be unethical to study this in humans as part of a randomized controlled trial.
    • In-vitro studies have demonstrated this effect clearly. 
  • To avoid this effect, it is important to dilute the ACV.
    • Instead of having a straight shot, dilute it with some water, or at minimum, rinse your mouth afterward. 

Oesophageal Health

  • There is no clear evidence that ACV has a negative impact on the oesophagus.  
  • From a cautious perspective, it is worth knowing that accidental ingestion of vinegar is a common cause of throat burn in children. 
  • There is also a case report of a woman who had an ACV tablet stuck in her throat and was suffering from burns as much as 6 months later. 
Blood glucose monitor with apples

Summary 

  • There is very little research supporting most claims about ACV.
  • This may be beneficial for those living with T2DM and could be something to consider on top of implementing other dietary and lifestyle changes for this condition.
  • If you are going to trial ACV, diluting it will help minimize any potential negative outcomes.

Relevant Links / Resources

Blog Posts

Studies Mentioned