Episode 108 – Apple Cider Vinegar

Key Topics Covered

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.

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.

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

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Studies Mentioned