Apple cider vinegar (or ‘ACV’) has been used as a health tonic for decades. There are a lot of health claims behind ACV, including the ability to balance blood sugar, balance skin pH, influence the gut microbiome, aid digestion, decrease risk of neuro-degenerative diseases, and helping to manage weight.
What is Apple Cider Vinegar?
Apple cider vinegar is made from crushed apples with added bacteria and yeast which ferment the liquid. It is similar to a ‘hard’ apple cider which is alcoholic, but with ACV additional fermentation changes the alcohol into vinegar. Raw, unfiltered, organic ACV (the only kind we recommend) ferments naturally, usually over a year or two, and contains the ‘mother’ – the brownish, cloudy collection of cellulose and acetic acid bacteria which is rich in enzymes, proteins and pectin.
Health Benefits
Balancing Blood Sugar
One of the most powerful benefits of ACV is its ability to balance the body’s blood sugar. Studies have shown that ingesting 2 tablespoons of ACV at mealtimes reduces the presence of glucose in the blood after eating. Furthermore, a small study of adults with type 2 diabetes concluded that taking vinegar at bedtime (along with a small snack of cheese) lowered waking glucose levels in the study group almost twice as much as the control group who had water with their snack instead of vinegar. 1
Another study compared the effects of ACV on healthy adults (insulin sensitive), those with pre-diabetes, and those with type 2 diabetes (insulin resistant). All three groups were given ACV drinks two minutes before consuming a high carbohydrate meal (a white bagel with butter and a glass of orange juice). All participants who consumed ACV (versus the control group who consumed water) showed improved blood glucose levels in blood samples taken 30 and 60 minutes after eating. The researchers concluded that ACV can significantly improve insulin sensitivity in those who are insulin resistant. Acetic acid, the active ingredient in ACV, has been shown to raise glucose-6-phosphate concentrations in skeletal muscle, indicating that ACV may have effects on the body which are comparable to pharmaceutical drugs like metformin. 2
Weight Control
Some research suggests that ACV may be helpful in managing weight. An animal study found that acetic acid (the key component in ACV) activates genes that trigger enzymes to break down fat, preventing weight gain. 3
In a double-blind human trial of obese adults with similar body weights and waist measurements, the participants drank either an ACV-containing beverage or one without ACV every day for 12 weeks. At the end of the study, those who drank the ACV-containing beverages had less abdominal fat, lower triglycerides, smaller waist measurements, lower body weight, and lower BMI than the group who did not consume ACV. 4
Gut Microbiome
ACV has been found to improve digestive health by increasing levels of healthy bacteria in the gut, as well as reducing symptoms in gastrointestinal disease. In an animal study of mice with ulcerative colitis, adding acetic acid to their drinking water increased levels of beneficial bacteria in their guts, including lactobacillus and bifidobacteria.
Reducing the Risk of Neurological Disease Including Alzheimer’s
A recent study examined the effects of ACV on the brain cells of cognitively impaired mice. Subjects were treated with either ACV, a synthetic flavonoid (Chrysin), or an anti-Alzheimer’s drug (Rivastigmine) to examine their protection against cellular toxicity and neurotoxicity. Results showed that ACV had better antioxidant and neuroprotection potential compared to the other substances. Researchers concluded that as ACV has high antioxidant potential and is readily available as a food additive in the daily diet, it may be effective in reducing the threat of neuro-degenerative diseases. 5
Heart Disease
An animal study measured the effects of acetic acid on rats which were fed a high cholesterol diet. The group which had acetic acid added to their diet had much lower cholesterol and triglyceride levels. Acetic acid is also believed to lower blood pressure. At present there are not any human trials studying the effects of ACV and heart disease. 6
Acid Reflux
Contrary to popular belief, acid reflux is often a result of too little stomach acid, not too much. Stomach acid is required to kill microbes and keep unhealthy bacteria from proliferating. Too little acid can lead to bloating, indigestion, decreased absorption of vitamins and minerals, and acid reflux. Drinking diluted ACV before meals helps to balance the pH of the stomach by increasing stomach acid. At present there is no research supporting this claim in medical journals, but there is plenty of anecdotal evidence.
Skin Remedies
Acetic acid, the key ingredient in ACV, is a synthetic carboxylic acid with antibacterial and antifungal properties. 7 Many DIY skin care recipes exist using ACV as a key ingredient, such as facial wash, toner, and spot treatment. Anecdotal reports suggest using ACV in skin care can help to tighten skin and protect it from forming wrinkles. The antimicrobial properties in ACV may help in reducing bacterial growth on the skin, thereby reducing acne breakouts. ACV may also be effective in exfoliating the outermost layer of skin due to the fruit acids it contains, including malic acid.
Safety
Tooth Decay
Like all vinegars, ACV is acidic, and an abundance of acidic foods and drinks can weaken tooth enamel over time. The risk is highest when regular consumption of undiluted ACV occurs. Diluting the ACV in filtered water and drinking before meals significantly reduces this risk.
Indigestion
Drinking undiluted ACV can worsen symptoms in people with digestive issues such as stomach ulcers or acid reflux. ACV should always be diluted in water before consuming.
Skin irritation
Applying ACV directly to the skin can cause irritation. ACV should always be diluted before applying to skin, except in the case of spot treatment where a very small amount may be applied with a cotton swab to the affected area only.
Silent Reflux
Those diagnosed with silent reflux (laryngopharyngeal reflux/LPR) (a kind of reflux that causes respiratory symptoms such as hoarseness, cough and asthma) should avoid consuming ACV.
Hiatus Hernia
Drinking a small amount of diluted apple cider vinegar at the beginning of meals is usually safe with a hiatus hernia and may also help reduce symptoms.
Apple Cider Vinegar Recipes
For everyday gut health
Mix one tablespoon ACV with a cup (200ml) filtered water and drink 15 minutes before meals. For a sore throat add 1tsp raw honey and ¼ tsp grated fresh ginger root.
A 2016 review suggests drinking around 15ml of vinegar (diluted into water) may help you achieve the above potential health benefits. 8
Face wash
Mix ¼ cup (60ml) warm water with 1 tablespoon ACV and gently cleanse skin with a clean cloth.
Face toner
1 part ACV to 2 parts purified water. Apply to skin with a cotton pad or ball, or use a spray bottle to spritz onto the skin.
Spot treatment
Dab undiluted ACV onto the spot with a cotton swab or ball. Use sparingly and only on the spot as it can irritate the surrounding skin.
References
White, A.M. and Johnston, C.S. (2007). ‘Vinegar Ingestion at Bedtime Moderates Waking Glucose Concentrations in Adults With Well-Controlled Type 2 Diabetes’, Diabetes Care, 30(11), pp. 2814-2815.
Johnston, C. S. et al. (2004). ‘Vinegar Improves Insulin Sensitivity to a High-Carbohydrate Meal in Subjects With Insulin Resistance or Type 2 Diabetes’, Diabetes Care, 27(1), pp. 281-282.
Kondo, T. et al. (2009). ‘Acetic Acid Upregulates the Expression of Genes for Fatty Acid Oxidation Enzymes in Liver To Suppress Body Fat Accumulation’, Journal of Agricultural and Food Chemistry, 57, pp. 5982-5986.
Kondo, T. et al. (2009). ‘Vinegar Intake Reduces Body Weight, Body Fat Mass, and Serum Triglyceride Levels in Obese Japanese Subjects’, Bioscience, Biotechnology and Biochemistry, 73(8). DOI: 10.1271/bbb.90231
Tripathi, S. et al. (2020). ‘Ameliorative effects of apple cider vinegar on neurological complications via regulation of oxidative stress markers’, Journal of Food Biochemistry, DOI: 10.1111/jfbc.13504
Fushimi, T. et al. (2006). ‘Dietary acetic acid reduces serum cholesterol and triacylglycerols in rats fed a cholesterol-rich diet’, British Journal of Nutrition, 95, pp. 916-924.
National Center for Biotechnology Information. "PubChem Compound Summary for CID 176, Acetic acid" PubChem, https://pubchem.ncbi.nlm.nih.gov/compound/Acetic-acid. Accessed 26 November, 2020.
Samad, A. et al. (2016). Therapeutic effects of vinegar: A review’, Current Opinion in Food Science, 8, pp. 56-61.