Health benefits: Apple cider vinegar

What is apple cider vinegar?

Apple cider vinegar is made by fermenting the sugars from apples which turns them into acetic acid – the active ingredient in vinegar.  In the shops you may see apple cider vinegar labelled as 'filtered' (a clear liquid), or unfiltered and containing something known as ‘mother’. That means there are proteins, enzymes and friendly bacteria present, and they give this type of vinegar a cloudy appearance. 

Nutritional benefits of apple cider vinegar

Apple cider vinegar doesn’t really contain any vitamins or minerals, other than a very small amount of potassium, copper and magnesium, and there isn’t enough research at the moment to demonstrate that buying the ‘mother’ variety is any better for you than buying filtered. However, apple cider vinegar does also contain amino acids and antioxidants.

How can you use apple cider vinegar?

Apple cider vinegar can be incorporated into cooking or used in salad dressings.

If choosing to drink apple cider vinegar, make sure that it is sufficiently diluted – it is too acidic to drink straight. Given that it's a traditional remedy and not a medicine, there are no official guidelines on how to consume it. Some people choose to stir between 1 tsp - 2 tbsp of apple cider vinegar into a glass of water.

What about some of the health claims for apple cider vinegar?

Can apple cider vinegar help manage blood sugar levels?

There have been several studies that demonstrate how vinegar can help improve insulin sensitivity (that is, how much insulin someone needs to lower blood sugar levels after eating) when drunk with a high-carbohydrate meal in both insulin-resistant and healthy participants.

Research published by the American Diabetes Association found that taking two tablespoons of apple cider vinegar before bed can reduce fasting blood sugars, too.

In 2016 a study carried out by Michael Mosley and Aston University showed that drinking dilute apple cider vinegar appeared to bring blood sugar levels down in a small study.

Can apple cider vinegar help with weight loss?

There are mixed results to date on whether apple cider vinegar is effective in aiding weight loss. There has been some evidence that as well as being of benefit to blood sugars, vinegar may also help to increase the feeling of fullness when consumed with a high-carb meal, which could help with weight loss by preventing overeating later in the day.

A 12-week study in Japan also found that acetic acid, found in apple cider vinegar, helped to reduce body weight, BMI and visceral fat in obese individuals. More research is needed, though, before we can confidently make this claim.

Can apple cider vinegar help lower cholesterol?

To date, only research in animal studies has demonstrated that apple cider vinegar, and its antioxidant chlorogenic acid, can help manage cholesterol and triglyceride levels, which is not robust enough for us to say that this would also be the case in humans.

Can apple cider vinegar help prevent heartburn?

There is little evidence to support this claim, but anecdotally some people do claim that apple cider vinegar does help reduce their heartburn which, if they have low stomach acid, may be of benefit. However, if the problem is that you have high stomach acid then this may in fact make the symptoms worse. One study in America did find that unfiltered apple cider vinegar can prevent heartburn but again more research is required in this area.

Are there risks to taking apple cider vinegar?

It is important to note that as apple cider vinegar is a traditional remedy and not a medicine, there are no official guidelines for how to take it. There is also limited data available for the effects of long-term use or consumption of large quantities of apple cider vinegar.

The potential lowering of blood sugars could be problematic for diabetics, including those who use insulin, and it may reduce potassium levels in the body. For the same reason, apple cider vinegar is best avoided if you are taking any diuretic medication or water pills.

For those suffering with gastroparesis or delayed gastric emptying, where the movement of food between the stomach and small intestine is slowed, apple cider vinegar may make the symptoms worse and should be avoided.

There is also a concern that acidic drinks, such as apple cider vinegar, may cause damage to tooth enamel. As a precaution, it is a good idea to dilute apple cider vinegar appropriately, never consume it neat, and don't sip throughout the day. It may also help to rinse the mouth with fresh water after consuming apple cider vinegar. Check with your dentist if you are concerned.

Written for BBC Good Food