Health Benefits of Apple Cider Vinegar
We are hearing more these days about the use of apple cider vinegar as a cure for everything from Type 2 Diabetes to eczema, high cholesterol, and obesity. Unfortunately there is only a small amount of of science-based studies about apple cider vinegar to support these therapeutic health claims. This is a common problem for many natural and alternative therapies. So what do we know?
Vinegar folklore is as colorful as it is practical. Legend states that a courtier in Babylonia (c. 5000 BC) “discovered” wine, formed from unattended grape juice, leading to the eventual discovery of vinegar and its use as a food preservative. Hippocrates (c. 420 BC) used vinegar medicinally to manage wounds. Hannibal of Carthage (c. 200 BC), the great military leader and strategist, used vinegar to dissolve boulders that blocked his army's path. Cleopatra (c. 50 BC) dissolved precious pearls in vinegar and offered her love potion to Anthony. Sung Tse, the 10th century creator of forensic medicine, advocated hand washing with sulfur and vinegar to avoid infection during autopsies. In Japan, “Less salt, more vinegar” is listed second in the ten longevity rules. In China’s written history, vinegar can be traced back to the 8th century B.C. There’s an old saying — “Firewood, rice, oil, salt, sauce, vinegar, and tea are indispensable in our daily life” — that indicates vinegar played an important role in Chinese life. The Prescriptions for Fifty-two Diseases unearthed in China’s Hunan Province is the earliest prescription ever found in the country. It details the uses of vinegar to treat everything from burns and hernias to dog bites to high cholesterol. Apple cider vinegar also has a strong history in Africa as an alternative medicine.
Based on the writings of US medical practitioners dating to the late 18th century, many ailments, from dropsy to poison ivy, croup, and stomachache, were treated with vinegar, and, before the production and marketing of hypoglycemic agents, vinegar “teas” were commonly consumed by diabetics to help manage their chronic aliment.
Research investigating the actual medicinal claims of apple cider vinegar is scant, however, a few studies do show some promise of apple cider vinegar as an alternative therapy.
- In 2009, a Japanese study found that in 175 obese subjects who consumed a daily beverage containing 15 ml of vinegar (750 mg AcOH) achieved a decrease in body weight, BMI, visceral fat area, waist circumference, and serum triglyceride levels that were significantly lower than in a placebo group.
- Another study demonstrated an improvement in insulin action in the skeletal muscle of human adults with diabetes.
- A 2015 study demonstrated that vinegar consumption in patients with Type 2 diabetes improved blood sugar control, insulin levels, and high triglyceride levels.
The mechanism of action of vinegar is not fully understood, but the lowering of the pH in the stomach may slow down gastric emptying, change metabolism of high-carbohydrate meals by decreasing post-meal spikes in glucose and insulin levels, and may have an influence on the gut microbiome. Aside from influencing obesity, diabetes and vascular disease, these may also help alleviate GERD (heart burn).
Unfortunately, not all of the study results are positive. One study showed promotion of further stomach issues for patients with Type I diabetes. One of the earlier studies also found isolated cases of significant tooth erosion related to drinking apple cider vinegar.
Safety
Vinegar's use as a condiment and food ingredient spans thousands of years, and perhaps its use can be labeled safe by default. Yet there are rare reports in the literature regarding adverse reactions to vinegar ingestion. Inflammation of the oropharynx and second-degree caustic injury of the esophagus and stomach have been reported. Esophageal injury by vinegar while possible is however very rare. Chronic inflammation of the esophagus is a cancer risk, but, vinegar appears to be inversely related to risk for cancer of the esophagus.
The unintentional aspiration of vinegar has been associated with laryngospasm and subsequent vasovagal syncope. Hypokalemia (low potassium) has been occasionally reported.
These complications attributed to vinegar ingestion do appear to be very isolated occurrences, but with the increased interest in vinegar as adjunct therapy in diabetes and weight loss, care should be taken, watching for potential adverse effects, with regular vinegar ingestion.
Bottom Line
A few scientific investigations have documented that vinegar ingestion reduces the glucose response to a carbohydrate load in healthy adults and in individuals with diabetes. There is also some evidence that vinegar ingestion increases short-term satiety and may be a beneficial adjunct for weight loss. Vinegar is widely available; it is affordable; and, as a remedy, it is appealing.
For most medicinal purposes no more than 1-2 tablespoons per day is recommended. The side effects of large amounts include decreased potassium levels, which could be life threatening. Vinegar may also interact with diuretics, laxatives, and medicines for diabetes and heart disease. So before you start to drink vinegar as an alternative therapy, consult your integrative medicine physician about the medications you are taking that could interact with consistent and or large doses.