Written by Cami Salisbury | Reviewed by Fit with Food dietitians

For years, apple cider vinegar (ACV) has been put on a pedestal in medicinal and culinary history for its countless healing benefits. I’m sure you’ve seen it advertised as a miracle elixir for everything from promoting weight loss to improving blood sugar levels, lowering cholesterol, and reducing that always irritating and often painful heartburn… but how much of those claims are anecdotal stories, and how much is actually backed by scientific evidence? Well lucky for you, that’s exactly what we’re going to talk about.  

ACV for Weight Loss?

         Let’s start with the hot topic that most people want to know about. Is ACV the missing component that I need to manage my weight or maximize weight loss? The short answer is no. You probably saw that coming, but if you’re anything like me, you have that inner little kid constantly asking, “but why?”. To start, there is very little scientific evidence supporting this claim, and the research that does exist is limited (as in small studies) and with incomplete information. For example, a randomized trial researching apple cider vinegar on weight management did find that taking ACV decreased overall body weight, improved BMI, and reduced hip circumference in overweight or obese subjects.1 However, the catch is the participants were also on a restricted calorie diet and engaged in physical activity, both of which are known to contribute to weight loss.1 Even when examining other studies that specified they did not restrict calories or measure physical activity, it’s challenging to account for the subjects’ potential interventions participated in outside of the study. Without more research, and better designed trials, apple cider vinegar for weight loss is inconclusive.

ACV for High Blood Sugar and High Cholesterol?

         While studies have suggested significant benefits for lowering blood sugar levels in individuals with high blood sugar (hyperglycemia) and improving cholesterol levels overall, the research suffers from similar complications seen with weight loss studies. In a meta-analysis of nine studies improvement was seen in patients with hyperlipidemia and type 2 diabetes, however, the studies are small and suggest limitations on knowledge of lifestyle changes the subjects engaged in (e.g., diet restrictions and physical activity).2 Typically, if an individual is engaging in health promoting behavior, they are likely making healthier choices all around, such as balanced meals, more exercise and better sleep habits. While these results are promising, more research is needed to support recommending apple cider vinegar as a treatment for these conditions. Additionally, there are some concerns as to the safety of taking ACV if you have diabetes or are on any heart medication, but more on that later.

ACV for Heartburn?

         Heartburn, also known as acid reflux, has been the most baffling trend for me to wrap my head around. Unlike the other conditions in which there are studies being conducted in an attempt to find answers, there is little to no scientific research to be found on apple cider vinegar’s effects on acid reflux. The information that exists pairs ACV with other functional foods and supplements as a treatment for heartburn, but even that information is anecdotal. The bottom-line here is, I can’t say one way or another if ACV is beneficial, because there is no significant evidence to analyze. 

What if I still want to try ACV, is it safe?

         Well yes, used in reasonable amounts, typically in condiments or other recipes, it is generally recognized as safe (GRAS) by the U.S. Food and Drug Administration (FDA), however there are circumstances that could be potentially painful and/or dangerous if consumed. First, regularly consuming a shot of ACV has a high risk of breaking down tooth enamel, along with potentially causing esophageal irritation or damage, and can exacerbate acid reflux.3 Most importantly, apple cider vinegar should be avoided when taking diuretics, laxatives, or if you have kidney issues, as it can lead to a significant reduction in potassium levels, and it may pose serious side effects in managing blood sugar levels when used alongside insulin or diabetic medications.3

At the end of the day what concerns me most is our constant search for quick fixes to improve our health, even though science repeatedly reinforces the importance of a well-balanced diet and regular exercise for controlling blood sugar, lowering cholesterol, and managing weight. Even heartburn requires a personalized approach that considers factors like meal size, timing, food choices, and overall lifestyle habits. This is precisely where nutrition professionals can step in, working with you to set achievable goals and guide you through the process one step at a time. It’s all about making sustainable changes for long-term health improvement. Still I’m curious, have you tried apple cider vinegar and experienced these potential benefits or risks? Leave a comment or send us an email and let us know about it! 

References

1. Khezri SS, Saidpour A, Hosseinzadeh N, Amiri Z. Beneficial effects of Apple Cider Vinegar on weight management, Visceral Adiposity Index and lipid profile in overweight or obese subjects receiving restricted calorie diet: A randomized clinical trial. ScienceDirect. April 2018. Accessed October 4, 2023. https://doi.org/10.1016/j.jff.2018.02.003. 
2.  Hadi A, Pourmasoumi M, Najafgholizadeh A, Clark CCT, Esmaillzadeh A. The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials. BMC Complement Med Ther. 2021;21(1):179. Published 2021 Jun 29. doi:10.1186/s12906-021-03351-w
3. Lawler M, Barrie L, Kennedy K, et al. 7 potential side effects of Apple Cider Vinegar. EverydayHealth.com. September 2022. Accessed October 4, 2023. https://www.everydayhealth.com/diet-nutrition/potential-side-effects-apple-cider-vinegar/.