The Wonder Drug in Your Pantry: Apple Cider Vinegar
Apple cider vinegar (ACV) is much more than a condiment. This unassuming pantry staple has been used for everything from cosmetics to medicine for thousands of years.
Once relegated to the realm of folk medicine, it's recently reentered the limelight as a panacea beloved by everyone from health bloggers to celebrities such as Katy Perry and Questlove. But it raises the question: Is ACV really a magical remedy, snake oil or something in between?
It's time to dig into these claims and separate fact from fiction.
What makes ACV so special?
Compared with other kinds of vinegar, like balsamic or white wine vinegar, apple cider vinegar has a disproportionately high level of fame even though it's made through fermentation—just like all the other cider varieties—and, like most, it contains 5 percent acetic acid.
"Apple cider vinegar is a fermented juice made from mixing crushed apples with yeast and sugar," explained Arika Hoscheit, a registered dietitian. "The fermentation process converts the sugars into alcohol and then into acetic acid. It contains beneficial yeast and bacteria that are formed during fermentation."
There are two main types of apple cider vinegar. Distilled ACV, which is clear and light, is what you'll typically find near the salad dressings and olive oil in the grocery store. However, what most proponents use is raw, unfiltered or unpasteurized ACV, which is murkier but purported to have more potent health benefits.
During the fermentation process, natural enzymes create a cloudy, stringy cluster known as the "mother." This wispy substance is filtered out of pasteurized apple cider vinegar but remains in unpasteurized varieties, settling to the bottom of the bottle. It's perfectly safe to consume, and some experts say it delivers additional acetic acid bacteria and other beneficial compounds, which might otherwise be destroyed or removed during the pasteurization and filtration process.
Listing the potential benefits
Right up there with coconut oil, ACV has been touted as a cure-all for all kinds of medical ailments. Some claims are more legit than others. Here's what we know.
Digestion and gut health
Evidence suggests a flourishing microbiome can have a substantial positive impact on various facets of well-being, from immunity to mental health. Like other fermented foods, including yogurt, kimchi and pickles, unpasteurized apple cider vinegar contains beneficial probiotic bacteria that promote a healthy gut microbiome.
Plus, although it seems counterintuitive, consuming unpasteurized ACV could provide temporary relief from stomach issues, such as indigestion, acid reflux and heartburn, due to its ability to neutralize stomach acid. However, it's unclear if apple cider vinegar would have a long-term impact on these conditions.
Blood sugar control
One of ACV's most promising potential perks is its ability to reduce postprandial glycemia—a post-meal blood sugar spike. A 2010 study published in the Annals of Nutrition and Metabolism found people who consumed two teaspoons of vinegar after eating a meal containing complex carbohydrates had a blood sugar increase of 20 percent less than participants who took a placebo.
Another study published in 2005, in the European Journal of Clinical Nutrition, found people who consumed vinegar before a meal experienced an improved insulin response compared to those who took a placebo.
"ACV has been shown to significantly lower blood glucose and insulin response levels after meals and increases satiety," Hoscheit explained. "This is in part due to acetic acid's ability to help delay gastric emptying."
Although not a cure by any means, vinegar's potential effects on blood sugar and insulin response mean it may be particularly beneficial for people with type 2 diabetes. People with this disease have insulin resistance or the inability to produce insulin in the body, resulting in high blood sugar.
A small study published in Diabetes Care indicated people with diabetes experienced a 4 percent decrease in fasting blood sugar in the morning after consuming 2 tablespoons of ACV before bed. That said, more research is needed, and experts, including registered dietitian Fareeha Jay, stress that people with diabetes or other conditions should not substitute medical treatment with as yet unproven solutions.
"It is vital to understand that to regulate your sugar levels, you must think of a spectrum of things from diet to lifestyle and medication," Jay said. "Being a diabetes specialist, I have never asked my patients to have ACV to regulate their sugar levels."
Some research suggests high blood sugar can cause or exacerbate other chronic diseases, so those without diabetes might want to consider ways to manage their glucose levels. This mainly involves strategies like minimizing high carbs and sugar, and eating protein at every meal, though an apple cider vinegar supplement probably wouldn't hurt.
Immune system support
For thousands of years, vinegar has been used as a cleaning and disinfecting agent. Hippocrates, widely considered the father of modern medicine, used vinegar to clean and disinfect wounds 2,000 years ago, and some still use it for this purpose. Meanwhile, these days, white distilled vinegar is the more common all-purpose disinfecting agent.
Different kinds of vinegar may help treat nail fungus, warts and ear infections while promoting gut health and general immune system function, thanks to their antiviral, anti-inflammatory, anti-yeast and antifungal properties.
"It has antimicrobial and anti-inflammatory properties, and has been shown to inhibit the growth of powerful infections like nonresistant MRSA, E. coli, S. aureus and C. Albicans," Hoscheit noted.
Vinegar also contains polyphenols, which are antioxidants that can protect against oxidative stress and reduce the risk of certain diseases, Hoscheit added.
Healthier skin and hair
Although there's been little scientific research in this regard, some experts and countless anecdotal accounts suggest ACV can promote healthier hair, skin and nails.
One of the most popular applications is for acne treatment. Apple cider vinegar contains organic acids—including lactic, citric, malic and acetic acids—that kill acne-causing bacteria. These acids provide a light exfoliant that can slough off dead cells. Many people swear by dabbing ACV on a spot to dry it up, while others use apple cider vinegar as a daily toner.
There's also evidence ACV might help assuage conditions like eczema and dandruff and prevent dry, brittle tresses because of its antibacterial and antifungal attributes, and the ability to balance pH.
Vinegar is commonly used as a foot soak to remedy rough, cracked heels and fungal nail infections, too. Some claim it can make varicose veins less conspicuous, possibly due to its anti-inflammatory properties. And while it's definitely not a wise solution for a severe sunburn, it might take some of the edge off a mosquito bite or poison ivy rash. However, a word of caution: Be careful not to apply undiluted vinegar to the skin for any reason as it can exacerbate irritation or cause a chemical burn.
Maybe not weight loss…
Although there is some moderate evidence that apple cider vinegar might aid in weight loss, it's unlikely that adding ACV to your diet alone is going to be enough to help you shed pounds permanently.
"The most popular claim for ACV is that it helps you with weight loss," Jay said. "This is a very common query asked by my clients and they are very keen on having it. There is no robust research to suggest that ACV will make you lose weight. There have been a few very small studies showing mild weight loss, but keep in mind that those studies were for a very short period with many other confounders."
For example, a 2009 trial published in Bioscience, Biotechnology and Biochemistry, examined 175 human participants who drank 0, 1 or 2 tablespoons of vinegar per day. After three months, researchers found the participants who had consumed vinegar had lost 2 to 4 pounds on average and had lower triglyceride levels compared to those who did not consume any vinegar.
There is no robust research to suggest that ACV will make you lose weight.
Another study published in 2018 in the Journal of Functional Foods had 39 participants follow a restricted-calorie diet with ACV or the same diet without apple cider vinegar for three months. Both groups shed pounds, but those who'd taken ACV lost slightly more. Some studies in obese rats and mice suggest the acetic acid in vinegar may prevent fat deposition and boost metabolism, too.
Jay said the notion that apple cider vinegar can promote weight loss through appetite suppression is also primarily unfounded.
"In one study, it reduced the appetite of the participants because it made them nauseous because of its bad taste," she explained.
"While ACV has been shown to improve weight loss success, it seems to be a modest benefit, and research on this topic is a bit limited," Hoscheit said. "In other words, it's not a magic bullet but rather a potential tool to add to your weight loss arsenal. It's important to also continue to approach weight loss with a nutrient-dense diet, reasonable calorie reduction and exercise."