Apple Cider Vinegar

We evaluated 22 human studies on Apple Cider Vinegar, including 13 randomised controlled trials and 4 meta-analyses or systematic reviews; the controlled studies include 473 participants in total. As of 9 October 2026.

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1. What Is Apple Cider Vinegar? Occurrence, Origin and Forms

Apple cider vinegar is a vinegar made from fermented apple juice. It is produced in two steps: first, yeasts ferment the sugar in the apple juice into alcohol; then acetic acid bacteria convert the alcohol into acetic acid. Traditionally it is used in the kitchen for seasoning, pickling, and preserving, and it is regarded as a home remedy.

Apple cider vinegar is found in foods and kitchens, for example in salad dressings, chutneys, and pickled vegetables. In studies it is examined as a drink, as a capsule, or as a powder.

Apple cider vinegar is made by fermenting apple juice; acetic acid is its main component by quantity. Studies examine liquid vinegar diluted with water, dried capsules and powders, and solutions of pure acetic acid.

Forms and Preparations Studied

• Liquid apple cider vinegar, diluted with water
• Apple cider vinegar capsules or tablets (dried)
• Apple cider vinegar powder
• Unfiltered apple cider vinegar with “mother”
• Pasteurised, clear apple cider vinegar

Not covered on this page:

• Apple juice and cider (unfermented or alcoholic)
• Other vinegars such as wine, rice, or balsamic vinegar
• Pure acetic acid solutions without an apple base
• Mixture products in which apple cider vinegar is only one ingredient among others

2. What Does Apple Cider Vinegar Do? Results by Area

How to read the table: counted are human studies whose results concern the area. “High” means at least one meta-analysis and two controlled studies showing improvement, or at least three controlled studies of which three quarters show improvement, with at least 300 participants in total. “Moderate” means at least two controlled studies showing improvement, as a majority, or one meta-analysis alongside controlled studies. “Low” means one controlled study showing improvement. Where an area has no controlled study, the strength of evidence is at most “low” (result “reviews only” or “observational data only”). Everything else is “unclear”. A study counts as showing improvement when at least half of its outcomes in this area improved. Reviews of combination products do not count as meta-analyses; results that only describe side effects or shares of users do not count as an effect. The same study is counted only once.

3. What the Studies Show in Detail

Apple Cider Vinegar and Blood Glucose After Meals: Human Studies

In adults with type 2 diabetes, fasting blood sugar fell more with daily apple cider vinegar than in the control group 7. Another randomized controlled trial found a more favorable HbA1c value than in the control group; fasting blood sugar fell in both groups there, significantly only with apple cider vinegar 16. Meta-analyses on apple cider vinegar support this finding for fasting blood sugar and HbA1c, although the form investigated is not specified in more detail 34. For postprandial blood sugar, diluted liquid vinegar attenuated the rise compared with water in a controlled crossover study in healthy young adults, while vinegar tablets swallowed whole did not; the type of vinegar is not specified 18. In a randomized crossover study in healthy women, dried apple pieces soaked in vinegar added to a rice meal attenuated the blood sugar rise, but dried apple without vinegar did as well 13. The evidence is considered high, but most studies are small, and the exact form of the apple cider vinegar — liquid diluted, capsule or powder, with or without "mother" — is often not described.

Further studies in this area: 21

Apple Cider Vinegar and Blood Lipids: Human Studies

In adults with type 2 diabetes, total cholesterol and the ratios of LDL to HDL and cholesterol to HDL fell more with daily apple cider vinegar than in the control group 16. LDL cholesterol fell within the apple cider vinegar group 16. A meta-analysis on apple cider vinegar found lower total cholesterol, but no effect on LDL and HDL 4. A systematic overview of vinegar in general, without a specified form, showed better total cholesterol, but no differences in LDL, HDL, and triglycerides 2. A small pilot study without a control group in patients with schizophrenia taking clozapine found no significant change in blood lipid levels 21. The evidence is moderate; the forms investigated range from liquid diluted apple cider vinegar to an unspecified form, and the number of participants and the comparison conditions remain open.

Apple Cider Vinegar and Blood Pressure: Human Studies

A randomized controlled trial in type 2 diabetes with elevated blood lipids found no difference in either systolic or diastolic blood pressure with apple cider vinegar drunk daily 7. A review of vinegar in general likewise found no difference in the diastolic value 2. The same review found a somewhat lower systolic value, but combines apple cider vinegar and other types of vinegar without specifying the form 2. The strength of evidence is medium, the data are thin: the controlled trial included 70 participants with type 2 diabetes and hyperlipidemia, and the review does not allow any statement specifically about apple cider vinegar. It remains open whether other forms such as capsules, powder or unfiltered apple cider vinegar with "mother" affect blood pressure.

Apple Cider Vinegar, Weight and Body Fat: Human Studies

For weight and body fat, only review articles are available, no controlled individual studies. A meta-analysis of randomized controlled trials in adults with type 2 diabetes and/or overweight found lower body weight as well as lower values for body mass index and waist circumference with daily apple cider vinegar 1. A systematic review of vinegar consumption in general, which combines apple cider vinegar and other types of vinegar without specifying the form, likewise found lower body weight, but no difference in body mass index and waist circumference 2. The strength of evidence is low because both works leave the studied form open and the second is not limited to apple cider vinegar. Whether diluted liquid apple cider vinegar, capsules or powder have an effect therefore remains open.

Apple Cider Vinegar, Appetite and Satiety: Human Studies

On satiety, only one randomized crossover trial in healthy women is available, and it did not test a pure vinegar preparation: dried apple pieces soaked in vinegar with rice did not reduce satiety 13. Statements about liquid diluted apple cider vinegar, capsules, powder or vinegar with "mother" cannot be derived from this. The strength of evidence is therefore unclear, and it remains open whether apple cider vinegar in other forms affects appetite or satiety.

Apple Cider Vinegar: Further Outcomes in Studies

Further studies tested apple cider vinegar or vinegar for quite different questions. In women with PCOS and metabolic syndrome, metabolic syndrome resolved more often with apple cider vinegar capsules in addition to metformin than with placebo; moreover, insulin resistance and hirsutism decreased 6. In type 2 diabetes with elevated blood lipids, apple cider vinegar drunk daily improved antioxidant capacity more than in the control group; insulin values and insulin resistance improved in both groups 7. In varicose veins, discomfort, pain and social appearance anxiety decreased markedly with topically applied apple cider vinegar, with no confirmed decrease in the untreated control group 5. In children with cerebral palsy, apple cider vinegar for oral care reduced dental plaque and gingivitis after a few months more than brushing teeth without toothpaste 8. As a root canal rinse in primary teeth, apple cider vinegar lowered the bacterial count, but less strongly than sodium hypochlorite 9. A review of meta-analyses on vinegar in general found more favorable values for postprandial blood sugar and insulin as well as for HbA1c, but no difference in fasting insulin and insulin resistance 2. Studies found no difference from the control for the skin microbiome in atopic dermatitis 10, for urinary values 11, for energy expenditure 12 and for endurance compared with a sports drink 14. Depression scores improved more with daily vinegar of unspecified type than with a tablet containing very little acetic acid, in one study only in one of two questionnaires 1517. The studies are mostly small and concern very different populations and applications; for vinegar with "mother", for powder and for long-term clinical endpoints, reliable data are lacking.

Further studies in this area: 14 15 17 19 20 21 22

4. How Is Apple Cider Vinegar Dosed? Preparation, Dose and Duration in Studies

Most studies gave liquid apple cider vinegar to drink, sometimes diluted with water; one study used apple cider vinegar capsules, another compared liquid vinegar with vinegar tablets, and several named only vinegar without specifying the type. Individual investigations applied apple cider vinegar to the skin, used it for oral care or root canal irrigation, or added dried apple pieces soaked in vinegar to a rice meal. Unfiltered apple cider vinegar with "mother" and pasteurized, clear apple cider vinegar were not specifically studied in the included studies.

5. Is Apple Cider Vinegar Safe? Side Effects in Studies

The studies report hardly any side effects. In type 1 diabetes with delayed gastric emptying, daily apple cider vinegar further slowed gastric emptying in a small controlled pilot study, which could make blood sugar control more difficult 19. Systematic information on tolerability, gastrointestinal complaints, or tooth enamel is lacking in the included works. Details on doses and duration of use are shown in the table.

6. What Remains Open: Limits of the Evidence

• Most studies are small, and the exact form of the apple cider vinegar — liquid diluted, capsule or powder, with or without "mother" — is often not described.
• For weight and body fat, only review articles are available, no controlled individual studies.
• For satiety, there is only one study, and it tested dried apple pieces soaked in vinegar instead of pure apple cider vinegar.
• Long-term clinical endpoints and data on unfiltered apple cider vinegar with "mother" or on powder are lacking.
• The comparison conditions differ greatly, from placebo to water to dietary recommendations.

7. Bottom Line: What Is Established About Apple Cider Vinegar

Apple cider vinegar is a vinegar made from fermented apple juice that is traditionally used in cooking. The findings are clearest for fasting blood sugar and the long-term value HbA1c, supported by meta-analyses 34.

For blood lipids, the evidence is moderate: apple cider vinegar mainly lowered total cholesterol 416, while LDL and HDL remained unchanged in meta-analyses 24. For blood pressure, weight, and body fat, the data are thin or limited to reviews 127. Overall, the studies are small, the forms investigated are often unclear, and statements apply only to the preparation tested in each case.