Apple Cider Vinegar Simply Explained

1. What Is Apple Cider Vinegar?

Apple cider vinegar is made from apple juice. First, yeasts convert the sugar in the juice into alcohol. Then acetic acid bacteria make acetic acid from the alcohol. This is how apple juice ultimately becomes vinegar. In the kitchen, it has long been used for seasoning, pickling and preserving. Many people also use it as a home remedy. It is available as a liquid, as a capsule, as a tablet and as a powder. Some types are clear and heated, others are cloudy and contain the so-called "mother". The "mother" are small residues of the bacteria that produced the vinegar.

2. Where Is It Found, and What Is It Made From?

Apple cider vinegar is found in salad dressings, chutneys and pickled vegetables. For studies, it is usually given as a drink, sometimes also as a capsule. Its most important active ingredient is acetic acid.

3. What Does Apple Cider Vinegar Do? What Research Shows

Blood Glucose After Meals

Blood sugar is the best studied. In healthy young adults, diluted liquid vinegar lowered the rise in blood sugar after a meal, vinegar tablets to swallow did not 13. In adults with type 2 diabetes, fasting blood sugar fell more with apple cider vinegar drunk daily than in the comparison group 7. Long-term blood sugar was also more favorable in one study 12. Review articles support these results, but do not say exactly which form of apple cider vinegar was tested 34. Most studies are small, and the exact preparation is often not described.

Blood Lipids

There are several indications regarding blood lipids. In adults with type 2 diabetes, total cholesterol fell more with apple cider vinegar drunk daily than in the comparison group 12. A review article likewise found lower total cholesterol, but no confirmed effect on "good" and "bad" cholesterol 4. Another review of vinegar in general showed better total cholesterol, but no differences in the other blood lipid values 2. A small study without a comparison group found no clear change in blood lipids 15. The strength of evidence is medium, and the forms tested are different.

Blood Pressure

On blood pressure, the situation is still unclear. A controlled trial (with comparison group) in type 2 diabetes with elevated blood lipids found no difference in blood pressure with apple cider vinegar drunk daily 7. A review of vinegar in general likewise found no difference in the lower blood pressure value 2. The same review, however, found a somewhat lower upper value; there, various types of vinegar were combined 2. Whether capsules, powder or vinegar with "mother" affect blood pressure remains open.

Weight and Body Fat

On weight and body fat, there are only initial indications. A review article in adults with type 2 diabetes and/or overweight found somewhat lower body weight, a lower body mass index and a smaller waist circumference with daily apple cider vinegar 1. Another review of vinegar in general likewise found lower weight, but no differences in body mass index and waist circumference 2. Both works leave the exact form of the apple cider vinegar open. The second is also not limited to apple cider vinegar. The strength of evidence is therefore low.

Appetite and Satiety

On appetite and satiety, there is only a small study in healthy women: dried apple pieces soaked in vinegar with rice did not make them less full 11. Nothing about liquid diluted apple cider vinegar, capsules, powder or vinegar with "mother" can be derived from this. The strength of evidence is therefore unclear. Whether apple cider vinegar in other forms affects appetite or satiety remains open.

Other Investigations

Further studies investigated quite different questions. In type 2 diabetes, apple cider vinegar drunk daily improved the defense against harmful oxygen compounds more than in the comparison group 7. In varicose veins, discomfort and pain decreased markedly with topically applied apple cider vinegar 5. In children with cerebral palsy, apple cider vinegar for oral care reduced dental plaque and gingivitis more than brushing teeth without toothpaste 8. Other studies found no difference, for example for the skin microbiome in atopic dermatitis 9 or for energy expenditure 10. The studies are mostly small and concern very different groups.

4. How Was Apple Cider Vinegar Taken in the Studies?

In most studies, liquid apple cider vinegar was drunk, sometimes diluted with water. One study used capsules, another compared liquid vinegar with vinegar tablets. Several studies named only "vinegar" without specifying the exact type. Individual investigations applied apple cider vinegar to the skin, used it for oral care or as a rinse at the dentist. In one study, dried apple pieces were soaked in vinegar and eaten with rice. Unfiltered apple cider vinegar with "mother" and clear, heated apple cider vinegar were not specifically studied in the studies.

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

The studies hardly report any side effects. In people with type 1 diabetes and delayed gastric emptying, apple cider vinegar in a small study slowed gastric emptying further, which could make blood sugar control more difficult 14. Clear information on tolerability, on gastrointestinal complaints or on tooth enamel is lacking. The studies are mostly small, and the exact form of the apple cider vinegar is often not described. Statements therefore apply only to the preparation tested in each case. For vinegar with "mother", for powder and for long-term results, reliable data are lacking.

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