Is Vinegar an Effective Treatment for Chronic Conditions?

Consumers are increasingly seeking out information to improve their health. Distinguishing between credible sources with an evidence-base versus what's trending in the media and among family or friends can be more of a challenge, though.

Vinegar, specifically apple cider vinegar, has been the focus of a variety of health claims over the centuries. The production of vinegar dates to antiquity where medicinal uses for it were not uncommon. By the eighteenth century in France, vinegar became a popular weight loss tonic for women – a practice not without risk. More than one case reported a cause of death attributed to excessive vinegar intake during the 1700s, as women drank a glass a day for over a month. Yet the clinical research on vinegar and its application to various health outcomes remains poorly studied.

In recent years, glycemic control, cardiovascular disease and weight management have been some of the areas in which the application of vinegar has been studied. A small randomized, double blind crossover study published in 2021 reports to be preceded by only two other human trials looking at vinegar and body mass. While the earlier studies reported an association with vinegar intake and weight loss, the most recent study looked specifically at vinegar supplementation on resting energy expenditure and exercise energy expenditure (measured with indirect calorimetry) and did not find a statistically significant difference with the consumption of vinegar when compared to a placebo.

A systematic review and meta-analysis, also published in 2021, analyzed nine randomized clinical trials using apple cider vinegar and its effect on glycemic load and lipid panels. Six hundred and eighty-six participants were included across the studies, including those who had Type 2 diabetes, elevated body mass index scores and dyslipidemia. The researchers found a significant association between apple cider vinegar consumption and the decrease of total cholesterol levels. There was also a significant relationship on fasting plasma glucose for participants with diabetes. However, there was no significant relationship found with other cholesterol or glycemic measures. Apple cider vinegar consumption also had a more notable affect when the duration of the trial was longer than 8 weeks. Due to several limitations, though, the authors cautioned with interpreting the results.

Although there is a lack of evidence at this time to recommend apple cider vinegar as a treatment for a variety of conditions - it is considered to be safe when consumed orally in moderate amounts. Medication and supplement interactions are theoretically possible, with the risks for hypoglycemia and hypokalemia being among the major concerns. There also have been adverse events reported with apple cider vinegar applied topically, including those in tablet form that have the potential to become lodged in the throat.

While it contributes minimally to the nutrient composition of a meal, the use of vinegar as an ingredient can be part of a healthy eating pattern and a way to limit calories, which can ultimately help with both weight loss and diabetes. Any additional mechanisms of vinegar in the diet require further research.

References:

• Almenara CA, Aimé A, Maïano C. Vinegar and weight loss in women of eighteenth-century France: a lesson from the past. Hist Psychiatry. 2020 Jun;31(2):232-236.
• Cobb KM, Chavez DA, Kenyon JD, Hutelin Z, Webster MJ. Acetic Acid Supplementation: Effect on Resting and Exercise Energy Expenditure and Substrate Utilization. Int J Exerc Sci. 2021 Apr 1;14(2):222-229.
• 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 Jun 29;21(1):179.
• Natural Medicines Comprehensive Database. Apple Cider Vinegar. Accessed August 2, 2021.