Does apple cider vinegar live up to its cure-all reputation?

It may help to lower blood sugar and cholesterol, but there’s little evidence that it is a cure for acid reflux or eczema, says Dr Catherine Conlon

Apple cider vinegar has long been used in naturopathy to treat things such as diabetes and high cholesterol.

As far back as 3,300 BC, apple cider vinegar was used to treat infections or insect bites.

Hippocrates, the father of modern medicine, used it to clean wounds 2,000 years ago.

It has also been touted for cleaning toilets, washing windows, unclogging drains, and flavouring salad dressings.

During the covid-19 pandemic, apple cider vinegar was proposed as an immunity booster.

Largely hanks to social media, the sour-tasting liquid is acclaimed for promoting weight loss and lowering blood sugar, potentially reducing the risk of heart disease and strokes. It is also promoted as a remedy for acid reflux and skin conditions.

One TikTok video shows a man pouring a tablespoon of apple cider vinegar into a cup of water and drinking it, before eating two slices of pizza.

Then, he tests his blood sugar.

“These are the best results of all,” he says, showing a much lower spike on a blood-sugar graph than when he ate the pizza without the vinegar.

Other TikTok posts enthuse about apple-cider vinegar’s ability to settle their stomachs and promote clear blemish-free skin.

Apple-cider vinegar is an acetic acid produced by fermenting apples. It’s 94% water.

Vinegar made from apples and other fruits also contains polyphenols, which have antioxidant and anti-inflammatory properties that may contribute to their potential health benefits.

Advocates often recommend using unpasteurised and unfiltered versions, which contain a haze of bacteria and undigested carbohydrates, called ‘the mother,’ according to Dr Chris Dammam, an associate professor of gastroenterology at the University of Washington School of Medicine.

“But there’s no evidence that these ‘raw’ apple-cider vinegars are healthier than the regular ones,” he told the New York Times.

Lowers blood sugar and cholesterol

Nutritionist Lindsey Wohlford told American Heart Association News this month that there is evidence that apple-cider vinegar lowers blood sugar.

Several studies have found that consuming it could slightly reduce fasting blood glucose and A1C — a test that measures average blood glucose levels over three months — in those with type-2 diabetes.

A 2021 meta-analysis published in BMC Complementary Medicine and Therapies outlined how consuming apple-cider vinegar reduced blood glucose by 8 mg/dl in people with type-2 diabetes.

The paper also suggested a link between consumption and a reduction in total cholesterol, which was most marked in people with type-2 diabetes and those who drank about one tablespoon a day for eight weeks.

Another study, in Frontiers in Clinical Diabetes and Healthcare (2023), showed A1C dropped from 9.21% to 7.79% in people who consumed about two tablespoons of apple cider for eight weeks, and while following a healthy diet.

Similarly, these participants saw a greater reduction in ‘bad’ LDL cholesterol and total cholesterol than people who were encouraged to follow a healthy diet without consuming apple cider vinegar.

Weight loss

Daily consumption of apple-cider vinegar could help people feel fuller and lose weight, according to research. But, according to Wohlford, these were small, short-term studies that showed insufficient evidence that the product would solve anybody’s weight problems.

“Apple-cider vinegar will not improve weight loss significantly and won’t become a sustainable habit. Most people won’t take it forever and ever. This will not take the place of a healthy diet and regular exercise,” Wohlford said.

Gut health

Because apple cider vinegar is fermented, it contains natural probiotics. Probiotics are microorganisms that increase healthy bacteria in our gastrointestinal tract and have been linked to immunity and brain health. It can potentially maintain a healthy microbiome as it boosts the ability to keep good bacteria thriving.

However, because it is acidic, apple cider vinegar has the potential to erode tooth enamel and damage the oesophagus. It should be diluted with water or put into tea.

Some people swear by apple cider vinegar for acid reflux. The idea is that because it is a probiotic, it can introduce ‘good’ bacteria into your gut and lead to digestive balance, which can also lessen gastroesophageal reflux disease. However, there is no good research to back up this claim.

Similarly, the evidence has not confirmed claims that applying dilute apple cider vinegar to the skin is a remedy for eczema. According to a small study involving 22 participants in 2019, published in Paediatric Dermatology, it could make the skin condition worse.

Researchers suggest that the best way to consume apple cider vinegar is in cooking or as part of a meal. To get the maximum nutritional benefits, mix it into a salad dressing, pair it with olive oil as a dip for bread, or incorporate it into a veggie juice.

• Dr Catherine Conlon is a public health doctor and former director of human health and nutrition, safefood