Recently apple cider vinegar has been garnering a fair amount of attention due to its possible health benefits. In order to provide you with the most up-to-date information, I decided to review the literature to find out if there is any scientific evidence to support these health claims. It appears that indeed there are some benefits to incorporating a small amount (1-2 Tablespoons) of apple cider vinegar into your diet, but adding more than that may be harmful.

Apple cider vinegar is made by crushing apples and collecting the liquid or cider. Bacteria and yeast are then added to this cider which causes the fruit sugars to ferment first into alcohol and ultimately, with the help of bacteria called acetobacter, into vinegar. Apple cider vinegar is more palatable then pure vinegar due to fact that is is made from apples. Regular vinegar is much more sour and made from the fermentation of grain alcohol. The benefits of apple cider vinegar are due to the acetic acid (vinegar) therefore in theory regular vinegar should be beneficial as well. The main issue is that regular vinegar is sour and harsh tasting.

Some of the benefits of apple cider vinegar consumption:

• Increased satiety or feeling of fullness
• Beneficial effect of fat levels in the blood
• Decreased blood levels of triglycerides
• Increased beneficial HDL cholesterol levels in the blood
• Decreased LDL cholesterol levels in blood
• Seems to prevent/lower risk for vascular disease/ plaque formation in the arteries
• May help with oxidative stress (functions as a beneficial antioxidant)
• Promotes glycogen synthesis (sugar storage, thus reducing blood sugar levels)

In a study done by Kondo T, et al, published in August 2009, it was found that Vinegar intake decreased body weight, body fat mass and serum triglyceride levels in obese Japanese individuals. These effects were fairly modest and on average individuals lost a few more pounds then the control subjects over a three-month time. It appears though, that this benefit only helped when the apple cider vinegar was consumed.

According to a study published by the American Diabetes Association in Diabetes Care, 2 Tablespoons of apple cider vinegar at bedtime taken with 1 ounce of cheese favorably impacted or decreased the waking blood sugar levels in patients with diabetes. These patients were given cheese because it was felt that a small amount of food was beneficial when taking the vinegar to prevent stomach upset. The fasting glucose levels improved by 4-8% as compared to controls.

It it theorized that vinegar slows down digestion in the stomach and causes delayed gastric emptying, which is usually beneficial. This is because by slowing gastric emptying, you are slowing down the rate of sugar being released into your blood stream. However, if you have a condition called Diabetic Gastroparesis (a problem with the nerves in the stomach leading to slowed or delayed digestion), it is not recommended to take apple cider vinegar because this can worsen your digestion.

Recommendations for consumption:

• 1-2 Tablespoons at most per day (can be used as a salad dressing or mixed with other foods/liquids)
• Drink either after meals or dilute with 8 ounces of water
• Don’t consume on an empty stomach or you may get nausea, bloating or gas
• Do not use the vinegar pills – there is a case report of a women with esophageal erosion (throat burns) due to the pill being stuck in her throat for several months

Potential side effects or complications:

• May interact with certain medications, specifically:
  • Diabetic medications
  • Digoxin
  • Anti-hypertensive medications (blood pressure medications) such as diuretics
  • Any other medications which effect potassium levels
• In a case study of a women who took 8 ounces per day for 6 years, she developed low potassium and osteoporosis (bone loss)
  • It is thought that too much vinegar consumption will take minerals from the bones to buffer the acidity and result in osteoporosis
• May cause damage to tooth enamel due to acidity
• May interfere with stomach emptying (called gastroparesis) and result in heartburn, bloating and nausea

In conclusion, there is scientific evidence that a modest intake of no more that 1-2 tablespoons of apple cider vinegar per day improves your blood sugar levels, helps you to feel fuller and thus consume less calories and improves the fat profile of your blood to decrease your risk for stroke and heart disease. As always if you are taking medications or have diabetes check with your physician to make sure this is safe addition to your diet.