Apple cider vinegar for weight loss, beauty, health...

What is apple cider vinegar?

Apple cider vinegar is fermented apple juice or, more precisely – fermented wine.

Acetobacter bacteria feed on sugars and alcohol and convert the wine into vinegar – a solution of acetic acid that may also contain other nutrients (vinegar can also be made from fruit juices, etc. – from anything that contains sugar and alcohol).

The process for producing natural vinegar is as follows:

1. Yeast is added to the juice of grapes (or other berries, fruit, etc.) to start fermentation. The yeast converts the sugars into alcohol and carbon dioxide.
2. Fermentation continues until most of the sugars are converted into alcohol, resulting in wine.
3. The wine is then treated with ‘the mother’ (Acetobacter bacteria), which converts the alcohol into acetic acid – an acetic acid solution or vinegar is formed.
4. The vinegar produced can be used immediately or aged to develop its flavour. It is usually filtered before bottling.

In general, both wine and vinegar are produced by fermentation processes. The difference is that wine production mainly focuses on alcohol production, while vinegar production involves secondary fermentation, where bacteria convert alcohol into acetic acid.

It is believed that acetic acid and the presence of beneficial compounds produced during the fermentation process by Acetobacter bacteria are the reason for the possible health benefits of apple cider vinegar, including weight loss.

Apple cider vinegar is believed to have antioxidant, antiviral and antimicrobial effects. Apple cider vinegar has also been studied for its ability to lower blood sugar levels, treat acne and other skin diseases and improve heart health.

However.

Only some of these benefits of apple cider vinegar are scientifically proven, while others remain unproven.

In this article, we will look at the science behind the effects of apple cider vinegar, possible side effects, drug interactions and dosage.

Types of apple vinegars.

Apple cider vinegars in grocery stores are mostly clear (filtered and pasteurised). They are essentially a simple acetic acid solution with flavours of apple, raspberry, etc.

But.

You can also buy raw and unfiltered vinegars that contain cloudy lees (fermentation by-products, yeast, settled bacteria…).

This sediment (also called the mother of vinegar) is thought to be what gives vinegar its health benefits.

However.

Although the fermentation process of vinegar is similar to that used in the production of other fermented foods (yoghurt, kefir and kimchi, etc.), live bacteria (probiotics) are not present in the vinegar sediment because acetic acid does not promote the survival of probiotic bacteria.

At the same time.

Raw (unfiltered, unpasteurised, etc.) apple cider vinegar (like any other naturally fermented and raw vinegar) may contain some beneficial compounds produced during fermentation, such as prebiotics – fibres from the fruits or berries used to produce the vinegar.

Prebiotics serve as food for the beneficial intestinal bacteria, promoting their growth and activity. Although these prebiotic fibres can support a healthy gut microbiota, they do not promote gut health to the same extent as probiotics – live beneficial bacteria.

Read more about probiotics HERE.

Potentially beneficial substances in unfiltered vinegar

Naturally fermented and unfiltered vinegar (including apple cider vinegar) are believed to be healthy because they contain acetic acid and beneficial compounds produced by Acetobacter bacteria during fermentation:

1. Acetic acid. Naturally fermented, unfiltered apple cider vinegar usually contains around 5-6% acetic acid. Acetic acid is known for its antimicrobial properties, which can help inhibit the growth of harmful bacteria and pathogens in the body. In addition, acetic acid is thought to have some health benefits, including the ability to regulate blood sugar and insulin levels, reduce appetite and improve digestion.
2. Polyphenols and antioxidants – substances produced during the fermentation of apples or other ingredients. These compounds have been linked to health benefits such as reducing inflammation, protecting against oxidative stress and possibly reducing the risk of chronic diseases such as heart disease and cancer.
3. Prebiotics. Although vinegar does not contain probiotics (live beneficial bacteria), unfiltered vinegar does contain prebiotics, such as pectin from the fruit used to produce the vinegar. Prebiotics serve as food for the beneficial bacteria in the gut, promoting their growth and activity. Healthy gut flora is linked to better digestion, immune function and overall health.
4. pH regulation. Despite its acidic nature, naturally fermented vinegar is believed to have an alkalising effect when processed by the body. Some even believe that consuming natural vinegar can help balance the body’s pH levels (although there are no studies to support this claim).
5. Regulation of blood sugar and insulin levels. Some studies suggest that consuming vinegar may help improve insulin sensitivity and lower blood sugar levels after meals, which could be useful for people with diabetes or prediabetes. Acetic acid, indeed, may have a role to play in this process, as it slows down the absorption of carbohydrates and improves glucose metabolism.

In summary, although there is some evidence to support the potential health benefits of apple cider vinegar, further research (in particular well-designed clinical trials) is needed to understand the mechanisms of action and effects of vinegar on different aspects of health. In addition, individual responses to apple cider vinegar may vary widely.

The health benefits of apple cider vinegar

It should be noted here that we are going to talk about the possible health benefits of naturally fermented vinegar because although there is some positive evidence, there is no conclusive proof that apple cider vinegar is the cause of the health improvements mentioned below (studies are few and the existing studies are limited in sample size and short in duration).

1 Apple vinegar can help destroy pathogens, including some strains of bacteria

Vinegar is traditionally used for cleaning and disinfecting, treating nail fungus, lice, warts and ear infections.

Hippocrates, the father of modern medicine, used vinegar to clean wounds more than 2000 years ago.

Vinegar is also a food preservative. Studies have shown that it inhibits the growth of bacteria such as Staphylococcus aureus and Escherichia coli and the spoilage of foods.

However, there is no support for the common belief that apple cider vinegar has antifungal properties, making it a potential treatment for various fungal infections.

In fact, there is a good deal of anecdotal evidence, but scientific studies to support this claim are still lacking.

There are some studies In vitro (‘in a tube’) suggesting, that apple cider vinegar has antifungal properties. For example, one study published in 2014 found that apple cider vinegar may be a possible therapeutic alternative for killing the fungus Candida spp on dentures.

A similar number of laboratory studies have reported positive effects of apple cider vinegar on different types of fungi, but these should be replicated in humans to be more conclusive.

2 Apple cider vinegar may help lower blood sugar and control diabetes

One of the most compelling uses of vinegar so far is in the treatment of type 2 diabetes caused by insulin resistance.

People without diabetes can also benefit from adding vinegar to food to keep their blood sugar levels within typical ranges (some researchers also believe that high blood sugar is a major cause of ageing and various chronic diseases).

A clinical study conducted in 2019 suggests that apple cider vinegar consumption may have a beneficial effect on the glycaemic index and oxidative stress in people with diabetes and dyslipidaemia.

A 2021 review of clinical trials also found that apple cider vinegar may improve glycaemic status in adults.

3 Apple cider vinegar may improve heart health

Several biological factors can influence the risk of heart disease.

Research suggests that vinegar may be able to improve some of them. However, many studies on the beneficial effects of apple cider vinegar have been carried out in animals, i.e. the effects of vinegar may vary in humans.

The 2020 review of human and animal studies indicates the potential beneficial effects of apple cider vinegar on high-density lipoprotein, low-density lipoprotein, triglyceride and total cholesterol levels.

The 2021 review of human studies concludes that apple cider vinegar may have a beneficial effect on total cholesterol levels.

However, both reviews point to limitations in the quality and scope of the studies supporting these claims.

4 Apple vinegar can improve skin health

Some people use apple cider vinegar to help with skin problems such as acne, dry skin and eczema.

Skin is naturally slightly acidic. But if you have eczema, it may be less acidic. Applying a dilute vinegar solution can help locally restore the skin’s natural pH balance, thus improving the skin’s protective barrier.

However, studies do not support this and warn that vinegar, when applied to the skin, irritates it and can do more harm than good (especially in people with skin conditions such as eczema).

5 Apple vinegar against acid reflux

Vinegar is often cited as a natural remedy for acid reflux, but its effectiveness is questionable.

Some people believe that vinegar, especially apple cider vinegar, can help relieve the symptoms of acid reflux because of its potentially alkalising effect on the stomach, although scientific evidence for this claim is limited.

However, it is important to note that vinegar is acidic and if too much is consumed, acid reflux symptoms may worsen in some people. 

There is a small study whose participants believed that apple cider vinegar helped relieve reflux symptoms. However, the researchers are not sure whether apple cider vinegar can really be considered beneficial in this respect.

Other lifestyle changes and dietary adjustments, such as avoiding foods that cause reflux, eating smaller but more frequent meals, maintaining a healthy weight, etc., can also help prevent acid reflux.

Apple cider vinegar and weight loss

Some studies have shown that drinking apple cider vinegar can help reduce appetite, increase satiety, and thus reduce calorie intake during the day.

A review of 7 short-term and 6 long-term studies published in 2022 suggests that vinegar containing at least 24.6 mmol of acetic acid, when used with food containing solid ingredients, suppresses appetite for up to 120 minutes after eating.

But.

Analysed long-term studies found no association between apple cider vinegar and appetite suppression.

There are also some animal studies suggesting, that acetic acid may possibly increase fat burning and reduce fat storage. However, human studies are needed to confirm these effects.

Perhaps vinegar indeed can reduce appetite a little, but in my 30+ years of professional practice, I have never met anyone who has successfully lost weight with apple cider vinegar.

A healthy and balanced diet is definitely a key tool for weight loss.

In other words, if you are a little more careful about what you eat, you will benefit much more than spending money on apple cider vinegar tablets and other types of dietary supplements with apple cider vinegar in them (or even worse, drinking apple cider vinegar and damaging your tooth enamel).

What are the side effects of apple cider vinegar?

While a small amount of apple cider vinegar is generally safe, too much can be harmful and even dangerous.

The following side effects have been reported:

1 Delayed gastric emptying

Human studies have shown that apple cider vinegar can reduce the speed at which food leaves the stomach and enters the lower digestive tract. This could slow the absorption of nutrients into the bloodstream, worsen symptoms of gastroparesis (a common condition in people with diabetes) and make blood sugar control more difficult in people with type 1 diabetes (timing and dosage of insulin is very difficult as it is difficult to predict how long it will take to digest and absorb the food).

A controlled study published in 2007 looked at patients with type 1 diabetes and gastroparesis.

Drinking water with 2 tablespoons (30 ml) of apple cider vinegar significantly increased the residence time of food in the stomach (compared to drinking plain water).

2 Digestive disorders

Apple cider vinegar may cause unpleasant indigestion in some people.

For example:

• Nausea (when taken as a drink).
• Digestive intolerance.
• Stomach burning.

3 Low potassium levels and bone loss

There are currently no controlled studies on the effects of apple cider vinegar on bone health and blood potassium levels.

However.

There are reports of low blood potassium levels and bone loss associated with prolonged use of high doses of apple cider vinegar.

For example.

A 28-year-old woman consumed 8 ounces of apple cider vinegar diluted in water daily for 6 years. She was admitted to the hospital with low potassium levels and other abnormal blood chemistry.

In addition, the woman was diagnosed with osteoporosis, a disease that is rare in young people.

The doctors treating her believed that the high daily intake of apple cider vinegar caused the minerals to leach out of the bones to balance the acidity of the blood.

It was also suggested that high acid levels could reduce bone formation.

4 Erosion of tooth enamel

Acidic foods and drinks have been shown to damage tooth enamel.

In other words – the acetic acid in vinegar can weaken tooth enamel and lead to mineral loss and tooth decay.

In a laboratory study carried out in 2013, wisdom teeth enamel was immersed in 30 different vinegars with pH levels ranging from 2.7 to 3.95. After 4 hours, mineral loss of up to 20% was found in the tooth enamel.

Of course, we don’t keep vinegar in our mouths for 4 hours at a stretch, but this study shows what can happen to our tooth enamel over a longer period of time.

There is also a case report of severe tooth decay in a 15-year-old girl who drank a glass of apple cider vinegar every day to lose weight.

5 Throat burns

Apple cider vinegar can cause burns to the oesophagus (throat).

This is mostly the case in children who accidentally drink pure vinegar.

But.

There are also reports of throat burns after an apple cider vinegar tablet got stuck in the oesophagus or cases where people who drank large amounts of vinegar drinks over a long period needed medical attention to treat throat burns.

6 Skin burns

Apple cider vinegar is highly acidic and can cause skin burns when applied to the skin.

There are several anecdotal reports of burns caused by apple cider vinegar applied to the skin, for example:

• A 4-year-old girl developed erosions on her nose after applying several drops of apple cider vinegar to her nose to remove two moles, based on a tutorial seen on the internet.
• An 8-year-old boy suffered burns to his legs after his mother treated a leg infection with apple cider vinegar.

Vinegar interactions with drugs

Vinegar (including apple cider vinegar) can interact with some medications, for example:

• People who take insulin or insulin-stimulating medicines and also take vinegar may experience dangerously low blood sugar or potassium levels.
• Digoxin (Lanoxin®) lowers blood potassium levels (this medicine is used for heart failure and irregular heartbeats). When digoxin is taken with apple cider vinegar, potassium levels may drop too much.
• The acidity of the vinegar may interfere with the absorption of some antibiotics such as tetracyclines (e.g. doxycycline) or fluoroquinolones (e.g. ciprofloxacin), thus reducing their effectiveness. It is recommended to avoid vinegar for a few hours after taking these medicines.
• The acidity of vinegar may exacerbate the effects of some laxatives and diuretics, causing dehydration and electrolyte imbalances (e.g. by removing too much potassium from the body).

How much apple cider vinegar to take?

I would recommend using vinegar exclusively as part of a healthy and balanced diet – add it to salads, dressings, marinades, etc.

But.

Do not drink it diluted with water or neat.

Also, vinegar supplements are not the best choice.

Scientific studies use different doses of apple cider vinegar, the concentration of acetic acid varies, and many of these studies have not been carried out in humans.

Therefore, there is no generally accepted, safe recommended dose of apple cider vinegar.

In general, low doses are usually well tolerated, while high doses are more likely to cause side effects.

Standard doses range from 1-2 teaspoons (5-10 ml) to 1-2 tablespoons (15-30 ml) per day.

I would define it as follows:

• If you use vinegar as a food ingredient (in a dressing for a vegetable salad, etc.) – the only limit is your taste buds.

But.

• If you use vinegar as a drink, mixed with water before or after meals – a semi-safe dose is 1-2 teaspoons (5-10 ml) of vinegar diluted in at least 200 ml of water.

To reduce side effects:

• Reduce the effects of acetic acid on your teeth – dilute vinegar in water and drink it through a straw.
• Rinse your mouth with water after drinking vinegar. To prevent further damage to enamel, wait at least 30 minutes before brushing your teeth.
• Avoid vinegar if you have gastroparesis or if you are taking medications that vinegar may interact with.
• Limit vinegar to 1 teaspoon (5 ml) in salad dressings, etc.

Key takeaways

Apple cider vinegar consists of acetic acid and small amounts of other acids, vitamins and minerals. It may have a slightly milder taste and smell, but otherwise, it has no significant advantages over other naturally fermented vinegar.

Use naturally fermented and raw vinegar – the darker the colour of the vinegar, the more healthy compounds it contains (the mother of vinegar). Conversely, the lighter and clearer it is, the less good it can do for us.

Studies have shown drinking vinegar can help lower blood sugar, improve insulin sensitivity and reduce total cholesterol.

Consuming naturally fermented and unprocessed vinegar can also support gut health.

But.

The effect of vinegar on weight loss is based more on myths and the desire to “lose weight effortlessly”.

It is important to use vinegar in moderation and as part of a balanced diet, not hoping for miracles using it as a dietary supplement or slimming aid.

The results of studies on the beneficial effects of vinegar should be interpreted with caution, as most studies have been carried out in the laboratory (test tube) or animals, and more studies in humans are needed to fully understand the effects of acetic acid and the compounds in vinegar on gut microbiota and general health.

If you want to support gut health, the best way to do so is to eat foods that contain live probiotic bacteria (fermented milk products, sauerkraut, etc.) rather than vinegar.

Apple cider vinegar is recognised as safe.

However.

Remember that it can interact with some medications, so – check with your doctor before increasing your vinegar intake.

Eat a healthy balanced diet, exercise and – stay healthy!