‘There’s a definite buzz around apple cider vinegar and, having carried out studies on it myself, I certainly believe it’s more than an ancient home remedy or a fancy vinegar to put over your salad,’ says Dr Darshna Yagnik, a biomedical research lecturer at Middlesex University.
Her comments follow the news last week that a daily shot of it could aid weight loss.
In a study published in BMJ Nutrition, Prevention & Health, 120 overweight or obese people were given either apple cider vinegar (ACV) or a placebo daily, first thing in the morning before food.
A study of 120 overweight or obese people who were given apple cider vinegar (ACV) or a placebo daily first thing found that ACV drinkers lost more weight
All those given ACV lost more weight than the placebo group, with those who had the most (15ml a day) losing up to 8kg in 12 weeks.
All the ACV drinkers also had improved blood sugar and cholesterol levels, reported the researchers, who were led by Dr Rony Abou-Khalil at Holy Spirit University of Kaslik in Lebanon.
‘The results are pretty significant— and unexpected, too,’ says Aidan Goggins, a pharmacist and an independent adviser to the supplement industry. ‘That’s because we always thought there might be something in the acetic acid [the main active ingredient in ACV] binding with carbohydrates to reduce their absorption, but in this study the ACV was taken in the morning on an empty tummy, so had a totally different independent effect.’
He adds: ‘It may increase secretion of gut satiety hormones including GLP-1 and PYY, in the same way weight-loss drugs such as Ozempic and Wegovy work.’
Dr Yagnik’s theory is that the acetic acid in ACV effectively raises levels of acetate in the blood, which in turn encourages the breakdown of fatty acids and prevents new fatty acids forming — potentially helping boost fat metabolism.
Yet other experts have questioned the study methodology — not least for not setting out what else the participants were eating nor their calorie intake changes.
‘In short, this needs caution, a lot of caution,’ said Miguel Angel Martinez-Gonzalez, who is a professor of preventive public health at the University of Navarra in Spain, and an expert on nutrition and disease.
Participants in the study were also young — aged 12 to 25 — so it’s not clear how the findings might apply to older people.
ACV is made by essentially chopping up apples, mixing them with water and sugar, and then allowing the mixture to ferment for three to four months.
There is little doubt about its increasing popularity — the market has grown in value by 24.5 per cent in the past year, with UK producers, such as Willy’s in Herefordshire, reporting an increase in sales of up to 26 per cent in the same period, fuelled by its supposed health benefits.
The research, published in BMJ Nutrition, Prevention & Health, found those who drank the most ACV (15ml a day) lost up to 8kg in 12 weeks
And helped, no doubt, by celebrity endorsements. Victoria Beckham shared on Instagram that she takes two tablespoons of it every morning; Liz Hurley has said she often puts some in hot water — and the novelist Louis de Bernieres recently told Good Health that he takes it because ‘it’s said to lower blood sugar’. Some evidence for this appears to be stacking up. ‘A number of studies have suggested it may help with managing blood sugar levels and lowering cholesterol,’ says Dr Yagnik.
When it comes to blood sugar, ‘human studies have shown that ACV increases the muscles’ uptake of glucose. It also slows down gastric emptying and the activity of enzymes in the gut’ — all of which helps control blood sugar levels.
‘Compounds in ACV have also been shown to increase “good” fat such as HDL cholesterol, which helps clear “bad” cholesterol by carrying excess amounts to the liver where it is broken down,’ Dr Yagnik adds.
Separately, she and her team have been looking at ACV’s potential role in fighting infection and boosting immunity.
This came about after Dr Yagnik herself ate something she shouldn’t from the back of the fridge and, feeling sick, remembered the old wives’ tale of ACV as a possible remedy. She had a glug and it worked — ‘I could literally feel something going on in my tummy and felt better within ten minutes,’ she says.
Testing this in lab studies, Dr Yagnik’s team found that ACV had antimicrobial effects, and is able to fight E. coli and MRSA. Studies with other vinegars did not work nearly as well: ACV was by far the most effective.
Going on to test the vinegar on white blood cells they found it reduced the response of cytokines, which are proteins that play a crucial role in controlling other immune system cells as well as blood cells and, in turn, controlling inflammation.
As with weight loss, the exact mechanism of how it works isn’t entirely clear, but Dr Yagnik believes it’s the combination of the acetic acid, polyphenols — powerful plant compounds with antioxidant effects — probiotics and enzymes that work together.
Many people take apple cider vinegar as they think its anti-inflammatory effects might help with their arthritis, but Aidan Goggins says: ‘This is quite anecdotal. Apple extracts are high in phytochemicals [antioxidants], which has led to them being thought of as good for inflammatory conditions, but there isn’t enough evidence to start recommending it.’
And if ACV isn’t just a health fad, the experts are still keen to stress that more research needs to be done before anything definitive can be said and, for some, caution should be exercised.
‘People taking metformin for diabetes, or weight-loss pills, need to consult their doctor before taking ACV, as there may be interactions,’ says Aidan Goggins. ‘It can also damage the tissue in your windpipe and cause heartburn.’
In the new study, the participants took ACV first thing in the morning to avoid other foods and drinks having an effect.
‘Interestingly, the oral antiobesity drug, Rybelsus [one of the newer Wegovy-type drugs], must be taken on an empty stomach for the same reason,’ says Aidan Goggins. ‘Clearly, if it’s working through the same mechanism, you’d need to take it the same way. And this applies to everyone, even older people — ACV is actually often recommended for this age group to help improve digestion, as natural stomach acid declines with age.
‘However, the unfiltered forms — the ones that have the extra health benefits — may be a problem for those people who need to avoid unpasteurised products, such as pregnant women,’ warns Dr Yagnik.
You also need to be careful how you take it. ‘Vinegar is, fairly obviously, very acidic — pH 2-3 on the scale, compared to milk, for instance, which is 6.5 to 6.9, and so can be very corrosive on the tooth enamel,’ says Tom Crawford-Clarke, a dentist at Luceo Dental in London.
‘Some of my patients take ACV as a health boost and, while I cannot say they’ve had problems as a result, it could certainly be adding to the yellowing and sensitivity of their teeth if not taken the right way.’
For this reason avoid having it as a ‘shot’ — dilute it in water instead.
The consensus seems to be that, if you’re healthy and wish to jump on the ACV bandwagon, it certainly won’t do you any harm.
‘For what it’s worth, I have two tablespoons of unfiltered apple cider vinegar diluted in water every day,’ says Dr Yagnik. ‘As do my friends, family and anyone else I’ve told about it.
‘I swear by it for immunity. If you feel like you’re coming down with something, there’s nothing better to ward it off.’
