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April 7, 2023

Apple Cider Vinegar: Should You?

by Karen Buynak, MS, RDN, LDN

Apple cider vinegar is a household staple ingredient that can be used for baking, making glazes and sauces, and for salad dressings. In addition to its culinary uses, it has long been investigated for its medicinal purposes and health applications.

The idea of using apple cider vinegar, or other vinegars as a health supplement, has been popularized for many centuries. Consumers are constantly bombarded with messaging that claims apple cider vinegar (ACV) will help them lose weight quickly, improve their blood sugars and cholesterol, and will help them reach their health goals- but are these claims rooted in fact?

Could there truly be a cure-all health supplement that doctors and other medical professionals are failing to prescribe?


For centuries, an aid in weight loss has long been coveted. The idea of using vinegar for weight loss was first documented through a scientific lens in 1733. The popularity of consuming vinegar to lose weight was widespread in 18th century France, particularly among women. Documentation of clinical outcomes during this time is sparse and difficult for today’s researchers to access; with the most prevalent takeaways from this time period being the reported deaths associated with the intake of high doses (one glass daily) of vinegar.

Scientists today do not have a solid understanding of the successful therapeutic applications of ACV historically and recognize that the topic was poorly studied centuries ago.

What does the research say?

ACV as a supplement for weight management and for decreasing risk in cardiovascular disease are heavily studied areas.

Weight Loss

Early studies that examined vinegar (no certain type in particular) consumption in obese rats suggested that supplementation of vinegar could help improve metabolism and help prevent fat deposition. A popular 2009 study from The Journal of Bioscience, Biotechnology, and Biochemistry showed clinical weight loss among patients who supplemented with vinegar, but the evidence is unreliable when considering external factors within the study and is not unique to apple cider vinegar either.

Most recently, a study published in the International Journal of Exercise Science in 2021 examined the effect of apple cider vinegar (ACV) supplementation on a person’s resting energy expenditure and fat burning. Resting energy expenditure (REE) is the energy, in calories, a person burns throughout the day at rest (no moderate or vigorous activity). If a person’s REE increases, this can help with weight loss. Scientists were trying to understand if ACV supplementation can increase a person’s REE to help with weight loss. The researchers found that after taking a 30mL supplement of ACV per day, neither a person’s REE nor their body’s preference to burn fat during exercise were different than compared to a group who took a placebo supplement.

Therefore, the ACV supplementation was ineffective at helping increase metabolism and fat-burning. This study had a relatively small sample size, which is a limitation for scientists. More research is needed in this field to suggest any effects on metabolism.

Cardiovascular Disease Risk Reduction

Another in-depth analytical study from 2021, published in The BMC Journal of Complementary Medicine and Therapies, looked at supplementing ACV in patients with type II diabetes mellitus, patients with high BMIs, and patients with high cholesterol.

The researchers found a significant association in the patients with diabetes who supplemented with ACV and having reduced fasting blood sugars. They also found a significant relationship in the patients who had elevated cholesterol levels; those who used ACV as a supplement tended to have lower total cholesterol lab values. Beyond the decreased fasting blood sugars and total cholesterol levels, researchers were unable to find any other notable relationships tying ACV usage to other biomarkers of glycemic or lipid management. Other notable results include that long-term use of ACV (longer than eight weeks) showed more positive correlations with improved health outcomes compared to short-term supplementation.

It is worth noting that there are several limitations in this study; so, interpretation of these results should be carefully weighed.

What are the pros to using ACV?

  • There is some evidence from a small, 2004 study suggesting that using ACV can help improve insulin sensitivity in addition to managing and lowering blood sugar levels to help manage diabetes.
  • ACV is a helpful food preservative and has been clinically shown to inhibit bacterial growth and spoilage in some foods.
  • ACV is a safe supplement to take under doctor supervision and can be used orally or topically if applied to the skin.
  • Some cited topical benefits of ACV use include acne treatment, prevention of skin infections, and potentially some eczema relief.

What are the cons to using ACV?

  • Due to the corrosive and acidic nature of vinegars, using ACV as a daily supplement has been shown to damage teeth, enamel, and intestinal lining of the upper GI tract.
  • Taking a liquid supplement of ACV is not recommended for patients who suffer from gastric reflux (GERD).
  • ACV can chemically interact with some medications due to its potassium-lowering nature. Consumers who take insulin, diuretics or “water pills,” and digoxin- a drug used to treat heart failure should avoid ACV supplementation. There are also some low blood sugar risks for patients who are on medications for diabetes management.
  • If using ACV topically, it is important to work with a dermatologist to prevent chemical burning or skin irritation if you have sensitive skin.

How can I take ACV?

ACV can be safely consumed in food, and is a harmless common house-hold ingredient when used in cooking and consumed in moderation.

For supplementation in particular, many people take ACV supplements in the liquid shot form. The liquid delivery of ACV can be irritating to the mouth and mucosal lining, so some users like to mix apple cider vinegar with water or juice to dilute the strong acidic taste. Recently, there have been many ACV supplements coming into the market in gummy-form, which is helpful for alleviating any concerns related to the corrosion of teeth, enamel, and gastrointestinal lining. ACV also can come in pill, tablet, and powder form.

It is best to start small and use low doses, as taking too much ACV can have harmful side effects.

What is the bottom line?

Apple cider vinegar can be a delicious and healthy ingredient in a meal and is safe to consume in moderation through food. Though its culinary purposes seem boundless, it is unclear whether ACV is effective as a health supplement.

Currently, there is a lack of evidence to suggest that apple cider vinegar supplementation should be used for treatment of disease. Results from studying ACV supplementation have been inconclusive and have not landed researchers to solid conclusions. The present position in scientific research remains that ACV is not recommended as a cure or therapeutic treatment for health conditions.

If you’re taking certain medications and worried about a risk of drug interactions, you should always check with your medical provider before starting a new supplement.

To best achieve your health or weight-loss goals in a healthy and successful manner, you should work with a registered dietitian for best results; where together, you will create a plan that is individualized to meet your lifestyle. Avance Care has a handful of dietitians- all with diverse backgrounds and interests- who are ready to help you achieve your goals.

Call 919.237.1337 option 4, or visit to learn more about our services and schedule an appointment virtually.


  1. Academy of Nutrition and Dietetics. (n.d.). Is vinegar an effective treatment for chronic conditions. – Academy of Nutrition and Dietetics.
  2. Apple cider vinegar diet: Does it really work? (2020, October 29). Harvard Health.
  3. Apple cider vinegar: Overview, uses, side effects, precautions, interactions, dosing and reviews. (n.d.). WebMD – Better information. Better health.
  4. Cobb, K. M., Chavez, D. A., Kenyon, J. D., Hutelin, Z., & Webster, M. J. (2021). Acetic Acid Supplementation: Effect on Resting and Exercise Energy Expenditure and Substrate Utilization. International journal of exercise science, 14(2), 222–229.
  5. Hadi, A., Pourmasoumi, M., Najafgholizadeh, A., Clark, C. C., & Esmaillzadeh, A. (2021). The effect of Apple cider vinegar on lipid profiles and glycemic parameters: A systematic review and meta-analysis of randomized clinical trials. BMC Complementary Medicine and Therapies, 21(1).
  6. Johnston, C. S., Kim, C. M., & Buller, A. J. (2004). Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects       with insulin resistance or type 2 diabetes. Diabetes Care, 27(1), 281-282.

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