Q&A: Is Apple Cider Vinegar Effective for Weight Loss?

Take-home messages:

 ACV, apple cider vinegar

Introduction

In the realm of natural remedies and dietary aids, apple cider vinegar (also known as ACV), has long been a topic of interest for its purported health benefits. Among these, its potential role in aiding weight loss is a subject of much debate and scientific scrutiny. This post delves into the various aspects of vinegar, with a particular focus on its primary constituent, acetic acid, and examines the existing research to evaluate its effectiveness in weight management.

Vinegar is a sour-tasting liquid produced by fermenting dilute wine, cider or beer or other alcoholic liquids. It is often used as a condiment or for pickling vegetables. In addition to apple cider vinegar, a diverse range of vinegar varieties such as persimmon vinegar and tomato vinegar are also available. The primary component in these vinegars is acetic acid, with 15 ml of vinegar containing approximately 750 mg of acetic acid (1, 2). Vinegar is composed of a complex array of constituents, including a variety of organic acids such as formic, lactic, malic, citric, succinic, and tartaric acids (1). Additionally, it contains amino acids, peptides, essential vitamins, mineral salts, and a spectrum of polyphenolic compounds, including catechin, caffeic acid, and ferulic acid, contributing to its nutritional and functional properties (1). The therapeutic value of vinegar could be due to the presence of the acetic acid and these other components.

From a regulatory standpoint, apple cider vinegar is generally regarded as safe when used as a food ingredient. While generally safe, vinegar can have side effects, particularly when consumed in excess such as tooth enamel erosion, throat irritation, digestive discomfort, lowered potassium levels and potential interactions with certain medications, such as diuretics or insulin. Individuals with pre-existing conditions like gastroparesis or acid reflux should be cautious (see Table below). The typical dosage of apple cider vinegar for weight loss is not well established, but 1-2 tablespoons (15-30 ml) per day, diluted in water is suggested and considered safe for most people. The regulatory status of vinegar supplements in tablet form can vary by country, and these products should be approached with caution (3).

GERD, gastroesophageal reflux disease

For detailed discussions on other possible health benefits of vinegar other than weight loss, please refer to the reviews by Petsiou et al. (1) and Samad et al. (2). In terms of vinegar's effects on body weight, most studies on rats and mice appear to be beneficial (4-10), with one finding no effects (11). Research on this topic in human participants is currently limited. A double-blind placebo-controlled randomised control trial in 155 obese (overweight according to the World Health Organisation) Japanese individuals studied for 12 weeks indicated beneficial effects that were lost after cessation of treatment (12).

The beneficial effects included a reduction in overall weight, waist circumference and abdominal fat. Notably the study of Kondo et al. (12) was sponsored by a manufacturer of vinegar products. Seo et al. (13) conducted a study investigating the impact of ginseng ripened in persimmon vinegar (a traditional ingredient in Korean cuisine) on body weight among obese female adolescents. Their findings indicated a decrease in body weight and fat, although it is important to note that the study had a small sample size. To ascertain the potential benefits of vinegar, it is crucial to conduct more high-quality, independent larger studies, specifically double-blind, placebo-controlled, randomised controlled trials that are not influenced by industry interests.

The exact physiological mechanisms remain an area of ongoing research. These findings, primarily based on research from animal studies, offer insights into the complex role of vinegar and acetic acid in weight-related processes. The table below serves as a summary of the current scientific understanding.

ACV, apple cider vinegar

In comparison with other dietary interventions for weight loss, apple cider vinegar's effects appear modest. It should be considered as a complementary approach rather than a standalone solution. It is also important to note that a balanced diet and regular exercise are the most effective and sustainable methods for weight loss and maintenance.

Conclusion

While the existing research, particularly in animal studies, points towards potential benefits of vinegar, especially apple cider vinegar, in weight management, the scarcity of robust human trials leaves a gap in our understanding. Future high-quality, independent research is necessary to conclusively determine the role of vinegar in human weight loss and its overall health implications. Until conclusive evidence emerges, one can relish guilt-free flavour enhancement by incorporating vinegar in various forms (including as a dressing for salads, in marinades, for pickling, as a condiment, enjoying the occasional French fries with vinegar instead of traditional mayonnaise or ketchup, and in soups, stews, baking, beverages, as well as a seasoning for rice and grains), all while benefitting from its low caloric value (12.6 kJ per tablespoon), while also exploring its potential, yet not fully validated, health benefits. However, a cautious approach, especially in the case of vinegar supplements, is recommended because of significant adverse events reported in studies.

Reflections

·       Reflect on your own experience or that of someone you know who has used vinegar, particularly apple cider vinegar, for health reasons. Consider how it was integrated into a broader health strategy. Was it used in conjunction with a balanced diet and regular exercise, or was it relied upon as a primary health solution? How did this approach affect the outcomes?

·       Reflect on whether you or someone else considered potential side effects before incorporating vinegar, especially ACV, into a regular health routine. Was there a consultation with a healthcare professional to understand possible interactions with health conditions or medications? How did this consideration impact the decision to use vinegar for health purposes?

References

1.         Petsiou EI, Mitrou PI, Raptis SA, Dimitriadis GD. Effect and mechanisms of action of vinegar on glucose metabolism, lipid profile, and body weight. Nutrition reviews. 2014;72(10):651-61. https://academic.oup.com/nutritionreviews/article/72/10/651/1935511

2.         Samad A, Azlan A, Ismail A. Therapeutic effects of vinegar: a review. Current Opinion in Food Science. 2016;8:56-61. https://www.sciencedirect.com/science/article/abs/pii/S2214799316300479

3.         Hill LL, Woodruff LH, Foote JC, Barreto-Alcoba M. Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products. Journal of the American Dietetic Association. 2005;105(7):1141-4. https://www.jandonline.org/article/S0002-8223(05)00477-3/fulltext

4.         Kondo T, Kishi M, Fushimi T, Kaga T. Acetic acid upregulates the expression of genes for fatty acid oxidation enzymes in liver to suppress body fat accumulation. Journal of agricultural and food chemistry. 2009;57(13):5982-6. https://pubs.acs.org/doi/abs/10.1021/jf900470c

5.         Lee J-H, Cho H-D, Jeong J-H, Lee M-K, Jeong Y-K, Shim K-H, et al. New vinegar produced by tomato suppresses adipocyte differentiation and fat accumulation in 3T3-L1 cells and obese rat model. Food chemistry. 2013;141(3):3241-9. https://www.sciencedirect.com/science/article/abs/pii/S0308814613007322

6.         de Dios Lozano J, Juárez-Flores BI, Pinos-Rodríguez JM, Aguirre-Rivera JR, Álvarez-Fuentes G. Supplementary effects of vinegar on body weight and blood metabolites in healthy rats fed conventional diets and obese rats fed high-caloric diets. Journal of Medicinal Plants Research. 2012;6(24):4135-41.

7.         Yamashita H, Fujisawa K, Ito E, Idei S, Kawaguchi N, Kimoto M, et al. Improvement of obesity and glucose tolerance by acetate in Type 2 diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) rats. Bioscience, biotechnology, and biochemistry. 2007;71(5):1236-43. https://www.tandfonline.com/doi/abs/10.1271/bbb.60668

8.         Yamashita H, Maruta H, Jozuka M, Kimura R, Iwabuchi H, Yamato M, et al. Effects of acetate on lipid metabolism in muscles and adipose tissues of type 2 diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) rats. Bioscience, biotechnology, and biochemistry. 2009;73(3):570-6. https://www.jstage.jst.go.jp/article/bbb/73/3/73_80634/_article/-char/ja/

9.         Yamashita H. Biological function of acetic acid–improvement in obesity and glucose tolerance by acetic acid in type 2 diabetic rats. Critical Reviews in Food Science and Nutrition. 2016;56(sup1):S171-S5. https://www.tandfonline.com/doi/full/10.1080/10408398.2015.1045966

10.       Yun SN, Ko SK, Lee KH, Chung SH. Vinegar-processed ginseng radix improves metabolic syndrome induced by a high fat diet in ICR mice. Archives of Pharmacal Research. 2007;30:587-95. https://link.springer.com/article/10.1007/BF02977653

11.       Fushimi T, Suruga K, Oshima Y, Fukiharu M, Tsukamoto Y, Goda T. Dietary acetic acid reduces serum cholesterol and triacylglycerols in rats fed a cholesterol-rich diet. British Journal of Nutrition. 2006;95(5):916-24. https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/dietary-acetic-acid-reduces-serum-cholesterol-and-triacylglycerols-in-rats-fed-a-cholesterolrich-diet/664258C668149C74D01A0F9E76094958

12.       Kondo T, Kishi M, Fushimi T, Ugajin S, Kaga T. Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects. Bioscience, biotechnology, and biochemistry. 2009;73(8):1837-43. https://www.tandfonline.com/doi/abs/10.1271/bbb.90231

13.       Seo H, Jeon B-D, Ryu S. Persimmon vinegar ripening with the mountain-cultivated ginseng ingestion reduces blood lipids and lowers inflammatory cytokines in obese adolescents. Journal of Exercise Nutrition & Biochemistry. 2015;19(1):1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4424440/

14.       Darzi J, Frost G, Montaser R, Yap J, Robertson M. Influence of the tolerability of vinegar as an oral source of short-chain fatty acids on appetite control and food intake. International Journal of Obesity. 2014;38(5):675-81. https://www.nature.com/articles/ijo2013157

15.       Hattori M, Kondo T, Kishi M, Yamagami K. A single oral administration of acetic acid increased energy expenditure in C57BL/6J mice. Bioscience, biotechnology, and biochemistry. 2010;74(10):2158-9. https://www.tandfonline.com/doi/pdf/10.1271/bbb.100486

16.       Johnston CS, Steplewska I, Long CA, Harris LN, Ryals RH. Examination of the antiglycemic properties of vinegar in healthy adults. Annals of Nutrition and Metabolism. 2010;56(1):74-9. https://karger.com/anm/article-abstract/56/1/74/40516/Examination-of-the-Antiglycemic-Properties-of?redirectedFrom=fulltext

17.       Johnston CS, Quagliano S, White S. Vinegar ingestion at mealtime reduced fasting blood glucose concentrations in healthy adults at risk for type 2 diabetes. Journal of Functional Foods. 2013;5(4):2007-11. https://www.sciencedirect.com/science/article/abs/pii/S1756464613001874

18.       Liatis S, Grammatikou S, Poulia KA, Perrea D, Makrilakis K, Diakoumopoulou E, et al. Vinegar reduces postprandial hyperglycaemia in patients with type II diabetes when added to a high, but not to a low, glycaemic index meal. European Journal of Clinical Nutrition. 2010;64(7):727-32. https://www.nature.com/articles/ejcn201089

19.       Ahmadniaye Motlagh H, Javadmanesh A, Safari O. Improvement of non-specific immunity, growth, and activity of digestive enzymes in Carassius auratus as a result of apple cider vinegar administration to diet. Fish Physiology and Biochemistry. 2020;46(4):1387-95. https://link.springer.com/article/10.1007/s10695-020-00797-6

20.       Hlebowicz J, Darwiche G, Björgell O, Almér L-O. Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC Gastroenterology. 2007;7(1):46. https://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-7-46

21.       Liljeberg H, Björck I. Delayed gastric emptying rate may explain improved glycaemia in healthy subjects to a starchy meal with added vinegar. European Journal of Clinical Nutrition. 1998;52(5):368-71. https://www.nature.com/articles/1600572

Always seek guidance from dietitians for personalised diets and weight management plans.

In the process of creating this work, the author utilised ChatGPT-4 to streamline the text and perform language editing. However, artificial intelligence was not used to generate the content.