Does Apple Cider Vinegar Live Up To The Hype?

Apple cider vinegar has been garnering popularity as a weight-control and blood sugar control aid. It has also been suggested to have a range of other health benefits. But is this fact or fiction? Let’s discover what research has to say about vinegar, and in particular, apple cider vinegar. How does it affect glucose metabolism?

Highlights

• Research reveals that consumption of 20 mL of apple cider vinegar diluted in 40 mL of water, could lower blood sugar after meals or postprandial hyperglycemia,
• Consuming vinegar with or before a meal containing bread or other forms of carbohydrates lowers post-meal glucose spikes and could also increase satiety,
• There isn’t enough scientific data to suggest ACV or vinegar could be a long-term solution for high blood pressure or a potential cure for cancer.

How is vinegar made? 

Vinegar comes from the French term vin aigre, which means sour wine. This kitchen staple is created by a two-step fermentation process: carbohydrates (usually fruit, rice, potatoes or whole grains) are converted into alcohol, which is then fermented to vinegar. Acetic acid (created in the first step) gives vinegar its sour, sharp taste, and has been linked to a reduction in blood sugar spikes, particularly after meals. There are many types of vinegar: distilled white vinegar, rice vinegar, balsamic vinegar (from grapes), apple cider vinegar (from apples) and various others.

How does vinegar impact blood sugar?

Vinegar is believed to reduce blood sugar, though the ways in which it affects blood glucose are still being determined through research. Studies have found that groups of adults suffering from or at risk of type 2 diabetes showed a sustained reduction in fasting glucose thanks to daily vinegar consumption. As an addition to meals, vinegar has been found to have anti-glycemic effects for these adults. Here are some research-backed theories that try to explain why this happens. 

1. One hypothesis is that acetic acid slows down the gastric emptying rate (the rate at which the stomach empties food into the small intestine). This in turn slows the breakdown of starches and gives you more time to reduce glucose levels in the blood. One study found that even within healthy volunteers, ingestion of acetic acid as vinegar reduced both blood glucose concentration and insulin responses after a heavy meal.
2. Another group of researchers discovered an increased glucose uptake in the forearm muscle cells of individuals with diabetes who consumed vinegar. This outcome was not seen in the control group, thus suggesting that vinegar may increase the uptake of glucose at a cellular level. Another study on rats found that balsamic vinegar improved the action of beta cells, which influence the secretion of insulin when glucose is broken down.
3. One theory is that vinegar balances blood glucose levels by interfering with the activity of disaccharidases (the enzymes in the small intestine that break down carbohydrates). By subduing their activity, the rapid absorption of glucose is reduced. This is perhaps why those who consumed vinegar with their meals were found to have lower blood sugar levels.
4. A study also found that vinegar that had been neutralised with sodium bicarbonate to change its pH didn’t have the same reducing effect on blood sugar, suggesting that the acidity has something to do with this.

Apple cider vinegar and blood sugar 

Apple cider vinegar is most commonly associated with blood sugar management. This is why its effects on glucose have been of particular interest to researchers. One small study in rats found that apple cider vinegar helped lower the levels of LDL cholesterol and HbA1c (hemoglobin A1c is an indicator of average blood sugar levels). A study shows that consumption of 20 mL of apple cider vinegar diluted in 40 mL of water, could lower blood sugar after meals or postprandial hyperglycemia. (7) Another study from 2007 found that consumption of apple cider vinegar before falling asleep helped moderate blood sugar levels in the morning.

Jessie Inchauspe, biochemist and author of the book, Glucose Revolution: The Life-Changing Power of Balancing Blood Sugar, swears by apple cider vinegar. ‘Need a silver bullet to reduce the glucose response of a meal? Go with vinegar,’ she says. A meta-analysis of various studies done on over 300 patients with type 2 diabetes concluded that the consumption of apple cider vinegar had beneficial effects in terms of reducing fasting blood sugar levels and HbA1c.

Myths about vinegar 

The media has been pushing ACV as a miracle cure but a number of sources warn that some of the health benefits vinegar is touted to have are either not verified or purely anecdotal. There isn’t enough scientific data to suggest ACV or vinegar could be a long-term solution for high blood pressure or a potential cure for cancer. A randomised trial found that consumption of apple cider vinegar along with meals led to a slightly greater weight reduction than in a control group. The link needs to be examined further, as researchers hypothesise this could be due to a reduction in appetite, among other factors. 

How to include vinegar in your diet 

Consuming vinegar with or before a meal containing bread or other forms of carbohydrates lowers post-meal glucose spikes and could also increase satiety. So here’s how you can incorporate vinegar into your diet:

1. Have a vinegar-based salad dressing using balsamic or apple cider vinegar along with olive oil, herbs, etc., before consuming your carbohydrates or a heavy meal.
2. Add vinegar over steamed or roasted vegetables, as even a small amount can help control blood sugar.
3. Dilute apple cider vinegar with water and drink it before your meals using a straw.

Studies on yoghurt, pickles and other fermented foods have also found that they reduced blood sugar and insulin. So including more fermented foods in your diet, including vinegar, could be a useful way to control blood sugar, particularly when combined with carb-heavy meals. 

Risks and who should avoid it

Although vinegar has been consumed for centuries and does not have any immediate health risks, it could be unsuitable for some people. Doctors advise people with kidney issues, stomach ulcers or certain medical conditions to avoid vinegar. And in no situation is it recommended as a substitute for medication. 

In fact, too much apple cider vinegar can lead to lower potassium levels and gastrointestinal trouble. Another potential risk of drinking vinegar directly or consuming large amounts of it (along with other highly acidic beverages) is the potential damage to or even erosion of tooth enamel. This is why apple cider vinegar is diluted with water before drinking and used as an ingredient in cooking.

Conclusion 

Research suggests that vinegar or apple cider vinegar can have beneficial effects in controlling blood sugar is substantial. More studies are required to establish the mechanisms that cause this effect, as well as the other potential health benefits of consuming it. Still, adding vinegar to your diet or routine if you are trying to avoid post-meal glucose spikes might be a good idea. It’s important to remember that vinegar is not a substitute for medication or other treatments and may not be suitable for people with certain medical conditions. It is best diluted with water or incorporated as part of a recipe. 

Disclaimer: The contents of this article are for general information and educational purposes only. It neither provides any medical advice nor intends to substitute professional medical opinion on the treatment, diagnosis, prevention or alleviation of any disease, disorder or disability. Always consult with your doctor or qualified healthcare professional about your health condition and/or concerns and before undertaking a new health care regimen including making any dietary or lifestyle changes.

References

1. https://www.uchicagomedicine.org/forefront/health-and-wellness-articles/debunking-the-health-benefits-of-apple-cider-vinegar
2. https://www.sciencedirect.com/science/article/abs/
   pii/S1756464613001874
3. https://pubmed.ncbi.nlm.nih.gov/9630389/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438142/
5. https://academic.oup.com/jn/article/130/3/507/4686196