Why You Should Take Apple Cider Vinegar

So, back when I was in medical school, I
thought apple cider vinegar was just
this woowoo treatment that didn’t have
any scientific basis. But then I’ve
heard so many of my patients swear by
it. And then the internet says things
like it can burn fat and it can reverse
your diabetes and even fight infections.
And some even say it can extend your
life. So, is apple cider vinegar this
miracle cure? Or is it just a fad? Well,
in this video, I want to break down
exactly what the latest evidence says
about apple cider vinegar, and I want to
go over proven benefits and the myths
and real risk you need to watch out for.
So, by the end of the video, you’ll know
whether this is something you need to
add to your routine or throw it in the
What exactly is ACV?
trash. So, first things first, what is
apple cider vinegar? Well, it’s not some
exotic supplement. It’s literally just
fermented apple juice. You crush apples
and you add yeast, and the yeast eats
the sugar and turns it into alcohol.
Acetic Acid
Now, this is where something special
happens because bacteria then turn that
alcohol into acidic acid. And acidic
acid is the star of the show. It’s what
gives vinegar that sharp smell and that
sour taste. And acidic acid is what
gives us that therapeutic biological
effects that we’re going to talk about.
And acidic acid, when measured on the pH
scale, which is just a scale that
measures how acidic something is, it’s
about 2 to three. And to put them in
perspective, water is neutral at 7 and
battery acid is all the way down to one.
So apple cider vinegar sits right in
that be careful acidic zone. And that’s
going to matter later when we talk about
precautions with apple cider vinegar,
especially when it comes to your teeth
and your reflux and just overall safety.
Blood Sugar Control
So let’s start with the strongest
evidence that we have for apple cider
vinegar, and that is blood sugar
control. This is actually where apple
cider vinegar shines. And there are
several randomized control trials like
these that show that apple cider vinegar
does have therapeutic effect on glucose
control especially in people with type 2
diabetes or obesity. In fact, there’s a
relatively recent meta analysis of 25
clinical trials that comprised over
1,300 participants found that apple
cider vinegar consumption could
significantly improve fasting blood
glucose levels and hemoglobin A1C and
triglycerides with the effects being
especially pronounced in folks with
diabetes. So why does it work? Well, the
key ingredient in apple cider vinegar,
the acetic acid. Think of it like a mild
brake pedal on your digestion. Acidic
acid slows down the enzyme in your gut
that normally breaks down starches into
sugar. So that means instead of a huge
blood glucose spike after a meal, the
rise in your blood glucose is smaller
and slower. And then on a cellular
level, acetic acid does a couple of
interesting things. One, it makes your
muscles more sensitive to insulin. So
imagine your muscle cells as doors with
locks. And insulin is your key. In
diabetes, the lock gets rusty and it
doesn’t turn so easily. So, this is
where acetic acid can oil that lock a
little so insulin can open the door and
let more glucose into the muscle cells.
And then there’s another effect that
happens, but this time it’s happening in
your liver. Normally, your liver can
pump out extra glucose when it thinks
you need it. But with insulin
resistance, the liver sometimes
overshoots and it adds even more
unnecessary sugar into the blood. So
apple cider vinegar and actually a lot
of vinegar do this. It can reduce the
glucose output. So your fasting blood
sugar can come down over time. And
here’s a concrete example of this. Let’s
say two people eat a bagel. Without
vinegar, blood sugar might shoot up
pretty quickly from 90 to let’s say 180.
But with vinegar before the meal, the
peak might be lower at 140 instead. So
it’s not curing diabetes, but it’s
lowering the stress on the system. And
then there’s another fascinating
process. Acetic acid can activate an
enzyme in your muscles called EMPK which
acts as your body’s fuel gauge and when
it turns on cells shift towards burning
fat and using glucose more efficiently.
Exercise does this too. So in a way
acidic acid mimics that metabolic effect
that you may get from exercise and it
acts on the same pathway as some
diabetes medications like metformin. Now
Weight Loss
what about weight loss? Well, there’s
one decent study out of Japan back in
2009 that was a double blind randomized
control trial that showed that 12 weeks
of daily vinegar intake anywhere from
750 to,500 millig of acetic acid led to
a small but a statistically significant
reductions in your body weight and fat
mass compared to placebo. I think it was
about 2 lbs in the span of 3 months. But
recent systematic reviews and meta
analyses concluded that the overall
current evidence is insufficient to
recommend apple cider vinegar or acetic
acid for weight loss. Mainly due to lack
of long-term and high quality data. So
yes, there may be some effect when it
comes to weight loss, but it’s not a big
Antimicrobial / Infection
one. It’s more of a nudge. Okay. But
what about fighting infections? Does
apple cider vinegar have antimicrobial
properties? Well, people have been using
vinegar as a disinfectant or as a food
preservative for thousands of years. In
fact, Hypocrates, the father of modern
medicine, reportedly prescribed vinegar
for colds and wounds. And we have in
vitro and animal studies that show that
apple cider vinegar and acetic acid
possess antimicrobial activity against
many different pathogens and against
bacteria like ecoli and stephforas
including MRSA and sudamonus and even
fungal infections like candida. So lots
of laboratory data but there’s no high
quality clinical trials in humans to say
that acetic acid can actually help with
Longevity / Anti-Aging
infections. I also see a lot of claims
on social media about longevity and
anti-aging benefits, but the existing
evidence is limited to animal studies
and in vitro experiments. So, for
example, some studies in aging rats and
mice suggest that acetic acid may
modulate pathways related to muscle
atrophy and mitochondrial function. And
there’s studies to look into gut
microbiome derived acidic acid and how
it can improve certain aging related
parameters in animal models. And there’s
even other animal studies that have
shown antioxidant and neuroprotective
effects of apple cider vinegar, but none
of these findings have been confirmed in
actual human clinical trials. So,
unfortunately, there’s currently no good
human evidence or any strong data to
support any of those longevity claims
Safety / Dosing
just yet. Okay, let’s talk about safety
because this is the part that most
people ignore. And the biggest concern
here is regarding your teeth. Acid
erodess enamel over time, especially if
you’re sipping vinegar undiluted. So, if
you want to add apple cider vinegar to
your regimen, here’s how to do it
safely. Do not take more than 1 tspoon
per day or no more than 15 ml and you
always want to dilute it in a big glass
of water of at least 8 or 10 ounces of
water. And this is the dose that was
most consistently studied in clinical
trials. And the best time to consume
apple cider vinegar is before a meal,
especially a meal that’s having carbs or
starches, as that’s what’s going to help
you to blunt that glucose spike. And
always use a straw to drink it to
protect the enamel of your teeth. And
most people tolerate these doses pretty
well, but it can sometimes cause an
upset stomach or an irritation in your
esophagus or your stomach, especially if
you’re suffering from gastrical reflux.
But the good news is for the most part
there were no serious adverse effects.
They’ve been reported in the literature
when apple cider vinegar is used at
those doses. But we also don’t have any
long-term safety data beyond 12 weeks.
So, we always have to keep that in the
back of our minds. And as always, please
talk to your doctor before you add this
to your regimen to make sure it’s safe
in your particular situation. So, based
on the current state of evidence, apple
cider vinegar is not a miracle by any
means, but it is cheap and it seems to
be fairly safe if dosed appropriately,
especially in the short term. And when
it comes to my own patients, the only
setting I recommend apple cider vinegar
is if they have issues with insulin
resistance like diabetes or
pre-diabetes. But looking at the current
state of evidence, it’s pretty hard to
recommend it for anything else at this
point.