The Everything Guide to Apple Cider Vinegar

You may think apple cider vinegar is the new coconut oil — except it’s not a new remedy at all.
You may think apple cider vinegar is the new coconut oil — except it’s not a new remedy at all. Photo: Garo/Phanie

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If you’ve been on a health or wellness site in the past year, or even just Facebook, you’ve probably seen at least one listicle claiming that apple-cider vinegar is a magical elixir that will solve nearly every malady, skin problem, and cleaning conundrum. It promotes weight loss too, the headlines crow! Many of us have a friend or co-worker who keeps a bottle of ACV (the parlance of the knowing) on her desk or countertop — but only the unpasteurized, unfiltered kind with the stringy “mother” inside, never that supermarket stuff.

It seems that apple-cider vinegar is the new coconut oil — except it’s not a new remedy at all. Hippocrates, the father of modern medicine, allegedly treated his patients with ACV, and it was touted as a health-promoting tonic in the Bible. It’s also a pickling agent that has helped keep food fresh for everyone from 17th-century sailors to your grandmother, though now you’re more likely to use it in salad dressings and other recipes.

But how magical is the stuff, really? Should you be drinking it, rubbing it on your skin, and gargling with it? Let’s examine the evidence.

The claim: Apple-cider vinegar helps you lose weight.

Johnson was initially interested in studying how diabetics could lower their blood-glucose levels by eating low-carb diets. But she could tell that an existence without bread or pasta was tough for her subjects, and doubted they’d stick with it. That’s why she was so excited to find an obscure animal study from the 80s which suggested that acetic acid, the defining component of vinegar, could help to regulate blood sugar.

She’s since corroborated that evidence with several 12-week experiments that showed drinking a diluted solution before a high-carb lunch and dinner reduced fasting blood-sugar levels in both type-2 diabetics and in prediabetics, compared to a control group that took a vinegar pill. Her theory is that acetic acid blocks an enzyme that digests starches, thereby preventing some carbs from being absorbed.

A few important points to make at this juncture: No, these studies don’t mean that an ACV tonic will allow you to eat all the cupcakes you desire without gaining an ounce, and it probably won’t help you lose weight, either. No one in Johnston’s studies slimmed down, and it’s unclear exactly how many calories vinegar could block. “It might cause a gradual weight loss but you would probably have to follow people for a year to see that, because most people fluctuate five pounds as it is,” she says. Also, the fact that it’s apple-cider vinegar probably didn’t make a difference here, as acetic acid is found in any vinegar.

Still, this information hasn’t halted the spread of stories, which claim ACV can help people lose weight, diabetic or not. Many of these articles cite the same 2009 study out of Japan, which isn’t as encouraging as people make it out to be. For the paper, researchers had 155 obese subjects drink eight ounces of water after breakfast and dinner for 12 weeks. They didn’t know it but they were split into three groups: water with one tablespoon of ACV, water with half a tablespoon, and a placebo drink. The vinegar-tonic drinkers lost an average of 4.2 and 2.6 pounds, respectively, while those in the control group gained about a pound. Yes, people lost weight without really changing their diet otherwise, but three or four pounds in three months isn’t a big difference, especially when you consider Johnston’s point about water-weight fluctuations. The kicker? The study was conducted by the “central research institute” of the Mizkan Group, a company which makes, you guessed it, vinegar. So, salt grains and all that.

The claim: Okay, so it doesn’t help you lose weight, but it does make you feel full.

The research on satiety and appetite suppression isn’t very conclusive, either. “Some people have looked at satiety, including me, and you do seem to not be as hungry for the next meal, but if you follow the person for a full 24 hours they catch up with the calories,” Johnston says. Then there’s a 2014 study out of the U.K. which found that ACV doesn’t really help you feel full so much as make you feel like you’re gonna hurl. “In the conclusion, the authors basically said, ‘That’s silly, you don’t take something that makes you nauseous in order not to eat.’” So much for that.

The claim: It’ll make your skin look better.

There haven’t been studies on other anecdotal uses of ACV, like clearing up acne or getting rid of warts, but if you’re going down the topical road, dilution is key. A 2015 paper cautioned that a 14-year-old girl developed chemical burns after trying to remove unwanted moles with drops of ACV. The same thing happened to an eight-year-old boy after his mom tried to treat his wartlike skin infection with cotton balls soaked in the stuff.

In theory, the acne and wart cures should work because ACV has germ-killing properties, according to Margarita Rohr, MD, an internist at the Joan H. Tisch Center for Women’s Health at NYU Langone Medical Center and a clinical instructor of medicine at NYU. But Dr. Rohr isn’t convinced that it’s particularly antibacterial, antiviral, or antifungal compared to other vinegars. She found one study showing that ACV can kill bacteria, but it was due to the acidity of the vinegar, not some special property of apples or apple cider.

The claim: It busts germs.

People gargle with ACV when they have a sore throat on account of the purported germ-fighting powers (and others still think it can help whiten teeth). While Dr. Rohr wouldn’t tell them to stop, she points out that it can erode your tooth enamel and advises not to do it every day, though gargling is a different beast than swishing. Gargling could offer relief, but it’s probably the act of clearing out the back of your throat itself — not the liquid used — that matters. “You would have the same effect, I think, if you gargled with mouthwash or with vinegar. If there’s a virus or bacteria that’s hanging out, you could help lessen the amount that’s there.” She recommends using plain old saltwater for the task.

The bottom line.

If so many of ACV’s benefits are anecdotal and unproven, then why is it so beloved? For starters, it’s cheap, natural, and versatile. It’s that last bit that makes it amazing, as far as Johnston is concerned. “I just think it’s funny how you can ingest it and it has some medicinal properties but then you can use it to season food or clean your floor. How many products are like that?” Also, there’s something to be said for marketing.

“Everybody, including you and me, wants to think there’s something we can ingest that’s going to be a magic bullet,” Johnston says. “With vinegar, people want to think that they’re doing something healthful. And really what people need to do is eat well-balanced meals, exercise, and be prudent with their serving sizes. It’s not going to be a pill or a liquid, like coconut oil. That’s not going to make you healthy, it’s all the other stuff.” (Though she does allow that apple-cider vinegar with its mother might have other health attributes that haven’t been scientifically studied yet.)

Still, if you happen to have ACV in your pantry and want to try it, there’s no reason why not. Just be careful to dilute it if you’re drinking it — quaffing it straight could burn your lungs if you accidentally inhale it, says Johnston. It could also irritate your esophagus, according to Dr. Rohr. She says it’s probably not a great idea for anyone with acid reflux, ulcers, or other gastrointestinal issues, even if you do water it down.

If you’re looking for a healthy thing to drink, though, how about a glass of water? It’s even easier to find than ACV. And you could always jazz it up with a slice of lemon.