All the Health Benefits of Apple Cider Vinegar, Explained
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At some point between coconut oil and cauliflower, apple cider vinegar became the "it" food (well, drink) of the wellness world. So much so that some folks gulp it by the glass, either diluted in water or mixed into other drinks such as tea. But is apple cider vinegar actually that good for you — or is it totally overhyped? Ahead, discover whether ACV is the MVP, according to research and dietitians.
Apple Cider Vinegar, Explained
Long story short, apple cider vinegar is a liquid made of fermented apple juice, notes Harvard T.H. Chan School of Public Health. Specifically, it involves two stages of fermentation, per an article in the journal Horticulture Studies. Whole apples are crushed and pressed by a machine to release their juice, which is then fermented by bacteria that are already naturally present in the apples. This turns the juice into ethanol (a type of alcohol) and completes the first stage of fermentation. Next, acetic acid bacteria — which are naturally present in sugary ethanol-based drinks including fermented apple juice — take over. These microbes convert the ethanol into an acid called acetic acid, explains an article in the journal Food Technology & Biotechnology. The acetic acid, which is diluted in water to make apple cider vinegar, is responsible for that pungent, tart flavor.
Typically, ACV (and vinegar in general) is less than five percent acetic acid, according to a 2020 scientific review. Apple cider vinegar can also vary in quality, depending on factors such as the length of fermentation and the specific bacteria involved, notes the Horticulture Studies article. (The mix requires adequate time to ferment and the presence of acetic acid bacteria to create vinegar.) The variety of apples used to make the juice also plays a role in quality, as pointed out in an article in the International Journal of Diabetes Research.
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Apple Cider Vinegar Nutrition
From a nutrient standpoint, there isn't much to vinegar. Vinegar (including ACV) contains minimal amounts of carbohydrates, vitamins, and minerals, as stated by the Harvard T.H. Chan School of Public Health. This includes nutrients such as calcium, magnesium, and iron, per the United States Department of Agriculture (USDA). Finally, ACV contains antioxidants and beneficial bacteria, which are responsible for most of the ingredient's purported benefits.
Here's the nutritional profile of one tablespoon (14.9 grams) of cider vinegar, according to the USDA:
3 calories
< 1 gram carbohydrate
0 grams protein
0 grams fat
0 grams fiber
Health Benefits of Apple Cider Vinegar
Real talk: Despite the buzz around cider vinegar benefits, the ingredient isn't exactly packed with health-promoting nutrients. And while it does contain some noteworthy components, apple cider vinegar is meant to be consumed in small amounts — which isn't enough to affect your health in the same meaningful way that whole foods would. However, apple cider vinegar is super tart and tangy, making it an excellent flavoring agent. For example, it's a superb alternative to things such as added sugar and salt, should you want to limit such ingredients. When used in this way, apple cider vinegar can provide some beneficial compounds to your food, which have been associated with the following effects.
Offers Some Antioxidants
Apples, which are used to make apple cider vinegar, contain antioxidants called flavonoids. Antioxidants can help protect against oxidative stress, a form of cell damage that can increase the risk of chronic conditions (such as heart disease and cancer) over time.
But, although ACV does have antioxidants, it's unclear how much of those flavonoids are retained after the fermentation process, according to Susan Greeley, M.S., R.D.N., registered dietitian and chef-instructor at the Institute of Culinary Education. So, if you're looking to boost your intake of protective antioxidants, you're better off eating whole apples instead of relying on apple cider vinegar, she says.
May Support Gut Health
Next on the list of potential apple vinegar benefits is promoting gut health. ICYMI above, ACV is fermented, meaning it's been chemically altered by bacteria. The fermentation process by acetic acid bacteria produces a buildup of nutrients called the "mother," aka the cloud-like strings floating in apple cider vinegar, says Greeley. These nutrients include probiotics, which are beneficial bacteria, explains Kelsey Lorencz, R.D.N., registered dietitian and founder of Graciously Nourished. Such microbes may support gut health as they can repopulate in your gut, ultimately increasing the healthy bacteria, she explains. This deserves a callout because increasing the ratio of good to bad bacteria can pave the way for a healthy gut. In contrast, if there are too many harmful gut microbes, it can increase the risk of digestive issues such as inflammatory bowel disease (IBD), according to a 2021 review. All that said, although apple cider vinegar does contain healthy bacteria, it's not considered to be a probiotic food in the same category as yogurt or kefir. (Speaking of gut health, kombucha is another fermented beverage that's good for your gut.)
Might Control Blood Sugar
Another apple cider vinegar benefit may include blood sugar control, though there are some specifics to keep in mind. Acetic acid (which, again, is the main component of vinegar) is thought to help manage blood sugar, notes Valerie Agyeman, R.D., a registered dietitian and founder of Flourish Heights. Specifically, "it reduces the rate at which carbs are broken down in the body, resulting in fewer blood sugar spikes," she says. This is key because frequent blood sugar spikes can increase the risk of type 2 diabetes — or complications such as heart disease and kidney problems if you already have diabetes — says the Centers for Disease Control and Prevention (CDC). Moreover, acetic acid suppresses the activity of disaccharidase, an enzyme that breaks down sugars for absorption, per the article from the International Journal of Diabetes Research. Curbing their activity may pump the brakes on blood sugar spikes, potentially offering some protection from diabetes.
So, in theory, acetic acid in apple cider vinegar (and vinegar in general) may be beneficial, though research is limited. For example, Agyeman points to a small 2010 study, which "found that drinking ACV with complex carbs [a source of glucose] may lower post-meal blood sugar levels by 20 percent." Similarly, another small 2015 study found that vinegar can slightly improve post-meal blood sugar levels by increasing glucose uptake — that is, the rate at which glucose moves out of the blood and into the muscles, where it's used for energy. Still, more research is needed to confirm the blood sugar benefits of apple cider vinegar, says Agyeman.
Related: Do Apple Cider Vinegar Gummies Actually Have Health Benefits?
May Support Heart Health
"ACV contains chlorogenic acid, [which is] also found in coffee and black tea," shares Agyeman. Chlorogenic acid is an antioxidant compound that may help reduce plaque buildup in blood vessels, she adds. (Plaque consists of cholesterol, fatty compounds, and cellular wastes. Over time, it can accumulate in the blood vessels, making the openings of said vessels narrower. This can decrease blood flow to the heart, potentially leading to heart disease, according to the American Heart Association.) Chlorogenic acid may also decrease high LDL ("bad") cholesterol levels, a major risk factor for heart disease, per the CDC, notes Agyeman.
Due to these effects, apple cider vinegar may hypothetically protect the heart, and "some research shows that it may reduce the risk for heart disease," says Agyeman. The only catch? "Many of [these] studies have been completed in animals," she notes. For example, in a study published in the Pakistan Journal of Biological Sciences, apple cider vinegar reduced LDL cholesterol and increased HDL ("good") cholesterol in rats. Similarly, another study published in the Journal of Advances in Biology & Biotechnology found that apple cider vinegar decreases overall cholesterol levels in rats. "There is currently no strong evidence that it [reduces the] risk of heart disease in humans, [so] more studies are definitely needed," explains Agyeman.
Potential Risks of Apple Cider Vinegar
"Apple cider vinegar isn't something you want to be chugging, [as drinking] large amounts every day can do real damage in the body," states Agyeman. That's because apple cider vinegar is highly acidic, so drinking it undiluted — and in excess — may lead to GI problems (think: nausea and stomach upset), she notes. The acidity of ACV can also "damage the enamel on your teeth or the tissues in your esophagus," warns Lorencz. That being said, your best bet is to consume ACV diluted in other ingredients.
Related: Your Apple Cider Vinegar Habit May Be Ruining Your Teeth
If you're taking diuretics or "water pills" for hypertension, you'll want to approach apple cider vinegar with even more caution. ACV can drastically lower your potassium levels, which is already a potential side effect of diuretics, says Lorencz. Diuretics help reduce high blood pressure by increasing the excretion of water and sodium via the urine — though some might promote the excretion of potassium, too, notes the Mayo Clinic. This can lead to low blood potassium levels, or hypokalemia, causing symptoms including weakness or muscle cramps. Drinking apple cider vinegar and taking diuretics may further increase your risk of low potassium, so be sure to chat with your doc before consuming it. The same goes if you're taking medication for diabetes, as the potential blood sugar–lowering effects of ACV might negatively interact with such meds, says Agyeman.
Finally, "you may want to avoid ACV if you have gastroparesis, a condition that slows down your digestion," says Lorencz. The reason? Apple cider vinegar might increase the amount of time food stays in your stomach, potentially worsening any gastroparesis symptoms, she says. Again, when in doubt, talk to your doctor before adding apple cider vinegar to your diet.
How to Buy and Use Apple Cider Vinegar
At the grocery store, apple cider vinegar is typically found in the condiment aisle next to oils and dressings. You'll also probably have two varieties to choose from: filtered and unfiltered. Among those choices, you can also pick between pasteurized and unpasteurized vinegar.
As you've probably guessed, unfiltered ACV has not been filtered during production. This means it contains the original byproducts of fermentation, including the beneficial bacteria and mother, as specified by an article published in the International Journal of Diabetes Research. And since the mother is naturally cloudy and stringy, unfiltered ACV tends to look murky. It will probably also also have particles (part of the mother) floating throughout the bottle. On the flip side, filtered ACV has been purified to remove substances including the mother, explains Greeley. This means it will be translucent and free of floating particles.
Both unfiltered and filtered apple cider vinegar may also be pasteurized, or heat-treated, to destroy microbes such as yeast and bacteria. This includes live bacteria such as the mother, according to West Virginia University. So, ACV labeled as "pasteurized" will likely not contain the mother, while unpasteurized (aka raw) versions mostly likely will.
As such, there are many varieties of apple cider vinegar, depending on their filtration and pasteurization status. If the nutritional value is your priority, go for unpasteurized and unfiltered ACV, which typically contains the mother. However, if you're not a fan of the cloudy appearance, a filtered or pasteurized version is another choice. The same goes if you want a clear, smooth ACV for a recipe such as for a dressing.
Additionally, apple cider vinegar is used as an ingredient in packaged products, most notably beverages (you can find a couple varieties at Trader Joe's). There are also apple cider vinegar gummies, but the jury's still out on the benefits of such supplements — even more so than with ACV itself. Either way, packaged items may contain added sugar and salt, so be sure to check the label if you want to limit your intake of these ingredients.
At home, keep your bottle of apple cider vinegar in an area away from direct sunlight, so store it in the cupboard or pantry. It's also recommended to keep it away from heat, per University of Illinois, so try to choose a cupboard away from the stovetop and oven. Once opened, a bottle of ACV will maintain its quality (i.e., taste and nutrients) for about one year, while sealed unopened bottles will last for about two years.
Related: Why an Apple Cider Vinegar Rinse Can Give You the Hair of Your Dreams
When it comes to actually consuming apple cider vinegar, it's best to dilute it first, says Greeley. In other words, you'll want to use it as a recipe ingredient, rather than as a supplement or drink. Not only is this safer (and tastier!), but you can still enjoy its potential benefits even when it's diluted, she notes. And if you're determined to drink straight ACV for whatever reason, you'll want to limit your intake to two tablespoons a day, max, suggests Greeley. Even then, it can still cause unwanted side effects for some people, so touch base with your doc before making it a permanent addition to your routine.
Apple Cider Vinegar Recipes
In terms of recipes, you can use apple cider vinegar to add flavor and brightness, just as you would with other acidic ingredients such as balsamic or rice vinegar. Need some inspo? Here are a few tasty ways to use apple cider vinegar in food:
Use it in condiments.
A splash of apple cider vinegar can brighten up myriad condiments, from tangy vinaigrettes to rich sauces. For example, one of these easy three-ingredient salad dressing recipes combines ACV with tahini and honey for a topping that's bursting with unique flavors. Other easy options include BBQ sauce and cilantro jalepeño sauce which would taste good with everything.
Add it to marinades.
Try using apple cider vinegar in marinades for proteins such as fish or chicken, recommends Agyeman. You could even add a tangy depth of flavor to a tofu marinade if meat and fish aren't your thing.
Mix it into lentils.
Elevate your next lentil dish with the help of ACV. Acids such as apple cider vinegar are the perfect partner for lentils, as they can boost the flavor of the legumes, notes Greeley. "Right before serving hot lentil soup, add one or two tablespoons of ACV," she suggests.
Add it to soups or stews.
If your soup or stew tastes a bit dull, stir in a tablespoon of apple cider vinegar. The tangy flavor will instantly brighten up your dish without the need for sugar and/or salt. Or try this chili recipe from Peloton's Jess King and her partner Sophia Urista, which calls for a bit of apple cider vinegar.
