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Apple Cider Vinegar - is it Effective in Regulating Blood Sugar and Appetite?

Developed by Claudia Hleap MS, RD, CDCES & Dietetic Intern, Reagan Dishaw


Overview of Today's Article


On average, about one in five of my clients is either already taking apple cider vinegar with meals or as a supplement or asks me whether it's effective and should be included in their diet.


I decided to dive into the research and give an evidence based response to this frequently asked question.


What is there to know about Apple Cider Vinegar?


Apple cider vinegar (ACV) is made from fermented apple juice. ACV research is evolving, exploring its possible health benefits like lowering blood sugar and blood cholesterol levels. At this point in time, there is not enough evidence to definitively recommend ACV for any condition. However, current research does strongly support ACV having a favorable effect on carbohydrate metabolism, therefore, more conclusive research for ACV and Type 2 Diabetes management may eventually surface. The mechanism of exactly HOW apple cider vinegar positively effects glucose and/or cholesterol levels is unclear.


So, what DO we know?


This information has been gathered from research studies and journal articles

What potential benefits does ACV have?

  • ACV was shown to slow gastric emptying and inhibit sucrase (enzyme that breaks down sugar), delaying the absorption of carbohydrates

  • ACV intake with a meal was shown to improve insulin sensitivity, thereby improving post-meal blood sugar levels

  • ACV intake with a meal demonstrated increased levels of satiety (feeling full)

  • In a meta-analysis, ACV consumption significantly decreased total blood cholesterol levels

  • ACV was shown to improve HDL cholesterol levels in those without diabetes


Dosage or Amount Needed to see Potential Results?


The most effective dosage:

  • 15 mL per day (about 1 tablespoon)

  • Most effective when taken for >8 weeks

  • ACV might be better tolerated when diluted with water, but does not have to be “The more, the better” mentality is NOT ideal with ACV

  • Excessive intake of ACV can cause:

    • Tooth decay, upset stomach, heartburn/reflux, or sore throat


When to be cautious with ACV:


Populations who have:

  • GERD

  • Ulcerative colitis

  • Chronic kidney disease

  • Consuming ACV on an empty stomach

  • If you are currently taking insulin, consult with your MD or RD before taking ACV


Dietitian Takeaway:


At this point in time, the quantity and quality of scientific evidence is insufficient to provide definitive answers about the effectiveness and safety of vinegar for individuals with diabetes. There is not enough evidence available for me to recommend clients go out of their way to include apple cider vinegar as a supplements or pre-meal beverage. However, current evidence strongly supports ACV having a favorable effect on carbohydrate metabolism and more research needs to be done to support these emerging potential benefits.


If you are interested in the benefits of apple cider vinegar, consider incorporating it in different recipes, such as in marinades and salad dressings (more ideas listed below)! There is no need to drink plain vinegar, as this may not provide as much benefit as suggested by these few articles and could potentially cause other negative side effects, such as reflux/heartburn or dental concerns.


A Few Ways to incorporate ACV into the diet:

​Salad dressing

1/3 cup olive oil ¼ cup apple cider vinegar 2 Tbsp lemon juice 1 Tbsp spicy mustard 2 Tbsp honey 1 clove garlic ¼ tsp each of salt & pepper

Pickled onions

1 medium red onion, thinly sliced ½ cup water ¼ cup distilled white vinegar ¼ cup apple cider vinegar 1½ Tbsp maple syrup 1½ tsp salt ¼ tsp red pepper flakes (optional)

Marinade for chicken

1 lb. boneless, skinless chicken breast ¼ cup apple cider vinegar 2 Tbsp Italian seasoning 1 Tbsp olive oil 1 tsp salt ½ tsp black pepper

Drink

1 cup water 2 Tbsp apple cider vinegar 2 Tbsp lemon juice 1 tsp ground ginger ¼ tsp cinnamon 1 dash cayenne pepper 1 tsp honey (optional)

Research Article Sources:


1. Hadi, A., Pourmasoumi, M., Najafgholizadeh, A., Clark, C.C.T., Esmaillzadeh, A. (2021). The effect of apple cider vinegar on lipid profiles and glycemic parameters: A systematic

review and meta-analysis of randomized clinical trials. BMC Complement Med Ther.

21(1):179.


2. McDonald IV, E. (2018). Debunking the health benefits of apple cider vinegar. University of Chicago Medicine. Retrieved from https://www.uchicagomedicine.org/forefront/health-

and-wellness-articles/debunking-the-health-benefits-of-apple-cider-vinegar


3. Mitrou, P., Petsiou, E., Papakonstantinou, E., Maratou, E., Lambadiari, V., Dimitriadis, P.,

Spanoudi, F., Raptis, S.A., Dimitriadis, G. (2015). Vinegar consumption increases insulin-stimulated glucose uptake by the forearm muscle in humans with Type 2 Diabetes. J Diabetes Res.


4. Siddiqui, F.J., Assam, P.N., de Souza, N.N., Sultana, R., Dalan, R., Chan, E.S. (2018). Diabetes control: Is vinegar a promising candidate to help achieve targets? J Evid Based Integr Med. Stanton, R. (2017). Is apple cider vinegar really a wonder food? The University of New South Wales School of Medical Sciences.


Apple image: https://www.istockphoto.com/

Salad dressing recipe: https://detoxinista.com/raw-apple-cider-vinaigrette/

Pickled onions recipe: https://cookieandkate.com/quick-pickled-onions-recipe/

Marinade recipe: https://www.eatingbirdfood.com/apple-cider-vinegar-chicken/

Drink recipe: https://www.eatwell101.com/apple-cider-vinegar-detox-drink-recipe




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