Guess what. Today, I have student that co-wrote (ok – almost entirely wrote!) on my blog – the AMAZING, Amy Pun from University of Alberta. She is a researcher-extraordinaire, and will be giving you the down-low on apple cider vinegar for gut health. If you loved her post – share it on social media! I love to give my students a chance to show just how much they know.
In recent years, society has become increasingly health-conscious. To a fault. We’ve become obsessed with food – attaching morality to food (which it shouldn’t have), and paying extra dollars for specialty products that frankly, have little, if any science behind them. Frustrating as it is for a dietitian – it makes sense. We’re inherently lazy. Why CAN’T one pill, one potion, be a cure-all? I’ll let you sit on that one for a while.
Should I Take Apple Cider Vinegar for Gut Health?
One of the most popular products gracing the shelves today is Apple Cider Vinegar (ACV). Apple cider vinegar has long been touted as a natural health remedy, but what are the actual benefits of consuming ACV? When you Google ACV, the search engine will yield endless beneficial claims of ACV, from detoxifying your body, to conditioning your hair and whitening your teeth. People are even putting it on open wounds (no, really… ) Let’s talk about facts versus fiction – especially around gut health.
Does ACV prevent inflammation in the gut?
If everyone’s shooting ACV, there’s someone with a big name who spews a ton of crap behind it. Guys. Let’s get this straight now. If it seems too good to be true, and there is NO real research behind it – it probably is too good to be true. Rinse and repeat ya’ll. Claimed benefits hail from several compounds within the vinegar, including acetic acid, potassium, magnesium, probiotics and enzymes. Some ahem – less reputable sources with poor ability to interpret research but yet are comfortable providing blanket claims, with it seems yet a new supplement each week (cough cough Dr. Axe), believe that that the acetic acid within the ACV can reduce “bad” bacteria and increase “good” bacteria, acting as a natural antibiotic to improve gut health without adverse effects on your body.
Little research has been done on the anti-inflammatory properties of ACV on the gut. Of the studies conducted, NONE have been able to prove that ACV is effective against gut inflammation.
One animal study found ACV is NOT an effective anti-inflammatory agent in arthritic rats2Funny. When animal studies promote a product with their results – people jump on them. As soon as they’re negative, they seem to be largely ignored. (Really if you’re basing your health decisions solely on rats, maybe you need to rethink a few things…)
In studies that looked at the effect of acetic acid on the body, it was found that acetic acid has little effect on gastric emptying, rate of food intake and glucose absorption3,4. The antimicrobial properties of acetic acid claimed may be effective only in fermented food products rather than in the human body4,5
What are the scientifically-proven benefits of ACV?
There are many varieties of vinegar products produced around the world. Different vinegars contain different types and amounts of bioactive compounds that defend against oxidative stress, diabetic progression, microorganisms, tumor growth, obesity, and high blood pressure and cholesterol5
There are 2 main scientific benefits associated with ACV:
ACV contains polyphenol and vitamins, which are powerful antioxidants that defend your body against cellular damage. There IS research coming out supporting the role in antioxidants and polyphenols in improving gut health; however, you can get these powerful nutrients from food, or by using ACV in a recipe, rather than drinking it10.
ACV can contain live bacteria, if you chose one that has not been pasteurized, and contains the mother. Fermented foods have been shown to introduce bacteria to the gut that may provide valuable metabolic byproducts, which may improve gut health9. The TRICKY thing with fermented foods is, we often don’t know what bacteria we’re getting, if those bacteria survive the trip through the gut, and if they’re truly beneficial. Is ACV a probiotic? No. To be called a probiotic – the bacteria HAS to have been shown in research to survive GI transit (passage through the gut) AND have a beneficial effect on the gut. They’re fermented foods. Which is fine by my books. But do we need to drink it, straight up? I’m gonna say that’s a big no.
Let’s talk ‘claimed’ benefits.
Does ACV reduce bad bacteria and improve good bacteria?
Maybe. Maybe not. Raw unfiltered ACV contains fermented apples and pectin. Pectin is a fiber found in fermented apple that promotes good digestion by clearing away excess cholesterol in your gut6Pectin is the key ingredient that encourages growth of good bacteria and reduces “bad” bacteria1. However, the amount of pectin found in a fresh apple will be WAY more than in ACV – much larger quantity than a tablespoon of vinegar. So just eat an apple, let pectin do its job in your gut and skip the ACV.
Does ACV have antimicrobial properties?
Well, I guess, if you’re making pickles. Guys. Let’s talk basic physiology. Your gut has a pH of 1-2.5. VERY acidic. Its JOB is to help digest AND protect you from dangerous pathogens. Your stomach acid is up to the task. Not to mention – the pH of ACV is around 3. Meaning it’s actually LESS acidic than the stomach.
You take an ounce of ACV. Your body produces 2 litres of gastric secretions a day. I don’t typically recommend peeing into the wind… but ya know, if you’re taking ACV as a shot, you may as well.
Are there risks associated with consuming ACV?
YES. There are definitely some risks associated with ingestion of ACV or any type of vinegar. Below are 3 scientifically proven risks associated with ACV ingestion. (Read – there is no great evidence supporting taking it, but mounds supporting that maybe you don’t drink the stuff.)
Contrary to the popular claim that ACV is a natural teeth whitening agent, studies have found that weekly consumption of apple vinegar increased the risk of dental erosion. The risk was positively associated with a habit of swishing and holding acid in the mouth, enhancing the contact surface area and time with the teeth. This means that frequent ACV ingestion may increase the risk of damage to your teeth enamel and cause dental cavities11, 12
Injury to Esophagus and Vocal Cords
Consumption of acid such as ACV may result in acid burns that damage your esophagus and vocal cords. In one case report, a woman reported severe pain and difficulty swallowing after an apple cider tablet was trapped in her throat for 30 minutes. A study that examined 8 different brands of apple cider vinegar tablets found varying concentrations of acetic acid in the tablets. Hence, ACV tablets with high concentration of acetic acid have a higher risk of acid burn to the throat compared to lower concentrations13. In another case report, a woman who consumed a teaspoon of vinegar resulted in inflammation of her oropharynx and second-degree caustic injury from her esophagus to her heart. This report confirmed the danger of ulcerative injury to the throat and gut. Furthermore, acid reflux from acid ingestion may damage the vocal cords as well14
May help blood sugars – but diabetics need to be aware of this
While research shows that consuming ACV alongside a starchy meal can reduce the glucose level in the blood in diabetics7,8, you would be wise to check with your physician prior to taking apple cider vinegar in therapeutic doses. If you take insulin, you may need to consider how ACV may influence your insulin dosing. The blood glucose lowering effect of vinegar without adjusting dosage of insulin-injection before meal may result in low-blood sugar in these patients. If you have diabetes and are taking insulin or oral hypoglycemics, you should consult your physician prior to any ACV consumption to reduce risks of unexpected lows15
Ok – so should I be taking ACV or not?
Yes and no. The risks associated with ACV in therapeutic doses (in pill form or as a straight up shot) may be far greater than their benefits.
My professional advice is – don’t drink it – straight or mixed. That’s just silly.
If you’re having gut problems – don’t self diagnose or treat with apple cider vinegar. See a doctor or talk with your dietitian about your gut issues.
However! It’s still a food. I say, using ACV as part of your cooking makes a heck of a lot more sense.
How to use Apple Cider Vinegar Like a Champ
- Use ACV in your salad dressing – I like a simple 1 part acid, 1 part oil, salt, pepper, dill, and a bit of honey or sugar
- Add ACV as part of the marinade for your steak
- When cooking stir fry – use ACV to de-glaze the pan and add flavor.
- Pickle your own veg! I love to pickle carrots and cabbage in vinegar, alongside spices, and top my tacos with it.
If you are currently taking prescribed medication, please consult your healthcare practitioner or doctor before using ACV products of any kind. This can prevent any risks on your body associated with herb-drug interactions13
- Shinohara, K., Ohashi, Y., Kawasumi, K., Terada, A., & Fujisawa, T. (2010). Effect of apple intake on fecal microbiota and metabolites in humans. Anaerobe, 16(5), 510-515.
- Ross, C. M., & Poluhowich, J. J. (1984). The effect of apple cider vinegar on adjuvant arthritic rats. Nutrition research, 4(4), 737-741.
- Kondo, S., Tayama, K., Tsukamoto, Y., Ikeda, K., & Yamori, Y. (2001). Antihypertensive effects of acetic acid and vinegar on spontaneously hypertensive rats. Bioscience, biotechnology, and biochemistry, 65(12), 2690-2694.
- Johnston, C. S., & Gaas, C. A. (2006). Vinegar: medicinal uses and antiglycemic effect. Medscape General Medicine, 8(2), 61.
- Budak, N. H., Aykin, E., Seydim, A. C., Greene, A. K., & Guzel‐Seydim, Z. B. (2014). Functional properties of vinegar. Journal of food science, 79(5), R757-R764.
- Miettinen, T. A., & Tarpila, S. (1977). Effect of pectin on serum cholesterol, fecal bile acids and biliary lipids in normolipidemic and hyperlipidemic individuals. Clinica Chimica Acta, 79(2), 471-477.
- Johnston, C. S., Kim, C. M., & Buller, A. J. (2004). Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes. Diabetes Care, 27(1), 281-282.
- Liatis, S., Grammatikou, S., Poulia, K. A., Perrea, D., Makrilakis, K., Diakoumopoulou, E., & Katsilambros, N. (2010). Vinegar reduces postprandial hyperglycaemia in patients with type II diabetes when added to a high, but not to a low, glycaemic index meal. European journal of clinical nutrition, 64(7), 727-732.
- Parvez, S., Malik, K. A., Ah Kang, S., & Kim, H. Y. (2006). Probiotics and their fermented food products are beneficial for health. Journal of applied microbiology, 100(6), 1171-1185.
- Nazıroğlu, M., Güler, M., Özgül, C., Saydam, G., Küçükayaz, M., & Sözbir, E. (2014). Apple cider vinegar modulates serum lipid profile, erythrocyte, kidney, and liver membrane oxidative stress in ovariectomized mice fed high cholesterol. The Journal of membrane biology, 247(8), 667-673.
- Jarvinen, V. K., Rytomaa, I. I., & Heinonen, O. P. (1991). Risk factors in dental erosion. Journal of dental research, 70(6), 942-947.
- O’Sullivan, E. A., & Curzon, M. E. (1999). A comparison of acidic dietary factors in children with and without dental erosion. ASDC journal of dentistry for children, 67(3), 186-92.
- Hill, L. L., Woodruff, L. H., Foote, J. C., & Barreto-Alcoba, M. (2005). Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products. Journal of the American Dietetic Association, 105(7), 1141-1144.
- Chung, C. H. (2002). Corrosive oesophageal injury following vinegar ingestion. Hong Kong medical journal= Xianggang yi xue za zhi/Hong Kong Academy of Medicine, 8(5), 365-366.
- Hlebowicz, J., Darwiche, G., Björgell, O., & Almér, L. O. (2007). Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC gastroenterology, 7(1), 46.