Chances are you have a bottle of apple cider vinegar sitting in your cupboard. You might use it to make salad dressing or sauces. Some people use apple cider vinegar for cleaning or rinsing their hair. Not surprisingly, perhaps, apple cider vinegar is also used as a health remedy (and has been since the time of Hippocrates). For example, it’s used to treat dandruff, sooth sunburns, acne and sore throats, and keep armpits and feet sweet smelling.
More recently, apple cider vinegar has ventured into the realm of diabetes. Claims abound on how this condiment can help to lower blood sugars, as well as promote weight loss. But are these claims all hype or is there some substance behind using apple cider vinegar as a form of diabetes treatment?
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Vinegar is a liquid that’s produced through the fermentation of ethanol alcohol. There are a number of foods and beverages that contain ethanol that can be used to make vinegar. These include distilled grain alcohol, beer, champagne, berries, grapes and apples.
In the case of apple cider vinegar, or ACV, for short, yeast is used to break down the sugars in apples and convert them to alcohol. Then, a bacterium called acetobacter turns the alcohol into acetic acid through the process of fermentation. The acetic acid is what gives vinegar its sour, tangy flavor (in fact, the word “vinegar” comes from the French phrase “vin aigre” which means sour wine).
ACV is available in two forms: filtered or unfiltered. Both forms are made from a “mother,” which is the bacterial culture that turns apple juice into vinegar. Filtered ACV, which is clear in appearance, has had the mother removed and is often pasteurized, whereas unfiltered ACV contains some of the mother, making it cloudy in appearance. It’s usually unpasteurized and often organic.
ACV is naturally low in calories and carbs. According to the website Nutritionix, a one tablespoon serving of ACV contains:
· 3 calories
· 0.1 grams of carbohdyrate
· 0 grams of fat
· 0 grams of protein
· 0.8 milligrams of sodium
· 11 milligrams of potassium
You can see why ACV is often recommended for people who are aiming to lose weight as its calorie content is so low. ACV is also a good condiment choice for people who need to limit their sodium intake.
In terms of other nutritional benefits, ACV contains small amounts of potassium and even smaller amounts of iron, calcium, copper and magnesium. It’s also a source of antioxidants and probiotics, which can support gut health.
Can swallowing ACV really help you lower your blood sugar? Maybe. In a sea of numerous health claims surrounding ACV, there’s actually a glimmer of credible evidence supporting the use of ACV for managing diabetes; however, the number of studies is relatively small. Here are few highlights:
· A 2018 study published in the Journal of Evidence-Based Integrative Medicine was a review that looked at 12 articles reporting 11 studies of 278 subjects with either type 1 or type 2 diabetes. The conclusion of this review article was that ACV did lead to a significant but small reduction in A1C levels after eight to 12 weeks. In the short-term, subjects who took ACV did notice a reduction in blood sugar levels after 30 minutes, but compared with control groups, there was no meaningful difference after 30 minutes. The authors of this article concluded that while vinegar is a “promising candidate and should be thoroughly evaluated for its possible incorporation as an adjuvant” in diabetes management, larger studies are needed, and more information is needed in certain areas, such as establishing an appropriate dose of ACV and any differences in people using oral diabetes medication vs. insulin, for example.
· A more promising study using ACV in people with type 2 diabetes was published in the journal Diabetes Care in 2007. This study was very small, very short-term and looked at 11 men and women with type 2 diabetes not taking insulin. For two days, the subjects were given either two tablespoons of ACV or water at bedtime with an ounce of cheese. Fasting blood sugar levels were reduced by up to 6% in subjects who took the vinegar at bedtime.
· A study published in Diabetes Care in 2005 included 10 people with type 2 diabetes, 11 people with insulin resistance, and a control group of eight people without diabetes or insulin resistance. They were randomly assigned to drink ACV or a placebo (inactive) drink and then eat a meal of a white bagel, butter and orange juice. The vinegar increased insulin sensitivity and significantly reduced post-meal blood glucose and insulin levels.
Other studies have hinted that ACV can benefit blood sugar levels after eating meals, but again, the number of subjects in these studies has been small.
How might ACV work to help with lowering post-meal blood sugars? It’s thought that the acetic acid in the ACV blocks enzymes that digest starch, a type of carbohydrate, leading to a lower rise in blood sugar after eating. In fact, using vinegar (or another acidic substance, like lemon juice) can lower the glycemic index (GI) of a food, by slowing the digestion of starch into glucose.
So, should you use ACV to get your blood sugar levels down? First, it’s important to not replace your diabetes medicines (including insulin) with ACV. Second, go easy with the amount of ACV (or any type of vinegar, for that matter) that you consume at one time. Here are some tips for taking ACV safely:
· Dilute a tablespoon of ACV in a large glass of water and drink it before meals or before bedtime.
· Avoid drinking undiluted ACV as this can irritate your esophagus and stomach, and possibly damage your tooth enamel. Stop drinking ACV if you have any side effects.
· Use ACV combined with some olive oil as a salad dressing or try it as a marinade for meat and poultry.
Keep a close watch on your blood sugar levels if you decide to go this route, especially if you take insulin or take pills called sulfonylureas (e.g., glimepiride, glipizide or glyburide), as these medicines can increase your risk of low blood sugar (hypoglycemia). Also, if you have gastroparesis, talk with your healthcare provider before using ACV as it may contribute to further delayed stomach emptying and more frequent hypoglycemia.
Finally, using a large amount of ACV over the long-term may lead to low blood potassium levels, which is particularly concerning if you take certain types of medications such as diuretics to lower blood pressure.
Can taking ACV really lead to weight loss? It depends. Obviously, it’s a very low-calorie condiment, so from that perspective, it can certainly be part of a weight-loss plan. But on its own, is ACV some magical substance that can peel away the pounds?
Of course, there just happens to be an “apple cider vinegar diet” that has made the rounds on social media. The basis for this diet stems from small studies, including one from 2009 in which 175 who drank a beverage containing 0, 1 or 2 tablespoons of vinegar daily. After three months, the people who drank the vinegar had lost two to four pounds. The, a 2018 study divided 39 people into two groups. One group was given a lower calorie diet with ACV and the other a lower-calorie diet without ACV for 12 weeks. Both groups lost weight, but the ACV group lost more (8.8 pounds vs. 5 pounds for the group without ACV). They also improved their cholesterol and triglyceride levels. However, keep in mind that this was a very short-term study, the subjects were following a reduced-calorie diet, and they also exercised.
As with any fad diet, if it sounds too good to be true, it likely is. Swallowing one to two teaspoons of vinegar as suggested by the apple cider vinegar diet proponents is unlikely to do much in the way of weight loss unless you’re also altering your eating and exercise habits at the same time. Also, avoid going the route of an apple cider vinegar detox, which is a cleansing diet that has no scientific evidence to support its safety or effectiveness.
ACV may not be the answer to lowering your blood sugar and helping you lose weight, but it’s definitely worth fitting into your eating plan. Try whipping up some dressings using apple cider vinegar. If you need some ideas, check out these recipes.
And if you’re faced with an abundance of vegetables this summer, give pickled vegetables a whirl with this recipe.
Another way to use ACV is when poaching eggs. If you’ve never poached eggs, now’s the time to give it a try. Learn how here.
ACV will last for at least five years, thanks to its acidity. Keep it stored in a cook, dark place to preserve its quality. Over time, it may become hazy or cloudy; if you’re concerned as to whether it’s safe, give it a smell and a quick taste. If it seems off, discard it.
Want to learn more about eating well with diabetes? Read “Improving Your Recipes: One Step at a Time,” “Top Tips for Healthier Eating” and “Cooking With Herbs and Spices.”
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