Apple cider vinegar (ACV) has been touted as a miracle at-home remedy, with claims of weight loss to curing ear infections and head lice. With reports of its healing properties going back to 3300 B.C., you’d expect plenty of peer-reviewed science to back up the claims of this commonly found vinegar, but is that always the case?
We’re going to lay down the benefits of ACV and tell you which ones are worth your time and which ones don’t have the science to back them. We’ll also cover some simple how-tos and commonly asked questions on the topic, but first what is it?
What is apple cider vinegar?
A product of controlled spoilage, ACV is made from crushed apples that form a slurry and the resulting juice is separated. Bacteria and yeast are added to the slurry and allowed to ferment. The sugars in the mixture are converted to alcohol in the fermentation process.
A second fermentation follows this where the alcohols in the mixture are converted to acetic acid. This is done by a species of bacteria – Acetobacter. In the presence of oxygen, these bacteria convert ethanol to acetic acid, the main volatile component of vinegar which gives rise to its sour taste and strong smell.
A by-product of this two-step fermentation is the ‘mother of vinegar’, composed of a type of membranous cellulose and the acetic acid-forming bacteria (probiotic). Much of ACV’s health benefits are attributed to this. Quite often the mother is removed during filtration and pasteurization steps to make the final vinegar more appealing as it can give the vinegar a murky appearance if left in. This does, however, remove the potential benefits from the probiotics and enzymes the mother provides. The mother is completely harmless though and can even form in store-bought vinegars if there is any remaining unfermented alcohol or in unpasteurized vinegars (1).
What about the nutritional benefits of ACV? According to the Agricultural Research Service, ACV is 94% water and 5-6% acetic acid (2). Whatever is remaining is largely negligible, but includes polyphenols (3), natural acids, and other micronutrients such as calcium and magnesium. It contains minimal carbohydrates at only 1%, and 100g of the vinegar comes to only 22 calories. There is no fat or protein to be found.
Why is it so popular?
The use of ACV for its health benefits has been reported back in 3300 B.C., and traces of vinegar have been found in vessels even before that in 6000 B.C. in Egypt and China. Circa 400 B.C., the “father of modern medicine”, Hippocrates, was known to prescribe vinegars including ACV for various illnesses and even used it in a healing elixir (4).
Samurai had been reported drinking vinegar tonic for its strength and power-giving properties, and US soldiers in the civil war used a vinegar solution to prevent gastric upset as well as a treatment for scurvy and pneumonia in the 1860s (5). Even today, ACV is used as a traditional at-home remedy to treat similar problems.
Whilst ACV has become extremely popular due to its health appeal, there also side effects that can occur from drinking too much of it. Be sure to check our FAQ to find out how to consume apple cider safely.
Benefits of apple cider vinegar
1. Helps you lose weight
Numerous studies have shown the use of vinegar to aid weight loss in several ways including making you feel fuller for longer and suppressing the metabolic formation of fat.
One study used 12 healthy volunteers who consumed varying concentrations of acetic acid along with a portion of white bread for breakfast after fasting overnight. The higher concentration of acetic acid they were given in the vinegar, the lower their metabolic response was and the higher their reported satiety was (6).
Another study used 175 obese Japanese volunteers and monitored their weight over 12-weeks where they drank a beverage containing acetic acid. Groups which consumed acetic acid beverages showed a moderate decrease in body weight, BMI, and triglyceride levels compared to those which were given a placebo. It is believed acetic acid may inhibit lipogenesis, i.e. the generation of fat, thus allowing for greater weight loss (7).
While the use of acetic acid shows promising use as a weight loss aid, few studies demonstrate the same for ACV specifically.
Verdict: The research looks very promising for acetic acid, a main component of ACV, to be an effective ingredient to augment weight loss. ACV plus a healthy lifestyle could be a winner!
2. Helps control your appetite
When acetic acid is mixed with water it dissociates and forms acetate and a hydronium ion (H3O+ – water (H2O) with an extra hydrogen). Acetate is associated with activating acetyl-CoA carboxylase, an important metabolic enzyme, and the regulation of neuropeptides which favor appetite suppression (8). Whether or not you need to lose weight, control over your appetite is a useful tool to have.
Verdict: An inexpensive and readily available appetite suppressor with research to back it? ACV might be worth a shot for those who are in the market for appetite suppressors!
3. Lowers blood sugar
Type 2 diabetes is an ever-growing problem and ways of minimizing the risk of developing it are always hot topics of research. ACV has been proposed as an at-home remedy to lower blood sugar and help prevent this.
A small study observed human subjects with varying levels of insulin sensitivity and how consuming an ACV and saccharine solution with a white bagel, butter and orange juice would affect their blood sugar after fasting overnight. Their blood sugar levels were monitored and showed that this method could lower blood sugar levels after high-carbohydrate meals (9).
A separate study which used adults with well-controlled type 2 diabetes demonstrated more regulated blood sugar levels upon waking after consuming 2 tablespoons of ACV and 1 ounce of cheese at bedtime (10).
Although these studies are mostly small, ACV, in particular the acetic acid component, has demonstrated good anti glycemic effects.
Verdict: While promising, don’t rely on ACV to lower your blood sugar too much! More research is needed.
4. Regulates insulin
In the same vein as lowering blood sugar levels, acetic acid has also been shown to regulate postprandial insulin levels.
The ACV and saccharine solution study above also demonstrated significantly reduced postprandial insulin fluxes in the non-diabetic insulin-sensitive subjects, as well as in type 2 diabetes subjects (11).
While ACV has shown to be a promising treatment for regulating both blood glucose and insulin, it is looked upon more as a potential adjunct treatment to improve glycemic control.
Verdict: Don’t leave your doctor for ACV just yet, these encouraging results need a bit more testing on ACV specifically! ACV would only be looked on as an adjunct treatment to an existing plan made by your Doctor.
5. Regulates blood pressure
Regulating blood pressure is yet another important health concern ACV has been reported to address. A study on spontaneously hypertensive rats which were fed a solution of vinegar or acetic acid for 6-weeks showed a significant reduction in systolic blood pressure (12). Another study concluded that it was the acetic acid component of vinegar which contributed to its antihypertensive effects (13).
Despite these results, there are no human trials which support that this would also apply to humans.
Verdict: What works for rats might not work for humans, we’d pass on using ACV to regulate blood pressure at least for now.
6. Improves heart health
Heart problems can arise for a multitude of different health reasons, and ACV has been reported to help with preventing or minimizing a number of these.
A study on rats fed a high-cholesterol diet and an acetic acid solution for 19 days showed rats which consumed both cholesterol and acetic acid had lower serum total for triacylglycerides and cholesterol compared to groups that had no acetic acid (14).
Another study on rabbits suggested consuming vinegar had acute effects on the biochemical risk factors for the leading cause of death in the world – atherosclerosis – where cholesterol and other components block your artery walls (15).
Like many studies, however, few studies specifically research the effects of ACV, and none have shown them replicated in humans.
Verdict: With the lack of human trials, it’s probably best to stick to seeing your health care professional about heart health for the time being.
7. Supports gut health
More and more we are seeing how our gut can have an impact on almost every aspect of our health, even our mental health! Many people use ACV as a means of supporting this to benefit their overall wellness. Going back to the production of vinegars, the mother produced during fermentation does contain the acetic acid-forming bacteria which could provide some probiotic activity.
The verdict is out, however, on whether or not vinegar is considered a probiotic in that the living microorganisms in it can be consumed in a high enough dose such that it confers a benefit to the host or that they even have beneficial activity in the first place (16).
Verdict: ACV doesn’t quite stack up against other known probiotics like yogurt and kombucha for improving gut health. No harm in trying it, but it’s best not to rely on it for this benefit!
8. Offers digestive support
Pepsin is an enzyme in the stomach which breaks down peptides into their building blocks, amino acids, during metabolism. A study which used swine demonstrated that the use of natural acids such as acetic acid and lactic acid decrease gastric pH, in turn activating more pepsin and allowing for greater digestive capacity and utilization of consumed proteins (17).
Verdict: With ACV’s main component being acetic acid, as well as the presence of some other natural acids, there is reason to believe it may provide some digestive support, however, more research is required.
9. Has Anticancer properties
One theory to explain cancer growth suggested that a more acidic body promotes cancerous growths, and so many people try to reduce the acidity of their body – “alkalizing”. Some believe consuming ACV is one method to do so.
While some studies have shown that cancers can grow more aggressively in an acidic environment, it is very difficult to force the body to become more alkaline as it has buffers in place to prevent pH changes (18).
Furthermore, no research has been conducted on living humans, only animals and cells in a petri dish, so while some research may suggest that acetic acid has anticancer properties, we can’t simply pour acetic acid on our body and get the same results.
Verdict: If ACV had encouraging anticancer properties, a lot more research would be available in this area. Unfortunately, ACV won’t cure cancer or help to prevent it.
10. Prevents heartburn
The burning feeling in your throat which many of us experience is heartburn. The acidic stomach acid travels up the esophagus and causes discomfort as the skin here is not used to the high acidity. This most commonly occurs when the valve which closes off the stomach relaxes too often.
One thought to explain what controls the opening of this valve is the pH of the stomach. A pH that is too high (less acidic) is thought to increase valve opening, thus causing more heartburn and that consuming acids such as ACV can help prevent this.
Verdict: With no research available to support this, you’re better off sticking to known heartburn relief medications as well as a diet that doesn’t promote it.
11. Offers antioxidant protection
Antioxidants protect against free radical damage which can lead to premature aging, damage to cells and DNA, and potentially cancer (19). Consuming ACV has been thought to offer antioxidant protection. ACV has been shown to contain catechins, natural phenols and antioxidants, including gallic acid, ferulic acid, and caffeic acid.
One study demonstrated the suppression of obesity-related oxidative stress, a result of free radical damage, for rats which were administered ACV daily (20). A separate study on rats again showed that 4 weeks of consuming ACV increased the activity of several antioxidant enzymes in the body (21).
It is not known if these results transfer to humans and more research is needed on the topic.
Verdict: Stick to an antioxidant-rich diet and practicing sun-safety, more research on humans needs to be done before this benefit gets a tick of approval!
12. Treats ear infections
ACV is a popular at-home ear infection treatment. Some studies have shown it to have antifungal and antibacterial activity (22). Its antibacterial activity has been attributed to its acetic acid content and is active at concentrations as low as 0.166% (23). Whether or not ACV is active against the bacteria which cause ear infections is unknown.
Verdict: Before you try and treat your next ear infection with ACV, be sure to read the side effects of using it down below. This one is probably a pass.
13. Helps with dandruff
Another at-home remedy, ACV is sometimes used to help with dandruff! Despite nearly 50% of the post-puberty population experiencing this condition, it can be debilitating to one’s self-worth and confidence. Dandruff is most commonly caused by a yeast-like fungus, Malassezia, which is attracted to the oil glands of your scalp. It causes flakiness, irritation, itching, and redness (24).
Some claim that ACV can help to slough away dead skin buildup on the scalp to help treat dandruff, but it is most likely the antifungal activity explained above which contributes to people’s success using this treatment. There is no evidence, however, that shows it has antifungal activity against Malassezia, the main cause of dandruff.
Verdict: With no research to say ACV is active against Malassezia, it might be best to try anti-dandruff treatments from your local pharmacy or see your doctor.
14. Combats head lice
Head lice are parasitic insects which feed on blood and are only found on humans, typically on the scalp. Vinegar rinses including ACV are popular at-home treatments to get rid of lice.
A study from 2004 pitted multiple at-home head lice treatments against each other to determine their effectiveness. Not only was vinegar the worst-performing treatment, none of the at-home treatments were effective at getting rid of lice eggs, a critical step in treating head lice (25).
Verdict: Skip ACV for head lice treatments, and most at-home treatments for that matter! Visit a pharmacy and pick up an over-the-counter head lice treatment instead.
15. Whitens teeth
With ACV being an acid, it lives up to its reputation for being an effective tooth whitening treatment. Whether it be from one too many cups of coffee in the morning, or you’re a frequent wine drinker, ACV is effective at removing plaque build-up and has a bleaching effect on the teeth (26).
Be wary though, while effective at whitening teeth, it may be a little too effective and comes with some adverse effects we’ll discuss further below.
Verdict: Are the benefits worth the risk? Perhaps investigate other safer teeth whitening treatments.
16. Kills bacteria
A healthy drizzling of ACV over your salad can prove to be both a tasty dressing as well as confer some antibacterial activity. It’s not uncommon to hear about yet another lettuce or spinach bag containing bacteria and having them recalled.
Studies have shown that ACV, as well as lemon juice and mixtures of the two, have antibacterial effects on kale and spring onion for specific bacteria (27). While it might be a useful edible sanitizer, it is still wise to properly wash your vegetables before you pour some ACV over them. Research hasn’t shown every bacteria ACV’s antibacterial properties are effective against.
Verdict: Go ahead and pour ACV over your salads and vegetables, you might even enjoy the tanginess it can give!
17. Helps jellyfish stings
Pouring vinegar on the welts left behind by a jellyfish sting has been the recommended treatment for decades now. Studies have shown that the application of vinegar deactivates nematocysts, a specialist cell type in jellyfish tentacles which contain barbed or venomous threads (28).
A 2014 study, however, showed that application of vinegar to the jellyfish tentacles caused more venom to be released, though the article has been questioned for the validity of the statistical analysis and data presentation (29). Further research is required to confirm this. Hot water-immersion appears to be the most effective initial treatment according to research (30).
Verdict: With only one study to say vinegar makes jellyfish stings worse, you’re probably fine to continue using it as a treatment option. Better safe than sorry, avoid jellyfish stings where you can!
18. Provides Relief from hemorrhoids
Hemorrhoids are swollen veins in the lower rectum and anus and are often caused by the pressure placed on the veins during bowel movements. They can be both internal or external (prolapsed) and while typically painless, they can become irritated and itchy.
ACV is often anecdotally cited to provide instant relief from these feelings. Supporters of this at-home remedy claim the astringent, skin tightening properties, as well as anti-inflammation effects from ACV, are the main contributors to this effect. There is no research to back up these claims yet, and so you’re better off skipping this remedy and consulting your healthcare professional.
Verdict: Purely anecdotal, go and see your doctor about getting this fixed!
19. Boosts skin health
Natural skincare products have experienced a surge in popularity in recent years, and many people look for DIY skincare they can make themselves. Proponents of using ACV in their skincare say it is effective in fighting pimples and acne, exfoliating, toning, fighting age spots and wrinkles, as well as soothe the skin.
Sounds like a bit of a miracle product, right? ACV does contain alpha-hydroxy acids such as lactic acid which exfoliate the skin and can help with acne, as well as having astringent properties that many older toners also have. If used incorrectly though, you might end up facing bigger problems than acne.
Verdict: Leave skincare to skincare formulators who know what they’re doing! Don’t risk sensitizing your face and making things worse.
20. Helps varicose veins
Varicose veins are enlarged and twisted veins, commonly found in the legs. Varicose veins are generally only a cosmetic concern, however some can cause pain and discomfort, which can later lead to more serious problems.
One study worked on 120 patients with varicose veins and had them apply ACV to the affected area alongside the treatment recommended by their doctor (31). The topical application of ACV combined with a treatment suggested by their doctor showed very good results in reducing the severity of the symptoms reported by the patients.
Verdict: While promising, one supporting study isn’t enough to recommend you lather varicose veins in ACV just yet.
21. Detoxes the body
Detox diets have become popular for people who want to shift to a healthier lifestyle. They claim to eliminate harmful toxins from your body, effectively cleaning your body from the inside out. ACV detoxes have been popular, promising healthy digestion, weight control, immune system support, and more.
Many of these health effects have been studied and supported to varying degrees, but no research exists to support an ACV detox. As for detoxes cleaning the body, our bodies already have systems in place to clean such as the kidneys and excrement. Support for most detoxes is purely anecdotal and should be proceeded with caution.
Verdict: With only anecdotal reports, don’t trust ACV to detox your body. Stick to eating clean and being active. Let your body do the rest!
With all the potential health benefits, you might be wondering how you can start implementing ACV into your everyday life. Here’s a list of easy at-home recipes and DIYs you can make that use ACV, from a delicious hot beverage to using it to clean your toothbrush!
Hot apple cider vinegar drink
For a hot and healthy start to your day, try mixing 2 tablespoons of ACV, 1 teaspoon of cinnamon, 1 tablespoon of honey and 2 tablespoons of lemon juice into 12 oz (355 ml) of hot water.
Ever been cooking and wanted to add some tanginess to your food? ACV can be a great addition to soups, salad dressings, and pretty much anything to give it a nice tang plus imparting some of its health benefits! Use just a splash and taste as you go until you reach your desired flavor.
Wash fruit and vegetables
After washing your fruit and vegetables with water, rinse them in some ACV to any remaining bacteria. Not only will you be using ACV’s antibacterial properties, but you will add a nice vinegar tang to them too!
All-purpose apple cider vinegar cleaning spray
If you’re after a natural all-purpose cleaning spray, try mixing equal parts ACV and water. While ACV does have antifungal and antibacterial properties, it is not known to be as effective as store-bought all-purpose sprays. If you’re in a pinch and need a cleaning spray and can’t buy one, this alternative might suffice in the meantime.
Put ACV’s antibacterial properties to work and pour a splash of it into your dishwashing water or dishwasher to help kill off any bacteria that might be lingering! Like the multi-purpose cleaning spray above, ACV alternatives won’t be as effective as those from the shops, so it is best to use this in conjunction with more effective detergents.
Clean your toothbrush
When was the last time you cleaned your toothbrush? Consider mixing ½ cup water, 2 tablespoons ACV, and 2 teaspoons of baking powder then letting your toothbrush head sit in the mixture for 30 minutes. Rinse your toothbrush well afterward to prevent damaging your teeth from any leftover acidity.
Spray undiluted ACV on weeds as a natural weed killer. You could consider adding soap and lemon juice to make it even more effective.
Trap fruit flies
Get rid of any pesky fruit flies in your area by pouring some ACV into a cup with some dish detergent and you’ll have a trap the fruit flies will sink in.
Organic vs. non-organic apple cider vinegar
Organic food has grown in popularity over the years, as has the supporting literature for its additional health benefits over traditionally grown food. Mayo Clinic extensively outline the requirements for food to be labelled as “organic”, including the exclusion of synthetic fertilizers and pesticides, genetic engineering, antibiotics, and more.
If you’re after an organic ACV, this is how it differs from its traditional counterpart. Organic ACV is usually both unpasteurized and unfiltered, and so it retains the mother – the biofilm developed during the second fermentation step in the production of ACV. The mother gives ACV a cloudy appearance and can show some sedimentation.
One study has shown organic ACV to have a more diverse microbiota than conventional ACV, likely a result due to the presence of the mother in organic forms (32). Many believe the health benefits of ACV originates from the mother and its probiotic activity, and this study further supports this. The same study, however, has addressed that additional research is needed to determine the effect of the different microbiota on the quality of ACV.
Where can I get apple cider vinegar?
With the huge popularity of ACV for all its potential benefits, you can pick up ACV pretty much anywhere, from your local grocery shop or organic grocer, to Amazon!
You can make your own home-made ACV as well. It is recommended, however, that you both pasteurize and filter it to ensure you aren’t consuming harmful bacteria that may come from improper processing of ACV – it is indeed a product of controlled spoilage that requires the growth of the proper bacteria! If you’re interested in making your own ACV, here are instructions from the National Center for Home Food Preservation on how to make apple cider and how you can turn this into vinegar!
How much apple cider vinegar should you drink a day?
Little research exists to confidently recommend a safe dosage of daily ACV. What information does exist recommends 15-30 mL, or 1-2 tablespoons, per day. Due to its acidity, it is best drunk when mixed into water to dilute it or drizzled over a salad.
A caveat to this recommendation, however, is that drinking ACV daily within the suggested dosage will not guarantee any of the benefits listed above. Whether it be weight loss or insulin regulation, there is simply not enough research to promise any of these results.
Can I drink apple cider vinegar every day?
While ACV boasts a long list of potential benefits, it also comes with many side-effects. The best way to prevent experiencing these negative side-effects will be to ensure you don’t ingest more than is recommended, i.e. 1-2 tablespoons.
In saying that, it is also important you pay attention to how your body reacts to ACV, and that you adjust your intake – while 2 tablespoons may be very tolerable for one person doesn’t mean it will be for you.
How to take apple cider vinegar?
ACV can be taken in a variety of different ways from drinking it diluted in water, ACV pills, and even poured over a salad. Ensure you measure how much ACV you will be using (1-2 tablespoons per day) to ensure you don’t overdo it.
Drinking ACV is likely the most convenient and readily available method of consumption. Many advocate taking a shot of ACV before a meal, and while this is an easy way of getting in your daily dose of ACV, it may come with a few side-effects you should be aware of, including throat burns, nausea, enamel erosion, and heartburn, all on top of the unpleasant taste! To minimize these effects, it is best practice to dilute the ACV with water.
For those seeking the benefits of ACV without having to endure the taste, ACV pills are likely a better option. While likely being a more costly method, many ACV pills also contain other beneficial ingredients as well. You should also have less concerns with the side-effects of drinking straight ACV.
What is the best time to drink apple cider vinegar?
The best time to drink ACV depends on what health benefits you want to target.
For those looking to regulate their blood sugar while they fast overnight, right before bed is recommended (make sure you brush your teeth after!).
If you’re after insulin and blood sugar regulation after eating, it is best to take it before a meal.
Other benefits are less time-dependent, and you are likely to receive them regardless of what time you drink ACV.
How many apple cider vinegar pills should you take a day?
Most ACV pills contain 500 mg of ACV and can come with other ingredients to help with digestion. This is equivalent to 2 teaspoons of ACV, or 10 mL. These can be a great alternative for those looking to reap the benefits of ACV without the unpleasant taste. Before jumping in and taking ACV pills, make sure to check with your healthcare professional that they won’t negatively interfere with any existing medication or health issues.
Little research exists on how much ACV is safe to consume, but the research that does exist recommends 1-2 tablespoons per day. Given this, you should be able to take 2-3 pills per day if your pill of choice also contains 500 mg ACV. Make sure you check how much ACV is in your pill to ensure you don’t exceed this daily limit.
What is apple cider vinegar with the mother?
Unpasteurized and unfiltered ACV, often called organic ACV, has a cloudy appearance and can have some sedimentation. This is the “mother”, a by-product from the second fermentation in the process of making ACV. It is a biofilm of acetic acid-forming bacteria and is thought to come with another set of health benefits on top of ACV without the mother which have not been extensively studied.
Pasteurization and filtration remove the mother, so if you’re looking for a vinegar that contains the mother, be sure to look for one that is unpasteurized, unfiltered or both!
How to make apple cider vinegar?
Because apple cider vinegar is a product of controlled spoilage, you’re generally better off getting a store-bought one. The average home isn’t capable of quality control like a manufacturer is. If you choose to consume home-made ACV, you risk potentially consuming harmful bacteria if the process is not done correctly.
That said, if you’re still interested in making your own, here are instructions from the National Center for Home Food Preservation on how to make apple cider and how you can turn this into vinegar! This method does suggest you pasteurize and filter your vinegar. Unpasteurized and unfiltered home-made ACV can be especially dangerous if not made correctly.
What is the pH of apple cider vinegar?
The pH scale is a measure of how acidic something is, with 1 being the most acidic, 7 is neutral, and 14 is the least acidic, also called basic/alkaline. It is a logarithmic scale, meaning something with a pH of 1 is ten times more acidic than a pH of 2, which in turn is ten times more acidic than a pH of 3, and so on.
ACV has a pH between 2 and 3 and so can be said to be mildly acidic.