Apple cider vinegar: a real effect on one meal, a small one on weight

The strongest evidence on apple cider vinegar is a 2025 meta-analysis of 10 randomized trials in 789 adults with overweight, obesity or type 2 diabetes. Taking it daily for at least four weeks lowered body weight by a standardized mean difference of 0.39 (95% CI 0.15 to 0.63), a small effect reported in statistical units rather than kilograms, and the trials disagreed with each other a lot. The authors searched up to March 2025, so the pooled result may still contain a Lebanese trial that was later retracted. A second meta-analysis pooled 16 trials in 910 adults who took 750 to 3600 mg of acetic acid a day, from various vinegars, for about 8 weeks. In people with type 2 diabetes fasting glucose fell by about 36 mg/dL (95% CI 7.7 to 63.8). HbA1c, the long term blood sugar marker, did not change, and neither did BMI or body fat. So the two meta-analyses disagree about weight, and neither can settle it. Most of the 16 trials had unclear or high risk of bias, and five of them never stated the dose.

Every statement here is tied to a source. The badge says what kind of evidence stands behind it: A is a meta-analysis or systematic review, E is the position of an expert body without its own analysis. How we verify →

We have no USDA entry for apple cider vinegar itself in this cohort. The evidence below stands on published studies rather than on a composition table, and we would rather say that than show you a number for something else.

What a real portion looks like

A 2025 meta-analysis of 10 RCTs found daily apple cider vinegar reduced body weight modestly, with a small standardized effect. — Adults with overweight, obesity or type 2 diabetes in 10 RCTs lasting at least 4 weeks (n = 789) Evidence A source
Body weight SMD -0.39 (95% CI -0.63 to -0.15); BMI SMD -0.65 (-1.05 to -0.26); I2 62 to 83%
Vinegar with 18 to 28 mmol acetic acid taken with white bread lowered early glucose and insulin responses and raised satiety in a dose dependent way. — Healthy volunteers, 12, bread meal with 50 g available carbohydrate (n = 12) Evidence B source
Inverse dose response for 30 min glucose and insulin; satiety rose with dose
The kidney stone trial served apple cider vinegar as 2 tbsp (30 mL) diluted with water to 1.1 quarts (1 liter) once a day. — Adult non-stone formers in the APUL trial (n = 20) Evidence B source
Dose used: 2 tbsp (30 mL) ACV per day, diluted to 1.1 quarts (1 L)

What your body absorbs

In small crossover trials, about 2 teaspoons (10 g) of vinegar with a starchy meal lowered after-meal glucose by about 20%, but not with simple sugars, not as neutralized sodium acetate, and less when taken 5 hours earlier. — Adults with and without type 2 diabetes, 9 to 10 per trial, four crossover trials (n = 9-10 per trial) Evidence B source
Postprandial glucose about 20% lower than placebo with complex carbohydrate meals
Native vinegar in a salad dressing lowered the glucose response to bread by 31% compared with vinegar neutralized to pH 6, and gastric emptying did not differ. — Healthy adults, 5 in the glucose test and 4 in gastric emptying ultrasound (n = 5) Evidence B source
Glucose response 31.4% lower (P = 0.0228) with acidic vs neutralized vinegar

What cooking and storage change

Boiled potatoes stored cold for 24 hours and dressed with vinaigrette containing 0.99 oz (28 g) of white vinegar had a 43% lower glycemic index than freshly boiled potatoes. — Healthy adults, 13, single potato meals with 50 g available carbohydrate (n = 13) Evidence B source
GI 96 vs 168 (43% lower), insulin index 31% lower vs freshly boiled potatoes
Soaking dried apple in vinegar and eating it with rice reduced the 2 hour glucose area by 42% compared with rice alone. — Healthy women, 15, randomized crossover meal tests (n = 15) Evidence B source
IAUC 0-120 42.4% lower; glucose peak 27.0% lower vs rice reference

What it does to your health

A 2022 dose-response meta-analysis of randomized trials found each 2 tbsp (30 mL) a day of vinegar lowered systolic blood pressure by about 3.3 mmHg, with low certainty. — adults in randomized controlled trials of vinegar (any type, not only apple cider vinegar), searched to April 2022 Evidence A source
Systolic BP MD -3.25 mmHg per 30 mL/day (95% CI -5.54 to -0.96); I2 67.5%; GRADE low
A 2026 umbrella review pooling 19 randomized trials found vinegar lowered fasting blood glucose by 9.4 mg/dL compared with control, with moderate certainty. — adults in 19 randomized trials of vinegar drawn from seven meta-analyses, healthy, overweight or with type 2 diabetes (n = 19 trials) Evidence A source
FBG MD -9.40 mg/dL (95% CI -12.46 to -6.34); GRADE moderate; I2 96.3%; larger in type 2 diabetes and with more than 8 weeks
Taken with a meal, vinegar lowered the after-meal glucose rise by 14.6 mg/dL across 15 trials in the umbrella review, with moderate certainty. — adults in 15 randomized trials of vinegar with a test meal, from four meta-analyses (n = 15 trials) Evidence A source
Postprandial glucose MD -14.59 mg/dL (95% CI -27.11 to -2.06); GRADE moderate; I2 93.6%; apple cider and wine vinegar significant
A 2021 meta-analysis of apple cider vinegar trials found fasting glucose fell by 7.97 mg/dL across 6 studies, while insulin and HOMA-IR did not change. — adults in clinical trials of apple cider vinegar for 30 to 90 days, mostly type 2 diabetes or overweight (n = 6 studies) Evidence A source
FPG WMD -7.97 mg/dL (95% CI -13.74 to -2.21; I2 75%); HbA1c -0.50 (95% CI -0.90 to -0.09); insulin and HOMA-IR not significant
A 2017 meta-analysis of meal trials found vinegar taken with a meal cut both the glucose and the insulin response after eating. — participants in controlled trials of vinegar co-ingested with a meal Evidence A source
Glucose AUC SMD -0.60 (95% CI -1.08 to -0.11); insulin AUC SMD -1.30 (95% CI -1.98 to -0.62)
A 2021 meta-analysis of 8 studies with 686 adults found apple cider vinegar lowered total cholesterol by 6.06 mg/dL, while LDL and HDL did not change. — adults in clinical trials of apple cider vinegar for 30 to 90 days, mostly type 2 diabetes or overweight, five of nine trials from Iran (n = 686) Evidence A source
TC WMD -6.06 mg/dL (95% CI -10.95 to -1.17; I2 39%); LDL-C -2.12 mg/dL (95% CI -10.09 to 5.85); HDL-C +0.92 mg/dL (95% CI -0.42 to 2.27); TG -33.66 mg/dL (95% CI -67.87 to 0.54)
A 2025 meta-analysis of 25 trials with 1,320 adults found apple cider vinegar lowered total cholesterol by 6.72 mg/dL, with no significant change in LDL, HDL or triglycerides. — adults in 25 clinical trials (33 arms) of apple cider vinegar (n = 1320) Evidence A source
TC -6.72 mg/dL (95% CI -12.91 to -0.53; I2 50.8%); TG, LDL-C and HDL-C not significant overall; TC and TG fell in the diabetes subgroup
The same umbrella review found vinegar did not significantly lower LDL cholesterol, a mean change of -8.18 mg/dL across 15 trials, low certainty. — adults in 15 randomized trials of vinegar drawn from five meta-analyses (n = 15 trials) Evidence A source
LDL MD -8.18 mg/dL (95% CI -18.46 to 2.10; p = 0.119; I2 96.1%); GRADE low
In the umbrella review triglycerides fell by a non-significant 14.94 mg/dL with vinegar across 15 trials. — adults in 15 randomized trials of vinegar drawn from five meta-analyses (n = 15 trials) Evidence A source
TG MD -14.94 mg/dL (95% CI -30.59 to 0.7; p = 0.061; I2 95.7%); GRADE high per the authors; no subgroup significant
In 10 healthy adults, vinegar added to a white bread meal lowered blood sugar and insulin responses, probably by slowing stomach emptying. — ten healthy volunteers, seven women and three men, aged 22-51 years, Lund, Sweden (n = 10) Evidence B source
Glycemic index 64 and insulinemic index 65 vs white bread reference (100); lower paracetamol levels indicating delayed gastric emptying
In a survey of 546 university students, how often they ate vinegar and other fermented foods was linked to gut symptom scores. — 546 university students (n = 546) Evidence C source
Significant differences in gastrointestinal symptoms by frequency of yogurt, kefir, vinegar, cheese and pickle intake (p < 0.05); direction for vinegar not given in abstract
In an 8-week trial of 70 adults with type 2 diabetes and high blood lipids, 1.4 tbsp (20 mL) of apple vinegar a day raised antioxidant activity (DPPH) and lowered fasting glucose by about 10 mg/dL versus control. — 70 adults with type 2 diabetes and hyperlipidemia, apple vinegar 20 mL/day vs control (n = 70) Evidence B source
Fasting glucose -10.16 mg/dl (p = 0.006), DPPH +16.58 (p < 0.001) vs control; MDA rose only in controls
The same 8-week trial found no effect of 1.4 tbsp (20 mL) of apple vinegar a day on blood pressure or homocysteine. — 70 adults with type 2 diabetes and hyperlipidemia (n = 70) Evidence B source
No considerable change in systolic or diastolic blood pressure or homocysteine in either group
In rats with carrageenan-induced paw swelling, Golden Delicious apple vinegar at 10 mL/kg cut swelling by 37.5 percent after 24 hours, against 58.3 percent for diclofenac. — rats, carrageenan paw edema model, vinegars from four apple cultivars Evidence D source
Inhibition of edema at 24 h: diclofenac 58.30%, Golden Delicious vinegar 37.50%, Red Delicious 28.30%, Starking Delicious 21.67%
In the only randomized trial of apple cider vinegar for stone prevention, a week of daily ACV did not change urinary citrate, pH or volume. — adult non-stone formers in a randomized crossover trial of four beverages; 6 completed the ACV arm (n = 20) Evidence B source
ACV: no significant change in 24-h urinary citrate, pH or volume
In a matched comparison of 122 Chinese adults, daily vinegar drinkers had urine chemistry linked to lower stone risk, with more citrate and less calcium. — adults without nephrolithiasis from a six-city Chinese screening survey; 61 drinking more than 1 tbsp (15 mL) vinegar a day vs 61 matched non-drinkers (n = 122) Evidence C source
Higher urinary citrate and pH, lower urinary calcium and CaOx crystallization index in daily vinegar drinkers
In rats given a stone-inducing chemical, daily vinegar raised urinary citrate and lowered urinary calcium, laboratory data suggest. — 8-week-old Sprague-Dawley rats with ethylene glycol-induced calcium oxalate crystals, vinegar 2 mL/kg for 4 weeks (n = 6 to 8 rats per group) Evidence D source
Higher urine citrate, lower urine calcium, no change in urinary oxalate
A 2025 meta-analysis of 10 RCTs with 789 adults found daily apple cider vinegar lowered body weight by a small standardized amount. — adults (18 years or older) in RCTs of apple cider vinegar for at least 4 weeks, mostly overweight, obese or with type 2 diabetes (n = 789) Evidence A source
Body weight SMD -0.39 (95% CI -0.63 to -0.15), I2 62%; BMI SMD -0.65 (-1.05 to -0.26), I2 83%; waist SMD -0.34 (-0.67 to -0.02)
A 2021 meta-analysis of 16 RCTs with 910 adults found dietary acetic acid had no significant effect on BMI, body fat, HbA1c or HDL. — adults in RCTs of dietary acetic acid from vinegar beverages and foods for at least 1 week (n = 910) Evidence A source
No significant effect on BMI or body fat percentage; triglycerides MD -20.51 mg/dL in overweight and obese adults
In a 12-week double-blind trial in obese Japanese adults, a drink with 15 or 2 tbsp (30 mL) of vinegar a day lowered body weight, BMI, visceral fat and waist more than placebo. — obese Japanese subjects randomly assigned to three groups of similar body weight, BMI and waist circumference Evidence B source
1 tbsp (15 mL) (750 mg acetic acid) and 2 tbsp (30 mL) (1500 mg) vs placebo for 12 weeks; weight, BMI, visceral fat, waist and triglycerides significantly lower in both vinegar groups

Safety, limits and interactions

A case report described acute pancreatitis in an 84 year old woman possibly linked to a weight loss supplement containing apple cider vinegar. — One woman aged 84 (n = 1) Evidence D source
Possible association only
Black vinegar taken with itraconazole raised the drug's peak blood level in 10 healthy adults pretreated with an acid reducing drug. — One patient plus 10 healthy adults pretreated with a proton pump inhibitor (n = 10) Evidence D source
Higher itraconazole and OH-itraconazole Cmax
Heavy tooth wear was reported in a 72 year old man who used lemons and vinegar daily against bad breath, alongside hard foods and hard-bristled brushing. — One man aged 72 (n = 1) Evidence D source
Heavy tooth wear and hypersensitivity
In a crossover trial of 16 healthy adults, drinking vinegar with breakfast raised nausea ratings, most with the less palatable drink. — healthy, young, normal weight unrestrained eaters, Study 1 (n = 16) Evidence B source
Significantly higher nausea ratings after vinegar; appetite also lower
The 8-week trial of 2 tbsp (30 mL) of apple cider vinegar a day in type 2 diabetes reported no adverse effects. — adults with type 2 diabetes in Iran (n = 73) Evidence B source
No adverse effects reported over 8 weeks
The same 8-week trial of 2 tbsp (30 mL) a day reported no adverse effects from apple cider vinegar. — adults with type 2 diabetes in Iran (n = 73) Evidence B source
No adverse effects reported; compliance 91%
A 2025 case report described liver injury in a 60-year-old man who had drunk about 2 tbsp (30 mL) of apple cider vinegar three times a week for four years to lower his blood fats. — one 60-year-old man with hypertension, hyperlipidemia and mild fatty liver (n = 1) Evidence D source
Jaundice with hepatocellular injury; improved after stopping vinegar
A 2024 case report linked acute pancreatitis in an 84-year-old woman to a newly started weight loss supplement containing apple cider vinegar. — one 84-year-old woman (n = 1) Evidence D source
Acute pancreatitis after starting an ACV-containing supplement
In 16 healthy adults, drinking vinegar with breakfast reduced appetite mainly by causing nausea. — healthy, young, normal weight unrestrained eaters (n = 16) Evidence B source
Lower appetite and food intake with significantly higher nausea ratings; tasting without swallowing had no effect (14 adults)
After an apple cider vinegar tablet injured a person's esophagus, tests of 8 tablet brands found wide variation in acidity, acid content and label claims. — one adverse event case and eight commercial apple cider vinegar tablet products (n = 8 products) Evidence D source
Considerable variability between brands in tablet size, pH, acid content and label claims; doubt whether ACV was an ingredient
Children with dental erosion ate vinegar and fruit more often than children without erosion, in a case-control study of 309 children. — 309 age and gender matched children (erosion, caries-active, caries-free), UK (n = 309) Evidence C source
Vinegar and fruit consumption higher in the erosion group; acidic drinks and swishing habits also more common
After an adverse event was reported, tests of 8 apple cider vinegar tablet products found wide variation in size, acidity, acid content and label claims, and doubt over whether some contained vinegar at all. — 8 apple cider vinegar tablet products (n = 8 products) Evidence D source
Considerable variability in tablet size, pH, acid content and label claims between brands
In a randomized crossover study of 16 healthy young adults, vinegar drunk with breakfast caused significantly higher nausea ratings, most with the less palatable drink. — healthy, young, normal weight unrestrained eaters; vinegar in palatable and unpalatable drinks vs non-vinegar control (n = 16) Evidence B source
Significantly higher nausea ratings after vinegar ingestion; reduced appetite largely explained by poor tolerability
No adverse effects were reported in the week-long apple cider vinegar trial. — adult non-stone formers drinking ACV, coconut water, lemon water or diet orange soda daily for one week (n = 20) Evidence B source
No adverse effects reported
The dose in that Chinese trial was 1 tsp (5 mL) of mature vinegar three times a day, about 12.5 mEq of acetate daily. — calcium oxalate stone formers in the vinegar arm (n = 79) Evidence B source
15 mL/day mature vinegar (12.5 mEq acetate per day) versus identical-looking control liquid
The same 2026 review found minor side effects may be more common with lemon juice, the acidic home remedy most often compared with vinegar. — adults in trials of stone prevention (n = 31 studies) Evidence A source
Possible increase in minor adverse events with lemon juice (low strength of evidence)
In a crossover trial of 16 healthy adults, drinking vinegar with breakfast raised nausea, most with the less palatable drink. — healthy, young, normal weight unrestrained eaters, Study 1 (n = 16) Evidence B source
Significantly higher nausea ratings with vinegar; largest with the unpalatable drink
In a randomized crossover study of 16 healthy young adults, vinegar drunk with breakfast caused significantly more nausea, which largely explained its appetite effect. — healthy, young, normal weight unrestrained eaters; not pregnant (n = 16) Evidence B source
Higher nausea ratings and lower appetite after vinegar; tasting without swallowing had no effect
Children with dental erosion ate vinegar and fruit more often than children without erosion, in a UK case-control study of 309 children. — 309 age and gender matched children (erosion, caries-active, caries-free), UK (n = 309) Evidence C source
Vinegar and fruit consumption higher in the erosion group
After an adverse event was reported with an apple cider vinegar tablet, tests of 8 tablet brands found wide variation in acidity, acid content and label claims. — one adverse event case and eight commercial apple cider vinegar tablet products (n = 8 products) Evidence D source
Brands varied in tablet size, pH, acid content and label claims
A case report links acute pancreatitis in an 84-year-old woman to a newly started weight loss supplement containing apple cider vinegar. — one 84-year-old woman (n = 1) Evidence D source
Acute pancreatitis possibly linked to an apple cider vinegar supplement
In a crossover trial of 16 healthy adults, vinegar with breakfast cut appetite, but nausea rose with it. — healthy, young, normal weight unrestrained eaters, Study 1 (n = 16) Evidence B source
Lower appetite and food intake with vinegar, accompanied by significantly higher nausea ratings; largest with the unpalatable drink
After a throat injury from an apple cider vinegar tablet, tests of 8 tablet brands found tablet size, acidity and label claims varied widely, and it was unclear whether some contained vinegar at all. — eight apple cider vinegar tablet products tested after one reported adverse event (n = 8 products) Evidence D source
Considerable variability in tablet size, pH, acid content and label claims
A 2024 case report linked acute pancreatitis in an 84-year-old woman to a newly started weight-loss supplement containing apple cider vinegar. — one 84-year-old woman (n = 1) Evidence D source
Acute pancreatitis possibly linked to an apple cider vinegar weight-loss supplement

What people believe that the data does not support

The same meta-analysis found no effect of acetic acid on HbA1c, HDL or body weight markers, and most included trials had unclear or high risk of bias. — Adults in 16 RCTs of dietary acetic acid (n = 910) Evidence A source
No significant change in HbA1c, HDL, BMI or body fat
In 16 healthy adults, the appetite drop after drinking vinegar with breakfast came with higher nausea ratings, and the authors judged promoting vinegar as a natural appetite suppressant inappropriate. — Healthy normal weight young adults, 16 in study 1 and 14 in study 2 (n = 16) Evidence B source
Lower appetite with higher nausea ratings; tasting without swallowing had no effect
In a small crossover trial, one week of apple cider vinegar did not change 24 hour urine citrate, pH or volume, while lemon water and coconut water raised citrate. — Adult non-stone formers, 20 enrolled, 6 completed the ACV arm, 1 week per beverage (n = 20) Evidence B source
ACV: no significant change; coconut water +273.8 mg/24 h citrate (95% CI 67.9 to 480)
The EU did not authorize the claim that apple cider vinegar helps control and normalize body weight. — Not applicable (regulatory decision) Evidence E source
Claim not authorized in the EU
The EU did not authorize claims that apple cider vinegar improves digestion or bowel regularity. — Not applicable (regulatory decision) Evidence E source
Claim not authorized in the EU
The EU did not authorize claims that apple cider vinegar purifies the body or eliminates toxins. — Not applicable (regulatory decision) Evidence E source
Claim not authorized in the EU
The EU did not authorize the claim that an apple vinegar drink helps maintain vascular health. — Not applicable (regulatory decision) Evidence E source
Claim not authorized in the EU
The American Diabetes Association 2026 Standards of Care do not mention vinegar and advise against herb or spice supplements for glycemic benefit. — adults with diabetes, recommendation 5.16 (evidence grade C) Evidence E source
Supplementation with micronutrients, herbs or spices not recommended for glycemia; vinegar not addressed
The EU health-claims register lists the claim that an apple vinegar drink helps maintain vascular health as non-authorized, and has no authorized claim for vinegar. — EU register on nutrition and health claims, snapshot 2026-09-21 Evidence E source
0 authorized, 6 non-authorized vinegar claims
Europe refused the claims that apple cider vinegar helps digestion and keeps bowel movements normal. — EU food labeling Evidence E source
Claim POL-HC-6625 (improve digestion, normal bowel movement, intestinal activity, bowel regularity), status Non-authorized; no ACV claim authorized in the register snapshot
In the same trial, lemon water raised urinary citrate by 168 mg a day and coconut water by 274 mg a day, while ACV did not. — adult non-stone formers; 8 drank lemon water, 6 coconut water (n = 20) Evidence B source
Urinary citrate: coconut water +273.8 mg/24 h (95% CI 67.9 to 480); lemon water +167.7 mg/24 h (16 to 319)
An umbrella review of 9 meta-analyses (88 trials, 27,286 people) found potassium citrate cut the risk of stone recurrence by 79%, with high-certainty evidence. — patients in RCTs of non-surgical kidney stone prevention and treatment (n = 27286) Evidence A source
Potassium citrate: recurrence risk -79% (high GRADE); thiazides -66% in 571 recurrent stone formers
A 2026 systematic review of 31 studies lists fluids, normal calcium, low protein and low salt, thiazides, alkali and allopurinol as options to prevent recurrent calcium stones, and vinegar is not among them. — nonpregnant adults and children with recurrent nephrolithiasis; 26 RCTs and 5 nonrandomised studies (n = 31 studies) Evidence A source
Increased water, normal to high calcium, low protein, low sodium, thiazides, alkali, allopurinol may reduce recurrence (low strength of evidence)
Europe refused the claims that apple cider vinegar helps digestion and keeps bowel movements normal. — EU food labeling Evidence E source
Claim POL-HC-6625 status Non-authorized; no apple cider vinegar claim authorized
Only 2 of the 10 trials in the 2025 meta-analysis were at low risk of bias across all domains, and one of those two, the Lebanese trial, was retracted in September 2025. — 10 RCTs of apple cider vinegar and body composition, risk of bias by the Cochrane tool (n = 10 trials) Evidence A source
Low risk of bias 2 of 10; unclear 3; high 5; low-risk trial ref 44 (Abou-Khalil 2024, PMID 38966098) retracted 23 Sep 2025

Who this works differently for

In a meta-analysis of 16 trials, dietary acetic acid lowered fasting glucose by about 36 mg/dL in type 2 diabetes and lowered triglycerides by about 21 mg/dL in overweight adults. — Adults in 16 RCTs, 910 participants, 750 to 3600 mg acetic acid daily for about 8 weeks (n = 910) Evidence A source
FBG MD -35.73 mg/dL (95% CI -63.79 to -7.67) in T2D; TAG MD -20.51 mg/dL (-32.98 to -8.04) in overweight or obese
In people with type 2 diabetes, vinegar added to a high glycemic index meal cut the 2 hour glucose area by about 40%, but had no effect on a low glycemic index meal. — Patients with type 2 diabetes, 16 in two groups of matched meals (n = 16) Evidence B source
Glucose iAUC 181 vs 311 mmol min/l with vs without vinegar (P=0.04); no change with low-GI meal
A 2025 meta-analysis of 7 trials with 463 people with type 2 diabetes found apple cider vinegar lowered fasting blood sugar by about 22 mg/dL. — adults with type 2 diabetes in Iran, Tunisia and Pakistan; 4 to 12 weeks of apple cider vinegar with about 5% acetic acid (n = 463) Evidence A source
FBS WMD -21.93 mg/dL (95% CI -29.19 to -14.67); I2 20.1%; GRADE moderate; each extra 1 mL/day about -1.26 mg/dL
In an 8-week RCT of 73 adults with type 2 diabetes, 2 tbsp (30 mL) of apple cider vinegar a day lowered HbA1c more than diet advice alone. — adults with type 2 diabetes in Iran; 2 tbsp (30 mL) apple cider vinegar a day, optionally in 3.4 fl oz (100 mL) water, plus diet advice, versus diet advice alone (n = 73) Evidence B source
HbA1c fell more with vinegar than in controls (p < 0.001); fasting glucose fell significantly only in the vinegar group (p = 0.01)
In 10 people with type 1 diabetes and gastroparesis, apple cider vinegar with a rice pudding meal slowed stomach emptying further, which the authors flagged as a risk for glucose control. — 10 adults with type 1 diabetes and diagnosed diabetic gastroparesis, mean age 67.9 years; honey-flavored commercial apple cider vinegar (5% acetic acid) before a 300 g rice pudding meal (n = 10) Evidence C source
Median gastric emptying rate 17% with vinegar versus 27% with water (p < 0.05)
In the same meta-analysis, people with type 2 diabetes saw larger falls, about 11.5 mg/dL in total cholesterol and 22.5 mg/dL in triglycerides. — patients with type 2 diabetes, subgroup of trials of apple cider vinegar Evidence A source
T2DM subgroup: TG -22.46 mg/dL (95% CI -40.27 to -4.65; I2 0%); TC -11.51 mg/dL (95% CI -18.16 to -4.86; I2 0%); similar with 15 mL/day or less
A 2021 meta-analysis of 16 RCTs with 910 adults found dietary acetic acid lowered triglycerides by 20.5 mg/dL in overweight people and 7.4 mg/dL in type 2 diabetes, with no effect on HDL. — adults in RCTs of acetic acid from vinegar beverages and foods, 750 to 3600 mg a day for about 8 weeks (n = 910) Evidence A source
TG MD -20.51 mg/dL (95% CI -32.98 to -8.04) in overweight or obese; TG MD -7.37 mg/dL (95% CI -10.15 to -4.59) in T2DM; HDL and LDL not changed
In an 8-week RCT of 73 adults with type 2 diabetes, 2 tbsp (30 mL) of apple cider vinegar a day with diet advice lowered LDL and total cholesterol versus diet advice alone. — adults with type 2 diabetes in Iran; 37 in the vinegar group and 36 controls completed (n = 73) Evidence B source
LDL fell in the vinegar group and rose in controls (p < 0.001); total cholesterol, LDL/HDL and cholesterol/HDL ratios differed (p = 0.003, 0.001, 0.001); HDL p = 0.06
In 10 people with type 1 diabetes and gastroparesis, apple cider vinegar with a meal slowed stomach emptying further, from a median 27% to 17%. — ten patients with type 1 diabetes and diagnosed diabetic gastroparesis, Malmo, Sweden (n = 10) Evidence C source
Median gastric emptying rate 17% with vinegar vs 27% with water reference meal (p < 0.05); reduced in 8 of 10 patients
In a Chinese pilot randomized trial of 79 calcium oxalate stone formers, daily mature grain vinegar cut the risk of stone recurrence to about a third of that with water. — stone-free patients with a history of calcium oxalate nephrolithiasis, followed 6 to 12 months or more (n = 79) Evidence B source
Relative risk of recurrence 0.31 (95% CI 0.12 to 0.69); urinary citrate improved in 72% vs 19%
A 2020 case report described severe metabolic acidosis in an obese patient combining a ketogenic diet, large amounts of vinegar and metformin, worsened by acute kidney injury. — one obese patient on ketogenic diet, vinegar and metformin (n = 1) Evidence D source
Severe acidosis requiring hospitalization
An 8-week RCT of apple cider vinegar in 73 adults with type 2 diabetes excluded pregnant and breastfeeding women. — adults aged 30 to 60 with type 2 diabetes in Iran; pregnancy and lactation were exclusion criteria (n = 73) Evidence B source
No data in pregnancy or lactation
The FDA warns that pregnant women risk serious illness from drinking untreated, unpasteurised juices, which includes raw apple cider (the juice, not the vinegar). — pregnant women, children, older adults and people with weakened immune systems Evidence E source
Untreated juice may carry harmful bacteria; FDA advice is to choose pasteurized or treated juice
Dutch dentists traced erosive tooth wear in a 15-year-old girl to a daily glass of apple cider vinegar drunk to lose weight. — one 15-year-old girl (n = 1) Evidence D source
Erosive tooth wear attributed to daily apple cider vinegar
In a non-randomized pilot of 10 people with type 1 diabetes and gastroparesis, 2 tbsp (30 ml) of apple cider vinegar a day further slowed gastric emptying (median 17% vs 27% with water), and one patient reported more hypoglycemic episodes. — patients with type 1 diabetes and diabetic gastroparesis (n = 10) Evidence C source
Median gastric emptying rate 17% with 2 tbsp (30 ml) apple cider vinegar vs 27% with water (p < 0.05); one patient reported more hypoglycemic episodes

What is still unknown

The same meta-analysis found diastolic pressure fell by about 3.3 mmHg per 30 mL of vinegar a day, also rated low certainty. — adults in randomized controlled trials of vinegar, searched to April 2022 Evidence A source
Diastolic BP MD -3.33 mmHg per 30 mL/day (95% CI -4.16 to -2.49); I2 57.1%; GRADE low; effect linear up to 30 mL/day
The largest meta-analysis of apple cider vinegar itself, 25 trials with 1,320 adults, set out to study blood fats and blood sugar. Blood pressure was not part of its stated aim. — adults in 25 clinical trials (33 arms) of apple cider vinegar (n = 1320) Evidence A source
Fasting glucose -21.20 mg/dL, HbA1c -0.91, total cholesterol -6.72 mg/dL; blood pressure not among the stated aims or abstract results
A 2021 meta-analysis of 16 randomized trials of acetic acid in 910 adults pooled glucose, blood fats and body measures, with no blood pressure analysis. — adults in RCTs of dietary acetic acid from vinegar beverages and foods for at least 1 week, 750 to 3600 mg a day (n = 910) Evidence A source
Outcomes pooled: fasting glucose, triglycerides, HDL, LDL, HbA1c, BMI, body fat; blood pressure not analyzed
In spontaneously hypertensive rats, long-term acetic acid lowered blood pressure and renin activity, which is the main proposed mechanism for vinegar. — spontaneously hypertensive rats given vinegar or acetic acid long term Evidence D source
Blood pressure lower (p < 0.05) and renin activity lower (p < 0.01) than controls; no change in ACE activity
Across 11 trials in the same umbrella review, vinegar lowered HbA1c by 0.70 percentage points, but the funnel plot showed signs of publication bias. — adults in 11 randomized trials of vinegar drawn from four meta-analyses (n = 11 trials) Evidence A source
HbA1c MD -0.70% (95% CI -1.07 to -0.33); GRADE moderate; I2 98.1%; Begg's test p = 0.037; significant in type 2 diabetes
On insulin resistance itself, the umbrella review found no effect: across 8 trials HOMA-IR did not fall with vinegar, in any subgroup. — adults in 8 randomized trials of vinegar from three meta-analyses (n = 8 trials) Evidence A source
HOMA-IR MD +0.13 (95% CI -0.37 to 0.64; p = 0.608); GRADE moderate; no subgroup significant; fasting insulin MD +0.82 uU/mL, not significant
In the same 2025 meta-analysis, apple cider vinegar did not change insulin resistance measured as HOMA-IR in 3 trials with 173 people with type 2 diabetes. — adults with type 2 diabetes in 3 trials of apple cider vinegar (n = 173) Evidence A source
HOMA-IR WMD +0.63 (95% CI -0.99 to 2.25; p = 0.446); GRADE low; HbA1c WMD -1.53 (95% CI -2.65 to -0.41), 4 studies, 319 people
Five of the 7 apple cider vinegar trials in type 2 diabetes were rated low quality, and only one was rated high quality. — 7 controlled trials of apple cider vinegar in type 2 diabetes, published 2009 to 2023 (n = 7 trials) Evidence A source
5 low, 1 moderate, 1 high quality by Cochrane risk of bias
In the same trial of 73 adults, HOMA-IR rose over 8 weeks on 2 tbsp (30 mL) of apple cider vinegar a day while it fell in controls, a significant gap (p = 0.04). — adults with type 2 diabetes in Iran, 8 weeks of 2 tbsp (30 mL) apple cider vinegar a day (n = 73) Evidence B source
HOMA-IR up with vinegar, down in controls (p = 0.04); insulin up with vinegar (p < 0.001 between groups)
A 2026 umbrella review of 10 vinegar meta-analyses found total cholesterol fell by 9.39 mg/dL across 15 trials, but rated the evidence very low certainty with signs of publication bias. — adults in 15 randomized trials of vinegar drawn from five meta-analyses (n = 15 trials) Evidence A source
TC MD -9.39 mg/dL (95% CI -18.04 to -0.75; I2 90.4%); GRADE very low; Begg's test p = 0.025
Of the 10 vinegar meta-analyses in the umbrella review only three were rated high quality, and most of the underlying trials were rated low quality. — 10 systematic reviews with meta-analysis of vinegar trials and their primary RCTs (n = 10 meta-analyses) Evidence A source
AMSTAR 2: 3 high, 5 low, 2 critically low; RCTs: 3 high, 3 fair, the rest low quality
A 2026 umbrella review of 10 vinegar meta-analyses (38 trials) covered blood sugar, cholesterol, weight and blood pressure, and no digestive outcome. — adults in randomized trials pooled in 10 meta-analyses of vinegar consumption (n = 38 primary studies) Evidence A source
Fasting glucose -9.40 mg/dL, HbA1c -0.70%, body weight -2.3 lb (-1.06 kg), systolic BP -2.94 mmHg; no gut, reflux or bowel outcome among those assessed
The largest meta-analysis of apple cider vinegar, 25 clinical trials with 1,320 adults, pooled only lipid and glucose outcomes, so no inflammatory marker has been meta-analyzed. — adults in clinical trials of apple cider vinegar (33 arms) (n = 1320) Evidence A source
Scope limited to lipid and glycemic parameters; no inflammatory outcome in the scope
The apple cider vinegar trial stopped recruiting early: of 20 people enrolled, only 10 finished both periods and 6 took ACV, too few to detect a modest effect. — 20 enrolled, 15 completed period 1, 10 completed period 2 (n = 20) Evidence B source
Effective sample size 25 treatment periods; recruitment goal not reached
A 2025 systematic review of 26 dietary intervention studies in people with stones mentions vinegar only in a list of foods tested, with no pooled estimate. — people with urolithiasis in dietary intervention studies up to July 2025 (n = 26 articles) Evidence A source
Vinegar listed among foods that changed serum or urinary parameters; no stone outcome pooled
Outside pregnancy, a 2026 umbrella review pooling 19 randomized trials found vinegar lowered fasting blood glucose by 9.4 mg/dL, with moderate certainty. — adults in 19 randomized trials of vinegar, healthy, overweight or with type 2 diabetes; no pregnancy trials (n = 19 trials) Evidence A source
FBG MD -9.40 mg/dL (95% CI -12.46 to -6.34); GRADE moderate

The bottom line

The effect people usually hear about is real at a single meal. In four small crossover trials of 9 or 10 adults each, with and without type 2 diabetes, studies used about 2 teaspoons (10 g) of vinegar with a starchy meal, and it cut the after-meal glucose rise by about 20% against placebo. It did nothing with simple sugars, and nothing once neutralized as sodium acetate. In 16 people with type 2 diabetes, vinegar cut the two hour glucose area of a high glycemic index meal from 311 to 181 mmol min/l and left a low glycemic index meal unchanged. Cold boiled potatoes dressed with 0.99 oz (28 g) of white vinegar scored a glycemic index 43% lower than freshly boiled ones in 13 healthy adults, a trial that used white vinegar and a day in the fridge together. Each of these is one meal in a small group. They tell you about a plate, and very little about months of eating. The EU register holds apple vinegar claims on weight control, on digestion and bowel regularity, on purifying the body of toxins and on vascular health, and none of them was authorized. In the trials on this page vinegar was diluted in water or served in a meal, and we have no card on the safety of drinking it neat or taking it as tablets. One hope was tested directly and failed. A week of 2 tbsp (30 mL) a day, diluted to a liter, did not change urine citrate, pH or volume in adults without kidney stones, in a trial stopped early where only 6 people finished that arm. Lemon water and coconut water did raise citrate. The cautions come from vinegar being an acid. In 16 healthy young adults, lower appetite after vinegar at breakfast went together with nausea, and the authors judged selling it as an appetite suppressant inappropriate. A 72 year old man who used lemons and vinegar daily against bad breath developed severe tooth wear, one case with several habits combined. Black vinegar, a different product, raised peak blood levels of the antifungal itraconazole in 10 healthy adults on an acid reducing drug. An 84 year old woman developed acute pancreatitis possibly linked to a weight loss supplement containing apple cider vinegar, and causation was not established. We found no official upper limit for vinegar or acetic acid. Who should be careful: the glucose lowering above was measured in people with type 2 diabetes. We have no card on vinegar taken together with insulin or other glucose lowering drugs, so anyone on diabetes medicine should ask their doctor before adding vinegar to meals regularly. We found no studies on pregnancy, children or kidney disease. None of the trials measured acetate in the blood.

Questions about apple cider vinegar, answered from the trials

Related foods

Apple cider: unfiltered apple juice, and the risk when it is raw

Sources

acvr8-03 · meta-analysis of RCTs
The pooled results using a random-effects model showed that daily ACV intake significantly reduced body weight [SMD: -0.39; 95% CI: -0.63, -0.15; p = 0.001; I² = 62%], BMI [SMD: -0.65; 95% CI: -1.05, -0.26; p = 0.001; I² = 83%], and WC [SMD: -0.34; 95% CI: -0.67, -0.02; p = 0.04; I² = 61%].
Nutrients, 2025 · checked 2026-09-29
acvr8-09 · acute RCT
Three levels of vinegar (18, 23 and 28 mmol acetic acid) were served with a portion of white wheat bread containing 50 g available carbohydrates as breakfast in randomized order after an overnight fast. ... A significant dose-response relation was seen at 30 min for blood glucose and serum insulin responses; the higher the acetic acid level, the lower the metabolic responses.
Eur J Clin Nutr, 2005 · checked 2026-09-29
acvr8-12 · RCT (methods)
ACV was prepared by diluting 30 mL of bottled ACV with water to a total volume of 1L.
Int Urol Nephrol, 2026 · checked 2026-09-29
acvr8-05 · acute RCTs
Two teaspoons of vinegar ( 10 g) effectively reduced PPG, and this effect was most pronounced when vinegar was ingested during mealtime as compared to 5 h before the meal. Vinegar did not alter PPG when ingested with monosaccharides, suggesting that the antiglycemic action of vinegar is related to the digestion of carbohydrates. Finally, sodium acetate did not alter PPG, indicating that acetate salts lack antiglycemic properties. ... In these situations, vinegar attenuated PPG by 20% compared to placebo.
Ann Nutr Metab, 2010 · checked 2026-09-29
acvr8-06 · acute RCT
Similarly, the glucose response was depressed by 31.4% (P = 0.0228) after AcOH+Bread with respect to AcNa + Bread and Blank + Bread. No difference was observed between gastric emptying times after AcOH + Bread and AcNa + Bread.
Eur J Clin Nutr, 1995 · checked 2026-09-29
acvr8-07 · acute meal trial
GI and II of cold potatoes added with vinegar (GI/II=96/128) were significantly reduced by 43 and 31%, respectively, compared with GI/II of freshly boiled potatoes (168/185).
Eur J Clin Nutr, 2005 · checked 2026-09-29
acvr8-08 · acute RCT
whereas the VDA + R resulted 42.4%, 27.0%, and 29.7% reductions in the incremental area under the curve0-120, peak, and glycemic excursion, respectively.
Nutr Res, 2020 · checked 2026-09-29
ev-acvbp-01 · meta-analysis of RCTs
Each 30 ml/d increment in vinegar consumption reduced SBP by - 3.25 mmHg (95 %CI: - 5.54, - 0.96; I2 = 67.5 %, GRADE = low).
Complementary Therapies in Medicine, 2022 (dose-response meta-analysis of vinegar and blood pressure) · checked 2026-10-07
ev-acvbs-01 · umbrella review
vinegar intake was associated with a significant reduction in FBG levels in comparison to the control group (MD = −9.40 mg/dL; 95% CI: −12.46, −6.34; p = < 0.001; GRADE = moderate)
Food Science & Nutrition, 2026 (Shahmohammadi et al., umbrella review) · checked 2026-10-07
ev-acvbs-04 · umbrella review
demonstrated that vinegar consumption significantly improved PPG levels in comparison to the control group (MD = −14.59 mg/dL; 95% CI: −27.11, −2.06; p = 0.022; GRADE = moderate)
Food Science & Nutrition, 2026 (Shahmohammadi et al., umbrella review) · checked 2026-10-07
ev-acvbs-08 · meta-analysis of RCTs
Pooled effect size from 6 studies, with 7 effect sizes, revealed a significant reduction in FPG (− 7.97 mg/dL; 95% CI: − 13.74, − 2.21, P = 0.007; I2: 75%) after ACV consumption.
BMC Complementary Medicine and Therapies, 2021 (Hadi et al.) · checked 2026-10-07
ev-acvbs-09 · meta-analysis of clinical trials
The pooled analysis of studies revealed a significant mean glucose and insulin area under the curve (AUC) reduction in participants who consumed vinegar compared with the control group (standard mean difference=-0.60, 95%CI -1.08 to -0.11, p=0.01 and -1.30, 95%CI -1.98 to -0.62, p<0.001, respectively).
Diabetes Research and Clinical Practice, 2017 (Shishehbor, Mansoori, Shirani) · checked 2026-10-07
ev-acvchol-01 · meta-analysis of RCTs
Findings from 8 studies, with 9 effect sizes, revealed that ACV consumption significantly decreased serum TC concentrations (− 6.06 mg/dL; 95% CI: − 10.95, − 1.17, P = 0.02; I2: 39%).
BMC Complementary Medicine and Therapies, 2021 (Hadi et al.) · checked 2026-10-07
ev-acvchol-03 · meta-analysis of clinical trials
No significant results were observed for BMI, HOMA-IR, serum insulin, TG, LDL-C, and HDL-C.
Current Medicinal Chemistry, 2025 (meta-analysis of apple cider vinegar and cardiometabolic risk factors) · checked 2026-10-07
ev-acvchol-05 · umbrella review
Following subgroup analysis, a substantial reduction in LDL is observed in the ginseng vinegar intervention.
Food Science & Nutrition, 2026 (Shahmohammadi et al., umbrella review) · checked 2026-10-07
ev-acvchol-06 · umbrella review
In addition, no significant improvement in TG was observed in any subgroup (Table S7).
Food Science & Nutrition, 2026 (Shahmohammadi et al., umbrella review) · checked 2026-10-07
ev-acvd-02 · acute crossover RCT
As judged from lowered paracetamol levels after the test meal with vinegar, the mechanism is probably a delayed gastric emptying rate.
European Journal of Clinical Nutrition, 1998, 52(5):368-371 (Liljeberg and Bjorck) · checked 2026-10-06
ev-acvd-07 · cross-sectional study
Significant differences were found between the frequency of yogurt, kefir, vinegar, cheese, pickle consumption, and gastrointestinal symptoms (p < 0.05).
PeerJ, 2025 · checked 2026-10-06
ev-acvin-02 · randomized controlled trial
Seventy participants with type 2 diabetes and hyperlipidemia were randomly assigned into an intervention and control group in order to assess the effect of 20 ml apple vinegar per day using an 8-week parallel study...The intervention with apple vinegar could significantly improve FBS (mean change: -10.16 ± 19.48 mg/dl, p = 0.006) and DPPH (mean change: 16.58 ± 11.56, p < 0.001) within intervention group and in comparison with control group (p < 0.001). Additionally, the significant increase of MDA in control group (p < 0.05) caused a considerable difference between two groups.
Clinical Nutrition ESPEN, 2019, 33:132-138 · checked 2026-10-07
ev-acvin-03 · randomized controlled trial
No considerable effect was observed on blood pressure and homocysteine in intervention group as well as control group.
Clinical Nutrition ESPEN, 2019, 33:132-138 · checked 2026-10-07
ev-acvin-04 · animal study
Additionally, Figure 5 illustrates that after 24 h, diclofenac (1%) presented the highest inhibition of inflammation (58.30%), followed by Golden Delicious vinegar (37.50%), Red Delicious vinegar (28.30%), and Starking Delicious vinegar, the latter of which showed only 21.67% inhibition of edema.
Plants (Basel), 2023, 12(22):3850 · checked 2026-10-07
ev-acvks-01 · randomized crossover trial
ACV did not significantly change 24-h urinary parameters.
Int Urol Nephrol, 2026 · checked 2026-10-07
ev-acvks-07 · cross-sectional study
Taken together, these analyses indicate that dietary vinegar is correlated with urine chemistry, particularly citrate and calcium excretion that might suppress kidney stone formation in adults.
EBioMedicine, 2019, 45:231-250 (Zhu et al., Dietary vinegar prevents kidney stone recurrence via epigenetic regulations) · checked 2026-10-07
ev-acvks-08 · animal study
However, administration of vinegar significantly increased urine citrate excretion (Fig. 1b), a well-known inhibitor of CaOx crystallization [28,29], and decreased urine calcium excretion which is a component and a strong promoter of CaOx crystal formation (Fig. 1c) [30,31].
EBioMedicine, 2019, 45:231-250 (Zhu et al., Dietary vinegar prevents kidney stone recurrence via epigenetic regulations) · checked 2026-10-07
ev-acvw-01 · meta-analysis of RCTs
The pooled results using a random-effects model showed that daily ACV intake significantly reduced body weight [SMD: -0.39; 95% CI: -0.63, -0.15; p = 0.001; I2 = 62%], BMI [SMD: -0.65; 95% CI: -1.05, -0.26; p = 0.001; I2 = 83%], and WC [SMD: -0.34; 95% CI: -0.67, -0.02; p = 0.04; I2 = 61%].
Nutrients, 2025, Effect of Apple Cider Vinegar Intake on Body Composition in Humans with Type 2 Diabetes and/or Overweight: A Systematic Review and Meta-Analysis of Randomized Controlled Trials · checked 2026-10-06
ev-acvw-03 · meta-analysis of RCTs
No significant effects of dietary acetic acid consumption were seen on HbA1c, HDL, or anthropometric markers.
J Acad Nutr Diet, 2021 · checked 2026-10-06
ev-acvw-04 · RCT
During the 12-week treatment period, the subjects in each group ingested 500 ml daily of a beverage containing either 15 ml of vinegar (750 mg AcOH), 30 ml of vinegar (1,500 mg AcOH), or 0 ml of vinegar (0 mg AcOH, placebo). Body weight, BMI, visceral fat area, waist circumference, and serum triglyceride levels were significantly lower in both vinegar intake groups than in the placebo group.
Bioscience, Biotechnology, and Biochemistry, 2009, 73(8):1837-43 · checked 2026-10-06
acvr8-13 · case report
We discuss an 84-year-old woman with acute pancreatitis possibly linked to a recently introduced weight loss supplement containing apple cider vinegar.
ACG Case Rep J, 2024 · checked 2026-09-29
acvr8-14 · case report
Administration of this combination increased ITCZ and OH-ITCZ Cmax significantly. For patients who produce too little gastric juice, black vinegar could thus serve to promote ITCZ capsule absorption.
Kansenshogaku Zasshi, 2009 · checked 2026-09-29
acvr8-15 · case report
His own subsequent breath odor-reducing efforts included daily use of lemons and vinegar to reduce or mask the odor, eating and chewing hard foods to clean his teeth, and extensive tooth brushing with a hard-bristled toothbrush.
Int J Dent, 2009 · checked 2026-09-29
ev-acvbp-06 · RCT
In Study 1, ingestion of vinegar significantly reduced quantitative and subjective measures of appetite, which were accompanied by significantly higher nausea ratings, with unpalatable treatment having the greatest effect.
Int J Obes (Lond), 2014 · checked 2026-10-07
ev-acvbs-13 · RCT
We found no adverse effects after consuming ACV.
Frontiers in Clinical Diabetes and Healthcare, 2023 · checked 2026-10-07
ev-acvchol-10 · RCT
We found no adverse effects after consuming ACV.
Frontiers in Clinical Diabetes and Healthcare, 2023 · checked 2026-10-07
ev-acvchol-11 · case report
However, the patient reported drinking about 30 cc of ACV three times weekly after meals for the past four years due to its reputed benefits for lowering lipids, particularly in relation to his fatty liver.
Oxford Medical Case Reports, 2025 · checked 2026-10-07
ev-acvchol-12 · case report
We discuss an 84-year-old woman with acute pancreatitis possibly linked to a recently introduced weight loss supplement containing apple cider vinegar.
ACG Case Rep J, 2024 · checked 2026-10-07
ev-acvd-04 · acute RCT
These studies indicate that vinegar ingestion enhances satiety whereas orosensory stimulation alone does not, and that these effects are largely due to poor tolerability following ingestion invoking feelings of nausea.
Int J Obes (Lond), 2014 · checked 2026-10-06
ev-acvd-05 · case report
After an adverse event was reported to the authors, eight apple cider vinegar tablet products were tested for pH, component acid content, and microbial growth.
Journal of the American Dietetic Association, 2005, 105(7):1141-4 (Hill et al.) · checked 2026-10-06
ev-acvd-06 · case-control study
Fruit and vinegar consumption was higher in the erosion group, as was the taking of vitamin C supplements.
ASDC J Dent Child, 2000 · checked 2026-10-06
ev-acvin-05 · laboratory product analysis
After an adverse event was reported to the authors, eight apple cider vinegar tablet products were tested for pH, component acid content, and microbial growth. Considerable variability was found between the brands in tablet size, pH, component acid content, and label claims. Doubt remains as to whether apple cider vinegar was in fact an ingredient in the evaluated products.
Journal of the American Dietetic Association, 2005, 105(7):1141-1144 · checked 2026-10-07
ev-acvin-06 · randomized controlled trial
Healthy, young, normal weight unrestrained eaters were recruited to Study 1 (n=16), an acute feeding study supplying vinegar within both palatable and unpalatable drinks alongside a mixed breakfast in comparison to a non-vinegar control...Both studies were a randomized crossover balanced design for the assessment of appetite, energy intake and glycaemic response. RESULTS: In Study 1, ingestion of vinegar significantly reduced quantitative and subjective measures of appetite, which were accompanied by significantly higher nausea ratings, with unpalatable treatment having the greatest effect.
Int J Obes (Lond), 2014 · checked 2026-10-07
ev-acvks-04 · randomized crossover trial
No adverse effects were reported.
Int Urol Nephrol, 2026 · checked 2026-10-07
ev-acvks-06 · randomized controlled trial
Participants administered 5 ml mature vinegar (Ninghuafu®) three times a day (containing 12.5 mEq. acetate per day) or control as liquid of the same type in identical bottles.
EBioMedicine, 2019, 45:231-250 (Zhu et al., Dietary vinegar prevents kidney stone recurrence via epigenetic regulations) · checked 2026-10-07
ev-acvks-11 · systematic review
There may be increased minor adverse events with lemon juice but no increased harm due to serious adverse events with thiazides and allopurinol (low SOE).
Ann Intern Med, 2026 · checked 2026-10-07
ev-acvks-13 · RCT
In Study 1, ingestion of vinegar significantly reduced quantitative and subjective measures of appetite, which were accompanied by significantly higher nausea ratings, with unpalatable treatment having the greatest effect.
Int J Obes (Lond), 2014 · checked 2026-10-07
ev-acvpg-03 · acute RCT
These studies indicate that vinegar ingestion enhances satiety whereas orosensory stimulation alone does not, and that these effects are largely due to poor tolerability following ingestion invoking feelings of nausea.
Int J Obes (Lond), 2014 · checked 2026-10-07
ev-acvpg-04 · case-control study
Fruit and vinegar consumption was higher in the erosion group, as was the taking of vitamin C supplements.
ASDC J Dent Child, 2000 · checked 2026-10-07
ev-acvpg-05 · case report
After an adverse event was reported to the authors, eight apple cider vinegar tablet products were tested for pH, component acid content, and microbial growth.
Journal of the American Dietetic Association, 2005, 105(7):1141-4 (Hill et al.) · checked 2026-10-07
ev-acvpg-06 · case report
We discuss an 84-year-old woman with acute pancreatitis possibly linked to a recently introduced weight loss supplement containing apple cider vinegar.
ACG Case Rep J, 2024 · checked 2026-10-07
ev-acvw-05 · RCT
In Study 1, ingestion of vinegar significantly reduced quantitative and subjective measures of appetite, which were accompanied by significantly higher nausea ratings, with unpalatable treatment having the greatest effect.
Int J Obes (Lond), 2014 · checked 2026-10-06
ev-acvw-07 · case report
Considerable variability was found between the brands in tablet size, pH, component acid content, and label claims.
Journal of the American Dietetic Association, 2005, 105(7):1141-4 · checked 2026-10-06
ev-acvw-08 · case report
We discuss an 84-year-old woman with acute pancreatitis possibly linked to a recently introduced weight loss supplement containing apple cider vinegar.
ACG Case Rep J, 2024 · checked 2026-10-06
acvr8-02 · meta-analysis of RCTs
Five of the 16 studies did not specify the dose of acetic acid delivered, and no studies measured blood acetate concentrations. Only one study controlled for background acetic acid-rich food consumption during intervention periods. Most studies had an unclear or high risk of bias. ... No significant effects of dietary acetic acid consumption were seen on HbA1c, HDL, or anthropometric markers.
J Acad Nutr Diet, 2021 · checked 2026-09-29
acvr8-10 · acute RCT
In Study 1, ingestion of vinegar significantly reduced quantitative and subjective measures of appetite, which were accompanied by significantly higher nausea ratings, with unpalatable treatment having the greatest effect. ... On this basis the promotion of vinegar as a natural appetite suppressant does not seem appropriate.
Int J Obes (Lond), 2014 · checked 2026-09-29
acvr8-11 · RCT
ACV did not significantly change 24-h urinary parameters. Coconut water (+ 273.8 mg/24 h, 95% CI 67.9-480 mg/24 h) and lemon water (+ 167.7 mg/24 h, 95% CI 16-319 mg/24 h) were associated with increased urinary citrate.
Int Urol Nephrol, 2026 · checked 2026-09-29
acvr8-16 · EU claims register
POL-HC-6626 Apple cider vinegar Helps control and normalize body weight. Non-authorised
EU Register on nutrition and health claims, claim POL-HC-6626, snapshot 2026-09-21 · checked 2026-09-29
acvr8-17 · EU claims register
POL-HC-6625 Apple cider vinegar 1. Helps improve digestion 2. Helps maintain normal bowel movement 3. Normalizes bowel movement 4. Promotes intestinal activity 5. Promotes/contributes to bowel regularity Non-authorised
EU Register on nutrition and health claims, claim POL-HC-6625, snapshot 2026-09-21 · checked 2026-09-29
acvr8-18 · EU claims register
POL-HC-6624 Apple cider vinegar 1. Apple cider vinegar has body purifying and healing properties 2. Splits and eliminates harmful toxins/end-products 3. Optimizes and balances the body function 4. Restores the inner balance of the body Non-authorised
EU Register on nutrition and health claims, claim POL-HC-6624, snapshot 2026-09-21 · checked 2026-09-29
acvr8-19 · EU claims register
POL-HC-6629 Apple vinegar drink Apple vinegar drink helps to maintain vascular health. Non-authorised
EU Register on nutrition and health claims, claim POL-HC-6629, snapshot 2026-09-21 · checked 2026-09-29
ev-acvbs-14 · guideline
Assess intake of supplements, as supplementation with micronutrients (e.g., vitamins and minerals, such as magnesium or chromium) or herbs or spices (e.g., cinnamon and aloe vera) is not recommended for glycemic benefits.
American Diabetes Association Professional Practice Committee, 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2026, Diabetes Care 2026;49(Suppl 1):S89-S131 · checked 2026-10-07
ev-acvchol-13 · regulatory register
POL-HC-6629 Apple vinegar drink Apple vinegar drink helps to maintain vascular health. Non-authorised
EU Register on nutrition and health claims, claim POL-HC-6629, snapshot 2026-09-21 · checked 2026-10-07
ev-acvd-08 · regulatory register entry
POL-HC-6625 Apple cider vinegar 1. Helps improve digestion 2. Helps maintain normal bowel movement 3. Normalizes bowel movement 4. Promotes intestinal activity 5. Promotes/contributes to bowel regularity Non-authorised
EU Register on nutrition and health claims (European Commission) · checked 2026-10-06
ev-acvks-02 · randomized crossover trial
Coconut water (+ 273.8 mg/24 h, 95% CI 67.9-480 mg/24 h) and lemon water (+ 167.7 mg/24 h, 95% CI 16-319 mg/24 h) were associated with increased urinary citrate.
Int Urol Nephrol, 2026 · checked 2026-10-07
ev-acvks-09 · umbrella review
The use of potassium citrate was able to prevent the risk of nephrolithiasis recurrence of 79%, supported by a high level of evidence.
Minerva Urol Nephrol, 2025 · checked 2026-10-07
ev-acvks-10 · systematic review
For adults with calcium oxalate or phosphate stones, increased water intake; a diet with normal to high calcium, low protein, and low sodium; thiazides; alkali treatment; and allopurinol may reduce stone recurrence (low SOE).
Ann Intern Med, 2026 · checked 2026-10-07
ev-acvpg-08 · regulatory register entry
POL-HC-6625 Apple cider vinegar 1. Helps improve digestion 2. Helps maintain normal bowel movement 3. Normalizes bowel movement 4. Promotes intestinal activity 5. Promotes/contributes to bowel regularity Non-authorised
EU Register on nutrition and health claims, claim POL-HC-6625, snapshot 2026-09-21 · checked 2026-10-07
ev-acvw-02 · meta-analysis of RCTs
Of the ten studies, two were classified as having a low risk of bias across all evaluated domains [44,46].
Nutrients, 2025, Effect of Apple Cider Vinegar Intake on Body Composition in Humans with Type 2 Diabetes and/or Overweight: A Systematic Review and Meta-Analysis of Randomized Controlled Trials · checked 2026-10-06
acvr8-01 · meta-analysis of RCTs
Sixteen studies were included, involving 910 participants who consumed between 750 and 3600 mg acetic acid daily in interventions lasting an average of 8 weeks. Dietary acetic acid supplementation resulted in significant reductions in TAG concentrations in overweight and obese but otherwise healthy individuals (mean difference [MD] = -20.51 mg/dL [95% confidence intervals = -32.98, -8.04], P = .001) and people with type 2 diabetes (MD = -7.37 mg/dL [-10.15, -4.59], P < .001). Additionally, acetic acid supplementation significantly reduced FBG levels (MD = -35.73 mg/dL [-63.79, -7.67], P = .01) in subjects with type 2 diabetes compared with placebo and low-dose comparators.
J Acad Nutr Diet, 2021 · checked 2026-09-29
acvr8-04 · acute RCT
In group A, the incremental area under the curve of glucose (GiAUC(120)) was lower after the addition of vinegar (181+/-78 mmol min/l vs 311+/-124 mmol min/l, P=0.04). ... In group B, the addition of vinegar did not affect either the GiAUC(120) (229+/-38 mmol min/l vs 238+/-25 mmol min/l, P=0.56) or the IiAUC(120) (2996+/-1302 microU min/ml vs 3007+/-1255 microU min/ml, P=0.98).
Eur J Clin Nutr, 2010 · checked 2026-09-29
ev-acvbs-05 · meta-analysis of controlled trials
ACV significantly reduced FBS based on the results of a random-effect model (WMD: −21.929 mg/dL, 95% CI: −29.19, −14.67, p < 0.001), with non-significant heterogeneity (I2 = 20.11%, p = 0.237) (Figure 2A).
Frontiers in Nutrition, 2025 (GRADE-assessed dose-response meta-analysis of apple cider vinegar in type 2 diabetes) · checked 2026-10-07
ev-acvbs-10 · RCT
HbA1C decreased in the ACV group more than in the control group and this difference was significant between the two groups (p < 0.001).
Frontiers in Clinical Diabetes and Healthcare, 2023 · checked 2026-10-07
ev-acvbs-12 · controlled clinical trial
Gastric emptying rates after the meal including vinegar were significantly lower (p < 0.05) than after the reference meal.
BMC Gastroenterology, 2007 (Hlebowicz et al.) · checked 2026-10-07
ev-acvchol-02 · meta-analysis of RCTs
In these analyses, we found a notable decrease in both TG and TC concentrations in studies conducted on type 2 diabetic patients (TG: − 22.46 mg/dL; 95% CI: − 40.27, − 4.65; I2: 0%; TC: − 11.51 mg/dL; 95% CI: − 18.16, − 4.86; I2: 0%)
BMC Complementary Medicine and Therapies, 2021 (Hadi et al.) · checked 2026-10-07
ev-acvchol-08 · meta-analysis of RCTs
Dietary acetic acid supplementation resulted in significant reductions in TAG concentrations in overweight and obese but otherwise healthy individuals (mean difference [MD] = -20.51 mg/dL [95% confidence intervals = -32.98, -8.04], P = .001) and people with type 2 diabetes (MD = -7.37 mg/dL [-10.15, -4.59], P < .001).
J Acad Nutr Diet, 2021 · checked 2026-10-07
ev-acvchol-09 · RCT
LDL was decreased in the ACV group but increased in the control (p < 0.001).
Frontiers in Clinical Diabetes and Healthcare, 2023 · checked 2026-10-07
ev-acvd-01 · non-randomized crossover trial
Gastric emptying rates after the meal including vinegar were significantly lower (p < 0.05) than after the reference meal.
BMC Gastroenterology, 2007, 7:46 (Hlebowicz et al.) · checked 2026-10-06
ev-acvks-05 · randomized controlled trial
The relative risk of a recurrence among the patients in the vinegar group, as compared with the patients in control groups, was 0.31 (95% confidence interval, 0.12 to 0.69; P = .0098).
EBioMedicine, 2019, 45:231-250 (Zhu et al., Dietary vinegar prevents kidney stone recurrence via epigenetic regulations) · checked 2026-10-07
ev-acvks-14 · case report
The use of dietary acetic acid is usually well tolerated; however, in this case, the large quantities and presence of acute renal injury may have worsened the acidosis.
Case Rep Nephrol, 2020 · checked 2026-10-07
ev-acvpg-01 · RCT
Exclusion criteria were lack of proper cooperation, BMI more than 35, pregnancy and lactation, insulin injection, and gastrointestinal disorders including reflux and gastric ulcer.
Frontiers in Clinical Diabetes and Healthcare, 2023 · checked 2026-10-07
ev-acvpg-07 · agency position
While most people's immune systems can usually fight off the effects of foodborne illness, children, older adults, pregnant women, and people with weakened immune systems (such as transplant patients and individuals with HIV/AIDS, cancer, or diabetes) risk serious illnesses or even death from drinking untreated juices.
US FDA, What You Need to Know about Juice Safety, page updated 03/05/2024 · checked 2026-10-07
ev-acvw-06 · case report
Erosive tooth wear was diagnosed in the dentition of a 15-year-old girl with a Moroccan background. After an anamnesis, extensive analysis of possible risk factors and a study of the pattern of erosion, it was concluded that the erosive tooth wear was induced by daily consumption of a glass of apple cider vinegar
Nederlands Tijdschrift voor Tandheelkunde, 2012, 119(12):589-91 · checked 2026-10-06
sf-vin-r2-1 · non-randomized crossover pilot trial
The median value of the GER after the meal including vinegar was 17% (range -55% to 43%, q1 = -9%, q3 = 32%), while the median value of the GER after the reference meal 27% (range -11% to 51%, q1 = 5%, q3 = 41%). ... One of the subjects who already had a slow GER spontaneously reported a higher frequency of hypoglycaemic episodes during the two-week period of drinking apple cider vinegar. ... However, a limitation of this study is that it was not randomized and the subjects were not blinded.
BMC Gastroenterology, 2007, Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study · checked 2026-10-08
ev-acvbp-02 · meta-analysis of RCTs
Each 30 ml/d increment in vinegar consumption reduced DBP by - 3.33 mmHg (95 %CI: - 4.16, - 2.49; I2 = 57.1 %, GRADE = low).
Complementary Therapies in Medicine, 2022 (dose-response meta-analysis of vinegar and blood pressure) · checked 2026-10-07
ev-acvbp-03 · meta-analysis
The present study aimed to perform a systematic review and meta-analysis of the effects of ACV consumption on lipid and glycemic parameters.
Current Medicinal Chemistry, 2025 (meta-analysis of apple cider vinegar and cardiometabolic risk factors) · checked 2026-10-07
ev-acvbp-04 · meta-analysis of RCTs
Meta-analyses were performed using a random-effects model on fasting blood glucose (FBG), triacylglycerol (TAG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), glycated hemoglobin (HbA1c), body mass index (BMI), and body fat percentage.
J Acad Nutr Diet, 2021 · checked 2026-10-07
ev-acvbp-05 · animal study
As a result, it was observed that acetic acid itself, the main component of vinegar, significantly reduced both blood pressure (p<0.05) and renin activity (p<0.01) compared to controls given no acetic acid or vinegar, as well as vinegar.
Bioscience, Biotechnology, and Biochemistry, 2001 (Kondo et al.) · checked 2026-10-07
ev-acvbs-02 · umbrella review
consuming vinegar had a significant effect on HbA1c levels, compared to a control group (MD = −0.70%; 95% CI: −1.07, −0.33; p = < 0.001; GRADE = moderate)
Food Science & Nutrition, 2026 (Shahmohammadi et al., umbrella review) · checked 2026-10-07
ev-acvbs-03 · umbrella review
investigated HOMA‐IR with vinegar intake and reported a non‐meaningful rise (MD = 0.13; 95% CI: −0.37, 0.64; p = 0.608; GRADE = moderate)
Food Science & Nutrition, 2026 (Shahmohammadi et al., umbrella review) · checked 2026-10-07
ev-acvbs-06 · meta-analysis of controlled trials
ACV did not influence HOMA-IR significantly (WMD: 0.631, 95% CI: −0.99, 2.25, p = 0.446)
Frontiers in Nutrition, 2025 (GRADE-assessed dose-response meta-analysis of apple cider vinegar in type 2 diabetes) · checked 2026-10-07
ev-acvbs-07 · meta-analysis of controlled trials
Five trials were classified as low quality (high bias risk in >2 domains) (24, 25, 27, 28, 30), one trial was classified as moderate quality (high bias risk in 2 domains) (29) and one was classified as high quality (high bias risk in <2 domains) (26).
Frontiers in Nutrition, 2025 (GRADE-assessed dose-response meta-analysis of apple cider vinegar in type 2 diabetes) · checked 2026-10-07
ev-acvbs-11 · RCT
HOMA-IR was increased in the ACV group, but decreased in the control group and showed a significant difference (p = 0.04).
Frontiers in Clinical Diabetes and Healthcare, 2023 · checked 2026-10-07
ev-acvchol-04 · umbrella review
The visual inspection of the funnel plot (Figure S9) and Begg's test revealed statistically significant evidence of publication bias (p = 0.025).
Food Science & Nutrition, 2026 (Shahmohammadi et al., umbrella review) · checked 2026-10-07
ev-acvchol-07 · umbrella review
The quality of the included meta‐analyses was evaluated using the AMSTAR 2 criteria.
Food Science & Nutrition, 2026 (Shahmohammadi et al., umbrella review) · checked 2026-10-07
ev-acvd-03 · umbrella review of meta-analyses of RCTs
Vinegar is a natural dietary product that has been proposed to exert beneficial effects on cardiometabolic health, including glycemic regulation, lipid metabolism, blood pressure control, and weight management.
Food Science & Nutrition, 2026, 14(5):e71849 (Shahmohammadi et al.) · checked 2026-10-06
ev-acvin-01 · meta-analysis
The present study aimed to perform a systematic review and meta-analysis of the effects of ACV consumption on lipid and glycemic parameters...Overall, 25 clinical trials (33 arms) comprising 1320 adults were entered in this study.
Current Medicinal Chemistry, 2025, 32(11):2257-2274 · checked 2026-10-07
ev-acvks-03 · randomized crossover trial
Patient accrual was stopped prior to reaching recruitment goals due to changes in department personnel and loss of research staff.
Int Urol Nephrol, 2026 · checked 2026-10-07
ev-acvks-12 · systematic review
In addition, foods such as lemon, orange, melon, lime, cranberry, apple juices, milk, vinegar, black seed, green bean extract, probiotics and synbiotic were also explored, which promoted significant changes in serum and urinary parameters related to UL.
Nutr Res Rev, 2025 · checked 2026-10-07
ev-acvpg-02 · umbrella review
vinegar intake was associated with a significant reduction in FBG levels in comparison to the control group (MD = −9.40 mg/dL; 95% CI: −12.46, −6.34; p = < 0.001; GRADE = moderate)
Food Science & Nutrition, 2026 (Shahmohammadi et al., umbrella review) · checked 2026-10-07

Review. Reviewed on 2026-09-29 for evidence level, dose and population context, and claims a reader could misread. Bioma Learn has no human medical reviewer at this time, and we say so rather than invent one. Methodology. This is information, not medical advice.