Cider vinegar: a small dent in blood sugar, and a retracted weight trial

In trials, mostly in people with type 2 diabetes or overweight, apple cider vinegar lowered fasting blood sugar by a small amount. Across 9 randomized trials in 686 adults, most with type 2 diabetes or overweight, fasting glucose fell by about 8 mg/dL (95% CI 2.2 to 13.7) and total cholesterol by about 6 mg/dL. Those glucose results disagreed widely between trials, five of the nine came from one country, and one trial used balsamic vinegar. In 7 trials of 463 people with type 2 diabetes drinking it for 4 to 12 weeks, fasting sugar fell by about 22 mg/dL (95% CI 14.7 to 29.2). The reviewers rated that moderate certainty, with five of the seven trials judged low quality, and the effects are small next to diet and drugs. People with diabetes in these trials were also on medication, which the trials do not separate well, and we have no card on vinegar alongside insulin or other glucose-lowering drugs, so this page cannot say whether adding it is safe for anyone taking them. Weight is a different story. The 2024 trial behind the viral claim that a daily spoon melts weight was retracted in 2025, because its analyses could not be replicated and its data did not look randomized. The European Union has refused every claim made for apple cider vinegar, including one about body weight.

The numbers, per 3.5 oz (100 g)

How much is actually in it

• US labeling rules use cider vinegar as the textbook example of a food that is naturally calorie free, under 5 calories per serving without any processing. — US FDA nutrient content claims for calories, 21 CFR 101.60 Evidence E source
  Cider vinegar named as the example of a food that meets the calorie free condition without special processing
• Apple cider vinegar is not a meaningful mineral source: USDA lists 73 mg of potassium, 5 mg of magnesium and 0.2 mg of iron per 3.5 oz (100 g), from one record with no spread. — USDA SR Legacy record for Vinegar, cider (n = 1 record) Evidence E source
  Potassium 73 mg per 3.5 oz (100 g) (2% DV), magnesium 5 mg (1% DV), iron 0.2 mg (1% DV)

What your body absorbs

• Acetic acid from a vinegar drink reaches the blood fast: in 30 healthy adults, 750 mg of acetic acid in 3.4 fl oz (100 mL) of vinegar drink peaked in serum at 15 minutes and was gone by 90. — 30 healthy adults after an overnight fast, randomized crossover of a vinegar drink, vinegar capsules and water, each with 750 mg acetic acid (n = 30) Evidence B source
  Serum acetate peak at 15 min (drink) vs 30 min (capsules), back to baseline at 90 and 120 min; capsule AUC about 80% of drink AUC, not significantly different

What cooking and storage change

• Neutralizing vinegar removes its effect on blood sugar: 1 g of acetic acid as vinegar in a salad dressing cut the glucose rise after bread by 31%, but the same vinegar neutralized with baking soda did not. — 5 healthy adults eating lettuce with olive oil and either vinegar or vinegar neutralized to pH 6.0, followed by 50 g carbohydrate as white bread, in random order (n = 5) Evidence B source
  Glucose response 31.4% lower (P = 0.0228) with acidic vinegar than with neutralized vinegar or no vinegar; gastric emptying unchanged

What it does to your health

• Across 9 randomized trials in 686 adults drinking 1 to 26 tbsp (15 to 770 mL) of apple cider vinegar a day for 30 to 90 days, fasting glucose fell by about 8 mg/dL and total cholesterol by about 6 mg/dL. — 686 adults with a mean age of 49.5 years in 9 parallel randomized trials, mostly people with type 2 diabetes or overweight, in Iran, USA, Japan, Pakistan and Tunisia (n = 686) Evidence A source
  Fasting plasma glucose -7.97 mg/dL (95% CI -13.74 to -2.21, I2 75%); total cholesterol -6.06 mg/dL (-10.95 to -1.17); HbA1c -0.50 (-0.90 to -0.09, I2 91%); no effect on LDL, HDL, insulin or HOMA-IR
• In 7 trials of 463 people with type 2 diabetes, apple cider vinegar for 4 to 12 weeks lowered fasting blood sugar by about 22 mg/dL, with moderate certainty of evidence. — 463 adults with type 2 diabetes, mean age 49 to 55, in 7 parallel controlled trials of 4 to 12 weeks in Iran, Tunisia and Pakistan, vinegar of about 5% acetic acid (n = 463) Evidence A source
  Fasting blood sugar WMD -21.93 mg/dL (95% CI -29.19 to -14.67, I2 20%); HOMA-IR unchanged
• Apple cider vinegar did not raise urine citrate, the stone-protective marker, in a small trial where 2 tbsp (30 mL) a day in a liter of water for a week did nothing, while lemon water and coconut water did. — 20 adults without kidney stones, median age 31, 6 of whom drank diluted apple cider vinegar for 7 days in a randomized crossover with coconut water, lemon water and diet soda (n = 20) Evidence B source
  No significant change in 24-hour urine citrate, pH or volume with apple cider vinegar; lemon water +167.7 mg/24 h (95% CI 16 to 319), coconut water +273.8 mg/24 h (67.9 to 480)

Safety, limits and interactions

• A 2024 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 with acute pancreatitis and no other clear cause (n = 1) Evidence D source
  Acute pancreatitis temporally linked to a new apple cider vinegar weight-loss supplement
• Observational data tie acidic foods including vinegar to tooth erosion in children: in 309 age and gender matched UK children, vinegar and fruit were eaten more often by those with erosion. — 309 age and gender matched UK children with dental erosion, active caries or no caries, structured dietary histories (n = 309) Evidence C source
  Higher fruit and vinegar consumption in the erosion group than in caries-active or caries-free controls, no effect size given
• 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 people believe that the data does not support

• The 2024 trial behind the viral claim that a daily spoon of apple cider vinegar melts weight was retracted in 2025 because its results could not be reproduced and its data did not look randomized. — Retracted randomized trial of apple cider vinegar for weight in Lebanese adolescents and young adults with overweight and obesity, BMJ Nutrition, Prevention and Health, 2024 Evidence E source
  Retracted; analyses not replicable, patterns inconsistent with random allocation, improbably small p-values, no prospective registration
• The European Union refused the claim that apple cider vinegar helps control and normalize body weight, and it has authorized no claim for apple cider vinegar at all. — EU register of nutrition and health claims, snapshot of 2026-09-21, four entries for apple cider vinegar Evidence E source
  Status Non-authorized; 0 authorized and 4 non-authorized claims for apple cider vinegar

What is still unknown

• The cholesterol drop from apple cider vinegar is concentrated in people with type 2 diabetes and in doses of 1 tbsp (15 mL) a day or less: total cholesterol fell about 11.5 mg/dL in diabetic trials but showed no significant change in others. — Subgroups of 9 randomized trials of apple cider vinegar, 5 in type 2 diabetes and 4 in other conditions (n = 686) Evidence A source
  Total cholesterol -11.51 mg/dL (95% CI -18.16 to -4.86) and triglycerides -22.46 mg/dL (-40.27 to -4.65) in type 2 diabetes; -10.22 mg/dL (-16.46 to -3.98) for doses of 15 mL/day or less; no significant reduction above 15 mL/day

The bottom line

The retraction leaves the weight question open. It removes the only large effect reported, and it does not show that vinegar has no effect. The cholesterol result is also hard to read. The drop of about 11.5 mg/dL came from the five trials in type 2 diabetes and from doses of 1 tbsp (15 mL) a day or less, while higher doses showed no significant reduction. A lower dose working when a higher one did not points to differences between trials more than to the vinegar. US labeling rules name cider vinegar as the textbook calorie free food. It is no mineral source either, with 73 mg of potassium per 3.5 oz (100 g) in one USDA record. The acid acts fast. In 30 healthy adults, 750 mg of acetic acid in a 3.4 fl oz (100 mL) vinegar drink peaked in the blood at 15 minutes and was gone by 90, though the vinegar was not named as cider. In 5 healthy adults, a salad dressing with 1 g of acetic acid cut the glucose rise after white bread by 31%, and the same vinegar neutralized with baking soda did nothing. Five people is a very small trial. It did not raise urine citrate, a marker that protects against kidney stones. In a one-week crossover in adults without stones, where only 6 people drank 2 tbsp (30 mL) a day in a liter of water, urine citrate did not change, while lemon water and coconut water raised it. In 309 UK children, those with tooth erosion ate vinegar and fruit more often, though the study covered vinegar of any kind and gave no effect size. One 84-year-old woman developed acute pancreatitis after starting a weight-loss supplement containing apple cider vinegar along with other ingredients, a single case linked only by timing. The trial amounts, from 1 to 26 tbsp (15 to 770 mL) a day, are what studies used, not a safe range: we have no card on an upper limit, on diluting vinegar or on harm from drinking it undiluted. We have no card on pregnancy or on medicines.

Sources

1. cvin-r3-09 · regulation text
   (ii) As required in § 101.13(e)(2), if the food meets this condition without the benefit of special processing, alteration, formulation, or reformulation to lower the caloric content, it is labeled to disclose that calories are not usually present in the food (e.g., “cider vinegar, a calorie free food”).
   21 CFR 101.60, Nutrient content claims for the calorie content of foods · checked 2026-09-28
2. cvin-r3-10 · USDA FoodData Central SR Legacy, dataset
   Vinegar, cider (FDC 173469, SR Legacy, Spices and Herbs): potassium 73 mg per 100 g = 2% DV; magnesium 5 mg = 1% DV; iron 0.2 mg = 1% DV; Foundation samples 0, CoFID match none
   USDA FoodData Central, SR Legacy, FDC 173469 · checked 2026-09-28
3. cvin-r3-05 · randomized crossover trial in humans
   In the vinegar drink group, serum acetate concentration increased immediately after intake, peaked at 15 min and returned to baseline at 90 min. That in the vinegar capsule group rose slowly, peaked at 30 min and returned to baseline at 120 min.
   J Nutr Sci Vitaminol (Tokyo), 2010 · checked 2026-09-28
4. cvin-r3-06 · randomized crossover trial in humans
   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 2026-09-28
5. cvin-r3-01 · systematic review and 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 Complement Med Ther, 2021 · checked 2026-09-28
6. cvin-r3-03 · systematic review and dose-response meta-analysis
   We included seven studies involving 463 participants. 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).
   Front Nutr, 2025 · checked 2026-09-28
7. cvin-r3-04 · randomized crossover trial in humans
   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 2026-09-28
8. cvin-r3-11 · case report in humans
   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 2026-09-28
9. cvin-r3-12 · case-control study in humans
   Structured dietary histories were taken from 309 age and gender matched children to determine the type and frequency of intake of acidic foods and drinks, together with any drinking habits that prolonged exposure of the teeth to dietary acids. ... Fruit and vinegar consumption was higher in the erosion group, as was the taking of vitamin C supplements.
   ASDC J Dent Child, 2000 · checked 2026-09-28
10. sf-vin-r2-2 · 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
11. cvin-r3-07 · journal retraction notice
    The paper is being retracted because the authors’ analyses could not be replicated and multiple errors were identified. The authors supplied dataset also demonstrated patterns inconsistent with random allocation of participants to treatment groups, improbably small p-values given the limited number of participants included in the study (see online supplemental material 1).
    BMJ Nutr Prev Health, 2025 · checked 2026-09-28
12. cvin-r3-08 · regulatory register entry
    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 2026-09-28
13. cvin-r3-02 · systematic review and 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%), as well as in studies with an ACV dose of ≤15 mL/day (TG: − 21.91 mg/dL; 95% CI: − 35.23, − 8.60; I2: 0%; TC: − 10.22 mg/dL; 95% CI: − 16.46, − 3.98; I2: 0%)
    BMC Complement Med Ther, 2021 · checked 2026-09-28