Does apple cider vinegar lower cholesterol?

A little, for total cholesterol, and LDL cholesterol has not changed significantly in any pooled analysis we found. A 2025 meta-analysis of 25 trials in 1,320 adults found apple cider vinegar lowered total cholesterol by 6.72 mg/dL, and saw no significant change in LDL, HDL or triglycerides. That analysis also counted trials that were not randomized. A 2026 umbrella review found a fall of 9.39 mg/dL across 15 trials of vinegar of any kind, and rated the certainty very low, with signs of publication bias. The trials were small and lasted 30 to 90 days, mostly in people with type 2 diabetes or overweight.

Unsettled. The answer is unclear for three reasons we can name. The fall in total cholesterol is small and its confidence intervals come close to zero. The umbrella review found evidence that negative trials went unpublished. And no trial enrolled people because their cholesterol was high, so we do not know what vinegar does in the people most likely to try it for this.

What the trials found

Total cholesterol

A 2021 meta-analysis pooled eight studies of apple cider vinegar in 686 adults, more than half of the trials from Iran, lasting 30 to 90 days. Total cholesterol fell by 6.06 mg/dL, with a 95% confidence interval from 1.17 to 10.95. The 2026 umbrella review rated that meta-analysis low quality. The 2025 meta-analysis of 25 trials found a fall of 6.72 mg/dL, interval 0.53 to 12.91. We could read only its abstract.

The umbrella review gathered 10 meta-analyses of vinegar and re-estimated the effect from 15 trials. Total cholesterol fell by 9.39 mg/dL, interval 0.75 to 18.04, with heterogeneity of 90.4%. The authors rated this very low certainty and found statistically significant publication bias, p = 0.025. That means the pooled figure is likely to overstate the true effect. The review appraised each meta-analysis with the AMSTAR 2 tool and judged most of the underlying trials to be of low quality.

LDL and HDL cholesterol

In the 2021 meta-analysis LDL changed by 2.12 mg/dL, with an interval from 10.09 lower to 5.85 higher, and HDL rose by 0.92 mg/dL, interval from 0.42 lower to 2.27 higher. Neither change was significant. The 2025 meta-analysis found no significant change in either. In the umbrella review LDL fell by 8.18 mg/dL, interval from 18.46 lower to 2.10 higher, p = 0.119, on low certainty evidence. The only subgroup with a real fall in LDL was ginseng vinegar, a different product.

Triglycerides

The 2021 meta-analysis found triglycerides 33.66 mg/dL lower, with an interval from 67.87 lower to 0.54 higher, so the result did not reach significance and depended on single trials. In the umbrella review the fall was 14.94 mg/dL and also not significant, interval from 30.59 lower to 0.7 higher. The authors rated that result high certainty although the trials disagreed with heterogeneity near 96%. That is their rating, and we would not lean on it.

The clearer triglyceride results are in narrower groups. In people with type 2 diabetes, the 2021 meta-analysis found triglycerides 22.46 mg/dL lower and total cholesterol 11.51 mg/dL lower. That is a subgroup of small trials. A 2021 meta-analysis of 16 randomized trials of acetic acid, the main acid in vinegar, in 910 adults at 750 to 3600 mg a day for about 8 weeks, found triglycerides 20.51 mg/dL lower in overweight people and 7.37 mg/dL lower in type 2 diabetes. HDL and LDL did not change. Most of those trials were at unclear or high risk of bias, and five of the 16 did not state the dose.

The one trial we read in full

In Iran, 73 adults with type 2 diabetes were randomized to 2 tbsp (30 mL) of apple cider vinegar a day with diet advice, or diet advice alone, for 8 weeks. LDL fell in the vinegar group and rose in the control group, p below 0.001, and total cholesterol differed between the groups too. There was no placebo drink, and the vinegar group also lost more weight, which may explain part of the change in blood fats.

Who should be careful

Not for everyone. Two case reports describe serious harm. 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, developed jaundice with liver injury that improved after he stopped. It is a single case, and causality was not proven. An 84-year-old woman developed acute pancreatitis possibly linked to a newly started weight loss supplement that contained apple cider vinegar among other ingredients.

Vinegar is an acid. Dutch dentists traced erosive tooth wear in a 15-year-old girl to a daily glass of apple cider vinegar drunk to lose weight. 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. The 8-week trial of 2 tbsp (30 mL) a day reported no adverse effects, but it was small and short, and it did not measure tooth enamel or potassium.

We found no trial of vinegar alongside cholesterol-lowering medicines, and none in pregnancy or in children. That absence is not reassurance. If your cholesterol is high, apple cider vinegar has not been tested against treatment that works.

What expert bodies say

The EU register of health claims lists the claim that an apple vinegar drink helps maintain vascular health as non-authorized, and it has no authorized claim for vinegar of any kind. Non-authorized means the evidence was judged insufficient when it was assessed, not that the effect was disproven. Nobody has filed a vinegar claim about cholesterol in the EU. We found no US health claim for vinegar, and no fact sheet from NIH, NCCIH, EFSA or the American Heart Association that addresses vinegar and cholesterol.

How we searched

What would change this answer

• A placebo-controlled trial that enrols people for high LDL cholesterol and makes LDL the main outcome. We found none.
• A trial longer than about 12 weeks, and any trial that measures heart attacks or strokes.
• A head-to-head comparison with a statin. One trial registered in Iran in 2026 compares apple cider vinegar with honey against atorvastatin and gemfibrozil, and its results are not out.
• Larger trials outside Iran, with a placebo drink, so that weight loss and diet advice cannot explain the result.

More on this food: apple cider vinegar, apple cider vinegar and blood pressure and apple cider vinegar and weight loss.

Sources

1. ev-acvchol-01 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized clinical trials, random effects · n = 686
   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%).
   
   Who: 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
   Effect: 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)
   Certainty: Rated low quality on AMSTAR 2 by the 2026 umbrella review; TG result sensitive to single trials.
   BMC Complementary Medicine and Therapies, 2021 (Hadi et al.) · checked 2026-10-07 · we read the full_text
2. ev-acvchol-02 · Meta-analysis or systematic review · subgroup analysis within a meta-analysis of randomized clinical trials · n = —
   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%)
   
   Who: patients with type 2 diabetes, subgroup of trials of apple cider vinegar
   Effect: 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
   Certainty: Subgroup of small trials; no trial enrolled people for high cholesterol alone.
   BMC Complementary Medicine and Therapies, 2021 (Hadi et al.) · checked 2026-10-07 · we read the full_text
3. ev-acvchol-03 · Meta-analysis or systematic review · systematic review and meta-analysis of clinical trials · n = 1320
   No significant results were observed for BMI, HOMA-IR, serum insulin, TG, LDL-C, and HDL-C.
   
   Who: adults in 25 clinical trials (33 arms) of apple cider vinegar
   Effect: 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
   Certainty: Includes non-randomized clinical trials; full text not available, abstract only.
   Current Medicinal Chemistry, 2025 (meta-analysis of apple cider vinegar and cardiometabolic risk factors) · checked 2026-10-07 · we read the abstract
4. ev-acvchol-04 · Meta-analysis or systematic review · umbrella review of meta-analyses of randomized controlled trials with re-estimated effects and GRADE · n = 15 trials
   The visual inspection of the funnel plot (Figure S9) and Begg's test revealed statistically significant evidence of publication bias (p = 0.025).
   
   Who: adults in 15 randomized trials of vinegar drawn from five meta-analyses
   Effect: 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
   Certainty: Covers all vinegar types; apple cider vinegar subgroup significant for TC; dose subgroups not significant.
   Food Science & Nutrition, 2026 (Shahmohammadi et al., umbrella review) · checked 2026-10-07 · we read the full_text
5. ev-acvchol-05 · Meta-analysis or systematic review · umbrella review of meta-analyses of randomized controlled trials · n = 15 trials
   Following subgroup analysis, a substantial reduction in LDL is observed in the ginseng vinegar intervention.
   
   Who: adults in 15 randomized trials of vinegar drawn from five meta-analyses
   Effect: LDL MD -8.18 mg/dL (95% CI -18.46 to 2.10; p = 0.119; I2 96.1%); GRADE low
   Certainty: Only a ginseng vinegar subgroup lowered LDL; no apple cider vinegar LDL effect.
   Food Science & Nutrition, 2026 (Shahmohammadi et al., umbrella review) · checked 2026-10-07 · we read the full_text
6. ev-acvchol-06 · Meta-analysis or systematic review · umbrella review of meta-analyses of randomized controlled trials · n = 15 trials
   In addition, no significant improvement in TG was observed in any subgroup (Table S7).
   
   Who: adults in 15 randomized trials of vinegar drawn from five meta-analyses
   Effect: 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
   Certainty: High GRADE for a null pooled result with I2 near 96% is the authors' rating, not ours.
   Food Science & Nutrition, 2026 (Shahmohammadi et al., umbrella review) · checked 2026-10-07 · we read the full_text
7. ev-acvchol-07 · Meta-analysis or systematic review · umbrella review quality appraisal (AMSTAR 2, Cochrane RoB) · n = 10 meta-analyses
   The quality of the included meta‐analyses was evaluated using the AMSTAR 2 criteria.
   
   Who: 10 systematic reviews with meta-analysis of vinegar trials and their primary RCTs
   Effect: AMSTAR 2: 3 high, 5 low, 2 critically low; RCTs: 3 high, 3 fair, the rest low quality
   Certainty: Explains why the cholesterol effect stays uncertain despite several positive meta-analyses.
   Food Science & Nutrition, 2026 (Shahmohammadi et al., umbrella review) · checked 2026-10-07 · we read the full_text
8. ev-acvchol-08 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials · n = 910
   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).
   
   Who: adults in RCTs of acetic acid from vinegar beverages and foods, 750 to 3600 mg a day for about 8 weeks
   Effect: 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
   Certainty: Most trials at unclear or high risk of bias; five of 16 did not state the acetic acid dose.
   J Acad Nutr Diet, 2021 · checked 2026-10-07 · we read the abstract
9. ev-acvchol-09 · Randomized controlled trial(s) · randomized controlled trial, open label, 8 weeks · n = 73
   LDL was decreased in the ACV group but increased in the control (p < 0.001).
   
   Who: adults with type 2 diabetes in Iran; 37 in the vinegar group and 36 controls completed
   Effect: 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
   Certainty: No placebo drink; weight also fell more in the vinegar group, which may explain part of the lipid change.
   Frontiers in Clinical Diabetes and Healthcare, 2023 · checked 2026-10-07 · we read the full_text
10. ev-acvchol-10 · Randomized controlled trial(s) · randomized controlled trial, 8 weeks · n = 73
    We found no adverse effects after consuming ACV.
    
    Who: adults with type 2 diabetes in Iran
    Effect: no adverse effects reported; compliance 91%
    Certainty: Small and short; adverse effects not systematically graded; tooth enamel and potassium not measured.
    Frontiers in Clinical Diabetes and Healthcare, 2023 · checked 2026-10-07 · we read the full_text
11. ev-acvchol-11 · Laboratory or animal data · case report · n = 1
    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.
    
    Who: one 60-year-old man with hypertension, hyperlipidemia and mild fatty liver
    Effect: jaundice with hepatocellular injury; improved after stopping vinegar
    Certainty: Single case; causality not proven; described by the authors as rare.
    Oxford Medical Case Reports, 2025 · checked 2026-10-07 · we read the full_text
12. ev-acvchol-12 · Laboratory or animal data · case report · n = 1
    We discuss an 84-year-old woman with acute pancreatitis possibly linked to a recently introduced weight loss supplement containing apple cider vinegar.
    
    Who: one 84-year-old woman
    Effect: acute pancreatitis after starting an ACV-containing supplement
    Certainty: Possible association only; multi-ingredient supplement.
    ACG Case Rep J, 2024 · checked 2026-10-07 · we read the abstract
13. ev-acvchol-13 · Position of an expert body · regulatory register entry · n = —
    POL-HC-6629 Apple vinegar drink Apple vinegar drink helps to maintain vascular health. Non-authorised
    
    Who: EU register on nutrition and health claims, snapshot 2026-09-21
    Effect: 0 authorized, 6 non-authorized vinegar claims
    Certainty: Non-authorized means evidence was judged insufficient at assessment, not that the effect is disproven; no cholesterol-specific vinegar claim was filed.
    EU Register on nutrition and health claims, claim POL-HC-6629, snapshot 2026-09-21 · checked 2026-10-07 · we read the dataset
14. ev-acvw-06 · Laboratory or animal data · case report · n = 1
    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
    
    Who: one 15-year-old girl
    Effect: erosive tooth wear attributed to daily apple cider vinegar
    Certainty: Single case; shows the mechanism of harm, not how often it happens.
    Nederlands Tijdschrift voor Tandheelkunde, 2012, 119(12):589-91 · checked 2026-10-06 · we read the abstract
15. ev-acvw-07 · Laboratory or animal data · case report with laboratory product analysis · n = 8 products
    Considerable variability was found between the brands in tablet size, pH, component acid content, and label claims.
    
    Who: eight apple cider vinegar tablet products tested after one reported adverse event
    Effect: considerable variability in tablet size, pH, acid content and label claims
    Certainty: One injury case; the product data date from 2005.
    Journal of the American Dietetic Association, 2005, 105(7):1141-4 · checked 2026-10-06 · we read the abstract