Apple cider vinegar (ACV) has been lauded for its potential health benefits, ranging from weight loss to improved digestion. With the rising popularity of the ketogenic (keto) diet, many are curious whether ACV can enhance fat loss within this low-carb, high-fat framework. This article dives into the science behind ACV, its compatibility with the keto diet, and whether it lives up to the hype.
What is Apple Cider Vinegar?
Apple cider vinegar is made from crushed, fermented apples, yeast, and sugar. This process results in a vinegar rich in acetic acid, which gives ACV its characteristic acidity, taste, and smell. ACV is used as an ingredient in foods such as salad dressings, pickles, and marinades. For many years, people have also used it as a home remedy for everything from fighting germs to preventing heartburn. More recently, research has shown that it might have some real health benefits, such as helping reduce blood sugar levels and aiding weight loss.
The Role of Acetic Acid
The key ingredient in ACV is acetic acid, which gives ACV its acidity, taste, smell, and all-around vinegar-ness. Researchers suspect most of the noted benefits of vinegar in studies are linked to acetic acid.
"The Mother" of Apple Cider Vinegar
Most ACV you find in the grocery store is the clear, pasteurized, and filtered type. But you can also buy raw, unfiltered ACV that contains a cloudy sediment. Called "the mother," this substance is made up of settled bacteria and yeast.
Some people give the mother credit for ACV's health benefits. And it's thought to contain small amounts of probiotics (healthy bacteria) that are good for gut health. But research hasn’t shown that the mother offers any particular health benefit.
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Nutritional Profile
Just 1 tablespoon (15 mL) of apple cider vinegar provides (2):
- Calories: 0 grams
- Protein: 0 grams
- Fat: 0 grams
- Total carbs: 1 gram
- Fiber: 0 grams
- Net carbs: 1 gram
ACV and Weight Loss: Does It Work?
ACV supporters claim it can help you lose weight, improve digestion, reduce heartburn, remove skin tags, clear up your skin, and more.
Overall, though, there’s really not enough research for us to be overwhelmingly convinced of ACV’s benefits for weight loss. Most studies that support ACV for health effects have been small, and the results haven't been decisive. We need more and bigger investigations of its benefits. So far, here's what research has found:
- Weight Loss: One study showed that taking 1-2 tablespoons of ACV a day helped people following a reduced-calorie diet lose a few extra pounds. But the study was small and short-term, following 39 people for 12 weeks. It didn't record what the study subjects ate on their diets or how much they exercised. Further, it wasn't blinded, which means people in the group who got ACV knew they were getting it. Some researchers thought the vinegar's acetic acid might speed up metabolism, but the data didn't bear this out. It may be that people lost more weight because of the placebo effect. Or perhaps the acetic acid made them nauseated, which caused them to eat less.
- Lower Cholesterol: The same small study that reported that ACV boosted weight loss also found that it lowered the total cholesterol levels of study subjects who took it. It also increased their "good" cholesterol and lowered levels of triglycerides (fats in the blood). Other studies have had similar findings. Experts caution that we need more research to fully understand this link.
- Lower Blood Sugar: Several smaller studies have reported that taking a tablespoon or two could lower your blood sugar after meals. The effect was moderate, and we need more research to know exactly how it works. Keep in mind that vinegar can't replace diabetes medications and a healthy lifestyle, but it should be safe to add to your treatment plan.
ACV and Belly Fat
The 39 people in the weight loss study also decreased their visceral adiposity index, an estimate of how much deep-belly fat the body contains. This visceral fat, which surrounds the organs in your belly area, is thought to be especially risky for health. But the study's small size and other flaws mean that it doesn't prove that ACV is effective in fighting belly fat.
Further Potential Benefits (and Limitations)
People also use apple cider vinegar for purposes that haven't been researched much or haven't been shown to be effective. Some of these uses include:
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- Lower blood pressure. One study in rats suggests that ACV could help with high blood pressure, but no studies involving humans back this up. High blood pressure can be a serious condition, so medical treatment and a healthy lifestyle are essential.
- Ease acid reflux. Many people swear by ACV as a remedy for heartburn and acid reflux. But there's no research to prove it works for those conditions. Ask your doctor if you could try it to ease your discomfort. Start with small amounts, diluted in water.
- Provide eczema relief. Some people with eczema use it to ease their skin symptoms. But some studies reported that it had little effect and irritated some people's skin. Ask your dermatologist if it's OK for you to try it.
- Kill germs. There's some evidence that ACV (along with lemon juice) can keep bacteria like salmonella from growing on salad greens. But it doesn't protect wounds against infection.
- Improve hair health. Some people use it as a hair rinse to ease dandruff or remove product buildup. There's no proof it works for these things. But it does contain things that fight bacteria and fungi, which could promote hair health.
ACV and Uric Acid Levels
When your body breaks down chemicals called purines in the foods you eat, it creates a waste product called uric acid. When too much uric acid builds up in your body, it can lead to gout or painful kidney stones. One study found that an alkaline diet that included small amounts of vinegar could cause more uric acid to leave your body in your pee. But the alkaline diet also contained lots of fruits and vegetables, and it's not clear whether the vinegar had much effect.
ACV on Keto: A Good Fit?
If you’re following the low carb, high fat keto diet, you may be particularly interested in ACV as a supplement or ingredient in your cooking.
At just 1 gram of carbs per 1-tablespoon (15-mL) serving, ACV is definitely doable on keto as a light garnish or occasional dressing. However, many people on keto limit their daily carb intake to 50 grams of total carbs or 25 grams of net carbs. Thus, ACV not be the best way to spend your carb allotment since it provides negligible calories (6). What’s more, some other vinegars - including white vinegar and rice vinegar - are completely carb-free and may be a better fit. They won’t add extra carbs to marinades, salad dressings, or any other recipes that call for vinegar (7, 8).
Checking Carb Counts
Remember to check the nutrient label on your ACV to confirm its carb count. Most major brands of ACV, including Bragg’s and Heinz, list 0 grams of total and net carbs on their food labels (3, 4, 5).
Therefore, it’s important to look at the nutrient label of any product you intend to buy, as some brands may have fewer carbs than others.
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Keto-Friendly Alternatives
Allergic or just not wild about the idea of taking vinegar every day? Here are some keto-friendly alternatives that may also help you lose weight a little more effectively.
- MCT Oil: Medium chain triglyceride (MCT) oil is made from fatty acids that consist of, well, medium chains of carbon, rather than short or long chains. MCTs have some unique properties that may make them useful for weight loss - particularly on keto. A 2018 study found that supplementing with MCT oil helped people get into ketosis (the state of burning fat for fuel instead of carbs) faster and with fewer side effects than people who supplemented with sunflower oil, with is made up mostly of long-chain fatty acids. Other studies - including some from the early 2000s and a more recent one from 2017 - suggest MCT oil may help you fill up more quickly and burn more fat, both of which are super helpful if you’re trying to shed some pounds.
- Exogenous Ketones: Ketones are the fuel your body produces from fat (either dietary fat or stored body fat) in the absence of carbs. Burning ketones from stored body fat is kinda the main goal if you’re doing keto for weight loss. But you can also supplement by taking exogenous ketones (ones from outside your body). One small 2018 study suggests that supplementing with exogenous ketones may reduce appetite, hunger levels, and desire to eat by directly affecting ghrelin (the hunger hormone).
Potential Risks and How to Mitigate Them
ACV isn’t risk-free. Because it’s super acidic, it can erode tooth enamel and even the lining of your digestive tract if you don’t dilute it or if you consume too much of it.
- Don’t consume more than 4 tablespoons per day (larger doses haven’t really been studied), and make sure it’s either used in cooking or diluted in at least 8 ounces of water per tablespoon of vinegar to reduce its corrosive effects.
- To be extra kind to your teeth, you can also sip your ACV concoction through a straw.
- Avoid drinking it on an empty stomach, and if you feel sick or throw up after you take it, stop using it.
- If you have low potassium levels (hypokalemia), too much ACV could make the condition worse. That's because large amounts can reduce potassium levels. Avoid overusing ACV if you have kidney disease, since your kidneys might not be able to handle high levels of acid.
Drug Interactions
The vinegar can also interact with some drugs, such as diuretics, laxatives, and insulin. Always ask your doctor if it’s safe to use ACV with your current medications.
How to Incorporate ACV into Your Diet
Wanna get some ACV in your diet and actually enjoy it? Try cooking with it! Its flavor and acidity make it a great addition to marinades and salad dressings.
It’s also a perf addition to some super-refreshing keto-friendly drinks. And if you wanna knock out dessert while getting your daily dose of ACV, keto-friendly ACV gummy candy is calling your name.
And if you really wanna feel the burn, you can use ACV to whip up a batch of fire cider, a home-brewed health tonic that supposedly helps ward off colds.
Generally, you can use ACV in any recipe that calls for vinegar - just remember that it’s got a pretty unique flavor.
Dosage Recommendations
Because we still have a lot to learn about ACV, there aren’t any official dosage suggestions. But some studies have given clues about the amount that may help with certain health conditions:
- Weight control. In the study that reported weight loss benefits, people drank about 2 tablespoons a day - one before lunch and the other before dinner. Experts say that amount should be safe for most people.
- Blood sugar and cholesterol control. People in the study saw improvement when they took about 1½ tablespoons after a meal.
- Acid reflux. A teaspoon or two diluted in a mug of warm water after a meal may help with your acid reflux. It's unlikely to make your condition worse.
Additional Tips for Using ACV
- Dilution is Key: Because it’s high in acid, it could irritate your esophagus (the tube that connects your throat and stomach) if you drink it straight or drink too much of it. Undiluted ACV can also break down tooth enamel. To avoid these issues, always water down the vinegar and drink it through a straw to protect your teeth. (ACV in food generally doesn't have these effects.)
- Patch Test for Skin Issues: If your doctor gives you the OK to try ACV for eczema, do a patch test first. Apply the vinegar to a small area of skin, then wait a few days to see if any irritation happens. You could then try it in a bath or a wet wrap.
- Hair Rinse: To use ACV as a hair rinse, put it on your hair after you shampoo. Leave it in for 5 minutes and then rinse. Don't use it more than once a week, as daily use can dry out your hair.
Honey and Apple Cider Vinegar
In folk medicine, a mixture of honey and vinegar (sometimes called oxymel) has long been used to treat coughs, colds, and other conditions. Like ACV, honey contains antioxidants. It's also thought to have anti-inflammatory properties. But there's been little research into the health benefits of this combination. One review of 20 studies concluded that oxymel might help manage asthma, obesity, and type 2 diabetes. But most of these studies were small, and some were done in animals, so we need further research. Another study found that honey-vinegar syrup increased blood sugar and reduced "good" HDL cholesterol levels in healthy people. Neither study specifically included apple cider vinegar.
If you find the taste of ACV too bitter, mixing it with honey can make it easier to take. But honey is high in sugar, so be cautious if you're watching your blood sugar levels.
Storing ACV Properly
Because ACV is highly acidic, it stays safe to use for a very long time. But the taste and appearance can change over time, so it's best to use it within 2-3 years after you buy it.
You don't have to refrigerate it once you open it. Instead, store it in a pantry or cabinet, away from direct sunlight. To keep it looking and tasting its best, store it in a glass or plastic container. Keep the lid on when you're not using it. And avoid letting moisture get into the container.