Hello all,
I hope you are enjoying your last August day! I am a bit sad that autumn will soon knock on our doors. I don’t mind the cold or the rain; I mind the lack of light.
Today, I wanted to discuss apple cider vinegar. People use it for weight loss, blood sugar management, and insulin resistance, but is it fact or fiction?
Let’s see what science says.
How does apple cider vinegar help
The mechanism by which apple cider vinegar is thought to help is:
Delayed gastric emptying: Apple cider vinegar slows the rate at which the stomach empties food into the intestines, resulting in a slower absorption of glucose into the bloodstream after a meal
Enhanced glucose uptake: Some animal and cellular studies suggest that apple cider vinegar may improve insulin sensitivity and stimulate greater glucose uptake by skeletal muscle, thereby lowering circulating blood glucose levels.
Reduced carbohydrate digestion: Acetic acid and other compounds in apple cider vinegar inhibit enzymes such as disaccharidases and α-amylase, which are responsible for breaking down complex carbohydrates into glucose. Inhibition leads to less glucose absorption from carbohydrate-rich food
All of these are believed to contribute to improved glucose metabolism.
I have found two meta-analyses from 2021 and 2025 looking at the effect this has on critical metabolic markers. Let’s dig into their results:
2021 Meta-analysis
9 studies with 686 participants included.
Participants: type 2 diabetics, overweight/obese adults, or mixed groups.
Duration: 4–12 weeks.
Results:
Total cholesterol (TC): ↓ by 6.06 mg/dL (significant).
Triglycerides (TG): Trend toward ↓ (−33.7 mg/dL, borderline).
LDL-C & HDL-C: No overall significant effect.
Fasting plasma glucose (FPG): ↓ by 7.97 mg/dL (significant).
HbA1c: ↓ by 0.50% (significant, but became non-significant after removing one influential study).
Insulin & HOMA-IR: No significant effects.
Some observations:
Type 2 diabetes patients: Greater reductions in Total Cholesterol (−11.5 mg/dL) and Triglycerides (−22.5 mg/dL).
Dose: Benefits more consistent at ≤15 mL/day than at higher doses.
Duration: Stronger effects after >8 weeks
Non-diabetics: ACV increased HDL-C modestly (+1.7 mg/dL).
Baseline values mattered: those with higher starting FPG/HbA1c saw bigger improvements.
2025 Meta-analaysis
To evaluate whether apple cider vinegar (ACV) improves glycemic control and insulin sensitivity in people with type 2 diabetes.
Included 7 controlled trials with 463 participants with T2DM
Duration: 4–12 weeks.
Results
Fasting blood sugar (FBS): Significantly reduced (−21.9 mg/dL on average). Each 1 mL/day increase in ACV was linked to a −1.25 mg/dL drop in FBS. Stronger effects at doses >10 mL/day.
HbA1c: Significantly reduced (−1.53%), though results varied widely between studies.
Insulin: Increased modestly (+2.06 μu/ml).
HOMA-IR (insulin resistance): No significant change.
What about weight loss?
Yes, several clinical studies have investigated apple cider vinegar (ACV) for weight loss. Recent studies in overweight and obese adults found that daily ACV intake (5–15 mL, diluted) for 12 weeks resulted in modest but significant reductions in body weight, body fat, BMI, waist circumference, and metabolic parameters compared to placebo. Average weight loss ranged between 2–8 kg over three months depending on dose and study design, and participants also saw improvements in blood sugar, cholesterol, and triglycerides. However, scientists caution that these studies have small sample sizes and short durations, and they are not definitive. More rigorous research is needed to fully validate long-term efficacy.
Conclusion
The research shows more significant effects for those with type 2 diabetes than for others. I couldn’t find any research on people with insulin resistance who took it, but you can assume that some of the people within the obese category will have it.
There are also some risks associated with apple cider vinegar. It can erode tooth enamel, irritate the throat and oesophagus, and upset digestion, causing nausea, bloating, or delayed stomach emptying; high doses may also lower potassium and weaken bones, and interact adversely with medications like diuretics or insulin.
My recommendations as a Nutritionist is to focus on your nutrition. If you really want to give this a try, you could do it for 8 weeks and see if you are feeling any better. You can check your cholesterol levels and insulin levels and see if it makes difference. However these tricks don’t substitute the foundation. I would personally hate to ruin every meal with a vinegar before it, but if you are love the taste, why not?
See you next Sunday,
Francesca
Hadi, A., Pourmasoumi, M., Najafgholizadeh, A., Clark, C.C.T. and Esmaillzadeh, A., 2021. The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials. BMC Complementary Medicine and Therapies, 21(1), p.179. https://doi.org/10.1186/s12906-021-03351-w
Sargolzaei, M., Bagheri, R., Ashtary-Larky, D., Bragazzi, N.L., Wong, A., Ernstsen, L., Suzuki, K. and Asle Mohseni, S., 2025. The effect of apple cider vinegar supplementation on glycemic control in patients with type 2 diabetes mellitus: a systematic review, meta-analysis, and meta-regression of randomized controlled trials. Frontiers in Nutrition, 12, p.1528383. https://doi.org/10.3389/fnut.2025.1528383