Last fall I had a pretty obnoxious cold, and since I was part of a singing group, I soon got advice from a lot of other singers on how to treat it or at least diminish the symptoms. One thing that seemed to come up a lot was various uses of apple cider vinegar. While this was new to me, there seems to be a large population of vinegar-o-philes who use this folk remedy for treating all kinds of things. Of course, this means it was something to look into and write about.
Vinegar is made in two stages: first you ferment fruit juice (apple or several other fruits) to make alcohol. Various yeasts speed up the fermentation process. Under the right careful conditions you can make wines or apple jack this way. Essentially, the sugars are broken down to make ethanol (ethyl alcohol, CH3CH2OH). However, if you expose that solution to oxidation or let the fermentation proceed further, the ethyl alcohol is oxidized to acetic acid: CH3COOH. It is this acetic acid that gives vinegars their acrid smell and taste.
If you don’t filter the vinegar, it remains somewhat cloudy, and this may add slightly to the flavor. If you do filter it, you are left with a clear, but colored, liquid. If you distill that vinegar, you are purifying the acetic acid, and this ends up giving the pure white vinegar used in some recipes. You usually use that in sweet-and-sour dishes and the like, but with little subtlety of taste.
Right now our pantry contains white vinegar, cider vinegar, malt vinegar, raspberry vinegar, balsamic and rice wine vinegar, each with different flavors for various kinds of cooking. You could use any of them to make a sour drink, but it really isn’t all that good for you.
Folk remedy claims
You will find a plethora of claims for the health benefits of apple cider vinegar (ACV) in articles like this wildly inaccurate one in Healthy and Natural World. Here the authors claim you can use it for sore throats (mixed with honey, I think) , joint pain, acid reflux, weight loss, reduced cholesterol and several other completely unsupported claims.
Now, here is why we know they are nuts: they correctly note that ACV (which is mostly acetic acid) is acidic (low pH), so using for heartburn and the like seems silly. But they then claim that when vinegar is consumed, it turns alkaline (high pH). Holy smoke! Is this some sort of magical transmutation? No, it is just plain wrong. This article also claims that honey is acidic (no it isn’t) but becomes alkaline in the body (no it doesn’t).
In fact ACV can be dangerous, since taking something so acidic, even diluted, it could harm your esophagus and damage your tooth enamel. WebMD says there is insufficient evidence for any of the claimed uses being effective.
Bragg Apple Cider Vinegar
One of the largest promoters of health effects of ACV is Bragg, a small company founded by two naturopaths, which makes unsupported and downright crazy claims on their cluttered web site, reminiscent of tabloids and the Wretched Mess News. Those claiming to be naturopaths are simply quacks, and are not practicing anything like science-based medicine. You can read a critical description of naturopathy here, in an article by a former naturopath.
Bragg ACV is organic, which is just a marketing term, gluten free (which apples contain gluten?), un- pasteurized (why?), and Non GMO (no GMO apples have yet reached the market anyway). They call the cloudy pulp that remains in the vinegar “the Mother,” but it has no particular nutritional value. This is in reference to Kombucha which has a similar culture of bacteria and yeast also called “the Mother.” It doesn’t have any real health benefits either.
As a company, Bragg promotes every kind of pseudo-science you can think of. The web site has links to why cell phones cause cancer (they don’t: microwaves are not energetic enough to break any chemical bonds), dangers of water fluoridation, GMOs, Monsanto’s Terminator seed (which does not exist) and, most disturbingly, a diet for preventing suicide. They also claim MSG is dangerous, while recognizing the glutamates are naturally occurring in our body.
Finally, if you wonder if there is any nutritional advantage to ACV, here is the USDA analysis of apple cider vinegar: there isn’t much to it.
It seems that much of the apple cider vinegar myths are being pushed by two crackpot naturopaths, who have made a successful business out of making up new folk remedy treatments. There is not a shred of evidence they work, and you would do better with conventional and much safer nostrums.
Food Science Institute 
To play the devil’s advocate here, the likely pH of the vinegar, low as is is, is still likely to be a little bit higher than gastric fluids so it might constitute an improvement (of course, just about anything else you could eat –for instance, antacid tablets– would be an even better improvement) and the acetate in vinegar might even provide a mild buffering action. However, the acetate pKa is 4.76 (according to Wikipedia) which might actually be too high to make it helpful as a buffer since that number is far enough above the pH of both stomach contents and vinegar as to put such low pH levels below its optimal buffering range.
The other (probably a lot more important) thing that we are not taking into account is that the stomach is not a passive bag. It reacts to different chemical stimuli in different ways. It would not be completely implausible that introducing high levels of acetate into the stomach (which, after all, feeds into almost all major metabolic pathways) may have a significant (direct or indirect) effect on acid secretion one way or the other (which way, I could not tell you).
But yes, other than that, vinegar is not going to magically turn into an alkali in the stomach (though it may ultimately metabolize into alkaline ash and raise urinary pH –honestly, I have no clue if it really does).
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It has been almost two decades since I learned about how the cardiac sphincter responds to stomach pH levels. But if I understand this correctly, the gastric/cardiac sphincter increases clamping force in response to increased stomach acid. If acid levels are not high enough the sphincter may not clamp down adaquately to prevent gastro-esophageal reflux. In those cases the remedy to acid reflux would, ironically, be to supplement gastric fluid with acid of sufficient concentration to trigger a cardiac sphincter reflex and clamping. That said, supplementing with apple cider vinegar, or any bio-compatible acid of sufficiently-low pH would be exactly what was needed to remedy the acid reflux.
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The alternative treatment to SPECIFICALLY target Loose and leaking cardiac sphincter related acid reflux would be to prescibe Reglan which has significant potential neaurological side effects including facial twitch and psychological problems. Indirectly you could reduce stomach acid pH through proton pump inhibitors, antacids, etc. so that the fluid being refluxed, that is, bypassing the cardiac sphincter is of such a low acidity that is does not significantly damage or irritatd the esophageal lining. This is likely to facilitate healing but the more specific treatment would affect the specific problem- cardiac sphincter leakage. The vinegar could activate the cardiac phincter reflex and increase its clamping for sufficiently to prevent or significantly reduce reflux altogether.
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Any citations?
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Any references?
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Yes. Here it is.
Cannon, W.B., Acid closure of the cardia. Am.J. Physiol. 23:105-114, 1903.
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Lataste, J. and Gonthier, F., Les reflux oesophagiens apre gastrectomies distales. La Presse Medicale 75:1025-28, 1967.
Earlam, op cit.
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It is reffered to as the Cannon-Dougherty reflex in mammals.
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References
Kondo T, et al. Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects . Biosci Biotechnol Biochem. (2009)
Kondo T, et al. Acetic acid upregulates the expression of genes for fatty acid oxidation enzymes in liver to suppress body fat accumulation . J Agric Food Chem. (2009)
Sakakibara S, et al. Acetic acid activates hepatic AMPK and reduces hyperglycemia in diabetic KK-A(y) mice . Biochem Biophys Res Commun. (2006)
Brighenti F, et al. Effect of neutralized and native vinegar on blood glucose and acetate responses to a mixed meal in healthy subjects . Eur J Clin Nutr. (1995)
Leeman M, Ostman E, Björck I. Vinegar dressing and cold storage of potatoes lowers postprandial glycaemic and insulinaemic responses in healthy subjects . Eur J Clin Nutr. (2005)
Ostman E, et al. Vinegar supplementation lowers glucose and insulin responses and increases satiety after a bread meal in healthy subjects . Eur J Clin Nutr. (2005)
Johnston CS, Kim CM, Buller AJ. Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes . Diabetes Care. (2004)
Hlebowicz J, et al. Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study . BMC Gastroenterol. (2007)
Liljeberg H, Björck I. Delayed gastric emptying rate may explain improved glycaemia in healthy subjects to a starchy meal with added vinegar . Eur J Clin Nutr. (1998)
Salbe AD, et al. Vinegar lacks antiglycemic action on enteral carbohydrate absorption in human subjects . Nutr Res. (2009)
Shishehbor F, et al. Apple cider vinegar attenuates lipid profile in normal and diabetic rats . Pak J Biol Sci. (2008)
Budak NH, et al. Effects of apple cider vinegars produced with different techniques on blood lipids in high-cholesterol-fed rats . J Agric Food Chem. (2011)
Hill LL, et al. Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products . J Am Diet Assoc. (2005)
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The Apple Cider Vinegar scam has been around, in one form or another, for decades !
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Yes – I remember my grandmother was really into apple cider back in the 60s.
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Hope she didn’t dissolve!
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Does ACV provide any of those things? You do not say, and I found nothing about them when I wrote the article. The article is completely accurate. ACV has not been shown to have any health benefits.
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So esophageal risk notwithstanding, there are some studies on pub med regarding its use to lower fasted glucose.
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There is also the “Trust me I’m a doctor” experiment on glucose levels. I don’t think the mechanism is understood but significant reduction of blood sugar levels was observed. I know amylase has a pH range it works best in. I don’t fully understand how but the ACV my be interfering with the ability of amylase to act upon starches.
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One of your previous comments is write….ACV is indeed (very) acidic. Its the pH sensors in your stomach that tell the pancreas that acid has been consumed….the pancreas then releases enough bicarbonate i onto neutralize the ACV but also make the body net basic
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Your USDA link takes the reader to paprika. I found the ACV though.
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Fixed
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to be fair there are some studies showing some small benefit regarding ACV and arthritis if i recall correctly
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There are some claims in health newsletters, but no studies to support them. Here is an eplanation from a dietician: http://www.arthritis.org/living-with-arthritis/arthritis-diet/anti-inflammatory/food-myths-arthritis.php
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Cat among the pigeons. I’m going to have to re-study this one.
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I’ve been taking ACV diluted in warm water every morning, for the last 10 mths, I find it’s a great way to start the day, 2teaspoons in warm water, gets me up and going,also find it’s a appetite detterant, not that I need to loose weight, is some one telling its not good for me ??
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Umm, I won’t exactly tell you it’s “not good” for you. But I will tell you there is absolutely no scientific evidence to suggest that it is good for you. So why do it? It’s like rubbing a grape on your left knee saying, “it’s a great way to start my day.” It’s just strange.
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FIRST- There is evidence to support the claim that ACV taken before a carbohydrate-rich meal moderated blood glucose elevation by for a total reduction of blood sugar concentration of 36% and that some cholesterol was reduced by 13% along with blood triglyceride levels. See the “trust me, I’m a doctor” study on ACV. Having studied biology and chemistry and done chemistry research I know the statistical significance of that study is not completely overwhelming. But the methodology was decent and lends credence to some ACV health-promoting claims.
SECOND- I’ve been studying or researching in the field of biology and chemistry for close to a decade and ifnthere isnone thing Inhave learned is that when somebody says there is absolutely no scientific evidencd for something they are usually speaking from a relatively inexperienced and usually mistaken point of view. It is VERY difficult to review all the literature in the world that is available on a subject. As a general rule, it is presumtuous and usually erroneous to make a claim that there is NO scientific evidence for something. Even the most experienced researchers will rarely make this type of blanket claim and will simply say that they have not found any scientific evidence to support a particular claim, and will often request in their publication that readers share any evidence to the contrary they may be aware of. Even general statistics should have taught you about confidence intervals and uselessness of absolute claims.
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What literature can you cite? I found none in PubMed.
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http://www.bbc.com/news/magazine-37229792
While not on Pubmed it is nonetheless significant and consistant with at least one formal study I am aware of but don’t have the time to search for at the moment.
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A rather harsh and unscientific rebuttal. Professor Matt Cooper has been studying the affects of Acetic acid on the microbiome and how it may reduce inflammatory responses. He has some rather interesting outcomes to date. Perhaps look a little further and keep an open mind. Your elementary science education has not provided you with all the answers. What you don’t know isnt wrong – its worth investigating.
More info search the work of
Prof Matt Cooper
Institute for Molecular Bioscience
University of Queensland, Australia
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I found nothing on Matt Cooper’s site nor anything on Pubmed. If you have a link, please post it in another comment.
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The professor basses his ‘attack’ on what science professes to know. Not on what it does not know. Is something only made good when science discovers it? There are, however, scientific documents that do confirm many of the claims of ACV’s usefulness.
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If there are such scientific documents, then they are part of what science “professes to know.” If you know of such research, please post a link to it.
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When you see Walmart making extensive strides to maintain a huge supply of the Bragg’s Vinegar and selling it for $6.00 you know someone is profiting off the passing fad albeit a temporary sound business model, consumers not notwithstanding. What Apple Cider Vinegar is to the diet , a meme is to social media–a short term fad that has a short shelf life in the mass consciousness of the public at large.
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Looks like there have been some basic test groups that saw some improvements.
http://www.bbc.com/news/magazine-37229792
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The reason apple cider vinegar helps with acid reflux has nothing to do with the explanation given – It may or may not be true.
What happens is that the ph of apple cider vinegar is just right for causing the upper valve in the stomach to close. But it must be diluted. I used 1 teaspoon in one glass of water and would drink up to half of it, in a very short while the indigestion would stop – every time.
I no longer need to drink this as I worked on improving my digestion with a little raw food and gradually increasing the amount.
My pharmacist explained that as we get older the stomach valve doesn’t close properly and when we bend over we get indigestion.
I would add: as we get older we have much lower levels of healthy acid in our stomach and apple cider vinegar not only closes the valve it also encourages the stomach to secrete its own acid naturally.
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This is interesting, but I haven’t located any articles to support it. If you have any such, please post them.
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Here is your reference.
Cannon, W.B., Acid closure of the cardia. Am.J. Physiol. 23:105-114, 1903.
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I find that a class of warm water with a freshly squeezed lemon added helps my aging (76) digestive system when taken 15 – 20 minutes before a meal. I’ve also noted that when overeating I suffer from heartburn, possibly because it may be holding the valve open.
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