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Wednesday, 2 January 2019

10 Apple Cider Vinegar Facts to Know Before You Drink It

Even though it's easy to find programs and products that claim to make weight loss quick and easy, according the research, as well as expert advice, not only do most weight loss diets fail, losing weight and keeping it off typically requires a fair amount of effort and commitment to the long game. It's no surprise, then, that supplements like apple cider vinegar (ACV), which some people turn to because of its reputation as a weight loss aide, "detoxifier," and general health booster, abound.
But does drinking ACV really promote weight loss, or deliver on any of the other popular rumors swirling around it? Here, experts get to the bottom of the debate around apple cider vinegar and weight loss and health.

1. It doesn't actually cause weight loss.

"There are many mostly unfounded claims about apple cider vinegar," Scott Kahan, M.D., director of National Center for Weight and Wellness, tells SELF. As a doctor specializing in obesity management as well as a researcher in obesity treatments, a lot of patients ask Dr. Kahan how apple cider vinegar may affect their weight. Simply put, there's no rigorous science to back up the claim that apple cider vinegar kicks off a metabolic process that results in weight loss.
"Like with most supplements, people make a lot of claims based on absent or extremely poor data," says Dr. Kahan. "Virtually no [scientific literature] comes up for this, and what does is usually tiny, not well-done studies in obscure journals." Because of that, he says they're "basically meaningless" when it comes to supporting claims of apple cider vinegar's weight loss benefits. In fact, one study that shows that study subjects who lost weight following a protocol that involved consuming two tablespoons of ACV per day were also eating 250 calories less than usual.
Another expert agrees. "Apple cider vinegar doesn’t have any physiological properties that speed up your metabolism or melt fat," Abby Langer, R.D., tells SELF.

2. It's value as a probiotic is questionable.

Nowadays "gut health" is all the rage and, subsequently, so are probiotics. But what do they actually do? It helps to first understand just what a probiotic is. Author of The Bloated Belly Whisperer Tamara Duker Freuman, R.D., explains that a probiotic is a specific species and strain of a microorganism, usually bacteria, that has been demonstrated through research to benefit human health. They occur naturally in products like yogurt and kefir and they can also be bought in supplement form. But unless a specific microorganism has been shown to do something health-promoting, there's really no way to know if it's doing much of anything, says Duker Freuman. "There's minimal evidence to suggest that the average person would benefit from taking probiotics," Duker Freuman says. Apple cider vinegar would fall into this category of bacteria-containing foods that probably won't do much for otherwise healthy people. The research that has shown probiotics to be promising for health typically are looking at a specific bacteria and a population with a specific condition, explains Duker Freuman, like studies of how a certain bacteria affects ulcerative colitis patients and others about how specific probiotic mixtures have been found to help patients with the gut infection Clostridium difficile, or C. diff.
Duker Freuman's bottom line about ACV is that it probably isn't harmful and it's also unlikely to promote gut health. The only people she says should steer clear of it entirely is anyone with acid reflux or acid damage to their esophagus from acid reflux.

3. Apple cider vinegar doesn't "detoxify" you.

"I've heard a lot about how apple cider vinegar 'detoxifies' you," says Langer, who explains that it's simply not true. In fact, the body is basically built to "cleanse" itself. Your body does a clutch job of detoxing all on its own—that's precisely what your liver, kidneys, and intestines are for. They work together to eliminate toxins and waste from your body in the form of urine and feces, while also helping your body absorb the beneficial nutrients from whatever you eat. "Despite what you may read, there's nothing magical about apple cider vinegar," says Langer.

4. It should not be used as an appetite suppressant.

While some research has proposed that the acetic acid in ACV may suppress the appetite and other research has shown acetic acid consumption to suppress body fat accumulation in mice, we so far lack any strong evidence that ACV is an effective appetite suppressant.
But perhaps more important than the fact that ACV hasn't been reliably shown to suppress appetite is the fact that cutting calories and undereating are not winning strategies for weight loss and are likely to leave you feeling hungry and deprived. Not to mention that restricting what you're eating can set you up for a restrict-binge-restrict cycle as well as hamper your ability to think intuitively about food and eating. To suppress your appetite when you feel hungry is deny your body the nourishment it's asking for. "It's unhealthy psychologically," Langer says.
"If you feel hunger at a time that’s unexpected, like between meals, an appetite suppressant isn’t the answer. The answer is to take a look at what you’re eating over all to see if it’s adequate in calories or volume, and also macronutrient-wise," says Langer.

5. There's a chance it could modestly lower blood glucose levels, but we don't have solid evidence for that.

One 2013 study in Journal of Functional Foods suggests as much, noting that participants who ingested apple cider vinegar each day for 12 weeks had lower blood sugar. The issue is that the study was only conducted on 14 people, and they were all already predisposed to type 2 diabetes.
"Because studies are typically done on certain subsets of people, you can usually only make very specific conclusions based on the population that's actually studied," says Dr. Kahan. In other words, studies are a great way to learn about various subpopulations, but unless the research is large-scale and designed to apply to many groups, it doesn't automatically tell you about the general population.
That's not to say apple cider vinegar can't help lower blood glucose levels, at least in the group studied. "It may have some effect in terms of decreasing the increase in blood sugar that happens after eating a carbohydrate in people who are prone to high blood sugar," says Dr. Kahan, although the mechanism behind this isn't totally clear. "Vinegar is an acid that changes the pH of food, which can affect how quickly something is metabolized and absorbed," he says. "It could also affect the enzymes that are responsible for metabolizing and absorbing the nutrients of different foods."
Until something has been rigorously studied, trusted experts refrain from developing any clinical guidelines about its use for health. In short, no one should be taking their health advice from the results of one very small study.

6. You shouldn't drink too much of it.

Even though the vast health claims are dubious, that doesn't automatically mean you can't drink apple cider vinegar. "Lack of scientific evidence doesn't mean that it's dangerous or won't make you feel healthier," says Langer. If you're going to incorporate it into your diet, it's all about how you do it.
Langer recommends never going over two tablespoons a day, and Dr. Kahan agrees that overdoing it could have negative health effects. Beyond exacerbating the stomach irritation issue, too much acidity can wear away at your tooth enamel and even harm your esophagus, he says. He also suggests eating before you drink anything with apple cider vinegar mixed in so that stomach irritation is less likely.
"Vinegar is a strong acid," he says. "Like with a lot of other 'magic' pills, potions, and foods, you want to be careful about having too much."

7. It hasn't been proven to control high blood pressure.

Just because acetic acid was shown to reduce blood pressure in rats, it doesn't mean it will have similar effects on humans. Again, until this is studied more rigorously and thoroughly, there's not enough evidence to show that consuming ACV will lower blood pressure.

8. It can cause nausea in some people.

While drinking ACV diluted in water can be "health neutral" for lots of people, it can make others nauseated, says Duker Freuman. If you have a sensitive stomach or other gastrointestinal woes, ACV might not be for you. In fact, going back to the idea that ACV could be an appetite suppressant, a 2014 study in the International Journal of Obesityfound that feelings of suppressed appetite after ingesting ACV were due to the nausea subjects felt after ingesting it.

9. ACV doesn't interact well with certain medications.

You should definitely talk to a doctor if you take insulin or diuretics and are interested in drinking ACV.

10. There hasn't been enough good research on ACV to determine whether it has other health-related uses.

Although it's touted as a supplement for acne, hiccups, allergies, and more, as a 2017 article noted, in Natural Product Research notes, "more in vitro and in vivo validations are necessary in order to precisely weigh the pros and cons of ACV." Reshmi Srinath, M.D., assistant professor in the Mt. Sinai division of endocrinology, diabetes, and bone disease, and director of the Mount Sinai Weight and Metabolism Management Program, tells SELF that while there have been small, non-controlled studies suggesting that apple cider vinegar may be beneficial in some ways, "there’s not enough clinical data to support its use to the general public."

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