Remedy · pantry
Apple cider vinegar: what the evidence says about blood sugar and weight
Taken with a starchy meal, vinegar modestly lowers the blood sugar spike that follows. The weight-loss claims rest on small, uneven trials, and the acid has real downsides.
By the editors of Alimentotherapy Last reviewed 4 min read Not medical advice
Apple cider vinegar
Acetic acid from fermented apple juice
Best-supported use: Blood sugar after a meal
The short answer
The best evidence for apple cider vinegar is narrow: a tablespoon or two taken with a carbohydrate meal modestly lowers the rise in blood sugar and insulin afterwards Shishehbor 2017. Trials of daily vinegar for weight loss and cholesterol show small effects in short, mostly small studies, and the acid can erode teeth and has injured the throat when taken as tablets Castagna 2025; Hill 2005.
The evidence, use by use
Each claim graded on human studies only. How we grade
| Use | Grade | What the research found |
|---|---|---|
| Blood sugar and insulin after a meal | Moderate | A meta-analysis of controlled trials found vinegar taken with a meal lowered the glucose and insulin response afterwards compared with control. The trials were short, single-meal studies. Shishehbor 2017 |
| Fasting blood sugar and HbA1c over weeks | Limited | Pooling nine trials, daily apple cider vinegar lowered fasting glucose and HbA1c, with very high variation between studies; in apparently healthy people fasting glucose did not fall. Hadi 2021 |
| Cholesterol | Limited | The same meta-analysis found a small fall in total cholesterol (about 6 mg/dL) but no significant change in LDL or HDL cholesterol. Hadi 2021 |
| Weight loss | Limited | Ten trials (789 adults) found a small reduction in body weight and waist size over up to 12 weeks, with large differences between studies and no effect on other body-composition measures. Castagna 2025 |
| Cleansing or alkalizing the body | Not supported | No controlled human trials test these claims. The meta-analyses of vinegar trials measured blood sugar, blood fats and body weight, nothing else. Hadi 2021; Castagna 2025 |
How people use it, and the amounts studied
Apple cider vinegar is apple juice fermented twice: first by yeast into alcohol, then by acetic acid bacteria into vinegar. Acetic acid, usually about 5 percent in a supermarket bottle, is the part studied for blood sugar.
- With a meal: the meal-response trials gave vinegar at the same time as a carbohydrate mealShishehbor 2017. Used this way it works as part of the meal, much like a vinaigrette on a salad.
- Daily, for weeks: the weight trials that showed the clearest effect used about 30 mL (two tablespoons) a day for up to 12 weeks Castagna 2025; in the cholesterol analysis, effects were seen with 15 mL a day or less Hadi 2021.
In the kitchen
Dilute it: a tablespoon in a large glass of water, or as a dressing on food, rather than a neat shot. Rinse your mouth with plain water afterwards and wait before brushing, because enamel softened by acid is easier to wear away.
Why it might work
Vinegar slows the rate at which the stomach empties into the gut, so sugar from a meal reaches the blood more gradually. A small trial in people with type 1 diabetes and slow stomach emptying (gastroparesis) showed this effect clearly: 30 mL of vinegar slowed emptying further Hlebowicz 2007. That is a plausible reason for the smaller post-meal spike, and also why it can be a problem for some people.
Tablets and gummies are a different product
Most research used liquid vinegar. After a woman reported a vinegar tablet stuck in her throat, researchers tested eight apple cider vinegar tablet brands and found wide variation in size, acidity and acid content, with label claims that did not match, and doubt over whether some contained vinegar at allHill 2005. If you use vinegar, the liquid in a bottle from the grocery aisle is the form the trials studied.
Before you try it: safety and interactions
Who should avoid it or ask first
- You have type 1 diabetes with slow stomach emptying (gastroparesis): vinegar slowed emptying further in a trial, which can make insulin timing harder.
- You take insulin or other glucose-lowering medicine: adding a food that lowers post-meal glucose can change how you respond, so check with your clinician.
- You take diuretics or digoxin, or have low potassium: a case report linked years of drinking large amounts of cider vinegar with low potassium and bone loss.
- You have reflux, ulcers or swallowing problems.
Possible side effects
- Tooth enamel erosion: vinegars dissolved minerals from human enamel in lab tests, more so with longer contact.
- Throat irritation or injury, especially from undiluted vinegar or tablets that lodge in the throat.
- Nausea or indigestion, particularly when taken neat on an empty stomach.
Pregnancy and breastfeeding
Vinegar as a food or dressing is part of a normal diet. There is no research on daily therapeutic doses in pregnancy or breastfeeding, so ask your midwife or doctor before taking it as a regular remedy. Willershausen 2014; Hill 2005; Hlebowicz 2007; Lhotta 1998
Medicine interactions
We found no well-documented medicine interactions for apple cider vinegar at food amounts. That is not proof there are none: tell your pharmacist about any herb or supplement you take.
Check another food or medicine in the interactions list.
Common questions
Does apple cider vinegar lower blood sugar?
Vinegar taken with a carbohydrate meal modestly lowers the rise in blood sugar and insulin after that meal, according to a 2017 meta-analysis of controlled trials. Evidence for lasting changes in fasting glucose or HbA1c is weaker and inconsistent. People on insulin or glucose-lowering drugs should talk to their clinician first.
Does apple cider vinegar help you lose weight?
Only a little, if at all. A 2025 meta-analysis of 10 trials (789 adults) found a small fall in weight and waist size over up to 12 weeks, with large differences between studies. It is not a substitute for changes to diet and activity.
Is it safe to drink apple cider vinegar every day?
Diluted, in food amounts, it is generally well tolerated. The risks are tooth enamel erosion, throat irritation, and, with very large amounts over years, low potassium. Avoid tablets, dilute the liquid, and check with a clinician if you take insulin, diuretics or digoxin.
Sources
Primary research and government sources, each checked on the date this page was reviewed.
- PubMedShishehbor F, Mansoori A, Shirani F. Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials. Diabetes Res Clin Pract. 2017. PMID 28292654.
- PubMedHadi A, et al. The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials. BMC Complement Med Ther. 2021. PMID 34187442.
- PubMedCastagna A, et al. Effect of apple cider vinegar intake on body composition in humans with type 2 diabetes and/or overweight: a systematic review and meta-analysis of randomized controlled trials. Nutrients. 2025. PMID 41010525.
- PubMedHlebowicz 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. PMID 18093343.
- PubMedHill LL, et al. Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products. J Am Diet Assoc. 2005. PMID 15983536.
- PubMedWillershausen I, et al. In vitro study on dental erosion caused by different vinegar varieties using an electron microprobe. Clin Lab. 2014. PMID 24839821.
- PubMedLhotta K, et al. Hypokalemia, hyperreninemia and osteoporosis in a patient ingesting large amounts of cider vinegar. Nephron. 1998. PMID 9736833.
Keep reading
- GoalFood and blood sugar: fiber, whole grains, cinnamon and vinegarRaising fiber and choosing whole grains have the best evidence for steadier blood sugar. Cinnamon and apple cider vinegar get far more attention than their trials justify.
- Kitchen practiceFermentationThe oldest way to keep vegetables through winter. A tested method, the right salt and clean equipment make it safe; the health claims are more modest than the hype.
- RemedyCinnamonMixed trial results for blood sugar and no change in long-term HbA1c. Cassia cinnamon, the common supermarket kind, carries coumarin, which limits how much is sensible.
- RemedyOatsOne of the best-supported foods in this whole reference: the soluble fiber in oats, beta-glucan, lowers LDL cholesterol a little but reliably.