Several websites extol the virtues of Apple Cider Vinegar. Variously, it has been promoted as a weight loss aid, a cure for arthritis, a cholesterol-lowering aid and according to Earth Clinic (http://www.earthclinic.com/Remedies/acvinegar.html), it “cures more ailments than any other folk remedy”. The people at Earth Clinic also seem to think that Cider Vinegar “has anti-fungal, anti-bacterial, and anti-viral properties”. We will come back to the curative properties of Apple Cider Vinegar later.
Let’s see, what else do we have? Hmm, composition… “Apple Cider Vinegar contains cholesterol-reducing pectin and the perfect balance of 19 minerals, including potassium, phosphorus, chlorine, sodium, magnesium, calcium, sulfur, iron, fluorine and silicon.” (From http://www.parrothouse.com/acv.html). This should be easy to check, as USDA (the United States Department of Agriculture) provides an online database of nutrient values: http://www.nal.usda.gov/fnic/foodcomp/search/. I typed in Cider Vinegar and found that Cider Vinegar contains the following minerals (amounts per 100 grams):
These minerals are present in miniscule amounts. To put this in some kind of context, the attached PDF ‘K in food’ shows levels of potassium in common foods. How much Cider Vinegar do you need to consume in order to get 300mg of Potassium? 410 grams. How much baked potato would you have to eat in order to obtian the same amount of potassium? 56 grams (about one third of a baked potato according to the PDF).
To put it another way – the Zinc present is 0.04mg, or 40 micrograms. This is 0.2% of the EU Recommended Daily Allowance (RDA) for Zinc. How significant an amount is 0.2% of your RDA? Two thousandths of the amount you require daily. Great, now I just need to find some way of getting the other 99.8 of my RDA. (See PDF for foods rich in Zinc).
Enough of the composition. Let’s look at the claims. Earth Clinic are certainly not alone. http://www.lacetoleather.com/wondrugpag3.html (apart from having a slightly weird url) sings the praises of this natural remedy with almost religious zeal. They have an A-Z of ailments that stretches over two pages. They also have statements like this – “Rheumatism, arthritis, cancer, heart ailments, high blood pressure etc, are all signs that the body has been neglected by the suppression of natural heating crisises” and under insomnia, they recommend that “Under severe cases, a naturopath or homeopath should be consulted”. Brilliant. So if the apple cider with miniscule amounts of minerals doesn’t work, go buy some water that contains no active ingredient at all.
Given that there is an A-Z list of ailments that can be prevented/cured by Cider Vinegar, one might expect that Pubmed is full of studies into the myriad benefits of this wonderdrug. Let’s see. http://preview.tinyurl.com/372w99 gives us 14 results. Can you find one that shows Cider Vinegar to have benefits in humans? I can’t, but I did find these:
1. Such treatments as vegetarian diets, fresh or raw diets, allergy diets, no-dairy-products diets, fasting, vitamin and mineral supplementation, apple cider vinegar, and honey drinks are touted in the popular press as effective for the treatment of arthritis. In contrast to conventional therapies, the unproven treatments promise not only relief from symptoms but freedom from the disease as long as the diet regimen is followed. Several of the remedies appear to be harmless, but others are dangerous, especially if followed for prolonged periods. Nutrition professionals should be aware of the nature of these treatments and be prepared to offer sound, scientifically based but nonjudgmental care and information.
Management of patients using unproven regimens for arthritis.
J Am Diet Assoc. 1987 Sep;87(9):1211-4.
PMID: 3624710 [PubMed – indexed for MEDLINE]
2. Apple cider vinegar products are advertised in the popular press and over the Internet for treatment of a variety of conditions. After an adverse event was reported to the authors, eight apple cider vinegar tablet products were tested for pH, component acid content, and microbial growth. Considerable variability was found between the brands in tablet size, pH, component acid content, and label claims. Doubt remains as to whether apple cider vinegar was in fact an ingredient in the evaluated products. The inconsistency and inaccuracy in labelling, recommended dosages, and unsubstantiated health claims make it easy to question the quality of the products.
Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products.
J Am Diet Assoc. 2005 Jul;105(7):1141-4.
PMID: 15983536 [PubMed – indexed for MEDLINE]
There doesn’t seem to be much evidence for the safety and efficacy of Cider Vinegar on Pubmed, so I had a look around. Maybe there are some scholarly articles not published on Pubmed that look at Cider Vinegar? http://findarticles.com/p/articles/mi_m0GCU/is_n6_v14/ai_20152545/pg_1 seems to be sceptical regarding the much vaunted benefits of Apple Cider Vinegar. Two quotes stand out for me:
“There is no scientific evidence that apple cider vinegar has any medicinal properties. While the folksy anecdotes from those who claim to have benefited from apple cider vinegar tonics may be amusing to read, they are simply that — anecdotes.“
“The Arthritis Foundation calls vinegar a harmless, but unproven, arthritis remedy. It points out that arthritis symptoms come and go, and that a person using an unproven remedy may think a remedy worked simply because they used it at a time when symptoms were going into natural remission. Such is undoubtedly the case for many of the “cures” connected to vinegar.”
EDIT: Spotted this – http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=nef80242. Quote: “Regular ingestion of cider vinegar is becoming an increasingly popular habit in Austria and Germany. Cider vinegar is described as a prophylaxis and cure for almost any disease or complaint. Doses from one teaspoon to six soupspoons per day have been recommended. A local bookshop offered nine different specialist books on the benefits of cider vinegar. Here we describe the case of a woman, in whom chronic ingestion of excessive amounts of cider vinegar caused serious health problems.” What kind of health problems? Well, the article is entitled ‘Hypokalemia, Hyperreninemia and Osteoporosis in a Patient Ingesting Large Amounts of Cider Vinegar’. Authors: Karl Lhotta, Günther Höfle, Rudolf Gasser, Gerd Finkenstedt. Ref: Nephron 1998;80:242-243 (DOI: 10.1159/000045180).
Before posting your personal anecdotes about your amazing recoveries from various illnesses, please read this post on evidence-based medicine.
I’ve gone back to Pubmed to look at the evidence that has been published since I wrote this blog post. There’s not much that’s new but here are some links to abstracts of papers that look relevant to use of apple cider vinegar in humans:
Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. “Previous studies on healthy people show that vinegar delays gastric emptying and lowers postprandial blood glucose and insulin levels. The aim of this study was to investigate the effect of apple cider vinegar on delayed gastric emptying rate on diabetes mellitus patients. […] This study shows that vinegar affects insulin-dependent diabetes mellitus patients with diabetic gastroparesis by reducing the gastric emptying rate even further, and this might be a disadvantage regarding to their glycaemic control.”
Vinegar lacks antiglycemic action on enteral carbohydrate absorption in human subjects. “Blood samples for insulin and glucose were drawn at 20-minute intervals. The oral octreotide/insulin suppression test suppressed endogenous insulin secretion for the first 100 minutes of the study. During this time, the rate of rise of glucose was modestly but significantly (P = .01) greater after vinegar ingestion compared to placebo, suggesting that vinegar does not act to decrease glycemia by interference with enteral carbohydrate absorption.”
Here is a link to an abstract of a paper that looked at human teeth inoculated with bacteria and then “irrigated” with various solutions (note that the apple cider vinegar group was not among the best performing irrigants):
Antibacterial efficacy of endodontic irrigating solutions and their combinations in root canals contaminated with Enterococcus faecalis. “Teeth were divided according to the irrigant: Group I (GI), 2.5% sodium hypochlorite solution (NaOCl); GII, 2.5% NaOCl + 10% citric acid; GIII, 2.5% NaOCl + apple cider vinegar; GIV, apple cider vinegar; GV, 2% chlorhexidine solution; GVI, 1% peracetic acid; GVII, saline solution. […] All solutions promoted reduction of E. faecalis after instrumentation, but bacterial counts were higher in the final sample. GI, GV, and GVI had lower bacterial counts than the other groups.”
And here is a link to an abstract of a paper that looked at blood lipids in rats that looks interesting. Bear in mind that the study was in rats, not humans and that the rats were being fed high levels of cholesterol.
Effects of apple cider vinegars produced with different techniques on blood lipids in high-cholesterol-fed rats. “Cholesterol and apple vinegar samples were administered using oral gavage to all groups of rats except the control group. Apple cider vinegars, regardless of the production method, decreased triglyceride and VLDL levels in all groups when compared to animals on high-cholesterol diets without vinegar supplementation. Apple cider vinegars increased total cholesterol and HDL and LDL cholesterol levels and decreased liver function tests when compared to animals on a high-cholesterol diet without vinegar supplementation.”