What's the deal with Apple Cider Vinegar: Weight Loss Tool or Bust?

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Type Apple Cider Vinegar (ACV) into your search engine and the first thing that comes up is an article on the Proven Benefits of Apple Cider Vinegar.   The first paragraph states, “little research exists, and further studies are needed before it can be recommended as an alternative therapy.”  Hopefully this makes you PAUSE and realize that the evidence is not robust.  ACV is made via a two-step fermentation process.  The main ingredient in ACV touted as having health benefits is acetic acid, which is a byproduct of fermentation of the sugars released by the apples.  Others believe health benefits come from mother, which is a combination of proteins/enzymes/bacteria in raw, unfiltered ACV.  

So about that evidence.  

Most of the evidence to support ACV for fat loss is in rat and mice studies.  Data in humans is limited.  

A 2009 Japanese study investigated the impact of  ingesting 0 mL, 15 mL (1 tbsp), or 30 mL (2 tbsp) of acetic acid daily over 3 months in 175 individuals.  The abstract states that body weight, BMI, visceral fat area, waist circumference, and serum triglyceride levels were significantly lower in both vinegar intake groups than in the placebo group.  However, it is important to always read the details of the study.  The participants were not aware if they were receiving placebo (no intervention) or one of the vinegar containing beverages.  They drank the study beverage twice daily, after breakfast and dinner.  Participants also kept food/diet diaries, were advised to limit alcohol and other vinegar containing foods during the study, and tracked their physical activity.  There were significantly more males than females in the study and there ended up being less than 60 individuals in each group when they analyzed the results.  When you take a closer look at the results, you can see what the changes from week 0 to week 12 are for each of the measures.  Now, just because a measurement is statistically significant, it does not mean it is clinically or real life significant.  

For example, body weight:

• Change between week 12 and week 0 is ~1.2 kg and ~1.8 kg, respectively, for the low dose and high dose groups.  
• Placebo group gained 0.4 kg.  
• For those drinking the vinegar beverage, weight loss was less than 4 lbs over 3 months.  

Some notable flaws of the study: it doesn’t mention being powered to actually look at these differences, the sample size is small, and the study duration is short.  Also, although the study reports there was no significant difference between the treatment groups for calories consumed and activity, you are relying on human reporting and it’s unclear how accurate the diaries were.  So yes, this small study shows that consuming vinegar may help promote weight loss but it’s not a drastic weight loss over a 3 month period.  The results also need to be studied on a much larger group of individuals with tighter control of other variables.  

Another study looked at the benefits of ACV for weight management in 39 overweight or obese individuals who were also on caloric deficit.   This study was also 12 weeks in duration and had participants consume 30 mL of ACV/day and restrict intake by 250 kcal/day (ACV + RCD group) or just restrict calories (RCD).  The investigators found a 4 kg and 2.3 kg change in weight between week 0 and 12 for the ACV + RCD group and RCD only group, respectively.  Again, the number of participants was small (even less than the first study), individuals had to recall their diet (subject to bias), AND THEY WERE ON A CALORIC DEFICIT; therefore more studies would be needed to support a benefit.  

Just as there is evidence lacking to support ACV for fat loss.  The potential side effects of taking ACV are based off small sample sizes or case reports where individuals consumed large quantities, consistently.  U Chicago Medicine debunked the benefits of ACV in this article and shared the negative possibilities:

• Decay of tooth enamel
• Worsening reflux
• Difficulty processing extra acid in chronic kidney disease

BOTTOM LINE:
There is no magic, quick fix.

A caloric deficit is the most evidence-based method for fat loss. If you still choose to take shots of ACV, then probably a good idea to chase with good old H20 so you save yourself some money at the dentist!