What does the research show about apple cider vinegar?

Apple cider vinegar

In type 2 diabetes, pooled trials found lower fasting glucose and HbA1c with apple cider vinegar. Two reviews found lower total cholesterol. One 2025 meta-analysis reported small weight and BMI reductions but included a retracted trial, and another found no BMI change. Vinegar slowed stomach emptying in diabetic gastroparesis. Tested tablets varied widely and may not contain vinegar.

Add to Bio HackChecked 2026-11-09

Status: Food, and sold as dietary supplement tablets and gummies in the US.
Also called: ACV, cider vinegar, apple vinegar, ACV gummies, ACV tablets, acetic acid
Taken for: weight loss, blood sugar, cholesterol, appetite, digestion, belly fat

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help2

StrongShown to lower fasting blood sugar and HbA1c in adults with type 2 diabetes. In apparently healthy participants, fasting glucose rose instead.
StrongShown to lower total cholesterol by about 6 mg/dL in adults, with no change in LDL or HDL.

Reported risks3

LimitedOne small study found 30 ml of ACV with a meal slowed stomach emptying in 10 adults with type 1 diabetes and gastroparesis.How often is not known
LimitedCase reports: one person had throat injury from an ACV tablet. Tests of 8 tablet brands found wide variation and doubt that ACV was in them.How often is not known
LimitedLab studies only: enamel slices from extracted teeth soaked in vinegar for 4 to 8 hours lost minerals, up to about 20%.How often is not known

What people take it for, and what was found

Shown to help2

Strong

Blood sugar

Shown to lower fasting blood sugar and HbA1c in adults with type 2 diabetes. In apparently healthy participants, fasting glucose rose instead.

The numbers and sources

Effect: In 7 controlled trials in type 2 diabetes, ACV lowered fasting blood sugar by 21.9 mg/dL (95% CI -29.19 to -14.67) and HbA1c by 1.53 (95% CI -2.65 to -0.41), with no change in HOMA-IR [1]. Across 9 studies in adults, ACV lowered fasting glucose by 7.97 mg/dL (95% CI -13.74 to -2.21) and HbA1c by 0.50 (95% CI -0.90 to -0.09), with no change in fasting insulin or HOMA-IR [2]. A review of 6 studies in 317 people with type 2 diabetes found lower fasting glucose and HbA1c with vinegar [3].
Population: Adults with type 2 diabetes [1][3]. Adults with and without diabetes [2].
Sources: [1], [2], [3]
Caveats: Heterogeneity for HbA1c was high (I² 91%) [2]. Vinegar content varied across studies and samples were small [3]. In apparently healthy participants, fasting glucose rose [2].

Strong

Cholesterol

Shown to lower total cholesterol by about 6 mg/dL in adults, with no change in LDL or HDL.

The numbers and sources

Effect: ACV lowered total cholesterol by 6.06 mg/dL (95% CI -10.95 to -1.17) with no significant effect on LDL or HDL [2]. A 2025 meta-analysis of 25 trials found total cholesterol 6.72 mg/dL lower (95% CI -12.91 to -0.53, I² 50.8%), with no significant change in LDL, HDL or triglycerides [4].
Population: Adults in 9 studies [2]. 1,320 adults in 25 trials [4].
Sources: [2], [4]
Caveats: Triglyceride reductions appeared only in subgroups [2][4].

Mixed results1

Limited

Body weight

Limited evidence: one review found lower weight, but it included a trial later retracted. A larger review found no change in BMI.

The numbers and sources

Effect: In 10 RCTs (789 participants), daily ACV reduced body weight (SMD -0.39, 95% CI -0.63 to -0.15), BMI (SMD -0.65) and waist circumference (SMD -0.34), with no change in other body composition measures [5]. In obese Japanese adults, a drink with 15 or 30 ml of vinegar a day for 12 weeks lowered body weight, BMI, visceral fat and waist circumference compared with placebo [6]. A 2025 meta-analysis of 25 trials found no significant change in BMI [4].
Population: Adults with overweight, obesity or type 2 diabetes [5]. Obese Japanese adults [6]. 1,320 adults in 25 trials [4].
Sources: [5], [6], [4]
Caveats: The 10-trial meta-analysis included a 2024 Lebanese trial [5] that was retracted in September 2025 because its analyses could not be replicated, multiple errors were found, and the dataset showed patterns inconsistent with random allocation [7]. The Japanese trial tested vinegar not specified as apple cider vinegar, and its lead author worked for Mizkan Group, a vinegar maker [6].

Doses studied

In diabetes trials, each 1 ml a day was associated with 1.255 mg/dL lower fasting blood sugar, and larger effects were seen above 10 ml a day [1]. Lipid subgroup effects were seen at 15 ml a day or less over more than 8 weeks [2]. The Japanese weight trial used 15 or 30 ml a day in a drink [6]. The gastric emptying study used 30 ml [8].

Risks

Reported risks3

LimitedHow often is not known

Slower stomach emptying in diabetic gastroparesis

One small study found 30 ml of ACV with a meal slowed stomach emptying in 10 adults with type 1 diabetes and gastroparesis.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: In 10 patients with type 1 diabetes and gastroparesis, 30 ml of ACV with a meal lowered the median gastric emptying rate from 27% to 17% (p < 0.05). The authors note this could be a disadvantage for glucose control [8].
Population: 10 adults with type 1 diabetes and gastroparesis [8].
Sources: [8]
Caveats: One small pilot crossover study.

LimitedHow often is not known

Tablet contents and throat injury

Case reports: one person had throat injury from an ACV tablet. Tests of 8 tablet brands found wide variation and doubt that ACV was in them.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: After an adverse event report of esophageal injury from an ACV tablet, 8 tablet products were tested. Tablet size, pH, acid content and label claims varied widely between brands, and it was doubtful whether ACV was an ingredient in the products tested [9].
Population: Product testing following one case [9].
Sources: [9]
Caveats: One 2005 sample of 8 products.

LimitedHow often is not known

Tooth enamel

Lab studies only: enamel slices from extracted teeth soaked in vinegar for 4 to 8 hours lost minerals, up to about 20%.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Human enamel slices soaked in five vinegars for 4 to 8 hours lost minerals. Losses reached about 20% at 45 µm depth after 8 hours with one vinegar [10].
Population: In vitro, extracted human teeth [10].
Sources: [10]
Caveats: The authors note in vitro results cannot be translated directly to the mouth [10].

Claims tested and not found

That ACV lowers LDL cholesterol. LDL did not change significantly across pooled trials [2][4].
That ACV improves insulin resistance. HOMA-IR did not change in pooled trials [1][2][4].

Sources

Arjmandfard D, Behzadi M, Sohrabi Z, Mohammadi Sartang M. Effects of apple cider vinegar on glycemic control and insulin sensitivity in patients with type 2 diabetes: A GRADE-assessed systematic review and dose-response meta-analysis of controlled clinical trials. Frontiers in Nutrition. 2025. https://doi.org/10.3389/fnut.2025.1528383
Hadi A, Pourmasoumi M, Najafgholizadeh 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 Complementary Medicine and Therapies. 2021. https://doi.org/10.1186/s12906-021-03351-w
Cheng LJ, Jiang Y, Wu VX, Wang W. A systematic review and meta-analysis: Vinegar consumption on glycaemic control in adults with type 2 diabetes mellitus. Journal of Advanced Nursing. 2020. https://doi.org/10.1111/jan.14255
Tehrani SD, Keshani M, Rouhani MH, et al. The Effects of Apple Cider Vinegar on Cardiometabolic Risk Factors: A Systematic Review and Meta-analysis of Clinical Trials. Current Medicinal Chemistry. 2025. https://doi.org/10.2174/0929867331666230822102021
Castagna A, Ferro Y, Noto FR, 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. https://doi.org/10.3390/nu17183000
Kondo T, Kishi M, Fushimi T, et al. Vinegar Intake Reduces Body Weight, Body Fat Mass, and Serum Triglyceride Levels in Obese Japanese Subjects. Bioscience, Biotechnology, and Biochemistry. 2009. https://doi.org/10.1271/bbb.90231
BMJ Nutrition, Prevention & Health. Retraction: Apple cider vinegar for weight management in Lebanese adolescents and young adults with overweight and obesity: a randomised, double-blind, placebo-controlled study. BMJ Nutrition, Prevention & Health. 2025. https://doi.org/10.1136/bmjnph-2023-000823ret
Hlebowicz J, Darwiche G, Björgell O, Almér LO. Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC Gastroenterology. 2007. https://doi.org/10.1186/1471-230X-7-46
Hill LL, Woodruff LH, Foote JC, Barreto-Alcoba M. Esophageal Injury by Apple Cider Vinegar Tablets and Subsequent Evaluation of Products. Journal of the American Dietetic Association. 2005. https://doi.org/10.1016/j.jada.2005.04.003
Willershausen I, Weyer V, Schulte D, et al. In Vitro Study on Dental Erosion Caused by Different Vinegar Varieties Using an Electron Microprobe. Clinical Laboratory. 2014. https://doi.org/10.7754/clin.lab.2013.130528

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