YYou may have noticed your supermarket offering more types of vinegar these days. Of course, balsamic vinegar and apple cider vinegar are long-standing products in the condiment industry, but other products such as coconut, champagne, pomegranate and raspberry are starting to emerge.
This may be due in part to recent research showing that small amounts of vinegar, consumed daily, can support your health in important ways. But which vinegars have been proven to improve health, as well as adding zest to your cooking?
Here’s what research says about vinegar’s effects on blood sugar, obesity, and fighting the flu—and what type of vinegar to take.
A long-standing tonic
Since the Babylonians first made vinegar some 7,000 years ago, cultures around the world have used it for medicinal purposes. Hippocrates mixed apple cider vinegar with honey to treat the respiratory problems of the ancient Greeks. Europeans in the Middle Ages believed that rice vinegar could protect against disease, while the Chinese used rice vinegar to treat pain.
Several scientific studies later, dietitians like New Jersey-based Erin Palinski-Wade are increasingly recommending vinegar to their clients. “What I love about using vinegar is that it can offer a variety of benefits without any downsides,” he says.
What makes vinegar special
One key ingredient that may explain vinegar’s health benefits: acetic acid. Once swallowed, acetic acid turns into acetate, a fatty acid that is good for digestion, metabolism and energy production.
Every type of vinegar starts with some form of sugar, aka carbohydrate—like apples, which are used to make apple cider vinegar, or grapes, which make red wine vinegar. Carbohydrates are pressed into liquid form and fermented by yeast into alcohol, which is then fermented into acetic acid. This process produces far more acetic acid in vinegar than in other foods, says Carol Johnston, a nutrition professor at Arizona State who studies vinegar.
The FDA requires that all vinegar sold in the US contain at least 4% acetic acid, although different bottles have that range. Some vinegars, especially balsamic, tend to also be high in polyphenols: compounds in plants that protect us from cell damage, inflammation, and infection.
Apple cider vinegar
The most researched type is apple cider vinegar, or ACV. Studies show that a small amount of ACV before or during a meal can lower blood sugar, or glucose, as measured immediately after a meal and, if used consistently, can contribute to improved blood sugar control over several months. This effect is most apparent with foods high in carbohydrates, which can increase blood sugar. “It’s clear that drinking vinegar with starchy foods will reduce the amount of glucose in the bloodstream,” says Johnston.
He and other researchers found that the acetic acid in ACV affects certain hormones that slow the rate at which food is delivered to the intestines. Because glucose enters the bloodstream gradually, regular intake of ACV over time may reduce the risk of developing type 2 diabetes.
Small studies have also shown healthier body weights, possibly due to the stomach-slowing effects of vinegar. And recent research found lower blood fat levels in overweight adults who consumed ACV, indicating better heart health, in addition to lower glucose.
Most of these benefits have been researched using 2-4 tablespoons per day. But larger studies are needed, said Sapha Shibeeb, a senior lecturer in laboratory medicine at RMIT University in Australia who published a review of research on ACV. “There is indeed an impact, but we have to be careful in stating what the impact is and how big it is.”
Mother of all benefits
Some brands of ACV are unfiltered and unpasteurized, with the result being obvious: a cloudy substance floating in the liquid. This fuzzy residue, called the “mother,” contains small amounts of protein and healthy enzymes and bacteria from fermentation. The company claims that the mother is contributing to the benefits of ACV—and charges more for this raw ACV.
Some scientists think it’s worth it. In her lab, Darsha Yagnik, an immunologist at Middlesex University, found that maternally administered ACV was uniquely potent in helping immune cells kill pathogenic microbes in the lab. “When I look at other vinegars, they’re not as effective,” he says, as are stronger acids that you wouldn’t eat, like sulfur. “The mother contains microbiome-friendly bacteria that support digestive immunity and nutrient absorption,” says Yagnik.
Based on this research, Yagnik argues that ACV, in addition to improving blood sugar, may also help prevent disease—as the ancients believed. Yagnik always packs a small bottle of ACV diluted with water when traveling on the tube in London. “If anyone nearby has a cold, I’m going to get a little cold,” he said. “I think it’s really helpful.”
“Because the host contains bacteria, it can be beneficial as part of a healthy microbiome in the gut,” adds Shibeeb. He notes that the more expensive vinegars with their parent are still quite cheap.
Others don’t buy it. Robert Hutkins, a microbiologist at the University of Nebraska, says that although maternal microbes can work wonders in the laboratory, they cannot compete or thrive in our microbiome because they need air to survive. “They won’t make much of a living in the gut” because it kills pathogens, he explained.
Johnston says mothers only have “small amounts” of the healthy substance, providing nothing but the benefits of acetic acid. “There’s no point in getting the baby the mother had,” he said. “Right now, the science is focused on acetic acid,” which is in all vinegars regardless of type, which has benefits such as lowering blood sugar.
Vinegar fermentation may have advantages
The vinegar fermentation process is different from fermented vegetables such as cucumbers and cabbage, which may yield some unique benefits.
Vegetables are fermented using healthy microbes. When eaten, microbes pass through the gut microbiome, where they slowly produce some fatty acids that fight infection and inflammation.
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One of these fatty acids is acetate. But when making vinegar, fruit fermentation can work more directly. Fruit fermentation produces acetic acid, which is converted into acetate before it reaches your intestines—so it is absorbed more quickly, potentially making it a valuable energy source for cells. “Essentially, what you’re doing is ignoring the need for the microbiome to do the job,” Johnston said.
Fermented foods like vegetables with live microbes provide equally important—or perhaps greater—benefits. “I highly recommend incorporating these fermented foods into one’s diet,” Hutkins says. Try to make a mixture, including types of vinegar. “ACV is not a superfood because there is no such thing. Each of these foods is just part of an overall healthy eating pattern.”
Red wine and balsamic vinegar
The benefits of ACV may apply to some other types of vinegar. ACV is generally sold in the US simply because apples are popular here, not because they are particularly healthy or flavorful. “It’s marketing,” Johnston said. “In the Mediterranean, they have a lot of grapes, so they have more balsamic vinegar and red wine vinegar.”
Johnston found that a few tablespoons of red wine vinegar, consumed daily, improved glucose control and, in just four weeks, people’s depression levels decreased. Again, the acetic acid in vinegar could be the culprit; acetate plays a role in improving brain inflammation, plasticity, and overall cognition.
Polyphenols may also contribute. Red wine vinegar has more polyphenols than other fruit vinegars, with antioxidant effects that may fight depression, the study authors wrote.
Another vinegar high in polyphenols is balsamic, especially the versions made in parts of Italy. “The polyphenols are concentrated,” says Johnston, resulting in a thicker, darker vinegar. Look for bottles, although more expensive, with production specifications in the Modena and Reggio Emilia regions. Balsamic vinegar, when combined with food, can slow stomach enzymes for better digestion.
The rest of the package
Some findings suggest that rice vinegar offers similar benefits. Only a few studies have looked at other vinegars, such as coconut, pomegranate, or sugar cane. Limited research shows that cane vinegar, for example, lowers blood fats.
This under-researched vinegar is lower in acetic acid and polyphenols than apple cider, red wine, and balsamic. But they still offer more acetic acid than non-vinegar foods; Palinksi-Wade recommends letting your taste preferences guide you. Vinegar may also contain at least some nutrients from its original food sources, compared to standard white vinegar, which is produced through a simple fermentation process that removes most of the potentially beneficial compounds, Hutkins adds.
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Last year, Hutkins and colleagues at Georgetown University Medical Center found that drinking kombucha—containing vinegar, live microbes, and other beneficial ingredients like ginger—positively affected blood glucose.
How to drink vinegar
While vinegar may be good for you, “it’s not a cure,” Johnston says. As part of an overall healthy diet, “the effects will be more gradual on measures like blood sugar” than medications.
Precautions should be taken with vinegar because of its acetic acid; in concentrated form, it can damage the teeth, mouth, and throat. Avoid direct injection of vinegar. Mix with water, juice, or food. “Don’t overdo it,” Johnston said. “You are dealing with acid.”
People who suffer from chronic kidney disease should be especially careful about consuming vinegar, as their kidneys are challenged to process the excess acid from the vinegar.
Dilute one tablespoon into 8 ounces of liquid, Palinski-Wade says, and consider drinking through a straw. “Maybe rinse your mouth with water afterward, just to make sure your tooth enamel is protected,” suggests Yagnik.
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Avoid consuming more than four tablespoons per day. “The highest amount you can aim for is two tablespoons after one meal, and two tablespoons after the second meal of the day,” says Johnston. If you’re new to vinegar, start slowly with one tablespoon each day. “Increase gradually to avoid digestive problems,” says Palinski-Wade.
To get the blood sugar benefits, drink vinegar before your heaviest meal, says Shibeeb. Yagnik drinks it 5-10 minutes after eating in the hope that it will help his immunity.
If you cook vinegar to make a dressing, such as a balsamic reduction, you may lose some of the acetic acid, along with some of its benefits, Hutkins says.
Pending further research, we do not yet know the long-term benefits of regular vinegar intake, nor the side effects. At least 12 weeks of research did not show any significant losses. Based on what we know today, “experimenting with vinegar in food is a good option for most individuals,” Palinski-Wade says, “with little risk.”
