Apple cider vinegar is a type of vinegar made from apple cider that has undergone fermentation — first fermented by yeast and bacteria, which turns the sugars into alcohol, and then a second fermentation process in which the alcohol is converted into acetic acid

The fermentation process increases the probiotics and enzyme content, and in turn, drastically reduces sugar content and fewer calories than apple cider or apple juice.

This fermentation process contributes to the numerous health benefits of apple cider vinegar.  Link, R(2022) article explained that it only takes one to two tablespoons of apple cider vinegar to get the positive effects of apple cider vinegar, and each tablespoon clocks in at just three to five calories and contains minimal sugar.

Apple cider vinegar has been consumed for thousands of years. Records show that we’ve been fermenting apple juice into vinegar since well before 5000 B.C.

It has been confirmed that in ancient Greece, Hippocrates used to prescribe it mixed with a bit of honey to help treat coughs and colds.

In the 17th century, Europeans began using vinegar medicinally. They started preparing it in syrups and antiseptics and even used it as a gargle to kill off germs.

Literature supporting Apple Cider Vinegar

Useful ingredients

Budak et al. (2014) found that two stages are involved in making apple cider vinegar. In the first stage, the producer exposes crushed apples to yeast, which ferments the sugars and turns them into alcohol.

In the second stage,  the producer adds bacteria to help ferment the alcohol, converting it into acetic acid — the main active compound in vinegar.

Ho et al.(2017) explained that acetic acid provides vinegar with a strong sour smell and flavor. The researchers held the view that this acid is accountable for apple cider vinegar’s health benefits. Cider vinegar is 5–6% acetic acid.

Another substance called mother is found in organic, unfiltered apple cider vinegar, this is made of components of proteins, enzymes, and friendly bacteria that provide the product a foggy appearance.

Link held that there is this notion that the mother is the key substance that gives apple cider vinegar health benefits, though studies are not found to buttress this assertion.  Though vitamins and mineral content are limited, apple cider vinegar contains some amount of potassium. Some good brands also contain amino acids and antioxidants.

Destroys bacteria

One study (Yagnik et al. 2018) agrees that Pathogens, including bacteria, can be destroyed by Vinegar. Traditionally,  indigenous have used vinegar for cleaning and disinfecting, treating nail fungus, lice, warts, and ear infections.

Hippocrates, the father of modern medicine, used vinegar to clean wounds over 2,000 years ago.

Other studies(Yagnik et al. 2018; Park et al. 2016; Etani et al.1998) also held that Vinegar can act as a food preservative. They found that it inhibits bacteria like E. coli from increasing in and spoiling food. This means that apple cider vinegar is a natural remedy for food preservation.  One article by  SaVanna Shoemaker, (2021) suggests that diluted apple cider vinegar may help with acne when used on the skin, though studies are yet to support this.

Lower Blood sugar

One of the most well-researched and convincing area vinegar is applied is to, treat type 2 diabetes. Also, for those who are concerned with preventing diabetics, then using apple cider vinegar is one of the natural ways to keep their blood sugar levels in the normal range.

The following studies convincingly support the use of apple cider vinegar in managing sugar and insulin levels: 

  • Carol et al.(2004) small study found that vinegar could improve insulin sensitivity by 19–34% during a high-carb meal and drastically lower blood sugar and insulin response.
  • In another old small study (Brighenti et al. 1995) in 5 healthy people, vinegar decreased blood sugar by 31.4% after eating 50 grams of white bread.
  • Andrea et al. (2007)  small study in people with diabetes found that eating  2 tablespoons of apple cider vinegar before bedtime reduced fasting blood sugar by 4% the following morning.
  • Johnston et al.(2004) suggest that vinegar ingestion helped significantly improve insulin sensitivity by up to 34 percent in those with either type 2 diabetes or insulin resistance.
  • Others(Shishehbor et al. 2017; Lim et al. 2016)in humans demonstrate that vinegar may improve insulin function and lower blood sugar levels after meals.

Though The National Centers for Complementary and Integrative Health (NCCIH) advises against replacing medical treatment with unproven health products.  To make sure that your blood sugar is normal, try diluting one to two tablespoons of apple cider vinegar in eight ounces of water and consuming it before meals.  Others on pharmaceutical drugs for lowering blood pressure should inform their doctors before increasing their intake of any type of vinegar.

Weight loss

Numerous studies have confirmed that apple cider vinegar may help with weight loss. For instance,  (Östman et al. 2005; Johnston et al. 2005) found that vinegar can increase feelings of fullness. This can lead to eating fewer calories and losing weight. They concluded that consuming vinegar with a high-carb meal led to increased feelings of fullness, and this made participants eat 200–275 fewer calories throughout the day.

Kondo et al.(2014), a study of 175 people for 3 months with obesity found that daily apple cider vinegar intake led to decreased belly fat and weight loss with the following prescription and outcomes:

  • taking 1 tablespoon (15 mL) led to a loss of 2.6 pounds (1.2 kg)
  • taking 2 tablespoons (30 mL) led to a loss of 3.7 pounds (1.7 kg)

Apple cider vinegar only contains about three calories per tablespoon, which is very low.

Reduces cholesterol

Cholesterol is a fat-like substance that can build up in the arteries, causing them to narrow and harden. High blood cholesterol puts a strain on your heart, forcing it to work harder to push blood throughout the body.

Link, R(2022) article held that apple cider vinegar may enhance heart health by maintaining low cholesterol.  The author further attributes this to one animal study from  Iran that found that giving rats apple cider vinegar decreased bad LDL cholesterol and triglyceride levels, and increased beneficial HDL cholesterol.

The author also concludes that when we add a tablespoon or two of apple cider vinegar to our diet daily, helps maintain low cholesterol levels.

Enhance Healthy Heart

Today, there are rising cases of heart disease in the Ghanaian community. However, there are many effective natural ways to manage these conditions. Several studies attest that vinegar may improve several of these risk factors. However, many of the studies were conducted on animals.

For instance, (Fushimi et al. 2006; Setorki et al. 2010; Halima et al. 2018) animal studies found that apple cider vinegar may reduce cholesterol and triglyceride levels,  and many other heart disease risk factors.

Other studies( Na et al. 2018; Kondo et al. 2001)  in rats found that vinegar lowers blood pressure, which is a major risk factor for heart disease and kidney problems. Finally, another animal study(Honsho et al. 2005).

Enhance Skin Health

An older study(Entani et al. 1998) established that vinegar is well-known for its antibacterial properties and is effective against many strains of harmful bacteria. Fast forward, another study( Wang et al. 2014) found that vinegar also contains special c constituents like acetic acid, lactic acid, succinic acid, and citric acid,  which study demonstrate to inhibit the growth of Propionibacterium acnes, the specific strain of bacteria responsible for causing acne.

Due to this, Sachdeva, S(2010) study found that these helpful constituents could also lower scarring.  The study further found that treating acne scars with lactic acid for three months led to improvements in the texture, pigmentation, and appearance of treated skin, as well as a lightening of scars.

Fast forward, to another study, Lee et al.(2016) agreed that apple cider vinegar treats eczema and dry skin, a common remedy for skin conditions. Lee et al.(2016) also note that due to the acidic nature of the skin, applying vinegar may rebalance the natural pH of the skin,  thus protecting the skin barrier.  Dlova et al.(2017) study established that alkaline soaps and cleansers may irritate eczema, thus worsening symptoms.  Hence, due to its antibacterial properties, apple cider vinegar may, in theory,  help avert skin infections linked to eczema and other skin conditions.

Link, further explained that some people use diluted apple cider vinegar in a face wash or toner. The idea is that it can kill bacteria and prevent spots.

This notwithstanding, a recent study(Linda et al. 2019) on 22 people with eczema found that apple cider vinegar soaks did not improve the skin barrier and caused skin irritation.

Due to this, one study by Feldstein et al. (2015) advised you to discuss with your doctor natural remedies for damaged skin and undiluted vinegar to the skin, as it can cause burns.

Helps with Acid Reflux

Gastroesophageal reflux disease, also known as GERD or acid reflux, is a condition triggered by acid backflow from the stomach up into the esophagus, causing symptoms like heartburn, belching, and nausea.

Link, R(2022) explained that acid reflux is often a result of having low stomach acid. If this is the case for you, consuming apple cider vinegar may help provide relief from acid reflux symptoms by introducing more acid into the digestive tract to prevent acid backflow.

Neiworth-Petshow and  Baldwin-Sayre(2018) provided a case study involving a 73-year-old woman with Parkinson’s disease who suffered from chronic acid reflux and constipation found that a combination of apple cider vinegar, DGL licorice, and a probiotic and magnesium supplement resulted in a 50 percent improvement in acid reflux after five days and complete resolution of symptoms after one month.

Link recommended that in case you want to use vinegar for this condition,  dilute one to two tablespoons of apple cider vinegar in an eight-ounce glass of water, and drink it just before eating.

Dosage and Usage

Gunnars, K(2021) suggests that it is best to use apple cider vinegar in cooking. It’s a simple addition to foods like salad dressings and homemade mayonnaise.

Also, it can be diluted in water and drunk as a beverage. Common dosages range from 1–2 teaspoons (5–10 mL) to 1–2 tablespoons (15–30 mL) per day mixed in a large glass of water.

It’s best to start with small doses and avoid taking large amounts. Too much vinegar can cause harmful side effects, including tooth enamel erosion and potential drug interactions.

Some dietitians recommend using organic, unfiltered apple cider vinegar that contains “mother.” Bragg seems to be one of the most popular brand options. several other varieties are also available.

Others to watch out for (Link, 2022):

  • Organic Apple Cider Vinegar: If your apple cider vinegar is labeled as certified organic, it means that it’s free of genetically modified organisms and synthetic additives that can do more harm than good in terms of your health.
  • Raw Apple Cider Vinegar: Raw apple cider vinegar is unheated and unprocessed. This means that it still has the “mother” intact, which is a cluster of proteins, enzymes, and beneficial bacteria often removed during processing. Consuming apple cider vinegar with mother intact ensures that you’re able to maximize the potential health benefits of this powerful ingredient.
  • Unfiltered Apple Cider Vinegar: For most apple cider vinegar uses, you’ll also want to go for unfiltered apple cider vinegar. When apple cider vinegar is filtered, it removes the mother as well as any sediment, leaving behind a clear, amber vinegar.


According to Link, R(2022) though apple cider vinegar consumption is healthy and safe for most people, consuming large amounts can lead to some negative effects on health.  A recent study(Chang et al. 2020) found that apple cider vinegar side effects include erosion of tooth enamel, burning of the throat or skin, and decreased levels of potassium.  Hence, it is advisable to always dilute apple cider vinegar in water instead of drinking it straight to prevent negative side effects.

It is also advisable to always start with a low dose and work your way up to assess your tolerance.

Those on blood sugar medications should discuss this with their doctors before using apple cider vinegar. Because apple cider vinegar may help reduce blood sugar, you may need to modify your dosage of diabetes medications to prevent hypoglycemia symptoms.

One old case study(Lhotta et al. 1998) confirmed that taking large amounts caused low potassium and decreased bone formation due to the high acidity. Therefore, it’s important to keep intake in moderation and avoid consuming very high amounts to prevent negative side effects.

Finally, Link, R(2022) concluded that though there is a wide range of apple cider vinegar uses, it shouldn’t be viewed as a quick fix or cure when it comes to your health. Instead, it should be paired with a nutritious diet and healthy lifestyle to see results and the best apple cider vinegar benefits.

Take Home

  • One of the convincing health conditions supporting the use of apple cider vinegar is diabetes.
  • Apple cider vinegar also helps improve weight loss, reduce blood pressure and cholesterol, enhance skin health, and relieve acid reflux symptoms.
  • In using,  mix one to two tablespoons in a glass of water. Otherwise, use it in salad dressings, detox drinks, or DIY recipes such as facial toner or hair rinse.
  • Choose raw, unfiltered, and organic apple cider vinegar with the mother still intact as this type of apple cider vinegar provides the greatest impact.
  • Remember to dilute apple cider vinegar in water, use it in moderation, and pair it with a nutritious diet and healthy lifestyle to maximize apple cider vinegar benefits.


Prof. Nyarkotey has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations to justify his write-ups.  My articles are for educational purposes and do not serve as Medical advice for Treatment. I aim to educate the public about evidence-based scientific Naturopathic Therapies.

The writer is a Professor of Naturopathic Healthcare, President, of Nyarkotey College of Holistic Medicine & Technology (NUCHMT)/African Naturopathic Foundation. E-mail:


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