The apple cider vinegar effect: from regulating blood sugar to improving PCOs

What we’ve learned so far this year

A brief review of some of the more interesting nutrition research so far this year…

Sometimes apparently unrelated subjects turn out to be closely related after all. That became evident from some of the research that emerged during the first few weeks of this year.

Apple cider vinegar stands on the cusp of achieving legendary status. According to both legend and science, it possesses many impressive medicinal properties, not least of all its ability to influence insulin and blood glucose. Is the hype justified?

In January, a systematic review of the research concluded that apple cider vinegar ‘significantly reduced fasting blood sugar’ in people with type 2 diabetes. The effect was dose-dependent: the more taken, the greater the reduction in blood sugar.

Before medical treatments became available, vinegar ‘teas’ were taken by diabetics to help manage their condition.

There’s nothing new about the use of vinegar for therapeutic purposes. Hippocrates (460-377 BC), dubbed the ‘father of modern medicine’ recommended vinegar to clean ulcerations and to treat sores.

A quick perusal of the literature reveals that for decades there has been a steady stream of studies reporting that drinking vinegar after a meal can prevent spikes in blood sugar. Most of these studies do not specify what sort of vinegar has this effect, though white wine vinegar gets an occasional mention.

There are many different types of vinegar. The main ingredient in all vinegars is acetic acid, and it is this acid that appears to be the key to glucose control. Blood glucose control is an important element of appetite and weight management.

What’s not clear, from all the research, is whether all vinegars have this effect or if cider vinegar is in a league of its own.

It is certainly the one that gets all the attention, and it does have its own unique properties. Other than acetic acid, cider vinegar contains many distinct compounds – flavonoids - that have anti-inflammatory and antioxidant properties that may play a role in glucose metabolism. These flavonoids include catechin, ferulic acid, caffeic acid and gallic acid, and the theory goes that these compounds give apple cider vinegar the edge over other vinegars; not just for blood sugar control, but also blood fat regulation.

If you want to experiment with cider vinegar and take it to another level, try adding a couple of tablespoons to a glass of fizzy water.

Another review, also published in January, found that fizzy water increases blood glucose uptake and metabolism. Carbonated water has previously been reported to induce satiety, possibly because anything that normalises blood sugar is likely to normalise appetite. The conclusion of this review was that carbonated water ‘may promote weight loss by enhancing glucose uptake and metabolism in red blood cells’.

The effect was, however, reported to be quite mild. You can increase the effect by combining carbonated water with apple cider vinegar, along with making appropriate dietary changes to regulate blood sugar and appetite.

It’s not just diabetics or the overweight who stand to gain. Women with polycystic ovaries (PCOs) might also benefit from a dose of cider vinegar with carbonated water, if it helps improve blood sugar and insulin resistance.

Approximately 10%-15% of women are affected by PCOs. This condition, characterised by excessive androgen levels, is a major cause of infertility. Symptoms include irregular menstruation, acne and hirsutism. It is a condition that is closely related to insulin resistance, excessive insulin (hyperinsulinemia), type 2 diabetes, obesity and inflammation.

There have been few studies into the effect of cider vinegar on PCOs, though one small trial found that women who drank the vinegar directly after dinner for at least three months experienced improved insulin resistance and normalised hormones and menstruation.

‘These findings suggest the possibility of vinegar to restore ovulatory function through improving insulin sensitivity in PCOS patients’

Another feature of PCOs is dysbiosis – disturbances to the gut microbiota. It is remarkable how everything always comes back to the gut.

Never underestimate the power of your invisible friends; they are the ones pulling all the strings. Also in January, we learned the results of a 12-week trial involving 50 women with PCOs. Half the group were given a placebo and the other half given a probiotic supplement containing nine different strains of Lactobacillus and Bifidobacterium.

Those receiving the probiotics experienced a significant, positive change in hormone levels, as well as weight loss.

That was not the first study of its kind, either. Supplementing with probiotics has previously been found to alter the activity and composition of the gut microbiota, and at the same time produce significant improvements in fasting glucose, insulin levels, insulin resistance and hormonal balance in women diagnosed with PCOs.

For that reason, researchers now acknowledge that ‘Probiotic supplements could be a viable option for treating PCOS in adults’.

Because dysbiosis is common in women with PCOs, treating the condition by first focussing on the gut might be a very good idea. And anything else that contributes to managing glucose and insulin should be considered after that.

Which brings us back to apple cider vinegar. This is a fermented product, meaning it contains good bacteria, in this case lactic acid and acetic acid bacteria. Taking cider vinegar is one way to improve your gut microbiota.

When buying cider vinegar, I recommend you choose the unfiltered, unpasteurised type with the live ‘mother’. You recognise the mother by the cloudy sediment appearance.

You can save the cheaper, processed varieties for cleaning your windows.

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In short, research so far tells us that apple cider vinegar can help stabilise blood sugar. This can be of help not only to diabetics and anyone wishing to lose weight, but also to women with PCOs. There is a link between blood sugar, gut microbiota dysbiosis and the development of PCOs, and cider vinegar can help with all three.