Apple cider vinegar for weight management | Hacker News Reader

Apple cider vinegar for weight management

nutrition.bmj.com

55 pointsjfoster73 comments

Achtung ! Proceed with caution ! Friend of mine was consuming a lot of Apple cider vinegar for what she consider "health and dietary reasons" and end-up with small hole in her stomach. One day, she felt a severe pain ended up in hospital, where they found a hole. It is possible that she had small ulcer that was made worst by the continuous consumption of vinegar. She stopped taking vinegar, took medication for a while and now ulcer is almost gone. Also, if you have acid reflux, vinegar will absolutely destroy your stomach and make your acid reflux 100% worse.

EDIT: I want to bring up another important point. People who suffer from acid reflux might not notice it's effect for years, but if you look at statistics, they suffer from higher rates of stomach and esophagus cancers, worst teeth and myriad of other health issues. Continuously raising your stomach pH might not be good for your in the long run. Keep this in mind when reading this article. Temporarily taking ACV might work, contentiously for years - not a great idea.

My dental hygienist told me about an old client who developed caries in her teeth because of the acid.

Vinegar has a similar pH to a Coke Cola. I would hazard a wild guess that the population drinks significantly more Coke than vinegar.

"as good for your teeth as Coca Cola" is a low bar.

No doubt, but an occasional bolus of vinegar seems less harsh than what many people routinely consume.

Could even mitigate further with a straw

The average consumer is not diluting their Coca Cola at a rate of 15ml Coke to 250 mL water, which is the high end of consumption for this study, 5ml to 250ml being the low end.

I didn't believe you, so I looked it up.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808596

A PH of 2.37 for Coca Cola

https://www.fda.gov.tw/tc/includes/GetFile.ashx?mID=148&id=8...

A mean Ph of 3.10 for Taiwanese apple cider vinegar, and 2.78 for "Imported" apple cider vinegar. Somehow I can't believe what I'm reading but you appear to be correct and if anything are understating your case. Amazing what adding obscene amounts of sugar to a beverage will do to our perception of sourness. What you're saying is so counter-intuitive your post was grey by the time I got to it but unpopular doesn't mean wrong.

Honestly this mostly makes me worry about coca-cola though... maybe we should be diluting it and drinking it through a straw :)

Worth noting that ph is a logarithmic scale.

This means that apple vinegar is more acidic than you might think just by looking at ph if you don’t take that into account.

just for fun, try to convert 2.37 = log_10(x) & 2.78 = log_10(x), and see how large the difference is (A: 234.4 vs 602.6).

Do you know the amount she was consuming and the brand? Total Dosage, dilution and the per unit strength of the ACV brand can really matter, like anything else we might consume.

The paper does do a good job of describing this pretty important detail: "Groups 1, 2 and 3 consumed 5, 10 and 15 mL, respectively, of ACV (containing 5% of acetic acid) diluted in 250 mL of water daily".

I can almost guarantee if that amount went up to 30-50ML and without any kind of dilution, effects can be pretty adverse.

I've been consuming it by diluting a tablespoon of ACV heavily with some warm water that I can barely taste it. It's really helped fix my acid reflux while all the prescription drugs from my PCP didn't seem to do anything.

The placebo was dilute lactic acid of similar pH. So one might imagine that the acidity didn’t cause the effect and try neutralizing the vinegar. Add, for example, calcium carbonate (cheap and safe) to convert most of the acetic acid to calcium acetate, leaving a neutral solution with extra calcium. Whatever magic other compounds in apple cider vinegar are beneficial seem likely to survive that process intact. The net result would be similar to drinking the vinegar and eating an antacid, minus the tooth damage.

> Also, if you have acid reflux, vinegar will absolutely destroy your stomach and make your acid reflux 100% worse

I replaced my Prilosec prescription (for severe acid reflux) with diluted ACV. After a few years, I no longer needed even the ACV, although I occasionally take it for various other claimed benefits. It has been about eight years since I last needed Prilosec. I don't have a hole in my stomach, and in fact am healthier than most people I know - mostly hooked on some meds.

Sounds like your friend did something wrong. Possibilities: she took way too much ACV, or she didn't dilute it. In my experience, it's pretty common for people to mess up even simple [nutrition and healthcare] instructions.

Acid lowers pH.

I was told that sometimes during world wars era my forefathers took long train rides for work etc, and being very poor they only had bread to take with them, but trains would have salt, oil and vinegar in the lunch wagons, so they would mix some salt into vinegar and dip their bread in that. I tried it and now it is something I occasionally enjoy with homemade bread crust.

Makes total sense. You can find Sea Salt & Vinegar chips in most grocery stores. I love it. So why not bread?

I actually never seen those in Europe, very interesting

Salt + vinegar is/was a popular combo growing up in Australia. You’d put them on hot chips (fries) etc. Basically anything involving fried potato.

Our name for this mix at school was 'savegar'.

If you didn't put it on your chips in England, you'd be considered weird :)

I thought this part was interesting, in the Discussion:

> Park et al reported that daily consumption of 200 mL of pomegranate vinegar for 8 weeks significantly reduced total fat mass in overweight or obese subjects compared with the control group without significantly affecting body weight and BMI.

If total fat mass decreases without significantly affecting body weight or BMI, that suggests a change in composition, doesn't it?

The pomegranate vinegar study they reference is this one: https://www.sciencedirect.com/science/article/abs/pii/S17564...

If BMI is unaffected, wouldn't that mean muscle loss as well?

You'd think you'd want BMI to be affected.

BMI is purely a weight/height calculation. If BMI is unchanged that just means total weight is unchanged — meaning, if fat was lost, muscle must have been gained.

> If BMI is unaffected, wouldn't that mean muscle loss as well?

For a given person, BMI is equivalent to weight (because height is fixed). If fat went down, but weight/BMI stayed the same, that would indicate an increase in the non-fat components of body weight.

Nope BMI is just a "weight to height" ratio ( https://www.nhlbi.nih.gov/health/educational/lose_wt/bmitool... )

This can lead to some funny errors in edge cases, like Mr.Universe Arnold being morbidly obese according to BMI

my reading is no change in mass but less fat, meaning gained muscle instead of muscle loss...

That's what I was thinking when I read it, but it seems strange that it isn't explicitly mentioned.

It also seems quite surprising to me that drinking pomegranate vinegar would increase muscle. Makes me wonder if there's something I'm missing.

Which doesn’t really make sense, as drinking ACV alone will definitely not result in a body recomp/the addition of muscle (every meat head lifter, myself included, would be drinking a few bottles a day in that case).

It could have changed their height...

... I'll see myself out.

They're misquoting Park et al. The PV study reduced visceral fat. If you take anything (including coffee) that results in lipolysis, and then don't burn the newly freed fats off with activity, it just goes (re-deposits) somewhere else. Specific to the PV paper, it resulted in a redistribution of the fat from VAT to SAT.

TL;DR: Pomegranate vinegar shifts fat from omentum to subcutaneous tissue. It does not increase muscle mass.

Participant composition:

> A total of 120 individuals (46 men and 74 women) with BMIs between 27 and 34 kg/m2, were enrolled in the study. The mean age of the subjects was 17.8±5.7 years and 17.6±5.4 years in the placebo and experimental groups respectively.

> The majority of participants, approximately 98.3%, were non-vegetarian and 89% of them reported having a high eating frequency, with more than four meals per day.

If this is real, it should be very easy to replicate in further studies. The protocol is exceedingly simple. I hope to see it proven in further studies because this would be an incredibly easy and inexpensive intervention for the billions of people that struggle with their weight.

Seems like it has the potential to be a decent alternative to the weight control drugs that significant portions of the population have recently been starting to take.

Because I see a lot of confusion and wrong information in the comments: It is 15 ml (for our US friends: about 3 teaspoons) of Apple Cider Vinegar diluted in 250 ml (8.45 fluid oz) of water. That's a tiny amount of vinegar! You drink that every morning on an empty stomach.

Some people seem to think they are supposed to drink a glass of vinegar every day …

I wonder if balsamic vinegar has a similar impact. I've been eating salads basically every day for lunch lately with balsamic vinegar and olive oil. I just like the taste and it's so easy to make. Don't need to cook/clean, just whip up some veggies and blast it with balsamic and olive oil.

God, I'd love to know. I could chug balsamic all day.

Be careful with oils of any kind. If you are generous with oil, you will gain weight.

Some oils are very healthy, for example true virgin olive oil (if you reliably get hold on it), so don't omit. Just use very little. Literally only drops of oil. Then you'll be good with salad.

One recipe: Cucumber and tomato salad: Peel and slice cucumber, generously salt it and let it stay for five minutes. Meanwhile cut tomatoes and arrange them on the plate. Salt them a little bit as well. Optionally have a slice of healthy bread and if needed some protein food like a small slice of grilled poultry, one egg, fish, grilled tofu, a bowl of yogurt and whatever. Pour away the water that the salt pulled out of the cucumber, then dress the tomatoes and the cucumber. Sprinkle some spices like pepper, basil, cilantro, oregano, thyme, and so on to your taste over your salad. If you like garlic, add it as well but only in minuscule amounts! Then: Pour five to ten drops of true virgin olive oil onto the cucumber and tomato slices and a few good dashes of balsamic or a little bit of apple cider vinegar.

Enjoy!

Note: If you are very hungry, eat a lot of salad and add enough protein.

this is unnecessary fear mongering about fats. you can put more than 10 drops of olive oil on your vegetables.

I mean I agree but the recipe sounds great

Japanese has long touted drinking various types of vinegar

https://www.amazon.co.jp/-/en/gp/bestsellers/food-beverage/7...

I always try random ones out whenever I get a chance. Never realising you need 200ml a day though, I find myself starting to reject it after 50-60ml in one setting.. perhaps I should push on next time

Don't. Paracelsus said (paraphrased): All is poison. It's the amount that makes something a poison.

So listen to your body and stop before you damage yourself.

Edit, I wonder if they looked at the overall ingredients in the diet intake, specifically how much sugar vs, say, fats, carbs, grains, water their intake was..

---

My mom taught me to do this!

I have a lot of Apple Cider V sin my cuppoard right now, but I rarely drink it. Its not tasty. But Ill do it when I get a "cleans you body" urgent feeling... (gunna do so now that we had this post)

She also taught me to eat a whole clove of garlic each day (swallow, dont chew, obv)

And to sage my house frequently, but... hippies...

This would be buterate effects on the lower gut?

> Results Our findings showed that daily consumption of the three doses of ACV…

> Groups 1, 2 and 3 consumed 5, 10 and 15 mL, respectively, of ACV (containing 5% of acetic acid) diluted in 250 mL of water daily, in the morning on an empty stomach, for 12 weeks.

So, which is it? Daily consumption of 3 doses OR once in the morning on an empty stomach?

Did I miss something?

My understanding the "three doses" is referring to the 5, 10, 15 mL amounts not 3 doses a day. Later on it says that the amount itself didn't seem to have as much of an effect as dose + time did.

I think they mean the 3 doses (dosages) as in 5, 10 and 15mL

I found this confusing, too. My take is that by "three doses" they are referring to the 5, 10 and 15ml, since effects were found for all of those groups.

There are 3 groups that all take one dose in the morning on an empty stomachc.

Group 1: 5ml + 250lm water

Group 2: 10ml + 250lm water

Group 1: 15ml + 250lm water

I drink a mixture of water, raw apple cider vinegar, and Stevia extract occasionally because I like the taste of tart apple juice but don't want the sugar that comes with such. I haven't noticed an appreciable loss of fat - I'd love to know what the hypothetical mechanism of action for this is.

marketing. that's the mechanism of action.

maybe, long shot maybe, it has something to do with vinegar bacteria getting into the gut, but in that case a probiotic style pill should do the same thing.

You’re suggesting that “Big Apple Cider Vinegar” put this study out as marketing?

The effect here seems to have little to do with gut microbiota: acetic acid itself induces the liver to stop making fats (lipogenesis) and start liberating fats into the blood (lipolysis). AcOH also by itself seems to decrease insulin resistance/increase insulin sensitivity, as well as downregulate gluconeogenesis. Several of the other studies in the bibliography confirmed this, and a couple even did tissue biopsies pre during and post to assess for changes in genetic expression of things like AMPK.

I’ve bought some apple cider vinegar at my local farmers market and it can be made to taste petty good actually! Not cheap though.

ACV is very cheap. The problem is that most urban "farmer's markets" have become incredibly bougie.

Consumption of highly acidic substances is extremely harmful to the enamel of your teeth.

Is no one's bullshit detector going off reading this? Looking at table 2, the effect size is insanely huge.

It's certainly very surprising. Either bullshit or a significant discovery.

Mine was but surprisingly this looks legit.

longitudinal design is good but where are the spaghetti plots.

Longitudinal design would usually refer to an observational study, but lest other readers be confused by your comment, this is -- from the title -- a "a randomised, double-blind, placebo-controlled study."

In my opinion, compared to numerous studies in the same category, the placebo seems very reasonable, and the dose-dependent effect size seems highly suggestive of a real effect.

I hope additional / larger studies confirm the effect, and if so that a metabolic ward study can help us determine where the effect is taking place! (Food diaries are better than nothing, but notoriously inaccurate.)

Its longitudinal in the sense that they are measuring change in outcome variables over time, even if in this case its not over the period of years. In this case it is a longitudinal randomized experiment.

200ml/day at $7.47/L AUD you'd really hope it was worth it!

That's a nauseating amount of apple cider vinegar.

By far the biggest concern. I suppose if you dilute it into a liter it would be slightly less horrible to suck down.

At some point you might as well go on and make yourself a shrub

https://www.feastingathome.com/shrub-recipe/

I actually like the taste, it's quite low vinegar/water ratio - especially after heavier meal it feels very good.

What also works for me is using carbonated water (soda stream) - this combination is surprisingly good.

Immediately after posting this, I started wondering what is the composition of a kombucha. Turns out the fermentation process creates acetic acid, so basically the same thing (but at a nifty inflated price).

Ergo, a bolus of vinegar, probably not all that bad, because I will chug down the occasional 200-500 mL kombucha without issue.

If you're worried about the cost of kombucha, you can bring it down close to zero by doing it yourself. It's as easy as replicating kefir.

Can't imagine what it is doing to your teeth long term.

If you dilute it, and then rinse your mouth out with water ... not much. At least my teeth are fine after years of this.

Not sure where you got that number... Protocol described in the paper was:

>Groups 1, 2 and 3 consumed 5, 10 and 15 mL, respectively, of ACV (containing 5% of acetic acid) diluted in 250 mL of water daily, in the morning on an empty stomach, for 12 weeks.

That's like $10/wk - which seems incredibly cheap for any sort of supplement if it actually works.

In US, Costco carries a 3 32Oz (946 ml) bottle pack for I think less than $10.

So at 10ml/day, it’ll come to less than $10 for 283 days or 40 weeks.

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