Vim and vinegar: Health benefits of the acidic liquid

Vim and vinegar is a malapropism for the expression vim and vigor, which is a large amount of vitality and energy. Malapropism is when a word or phrase is used by mistake in place of a similar sounding word or phrase. In this case, "vinegar" for "vigor." Vinegars are the result of fermentation giving the liquid its distinct smell. The use of vinegar has been recorded as far back as the 3rd-century B.C. The key component to vinegar solutions is acetic acid. White vinegar is 5-10% acetic acid compared to apple cider vinegar, which is 5-6% acetic acid. Apple cider vinegar is a 2-step process allowing for apples to be crushed into juice and then fermented to produce the amber vinegar color. It contains vitamins and minerals as well as flavonoids. The flavonoids have anti-inflammatory and antioxidant properties. Due to these properties, apple cider vinegar has been promoted for diabetes, lipid management, weight loss, kidney stones, improving athletic performance, and improving COVID-19 symptoms. In the last 4-6 years, more research has focused on apple cider vinegar to either support or refute these claims. Although there is quite a bit on the internet about use of apple cider vinegar for kidney stones, no well-designed studies evaluating this use in humans have been done. It is theorized the effect may be due to a reduction in pain and inflammation. A 2019 study completed in rats found apple cider vinegar could reduce or prevent the formation of calcium oxalate kidney stones. Calcium oxalate is responsible for about 80% of human kidney stones. More human data would be needed to make a better recommendation. A 2020 study researched apple cider vinegar compared to sports drinks in healthy athletes to determine if vinegar improved performance. The study required participants to drink either 2 cups of apple cider vinegar or 2 cups of a sports drink before completing extensive training. The study showed no benefit of apple cider vinegar over a sports drink. The Journal of Functional Foods in 2018 printed a study evaluating 2 tablespoons of apple cider vinegar combined with a restricted calorie diet and its impact on several weight-related measures. The 12-week study showed a reduction in hip measurements and a reduction in triglycerides and appetite. A study published in 2021 evaluated 9 different studies with apple cider vinegar used to manage patients with diabetes with elevated lipid levels. The combined studies showed a favorable impact of vinegar on lowering fasting blood sugar, hemoglobin A1C (an average measure of blood glucose over 3 months), total cholesterol, and triglycerides. The average amount of apple cider vinegar consumed each day was 1 tablespoon with results seen in 8 weeks. A 2024 study published in BMJ Nutrition, Prevention & Health evaluated 3 different doses of apple cider vinegar compared to a placebo with a similar taste in overweight and obese teenagers and young adults. The study included both men and women. The doses given for 12 weeks in the apple cider vinegar groups were 1 teaspoon, 2 teaspoons, and 1 tablespoon daily. All 3 of the apple cider vinegar treatment groups showed a benefit with reductions in body weight, blood glucose levels, total cholesterol levels, and triglycerides. Benefits were noted as early as 4 weeks. The best results were seen in the group taking 1 tablespoon daily with an average weight loss of 14 pounds in 12 weeks. This study confirms some earlier results. No human studies confirmed the use of apple cider vinegar to reduce the symptoms of COVID-19, but a 2023 study demonstrated the benefits of white vinegar as a disinfectant for countertops by killing the SARS-CoV-2 virus. The studies all used liquid apple cider vinegar products with the best doses being 1 to 2 tablespoons daily. Many commercial products are supplied as gummies, capsules or tablets. These formulations are often not pure apple cider vinegar and contain other ingredients. In addition, they report the amount of apple cider vinegar as milligrams or grams (1000 milligrams = 1 gram). Based on the liquid concentrations in the trials, the dose of gummies, tablets, or capsules would need to be 1-2 grams per day. Many of these products have added sugar and calories nullifying the benefit. Being full of vim and vinegar could have some health benefits! Kier is a pharmacist with Ohio Northern University HealthWise Pharmacy.