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Vinegar and Blood Sugar Control

December 16, 2009 Written by JP    [Font too small?]

Each day we are challenged to live up to our highest potential. These tests can be as basic as the thoughts upon which we choose to focus or as profound as life and death decisions such as whether or not to quit smoking. One of the issues that I’ve tried to work on over the years is to refrain from comparing myself to others. I’d like to say that I came to this realization after years of careful contemplation and devout study of the most sacred spiritual texts. But, in reality, I attribute this shift of thinking to a rerun of an old television sitcom. Many years ago, I fell asleep watching TV. I awoke at about 3:00 or 4:00 in the morning and I recall seeing a few moments from an episode of M*A*S*H. The scene involved an older, wiser character (Colonel Potter, played by Harry Morgan) giving some sage advice to a younger, wilder surgeon under his command (“Hawkeye” Pierce, played by Alan Alda): “The only person you need to compare yourself to is who you have been. And the only person you need be better than is who you are now”. To this day, I don’t know whether I actually heard that wisdom or conjured it up in the fog of my sleepy head.

A NY Times column from November 24th put this philosophy to the test. It seems that thousands upon thousands of people read and sometimes cited a short piece written by Anahad O’Connor entitled “The Claim: Vinegar Can Help Lower Blood Sugar Levels”. I read it myself and thought it was fairly balanced and well written. But I also had the feeling that there was more to the story that needed to be told. That’s the diplomatic way of saying: “I could do better than that!”. But alas, I don’t want to fall back into my old pattern of comparing myself to others. Therefore, I proclaim that today’s article is not an effort to “one up” the NY Times, but rather add to their preliminary coverage of the topic! (1)

I want to first establish why it’s important to maintain stable blood sugar levels. This is not just an issue for people who have or are at risk for diabetes. Having blood sugar levels that are either too high or too low can dramatically impact your mental and physical health. Hyperglycemia or high blood sugar can result in blurred vision, fatigue, headaches, increased thirst and poor cognitive function. People with hypoglycemia (low blood sugar) often suffer from anxiety, confusion, dizziness, inappropriate sweating and weakness. Eating a diet rich in high glycemic carbohydrates and living a sedentary lifestyle are two of the chief causes for inappropriate blood sugar levels surrounding meals. (2,3)

The vast majority of the population could improve their health by simply lowering post meal blood glucose levels. The consumption of vinegar appears to be one way to accomplish this. However the picture that is forming in the scientific literature is not quite so “cut and dry”.

The Early Days of Vinegar Research

There were three pioneering studies that helped to get the vinegar/blood sugar ball rolling. A 1995 study from the University of Milan, Italy was the first published account I found of dietary vinegar lowering blood sugar. The addition of vinegar to a meal containing a salad resulted in a 31% depression in glucose response in a group of 5 healthy participants. In 1998, Swedish researchers demonstrated similar effects in 10 healthy men and women. This time, it was determined that vinegar not only lowered post meal blood sugar, but also decreased insulin response. The next study in humans didn’t occur until 2003. Japanese scientists tested the effects of 32 “common food products” to see if any of them could lower the glycemic response to white rice. This experiment was much larger, including 38 women and 20 men. Beans, dairy products and vinegar were all found to lower the glycemic index of white rice by 20-40%. Interestingly, the blood sugar modifying effect took place no matter whether the vinegar was taken prior to, during or directly after eating the rice. (4,5,6)

The Golden Age of Vinegar Research (2004-2009)

2004 began with a bang. A study in the journal Diabetes Care determined that apple cider vinegar “raised whole-body insulin sensitivity” in people with insulin resistance, a hallmark of metabolic syndrome and/or “pre-diabetes”. The fascinating thing about this trial is that these “pre-diabetics” responded to vinegar in a more profound way than did the type-2-diabetics. (7)

2005 yielded three trials that further shed light on the activity of vinegar. A study from Arizona State University discovered that vinegar is more effective at lowering blood sugar when it’s taken with a higher glycemic meal, such as a bagel and juice. That research also revealed that subjects taking vinegar, along with a bagel and juice, consumed about 200 – 275 fewer calories per day. The remaining two studies of ’05 describe white vinegar’s ability to soften the glycemic impact of potatoes and white bread. These two foods are widely believed to be especially troublesome for those with blood sugar abnormalities. (8,9,10)

2007, 2008 and 2009 took the vinegar story into previously uncharted territory: type 1 diabetes. A Swedish study from the University of Lund examined the effects of apple cider vinegar (ACV) in this specialized segment of the diabetic community. In particular, the scientists were interested in whether ACV could affect the “gastric emptying rate” in relation to a snack containing rice pudding. The authors of the trial concluded that vinegar was capable of delaying stomach emptying which may lead to a greater sense of hunger satisfaction. This hunger modifying effect was also borne out in a 2008 study which used whole wheat bread as a vehicle for the vinegar. (11,12)

Even broader effects were verified in both 2007 and 2009. Researchers from Arizona State University discovered that the addition of 2 tablespoons of apple cider vinegar prior to bed could significantly lower “waking glucose concentrations”. This was especially true for the study participants with the highest initial blood sugar readings. In a follow up study, these same researchers tested the effects of several forms of acetic acid/vinegar (dill pickles, vinegar or a vinegar pill) in a group of type 2 diabetics. Acetic acid is widely believed to be the “active ingredient” in vinegar. A measure of long term blood sugar (hemoglobin A1c) dropped in those receiving the vinegar. However, there was an unexpected glucose elevation in those receiving the pickles and the vinegar pill. Vinegar pills are commonly sold in health food stores and pharmacies. This recent study appears to question the wisdom of using such supplements. (13,14)

Apple Cider Vinegar May Affect Appetite Via Delayed Gastric Emptying (GER)
Source: BMC Gastroenterology 2007, 7:46 (link)

One thing that wasn’t mentioned in the NY Times column is that chronic vinegar use isn’t necessarily safe. In fact, the one trial that examined this issue found some potentially troubling findings. 27 type 2 diabetics were asked to “supplement” with one of three different sources of acetic acid: pickles, vinegar or a low-dosage vinegar pill. The trial lasted 12 weeks and included a variety of blood tests, diaries and interviews to assess safety and tolerability. A statistically larger number of those eating the pickles and vinegar reported “at least one treatment-emergent adverse event” as compared to those given the low dose pill. The researchers also noted a possible indication of liver irritation in the pickle and vinegar users, demonstrated by an increase in the level of a liver enzyme known as aspartate aminotransferase. (15)

Another wrinkle in the vinegar saga was just revealed in this month’s edition of Nutrition Research. Scientists from the Kronos Longevity Research Institute began their presentation by discussing several proposed mechanisms by which vinegar can improve blood sugar control: a) by slowing the breakdown of carbohydrates via enzyme inhibition; b) by delaying gastric emptying; c) by improving “glucose uptake” and; d) by increasing satiety (hunger satisfaction). Imagine their shock when their very own study found that 20 mL of apple cider vinegar given before a mashed potato meal actually increased glucose response! This may just be a fluke but it brings up an important point: If you decide to experiment with vinegar, make sure it’s working for you. Test your blood sugar regularly to verify that you’re actually experiencing the desired effect. (16)

According to historians, Hippocrates used vinegar to help promote the healing of wounds. Cleopatra reputedly dissolved her prized pearls in vinegar to make a love potion for Antony. The “creator of forensic medicine”, Sung Tse, supposedly washed his hands in a solution of sulfur and vinegar after conducting autopsies. Even in the United States, the medicinal use of vinegar runs deep. Records show that as far back as the 18th century vinegar was being used to address diabetic complaints and a whole host of other unrelated conditions such as poison ivy rash and stomach aches. With the advent of controlled scientific studies, we now have the tools by which to accurately identify the healing potential of this food that is so heavily steeped in folklore. I’ll continue to add organic apple cider vinegar to my recipes and hope for the best. I don’t currently have cause to use vinegar therapeutically, but I know that some of you do. If you decide to try it out, please let me know how it turns out for you. Your experiences are always welcome and, more importantly, of great value to the Healthy Fellow community. (17)

Be well!


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Posted in Diet and Weight Loss, Food and Drink, Nutrition

22 Comments & Updates to “Vinegar and Blood Sugar Control”

  1. Nina K. Says:

    Morning JP,

    wow thats interesting. my organic manufacturer of organic vinegars (apple, pomegranate, rhaspberry, balsamico etc.) send me some recipes and information about vinegar. so vinegar is used in the very begining of his time as medicine and to make food more lasting. vinegar has a potential antibacterial capacity, whats very good because some raw foods contain bacteria and germs which can cause foodborne illness. furthermore vinegar will improve digestion of whatever is in your stomach and gut.

    for all people who want to fasting a few days, apple vinegar in water as the first drink after wake up shall help emptying the gastrointestinal system, lemon juice mixed with water works as good.

    Stay healthy!

    Nina K.

  2. Sai Says:

    Hello JP

    I have tried this and results are not encouraging for me. Infact there was a journal which asked to try apple cider vinegar with cheese to get good fasting sugar numbers, But i have been unsucessful. I am still searching for remedies that would bring my blood sugar (under 100 on fasting)- currently 140-150 with Medication, but no luck so far! But it certainly would work for many others. JP, thnaks again for a very good post! Looking forward for your new blog 🙂



  3. JP Says:

    Thanks, Nina! 🙂

    I agree that vinegar has many healing and nutritional applications. I was really impressed to recently read that it could even reduce the allergenic potential of certain foods such as lentils.

    I’ll keep on the lookout for more research on vinegar and report back as I find it!

    Be well!


  4. JP Says:

    Thank you, Sai! 🙂 A few questions for you:

    Does your doctor have any idea why your blood sugar is so difficult to control? Have other members of your family suffered from this type of problem? Have you ever tried a strict low carbohydrate diet? If so, how did it work out for you?

    Be well!


  5. Sai Says:

    Dear JP

    Thanks for the concerns first! Doctor keeps switching medicines and says my AiC is under 7 (so he says i am fine). But personally i know that my fasting numbers are not good. None of my family members have *any disease* but none of them are overweight too (like me). i am on a low carb diet right now. Although the A1C numbers are OK, the bllod sugar spike is out of control (i have noticed this happen after starting to take a complex Multivitamin). I have also noticed good energy since starting to take the Multivitamin (thanks to you for guiding me there), so on one side i do not want to lose this new found energy and on the other side, i want better fasting numbers for blood sugar. It is a constant fight JP but i beleive that most of the problems could be solved by being in the “research” mode and supplying the doctors with the information. Expecting the docs to solve your problems is never going to happen unless you have a sibling who does that job or a very close friend. Here is another info..my uric acid levels and cortisol levels were high when i had my diabetes diagnosed. after a while the PM cortisol levels were still high. AM was OK. but the 24 hour cortisol check was OK too. Thanks again JP for the concerns and i hope to reverse this one day for sure, not without help though!

    Best Regards


  6. JP Says:


    Thank you for adding those details. I’ll keep on looking for possible answers to this mystery – as I know you’re not the only one dealing with it! Hyperglycemia is far too common. I will, of course, post anything that I think may be useful.

    In the meantime, have you read any of the books by Dr. Richard Bernstein? It’s my understanding that his program can often help in even the most difficult cases of blood sugar irregularities.

    More info. on Dr. B – http://www.diabetes-book.com/

    Be well!


  7. Sai Says:

    Thanks JP!

    I just ordered that book! As i said the spike after the meal (even a low carb one) is the one very difficult to control. Thanks again.

    Best Regards


  8. JP Says:


    I sincerely hope Dr. Bernstein’s suggestions help you achieve optimal blood sugar levels. Please let me know how it works out.

    Be well!


  9. liverock Says:

    Pycnogenol is supposed to be very good for reducing blood glucose spiking.

    “A new study to be published in an upcoming edition of the journal of Diabetes Research and Clinical Practice reveals that French maritime pine tree extract known as Pycnogenol® (pic-noj-en-all) delays the uptake of glucose from a meal 190 times more than prescription medications, preventing the typical high-glucose peak in the blood stream after a meal. The study revealed the pine bark is more potent for suppressing carbohydrate absorption in diabetes than synthetic prescription alpha-glucosidase inhibitors such as Precose®.”


  10. JP Says:

    Thanks, Liverock! 🙂

    Pycnogenol and (possibly) grape seed extracts are likely helpful for those with hyperglycemia and diabetes in multiple ways. I highly recommended them!



    Be well and happy holiday to you and yours!


  11. Anonymous Says:

    thanks JP for this great and valuable post and elaborating this , i am suffering from Diabetes and taking medical care from my family doctor and i will talk to my doctor about this .Really a good discussion.

  12. JP Says:

    It’s my pleasure! I hope your doctor will be receptive to the idea and that you’ll benefit from your experimentation with vinegar!

    Be well!


  13. Lisa Says:

    Hi, JP!

    Really enjoying your blog! Haven’t gotten very far into it yet, but it’s so refreshing to find well-written, info-packed articles that aren’t biased or designed to get you to buy a book to “find out more!”

    Regarding the vinegar issue: I’ve tried taking apple cider vinegar straight in the past (just a tablespoon per day), but found that I developed painful mouth ulcers from it. If the acv pills aren’t worth their salt, so to speak, does it matter if one dilutes the vinegar with water? Not diabetic yet, but had been diagnosed as pre-diabetic, and have had gestational diabetes in the past, which was controlled by diet alone. Thanks for the valuable insight!


  14. JP Says:

    Thank you, Lisa! 🙂

    In my opinion, it would be acceptable to dilute the ACV provided that you ultimately consume the same amount per serving (of ACV). I would try adding the least amount of water necessary in order to make it tolerable. You might also consider drinking the ACV through a straw. This is an old trick that some dentists recommend in order to keep acidic beverages from making contact with tooth enamel. This could be used in addition to or instead of diluting the ACV. A little trial and error should reveal the winning formula.

    If you’re at risk for type 2 diabetes, please search under the term “metabolic syndrome”. I’ve covered this topic extensively over the past few years. It’s a major health issue which seems to be growing in its impact.

    Be well!


  15. steve goss Says:

    I have type 2 diabetes been taking 15 mg of actos daily, The Dr. Oz show talked about vinegar(4tsp) daily in your diet. Been trying this for 12 weeks now and been off the actos. My fasting sugar content now is between 70-85. I take about 2 tsp. white vinegar after each meal X 3 meals daily. Does not taste good but it works.

  16. Alvin Says:

    I feel sleepy after taking vinegar postmeals

  17. JP Says:

    Hi, Alvin.

    I wonder if a smaller dosage of vinegar may be more beneficial for you? Since adopting your vinegar regimen, have you tested your blood sugar prior to meals and afterwards when you feel sleepy? It would be interesting to determine if there’s a connection to be found there.

    Be well!


  18. steve goss Says:

    I had noticed since on the vinegar regimen, my GFR increased from 49 to 97, that was very good news.

  19. JP Says:

    That’s wonderful news, Steve! Thanks a lot for sharing your success with us.

    For those unfamiliar with GFR, here’s a description:

    “Glomerular Filtration Rate (GFR): Your GFR tells how much kidney function you have. It may be estimated from your blood level of creatinine. If your GFR falls below 30 you will need to see a kidney disease specialist (called a nephrologist), Your kidney doctor will speak to you about treatments for kidney failure like dialysis or kidney transplant. A GFR below 15 indicates that you need to start one of these treatments.”


    Be well!


  20. Bjensen6 Says:

    I don’t mean to get off the subject but has there ever been a study done to see it the prevention of dry mouth and maintaining hydration in a type 2 diabetic can decrease blood sugar readings?
    I found a French study that found that people who drank more water were less likely to become diabetic and all the reading I have done suggests that diabetics will have dry mouth but can it work backwards? Can the prevention of dry mouth help a diabetic?

  21. JP Says:



    The role of acetic acid on glucose uptake and blood flow rates in the skeletal muscle in humans with impaired glucose tolerance


    Previous studies support the glucose-lowering effect of vinegar. However, the effect of vinegar on muscle glucose metabolism and endothelial function has not been studied in humans. This open, randomized, crossover, placebo-controlled study aims to investigate the effects of vinegar on muscle glucose metabolism, endothelial function and circulating lipid levels in subjects with impaired glucose tolerance (IGT) using the arteriovenous difference technique.


    Eight subjects with IGT (4 males, age 46±10 years, body mass index 30±5) were randomised to consume 0.50 mmol vinegar (6% acetic acid) or placebo before a mixed meal. Plasma samples were taken for 300 min from the radial artery and the forearm vein for measurements of glucose, insulin, triglycerides, non-esterified fatty acids (NEFAs) and glycerol. Muscle blood flow was measured with strain gauge plethysmography. Glucose flux was calculated as the arteriovenous difference of glucose multiplied by the blood flow rates.


    Vinegar compared with placebo: (1) decreased arterial plasma insulin (Poverall<0.001; P75 min=0.014, β=−42), (2) increased forearm blood flow (Poverall<0.001; P240 min=0.011, β=1.53; P300 min=0.023, β=1.37), (3) increased muscle glucose uptake (Poverall<0.001; P60 min=0.029, β=2.78) and (4) decreased arterial plasma triglycerides (Poverall=0.005; P240 min<0.001, β=−344; P300 min<0.001, β=−373), without changing NEFA and glycerol.


    In individuals with IGT, vinegar ingestion before a mixed meal results in an enhancement of muscle blood flow, an improvement of glucose uptake by the forearm muscle and a reduction of postprandial hyperinsulinaemia and hypertriglyceridaemia. From this point of view, vinegar may be considered beneficial for improving insulin resistance and metabolic abnormalities in the atherogenic prediabetic state.

    Be well!


  22. JP Says:

    Update: The (mostly unfavorable) health effects of a popular combination – honey and vinegar …


    Int J Prev Med. 2014 Dec;5(12):1608-15.

    Effect of honey vinegar syrup on blood sugar and lipid profile in healthy subjects.

    The impact of honey or vinegar on several metabolic abnormalities has been studied separately, a mixture of these two ingredients known as honey vinegar syrup (HVS) has not been investigated previously so far. The aim of this study was to assess the impact of HVS consumption (Iranian’s traditional syrup) on glycemic parameters and lipid profiles in healthy individuals.

    METHODS: We conducted a 4-week, randomized, controlled, parallel study consisting of two groups of nonobese healthy volunteers. All subjects were asked to stay on their normal diet. Intervention group (n = 36) received a cup of HVS daily in the evening snack for 4-week (250 cc syrup contains 21.66 g honey vinegar). Assessments of fasting blood sugar (FBS), insulin, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were conducted at the baseline and after 4-week of study.

    RESULTS: We observed no significant effect of HVS on FBS, HOMA-IR, LDL-C and TG. A significant effect of HVS was found on increasing fasting insulin and HOMA-IR and reduction in TC level only in intervention group (Δ =3.39 P = 0.01, Δ =1.65 P = 0.03, Δ = -9.43 P = 0.005, respectively). Changes of FBS, TG and LDL-C were 1.83 mg/dl, -1.53 mg/dl and – 3.99 mg/dl respectively in the intervention group. These changes were not significant. An unfavorable and significant reduction in HDL-C level was also observed between two groups (Δ = -4.82 P < 0.001 in the intervention group). CONCLUSIONS: Honey vinegar syrup increased fasting insulin level and decreased TC level in the intervention group. HVS had an unfavorable effect on HDL-C level. Further prospective investigations are warranted to confirm these findings. Be well! JP

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