How Much Vinegar Every Day?

Consuming vinegar with a meal reduces the spike in blood sugar, insulin, and triglycerides, and it appears to work particularly well in those who are insulin resistant and on their way to type 2 diabetes. No wonder the consumption of vinegar with meals was used as a folk medicine for the treatment of diabetes before diabetes drugs were invented.

Many cultures have taken advantage of this fact by mixing vinegar with high glycemic foods. For example, in Japan, they use vinegar in rice to make sushi, and, in the Mediterranean, they dip bread into balsamic vinegar. Throughout Europe, a variety of sourdough breads can lower both blood sugar and insulin spikes. You can get the same effect by adding vinegar to boiled white potatoes then cooling them to make potato salad.

Adding vinegar to white bread doesn’t just lower blood sugar and insulin responses—it increases satiety, or the feeling of being full after a meal. As you can see in my video Optimal Vinegar Dose, a study found that if you eat three slices of white bread, it may fill you up a little, but in less than two hours, you’re hungrier than when you began eating. If you eat that same amount of bread with some vinegar, though, you feel twice as full and, even two hours later, still feel nearly just as full as if you had just eaten the three pieces of bread plain. But this remarkable increase and prolongation of satiety took nearly two tablespoons of vinegar. That’s a lot of vinegar. What’s the minimum amount?

It turns out that even just two teaspoons of vinegar with a meal can significantly decrease the blood sugar spike of a refined carb meal, a bagel and juice, for instance. You could easily add two teaspoons of vinaigrette to a little side salad or two teaspoons of vinegar to some tea with lemon. Or even better you could scrap the bagel with juice and just have some oatmeal with berries instead.

What if you consume vinegar every day for months? Researchers at Arizona State University randomized pre-diabetics to take daily either a bottle of an apple cider vinegar drink—a half bottle at lunch, and the remaining half at dinner—or an apple cider vinegar tablet, which was pretty much considered to be a placebo control: While the bottled drink contained two tablespoons of vinegar, the two tablets only contained about one third of a teaspoon. So in effect, the study was comparing about 40 spoonfuls of vinegar a week to 2 spoonfuls for 12 weeks.

What happened? On the vinegar drink, fasting blood sugars dropped by 16 points within one week. How significant is a drop of 16 points? Well this simple dietary tweak of a tablespoon of vinegar twice a day worked better than the leading drugs like Glucophage and Avandia. “This effect of vinegar is particularly noteworthy when comparing the cost, access, and toxicities” associated with pharmaceutical medications. So the vinegar is safer, cheaper, and more effective. This could explain why it’s been used medicinally since antiquity. Interestingly, even the tiny amount of vinegar in pill form seemed to help a bit. That’s astonishing. And, no: The study was not funded by a vinegar company.

What about long-term vinegar use in those with full-blown diabetes? To investigate this, researchers randomized subjects into one of three groups. One group took two tablespoons of vinegar twice a day, with lunch and supper. Another group ate two dill pickles a day, which each contained about a half tablespoon’s worth of vinegar. A third group took one vinegar pill twice a day, each containing only one sixteenth of a teaspoon’s worth of vinegar. I wasn’t surprised that the small dose in the pill didn’t work, but neither did the pickles. Maybe one tablespoon a day isn’t enough for diabetics? Regardless, the  vinegar did work. This was all the more impressive because the diabetics were mostly well controlled on medication and still saw an additional benefit from the vinegar.


Make sure to check out my other videos on vinegar’s benefits:

This vinegar effect seems a little too good to be true. There have to be some downsides, right? I cover the caveats in Vinegar Mechanisms and Side Effects.

There are a few other foods found to improve blood sugar levels:

The best approach, of course, is a diet full of healthy foods:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

The Benefits of Vinegar Beyond Weight Loss

A double-blind, placebo-controlled, randomized study found that body weight and belly fat were significantly reduced by adding just a single tablespoon of vinegar to one’s daily diet. Is there any benefit to vinegar consumption if you’re not overweight? Well, the subjects’ triglycerides normalized, and, for those taking the larger dose of two tablespoons per day, there was a dip in blood pressure. Those effects may have just been because of the weight loss, though. Other than taste, is there any benefit to normal-weight individuals sprinkling vinegar on their salads? What about vinegar for controlling blood sugar? That’s the topic of my video Can Vinegar Help with Blood Sugar Control?.

If you feed people a half cup of table sugar, as their blood sugars spike, their artery function can become impaired. The higher the blood sugars go, the more the arteries take a hit. There’s a drug, though, that can block sugar absorption. By blunting the blood sugar spike with this drug, you can prevent the arterial dysfunction. This demonstrates that it’s probably good for your heart if you don’t have big blood sugar spikes after meals. In fact, how high your blood sugars spike after a meal is a predictor for cardiovascular mortality. So do people who eat lots of high glycemic foods, like sugary foods and refined grains, tend to have more heart attacks and strokes? Yes. They also appear more likely to get diabetes—but maybe people who eat lots of Frosted Flakes and Wonder Bread have other bad dietary habits as well?

The diets that have been put to the test in randomized controlled trials and proven to prevent diabetes are the ones focusing on cutting down on saturated fat and ramping up the consumption of fiber-rich whole plant foods, such as fruits, vegetables, and whole grains, without specific regard to lower or higher glycemic loads. The drug has been put to the test, though, and blunting one’s mealtime blood sugar spikes does seem to reduce the risk of developing diabetes, as well as reduce the risk of heart attacks and high blood pressure. So is there any way to prevent these blood sugar spikes without having to take drugs? Well, one way would be to not sit down to a half cup of sugar!

Yes, the drug can slow the progression of your atherosclerosis. You can see in my video Can Vinegar Help with Blood Sugar Control? how the arteries going to your brain narrow somewhat more slowly with the drug than without it. But wouldn’t it be better to eat a diet that actually reverses heart disease and diabetes? The healthiest diet to prevent the meal-related blood sugar and fat spikes—the oxidation and inflammation—is a diet centered around whole plant foods. But what if you really want a bagel? Instead of spreading drugs on it, spreading on some almond butter may help blunt the blood sugar spike from refined carbs. Another option is to dip your baguette in some balsamic vinegar.

“The consumption of vinegar with meals was used as a home remedy for diabetes before the advent of pharmacologic glucose-lowering therapy”—that is, before drugs came along—but it wasn’t put to the test until 1988. After all, how much money can be made from vinegar? Well, according to The Vinegar Institute, millions of dollars can be made! But a single diabetes drug, like Rezulin, can pull in billions—that is, until it was pulled from the market for killing too many people by shutting down their livers. The drug company still made out like a bandit, though, having to pay out less than a billion to the grieving families for covering up the danger.

There’s no liver failure from schmearing peanut butter on a bagel, though, and it cuts the blood sugar response in half. Similarly, drinking four teaspoons of apple cider vinegar diluted in water gives the same blunting of the spike—with the additional advantage over the peanut butter of lowering insulin levels in the blood. This is something peanut butter apparently can’t do. But putting peanut butter on your bagel is presumably better than having a bagel with lox because fish causes triple the insulin response. Red wine also increases insulin levels, though not as much as fish does, and also shoots up triglycerides. Non-alcoholic red wine, however, doesn’t cause the same problem.

What about vinegar? Not only may a tablespoon a day tend to improve cholesterol and triglycerides over time, vinegar can drop triglycerides within an hour of a meal, as well as decrease blood sugars and the insulin spike, potentially offering the best of all worlds.


Was that bursting with information or what? It’s because of everyone’s kind support that I was able to hire more than a dozen researchers to help me plow through the literature. I’m extremely grateful so many of you were able to see the potential and help NutritionFacts.org become what it is today. Onward and upward!

What’s that about belly fat being reduced? Check out other videos in my series on vinegar:

Did I say reverse diabetes? Reverse heart disease? For examples, see:

Sharing information that can help people prevent and reverse common diseases is my life’s work. Check out the full story in my series of introductory videos.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

 

How to Lose Weight Eating More Food

What happens if you add fruit to your regular diet, eating three apples or pears as between-meal-snacks every day? I explore this in my video Eating More to Weigh Less, which I titled as a nod to Dr. Dean Ornish’s smash bestseller.

Fruit is low in calories, but it does have some. It isn’t calorie-free. So, if you add food—even healthy food—to people’s diets, won’t they gain weight? No, subjects who ate three apples or pears every day added on top of their regular diet lost a couple of pounds. Was that reduction because of all that fiber since our gut bacteria can create anti-obesity compounds from fiber? (See my Beans and the Second Meal Effect video for more on this.) Good question. That’s why, in addition to the fruit groups, the researchers had a cookie group!

Subjects ate either three apples, three pears, or three cookies with enough oats in them to have about the same amount of fiber as the fruit. Despite the fiber, adding cookies to one’s diet did not lead to weight loss. The researchers thought the weight-reducing secret of fruit was its low energy density, meaning you get a lot of food for just a few calories, so it fills you up.

“Energy density is a relatively new concept that has been identified as an important factor in body weight control in adults and in children and adolescents…Energy density is defined as the amount of energy [calories] per unit weight of a food or beverage….” Water, for example, provides a significant amount of weight without adding calories. Fiber, too. “Thus, foods high in water and/or fiber are generally lower in energy density. On the other hand, because dietary fat provides the greatest amount of energy per gram [calories per unit weight], foods high in fat are generally high in energy density.”

The CDC offers some examples. High energy density foods are like bacon, which have a lot of calories in a small package. A medium energy density food is like a bagel, and low energy density foods are typified by fruits and vegetables. In general, the lower the better, but there are two exceptions: Soda is so heavy that by energy density it looks less harmful than it is, and nuts have so much fat that they appear less healthy than they are.

Otherwise, though, the science “supports a relationship between energy density and body weight…such that consuming diets lower in energy density may be an effective strategy for managing body weight.” This is because people tend to eat a consistent weight of food. So, when there are fewer calories per pound, caloric intake is reduced.

A small drop in energy density can lead to a small drop in weight, and the greater the decrease in energy density, the greater the weight loss.

“Energy density can be reduced in a variety of ways such as the addition of vegetables and fruits to recipes or by lowering the fat or sugar content.” Indeed, that’s how we evolved—eating predominantly low energy density foods such as fruits, vegetables, plants, and tubers (starch-filled roots like sweet potatoes). The first study emphasizing how fruits and vegetables could affect energy density and food intake was conducted more than 30 years ago.

Researchers were able to cut people’s caloric intake nearly in half—from 3,000 calories a day down to 1,570—without cutting portions. They simply substituted high energy dense foods with less calorie dense foods. That means subjects ate lots of fruits, vegetables, whole grains, and beans, compared to having high-energy density meals with lots of meat and sugar. They ate nearly half the calories, but they reported enjoying the meals just as much.

Researchers tried this in Hawaii by putting people on a traditional Hawaiian diet with all the plant foods they could eat. The subjects lost an average of 17 pounds in just 21 days, resulting in better cholesterol, triglycerides, blood sugars, and blood pressure. Caloric intake dropped 40 percent, but not by eating less food. In fact, they lost 17 pounds in 21 days while eating more food—four pounds of food a day. But, because plants tend to be so calorically dilute, one can stuff oneself without seeing the same kind of weight gain.

“The energy density of foods is of interest for weight management not only because it allows people to eat satisfying portions while limiting calories, but also because reductions in energy density are associated with improved diet quality.” For example, lower energy dense diets are associated with lower risk of pancreatic cancer.

Lower energy-dense diets tend to be of healthier foods, so we get the best of both worlds.


I talk more about the energy density concept in The Ice Diet and Nutrient-Dense Approach to Weight Management. Are There Foods with Negative Calories? Find out in my video!

The amazing Hawaii study was done by Dr. Terry Shintani. Find out more about the natural human diet in What’s the “Natural” Human Diet?.

Doesn’t fruit have a lot of sugar in it? Check out my videos:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: