## Apple Cider Vinegar and Body Composition
In a recent meta-analysis in the journal Nutrients,researchers in Italy reviewed randomized controlled trials (RCTs) that evaluated the use of apple cider vinegar supplementation aiming to improve body composition in adults.
Vinegar intake was associated wiht modest but important reductions in waist circumference, BMI, and body weight, especially in adults with obesity, overweight, or type 2 diabetes (T2DM), highlighting its potential for improving body composition.
## Background
Obesity and T2DM represent urgent global health challenges, with over one billion people currently living with obesity and projections suggesting more than half of the world’s adult population could be affected by 2035. These conditions not only increase the risk of T2DM but also contribute to cardiovascular disease, cancer, and premature mortality.
While established treatments, such as dietary changes, physical activity, medications, and bariatric surgery, can promote weight loss, many patients struggle with maintaining thier weight in the long term. Moreover, drug therapies and surgery carry risks, side effects, and accessibility barriers. This has led to growing interest in plant-based products as safer, more affordable alternatives for managing obesity and its complications.Apple cider vinegar, produced by fermenting apple juice into acetic acid, is widely used as a condiment and natural remedy. Beyond its culinary role, these vinegars contain bioactive polyphenols and acetic acid, which may improve insulin sensitivity, glycemic control, lipid profiles, and oxidative stress. Small-scale studies have suggested that apple cider vinegar may reduce body weight and fat mass, but results remain inconsistent. For example, a recent meta-analysis reported no significant effect on BMI, though it excluded othre key anthropometric outcomes.
## About the Study
To address these uncertainties, researchers conducted a systematic review and meta-analysis that followed established guidelines, screening major databases up to March 2025.RCTs lasting at least four weeks and comparing vinegar
Apple Cider Vinegar and Weight Management: A Meta-Analysis Review
A recent meta-analysis published in Nutrients (Castagna et al., 2025) suggests that apple cider vinegar (ACV) supplementation may contribute to weight loss and improved metabolic markers in adults. The study, a systematic review and meta-analysis of randomized controlled trials, indicates potential benefits for obesity management and type 2 diabetes mellitus (T2DM).
Key Findings:
The analysis of multiple studies revealed that ACV supplementation led to significant reductions in body weight, Body Mass Index (BMI), and waist circumference. The most pronounced effects were observed with a daily dose of 30 mL. These benefits were seen in both overweight/obese individuals and those diagnosed with T2DM. However, the reduction in waist circumference was not consistent across all subgroups, with significant reductions primarily observed in participants with T2DM.
Sensitivity analyses, excluding studies with a high risk of bias, confirmed the positive impact of ACV on body weight and BMI, bolstering the reliability of these findings. Interestingly, waist-to-hip ratio (WHR) showed no significant changes regardless of dosage or intervention duration.
Study Quality and Limitations:
The included studies exhibited mixed methodological quality.While two studies were deemed to have a low risk of bias, three were unclear, and five were considered high risk, largely due to challenges with blinding participants.Despite this,excluding the high-risk studies in sensitivity analyses did not diminish the observed benefits on weight and BMI.
The researchers acknowledge several limitations, including substantial heterogeneity between studies, relatively short intervention periods, variations in ACV formulations and dosages, and the potential for publication bias.
Proposed Mechanisms:
Several mechanisms may explain the observed effects of ACV. These include:
* Slower Gastric Emptying: ACV may slow the rate at which food leaves the stomach, promoting feelings of fullness.
* Improved Satiety: Contributing to reduced calorie intake.
* Modulation of Glucose and Lipid Metabolism: Potentially improving how the body processes sugars and fats.
* Activation of AMPK: ACV may activate adenosine monophosphate-activated protein kinase (AMPK) pathways, which play a role in energy regulation.
* Gut Microbiota effects: Possible alterations in the composition and function of gut bacteria.
Conclusions and future Research:
The meta-analysis concludes that apple cider vinegar appears to be a promising adjunct to obesity management. Though, the authors emphasize the need for larger, longer-term, and more standardized clinical trials with rigorous safety monitoring to definitively confirm its long-term effectiveness and safety. The study’s strengths lie in its exclusive use of randomized controlled trials and focus on relatively homogeneous populations.
Source:
* Castagna, A., Ferro, Y., Noto, F.R.,Bruno,R., Guimaraes, A.A.,Pujia,C., Mazza, E., Maurotti, S., Montalcini, T., Pujia, A. (2025). Effect of Apple Cider Vinegar Intake on Body Composition in Humans with Type 2 Diabetes and/or Overweight: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Nutrients, 17(18), 3000. https://doi.org/10.3390/nu17183000