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Reactions: small clinical trial concludes that consuming apple cider vinegar helps control obesity

Ingesting small amounts of apple cider vinegar daily for three months helps control weight in overweight or obese people, according to a clinical trial involving 120 young Lebanese people. The results, published in the journal BMJ Nutrition, Prevention & Health, show that consumption of this substance - which has become fashionable among some celebrities - was associated with decreases in weight, body mass index and blood levels of glucose, triglycerides and cholesterol. The authors suggest that this substance could serve as a complementary treatment for obesity.

13/03/2024 - 00:30 CET
Expert reactions

Miguel Ángel Martínez - vinagre sidra obesidad EN

Miguel Ángel Martínez González

Professor of Preventive Medicine and Public Health at the University of Navarra and Adjunct Professor in the Department of Nutrition at the Harvard T.H. Chan School of Public Health (United States)

Science Media Centre Spain

There are several repeated measures over time, but they don't use the proper statistical methodology for repeated measures in a longitudinal design of this type.
They only use apparently t-tests [a statistical tool for making comparisons] and they should have used other models that allow for the valuation of fixed and random components, but they also don't describe the total diet of the participants and how their caloric intake changes, the consumption of fruits, vegetables, ultra-processed foods, and so on.
In short, caution, a lot of caution.

The author has not responded to our request to declare conflicts of interest

Helen Truby - vinagre sidra manzana EN

Helen Truby

Professorial Research Fellow (Nutrition and Dietetics) at The University of Queensland

The Australian Science Media Center

This study of 120 individuals that were above a healthy weight, aged between 12 and 25 years old, who were provided with either 5ml which is about a teaspoon, 10ml or 15ml of apple cider vinegar per day, one group were given a placebo drink which did not contain any apple cider vinegar. Subjects were asked not to alter their diet or exercise patterns over the 12-week period.

The weight loss experienced by all those who received the apple cider vinegar was remarkable, about 6kg over 12 weeks, when compared to the group who did not take any apple cider vinegar, who only lost only a tiny amount of weight. The authors conclude that weight loss and improvements in metabolic markers were due entirely to the apple cider vinegar. Although this study design has the ability to prove cause and effect there are some substantial problems in this study, which would make the conclusions drawn questionable.
First, the subjects were not weight stable at the beginning of the study, so may have been on a weight loss journey before they began taking the vinegar, diet and activity were self-reported so we cannot be sure that these large weight losses were not due to lifestyle changes, plus the use of weight loss medications has not been reported.

There is existing evidence that weight loss of around [more than] >5% body weight, which was achieved in this study, leads to improvements in risk factors for heart disease itself.  Here the authors suggest that these are solely due to the apple cider vinegar and have not taken into consideration the actual weight changes.
The results reported here are remarkable but would need to be reproduced in a more rigorously controlled environment before any confidence could be placed in their conclusions. It would be wonderful if a teaspoon of apple cider vinegar caused substantial weight loss, but with the complexity of obesity and its management that we grapple with, sometimes if something seems too good to be true - it often is.

The author has declared they have no conflicts of interest
Apple cider vinegar for weight management in Lebanese adolescents and young adults with overweight and obesity: a randomised, double-blind, placebo-controlled study
  • Research article
  • Peer reviewed
  • Randomized
  • Clinical trial
  • People
BMJ Nutrition, Prevention & Health
Publication date

Rony Abou-Khalil.

Study types:
  • Research article
  • Peer reviewed
  • Randomized
  • Clinical trial
  • People
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