Not many foods play the role of both a prized cooking ingredient and household cleaner. The word vinegar derives from the French “vin aigre,” or sour wine. It has been traced back to 5000 B.C.E. in Babylon, not just for cooking but as a medicine, a preservative, and a drink to boost strength and promote wellness. Legend describes vinegar’s discovery when a forgotten wine was left in storage for several months, causing it to ferment and turn sour.
Vinegar is a combination of acetic acid and water made by a two-step fermentation process. First, yeast feed on the sugar or starch of any liquid from a plant food such as fruits, whole grains, potatoes, or rice. This liquid ferments into alcohol. The alcohol is then exposed to oxygen and the acetic acid bacteria Acetobacter to ferment again over weeks or months, forming vinegar. The U.S. Food and Drug Administration requires vinegar to contain at least 4% acetic acid, but may range up to 8% in commonly used vinegars. Although acetic acid is responsible for the tart and pungent flavors and odors we recognize, vinegar also contains trace vitamins, mineral salts, amino acids, and polyphenolic compounds . Flavors range from sour to savory to sweet. Some vinegars, such as balsamic, can be left to ferment up to 25 years.
Vinegars and Health
Early records from China, the Middle East, and Greece describe vinegar for medicinal purposes: as a digestive aid, an antibacterial balm to dress wounds, and treatment for cough. Today, vinegar is often touted as an all-purpose treatment for everything from minor ailments to chronic diseases. To be clear, existing scientific research does not support the use of vinegar as an effective treatment for any of these conditions. However, some animal studies and small human studies have suggested a health benefit from vinegar, which has fueled its popularity in mainstream media.
Below we take a look at some of the most popular health claims associated with vinegar, and review the limited research behind them.
Can vinegar lower blood sugar? Those with diabetes or prediabetes are eager to know the answer. A handful of human studies have produced conflicting results, with small sample sizes of a dozen or fewer participants. [2-5] A meta-analysis of 11 clinical trials (ranging from 5 to 12 participants) that observed individuals who were healthy, insulin-resistant, or with type 2 diabetes found that taking vinegar (ranging in amount from 2-4 teaspoons daily) significantly reduced glucose and insulin levels after meals.  A pilot study of 14 participants with type 2 diabetes found that taking vinegar twice daily with meals reduced fasting glucose at 12 weeks but not glucose levels after meals. 
These studies are difficult to compare because of differences in study design: healthy subjects versus those with insulin resistance or diabetes; when and how much vinegar was taken; the carbohydrate content of meals; and a diet that was high versus low glycemic index. These factors may have independently caused either an increase or decrease in blood sugar or insulin levels.
One theory is that vinegar interferes with the digestion of carbohydrates by blocking enzymes that break down them down. This delay in digestion might produce less of a blood sugar spike after eating or a greater feeling of fullness. Other possible actions are slowing the production of glucose by the liver or more efficient use of insulin in people who are insulin-resistant.  However, the American Diabetes Association does not promote the use of vinegar for glycemic control due to lack of consistent evidence. Larger long-term trials with a more uniform study design are needed before making recommendations.
If vinegar causes a delay in digestion and stomach emptying, this might produce a feeling of fullness when eating, thereby causing one to eat less. Other theories suggest a direct effect on fat metabolism. One animal study found that acetic acid protected rats from developing abdominal fat and prevented excess storage of fat in the liver.  A double-blind placebo-controlled trial that followed 155 Japanese people for 12 weeks with a body mass index of 25-30 (classified as obese in Japan) were given a drink containing 0, 15, or 30 mL of apple cider vinegar.  The results showed a small but significant decrease in body weight (2-4 pounds) and body mass index (0.4-0.7 points) at 12 weeks. However, when comparing the whole body of research on vinegar and body weight, primarily animal studies, there is not consistent evidence to show a benefit. The findings of vinegar’s effects on gastric emptying and appetite are mixed. [1,5]
Vinegar contains polyphenols, plant chemicals that have an antioxidant effect that may protect cells from oxidative stress, a possible stimulator of tumor growth. Cell and mouse studies suggest that vinegar may prevent the growth of cancer cells or cause tumor cells to die. However, there is a lack of research in humans showing a benefit of vinegar with this disease.  Regardless, vinegar adds flavor and complements other plant foods that contain polyphenols like fruits, vegetables, and whole grains, which comprise a healthy disease-preventive diet.
Even though vinegar is produced by fermentation, it is surprisingly not a probiotic food that contains beneficial bacteria. However, certain vinegars like apple cider vinegar which contains pectin may act as a prebiotic, or food for beneficial bacteria.
Vinegar has been taken as a home remedy to treat gastroesophageal reflux disease or GERD. If GERD is caused by a stomach condition of too low acid, a theory is that taking vinegar may increase stomach acid and improve digestion. Another theory is that vinegar can help to lower blood pH to a more acidic environment that destroys harmful pathogens in the gut. There is no published research that supports these theories. Furthermore, there can be side effects of taking too much vinegar at once in concentrated form, including stomach upset and irritation of the esophagus. Its high acid content can erode tooth enamel.
Vinegar is low in calories and nutrients. Depending on the type, one tablespoon of vinegar contains anywhere from 2 to 15 calories. The lowest calorie versions like distilled vinegar have no nutrient value; others contain trace amounts of nutrients. Because most vinegars are free of sodium and sugar, they are an ideal ingredient to flavor foods on restricted diets. However, not all are calorie-free. Some vinegars are a blend of grape juice and wine vinegar, sometimes with added sugar, so it is important to read the nutrition facts label and ingredients list to know exactly what you are getting.
How To Use
- The acidity or sourness of vinegar brightens the flavor of food and adds balance to a rich dish. It is found in popular kitchen staples like salad dressings, marinades, sauces, mayonnaise, and ketchup.
- Vinegar can change the texture of foods. It breaks down the chemical structure of protein, such as when used as a marinade to tenderize meats and fish. Vinegar can also be used to make cottage cheese by adding it to milk. The acid in vinegar separates the milk’s solid curds from the liquid whey.
Vinegar may be used to pickle food, a preservation method that extends the shelf life of perishable foods by killing bacteria. Pickling involves soaking a food in a brine solution made from vinegar, water, salt, and sugar, which also changes the food’s flavor.
- There are several types of vinegars available. Specialty vinegars may have added herbs like basil, clove, or cinnamon, or are sweetened with fruit juices. The following are common types and how they are used:
- White Distilled: Made by fermentation of a distilled alcohol, which often originates from fermented grains. Note that the role of grains is only indirect in their use to make alcohol, which is then distilled to produce a water solution of nearly pure ethyl alcohol, followed by fermentation into a solution of nearly pure acetic acid (in water). This process accounts for the lack of savory, aromatic flavors found in wine vinegars. The resulting acidity is ideal for pickling because it does not alter the color of fruits and vegetables. It’s also a popular inexpensive choice for cleaning.
- Balsamic: Made from fermented grape must (whole pressed grapes). This thick dark brown vinegar may taste a little sweeter and mellow in comparison with other vinegars. It can be used in salad dressings and marinades, or simmered into a thick sauce called a “reduction” to be drizzled onto fruit or ice cream.
- Rice: Made from fermented rice. Not too acidic with a milder, sweeter flavor. Used for dishes with Asian flavors like sushi, pickled vegetables, and stir-frys.
- Wine: Made from red or white wine. Has an acidic and sharp flavor that varies with the type of wine used. Used in marinades and salad dressings, and for cooking meat and fish.
- Apple Cider: Made from the liquid of crushed apples. Lower acidity than other types with a faint apple flavor. Used for salads, salad dressings, marinades, and sweeter dishes.
- Malt: Made from fermented un-hopped beer. Has a strong acidic flavor that is selected for sauces or dips.
Flavored: A vinegar base (usually wine vinegar) that is infused with fruit purees or herbs like rosemary or sage to create unique flavors for vinaigrette dressings and marinades.
Recipe ideas and serving suggestions featuring vinegar:
- Asparagus with Warm Tarragon-Pecan Vinaigrette
- Quick-Pickled Beets & Fennel
- Roasted Beets with Balsamic Vinegar
- Mint Vinaigrette
Did You Know?
After cooking, the next most popular use for vinegar—particularly white vinegar—is cleaning. While the 5% acetic acid in vinegar is strong enough to kill some household pathogens, it does not kill them all (e.g., salmonella) and is not recommended as a replacement for commercial disinfectants.  However, distilled white vinegar is an inexpensive, nontoxic “green” product that may be useful for certain household chores. It appears to work particularly well on removing mineral deposits and soap scum, such as in sinks, drains, and shower stalls.
- Johnston, C.S. and Gaas, C.A. Vinegar: Medicinal Uses and Antiglycemic Effect. 2006; 8(2): 61.
- Johnston CS et al. Examination of the antiglycemic properties of vinegar in healthy adults. Ann Nutr Metab. 2010;56(1):74-9.
- Salbe AD et al. Vinegar lacks antiglycemic action on enteral carbohydrate absorption in human subjects. Nutr Res. 2009 Dec;29(12):846-9.
- Ostman E. et al. Vinegar supplementation lowers glucose and insulin responses and increases satiety after a bread meal in healthy subjects. Eur J Clin Nutr. 2005 Sep;59(9):983-8.
- Petsiou E., et al. Effect and mechanisms of action of vinegar on glucose metabolism, lipid profile, and body weight. Nutr Rev. 2014 Oct;72(10):651-61.
- Shishehbor, F., Mansoori, A., Shirani, F. Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials. Diabetes Res Clin Pract. 2017 May;127:1-9.
- Johnston, C.S., Quagliano, S., White, S. Vinegar ingestion at mealtime reduced fasting blood glucose concentrations in healthy adults at risk for type 2 diabetes. Journal of Functional Foods. Volume 5, Issue 4, October 2013, Pages 2007-2011.
- Yamashita H. Biological Function of Acetic Acid-Improvement in Obesity and Glucose Tolerance by Acetic Acid in Type 2 Diabetic Rats. Crit Rev Food Sci Nutr. 2016 Jul 29;56 Suppl 1:S171-5.
- Kondo T1, Kishi M, Fushimi T, Ugajin S, Kaga T. Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects. Biosci Biotechnol Biochem. 2009 Aug;73(8):1837-43. Epub 2009 Aug 7.
Last Reviewed: October, 2019
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