The health benefits of vinegar
Vinegar is one of the oldest fermented foods. Humans have been making vinegar for thousands of years across many cultures, and writing about the health benefits of vinegar for nearly as long.
What is vinegar?
Vinegar is a solution containing around 4-7% acetic acid. Traditional vinegar is made through a two-step process:
Sugars derived typically from potatoes, wheat, barley, rice, honey, grapes or apples are fermented by yeast into alcohol
The alcohol is then converted to acetic acid by acetic acid producing bacteria often derived from a vinegar starter culture. This is called acetification.
Vinegars are more than just acetic acid though. Other constituents of vinegar include vitamins, mineral salts, amino acids, polyphenolic compounds (e.g., galic acid, catechin, caffeic acid, ferulic acid), and non-volatile organic acids (e.g., tartaric, citric, malic, lactic).
What’s special about balsamic Vinegar?
My favourite vinegar, traditional balsamic vinegar, is made from "grape must"- freshly crushed grape juice with all the skins, seeds and stalks, that is boiled to a concentrate, fermented and acidified, and then aged for 12 to 25 years or longer in wood barrels. The grape skins and stems add especially high levels of phenolic compounds and additional bioactive ingredients to the vinegar, as well as a depth of flavour and sweetness.
Of course, if you prefer the taste of apple cider vinegar or rice vinegar, or a particular vinegar is part of your food culture, then stick with that. Food is about so much more than nutrition. Flavour preferences and traditions are also important. By rights my British heritage should point me towards malt vinegar, but Modern British cuisine, much like Australian cuisine, has embraced elements of the Mediterranean diet including balsamic vinegar – thank you Nigella Lawson, Jamie Oliver and Rick Stein!
External effects - Anti-infective Properties
The preserving and sanitizing effects of vinegar were the most obvious and first employed beneficial effects of vinegar.
Hippocrates recommended vinegar for cleaning ulcerations and the ancient Romans took vinegar with them on long military campaigns to disinfect wounds.
Sung Tse, the 10th century creator of forensic medicine, advocated hand washing with sulphur and vinegar to avoid infection during autopsies.
And during the Black Plague in Europe, the inhabitants of towns and villages in the North of England where I grew up used vinegar stones to hold vinegar for cleaning coins, along with quarantine and isolation to contain the spread of pestulance.
Today, experts advise against using vinegar preparations for treating wounds, we have far more effective disinfectants available, but recent scientific studies have confirmed the antimicrobial properties of vinegar in the context of food preparation.
Pickling vegetables with vinegar likely originated in ancient Mesopotamia around 2,400 BC. Pickling vegetables in vinegar continued to develop in the Middle East region before spreading to North Africa, Sicily and Spain.
As well as limiting the growth of food-spoiling bacteria and fungi, pickling can also alter the fodmap content of some foods. A safe low FODMAP serving of drained pickled onions is 60g compared to just 22g of raw Vidalia (brown) onion. A low FODMAP serving of pickled garlic is one clove, whereas there is no low FODMAP serving of regular raw garlic.
What about effects inside the human body?
Vinegar affects a range of body systems. I’ll start with the effects for which have the strongest body of supporting evidence, and move through to claims that are a little more tentative.
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1. Lowering Cholesterol:
The antioxidants found in balsamic vinegar target the “scavenger cells” that are toxic to your body and inflate your LDL (unhealthy cholesterol) levels. Research involving rabbits suggests it may help maintain or lower cholesterol levels. Hence, balsamic vinegar can help protect your body from clogged arteries.
2. Regulating Blood Sugar:
Studies suggest that balsamic vinegar has an anti-glycaemic effect when consumed with meals. It helps to stabilize blood sugar levels, leading to less drastic spikes after eating. The impact can last up to 5 hours after a meal.
This may be in part due to effect on our digestive enzymes. A study using simulated stages of digestion in the lab demonstrated that balsamic vinegar affects the digestion of starch-rich foods (boiled potatoes) through the reduction of pancreatic amylase activity. Similarly, digestion of protein-rich foods, Parmigiano Reggiano cheese, and cured meat (Bresaola), is affected through the inhibition of gastric pepsin. You might have guessed that this study was conducted in Italy.
Other vinegars also have anti-glycaemic effects. A Japanese clinical study demonstrated that the addition of vinegar or pickled foods to rice (e.g., sushi) decreased the glycaemic index (GI) of rice by 20% to 35%.
3. Gut microbiome effects
The effects of vinegar on the gut microbiome are two-fold: decreasing harmful bacteria and promoting beneficial bacteria.
Vinegar decreases gastroenteritis-causing E. coli and Salmonella.
The acetic acid and other organic acids found in vinegar create an environment in the gut which promotes the beneficial bacteria that produce short chain fatty acids. The short chain fatty acids have anti-inflammatory and anti-oxidant effects in the body as well as providing energy for the epithelial cells of the colon and improving the integrity of gut barrier.
Similarly, the phenols found in balsamic vinegar (from the grape skins and stalks) act as prebiotic substrates for good gut bacteria. The phenols and other bioactive chemicals found in a traditionally fermented vinegar like balsamic vinegar also have their own beneficial effects directly on the body.
Kuroso a traditional Japanese rice wine vinegar is also very rich in phenolic compounds. The effects on the gut microbiome are not known, but studies in the lab. have indicated that an ethyl acetate extract of Kurosu vinegar has very high antioxidant properties. It is possible that clinical studies in the future may demonstrate health benefits associated with these antioxidants, but there is no data available yet.
4. Reducing Hypertension
Rat studies have indicated that vinegar may help to reduce high blood pressure, but again these effects have not been confirmed by any studies in humans.
5. Reducing obesity
There is some evidence that vinegar may help with weight loss – possibly increasing satiation levels. However, the studies have largely been in animals or are only short term in nature.
Any potential problems?
Are there any problems associated with vinegar? Not when consumed at normal levels. However, taken in high quantities the acid in vinegar can damage teeth and there are even records of vinegar damaging the oesophagus. Take special care if you have reflux.
Low FODMAP serving sizes
The low FODMAP serving sizes of vinegars are substantial.
You can consume 2 tablespoons (42g) per meal of red wine vinegar, Chinkiang vinegar, malt vinegar white vinegar, rice wine vinegar or apple cider vinegar.
There is a little more fructose in balsamic vinegar linked to its sweeter flavour. The low FODMAP serving size for balsamic vinegar is 1 tablespoon (21g) per meal.
The best way to enjoy balsamic vinegar
Whilst extra virgin olive oil is often seen as the star of the Mediterranean diet, some researchers believe that vinegar may play just as important a role in driving the longevity-boosting effects of the diet.
The Mediterranean diet is as much about a way of life as it is about food. Vinegar, especially wine vinegar like balsamic vinegar has the strongest health effects when combined with extra virgin olive oil in a generous dressing of leafy greens, tomatoes or other vegetables, enjoyed as part of a leisurely meal with friends.
Try our new recipe here,
And if vinegar, isn’t your thing. Why not try our Berries+ Daily Gut Health Boost with prebiotic fibre from PHGG to boost your SCFA producing bacteria, plus phenols from the real raspberry, strawberry and acai berry powders.
There is also data to indicate that PHGG promotes a healthy cholesterol profile. We’ll have a blog on that soon.
References:
Johnston, C. S., & Gaas, C. A. (2006). Vinegar: medicinal uses and antiglycemic effect. MedGenMed : Medscape general medicine, 8(2), 61.
Kondo, T., Kishi, M., Fushimi, T., Ugajin, S., & Kaga, T. (2009). Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects. Bioscience, biotechnology, and biochemistry, 73(8), 1837–1843. https://doi.org/10.1271/bbb.90231
Chen, H., Chen, T., Giudici, P. and Chen, F. (2016), Vinegar Functions on Health: Constituents, Sources, and Formation Mechanisms. Comprehensive Reviews in Food Science and Safety 15: 1124-1138. https://doi.org/10.1111/1541-4337.12228
Urbinati E, Di Nunzio M, Picone G, Chiarello E, Bordoni A, Capozzi F. (2021) The Effect of Balsamic Vinegar Dressing on Protein and Carbohydrate Digestibility is Dependent on the Food Matrix. Foods.10(2):411. https://doi.org/10.3390/foods10020411
Ninfali P, Mea G, Giorgini S, Rocchi M, Bacchiocca M. (2005) Antioxidant capacity of vegetables, spices and dressings relevant to nutrition. British Journal of Nutrition. 93(2):257-266. https://doi:10.1079/BJN20041327
Blog written by: Noisy Guts co-founder Dr Mary Webberley. Mary has a background in biology, with two degrees from the University of Cambridge and post-doctoral research experience. She spent several years undertaking research into the diagnosis of IBS and IBD. She also loves a salad doused in an EVOO and balsamic vinegar dressing 😋