Doctor's Note

Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. And check out the other videos on vinegar. Also, there are 1,686 other subjects covered in the rest of my videos--please feel free to explore them as well!

For some context, please check out my associated blog posts: Soymilk: shake it up! and  NutritionFacts.org: the first month.

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  • Michael Greger M.D.

    Just wanted to clarify about the “calorie-free” nature of vinegar. If you walk into your kitchen right now and pick up a bottle of vinegar you will see on the label: zero calories. Does it actually have zero? No. According to the USDA nutrient database, it has 3 calories per tablespoon, but that is considered such an insignific­ant amount (how much vinegar can you really use in a meal anyway?) that the FDA allows them to label it zero (per 1 CFR 101.9(c) of the FDA labeling guide: “less than 5 calories [per serving] may be expressed as 0 calories”)­. So I should have said “virtually­” zero, or “effective­ly” zero. Given the effects on gastric emptying I talk about in the video, though, one would expect a net decrease in caloric intake, which is what matters in the end (i.e. why we typically care about calories). So there are actually technicall­y a few calories, but for practical purposes (and that’s what the website is all about–hel­ping inform people to making real-world day-to-day decisions based on the best available science) it’s essentiall­y calorie-fr­ee.

    • Mikedownunder

      Some balsamic vinegars have a lot of sugar in them and therefore have a substantial calorific value!

  • http://www.facebook.com/profile.php?id=100001374954706 Shanta Jackson

    Can individuals just drink the 2 tablespoons of vinegar by month or just adding it to prepare food is equall

  • Karen LaVine

    Just 2 TEASPOONS, not tablespoons was the effective amount that was used in the study. But be sure to dilute it with something – a serving of food or some water or into a serving of salad dressing, before you ingest it.

    • NotRappaport

      “But be sure to dilute it with something … before you ingest it.”

      Why?

      • ken

        I believe that it’s rough on the tooth enamel. But some people do drink it (apple cider vinegar) straight up. I’d guess they put it in the back of the throat and swallow to keep it away from the teeth. Maybe something the good Dr. can checkout if it’s fact or fiction. :)

        Also heard you shouldn’t brush you teeth within 30mins of consuming vinegar.

  • aeason

    I have heard that apple cider vinegar which I know contains potassium, that is can also leach potassium, and can thus contribute to high blood pressure.
    Do you have any information about this?

  • Michael Greger M.D.

    There are a baker’s dozen articles in the medical literature on apple cider vinegar (as indexed by the National Library of Medicine), and indeed there is a case report “Hypokalemia, Hyperreninemia and Osteoporosis in a Patient Ingesting Large Amounts of Cider Vinegar” that does suggest ingestion may lead to potassium wasting. Acetic acid in vinegar is rapidly metabolized in the liver into bicarbonate, which the kidneys use potassium to excrete from the body. So chronic use of high doses could lead to problems–the woman described in the report was drinking more than a cup of vinegar day! One would not expect any such problems as the doses described in the studies featured in the Is Vinegar Good For You? video (2 teaspoons with meals). I would, however, warn against apple cider vinegar pills. A study published in the Journal of the ADA of 8 such products found some “could be considered poisonous, as indicated by the Consumer Product Safety Commission….”

  • Synergy

    What of ACV’s long reported ability to stop a cold/flu in its tracks? Are there any studies that confirm or deny this old folk remedy? On the same note, what of ginger, garlic and onions for the same (and vitamin D3 for that matter — I’ve heard one theory that we get the flu because the sun is at too low an angle to synthesize sufficient if any vitamin D)?

    Around this time of year everyone is always looking for safe natural remedy’s without resorting to ibuprofen etc. I also recall something about red seedless grapes, pineapple and a few other fruits and veggies being beneficial when it comes to cold/flu with grapes being most effective if you catch it early.

    Sorry, a whole lot of questions but all the same main idea. Nobody likes getting sick!

    • DrDons

      Colds and flus are caused by viruses. Colds while annoying are less a concern than flu which can be a real problem. Avoiding influenza is complex area but the best overview I have read is in Dr. Greger’s book on Bird Flu available for free read on internet at http://birdflubook.com/g.php?id=5… go to the chapter on “Our Health in Our Hands” for information on social distancing, masks, handwashing. Reading the whole book will provide a sobering context of the situation we may find ourselves due to CAFO’s and provide insight in to where the real danger to the world’s population arises. You could also view Dr. Greger’s answers to questions about being prepared during the swine flu infestation. http://crazysexylife.com/2009/what-you-should-know-about-swine-flu-qa-with-dr-michael-greger/… key is to be prepared not scared! I would not put as much faith in home remedies as the efforts mentioned above plus boosting our immunity through sleep see http://nutritionfacts.org/videos/sleep-immunity/.

  • Jessica

    Dr. Greger, are you familiar with research linking high glycemic foods with incidence of macular degeneration? (NY Times reported on a 7/07 study in The American Journal of Clinical Nutrition.)

    Is there any reason to believe that restricting high glycemic foods, adding in vinegar, or boosting antioxidants by eating lots of leafy greens would help prevent further development of severe macular degeneration?

    • Michael Greger M.D.

      I’m so glad you brought this up. Age-related macular degeneration (AMD) is the leading threat to eyesight among the elderly and responsible for millions of cases of blindness every year. The study you may be referring to is “Dietary glycemic index and the risk of age-related macular degeneration” available full-text here. As you’ll read, they conclude that “Low-glycemic-index foods such as oatmeal may protect against early AMD.” Eliminated refined carbs may also slow progression. A study published this year (and available full-text here) suggests that three simple lifestyle behaviors (a healthy diet “abundant in plant foods,” daily exercise, and no smoking) can eliminate most of our risk. See My video Egg Industry Blind Spot for a discussion of the best sources of eyesight-sparing nutrients.

      • Jessica

        Thank you, Dr. Greger. This is precisely the information I needed, and I really appreciate your sharing the links to the full articles. I will be sure to pass this information along — the person I have in mind has been told, “There’s nothing you can do to fix this.” While that may be accurate, what she hasn’t been told is that there is something she can do to keep it from getting worse.

  • Toxins

    Hello Jessica,

    Eating leafy greens is extremely effective in preventing macular degeneration. Check out Dr. Greger’s video on the topic.
    http://nutritionfacts.org/videos/egg-industry-blind-spot/

  • Jessica

    Toxins,

    Thanks! I am interested in preventing macular degeneration (in myself) but also in arresting further development in a loved one who has severe, wet macular degeneration. My question for Dr. Greger had to do with that second concern – this far in, can anything be done?

    Jessica

  • Tim J.

    I have been listening to your articles and I find many good points that I agree with. In regards to taking vinegar with meals I believe that it shows lower levels of blood spiking due to the vinegar impeding digestion. A better choice for folks would be to not consume cooked and processed foods like bread (which converts to sugar anyway) that spike blood sugar and stick to a plant based diet that regulates blood sugar (especially living foods such as freshly harvested sprouts). If people ate more plants they would not need the vinegar and they would not feel like they were hungry all the time.

  • Mary

     Is it safe to intake vinegar if you have ulcers.

  • BigBoyyy

    Am wondering If vinegar Is healthy For your Body?

  • sierra

    well is it good for u or not it dosent realy tell if it is or not

  • http://www.facebook.com/dan.lundeen Dan Lundeen

    What about the acids in cultured veggies like sauerkraut or kimchee?

  • Ronald Chavin

    Does vinegar cause cancer? Russian researchers say, no, not by itself but vinegar (acetic acid) increases
    the deadliness of any cancer-causing nitrosamines in our diet. Salt
    and sea salt always contain nitrosamines. Beef, pork, and poultry
    always develop nitrosamines (and heterocyclic amines) when they are
    cooked in normal ways. Processed meats contain nitrosamines even before
    they are cooked. The only way to avoid creating nitrosamines in
    bloody, raw meat is to boil it in water without adding any salt. Balsamic vinegar is by far the
    most delicious of all vinegars but it contains a substantial amount of
    lead, which is toxic. The lead comes from the oak wood casks used in
    Italy to manufacture balsamic vinegar. Distilled white vinegar is made
    from corn and is very low in lead. French’s Yellow Mustard,
    Worcestershire Sauce, Heinz Ketchup, and many other commonly consumed
    foods contain substantial amounts of distilled vinegar in their
    ingredients.

    These 2 scientific studies from Russia say that vinegar does not
    cause cancer by itself but it increases the severity of the
    cancer-causing effect of nitrosamines:
    http://www.ncbi.nlm.nih.gov/pubmed/2635642
    http://www.ncbi.nlm.nih.gov/pubmed/3381501

    Balsamic vinegar is delicious, almost always made in Italy, and contains the most lead:
    http://www.ncbi.nlm.nih.gov/pubmed/21550100

    According to Environmental Health News, “The aged varieties produced by the traditional method, which involved concentration in wood
    barrels for at least 12 years, have the highest lead levels:”
    http://www.environmentalhealthnews.org/ehs/news/lead-in-vinegar

    Balsamic vinegar must be aged for a minimum of 12 years to a maximum of 25 years during which time the atoms of lead transfer from the oak or
    other wood into the balsamic vinegar.

    However, vinegar is slightly beneficial in causing weight loss,
    preventing and treating diabetes, preventing heart disease, preventing
    stroke, and preventing and treating high blood pressure.

    • DH

      Ron, do you still stand behind the statement that balsamic vinegar has a tremendous amount of lead?

  • Mike Lovett

    I love vinegar! I lived in China several years and vinegar is a staple. You will find (usually) three condiments and one spice on an authentic Chinese restaurant’s table: Soy Sauce (Jiang You), rice vinegar (cu), chili sauce (la jiao) and white pepper (bai hujiao)

  • Suzanne

    thank you for posting again Dr. Greger! My husband (diabetic) is on this kick from a book called PH Miracle. And that author concludes that diabetics must keep their bodies very high alkaline and does not want any vinegar in the diet. The author also wants readers to take alkaline pills which I guess are most sodium chloride – isn’t that table salt? – and to eat 4+ avocados/day (I did say 4) and liberally use cold pressed olive oil as salad dressings to help absorb vegetable nutrients. Luckily he does prescribe a most vegan diet – no grains/starchy veg, but allows some oily fish. Sounds a bit whacky if you ask me.

    • Toxins

      All whole plant foods will produce a net alkalinity or very close to it. Please see Dr. Greger’s video here.
      http://nutritionfacts.org/video/alkaline-diets-animal-protein-and-calcium-loss/

    • Thea

      Suzanne: Wow. I agree, that diet sounds super, super whacky to me. (Perfect word.) If you are able to get your husband to read the following book, I think it would do him (and you) a world of good. It not only includes great info, but has a set of recipes in the back of the book. And his diet is clinically proven.

      “Dr. Neal Barnard’s Program for Reversing Diabetes. The scientifically proven system for reversing diabetes without drugs.”

      http://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_1?s=books&ie=UTF8&qid=1384808299&sr=1-1&keywords=barnard+diabetes

      If you can’t get him to read the book, you might start by seeing if you can find a YouTube video from Dr. Barnard on this topic. Someone told me that she found a 20 minute video from Dr. Barnard on this topic. Her husband had just been diagnosed with diabetes, but wasn’t interested in a vegan diet. But she got him to watch the video (sorry I don’t have a link) and her husband said something like, “Hmmm. He’s not a crackpot.” Now her husband is a HUGE believer. :-)

      Best of luck to you both.

      • http://www.DonForresterMD.com/ Don Forrester MD

        I second Thea’s recommendation to read Neal Barnard’s book. Other resources including a DVD can be found on the PCRM website. The diet from the book The PH Miracle is not the best diet for diabetics. I’m not aware of any good scientific studies to support it’s use. The recommendations you mention are not consistent with the current science. My patients who read and followed Dr. Barnard’s recommendations did very well. It is important to work with your physicians as medications need to be reduced quickly. Another resource is the McDougall newsletter article entitled, Simple Care Diabetics, in the December 2009 issue. Best.

  • Dee

    Are you telling me this information is wrong? If so, would you kindly explain.

    • Kitsy Hahn

      Dee, I don’t know if anybody else saw your question, but I’m wondering where you found this article. Who is the author? Dr. Jarvis, who wrote Folk Medicine, highly recommended apple cider vinegar. Whenever I eat out in restaurants I take a bottle of water mixed with two teaspoons ACV to help digest some of the questionable food items that are served to us. Works for me!

      http://en.wikipedia.org/wiki/D._C._Jarvis

      • vardarac

        That info is from the “80-10-10″ diet, which advocates raw high carbs. I can’t speak to the correctness of the information there. Anyone have the sources he uses for those paragraphs?

    • vardarac

      What was the original source of the information? I can find the book it was written in, but not the sources cited for these specific claims.

  • Beth

    Was recently diagnosed with GERD. I had been consuming about 2 tsp of Org apple cider vinegar in warm water every morning and eating a homemade garlic dill pickle with meals in the afternoon. The typical GERD dietary suggestions have you eliminating most acidic foods. So is it safe for me to be drinking vinegar or anything else acidic? I have also been drinking organic aloe vera juice, about 4 to 8 oz per day. But now am wondering if I should be doing that as well because the aloe tastes very acidic, like I’m drinking lemon juice in water, which I have stopped doing as lemons are on the typical list of foods to avoid. I have been diagnosed with a hiatal hernia in the cardia, erythema and congestion in the duodenal bulb and in the antrum & distil stomach body, & ring in the GE junction. I was prescribed omeprazole-sodium bicarbinate, but have not taken any of this, as I am very reticent of starting on any PPIs. I want to attempt to control this condition with dietary and physical changes, but the information out there is so confusing. Also high carb VS low carb diets? I’ve found resources for both points of view, and so I really don’t know what to eat. Right now I am following the typical GERD diet protocol, minus any meat or eggs. What suggestions might you offer?