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Vinegar, Wine, and Artery Function

In my video Vinegar and Artery Function, I discuss a famous study from Harvard University published back in 1999, which found that women who used oil and vinegar salad dressing about every day went on to have fewer than half the fatal heart attacks compared to women who hardly ever used it. That’s less than half the risk of the number-one killer of women.

Researchers figured it was the omega-3s in the oil that explained the benefit. I know you’re thinking: Those who use salad dressing every day probably also… eat salad every day! So perhaps it was the salad that was so beneficial. But no, they were able to adjust for vegetable intake so it didn’t appear to be the salad. Why, though, does oil get the credit and not the vinegar? Well, what about creamy salad dressings? They’re also made from omega-3-rich oils like canola, in fact even more so than oil and vinegar dressing. So if it’s the oil and not the vinegar, then creamy dressings would be protective, too. But they’re not. They found no significant decrease in fatal heart attacks rates or in nonfatal heart attack rates, for that matter. Now, it could be the eggs or butterfat in these dressings counteracting the benefits of the omega-3s or perhaps the vinegar is actually playing a role. But how? 

In my Does Apple Cider Vinegar Help with Weight Loss? video, I highlight a paper entitled, “Vinegar Intake Enhances Flow-Mediated Vasodilatation via Upregulation of Endothelial Nitric Oxide Synthase Activity.” In other words, vinegar enhances arterial function by allowing our arteries to better dilate naturally by boosting the activity of the enzyme in our body that synthesizes nitric oxide, the open sesame signal to our arteries that improves blood flow. Acetate is cleared out of your blood within half an hour of consuming a salad with a tablespoon of vinegar in it. This apparently isn’t enough time to boost the AMPK enzyme, but within just ten minutes, those kind of acetate levels can boost the activity of the nitric-oxide-synthesizing enzyme within human umbilical cord blood vessel cells in a petri dish.

But what about in people? Researchers also measured the dilation of arteries in the arms of women after they had one tablespoon of rice vinegar, one tablespoon of brown rice vinegar, or one tablespoon of forbidden rice vinegar that’s made from black or purple rice. All the vinegars appeared to help, but it was the black rice one that mostly clearly pulled away from the pack. Black rice contains the same kind of anthocyanin pigments that make some fruits and vegetables blue and purple, and may have independent benefits. For example, if you give someone a big blueberry smoothie containing the amount of anthocyanins in one and a half cups of wild blueberries, you get a nice spike in arterial function that lasts a couple of hours.

Thus, the highest maximum forearm blood flow in the forbidden rice vinegar group might be attributed to an additional or synergistic effect of anthocyanin with the acetate. But it could also just be the antioxidant power of anthocyanins by themselves. This could mean that balsamic vinegar, which is made from red wine, may have a similar effect, as it’s been shown to have remarkably higher free radical scavenging activity than rice vinegar. Could it be enough to counter the artery-constricting effects of a high-fat meal? We’ve known for nearly 20 years that eating a single high-fat meal like Sausage and Egg McMuffins with deep-fried hash browns is crippling to our arteries, halving their ability to dilate normally within hours of consumption. Even a bowl of Frosted Flakes, with its massive, unhealthy sugar load, it has no acute effect on the arteries because it lacks fat.

We aren’t just talking about animal fat. A quarter cup of safflower oil had a similar effect. In fact, the very first study to show how bad fat was for our arteries basically dripped highly refined soybean oil into people’s veins. Does this apply to extra-virgin olive oil, which isn’t refined? We know that some whole food sources of plant fat, such as nuts, actually improve artery function, whereas oils, including olive oil, worsen function. But you can see, smell, and taste the phytonutrients still left in extra virgin olive oil. So are they enough to maintain arterial function? No. Research showed a significant drop in artery function within three hours of eating whole-grain bread dipped in extra-virgin olive oil, and the more fat in the subjects’ blood, the worse their arteries did.

What if you ate the same meal but added balsamic vinegar on a salad? That seemed to protect the arteries from the effects of the fat. Because balsamic vinegar is a product of red wine, you might ask whether you’d get the same benefits drinking a glass of red wine. No. They found no improvement in arterial function after red wine. So why does balsamic vinegar work, but not red wine? Maybe it’s because the red wine lacks the benefits of the acetic acid in vinegar or because the vinegar lacks the negative effects of the alcohol. A third option might be that it was the salad ingredients and had nothing to do with the vinegar.

To figure out this puzzle, non-alcoholic wine was tested. The result? Non-alcoholic red wine worked! So maybe it was the grapes in balsamic vinegar and not the acetic acid. Indeed, if you eat one and a quarter cups of seeded and seedless red, green, and blue-black grapes with your Sausage and Egg McMuffin, you can blunt the crippling of your arteries. So, plants and their products may provide protection against the direct impairment in endothelial function, unless those products are oil or alcohol.

Check out my other videos on vinegar:

We are only as healthy as our arteries. For more videos on what may help or hurt, see:

Note that there is a level of sugar intake that can adversely impact artery function. I discuss this in my video How to Prevent Blood Sugar and Triglyceride Spikes After Meals.

Surprised about the alcohol data? For more on wine, see:

If you’ve been able to find forbidden rice vinegar, please let me know. I’d love to try it! You may be interested in my video on how pigmented rice may beat out brown rice: Brown, Black, Purple and Red (Unlike White on) Rice.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

78 responses to “Vinegar, Wine, and Artery Function

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  1. I must have a pea sized brain for I find the information on these blogs to be difficult to unravel. Someone once suggested that a summary at the end which highlighted the conclusion would be helpful. My brain and I agree!

    1. The conclusion is in the last sentence of the article. “So, plants and their products may provide protection against the direct impairment of endothelium protection unless those products are oil or alcohol.”

      But! at the end of the day, those women using oil and vinegar had half the fatal heart attacks. Bottom line. So, my questions would be:
      1. If a person can not afford the exhorbitant price of vegan omega 3, wouldn’t 1 tsp organic canola oil added to salad be a good thing? Already doing the 1 walnut and 1 tbsp flax btw.
      2. If salads are not eaten for lack of oil and vinegar dressing?

      There are 1 or 2 organic commercial salad dressings available with very low fat ie less than 2 gm per tbsp. They are alright, but not great. The online recipes for oil free dressings to me are unusable. Many contain concoctions of soy sauce, maple syrup, mustards or salsa/chili (ie condiments) or silken tofu which spoils quickly.

      1. Barb,
        Blog just seems so circuitous and in the end is it all over plant foods that provide this arterial benefit despite grapes being specifically mentioned?

        1. Yes Lida, Dr Greger has presented studies that demonstrate plants lower mortality, ie salad with oil and vinegar. He then went on to challenge the conclusion of that study which stated the benefit was seen to lie in omega 3s in the oil. By presenting other studies showing deleterious effects of oils on the arteries, and then studies showing benefit to vinegars, he singled out the plant product with most benefit.

          Dr Greger also cites studies on grapes, wine, non-alcoholic wine to compare effects on arteries. The alcohol had a negative effect. So, whole plant food, vinegars, and other plant products except for oil (including olive oil) and alcohol, have a positive/protective effect on our arteries.

      2. “Many contain concoctions of soy sauce, maple syrup, mustards or salsa/chili (ie condiments) or silken tofu which spoils quickly.”
        – – – –

        Ugh to anything containing more than 3 ingredients. :-( I cut right to the chase and use only a few drizzles of EVOO and a shake of apple cider vinegar plus lemon juice) on my salads.

        1. YR, I agree. There are some things I am willing to spend time on, but salad dressing isn’t one of them. Plus, for many salads a light viniagrette is just the right thing.

          As always though, reading Dr G’s articles is a learning experience for me. I spent time reading vinegar labels at the store and, like Blair, I am soo not impressed with many of the balsamic vinegars on the shelves. Why all the additives? I was looking for a sherry vinegar, but no luck. Lemon juice or apple cider it is.

          Also, I have in the past seen studies on mustard oil (used in india with the best omega 6:3 ratio out there )

        1. BChristine, no, actually organic canola oil is NOT gmo. Insist on organic, cold pressed. No oils are healthy, but that one has the best ratios imo.

            1. I just asked if there was any evidence at all in this instance.

              But, yes, personal testimony and anecdotes are one form of evidence. So are industry funded studies of the health effects of that industry’s products. They are not always regarded as credible evidence though.

              What do you intuit? Or do Abraham Hicks or Anthony Williams have anything to say on this?

              1. Were you asking me Mr Fumblefingers? Whenever the words ‘soy’ or ‘canola’ come up, we always get a hit and run comment on the ‘it’s gmo’ theme, which is why I replied the way I did. Some people do not realise that you can avoid the gmo objection (even if you are not sure what you are objecting to) by purchasing organic products.

                I believe Dr Greger did videos about gmo corn did he not? I will have to watch them again. EWG has sweet corn on their clean thirteen list, and that speaks volumes.

                1. No Barb. I was responding to BChristine who seems pretty definite that GMO canola oil is unhealthy if only because it is GMO.

                  I avoid GMO products myself on better-safe-than-sorry grounds rather than because I am aware of any convincing evidence that they are more unhealthy than their non-GMO equivalents. I just wondered if BChristine had any evidence for his/her statement.

              2. Fumbles dear, Abraham-Hicks does indeed have something to say about our beliefs regarding the foods we eat.

                You won’t check it out, of course, but A-H discusses this very subject in a video “Food, Diet, Supplements.” Woo-woo!

                1. YR

                  As that WC Fields quote I posted previously notes

                  ‘You can fool some of the people some of the time — and that’s enough to make a decent living’

                  A very decent living sometimes. I believe that Esther Hicks is now richer than Canada.

                  I believe he also said ‘It’s morally wrong to allow a sucker to keep his money’ so do you think that he might wish good luck to her and AW?

                  1. Ah yes….it’s always the money they find objectionable!

                    Money has been known to corrupt; therefore, anybody with a lot of money is corrupt.

                    I can’t say I know too much about AW. Have read only two of his books, so am not a groupie, per se. (There are plenty of NF groupies, though. *wink wink*)

                    1. Yes NF makes videos about the findings of scientific studies on nutrition and health. It is also a registered charity.

                      AW appears to just make stuff up that is largely drawn from various current alternative health beliefs. Nor is he a registered charity.

                      But sure there’s no real difference between NF, AW and the Hicks enterprise – they are all equally valuable and legitimate sources of information.


                    2. Cute horse. Sorta looks like you. *har-har snort-snort*

                      “…..they are all equally valuable and legitimate sources of information.”

                      I perceive that as a truthism, as truthisms go. “When the pupil is ready, the teacher appears.” It’s all good. AND it’s all an illusion.

                    3. YR

                      With beliefs like that, I’m surprised that you haven’t already disappeared up your own backside so you can do your navel gazing from the inside.

                      As for the old idea that everything is an illusion, the good Dr Johnson had something to say about it

                      ‘After we came out of the church, we stood talking for some time together of Bishop Berkeley’s ingenious sophistry to prove the nonexistence of matter, and that every thing in the universe is merely ideal. I observed, that though we are satisfied his doctrine is not true, it is impossible to refute it. I never shall forget the alacrity with which Johnson answered, striking his foot with mighty force against a large stone, till he rebounded from it — “I refute it thus.”
                      Boswell: Life

                    4. What did some dude who probably hadn’t bathed in weeks know about quantum physics or maya?

                      “Dr. Johnson,” she said. “You smell.”

                      “No, madam,” the good doctor replied. “You smell. I stink.”

                    5. OK I’ll bite. Ẁhat is ‘maya’ – since I assue you are not referring to either the Maya or the software program

                    6. And then there’s A Course in Miracles. So much to “play around with” — so little time! :-)

                      You got yourself a new keyboard, huh? You must feel confident that you’ll no longer fumble.

                    7. No the comment log-in proforma lost my Mr FF id and I absent-mindedly signed in under my real name. Still using the old laptop and a separate plug-in keyboard to add ‘m’ and commas, periods and use the ‘enter’ posts.

                      i don’t think that quantum physics affects Hume’s argument. For that matter, I suspect that you aren’t going to put the ‘it’s all an illusion’ idea to the test by jumping off the Empire State buiding or sticking a loaded shotgun in your othand pulling the trigger.

                      They say that BS baffles brains. I’m obviously not brainy enough to be baffled. Perhaps I should eat fish like you.

                      By the way, I had a look at the website. It sees right up your alley. Apparently it is the no 1 source for the truth and

                      ‘Human beings were created (that is, invented)
                      via genetic experiments that were conducted by
                      reptilian aliens. These reptilian aliens, also known
                      as the “Anunnaki” or the “Reptilians,” still rule the
                      Earth to this day.

                      In fact, the Reptilians have indoctrinated you so
                      thoroughly that you are probably too weak-minded to
                      even fathom that they exist. Via religion, science, and
                      other forms of indoctrination (i.e., brainwashing), the
                      Reptilians have steered you (and the rest of humanity)
                      in the exact opposite direction of the truth, to the point
                      where the concept of an alien master/creator is
                      considered to be the ultimate crazy fantasy.’

                      I think I’ll leave the Truth to you and stick with what the scientific evidence shows about nutrition and health.

                    8. Yada yada yada! I’m guessing you’re one of the air signs. Or…..a Virgo.

             is an interesting website, isn’t it! :-) It’s good to see you’re broadening your mind, so to speak. Again I say, we must discernment with everything we hear or read on the internet.

                      Yes, I DO believe in ETs and life on other planets, etc. Have good reason to do so, but I dare not touch that subject. :-P

      3. My all purpose dressing and marinade is two parts apple cider vinegar, one part lemon juice, one part soy sauce. Fantastic. I don’t use Balsamic because I can’t find any without sulfites.

        1. Blair,

          I am going to try it.

          I see no benefit to the oil. Though I do like grapes and will be giving them to my high-fat diet relatives.

          This sentence needs at least 5 exclamation marks: “Indeed, if you eat one and a quarter cups of seeded and seedless red, green, and blue-black grapes with your Sausage and Egg McMuffin, you can blunt the crippling of your arteries!!!!!”

          1. WebMD said that grapes also might lower cholesterol, so we can add them to both current topics.

            Hooray. That is an easy one to give to my brother.

            I don’t know that he is eating the blueberries for his NK cells, but grapes might be easier for him to eat daily.

            Does anyone know where they sell grape extract for when the store bought grapes are bitter.


            1. Deb

              The one used in the study is a patented Spanish product but you can get other types of grape exract from eg and a squillion other online supplement sellers.

      4. My fallback quickie is a creamy sort of ranch style dressing made of 1/2 avocado blended with a 1/2 cup + of plant milk and some vinegar and asst. spices of choice, and stored in a recycled glass jar… it will dress 3 salads or more for me. Easy, healthy, and no waste or spoilage providing you make salads a daily habit.

        1. Vegetater, am curious to know how much is your “some” vinegar — a tablespoon or so?

          Not that I would ever make this, delicious as it sounds. Too much work! :-)

  2. The blog focuses on arterial benefits of balsamic vinegar, and also mentions black rice vinegar…which I’ve never noticed on store shelves. I’m wondering if apple cider vinegar would have comparable benefits and would love to hear from you.

    1. Same question. Is balsamic vinegar best overall or do we know of any unique benefits offered by Apple cider vinegar?

      Do the benifits survive cooking? (I guess they do). I add balsamic vinegar to any sauces that red wine would be good in.

      They’re so many balsamic vinegars to choose from now in the supermarket, some have higher acidity or higher amounts of grape must. Which is best?

      1. Hi, Fan, I added freeze dried grapes to a sauce recipe in place of wine once, and it was fantastic! Thanks for your idea of using balsamic vinegar.

      2. Hi I’m a RN health support volunteer. Benefits have been found from all vinegars. That has what raised the theory that it is acetic acid in vinegar. There also may be some benefit from the grapes in balsamic vinegar. I don’t think there has been any studies comparing different types or brans of balsamic vinegars. But they would all have the grape antioxidants and acetic acid. I have not found any data that says cooking destroys the benefits of vinegar. I would recommend using whatever you like the most.


    2. Hello Hilda. Many thanks for your comments.

      Actually, apple cider vinegar has been extensively reviewed by Dr. Greger. He recently made an update here >>>

      And there’s also some other videos in relation to this type of vinegar:



      Hope this helps

  3. Can someone please tell me where my thinking is wrong?
    If acetate is the mediator of all the positive effects, but the low pH of acetic acid a concern, why don’t any interventions evaluate acetate salts, like sodium or calcium acetate? These can be easily dissolved into liquid or sauces, and they are both FDA GRAS food additives.

    Thanks in advance for the insights

    1. Good question, I would like to know the answer as well. I believe vinegar is a very dilute acid so it is quickly turned into acetate in the body. Your question did remind me that acetate is a by-product of fiber fermentation in the gut. At least some of the positive effects of fiber might be explained by this.

    1. Extra virgin olive oil does not affect the endothelial layer when eaten on a salad. The little antioxidants of the salad (or vinegar) somehow creates that effect. But the olive oil has many other positive effects. Thus, if you are able to eat it without any negative effect (on a salad), your net would be positive. For example, extra virgin olive oil will multiply lutein absorption (dark leafy greens like baby spinach).

            1. Good news for genetically engineered mice certainly.

              The AHA’s scientific advisory on dietary fats, however, suggests that omega 6 PUFAs may be a better bet than MUFAs for humans. When it comes to animal studies, they noted, PUFAs apparently reversed atherosclerosis in primates but MUFAs did not

              ‘We judge the evidence to favor recommending n-6 polyunsaturated fat, that is, linoleic acid, stronger than monounsaturated fat to replace saturated fat because of the positive results of randomized clinical trials that used polyunsaturated fat compared with the paucity of trials that used monounsaturated fat10; the greater relative risk reduction for polyunsaturated fats in observational studies12,17,18; the greater reduction in LDL cholesterol with polyunsaturated fat4; and the regression of atherosclerosis in nonhuman primates by polyunsaturated but not monounsaturated fat.5’

              ‘In sum, the monkeys fed monounsaturated fat developed equivalent amounts of coronary artery atherosclerosis as those fed saturated fat, but monkeys fed polyunsaturated fat developed less. The beneficial effects of the lower LDL and higher HDL in the animals fed monounsaturated fat apparently were offset by the atherogenic shifts in LDL particle composition. Dietary polyunsaturated fat appears to result in the least amount of coronary artery atherosclerosis because it prevents cholesteryl oleate accumulation in LDL and the coronary arteries in these primates.’

              This may be a reason why Dr Greger appears to think that canola oil is preferable to olive oil (If people insist on using oil in the first place)

              1. But you treat olive oil by itself. But the benefits are obtained from a combination (leafy greens + olive oil). Thus you are not making any point.

                Treat [OLIVE OIL + LEAFY GREENS] as one

  4. Try this simple one: 2 apples, cored, 1 navel orange, peeled plus 1/2 tsp cinnamon blended together. (Add a little water if your blender is not a Vitamix or Blendtec.) After these videos about the benefits of vinegar, I now add 2 -3 Tbs. balsamic vinegar but still, it’s very easy and tasty..

  5. Enzymedica has a black vinegar supplement from black rice. Not ideal but couldn’t find anything in pure form. Saw it in Whole Foods today.

  6. I prefer not to use any oils or vinegar’s, oil is just fat, and the liver does not like vinegar’s or alcohol, just eat the grapes folks! I use tahini and lemon in my salads, sometimes avocado especially in potato salad.

      1. Valid point that no control group but neither did this study which Dr. G mentions in this article.
        6 weeks may not be long but then the study above was based on 10 meals.
        I am wary of any refined oil but there is a groundswell of praise for olive oil here in the U.K. It is a significant factor in the Med. diet.

        1. There is a lot of support for the Mediterranean Diet everywhere in the English-speaking world and olive oil is certainly better than hydrogenated oils, butter, lard and many other fats. if you are going to include a concentrated source of fat in your diet though (I see no reason why you should but that’s another matter) olive oil may not be optimal. It is mainly monounsaturated fat and the Aerican Heart Association’s expert scientific panel (which reviewed dietary fat and heart disease) concluded (page e3):

          ‘We judge the evidence to favor recommending n-6 polyunsaturated fat, that is, linoleic acid, stronger than monounsaturated fat to replace saturated fatbbecause of the positive results of randomized clinical trials that used polyunsaturated fat compared with the paucity of trials that used monounsaturated fat10; the greater relative risk reduction for polyunsaturated fats in observational studies12,17,18; the greater reduction in LDL cholesterol with polyunsaturated fat4; and the regression of atherosclerosis in nonhuman primates by polyunsaturated but not monounsaturated fat.5 However, progress in reducing CVD would be enhanced by replacing saturated fat by either type of unsaturated fat.’

          They also remarked (pe8):

          ‘Finally, we note that a trial has never been conducted to test the effect on CHD outcomes of a low-fat diet that increases intake of healthful nutrient-dense carbohydrates and fiber-rich foods such as whole grains, vegetables, fruits, and legumes that are now recommended in dietary guidelines.’

          You might also find it interesting to review some of the other videos/blogs on this site about olive oil eg

  7. I am unit leader for Aging Life Association SE Unit
    I am still looking for a speaker to present to our group of professionals ( nurses, social workers care managers.

  8. I have been unable to find a source of black rice or forbidden rice vinegar anywhere. Most vinegars labeled “black vinegar” are made from brown rice.

    If you’re going to say that a particular type of product is rated the best, it would be helpful if you could give some sort of pointers as to how to obtain it. It is totally frustrating to be told that the effects of black rice vinegar were way ahead of the other vinegars and then to not find it.

    I appreciate your videos and have since you started. And I realize you don’t advertise or recommend. But with something not widely available, you could at least provide a couple of sources (web sites or companies).


  9. Here is where the confusion is. The vinegar or grape product may protect you from the impairment of the olive oil unless the grape product has alcohol in it. There is an error in the last sentence on the blog post. It should not say “unless those products are oil or alcohol”. The vinegar, grapes or alcohol free wine does not have oil in them obviously. The last sentence should read unless those products contain alcohol.

    What if you ate the same meal but added balsamic vinegar on a salad? That seemed to protect the arteries from the effects of the fat.

    So, plants and their products may provide protection against the direct impairment in endothelial function, unless those products are oil or alcohol.

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