Health Benefits of Vinegar: All vinegars are not equal

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Historical perspective

Vinegar has been in use for thousands of years during the course of civilization. It was frequently flavored with different types of fruit and honey. The medicinal use of vinegar is mentioned in the bible. Hippocrates used it for healing wounds.

One of stories attributes the discovery of vinegar to a courier in Babylonia from ancient Mesopotamia in 5000BC. He discovered wine form from unattended grape juice eventually leading to discovery for use as a preservative.

Cleopatra in 50 BC  is reported to have used vinegar to dissolve precious pearls in vinegar and presented it as a love potion to Anthony.

According to Chan and colleagues, “Sung Tse, advocated hand washing with sulfur and vinegar to avoid infection during autopsies” in China during the 10^th century.

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Traditional uses of vinegar

• Medicinal use
• Cleansing agent
• Culinary use
• Preservative including but not limited to Fruits and vegetable pickles
• Use in salad dressings
• Mustard,
• Flavoring agent

Types of vinegar

Various kinds of vinegar are produced in different geographic areas of the world.

• Apple cider vinegar and red wine vinegar are ubiquitous throughout the world.
• Distilled vinegar, rice vinegar and champagne vinegar are common in the United States.
•   Fruit vinegar is popular is popular in Austria, cane vinegar in Philippines, whereas coconut is the common substrate for vinegar in Southeast Asia.

History of medicinal use

Before the modern pharmaceutical era began, mainly diseases were treated with vinegar. These included:

• Dropsy, old term used for swelling in body with excess water
• Intestinal colic
• Infections
• Poison ivy
• Stomach pains and indigestion
• Croup, term used for some types of upper respiratory infection usually viral
• Vinegar tea for diabetes

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Antioxidant properties of vinegar

Reactive oxygen species in the body are involved in many degenerative diseases. Antioxidants may help modulate the occurrence and course of such degenerative disorders.

Vinegar contains a variety of polyphenols and vitamins with antioxidant properties. However, the polyphenol content of various vinegars varies with the substrate used for vinegar.

• While grape vinegar has 2000-3000 mg/L of polyphenols, apple cider vinegar has 400-1000 mg/L followed by sherry vinegar at 200-100 mg/L.
• Persimmon vinegar has greater anti-oxidative capacity than red or white wine vinegars.
• Antioxidant activity of Kurosu vinegar is superior to that seen in wine and apple vinegars.
  

Production process for vinegar

Vinegar is produced as a 2-step process, first producing alcohol by fermentation of sugar-starch containing substances like grapes, apples, tomatoes, rice etc. and then converted into acetic acid.

• Acetic acid bacteria are ubiquitous, and play an important role in food and beverage industry. They are used as starting culture and a variety of species have been identified.
• Due to increasing recognition of functional properties of vinegar as well as potential health benefits, the production of fruit-based vinegar has been rising across the world.

A starter culture of vinegar is used just as starting culture is used in making yogurt. While traditional vinegar fermentation process might take a month, current techniques can make it in less than a day. Many of these advanced techniques took root in the 18^th and 19^th century.

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Functional actions depend upon types of acids in vinegar

All vinegar is not created equal with respect to its functional properties

While acetic acid is the most common component, other acids depending on the substrate used, bacterial culture and fermentation process include but not limited to citric acid, lactic acid, tartaric acid, malic acid, succinic acid etc.

Vinegar production is sometimes based on plants considered to be medicinal in the area that it is produced. For example:

• Persimmon vinegar utilizing persimmon fruit and ophiopogon vinegar produced from medicinal herb Radix Ophiopogon japonicus in China.
• Prebiotic rich plants like Yacon (Smallanthus sonchifolius) is found widely in South America. Yacon is rich in prebiotic fructo-oligosaccharides.

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Health and Therapeutic Effects of Vinegar

Antibacterial effects

While not as effective as commercial products, vinegar/acetic acid have been used as home remedies or cleansing agents for thousands of years.

Acetic acid exerts antibacterial properties by entering the cell wall of bacteria and essentially killing it.

• Cleaning and disinfecting for diverse roles including cleansing of modern feeding tubes and treatment of external ear infections.
• Different acids in vinegar have different antibacterial capacities, with acetic acid being the most active with lactic, citric, and malic acids less potent.
• Preserving food.

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Vinegar helps against diabetes

Johnston and colleagues studied subjects with insulin resistant diabetes type 2 and healthy controls in a cross-over fashion. Subjects consumed 20g apple cider vinegar with water or a placebo drink followed by high carbohydrate meal (87g of carbohydrate). Blood samples were analyzed in fasting state and after meal.

• Whole body insulin sensitivity index improved 34% in insulin resistant diabetics versus 19% in insulin sensitive diabetes. Vinegar administration also resulted in significant reductions in fluctuations in glucose and insulin levels. Authors suggested that acetic acid in vinegar may have properties similar to antidiabetic medications such as metformin and acarbose.

Brighenti and colleagues have demonstrated that a small amount of vinegar used as salad dressing significantly affects the glucose response to a mixed meal in normal healthy individuals.

Ostman and colleagues reported in the European Journal of Clinical Nutrition that use of vinegar after a bread rich meal produces lower glucose and insulin responses and increases satiety in healthy subjects.

Dr. Carol S. Johnston and colleagues from the Arizona State University investigated the effect of vinegar on glucose and insulin levels in humans in a crossover trial.

• Subjects included nondiabetic subjects as well as those with diabetes. They consumed vinegar (20 g apple cider vinegar, 40 g water, and 1 tsp saccharine) or placebo followed by a high carbohydrate meal.  Vinegar ingestion raised whole-body insulin sensitivity in insulin-resistant subjects as well in in diabetics.

Vinegar controls high blood pressure or hypertension

Dr. Kondo and colleagues have shown that dietary vinegar reduces blood pressure in animals and this action is due to the acetic acid in it.

Vinegar use enhances physical endurance

Sugiyama et al studied 40 untrained subjects during a 1-h walking experiment to examine the effects of acetic acid bacteria administration on muscle damage in a double-blind placebo-controlled crossover trial. The investigators found that results indicated that administration of acetic acid bacteria resulted in lesser inflammation, muscle damage and ankle pain as compared to placebo. 

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Effects against cancer

Shimoji and colleagues demonstrated that Kurosu, a Japanese vinegar from unpolished rice blocks experimental colon production in rats.

• Kurosu vinegar, probably due to its high anti-oxidant properties blocks cells from cancers of the colon, breast, bladder and prostate in the laboratory. Higher the amount of vinegar used, more the blocking effect.

Kibizu vinegar produced from sugar cane is effective against leukemia cells.

Linzhou city in China has a high prevalence of cancer of esophagus. Xibib conducted a case control study using patients diagnosed with this cancer and between the ages of 30 and 75 yrs. 211 cases and 633 control subjects formed the data base. They found that the those consuming vinegar were much less likely to develop this cancer.

Studies from Dr. Nishidai’s laboratory in Japan have demonstrated that vinegar produced from polished rice has anti-tumor actions in mice and these are mediated by its antioxidant actions.

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Effects against obesity

Vinegar affects glucose levels of a meal by causing satiety and as such person may consume less food.

• Ginsam, is a popular herbal medicine. It is a vinegar extract from Panax ginseng. According to Dr. Lim and colleagues, has a beneficial effect on body weight control in obese animals. The animals also displayed a superior glucose control. These effects occurred via ginsam affecting the functioning of genes involves in glucose and fat metabolism.
• Dr. Kondo and colleagues conducted a double blind trial to examine the effects of vinegar intake on the body fat m in obese Japanese in a double-blind trial. The subjects randomly received 500 ml daily of a drink containing either 15 ml of vinegar, 30 ml of vinegar , or placebo). The investigators found that body weight, waist circumference were significantly lower in both vinegar dose groups as compared to placebo group.
• Another study involved human subjects consuming red raspberry vinegar daily or cranberry juice for 4 weeks. The investigators found that vinegar group lost weight while cranberry group gained.
• Drs, Johnson and Buller conducted randomized, crossover design involving use of vinegar or peanut ingestion along with high carbohydrate meal. Both groups had reduced food consumption during the day.

Vinegar lowers cholesterol

Administration of apple vinegar to fat animals results improved lipid profile showing lower cholesterol and triglyceride levels. The effect of even apple vinegar on lipids can vary with the manufacturing method.

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 Jen reviews on on apple cider vinegar.

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