The systematic review and meta-analysis from authors in Italy assessed the effect of ACV on anthropometric measurements in adults, in light of a growing trend of taking ACV shots to support weight control.
The researchers noted that some ACV studies have historically faced high risks of bias and low-quality influences, including publication bias, heterogeneity and small sample sizes. However, even after excluding these factors, they found that ACV may still improve weight and BMI.
“ACV may represent a valuable nutritional intervention for managing obesity, particularly when combined with appropriate lifestyle modifications,” the researchers wrote.
Benefits of apple cider vinegar
ACV continues to grow in popularity across social media wellness trends, praised for its “natural”, and “holistic” remedying effects.
It is often touted for many different health benefits, such as digestion, weight loss, skin and hair health, energy and detoxing. ACV has drawn particular attention for its potential metabolic benefits and reportedly improves glycemic control, insulin sensitivity, lipid profiles and oxidative stress. Some studies also suggest it reduces body weight and fat mass.
Evidence on ACV’s anti-obesity effects remains inconclusive, however, and many claims are anecdotal or derive from influencer content, increasing risk of exaggeration, the researchers noted. A recent meta-analysis found no significant impact on body mass index (BMI) but did not assess body weight or composition—a knowledge gap the researchers aimed to fill with their own meta-analysis of randomized controlled trials (RCTs).
Apple cider vinegar linked to weight and BMI reduction
The researchers searched PubMed, Scopus, Web of Science and Central for human studies on ACV and body composition, including RCTs in adults (18 years or older) that used ACV (alone or with diet/exercise) for one month or more and compared it against placebo or active controls. Outcomes included body weight, BMI, waist circumference (WC), waist-to-hip ratio (WHR) or fat mass (FM).
Eligible populations included healthy adults or those with obesity, diabetes, metabolic syndrome, hypercholesterolemia, MASLD or hypertension. Animal/in vitro studies, trials in minors, pregnant or breastfeeding women, interventions using other vinegars and studies without control groups were excluded.
Of the 2,961 reports screened, 10 RCTs with a total of 789 participants were eligible for inclusion in this meta-analysis, and results showed that ACV significantly reduced body weight, BMI and waist circumference, but not waist-to-hip ratio.
Subgroup analyses revealed that ACV also lowered body weight and BMI in both overweight/obese individuals and patients with type 2 diabetes, while waist circumference decreased only in the diabetic group. Higher doses (30 mL/day) produced greater reductions than lower doses.
“This systematic review and meta-analysis highlights that ACV may be effective in the prevention and management of obesity in overweight or obese adults, as well as in individuals with type 2 diabetes,” the researchers wrote “The results showed that daily intake of ACV was associated with a statistically significant reduction in body weight, BMI and visceral adiposity.”
They explained that ACV likely works through several mechanisms: slowing gastric emptying to increase satiety, improving insulin secretion and glycemic control, activating AMPK to boost fat oxidation and inhibit fat synthesis, lowering lipids and possibly modulating gut microbiota.
These mechanisms appeared especially relevant for individuals with type 2 diabetes, where ACV could complement lifestyle and pharmacological interventions.
As many of the studies included short intervention durations of between four and 12 weeks, the researchers suggested that future research test standardized ACV formulations at fixed dosages in larger, longer trials with body composition measured directly.
Source: Nutrients 2025, 17(18), 3000. https://doi.org/10.3390/nu17183000. “Effect of Apple Cider Vinegar Intake on Body Composition in Humans with Type 2 Diabetes and/or Overweight: A Systematic Review and Meta-Analysis of Randomized Controlled Trials”. Authors: Castagna, A. et al.
