After reading my pH results on beverages, fellow mamas have raised the question: would it be possible to add a pinch of baking soda to Good Girl Moonshine (GGMS) to neutralize the acid to make it safer for dental enamel while still having the health benefits of apple cider vinegar (ACV)?  They cite the tip that you can do this with coffee to reduce its acidity. So, as with many things in my life, this pH experiment has sent me down a rabbit hole.

Please note, I am not a nutritional expert by any stretch of the imagination, just curious. I’m a skeptic by nature, and when I hear things like, “The ACV in GGMS will destroy your tooth enamel! Don’t drink it!”, I start thinking, “Is it any worse than Diet Coke or coffee or is it just fact that vinegar is a known acid that has people freaking out?” And then I end up with science experiments in the kitchen with my homeschooled kids. Then people ask more questions and that leads to more digging. I’m sure someone smarter than me can find more concrete evidence and for every piece of evidence I find to validate one perspective, there is one that can be found to back up the opposite claim. For more on that whole thing, see my I Watched a Documentary… post. What you will see here is a summary of a quick hour’s worth of reading I did before church this morning. It is not exhaustive, and there are conflicting viewpoints on ACV and its uses. You will have to judge for yourself what to believe. The core question I am trying to deal with in this post is whether it is the acid in the ACV that provides health benefits because if it is the acidity of it that provides the benefits then adding baking soda to neutralize the acidity will also negate the health benefits.

Challenges

About the only benefit of ACV that I could find a scientific study to back up was that ACV has an anti-glycemic effect. There was one small study done in Japan that showed a potential connection to ACV consumption and weight loss (ACV users lost 1-2 pounds more than the non-ACV users), but I didn’t come across any in-depth studies published in reputable journals other than that. ¹  Now, I am not anti-alternative medicine, but I do need more than “it has been used for centuries to cure xyz condition” as proof of a claimed benefit because, let’s face it, just because it has been used for centuries doesn’t mean it is actually what is doing the curing of xyz condition. Correlation and causation are two different things and we often get them confused. So, ACV may or may not do all the stuff listed at various websites, but there isn’t much out there to backup those claims aside from anecdotal evidence. I have tried to include sources from both the alternative/naturopathic health camp and more conventional Western medicine organizations to cover my bases between various types of mamas, however, the alternative/naturopathic claims often lack evidence or sources to back them up.  This means that I can’t say with certainty that their theories on the mechanisms that make ACV effective are indeed accurate or simply educated guesses. Some think the National Institute of Health (NIH) is an arm of the devil himself, while others will only accept NIH endorsed stances.  The sources listed here that come from the NIH PubMed website are simply research journal articles that are indexed by the NIH for searching.  Keep in mind there are probably elements of truth and myth in both camps.

The problem I am running into in trying to get answers for this question is that there is very little explanation of the science or mechanism of why ACV works for things like stabilizing blood sugars and possibly helping with weight loss and digestive health. Even when there have been scientific studies of ACV, they have only studied the outcomes (i.e. weight loss or lower blood sugar) and haven’t studied the how of those outcomes (i.e. if it’s the acid that is causing the improved health benefit, or the “mother”, or other aspects of the vinegar). They are often reported with phrases like “the researchers suggest…” meaning that scientists are speculating at what about ACV is causing the benefits. I suspect that as more studies are done that show a relationship between ACV use and health benefits, researchers will move on to studying the how. But for now, there are many gaps and unknowns.

What the Evidence Says

That said, my gut feeling (no pun intended) is that it is, at least partially, the acidity of the vinegar that causes some of its benefits—particularly the glycemic effects and weight loss. This was backed up in a research study in the European Journal of Clinical Nutrition titled “Effect of neutralized and native vinegar on blood glucose and acetate responses to a mixed meal in healthy subjects”, published in April 1995, where researchers noted that white vinegar used as a salad dressing significantly reduced the glycemic response of normoglycemic (non-diabetic, non-hypoglycemic) individuals while neutralized vinegar did not alter the glycemic response. ²

Additionally, a study in the September 2005 edition of the European Journal of Clinical Nutrition noted a negative linear relationship between the acid level of a meal and the post-meal blood glucose levels (when the meal included more acid, post-meal blood glucose levels were lower). This study also noted that there was a direct linear relationship between the acid level of the meal and the feeling of satiety post-meal. The higher the amount of vinegar consumed with the meal, the longer the person felt full afterward. ³

However, another study in the Journal of Nutrition in March 2000 indicated that there is something about acetic acid (vinegar) that alters the glycemic response that other acids (citric acid and others) don’t do. ⁴ This does not mean it isn’t the acid of the vinegar that makes it work, just that other acids don’t do the same thing as the acetic acid in vinegar.

Dr. Mercola proposes this about the benefits of the acid in ACV, “One thing that apple cider vinegar is high in is acetic acid. Like other acids, acetic acid can increase your body’s absorption of important minerals from the foods you eat. Therefore, it is possible that drinking a mild tonic of vinegar and water just before meals might improve your body’s ability to absorb the essential minerals locked in foods.” ⁵

Some have also suggested that ACV helps prevent starch digestion and that those starches in turn will feed the beneficial bacteria in your digestive system, but no mechanism for this process was indicated. ¹

Something worth noting is that many of the studies noted above, especially the ones available at PubMed, don’t specify apple cider vinegar but just refer to vinegar or acetic acid.  This would line up with the idea that it is the acetic acid that is the mechanism behind the benefits noted in those studies, as there is nothing else in white vinegar.

Daily Dosage

Several articles pointed to recommended doses of ACV. One article indicated 1-2 tablespoons per day was appropriate for medicinal use. ⁶  Carol Johnston, an Arizona State University veteran ACV researcher for using ACV to help treat diabetes, recommends 1-2 tablespoons in a large glass of water sipped on at meal time once or twice a day is sufficient.¹  One thing I did find particularly humorous given my earlier experiment on the pH values of beverages is that several articles and slideshows cautioned against swallowing ACV undiluted due to risk of esophageal burning or erosion.^{1, 5}  Yes, straight up ACV is pungent and acidic, but no more so than a can of regular Coke, which mainstream medical professionals don’t warn people about (or at least they don’t warn them about the burning potential, just the sugar and other junk in it).

Cautions

Also noted in a couple of articles was the fact that excessive use of vinegar can reduce potassium levels and interfere with diabetes and heart disease medication, diuretics, and laxatives. ^{5, 6}  It did not specify what would be considered excessive use, but probably more than a couple of tablespoons per day. Other articles, however, pointed out that potassium levels could be helped and recommended using ACV to treat nighttime leg cramps. ⁸  Upon looking into this apparent discrepancy, it appears that ACV with the “mother” contains potassium (11 mg per tablespoon for Bragg’s brand) where distilled vinegar does not contain potassium and would be potassium depleting. Not much of a concern for THMs, as we encourage ACV with the “mother”, but worth noting. As for the reaction with medications, that is sort of a ‘duh’. Anything can cause reactions with medications, and if you take medications, it is wise to consult with a health professional before taking any dietary supplements or using foods in a medicinal capacity on a daily basis.

The Take Away

That really leaves us back where we started, with no definitive answers. There does seem to be some research to support the acid as being the mechanism behind some of the benefits of ACV, particularly the study that found neutralized vinegar did not perform the same as straight vinegar in stabilizing glycemic levels. ²  Given that a major tenant of THM is to keep blood glycemic levels as stable as possible, it would seem that the tendency for ACV to moderate glycemic response to foods would be one of the main benefits Serene and Pearl have looked at in ACV. Since neutralizing the vinegar seems to take away that benefit it would not be recommended to use baking soda in GGMS. However, “Future investigations are needed to delineate the mechanism by which vinegar alters postprandial glycemia.” ⁷

My recommendation would be for each mama to evaluate her situation. In my case, I do not drink plain water unless it is ICE cold and it is really hard to keep it that cold in a sippy of some kind (my favorite is a Thermos I have but it is too small to hold much). So for me drinking GGMS is a big part of staying hydrated. In that case, mix it as weak as you can and still get the taste you need to be encouraged to sip, use a straw and aim for the roof of the mouth as far back as possible, and consider using a pinch of baking soda to neutralize the acid but not the flavor. If you are more wanting the health benefits of glycemic stability, it seems like it might be better to mix 1T with 8-16 oz water and drink that with a meal twice a day (rinse with plain water after just to be sure the acid is not sitting on your teeth, if you’d like) rather than having a sipper.

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Sources

¹ Manning, Joy. “Apple Cider Vinegar and Your Health.” WebMD. Ed. Elaine McGee. WebMD, 01 Oct. 2014. Web. 17 Apr. 2016.

² Brighenti, F., G. Castellani, L. Benini, M.C. Casiraghi, E. Leopardi, R. Crovetti, and G. Testolin. “Effect of Neutralized and Native Vinegar on Blood Glucose and Acetate Responses to a Mixed Meal in Healthy Subjects.”European Journal of Clinical Nutrition 49.4 (1995): 242-47. PubMed.gov. Web. 17 Apr. 2016. <http://www.ncbi.nlm.nih.gov/pubmed/7796781>.

³ Östman, E., Y. Granfeldt, L. Persson, and I. Björck. “Vinegar Supplementation Lowers Glucose and Insulin Responses and Increases Satiety After a Bread Meal in Healthy Subjects.” European Journal of Clinical Nutrition Eur J Clin Nutr 59.9 (2005): 983-88. PubMed.gov. Web. 17 Apr. 2016. <http://www.ncbi.nlm.nih.gov/pubmed/16015276>.

⁴ Ogawa, Nobumasa, Hideo Satsu, Hirohito Watanabe, Masahiro Fukaya, Yoshinori Tsukamoto, Yusei Miyamoto, and Makoto Shimizu. “Acetic Acid Suppresses the Increase of Glycosidase Activity During Culture of Caco-2 Intestinal Epithelial Cells.” Journal of Nutrition 130.3 (2000): 507-13. PubMed.gov. Web. 17 Apr. 2016. <http://www.ncbi.nlm.nih.gov/pubmed/10702577>.

⁵ Mercola, Joseph. “What the Research Really Says About Apple Cider Vinegar.” Mercola.com. N.p., 02 June 2009. Web. 17 Apr. 2016. <http://articles.mercola.com/sites/articles/archive/2009/06/02/apple-cider-vinegar-hype.aspx>.

⁶ Khakpour, Dorrine. “Beyond the Hype: Apple Cider Vinegar as an Alternative Therapy.” The Whole U. University of Washington, 07 July 2015. Web. 17 Apr. 2016. <https://www.washington.edu/wholeu/2015/07/07/beyond-the-hype-apple-cider-vinegar-as-an-alternative-therapy/>.

⁷ Johnston, Carol S., and Cindy A. Gaas. “Vinegar: Medicinal Uses and Antiglycemic Effect.” Medscape General Medicine 8.2 (2006): 61.PubMed.gov. Web. 17 Apr. 2016. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1785201/>.

⁸ “Apple Cider Vinegar: 13+ Health Benefits | Reader’s Digest.” Readers Digest. Ed. Alyssa Jung. N.p., n.d. Web. 17 Apr. 2016. <http://www.rd.com/health/wellness/apple-cider-vinegar-benefits/>.Adapted from Kitchen Cabinet Cures by Reader’s Digest Publishers.