Dr. Brian Cole is a nationally acclaimed orthopedic surgeon and sports-medicine doctor who cohosts the popular radio show Sports Medicine Weekly. Whether you want to know about bunions, better sleep, or running your first marathon without getting hurt, Dr. Cole can offer an expert’s take. Eric Haunschild, his research assistant, also contributes to this column. Have a question? Email AskADoctor@outsideim.com. The doctor is in.
Does apple cider vinegar actually do anything for your body or gut, or is it just something Goop has been selling us? If it is good, how should we be supplementing with it?
Apple cider vinegar (ACV) has been touted as a holistic cure-all for decades, and it’s as popular as ever in the wellness world. Proponents claim the pantry staple has all sorts of positive benefits: reducing inflammation, slowing down aging, and promoting weight loss, to name a few. And in theory, certain properties of ACV suggest that these claims may have some truth to them. For example, ACV contains B-complex vitamins, which do have anti-inflammatory effects in the body. But the anti-inflammatory properties of these vitamins haven’t been studied in the context of vinegar consumption. That’s the problem with most of the claims people make about ACV—they just haven’t been proven, one way or the other.
ACV also has plenty of antioxidants, and researchers think antioxidants may help reduce chronic disease burden as we age. However, scientific studies on antioxidants have been inconclusive, and there isn’t really any research about ACV’s antioxidants and their effects. When it comes to the gut, it’s possible that the acetic acid in ACV could aid our digestion and thus ease gut issues, particularly as we age and produce less of our own stomach acids. In theory, adding another acid may help achieve the same thing, but whether it actually works is also, as yet, unproven.
However, there are a few evidence-backed, measurable physiological effects, including increased satiety: in a small study from the European Journal of Clinical Nutrition in 2005, participants who supplemented a standard meal with ACV reported feeling more full than those who didn’t. Another randomized controlled trial, in the Journal of Functional Foods from 2018, found that regular supplementation of two tablespoons of ACV daily for three months contributed to modest weight loss of a few pounds when compared to controls. So it seems apple cider might offer a small boost for those interested in weight loss—but that’s not necessarily a health benefit, unless you’re working toward a specific goal that you and your doctor have agreed would be beneficial for you.
ACV has also been shown to offer a small amount of help modulating blood sugar and insulin levels after you eat a meal, but not so reliably that it could replace traditional treatments and medications. A recent meta-analysis in the Journal of Advanced Nursing reported that in studies that collectively evaluated over 300 Type 2 diabetics, ACV supplementation did have beneficial effects on blood-sugar levels. However, most of the individual studies used small sample sizes, and while the results were promising, they were still pretty minimal.
If you’re interested in experimenting with supplementation, it’s safe to take ACV in small doses. Recommendations vary, but an ounce a day diluted in water is a safe place to start. The only notable side effects of overconsumption are an upset stomach and, if you take it undiluted, a sore throat or weaker tooth enamel over time. Just don’t expect a miracle, and remember that if something sounds too good to be true, it probably is.
I’m obsessed with my Theragun and generally any type of self-myofascial release, like vibrating foam rollers. Is it possible to overuse tools like this? The Theragun feels fantastic, but it’s also pretty aggressive.
From Theraguns to Hypervolts, it seems like everyone (including myself) nowadays is raving about the benefits of self-percussion therapy devices. Manufacturers claim that these devices accelerate recovery and muscle repair, improve blood and lymphatic flow, and relieve stiffness when regularly used before and after exercise. While some of these claims are likely overblown, there is some evidence that these devices can alleviate delayed onset muscle soreness—and as long as you aren’t finding that the tool is leaving you achier than you were when you started, you’re probably fine. The key here is to listen to your body, and stop if it starts to feel painful.
Most of the benefits listed above are anecdotal; of the above claims, the only one with scientific evidence behind it is that these devices can reduce soreness following vigorous exercise. A 2014 study in the Journal of Clinical and Diagnostic Research examined delayed onset muscle soreness. One group received vibration therapy after exercise, and another group had regular massage therapy. Those who received vibration therapy had a greater reduction in pain 48 hours after an intense workout compared to the massage-therapy group.
When using a percussive device, you can expect to feel some transient, mild soreness over the area being massaged, but you should use common sense. If you are percussing over areas that result in significant and increasing pain of a different character than simple muscle soreness, back off. These devices should only be used on muscle—other sensitive areas, such as an inflamed tendon or bursa, may benefit from a mild manual massage but should not be aggressively percussed. Percussing bone, in addition to being extremely painful, has no benefit. With these considerations in mind, using a Theragun on tired muscles may fast-track your post-workout recovery, and as long as you pay attention to your body, there is no real risk of overuse or injury.
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