Vinegar Consumption and Health: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials

Vinegar is a natural dietary product that has been proposed to exert beneficial effects on cardiometabolic health, including glycemic regulation, lipid metabolism, blood pressure control, and weight management. Although several meta-analyses have reported favorable outcomes associated with vinegar consumption, the overall strength and quality of the available evidence have not been comprehensively evaluated. We systematically searched PubMed, Scopus, Web of Science, and Google Scholar for relevant studies published up to January 2025. Effect sizes from eligible meta-analyses were re-estimated using a random-effects model. Ten meta-analyses, comprising a total of 38 primary studies, were included. Pooled results indicated that vinegar consumption was associated with improvements in fasting blood glucose (FBG) (-9.40 mg/dL), postprandial glucose (PPG) (-14.59 mg/dL), postprandial insulin (PPI) (-1.29 mu/L), hemoglobin A1c (HbA1c) (-0.70%), total cholesterol (TC) (-9.39 mg/dL), body weight (-1.06 kg), and systolic blood pressure (SBP) (-2.94 mmHg). In contrast, no significant effects were observed for fasting plasma insulin (FPI), insulin resistance assessed by homeostatic model assessment of insulin resistance (HOMA-IR), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), triglycerides (TG), body mass index (BMI), waist circumference (WC), or diastolic blood pressure (DBP). Vinegar intake was associated with statistically significant improvements in FBG (moderate certainty), PPG (moderate certainty), HbA1c (moderate certainty), TC (very low certainty), body weight (high certainty), and SBP (high certainty). No significant effects were observed for other outcomes. The certainty of evidence ranged from very low to high across outcomes.