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.

Background: Apple cider vinegar (ACV) is a naturally fermented beverage with potential metabolic health benefits; however, its effects on weight loss remain controversial. This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to assess the effect of ACV on anthropometric measurements in adults. Methods: We performed a systematic search of PubMed, Web of Science, Scopus, and CENTRAL up to March 2025 for randomized controlled trials (RCTs) in adults (≥18 years) evaluating the effects of ACV for ≥4 weeks on body composition parameters. Primary outcomes included changes in body weight, BMI, waist circumference, and other anthropometric measures. Risk of bias was assessed using the Revised Cochrane Risk-of-bias tool. Results: Out of 2961 reports screened, 10 RCTs comprising a total of 789 participants were eligible for inclusion in this meta-analysis. The pooled results using a random-effects model showed that daily ACV intake significantly reduced body weight [SMD: -0.39; 95% CI: -0.63, -0.15; p = 0.001; I2 = 62%], BMI [SMD: -0.65; 95% CI: -1.05, -0.26; p = 0.001; I2 = 83%], and WC [SMD: -0.34; 95% CI: -0.67, -0.02; p = 0.04; I2 = 61%]. However, no significant effects of ACV were observed on the other body composition parameters analyzed. Sensitivity analyses excluding high-risk-of-bias studies confirmed the robustness of ACV's beneficial effects on body weight and BMI. Subgroup analyses suggested that ACV consumption significantly improved anthropometric parameters when administered for up to 12 weeks, at a dose of 30 mL/day, and in adults who were overweight, obese, or had type 2 diabetes. Conclusions: Overall, this meta-analysis suggests that ACV supplementation may be a promising and accessible adjunctive strategy for short-term weight management in adults with excess body weight or metabolic complications.