Fall always makes me think of apples … crunchy raw apples, baked apple crisp, caramel apples and apple cider vinegar. Wait, vinegar? Apple cider vinegar has long been associated with a variety of health claims, and has been getting a lot of new press lately, but which claims are actually true?

Apple cider vinegar may help with diabetes and blood sugar control. Researchers have found that individuals with insulin resistance had a slower increase in blood sugar after eating starchy carbohydrates when they drank diluted cider vinegar before eating. Their vinegar was about 1½ tablespoons in ¼ cup water. It appears the effect is due to decreased absorption of the carbohydrate into the blood or a slowed breakdown of the carbohydrate into sugars. Just be careful; some patients with diabetes have slow stomach emptying, and vinegar appears to make it worse.

There is also some evidence that apple cider vinegar may improve blood fats, including cholesterol and triglycerides. While studies have been mostly done in animals, watch for continued evidence in this area and continue to follow nutrition and exercise recommendations.

Another top reason for apple cider vinegar’s renewed popularity is the claim that it promotes weight loss. It is an ingredient in many cleansing drinks, and advocates claim that drinking a small amount of apple cider vinegar before meals helps curb appetite and burn fat. While it does not burn fat, its effect on appetite may have some merit; individuals have reported a decrease in appetite after drinking 2 tablespoons, but mostly due to a queasy feeling and upset stomach. Vinegar may also aid in weight loss when it replaces higher calorie foods. For example, using apple cider vinegar as a substitute for other condiments can reduce calorie intake significantly; try replacing or mixing commercial salad dressings with vinegar, using vinegar to marinate meat or seafood, and sautéing vegetables with a splash of vinegar and oil. As always, weight management is best attained with portion control and physical activity.

No discussion of vinegar is complete without precautions. Apple cider vinegar is a highly acidic fermented byproduct of apples. Some experts are concerned that drinking vinegar increases the acidity of your body, putting a strain on your kidneys and bones. Furthermore, it can decrease potassium levels in your body and may interact with supplements or medications, including diuretics and insulin. Avoid drinking it plain as it has been shown to cause damage to tooth enamel, irritate the throat and increase stomach acidity.

As tempting as it might be to bypass these risks by taking apple cider vinegar pills, there is no research to support their value. These supplements are not regulated so you cannot know what or how much you are getting, and there is evidence that some do not even contain vinegar. In short, save your money.

As for other health claims, there have been no scientific studies in humans that substantiate apple cider vinegar’s ability to reduce inflammation and symptoms of arthritis or its effects on eczema, leg cramps, sinus problems, split ends or aging. If you believe it makes you healthier, just remember its side effects and proceed with caution; dilute with water and drink with or after meals.

Melissa Wdowik, PhD, RDN, FAND, is an assistant professor at Colorado State University in the Department of Food Science and Human Nutrition, and director of the Kendall Reagan Nutrition Center.