[3] There is no high-quality clinical evidence that regular consumption of apple cider vinegar helps to maintain or lose body weight,[5] or is effective to manage blood glucose and lipid levels.

[4][6] Autochthonous or inoculated yeasts, mainly Saccharomyces cerevisiae, initiate alcoholic fermentation, converting the sugars in the juice into ethanol and producing apple cider.

[10] Moderate consumption of apple cider vinegar is safe, particularly if it is diluted, and the chance of side effects when it is consumed as directed and in the recommended amounts appears to be low.

[9] Reported adverse effects include esophageal damage due to incomplete swallowing of apple cider vinegar tablets, tooth enamel damage due to swallowing excessive quantities of apple cider vinegar, and increased frequency of burping, flatulence, and bowel movements.

[10] Although small amounts of apple cider vinegar may be used as a food flavoring,[10] it may be unsafe for use by pregnant and breastfeeding women and by children.