New Research – An Apple a Day Keeps the Doctor Away

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110412131923-largeEveryone has heard the old adage, “an apple a day keeps the doctor away.” We all know we should eat more fruit. But why apples? Do they contain specific benefits?

According to Dr. Bahram H. Arjmandi, PhD, RD, Margaret A. Sitton Professor and Chair, Department of Nutrition, Food and Exercise Sciences at The Florida State University, apples are truly a “miracle fruit” that convey benefits beyond fiber content. Animal studies have shown that apple pectin and polyphenols in apple improve lipid metabolism and lower the production of pro-inflammatory molecules. Arjmandi’s most recent research is the first to evaluate the long-term cardioprotective effects of daily consumption of apple in postmenopausal women.

In their USDA-funded study Arjmandi and his team randomly assigned 160 women ages 45-65 to one of two dietary intervention groups: one group received dried apples daily (75g/day for 1 year) and the other  ate dried prunes every day for a year. Blood samples were taken at 3, 6 and 12-months. The results surprised Dr. Arjmandi, who stated that “incredible changes in the apple-eating women happened by 6 months — they experienced a 23% decrease in LDL cholesterol,” which is known as the “bad cholesterol.” The daily apple consumption also led to a lowering of lipid hydroperoxide levels and C-reactive protein in those women.

“I never expected apple consumption to reduce bad cholesterol to this extent while increasing HDL cholesterol or good cholesterol by about 4%,” Arjmandi said. Yet another advantage is that the extra 240 calories per day consumed from the dried apple did not lead to weight gain in the women; in fact, they lost on average 3.3 lbs. “Reducing body weight is an added benefit to daily apple intake” he said. Part of the reason for the weight loss could be the fruit’s pectin, which is known to have a satiety effect. The next step in confirming the results of this study is a multi-investigator nationwide study.

New  Study: Apples vs Statins

In a new study published in the Christmas 2013 edition of The BMJ., British researchers state that prescribing an apple a day to all adults aged 50 and over could prevent or delay around 8,500 vascular deaths such as heart attacks and strokes every year in the UK — similar to giving statins to everyone over 50 years who is not already taking them.

The researchers conclude that the 150 year old public health message: “An apple a day keeps the doctor away” is able to match more widespread use of modern medicine, and is likely to have fewer side effects. The research takes into account people who are already appropriately taking statins to reduce their risk of vascular disease and therefore the authors stress that no-one currently taking statins should stop, although by all means eat more apples.

As in the United States, doctors in the United Kingdom recommend lifestyle changes as a first step to preventing heart disease. However, trial data suggest that statins can reduce the risk of vascular events, irrespective of a person’s underlying risk of cardiovascular disease. As such, calls are being made for greater use of statins at a population level, particularly for people aged 50 years and over.

Using mathematical models a team of researchers at the University of Oxford set out to test how a 150 year old proverb might compare with the more widespread use of statins in the UK population. They analysed the effect on the most common causes of vascular mortality of prescribing either a statin a day to those not already taking one or an apple a day to everyone aged over 50 years in the UK.

They estimate that 5.2 million people are currently eligible for statin treatment in the UK and that 17.6 million people who are not currently taking statins would be offered them if they became recommended as a primary prevention measure for everyone over 50.

They calculate that offering a daily statin to 17.6 million more adults would reduce the annual number of vascular deaths by 9,400, while offering a daily apple to 70% of the total UK population aged over 50 years (22 million people) would avert 8,500 vascular deaths.

However, side-effects from statins mean that prescribing statins to everyone over the age of 50 is predicted to lead to over a thousand extra cases of muscle disease (myopathy) and over ten thousand extra diagnoses of diabetes.

Source: Federation of American Societies for Experimental Biology (2011, May 3). ‘Apple a day’ advice rooted in science.

Source: A. D. M. Briggs, A. Mizdrak, P. Scarborough. A statin a day keeps the doctor away: comparative proverb assessment modelling studyBMJ, 2013; 347 (dec17 2): f7267 DOI:10.1136/bmj.f7267