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An apple a day doesn't keep the doctor away

April 01, 2015

Who hasn’t heard the popular Scottish proverb: “An apple a day keeps the doctor away?”

But do you believe it and practice what it preaches?

According to an article published online on April 1 by JAMA Internal Medicine, a new study concludes an apple a day won’t keep the doctor away.

A look at the research

Matthew A. Davis, D.C., M.P.H., Ph.D., of the University of Michigan School of Nursing, Ann Arbor, and coauthors analyzed data from the National Health and Nutrition Examination Survey (2007-2008 and 2009-2010) to find out if apples really cut the muster.

The authors compared daily apple eaters (those who consumed at least one small apple per day or 149 grams of raw apple) with non-apple eaters. The authors measured “keeping the doctor away” as no more than one self-reported visit to a physician during the past year.

When sociodemographic and health-related characteristics were taken into account, there was no statistically significant difference between apple eaters and non-apple eaters when it came to avoiding an overnight hospital stay or visiting a mental health professional. However, apple eaters had marginally higher odds of avoiding prescription medications, according to the results.

“The proverb most likely makes the assumption that people who choose to eat an apple each day are making the conscious decision to consume a food item that is healthy. It follows that these individuals would also make choices in their lives that would help them to remain healthy and, consequently, not have frequent visits to doctors,” said Dr. Kimberly Bucknor of Baystate Medical Practice – Northern Edge Adult Medicine.

“Not surprisingly, this is not necessarily the case as there are many factors that contribute to an individual’s overall health and wellness, some of which include incorporating exercise into one’s lifestyle, avoiding smoking and making other healthy choices regarding not only the right kinds of foods to eat, but also the quantity of food that one eats,” she added.

What apples Can do

Despite the newest findings, while apples may not keep the doctor away, a diet rich in apples is associated with a host of health benefits and studies have cited the potential of apples to:

  • Improve neurological health – Apples contain the antioxidant quercetin, which is known to reduce cellular death caused by oxidation and inflammation of neurons, and may play a role in reducing the risk of neurodegenerative disorders, such as Alzheimer’s disease.
  • Reduce stroke risk – A study involving nearly 10,000 men and women concluded that those who ate apples during a 28-year period had the lowest risk of having a stroke.
  • Reduce the risk of diabetes – Fiber rich apples slow the digestion of food. As a result, the entry of glucose into the bloodstream is also slowed, which helps to maintain a healthy blood sugar level.
  • Prevent several cancers – Oncologists have long known the benefits of a healthy diet in helping to prevent cancer, and especially recommend a high fiber diet to reduce the risk of colorectal cancer. Also, researchers at Cornell University identified several compounds called triterpenoids in apple peel that have potent anti-growth properties against cancer cells in the liver, colon and breast.
  • Lower the risk of respiratory diseases – Similar to their anti-cancer benefits, the antioxidant and anti-inflammatory nutrients found in apples may play a role in reducing asthma risk.
  • Lower cholesterol and improve heart health – According to a group of researchers at Florida State University, pectin, considered a soluble fiber found in apples, blocks the absorption of cholesterol resulting in lower levels of LDL or “bad” cholesterol. Apples are a good source of potassium, and combined with their content of antioxidant flavonoids, may promote general heart health.
  • Control weight – High fiber apples, with only about 50-80 calories depending on the size of the apple, and no fat or sodium, satisfy hunger and tend to fill you up.

Other health benefits cited in Reader’s Digest from eating apples include healthier teeth, protection against Parkinson’s disease, reduction of diarrhea and constipation and helping to neutralize irritable bowel syndrome, less chance of hemorrhoids, detoxifying your liver, preventing cataracts, and a boost to your immune system.

“Apples store well and can be kept for a few months under proper conditions. So, maybe we don’t say “a peach a day will keep the doctor away,” since the growing season is so short and peaches do not keep as long as apples,” laughed Baystate Medical Center clinical dietitian Paula Serafino-Cross RD.

Living a healthy lifestyle

The registered dietitian said, based on her own observations, she agrees with Dr. Bucknor that people who eat an apple every day are more likely to not smoke, to exercise, and to eat a better diet overall.

“By eating an apple, people are not eating junk snacks instead,” Serafino-Cross said.

Apples are good to “eat on the run” and are one of the easiest fruits to carry with you to work or school.

“They don’t get mushy like bananas, and apples and can be purchased locally in New England. Although I do try to eat mindfully, sometimes I will eat an apple in the car when I am leaving work to go the gym for an exercise class. The crunch is satisfying and the fiber helps to fill you up,” said Serafino-Cross.

The Baystate dietitian noted with the emphasis on local, organic food, there are many types of apples grown in the local region that can be purchased from are markets or co-ops.

“I have no objections to eating an apple a day, as long as individuals take a holistic view regarding their health and make other healthy choices as I mentioned, such as quitting smoking and exercising more, as well as other practices that would be beneficial to their overall health,” said Dr. Bucknor.

“Overall, I believe the JAMA article is trying to not only analyze the veracity of the proverb ‘An apple a day keeps the doctor away,’ but to also facilitate dialogue between medical providers and patients to reiterate the importance of a comprehensive approach towards health and wellness,” she added.