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An apple a day keeps cardiovascular disease away

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According to a new study, the proverb “An apple a day keeps the doctor away” holds true for reducing the risk of dying from cardiovascular disease. In fact, the benefits were comparable to taking statins (cholesterol-lowering drugs. Researchers at the University of Oxford published their findings on December 17 in the British Medical Journal (BMJ).

The researchers note that the apple a day proverb originated in 19th Century Victorian England, when medicine was at a much more primitive stage. Although many medical practices, such as blood-letting for a variety of diseases, has fortunately fallen by the wayside, “apple therapy” has current merit. The study authors note that, at present in the United Kingdom, lifestyle changes such as regular exercise and a healthy diet are recommended for reducing the risk of cardiovascular disease and that statins are often prescribed for individuals with an elevated cholesterol level. In view of the foregoing, the researchers conducted a study to compare almost 150 years of Victorian wisdom to statin therapy. They compared cardiovascular mortality among all individuals over 50 years of age who either ate an apple (Malus domestica) a day or a statin a day. The researchers estimated the number of adverse events, and compared the costs of the statins versus the apples. Fruit and vegetables contain fiber, which is known to have beneficial effects on health. Apples are an excellent source of fiber, antioxidants, and flavonoids, which are all related to better cardiovascular health.

The researchers conducted an experimental model in which either a statin a day (for individuals not already taking a statin) or an apple a day was taken by all UK citizens. They assumed 70% compliance and no change in calorie consumption. The experimental model used routinely available UK population datasets; parameters entailing the relationships between statins, apples, and health were derived from meta-analyses. The main outcome measurement was cardiovascular mortality.

The investigators found that the estimated annual reduction in deaths from cardiovascular disease of a statin a day (assuming 70% compliance) was 12%. This reduction was comparable to eating an apple a day.

The authors concluded that both nutritional and pharmaceutical approaches to the prevention of vascular disease may be able to significantly reduce cardiovascular mortality in the UK .They note that a 150 year old health promotion message is comparable in benefit to modern medicine and is likely to have fewer side effects. Obviously, the cost of an apple a day is far below that of a statin a day.

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