[mukto-mona] “an apple a day keeps the doctor away

TUESDAY, Dec. 17, 2013 — You've heard the old saying "an apple a day keeps the doctor away," and it turns out that the phrase is actually sage advice after all, according to a new study published in the journal BMJ. Researchers from the University of Oxford in the United Kingdom found that prescribing an apple a day to all adults age 50 or older in the United Kingdom would prevent around 8,500 heart attack and stroke deaths every year – similar to the number that could be prevented by prescribing statins to that same group, without any of the side effects.

The researchers created a mathematical model to test the adage, and compared the effects of a daily apple to the effects of prescribing a statin per day to the 17.6 million people in the U.K. who are candidates for them, but currently not prescribed them. Assuming 70 percent of the population complied with the prescription, and that their overall number of calories remained the same, a daily apple could save an average of 8,500 lives every year, compared to 9,400 lives saved by a daily statin.

"The Victorians had it about right when they came up with their brilliantly clear and simple public health advice: 'An apple a day keeps the doctor away,'" study author Adam Briggs, MSc, academic clinical fellow at the University of Oxford, said in a statement. "It just shows how effective small changes in diet can be, and that both drugs and healthier living can make a real difference in preventing heart disease and stroke."

Apples contain heart-healthy compounds that combine to make it an under-the-radar superfruit. Among the compounds are:

• Pectin – a form of soluble fiber shown to lower blood pressure and blood sugar.
• Quercetin – a flavonoid shown to prevent inflammation and asthma that has also been linked to cancer prevention.
• Phytochemicals – a variety compounds that have been linked to a reduction in cardiovascular disease and cancer.

An apple a day also comes without the side effects of statins, according to the study. Using apples instead of pills would result in more than one thousand fewer cases of muscle disease and more than 10,000 fewer diagnoses of diabetes that would arise if this population was all prescribed statins – something David Friedman, MD, chief of heart failure services at North Shore-LIJ's Franklin Hospital in Long Island, N.Y., said underscores the benefit of helping your heart through diet and exercise, instead of medicine.

"I've always joked that statins should be in the water," Dr. Friedman said, "and many doctors have been saying that for years. But clearly, there are side effects that need to be considered. This study shows that an ounce of prevention might be worth more than a pound of cure."

However, Friedman stressed that for some people, simply eating an apple won't offer the same benefit as taking a statin.

"If someone comes to me and is active and healthy, but has high cholesterol, I'll try telling them to eat an apple a day," he said. "But if that person has a number of other risk factors for heart disease, such as smoking or a family history, statins may be the best way to go."

But pairing both statins and an apple a day in people at risk for heart disease would be best, Friedman added.

"A simple addition of an apple a day is a clear way to have a cost-effective prevention of heart disease," he said, "but if the benefits outweigh the risks, and they usually do, statins still offer the best bang for your buck – especially when paired with a healthy diet."

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