Apple Nutrition Benefits

Jennette HiggsBsc(Hons) Nutrition, RD RPHNutr

Registered Public Health Nutritionist & Dietitian

Nutrition Consultant for the World Apple & Pear Association (WAPA)

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An apple a day keeps the doctor away!

“Eat an apple on going to bed, And you'll keep the doctor from earning his

bread” (Welsh Proverb,1866)

Our ancestors knew apples were good for our health, but today we need to

have the research to prove it conclusively for commercial gain!

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Apples Nutrition Strengths

Apples are:

A good source of fibre - soluble (pectin) & insolubleSource of energy (52kcal/100g) & carbohydrateNo added sugar – just naturally occurring sugarsFat- free Saturated fat-freeSalt-free Fat & salt-free + high fibre =

excellent snack for healthFood to Fit

What about potassium?

• All fruit & vegetables supply potassium in the diet

• Increasing potassium intakes is effective in reducing blood pressure & protects against stroke

BUT

• Apples contain relatively low amounts of potassium – 107mg/100g– Equates to only 5% of daily needs– (vs Banana: 400mg/100g =20% daily needs)

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What about Boron?

• Apples contain boron BUT• Boron is not an essential nutrient and is found

widely in the diet, especially fruit & vegetables• Boron linked to osteoporosis & menopausal

symptoms, although evidence not well developed or convincing

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AntioxidantsNutrition claims:Apples are a source of

flavonoids

Apples contain – Quercetin– Phloridzin– Proanthocyanidins– Catechin,– Epicatechin– Coumaric acid– Chlorogenic acid– Gallic acid

Health claims:

not legal in the EU

• Apples are a good source of antioxidants

• Apples contain the antioxidant quercetin

• Apples help protect against oxidative stress

• Apples are good for you

• An apple a day keeps the Doctor away

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Phytochemicals in applesContent & bioavailability important for health benefit

Rank highly compared to other fruit & vegetablesOne of the most commonly consumed fruits, so greater influenceContain highest amounts free phenolics compared to other fruits may be better absorbed so more readily used in the body

More phytochemicals in peel flesh/pulp juiceCommercial opportunities utilising waste (peel & pomace)

Promising, but need more research to prove cause and effects

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Apples & antioxidantspreliminary analysis of science

Insufficient Possible Probable Convincing

In vitro /animal studies

Single large human study

Meta analysis

33

Small uncontrolled human studies

Multiple small human studies- flawed designs

Multiple small human studies- Good designs

3

Epidemiological data- contradictory results

Epidemiological data consistent results & biological plausibility

Critical reviews by experts

Evidence accepted by scientific / independent expert bodies

?6 ?4 ?5 2 compositional data only

Total= 42 Total= ?4 Total=?5 Total=2

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http://www.besthealthmag.ca/eat-well/nutrition/15-health-benefits-of-eating-apples

Get whiter, healthier teethAvoid Alzheimer’sProtect against Parkinson’sCurb all sorts of cancersDecrease your risk of diabetesReduce cholesterolGet a healthier heartPrevent gallstonesBeat diarrhea and constipation

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Neutralize irritable bowel syndrome

Avert hemorrhoids Control your weight Detoxify your liver Boost your immune system Prevent cataracts

Classed as unauthorised health claims within EU

- not legal for consumer communications

Health claims in EU?Conclusion of F2F Apple Scrutiny of science, 2009

Although there are some promising lines of research for a beneficial role for apples on health, at this point in time, there is insufficient research to fully satisfy the rigorous scientific substantiation process as determined by EFSA. – lung function, asthma, heart health, aging,

Alzheimer’s disease, cancer, satiety, obesity

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Apples & health benefits

How do we demonstrate benefit?Good indications from epidemiological studies

(comparing food intakes & disease patterns between countries)

Reinforced with possible mechanisms identified from animal & lab studies

Confirmation comes from well designed randomised, controlled human intervention studies = few for apples to date

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Apples & Cardiovascular DiseasePopulation &

cohort studies of diet & disease

Animal & laboratory

studies

Human intervention studies

9 studies

Not sufficiently robust cause & effect evidence

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Apples & Cancer PreventionPopulation &

cohort studies of diet & disease

Animal & laboratory

studies

Human intervention studies

No cause &effect evidence

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Apples & asthma/ lung functionPopulation &

cohort studies of diet & disease

Animal & laboratory

studies

Human intervention studies

No cause &effect evidence

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Apples & Alzheimer’s Disease/aging

Population & cohort studies

of diet & disease

Animal & laboratory

studies

Human intervention studies

No cause &effect evidence

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Apples & Risk of Stroke(Griep et al, Stroke, 2011)

Prospective, Dutch population-based cohort study (MORGEN)– 20,000men & women 45yrs assessed for 10yrs– Food intake from validated food frequency questionnaires– Fruits & vegetables divided into 4 groups based on colour– Recorded stroke incidence

RESULTS: Higher intake of white fruit & veg. inversely associated with stroke incidence Each 25g increase in intake 9% lower stroke riskApples & pears made up 55% of the white fruit & veg group- ie most commonly consumed

RECOMMENDATION: More research needed to confirm results before adding to public health advice around increased fruit & vegetablesFood to Fit

Apples & Weight Control(de Oliveira et al, 2008, Appetite: 51, 291-5)

Intervention study, hypo-caloric diet + snack feeding 3xday for 10wks– 49 Brazilian overweight women, 30-50yrs– 300g Apple, 300g Pear or 60g Oat Cookie snacks provided– Equal fibre, protein, CHO; cookies higher in kcal & fat– Personalised diet provided to be 250kcal less than usual diet to encourage

weight loss RESULTS:

Snacking on apples & pears resulted in significant reductions in energy intakes & weight loss compared to the oat groupLow energy density of fruit, more than fibre content that can aid energy intakes & body weight.

RECOMMENDATION: • Provide sound evidence to raise recommended fruit intakes • Further follow-up studies needed to confirm & extend findingsFood to Fit

A low-energy-dense diet adding fruit reduces weight and energyintake in women.

de Oliveira, Sichieri, Mozzer, 2008, Appetite: 51, 291-5

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Apples & Health Conclusions

• Apples show great potential as significant protectors of several diseases of developed world

• Principally due to their:– Phytochemicals– Fibre (pectin)– Low energy

• More human intervention research needed to support health claims– This is essential for their use within the EU at least

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