Michael Greger M.D. FACLM asks in his NutritionFacts.org blog, “Which would save more lives: eating an apple a day or taking statin drugs?”
Does an apple a day really keep the doctor away? That’s a public health message that’s been around since 1866, but is it true? You don’t know until you put it to the test. As I discuss in my video Flashback Friday: Does an Apple a Day Really Keep the Doctor Away?.
The objective of “The Association Between Apple Consumption and Physician Visits,” an article published in the American Medical Association’s internal medicine journal, was simple: “To examine the relationship between eating an apple a day and keeping the doctor away.”
The message has been “promoted by the lay media and powerful special interest groups, including the US Apple Association”—a force so powerful that it spent a whopping $7,000 lobbying politicians during the 2017-18 election cycle. (Okay, so maybe Big Apple is more like an itty bitty appletini.) At any rate, the beneficial effects of apple consumption may include the facilitation of “weight loss, prevention of neurologic degradation [protection of the brain], cancer suppression, reduction in asthma symptoms, and improved cardiovascular health.” So, apple consumers ought to require less medical care, right? “Although some may jest, considering the relatively low cost of apples…a prescription for apple consumption could potentially reduce national health care spending if the aphorism holds true.”
Researchers compared daily apple eaters to non-apple eaters and asked if they had been to the doctor in the last year, been hospitalized, seen a mental health professional, or taken any prescription medication within the last month. More than 8,000 individuals were surveyed, and only about one out of ten reported they had eaten an apple in the last 24 hours. The finding? “Evidence does not support that an apple a day keeps the doctor away…” Maybe it takes more than an apple a day? Maybe we need to center our whole diet around plant foods. “However, the small fraction of US adults who eat an apple a day do appear to use fewer prescription medications.” Given that, perhaps we should “update the well-known proverb to clarify that, if anything, apple eating may help keep the pharmacist away.”
But, based on the average medical prescription cost, the researchers estimate that “the difference in annual prescription medication cost per capita between apple eaters ($1697) and non-apple eaters ($1925) to be $228”—hundreds of dollars saved. So, if all U.S. adults were apple eaters, we could save nearly $50 billion. Of course, if you factor in the cost of the apples themselves, our net savings would be closer to $19 billion, but that’s still a hefty chunk of change. If this all seems a bit like tongue-in-cheek-apple-polishing, you may be tickled to learn this study was published suspiciously close to April Fool’s Day. Indeed, this was in the tradition of the British Medical Journal’s annual Christmas issue that features scientifically rigorous, yet light-hearted, research. In fact, the BMJ itself took on the apple issue to model the effects on stroke and heart attack mortality of all older adults prescribed either a cholesterol-lowering statin drug or an apple a day.