Apples Are Both Nutritious and Delicious
This is the conclusion of researchers from the United Kingdom. To assess the potential benefits of putting more patients on statins, researchers used data from the Cholesterol Treatment Trialists’ meta-analysis that showed vascular mortality is reduced 12% for every 1.0-mmol/L reduction in LDL cholesterol. This was applied to the annual reduction in vascular mortality rates in UK individuals 50 years of age or older who were not currently taking a statin for primary disease prevention.
For the apple-a-day assessment, they used a widely published risk-assessment model (PRIME). This model includes a multitude of dietary variables, in which investigators can substitute different food choices to assess the effects on population health. The apple was assumed to weigh 100 g, and calorie intake was assumed to remain constant. This allowed investigators to assess the effect of substituting in one apple daily on vascular mortality in the UK population.
Briggs said he was surprised at how well the apples compared with statin therapy. However, he stressed the point is not to encourage patients to stop taking their medication. He points out that the UK has a “five-a-day” campaign to increase fruit and vegetable consumption, but 69% of the population do not meet the recommendations.
For statin therapy, offering the treatment to an extra 17 million individuals and assuming 70% compliance would prevent 9400 vascular deaths each year. Assuming 70% compliance with the apple, even though “apples are of course both delicious and nutritious,” say the researchers,the estimated reduction in vascular deaths (with apples) would be 8500. They add that prescribing statins to all those eligible would lead to 1200 cases of myopathy, 200 cases of rhabdomyolysis, and 12 300 new diagnoses of diabetes mellitus.
Having now studied the science underlying an apple a day for keeping the doctor away, the group jokingly states they will next “model the effect of inquisitiveness on feline mortality rates.”
I’m Dr. Michael Hunter, and believe that an apple a day is a smart way to help lower your cholesterol level. I must admit, we have some of the best apples in the world here in Washington state (USA).
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Reference: An Apple (or Statin) a Day Will Keep the Doctor Away: Population Health Analysis. Medscape. Dec 18, 2013.