This brief article discusses some of the health benefits of apples and introduces some of the benefits of apple cider vinegar .
Apples and health
Apples ( Malus domestica ) are one of the most widely consumed fruits worldwide . 7 , 8 Apples can be eaten whole , except for the seeds . 9 Juices , 9 , 10 ciders , 9 , 10 jams , 9 vinegars , 9 , 10 compotes , 9 tea , 9 and wine 9 , 10 can be produced from apples . Apple pomace consists of apple peels , leftover flesh , core , and stems . 18
Apples have a high content of phenolic compounds , 7 , 8 catechins , 9 , 19 epicatechins , 9 , 19 8 , 10 , 19
anthocyanins , procyanidin , 9 caffeic acid , 9 ferulic acid , 9 chlorogenic acid , 9 , 19 gallic acid , 19 malic acid , 10 hydroxycinnamic acids , 10 dihydrochalcones , 8 flavanols , 8 , 10 , 19 quercetin , 9 quercetin-3 galactoside , 9 quercetin-3-rhamnoside , 9 hydroxycinnamic acids , 8 vitamins A , 8 B1 , 8 , 12 B2 , 8 , 12 B3 , 12 B6 , 12 C , 8 , 9 , 12 E , 12 and K , 8 iron , 8 magnesium , 12 phosphorus , 8 potassium , 8 , 12 polysaccharides , 9 pectin , 9 , 10 , 20 prebiotics , 20 and fibre . 7 , 8 , 12 Cloudy apple juice has been found to contain a higher content of polyphenols than clear apple juice . 19 The health effects of apples can be attributed to these forementioned constituents .
Epidemiological studies support the association between frequent apple consumption and reduced risk of chronic diseases , such as cardiovascular disease , 12 , 13 type 2 diabetes , 12 and some specific cancers . 7 Observational studies ( from 3 years to 16 years ) collated in a review paper found that consumption of approximately 100 g of whole-apple , corresponding to 1 apple a day , led to reductions of death from all causes , cardiovascular disease , coronary heart disease and ischaemic heart disease , along with reductions in acute coronary syndrome , hypertension , thrombotic stroke , abdominal aortic calcification , and serum C-reactive protein ( CRP ). 8 A cohort study was conducted on 9,208 Finnish men and women aged 15 years or more and initially free from cardiovascular disease . 21 The results of the 28 years study suggested that the consumption of apples is related to a decreased risk of thrombotic stroke . 21
Apples have potential health benefits in cardiometabolic health . Intervention studies suggest that apple consumption may positively affect lipid metabolism , vascular function , inflammation , and weight management . 7 Randomised trials ( ranging from one apple per day from 4 weeks to 12 months ) collated in a review paper found that consumption of approximately 100 g of whole-apple , corresponding to 1 apple a day , led to reductions in blood pressure , CRP , interleukin-6 ( IL-6 ), lipopolysaccharide ( LPS ) -stimulated ( IL-6 , interferongamma ( INF-γ ), tumour necrosis factor-α ( TNF-α )) blood mononuclear cell ( PBMC ) -secreted inflammatory cytokines , total cholesterol , low-density lipoprotein ( LDL ) -cholesterol 8 and increases in highdensity lipoprotein ( HDL ) -cholesterol , flow , pulse pressure , and mediated dilatation . 8 Apple polyphenols have antioxidant effects and could decrease LDL-cholesterol oxidation . 19
A potential prebiotic impact of apple ingestion may be an important mechanism of cardiovascular disease risk marker reduction . 12 A randomised , controlled , crossover intervention study investigated the effect of apples in healthy volunteers with mild hypercholesterolaemia ( 23 women , 17 men ). 22 Participants were randomly allocated into 2 groups . One group consumed 2 apples ( approximately 340 g ) per day for 8 weeks , followed by a 4-week washout period , then a 500 mL sugar- and energy-matched apple control beverage ( 100 mL concentrate + 400 mL water ) for 8 weeks . The other group received the intervention in the reverse order . Two apples daily decreased serum total cholesterol , LDL-cholesterol , and plasma intercellular adhesion molecule-1 ( ICAM-1 ). 22
In another study , one group ate at least two apples per day over a 4-month period while the other group ate only three apples , or their fruit equivalent , per week . Total cholesterol was reduced in the two apples daily group . 22 One-hundredand-sixty postmenopausal women were randomly assigned to one of two groups : dried apple ( 75 g per day , approximately two medium-sized apples ) or dried plum ( comparative control ). 23 After 6 months , serum total cholesterol levels were significantly lower in the dried apple group than in the dried plum group . 23 A 5 x 4 weeks crossover study was conducted to assess the effects of whole apples ( 550 g per day ), apple pomace ( 22 g per day ), clear and cloudy apple juices ( 500 ml per day ), or no supplement on lipoproteins and blood pressure in a group of 23 healthy volunteers . 24 At the completion of the study , a reduction in lower serum LDL-concentration was found for whole apple ( 6.7 %), pomace ( 7.9 %) and cloudy juice ( 2.2 %) intake . 24 A randomised , controlled crossover trial investigated the effects of acute and 4 week intake of apple with skin ( high flavonoid apple ) compared to intake of apple flesh only ( low flavonoid apple ). 25 A significant increase in flow-mediated dilation , acutely and after 4 weeks chronic intake of apples with skin ( high flavonoid apple ), was observed . 25
Apples have potential health benefits in asthma . In an Australian communitybased , cross-sectional study , 1,601 young adults were recruited to analyse the effects of diet on asthma . 11 The following analyses were completed : detailed respiratory questionnaire , a validated semiquantitative food-frequency questionnaire , skin-prick testing , and lung function tests , including a methacholine challenge test for bronchial hyperreactivity . Apples appeared to be protective for current asthma , asthma , and bronchial hyperreactivity . 11
Apple pectin is a soluble and viscous fibre that has cholesterol lowering properties and beneficial effects on glucose metabolism . 12 Pectin is a gelling agent and affects transit time , gastric emptying , and nutrient absorption from the digestive tract . 12
82 | vol29 | no2 | JATMS