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Most Americans know Ben Franklin's famous saying "An apple a day keeps the doctor away." In Ben Franklin's time, of course, that just fewer bloodleetings and applications of leeches. Does the saying hold true in the twenty-first century?

Benjamin Franklin, the American famously pictured on the $100 bill, has a lasting influence on American culture. Not only did Franklin contribute to the writing of the Declaration of Independence and help the American revolutionaries get help from France, he also coined many of the most common expressions in the English language as it is spoken in the United States.

For example, Franklin's Poor Richard's Almanack popularized dozens of sayings, including:

"Early to bed and early to rise, makes a man healthy, wealthy, and wise."

"Eat to live, not live to eat."

"Three may keep a secret if two are dead."

Also, "An apple a day keeps the doctor away."

Does an apple a day really keep the doctor away? About 250 years after Benjamin Franklin popularized the expression, a team of doctors publishing their findings in the New England Journal of Medicine took a closer look at the relationship between apple consumption and health outcomes and found some interesting connections, but failed to prove the old adage.

Separating Fact From Folksy Fiction

Dr Michael Davis of the Dartmouth School of Medicine and his colleagues took a deeper look at survey data from the 2007-2008 and 2009-2010 National Health and Nutrition Surveys to see if there were some verifiable truths about the usefulness of apples in the diet for maintaining health. It turned out that of the 8,399 people who completed the survey, a whopping 7,646 respondents reported that they did not eat an apple every day. Only a small fraction of people answering the survey, 753 in all, reported that they ate at least a small apple every day. Davis and his team set out find differences between the 753 apple eaters and the 7,646 who were not.

The research team failed to find any magical effects of eating Granny Smiths or Red Romes or Fujis or any other kind of apple on general health.

The survey data did not find that daily apple eaters were less likely to have seen a mental health professional in the previous 30 days before answering the survey, or that they were more able to avoid an overnight hospital stay. A first pass at the data found that apple eaters were more highly educated, more likely to be racial minority group members, and even five percent less likely to have made a doctor's appointment in the last years, but the difference was not statistically significant.

"Our findings may imperil the veracity of this time-worn (but not time-tested) adage. We estimate that in the United States, the equivalent of 26.9 million small apples are eaten daily by nearly 20 million adult apple eaters," Dr Davis and his co-authors. "While the direction of the associations we observed supports the superiority of apple eaters over non–apple eaters at avoiding the use of health care services, these differences largely lacked statistical significance."

Eating Apples Leads To Spending Less On Medication?

However, the regular apple eaters did have one advantage over people who don't enjoy them every day. The 753 people who reported enjoying the fruit every day spent an average of $228 a year less on medications. An apple a day may not keep the doctor away (or, ih the twenty-first century, make it less necessary to go the doctor), but eating apples daily seems to discourage trips to the pharmacist, or "An apple a day keeps the pharmacist away."

Why Apples Really Are Good for You

It is worth noting that, although the apple a day researchers presented serious, evidence-based data, they published their article just before April Fool's Day. The good doctors were having a little fun with us. The value of apples in the diet is actually very well established. Here are just a few of the reasons you should eat apples as often as you can, twice a day not being too often if you eat small apples. 

  • Apples fight allergies. Apple peels are particularly good sources of a plant chemical called quercetin. Structurally, the quercetin molecule resembles a common antihistamine. Eating just one apple a week, in a study conducted in Scotland, reduces the risk of allergic reactions and asthma.
  • Apples activate the liver. We all know that high-fructose corn syrup causes numerous health problems. The small amount fructose in an apple, however, actually increases the ability of the liver to deal with sugars so that fewer are stored as fat. There is a limit to how much fructose is helpful, about 25 grams a day, or the equivalent of two apples, if you don't eat any products containing high-fructose corn syrup at all.
  • Apples may lower your risk of stroke. A study of over 9,000 people by Cornell University found that people who ate the most apples over a 28-year period had the lowest risk of stroke.
  • Apples may lower your risk of dementia. The quercetin in apples also seems to reduce inflammation in the brain, reducing the complications caused by tangled proteins that coat neurons as the brain ages.
  • Apples lower cholesterol in obese people. Laboratory studies with animals and preliminary studies with humans find that eating an apple a day lowers total cholesterol and LDL cholesterol when they are high, but not when they are normal or low.
  • Apples may lower your risk of cardiovascular disease. A study at Oxford University found that people who at least three servings of apples a week had a lower risk of developing heart disease than people who took statins for lowering cholesterol. The National Health Service of the UK estimated that persuading Britons over the age of 50 to eat apples could save nearly 10,000 lives a year. Women who eat apples daily, according to another study, have a 13 to 22 percent lower risk of developing heart disease.
  • For women, apples (and pears) reduce the risk of lung cancer. Very few vegetables seem to reduce risk of lung cancer in either women. A single serving of apples or pears a day, however, lowers risk of lung cancer in women. Eating two servings of apples or pears with either grapefruit or onion daily reduced the risk of lung cancer in women 40 to 50 percent. A simlar effect was not observed for men.
  • For both men and women, apples contain chemicals that may reduce the proliferation of most forms of cancer, the process that causes a single cancer cell to grow into a tumor.

An apple is a great source of antioxidants. A single apple only contains about 6 mg of vitamin C. However, the total antioxidant power of an apple is equivalent to about 1500 mg of vitamin C, only in a variety of forms that can perform a variety of functions in the human body.

Apples are inexpensive, they are available in most of the world, and they taste great. An apple a day may not keep the doctor away, but it may improve your health.

Read full article

  • Matthew A. Davis, DC, MPH, PhD, Julie P. W. Bynum, MD, MPH, Brenda E. Sirovich, MD, MS. Association Between Apple Consumption and Physician Visits: Appealing the Conventional Wisdom That an Apple a Day Keeps the Doctor Away. JAMA Intern Med. Published online March 30, 2015. doi:10.1001/jamainternmed.2014.5466Photo courtesy of cbransto via Flickr: www.flickr.com/photos/cbransto/3857287361
  • Photo courtesy of tea-bear via Flickr: www.flickr.com/photos/goodbyeloralie/6854537021

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