Apple Nutrition Benefits

1. Apple Nutrition Benefits Jennette Higgs Bsc(Hons) Nutrition, RD RPHNutr Registered Public Health Nutritionist & Dietitian Nutrition Consultant for the World Apple & Pear Association (WAPA) Food to Fit

2. 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! Food to Fit

3. Apples Nutrition Strengths Apples are: • A good source of fibre - soluble (pectin) & insoluble • Source of energy (52kcal/100g) & carbohydrate • No added sugar – just naturally occurring sugars • Fat- free • Saturated fat-free • Salt-free Fat & salt-free + high fibre = excellent snack for health Food to Fit

4. 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) Food to Fit

5. 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 Food to Fit

6. Antioxidants Nutrition 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 Food to Fit

7. Phytochemicals in applesContent & bioavailability important for health benefit • Rank highly compared to other fruit & vegetables • One of the most commonly consumed fruits, so greater influence • Contain 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  juice • Commercial opportunities utilising waste (peel & pomace) Promising, but need more research to prove cause and effects Food to Fit

8. Apples & antioxidantspreliminary analysis of science Food to Fit

9. http://www.besthealthmag.ca/eat-well/nutrition/15-health-benefits-of-eating-appleshttp://www.besthealthmag.ca/eat-well/nutrition/15-health-benefits-of-eating-apples Get whiter, healthier teeth Avoid Alzheimer’s Protect against Parkinson’s Curb all sorts of cancers Decrease your risk of diabetes Reduce cholesterol Get a healthier heart Prevent gallstones Beat diarrhea and constipation Classed as unauthorised health claims within EU - not legal for consumer communications • Neutralize irritable bowel syndrome • Avert hemorrhoids • Control your weight • Detoxify your liver • Boost your immune system • Prevent cataracts Food to Fit

10. 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 Food to Fit

11. 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 Food to Fit

12. Apples & Cardiovascular Disease Food to Fit

13. Apples & Cancer Prevention Food to Fit

14. Apples & asthma/ lung function Food to Fit

15. Apples & Alzheimer’s Disease/aging Food to Fit

16. 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 risk • Apples & 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 & vegetables Food to Fit

17. 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 group • Low 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 findings Food to Fit

18. A low-energy-dense diet adding fruit reduces weight and energyintake in women. de Oliveira, Sichieri, Mozzer, 2008, Appetite: 51, 291-5 Food to Fit

19. 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 Food to Fit