An Apple a Day Does Not Keep the Doctor Away After All

Diedtra Henderson

March 31, 2015

Forget that bit from Poor Richard's Almanack: The small fraction of people who still eat an apple a day are no more likely to keep the doctor away than their more numerous non-apple-eating peers, according to an April Fool's–themed JAMA Internal Medicine article published online March 30. However, the study, performed with modern standards of quality, did suggest that regular apple-eaters were more likely to keep pharmacists at bay.

The study, by Matthew A. Davis, DC, MPH, PhD, from the Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, and colleagues, marks a new effort by JAMA editors to leaven hard science with a dose of humor — at least annually for April Fool's.

Dr Davis and colleagues leveraged National Health and Nutrition Examination Surveys from 2007 to 2008 and 2009 to 2010 to separate truth from folksy fiction. Of 8399 survey respondents asked to recall their usual daily diet, a small fraction, 753, said they ate at least one small apple a day. That number was dwarfed by the 7646 non-apple-eaters who completed the survey.

Neither daily Braeburns or Red Delicious nor munching Honeycrisp or nibbling Granny Smiths conferred any statistically significant health benefits. The researchers found no association with daily apple eating and avoiding an overnight hospital stay or a visit to a mental health professional in the month before.

"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," the authors write. "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."

When it comes to taking a prescription medicine in the previous month, however, apple-eaters triumphed, spending an estimated $228 less on medicines per year compared with non-apple-eating individuals. "In the age of evidence-based assertions...there may be merit to saying, 'An apple a day keeps the pharmacist away,' " the research team adds.

Financial support for the study was provided by the National Institutes of Health. The authors have disclosed no relevant financial relationships.

JAMA Intern Med. Published online March 30, 2015. Abstract

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