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Apple Aphorism Proves Half-Baked

An apple a day won’t keep the doctor away, but it may decrease your likelihood of using prescription drugs.
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(Photo: Markus Mainka/Shutterstock)

(Photo: Markus Mainka/Shutterstock)

Apples started out with a bad reputation—think the Garden of Eden—but for the past century or so, they’ve been widely associated with good health. This is due in large part to a proverb that can be traced back to 1913: “An apple a day keeps the doctor away.”

That statement still makes a certain amount of sense, if you don’t take it too literally. After all, eating healthy food, such as fresh fruits, is good for your health. But does it really hold up to intense scrutiny?

A study just published in the journal JAMA Internal Medicine finds the answer is, sadly, no. After taking a variety of other health-related factors into account, a research team led by the University of Michigan’s Matthew Davis found no significant link between consumption of popular fruit and avoiding the doctor’s office.

"Apple eaters had higher educational attainment, were more likely to be from a racial or ethnic minority, and were less likely to smoke."

However, it did find regular apple eaters are at least slightly less likely to use prescription drugs.

“Our findings suggest that the promotion of apple consumption may have limited benefits in reducing national health-care spending,” the researchers write. “In the age of evidence-based assertions, however, there may be merit to saying, ‘An apple a day keeps the pharmacist away.’”

Davis and his colleagues used data on 8,399 American adults who participated in the National Health and Nutrition Examination Study. All underwent in-depth interviews, in which they were asked how many times in the last year they had seen “a doctor or health professional” about any health concern.

“We categorized study participants as either apple eaters or non-apple eaters using a cutoff point of 149 grams per day, which corresponds to eating at least one small apple,” the researchers write.

Using those guidelines, nine percent of participants were classified as apple eaters, while 91 percent were not. “Apple eaters had higher educational attainment, were more likely to be from a racial or ethnic minority, and were less likely to smoke,” they report.

While the data initially showed apple eaters were less likely to have seen a doctor during the previous 12 months, the difference between the two groups shrunk to insignificance after the researchers took into account such factors as age, race, body-mass index, and having health insurance.

That negative result doesn’t mean Davis and his colleagues were frittering away their time. Further analysis revealed that, even after adjusting for such variables, “apple eaters were somewhat more likely to avoid prescription medication use than non-apple eaters.”

Given that “prescription medication costs represent approximately 30 percent of out-of-pocket U.S. health care spending,” this finding is of some interest. If eating apples really does negate, to a degree, the need for prescription drugs—a causal link not established by this study—“the promotion of apple consumption could, at least in theory, help contain (medical) costs,” the researchers write.

This doesn’t mean you should rush out to buy stock in apples (as opposed to stock in Apple). As the researchers note, people who regularly enjoy the fruit “may be more health conscious and otherwise healthier (than apple avoiders), which could entirely explain the associations we observed.”

Aye, there’s the worm.

Findings is a daily column by Pacific Standard staff writer Tom Jacobs, who scours the psychological-research journals to discover new insights into human behavior, ranging from the origins of our political beliefs to the cultivation of creativity.