Tuesday, April 19, 2011
"Apple A Day"
Advice Rooted in Science
ScienceDaily (Apr. 12, 2011) — Everyone has heard the old adage, "an apple a day keeps the doctor away." We all know we should eat more fruit. But why apples? Do they contain specific benefits?
According to Dr. Bahram H. Arjmandi, PhD, RD, Margaret A. Sitton Professor and Chair, Department of Nutrition, Food and Exercise Sciences at The Florida State University, apples are truly a "miracle fruit" that convey benefits beyond fiber content. Animal studies have shown that apple pectin and polyphenols in apple improve lipid metabolism and lower the production of pro-inflammatory molecules. Arjmandi's most recent research is the first to evaluate the long-term cardioprotective effects of daily consumption of apple in postmenopausal women.
The results of this USDA-funded study will be presented at Experimental Biology 2011 on April 12 in Washington, DC.
This study randomly assigned 160 women ages 45-65 to one of two dietary intervention groups: one received dried apples daily (75g/day for 1 year) and the other group ate dried prunes every day for a year. Blood samples were taken at 3, 6 and 12-months. The results surprised Dr. Arjmandi, who stated that "incredible changes in the apple-eating women happened by 6 months- they experienced a 23% decrease in LDL cholesterol," which is known as the "bad cholesterol." The daily apple consumption also led to a lowering of lipid hydroperoxide levels and C-reactive protein in those women.
"I never expected apple consumption to reduce bad cholesterol to this extent while increasing HDL cholesterol or good cholesterol by about 4%," Arjmandi said. Yet another advantage is that the extra 240 calories per day consumed from the dried apple did not lead to weight gain in the women; in fact, they lost on average 3.3 lbs. "Reducing body weight is an added benefit to daily apple intake" he said. Part of the reason for the weight loss could be the fruit's pectin, which is known to have a satiety effect. The next step in confirming the results of this study is a multi-investigator nationwide study.
There is frequently some truth behind our common expressions, and in the case of 'an apple a day,' Dr. Arjmandi has shown that nutrition science backs up the expression. "Everyone can benefit from consuming apples," he said.
This research was performed by Drs. Sheau C. Chai, Shirin Hooshmand, Raz L. Saadat, and Bahram Arjmandi, Florida State University.
What's New and Beneficial About Apples
The phytonutrients in apples can help you regulate your blood sugar. Recent research has shown that apple polyphenols can help prevent spikes in blood sugar through a variety of mechanisms. Flavonoids like quercetin found in apples can inhibit enzymes like alpha-amylase and alpha-glucosidase. Since these enzymes are involved in the breakdown of complex carbohydrates into simple sugars, your blood sugar has fewer simple sugars to deal with when these enzymes are inhibited. In addition, the polyphenols in apple have been shown to lessen absorption of glucose from the digestive tract; to stimulate the beta cells of the pancreas to secrete insulin; and to increase uptake of glucose from the blood via stimulation of insulin receptors. All of these mechanisms triggered by apple polyphenols can make it easier for you to regulate your blood sugar.
Even though apple is not an excellent source of dietary fiber (it ranks as a "good" source in our WHFoods Rating System), the fiber found in apple may combine with other apple nutrients to provide you with the kind of health benefits you would ordinarily only associate with much higher amounts of dietary fiber. These health benefits are particularly important in prevention of heart disease through healthy regulation of blood fat levels. Recent research has shown that intake of apples in their whole food form can significantly lower many of our blood fats. The fat-lowering effects of apple have traditionally been associated with its soluble fiber content, and in particular, with its fat-soluble fiber called pectin. What we now know, however, is that whole apples only contain approximately 2-3 grams of fiber per 3.5 ounces, and that pectin accounts for less than 50% of this total fiber. Nevertheless, this relatively modest amount of pectin found in whole apples has now been shown to interact with other apple phytonutrients to give us the kind of blood fat lowering effects that would typically be associated with much higher amounts of soluble fiber intake. In recent comparisons with laboratory animals, the blood fat lowering effects of whole apple were shown to be greatly reduced when whole apples were eliminated from the diet and replaced by pectin alone. In summary, it's not fiber alone that explains the cardiovascular benefits of apple, but the interaction of fiber with other phytonutrients in this wonderful fruit. If you want the full cardiovascular benefits of apples, it's the whole food form that you'll want to choose. Only this form can provide you with those unique fiber-plus-phytonutrient combinations.
The whole food form of apples is also important if you want full satisfaction from eating them. Researchers have recently compared intake of whole apples to intake of applesauce and apple juice, only to discover that people report less hunger (and better satiety, or food satisfaction) after eating whole apples than after eating applesauce or drinking apple juice. But especially interesting was an additional finding about calorie intake following apple consumption. When healthy adults consumed one medium-sized apple approximately 15 minutes before a meal, their caloric intake at that meal decreased by an average of 15%. Since meals in this study averaged 1,240 calories, a reduction of 15% meant a reduction of 186 calories, or about 60 more calories than contained in a medium apple. For these researchers, "getting ahead" in calories with a net reduction of 60 calories was a welcomed outcome of the study, and an extra benefit to their study's primary conclusion-the importance of whole apples (versus other more processed apple forms) in helping us manage our hunger and feeling more satisfied with our food.
Scientists have recently shown that important health benefits of apples may stem from their impact on bacteria in the digestive tract. In studies on laboratory animals, intake of apples is now known to significantly alter amounts of two bacteria (Clostridiales and Bacteriodes) in the large intestine. As a result of these bacterial changes, metabolism in the large intestine is also changed, and many of these changes appear to provide health benefits. For example, due to bacterial changes in the large intestine, there appears to be more fuel available to the large intestine cells (in the form of butyric acid) after apple is consumed. We expect to see future studies confirming these results in humans, and we are excited to think about potential health benefits of apple that will be related to its impact on bacterial balance in our digestive tract.
Apples belong to the Rose family of plants and are joined in that family by a wide range of very popular foods, including apricots, plums, cherries, peaches, pears, raspberries, and almonds. Foods in the Rose family are simply too diverse in their nutrient value to allow for any one single recommendation about the number of servings that we should consume from this family on a weekly basis. However, when focusing specifically on apples, several anti-cancer studies show daily intake of this fruit to provide better anti-cancer benefits than lesser amounts. So there may be some truth to that old phrase, "An apple a day keeps the doctor away!" Still, we don't recommend that everyone eat one apple on a daily basis, given the wide variety of available fruits and the nutritional uniqueness of each type. But we do recommend that everyone eat at least 2-3 whole fresh fruits per day, or the equivalent of 2-3 cups' worth of fresh fruit. Within this framework, if apples are a type of fruit that you strongly prefer, there would be nothing wrong with consuming one on a daily basis, and you may get some special health benefits by doing so.
This chart graphically details the %DV that a serving of Apples provides for each of the nutrients of which it is a good, very good, or excellent source according to our Food Rating System. Additional information about the amount of these nutrients provided by Apples can be found in the Food Rating System Chart. A link that takes you to the In-Depth Nutritional Profile for Apples, featuring information over 80 nutrients, can be found under the Food Rating System Chart.
Apple's Amazing Polyphenols
In the past five years, no area of apple research has been more dynamic than the area of apple polyphenols. The balance of these phytonutrients in apples is far more unique than many researchers previously suspected. In terms of flavonols, quercetin is the primary phytonutrient found in apples, and it's far more concentrated in the skin than in the pulp. Kaempferol and myricetin are also important apple flavonols. Chlorogenic acid is apple's primary phenolic acid, and it's found throughout the pulp and also in the skin. If apples are red, it's because of their anthocyanins, which are largely restricted to the skin. When an apple is more uniformly red in color, or when its red color is deeper in hue, it's because there are more anthocyanins. In terms of catechin polyphenols, epicatechin is the primary nutrient found in apples. The flavonoid phloridzin accounts for 98% of the flavonoids found in the apple seeds. The total polyphenol contents of apples range from about 1-7 grams/kilogram of fresh pulp, but this ratio gets much higher in the skin, underscoring the special value of apple skins for deriving optimal polyphenol benefits from this fruit. In fact, in animal studies, there is a very commonly used standardized apple extract called standardized apple peel polyphenol extract, or APPE.
You might wonder why apples end up with such an amazing array of polyphenols. In this context, it's fascinating to see that recent research studies show polyphenols to be the favorite mechanism used by apples to protect themselves from UV-B radiation. Cells in the skin of apple that conduct photosynthesis are especially sensitive to UV-B light from the sun. Many of the polyphenols in the skin of apples can actually absorb UV-B light, and thereby prevent UV-B from damaging the photosynthetic cells in the apple skin. Polyphenols, then, are like the apple's natural sunscreen.
It is also interesting to note that the amazing polyphenol content of apples is related to their easy browning when sliced open or bruised. Inside the cells of apple skin and pulp are enzymes called polyphenol oxidases, or PPOs. When the cells of the apple are sliced through or physically damaged when an apple is dropped, the PPOs start oxidizing the polyphenols in apples, and the result you see is a browning of the damaged apple portion. It's important to handle apples delicately in order to protect their health-supportive polyphenols! (Also in this context, it's worth mentioning that damaged apples not only turn brown from the oxidation of their polyphenols, but they also start releasing relatively large amounts of ethylene gas that can pose a risk to other undamaged apples. This phenomenon is why people say that "one bad apple can spoil the whole bunch." Once again, the problem of ethylene gas from apple bruising or other damage underscores the importance of handling this amazing fruit with tender loving care and removing any damaged apples from groups of apples stored in bulk.)
Since most of the polyphenols in apples function as antioxidants, it's not surprising to see so many health benefit studies focusing on the antioxidant benefits from apple. Particularly strong is the ability of apples to decrease oxidation of cell membrane fats. This benefit is especially important in our cardiovascular system since oxidation of fat (called lipid peroxidation) in the membranes of cells that line our blood vessels is a primary risk factor for clogging of the arteries (atherosclerosis) and other cardiovascular problems. Apples' strong antioxidant benefits are also related to their ability to lower risk of asthma in numerous studies, and their ability to lower risk of lung cancer. In addition to their unusual polyphenol composition, apples also provides us with about 8 milligrams of vitamin C. While that amount is not a lot, it's still important, especially since the recycling of vitamin C in our body depends on the presence of flavonoids and apples do an amazing job of providing us with those flavonoids.
The cardiovascular benefits of apples are well-documented in research studies, and they are closely associated with two aspects of apple nutrients: their water-soluble fiber (pectin) content, and their unusual mix of polyphenols. Total cholesterol and LDL-cholesterol are both decreased through regular intake of apples. In some studies, "regular intake" has meant apple intake very close to the level of one whole fresh apple per day. As mentioned earlier, the strong antioxidant composition of apples provides us with protection from possible oxidation of fats (called lipid peroxidation), including fats found in the bloodstream (like triglycerides) or fats found in the membranes of cells linking our blood vessels. Decreased lipid peroxidation is a key factor in lowering risk of many chronic heart problems. Recent research has shown that the quercetin content of apples also provides our cardiovascular system with anti-inflammatory benefits. (Our blood levels of C-reactive protein, or CRP, are reduced following consumption of apples and researchers believe that the quercetin content of apples is the primary reason for this drop in CRP.) What a fantastic combination of cardiovascular benefits from such a widely available and delicious fruit!
Benefits for Blood Sugar Regulation
This area of research on apple benefits is relatively new, but it's already awakening the interest of an increasing number of food scientists. At many different levels, the polyphenols in apples are clearly capable of influencing our digestion and absorption of carbohydrates, and the overall impact of these changes is to improve regulation of our blood sugar. The impact of apple polyphenols on our carbohydrate processing includes:
Slowing down of carbohydrate digestion. Quercetin and other flavonoids found in apples act to inhibit carbohydrate-digesting enzymes like alpha-amylase and alpha-glucosidase. When these enzymes are inhibited, carbohydrates are broken down less readily into simple sugars, and less load is placed on our bloodstream to accommodate more sugar.
Reduction of glucose absorption. Polyphenols in apples clearly lower the rate of glucose absorption from our digestive tract. Once again, this change lessens the sugar load on our bloodstream.
Stimulation of the pancreas to put out more insulin. Getting sugar out of our bloodstream often requires the help of insulin, a hormone produced by the beta cells of our pancreas. By telling the beta cells of our pancreas to produce more insulin, the polyphenols found in apple can help us clear more sugar from our blood and keep our blood sugar level in better balance.
Stimulation of insulin receptors to latch on to more insulin and increase the flow of sugar out of our bloodstream and into our cells. In order for sugar to leave our bloodstream and enter our cells (especially our muscle cells), insulin receptors on those cells must bind together with the insulin hormone and create cell changes that will allow sugar to pass through the cell membrane and into the cell. (Muscle cells, for example, continuously need this uptake of sugar from the bloodstream in order to function.) Polyphenols in apples help to activate the muscle cell insulin receptors, and in this way, they help facilitate passage of sugar from our bloodstream up into our cells. Once again, the result is better blood sugar regulation in our body.
Although some preliminary results show apple benefits for several different cancer types (especially colon cancer and breast cancer), it's the area of lung cancer benefits that stand out in the apple research. There are numerous studies involving vegetable/fruit intake and risk of lung cancer. The number of subjects in these studies numbers into the high hundreds of thousands. Although many research studies show an impressive ability of overall fruit and/or vegetable intake to lower lung cancer risk, very few individual fruits show up as protective against lung cancer. Except apples! It's really quite remarkable how apples have been one of the few fruits to demonstrate this unique relationship with lung cancer risk reduction. (Interestingly, this same phenomenon has to some extent also been present in research on asthma.) Researchers aren't certain why apples are so closely associated with reduction of lung cancer risk. Their antioxidant and anti-inflammatory benefits are definitely involved here, but they don't fully explain why apples are such a standout in this health benefit area. We look forward to future research that will help shed light on this unique capacity in apples.
Like the lung cancer benefits of apples, the anti-asthma benefits have been somewhat surprising to health researchers. Multiple studies have shown apple intake to be associated with decreased risk of asthma. However, in some cases, the study findings have been even stronger. In one study, apples showed better risk reduction for asthma than total fruit-plus-vegetable intake combined! (That comparison might seem like a contradiction since fruit-plus-vegetable intake would clearly include apples. But in this particular study, it turned out that apples were not routinely consumed by fruit-plus-vegetable eaters, such that researchers could separate out a small group of study participants who regularly ate apples and could compare this group to other study participants who regularly ate fruits-plus-vegetables but did not include apples among their fruits.) Like the anti-cancer benefits of apples, apples' anti-asthma benefits are definitely associated with the antioxidant and anti-inflammatory nutrients found in this fruit. However, there is very likely to be something else going on as well since apples appear to be a truly standout fruit in this regard.
Other Health Benefits
While not as developed as research in other areas, preliminary health benefits of apples have also been established for several age-related health problems, including macular degeneration of the eye and neurodegenerative problems, including Alzheimer's disease. In animal studies, prevention of bone loss has also been an area of investigation, particularly related to the phloridizin content of apples.
Apples are a crisp, white-fleshed fruit with a red, yellow or green skin. The apple is actually a member of the Rose family, which may seem strange until we remember that roses make rose hips, which are fruits similar to the apple.
Apples have a moderately sweet, refreshing flavor and a tartness that is present to greater or lesser degree depending on the variety. For example, Golden and Red Delicious apples are mild and sweet, while Pippins and Granny Smith apples are notably brisk and tart. Tart apples, which best retain their texture during cooking, are often preferred for cooked desserts like apple pie, while Delicious apples and other sweeter varieties like Braeburn and Fuji apples are usually eaten raw.
The apple tree, which originally came from Eastern Europe and southwestern Asia, has spread to most temperate regions of the world. Over the centuries, many hybrids and cultivars have been developed, giving us the 7,000 varieties in the market today.
Apples have long been associated with the biblical story of Adam and Eve, although there is actually no mention that, in fact, the fruit in question was actually an apple. In Norse mythology, apples were given a more positive persona: a magic apple was said to keep people young forever. Apples' most recent appearance in history occurred in the 1800s in the U.S., when Johnny Appleseed-a real person named John Chapman-barefoot across an area of 100,000 square miles, planting apple trees that provided food and a livelihood for generations of settlers.
How to Select and Store
Look for firm fruits with rich coloring. Yellow and green apples with a slight blush are best. Your preference for a sweeter or more tart fruit and whether you plan to enjoy your apples raw or cooked will guide your choice of variety. Just remember that Red and Golden Delicious are among the sweetest apples. Braeburn and Fuji apples are slightly tart, and Gravenstein, Pippin, and Granny Smith apples are the most tart, but retain their texture best during cooking.
In the northern hemisphere, apple season begins at the end of summer and lasts until early winter. Apples available at other times have been in cold storage or are imported from the southern hemisphere.
Whole apples are a much better nutritional choice than apple juice. Not only are whole apples richer in dietary fiber, but the current processes of juicing seem to drastically reduce the polyphenolic phytonutrient concentrations originally found in the whole fruit.
Apples can be stored for relatively long (3-4 months) periods of time. Cold storage at low refrigerator temperatures (35-40F/2-4C) is able to help minimize loss of nutrients. In addition, it's helpful to maintain some moisture in the cold storage area, for example, by inclusion of damp cheesecloth in the crisper bin of a refrigerator. Over a period of time involving months, there is loss of total polyphenols from apples, including both flavonoid and non-flavonoid polyphenols. However, valuable amounts of polyphenols (and all other nutrients) remain. In some food traditions, cold storage of apples over the winter months is still counted on as a key part of dietary nourishment from fruits.
You've no doubt heard the saying, "one bad apple can spoil the whole bunch." Well, research studies agree. An apple that has been bruised from being dropped (or that has been damaged in some other way) will start to release unusual amounts of ethylene gas. This ethylene gas can pose a risk to other apples that have not been damaged and greatly decrease their shelf life. For this reason, it's important to handle apples with tender loving care, and also to remove any damaged apples from groups of apples stored in bulk.
How to Enjoy
Tips for preparing apples
The skin of the apple is unusually rich in nutrients, and even if the recipe you've chosen requires peeled apples, consider leaving the skins on to receive the unique benefits found in the skins. Ideally, of course, choose organic apples to avoid problems related to pesticide residues and other contaminants on the skins. If you cannot obtain organic apples, and you are willing to accept some level of risk related to consumption of residues on the apple skins, we believe that it can still be a good trade-off between nutrients and contaminants if you leave the skin of the apple intact and eat the apple unpeeled. Just be sure to thoroughly rinse the entire apple under a stream of pure water while gently scrubbing the skin with a natural bristle brush for 10-15 seconds.
To prevent browning when slicing apples for a recipe, simply put the slices in a bowl of cold water to which a spoonful of lemon juice has been addedFor use in future recipes, sliced apples freeze well in plastic bags or containers.
There's an important loss of nutrients that usually occurs when apples are processed into applesauce, and an even greater loss when they are processed into juice. Some types of processing are easier on nutrients than others, but in general, apple sauces require boiling of apples and apple juices require some extraction of pulp. In all cases, the more apple that can be retained, the better the resulting nourishment. Processing can take a special toll on polyphenols. We've seen recent studies where only 10% of the flavonols and 3% of the catechins from the original apples remained present in the processed apple juice, Even chlorogenic acid (one of the more stable polyphenols in apples) tends to be decreased by at least 50% during the processing of whole apples into juice.
Obviously, there are exceptions to these generalized findings. For example, it is possible to put whole apples into a powerful blender and consume the resulting juice. In this case, very little if any of the nutrients are lost. However, this type of blending is not used in the commercial production of apple juice. Commercial apple juices are typically either "clear" or "cloudy." Clear apple juices have the vast majority of the apple pomace (pulpy apple solids) removed. Cloudy apple juices typically retain some of these pulpy solids because even though the pulpy solids have been removed from the juice through pressing and filtering, they are added back in at some designated level. When purchasing apple juice, always choose cloudy juices if possible.
Apples and Pesticide Residues
According to the Environmental Working Group's 2010 report "Shopper's Guide to Pesticides," apples are among the 12 foods on which pesticide residues have been most frequently found. Therefore, individuals wanting to avoid pesticide-associated health risks may want to avoid consumption of apples unless they are grown organically. Individuals willing to accept some level of pesticide-associated health risks may decide to consume non-organic apples. Under those circumstances we recommend thoroughly rinsing the entire apple under a stream of pure running water while gently scrubbing the skin with a natural bristle brush for 10-15 seconds.
If you do purchase non-organic apples, you may want to ask your grocer about the kind of wax used to protect the apple's surface during storage or shipping. Carnauba wax (from the carnauba palm tree), beeswax, and shellac (from the lac beetle) are preferable to petroleum-based waxes, which contain solvent residues or wood resins.
Apple polyphenols are standout nutrients in this widely loved fruit. These polyphenols include flavonols (especially quercetin, but also kaempferol and myricetin), catechins (especially epicatechin), anthocyanins (if the apples are red-skinned), chlorogenic acid, phloridizin, and several dozen more health-supportive polyphenol nutrients. Apple is a good source of fiber, including the soluble fiber pectin, and it's also a good source of vitamin C. Apple nutrients are disproportionately present in the skin, which is a particularly valuable part of the fruit with respect to its nutrient content.
Introduction to Food Rating System Chart
In order to better help you identify foods that feature a high concentration of nutrients for the calories they contain, we created a Food Rating System. This system allows us to highlight the foods that are especially rich in particular nutrients. The following chart shows the nutrients for which this food is either an excellent, very good, or good source (below the chart you will find a table that explains these qualifications). If a nutrient is not listed in the chart, it does not necessarily mean that the food doesn't contain it. It simply means that the nutrient is not provided in a sufficient amount or concentration to meet our rating criteria. (To view this food's in-depth nutritional profile that includes values for dozens of nutrients - not just the ones rated as excellent, very good, or good - please use the link below the chart.) To read this chart accurately, you'll need to glance up in the top left corner where you will find the name of the food and the serving size we used to calculate the food's nutrient composition. This serving size will tell you how much of the food you need to eat to obtain the amount of nutrients found in the chart. Now, returning to the chart itself, you can look next to the nutrient name in order to find the nutrient amount it offers, the percent Daily Value (DV%) that this amount represents, the nutrient density that we calculated for this food and nutrient, and the rating we established in our rating system. For most of our nutrient ratings, we adopted the government standards for food labeling that are found in the U.S. Food and Drug Administration's "Reference Values for Nutrition Labeling." Read more background information and details of our rating system.
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