Does An Apple A Day Really Keep The Doctor Away?

Does an apple a day really keep the doctor away? That’s a public health message that’s been around since 1866, but is it true? You don’t know until you put it to the test. The “Association Between Apple Consumption and Physician Visits,” published in the AMA’s internal medicine journal. Objective: To examine the relationship between eating an apple a day and keeping the doctor away. Promoted by the lay media and powerful special interest groups, including the US Apple Association, so powerful that Big Apple recently spent a whopping $7,000 lobbying politicians? The beneficial effects of apple consumption may include a facilitation of weight loss, protection of the brain, cancer suppression, a reduction in asthma symptoms, improved cardiovascular health.

So, apple consumers ought to require less medical care, right? “Although some may jest, considering the relatively low cost of apples, a prescription for apple consumption could potentially reduce national health care spending if the aphorism holds true.” So, they compared daily apple eaters to non-apple eaters, and asked if they had been to the doctor in the last year, been hospitalized, seen a shrink or took a prescription medication within the last month. 8,000 individuals surveyed and only about 1 out of 10 reported eating an apple over the last 24 hours, and the evidence does not support that an apple a day keeps the doctor away. So, maybe it takes more than an apple a day.

Maybe we need to center our whole diet around plant foods. However, the small fraction of US adults who eat an apple a day do appear to use fewer prescription medications. So, maybe the proverb should be updated to clarify that, if anything, apple eating may help keep the pharmacist away. But, hey, based on the average medical prescription cost, the difference in annual prescription medication cost per capita between apple eaters and non-apple eaters could be hundreds of dollars. So, if all US adults were apple eaters, we could save nearly $50 billion. Of course, if you factor in the cost of the apples themselves, we’d only get a net savings of like $19 billion.

If this all seems a bit tongue-in-cheek apple polishing, you’ll note this was published suspiciously close to April Fool’s day. And, indeed, this was in the tradition of the British Medical Journal’s annual Christmas issue that features scientifically rigorous yet light-hearted research, which itself took on the apple issue to model the effects on stroke and heart attack mortality of all older adults being prescribed either a cholesterol-lowering statin drug or an apple a day. Basically, they took studies like this where you see this nice dose response where the more fruit you eat, the lower your stroke risk appears to fall— and similar data for heart disease— compared to the known drug effect, and concluded that prescribing an apple a day is likely to have a similar effect on population stroke and heart attack mortality as giving everyone statin drugs instead.

And, hey, apples only have good side effects. Choosing apples rather than statins may avoid more than a thousand excess cases of muscle damage, and more than 12,000 excess diabetes diagnoses, because statins increase the risk of diabetes. And this was in the UK. I mean here in the US, one would expect five times those numbers, though ironically, the cost of apples is likely to be greater than those of statin drugs. I mean like Generic Lipitor is like 20 cents a day. So, yes, with similar reductions in mortality, the 150-year-old health promotion message of an apple a day is able to match modern medicine and is likely to have fewer side effects. But apples are a few pennies a day more expensive, not to mention the increased time and difficulty associated with consuming an apple compared to a statin.

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Tips for Parents Of Picky Eaters

Does this sound familiar: “when I go to the grocery store, I know there are five hundred kinds of vegetables and fruit, but I buy the same three all the time.” About one third of parents say their child is a picky eater and, in many cases, it’s nothing to worry about.  The behavior is one of the few ways children can exert an influence on their parents and caregivers and that’s through eating or not eating. It’s a natural stage of developing some independence. But there are some things parents can do. Introducing a variety of foods in the toddler ages are crucial because it is such a short window of time. When children get older, it’s hard to accept new flavors. Parents also need to keep in mind that kids are more tuned in to their satiety cues than adults. Also, a child’s appetite will fluctuate at various stages. We are so used to seeing our portion sizes, that as adults we forget that kids have a smaller tummy and they don’t need as much food.

That means don’t bribe them into eating that extra bite by promising a cookie. When approaching mealtime, we recommend a division of responsibilities. Parents decide what, when, and where to eat and children decide whether to eat and how much. It can help to involve a child in preparing meals, but don’t cook them a separate meal. One family meal, no short order cooking.  If you’re concerned with your child’s growth, be sure to consult your physician. Seek their advice to make sure your child is getting the nutrients they need and to rule out any underlying medical conditions that may be contributing to a change in growth.  And unless your health care provider gives you specific instruction otherwise, rely on healthy food options instead of supplements!

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constructing healthy plate

Constructing a Healthy Plate

A healthy meal begins with assembling a healthy plate. And before you bring anything to that plate, it might be worthwhile to buy a set of smaller dinner plates cups and glasses. Interestingly, many hardware stores sell these very inexpensively, but they’re harder to find in fancy kitchen stores. Mostly because small plates have gone out of style. One of the reasons we like to obsess about nutrients, and the industry likes us to obsess about nutrients, is a way of distracting us from the quantities of food.

We are eating more. Thus, this supersizing has made plate sizes bigger. Soda sizes are bigger and the portions have been doubled. The bigger the portion, the more you will eat! So, size matters when it comes to your plate. But once you’ve found a reasonably sized plate, the first step in constructing the meal should be deciding what is my vegetable component of this meal going to be? We tend to start by thinking about the protein when we’re planning a meal. If we can think of the vegetables as the feature then the entire meal will likely end up being healthier.

The plate itself should consist of about one half plant based food, ideally with a mix of different colored vegetables. Different colored vegetables contain different micro nutrients. So, eating a variety of them maximizes our nutrient coverage. In general, eating a variety of foods is also beneficial because it minimizes the chances of getting sick from potential contaminants in any one food. The remaining one half of the plate should be equally divided into whole grains and lean protein rich foods. These foods can come from animal sources or from plant sources, but again variety is good. Eating chicken every night of the week is almost certainly not the best way to stay healthy or excited about your next meal.  Next comes thirst.

Most of the time the best drink to quench thirst and keep us hydrated and healthy is plain, clean water. The human body is made up of more than 50% water so don’t forget to replace it during mealtime. Drinking water before each meal may even be helpful for weight management. The variations are endless. But getting into the habit of creating a healthy plate, sitting down for mealtimes, and taking time to enjoy our meals are priceless.

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