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We explore if the old saying ‘eat an apple on going to bed, and you’ll keep the doctor from earning his bread’ is fact or fiction. Medically reviewed by Dr Juliet McGrattan (MBChB) and words by Helen Bond If your parents ever struggled to get you to eat your five-a-day you will be familiar with the old adage, ‘an apple a day keeps the doctor at bay’. But is there any truth to the saying, and just how much fruit and veg should you be consuming on a daily basis? We spoke to registered dietitian Helen Bond about the health benefits of the humble apple and if you really do need an apple a day to get the most from your health: Should you eat an apple a day? The saying ‘an apple a day keeps the doctor away’ is believed to come from the old Welsh proverb, ‘eat an apple on going to bed, and you’ll keep the doctor from earning his bread’ – first cited in Wales in 1866. Sadly a US study published in JAMA Internal Medicine found that eating an apple is not associated with fewer visits to the doctor. However! Research confirms that regular consumption of fruits and vegetables, including apples, as part of a healthy balanced diet can help in the prevention of chronic disease and maintenance of good health – all of which can help keep you out of GP surgeries and the hospital. To be on the safe side, aim to eat at least five portions of fruit and veg every day, and add an apple into the mix if you’re in the mood! Apple a day health benefits However you choose to eat yours, adding apples to your daily diet is always a good thing, and an apple a day comes with the following health benefits: 🍎 Support weight management Apples are the kind of fruit that our waistlines love. Packing in quite a bit of fibre (1.8g per medium apple) for a modest amount of calories (77 calories) makes apples a filling, naturally sweet snack that you can enjoy morning, noon and night. 🍎 Gut health Apples contain good amounts of fibre (1.8g per medium sized apple), including the prebiotic fibre pectin, which help to feed our gut flora, supporting them to grow and flourish, so they can regulate every aspect of our digestive health effectively. 🍎 Good digestion Apples provide stool-bulking fibre, which helps to keep your gut healthy, by speeding the passage of waste products through the digestive tract. In other words, an apple a day is good for healthy poo too! 🍎 Beat diabetes A large review of three consecutive studies found that an apple a day was linked to a whopping 28 per cent lower risk of developing type 2 diabetes, so it’s worth chowing down on your daily fruit after all. 🍎 Reduced cancer risk Several studies have specifically linked apple consumption with a reduced risk for cancer, especially lung cancer. In the Nurses’ Health Study and the Health Professionals’ follow-up study, women who consumed at least one serving per day of apples and pears had a reduced risk of lung cancer. 🍎 Boost your heart health Studies show that eating apples could have cardiovascular benefits, as apple consumption is associated with a reduced risk of heart disease. What’s more, another large study found that eating fruit and veg was linked to a lower risk of stroke thanks to flavonoids, which are compounds that reduce inflammation and boost heart health. How many apples should you eat? One medium (150g) apple does count as one of your five-a-day, so if you aim to eat at least one piece of fruit you’ll be well on your way to meeting your daily fruit and veg daily quota. With lots of British apple varieties to choose from, there are many possibilities to enjoy them – whether that’s as an everyday healthy snack or ingredient in main meals. Regular consumption of fruits and vegetables can help in the prevention of chronic disease. To jazz up your apple consumption, liven up a winter salad by throwing in peel-on apple shavings, add extra crunch to your morning porridge by mixing in sliced apple, or stew with a sprinkling of cinnamon for a warming compote. Should we follow the five-a-day rule? As a dietitian I always try and lead by example and get my (at least) five-a-day, but sadly the average Brit doesn’t manage this – let alone seven-a-day! Worryingly, the National Diet and Nutrition Survey have revealed these stats about who currently meets their five-a-day fruit and vegetable recommendation, and it looks like many of us are not eating an apple a day: • 9 per cent of teenage girls (11-18 years) • 7 per cent of teenage boys • 29 per cent of UK men • 32 per cent of women aged 19-64 year olds • 31 per cent of men • 32 per cent of women aged 65-74 years • 18 per cent of men and 20 per cent of women over 75 On average, adults aged 19-64 years consume 4.2 portions of fruit and vegetables daily. Those aged 65 to 74 years have 4.3 portions and teenagers just 2.7. There is clearly room for improvement in the nation’s eating habits! So while five-a-day is a healthy goal, ‘just eating more’ fruit and veg is a message that may be more achievable to many. What is the best veg/fruit ratio? According to Public Health England’s Eatwell Guide, fruit and veg should make up just over a third of the food we eat every day and we should aim for at least five portions of a variety of fruit and veg each day. It’s best to have a variety, but there’s no specific advice on how the five should be split between fruit and vegetables. Many people worry about the sugar content of fruit, but British apples, like other fruits and vegetables, only contain naturally occurring sugars, contained within their plant cell structure and come wrapped in fibre, which slows its absorption in the bloodstream. Fruit is also a nutrient dense food. When you eat a British apple, you’re also consuming a variety of vitamins, minerals and phytochemicals such as flavonoids. They’re also 86 per cent water and a source of fibre, which is good for your gut and heart health. How much fruit should we eat? What’s important is that we should all be eating a wide variety of both fruit and vegetables each day for our overall health and wellbeing. And with only 31 per cent of adults (19-64 years) achieving the five-a-day recommendation, most of us shouldn’t cut back on fruit or veg! More is definitely better! We should all be eating a wide variety of both fruit and vegetables each day for our overall health. Get people thinking about how many portions they’re eating now and how they can improve this. One serving should be 80g and is roughly equal to a piece of fruit eg an apple, banana or pear, two small fruits eg satsumas, plums or apricots, a bowl of fruit salad, berries, or salad, or three heaped tablespoons of vegetables. For dried fruit, one heaped tablespoon (30g) counts as one serving. Limit unsweetened fruit or vegetable juice or smoothies to just one small (150ml) glass a day. What’s the best way to eat apples? We all like a bit of individual attention – and so do our apples. Storing and cooking your apples just the way they like it and you’ll make the most of them by helping to retain their nutrients and quality. Where possible, try to make the most of the British apple varieties available and enjoy eating unpeeled apples raw (sliced, diced, grated or even spiralised) to obtain the maximum amount of nutrients. But, if you are going to cook your apples, keep apples pieces large, prepare them just before they’re to be cooked rather than leaving them to stand in water, or exposed to air and light. This will help preserve apples’ nutrients and minimise any losses – especially fragile water-soluble vitamins, like Vitamin C. Apples also love to be baked and it’s a great and healthy way to cook apples, and enjoy different textures and flavours. 🍏 Did you know that an apple eaten with its peel provides an incredible 13% more vitamin C, 10% more vitamin B6, 27% more vitamin K, 16% more potassium, and 46% more fibre than when it’s peeled. What’s more, try to leave the skin on your apples when cooking (even if you’ve chosen a recipe that requires peeled apples!) – not only does the skin naturally protect the apple flesh inside, a high concentration of nutrients and plant phytochemicals are found just below the skin – peel it away and you’ll miss out on those, as well an all-important fibre boost! To prevent browning when slicing apples for a recipe, simply put the slices in a bowl and add a spoonful of vitamin C rich lemon juice. For use in future recipes, sliced ‘skin-on’ apples also freeze well in plastic bags or containers and retain their beneficial nutrients. Net Dotor