Daily dried apples improve cardiovascular risk factors in women
October 10, 2012
Jacob Schor ND, FABNO
It’s apple-harvesting time here in Denver and I am envious of our neighbors with trees in their yards. So much so that I’ve been volunteering the use of my fiberglass ladder in the hope that someone offers some apples in trade.
This is a good time to discuss the results of Chai et al’s analysis of the apple-prune cohort that was published last August. This is a curious study as it is so similar to Arjmandi’s prune study published last year that it is hard to imagine that we are not looking at the control group from that earlier paper. But, of course, they used dried plums, not prunes. How forgetful of me. Whether or not this are the same 160 women who were randomly assigned to eat a daily portion of dried apples or dried plums, it doesn’t really matter.
In this current study the researchers looked at the impact of either dietary addition on blood lipid panels and other markers of cardiovascular disease risk.
One-hundred sixty postmenopausal women were recruited during 2007-2009. They were not taking hormone therapy or cholesterol-lowering drugs, for at least 3 months prior to the start of the study. They did not suffer from bone disease, renal disease, urolithiasis, cancer, cardiovascular disease, diabetes mellitus, respiratory disease, and liver disease. If they were heavy smokers they were sent home. Approximately 82% of the participants in each group completed the study. This wasn’t an easy study to complete. Participants were asked to eat a sizeable portion of dried fruit each day. Depending on which group they were assigned to this was either 75 grams of dried apples or 100 grams of dried plums (aka prunes). These two portion sizes are close to equivalent in calories, fiber etc. This couldn’t be a blinded study as the women obviously knew what they were eating. The statisticians who analyzed the data were ‘blinded’ and didn’t know which group the women were in. Blood samples were taken at the start of the study and then at 3, 6 and 12 months to measure various chemistries including total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL), triglycerides (TG), lipid oxidation and c-reactive protein..
The women who ate the dried apples lost an average of 3 pounds by the end of the year. Their total cholesterol and LDL- cholesterol dropped from the start of the study by 9% and 16% respectively after 3 months. Their numbers continued to drop; after 6 months there was a 13% decrease in total cholesterol and 24% decrease in LDL cholesterol. This decrease remained constant through the remainder of the trial.
In the dried plum group there was a non-significant decrease in total and LDL cholesterol of 3.5% and 8% respectively at the 12-month time point. Otherwise the dried plums did not affect the lipid profile.
While HDL cholesterol did not change significantly in the apple group, measurements did increase numerically by 3%. Triglycerides levels dropped non-significantly by 9%. Cardiovascular risk ratios dropped significantly, total cholesterol:HDL cholesterol by 15% and LDL:HDL by 21%. C-reactive protein dropped significantly by 17% in the dried plum group within 3 months and then remained constant. The dried apple group showed a slower response; a significant decrease was not seen until six months, at which time it had dropped by 22% from baseline. At 12 months c-reactive protein had dropped 32% in the apple group. Both dried apples and plums decreased lipid oxidation status significantly at 12 months levels had dropped by 33% and 38% respectively.
This is all kind of nifty. Prunes seem to be good for the bone but not the heart while apples are good for preventing heart disease but do little to prevent osteoporosis. Eating either in these quantities is probably good for constipation, though the authors don’t dwell on this effect in either paper.
Are either of these practical interventions, either to treat osteoporosis or poor lipid profiles? Actually, yes. More than 80% of the women who started this study finished it. So it’s obviously doable.
There are a couple of obvious questions some of you are going to ask me, and I’ll tell you up front, I don’t know. The questions by the way are whether smaller amounts of dried fruit will work and whether smaller amounts along with other things we know improve lipids, such as nuts and chocolate, might also work as well or better? I can’t be the only one thinking about prescribing chocolate covered dried apple and nut bars.
But as I said, I don’t know that these will work better. I would think it wouldn’t be too hard to recruit willing participants to try this out though. This might be a good afternoon to experiment in the kitchen grinding up nuts and apples.
Perhaps it might not be such a good idea though. I’m already taking up a good portion of the kitchen experimenting with homemade sauerkraut. Our kind neighbor Meredith and kids recently dropped of a 26-pound head of cabbage grown in their back yard. Apparently there was a cabbage-growing contest but don’t let me digress. What does one do with that much cabbage? There is a limit to how much stuffed cabbage even a devotee such as myself can stand. So our attention turned to kraut.
Ace Hardware turns out to have the best deals on pickling crocks. Though not in stock, if you order online, you can pick up the crock at your nearest store and not pay for shipping. Other online sources charge for shipping. So currently a bit more than 10 pounds of cabbage, a pile of salt and a handful of juniper berries are bubbling away on our kitchen counter. We’ll keep you posted.
How does one eat this much cabbage?
Hooshmand S, Chai SC, Saadat RL, Payton ME, Brummel-Smith K, Arjmandi BH. Comparative effects of dried plum and dried apple on bone in postmenopausal women. Br J Nutr. 2011 Sep;106(6):923-30. Epub 2011 May 31.
Chai SC, Hooshmand S, Saadat RL, Payton ME, Brummel-Smith K, Arjmandi BH. Daily apple versus dried plum: impact on cardiovascular disease risk factors in postmenopausal women. J Acad Nutr Diet. 2012 Aug;112(8):1158-68.