Body & Fitness

An apple a day does keep the doctor away

Why should we eat five a day? And is butter that bad? Food writer, Hattie Ellis explores the science and explains why.

Deciding what to eat is no longer a simple matter of instinct or appetite. Every choice we make about food is complicated. Is meat good or bad for us? Why is five a day recommended for fruit and vegetables? And can diet really cause cancer or prevent it? As a food writer, I am often asked these questions, and in an effort to answer them I have looked at the latest scientific research, hopefully exposing some of the myths and providing a practical guide to the things we eat.

Are apples really that good for me?

The phrase ‘an apple a day keeps the doctor away’ was originally a marketing slogan dreamt up by American apple growers at the start of the 20th Century. Their fruit had been made into cider, but after the drink was banned during Prohibition they tried to promote apples as being good to eat instead. So how true is that old adage?

Apples have taken a bashing lately for being full of sugar, which dentists warn causes tooth decay, but advising against them is like throwing the baby out with the bath water. Apples are a good source of fibre. There are two types – the first is insoluble, also referred to as roughage, which increases the bulk of stools, and in turn stimulates gut contractions and keeps the bowels moving regularly.

The second type, soluble fibre, which apples contain, dissolves in the stomach, forming a viscous gel. It helps food move along the gut too by adding bulk, but it also lowers cholesterol by binding to it in the gut. This gel slows down the rate at which sugar enters the bloodstream, keeping energy levels steady.

Health experts reccommend that adults consume 18g of fibre per day, and a medium apple provides about 3g, similar to a bowl of brown rice. Several studies into the cholesterol-lowering properties of apples recommend eating two a day to get a beneficial dose.

By hitting the daily recommended fibre intake, we may be lowering our risk of colorectal cancer. While diets containing more than 80g of meat per day have been linked to a higher incidence of these tumours, a fibre-rich diet seems to cancel out this effect. The peel, which contains insoluble fibre, has the highest concentration of disease-fighting flavonoids and polyphenols, although this research is based on concentrated extracts rather than the whole fruit.

You can drink some of the goodness in an apple as well as eating it. Juicing doesn’t alter the vitamin content dramatically, although you do lose a lot of the fibre. Cider vinegar has long been used as a folk-medicine tonic. Science has shown that it can lower blood-sugar levels and that it helps with weight loss, probably by suppressing appetite.

A 2009 Japanese study showed drinking a 500ml drink with a tablespoonful or half-tablespoon of cider vinegar led to greater weight loss, because people ate less, and lower blood cholesterol than drinking water. Mix a splash with honey and oil to make a healthy salad dressing.

What is the best breakfast?

Packaged cereals shout about nutritional goodness. However, studies have shown that many types are shockingly high in sugar. This is the type of refined sugar dentists are right to be concerned about. And, it can be argued, these cereals won’t keep us full until lunch.

Sugary breakfast cereals have a high glycaemic index (GI) score – a measure of the effects of carbohydrates in food on blood-sugar levels. It estimates how much each gram of digestible carbohydrate in a food raises blood glucose following consumption, relative to consumption of glucose. GI scores are calculated in relation to glucose, which has the highest score of 100.

The higher a GI reading, the faster the food is digested and the quicker we are hungry again. Conversely, the lower the GI, the longer we feel full and the fewer calories we consume. This is the reason why a low GI diet is associated with healthy weight, and a lower risk of type 2 diabetes and heart disease, according to the University of Sydney’s International GI Group.

Cornflakes, which are some of the least sugary cereals, have a GI score of more than 80, which is similar to white bread. Low-GI breakfast foods include muesli (avoid added-sugar varieties) and porridge.

‘Go to work on an egg’ – another old marketing phrase is good advice. Eggs contain protein which makes you feel fuller for longer. A poached egg on wholegrain toast is a great choice. A full English fried breakfast contains protein and fat as well as carbohydrates and will keep you full for a long time. However, the calories can be alarmingly high, so a regular fried breakfast will only make you put on weight.

As for bread, sourdough has a higher acidity than others due to the addition of lactbacillus, which produces lactic acid, giving it a distinctive tangy taste. There is ongoing research into how this element aids absorption of nutrients such as calcium, zinc and iron better than standard bread.

**Can I eat to avoid heart disease and cancer?

**No one food will kill or cure. But the good news is that a balanced, varied diet has room for fats and carbohydrates, just choose the right kind in the right amounts. Fats help build our cells and are part of good health, but they are high in calories. Eating too many calories can lead to you becoming overweight, which raises risks of heart disease and cancer. Butter has been demonised in the past, but like other fats it delivers and contains fat-soluble vitamins such as A, D and E.

Wholegrains are another key food. “They provide fibre and micronutrients such as folic acid, magnesium and Vitamin E”, says Professor Walter Willett of Harvard Medical School, where researchers have shown how a diet rich in grains is associated with lower rates of cancer and heart disease. Oatcakes, porridge, wholegrain couscous, brown rice and quinoa are good options.

The World Cancer Research Fund recommends having no more than 500g of cooked red meat in a week due to the risk of colon cancer. A slice of roast beef is 45g, a thick piece of lamb 90g and a small steak is 100g.

Moderate wine-drinking is championed by Professor Roger Corder, at Barts and the London School of

Medicine. In his book The Wine Diet, he recommends traditionally made red wines, which are high in polyphenols, especially one type, procyanadins. These seem to be particularly good for cardiovascular health by protecting against the damage to your blood vessels that causes disease.

The word “superfood” refers to those that are rich in phytochemicals, the micronutrients in food other than vitamins and minerals that protect your body against disease. Tomatoes, onions, garlic, cabbage and green tea are also rich in these compounds and are affordable.

How should I eat my five a day?

Fruit and vegetables contain vitamins, minerals, phytochemicals and fibre and they are low in calories. But only a third of adults eat their five a day, according to health experts. A 2011 a study showed that people who ate eight a day were 22 per cent less at risk of dying of heart disease than those who ate three a day.

It’s good to eat vegetables in abundance because they are very high in micronutrients and have less sugar than fruit. Eat as many different kinds as possible and try to “eat a rainbow”, as the pigments are linked to different phytochemicals. A number of micronutrients, including Vitamin C, are best consumed raw or steamed, rather than boiled, in order to not destroy the more fragile types and lose water-soluble vitamins in cooking water.

– Hattie Ellis

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