Prescribing an apple a
day to all adults aged 50 and over would prevent or delay around 8,500 vascular
deaths such as heart attacks and strokes every year in the UK -- similar to
giving statins to everyone over 50 years who is not already taking them --
according to a study in the Christmas edition of The BMJ.
The researchers conclude
that the 150 year old public health message: "An apple a day keeps the
doctor away" is able to match more widespread use of modern medicine, and
is likely to have fewer side effects. The research takes into account people
who are already appropriately taking statins to reduce their risk of vascular
disease and therefore the authors stress that no-one currently taking statins
should stop, although by all means eat more apples.
Using mathematical models
a team of researchers at the University of Oxford set out to test how a 150
year old proverb might compare with the more widespread use of statins in the
UK population. They analysed the effect on the most common causes of vascular
mortality of prescribing either a statin a day to those not already taking one
or an apple a day to everyone aged over 50 years in the UK.
The researchers assumed a
70% compliance rate and that overall calorie intake remained constant.
They estimate that 5.2
million people are currently eligible for statin treatment in the UK and that
17.6 million people who are not currently taking statins would be offered them
if they became recommended as a primary prevention measure for everyone over
50.
They calculate that
offering a daily statin to 17.6 million more adults would reduce the annual
number of vascular deaths by 9,400, while offering a daily apple to 70% of the
total UK population aged over 50 years (22 million people) would avert 8,500
vascular deaths.
However, side-effects
from statins mean that prescribing statins to everyone over the age of 50 is
predicted to lead to over a thousand extra cases of muscle disease (myopathy)
and over ten thousand extra diagnoses of diabetes.
Additional modelling
showed a further 3% reduction in the annual number of vascular deaths when
either apples or statins were prescribed to everybody aged over 30. However the
number of adverse events is predicted to double.
"This study shows
that small dietary changes as well as increased use of statins at a population
level may significantly reduce vascular mortality in the UK," say the
authors.
"This research adds
weight to calls for the increased use of drugs for primary prevention of
cardiovascular disease, as well as for persevering with policies aimed at
improving the nutritional quality of UK diets," they conclude.
Dr Adam Briggs of the BHF
Health Promotion Research Group at Oxford University said: "The Victorians
had it about right when they came up with their brilliantly clear and simple
public health advice: "An apple a day keeps the doctor away." It just
shows how effective small changes in diet can be, and that both drugs and
healthier living can make a real difference in preventing heart disease and
stroke.
While no-one currently
prescribed statins should replace them for apples, we could all benefit from
simply eating more fruit."
Story Source:
The above story is based
on materials provided by BMJ-British Medical Journal.
Note: Materials may
be edited for content and length. For further information, please contact the
source cited above.
Journal Reference:
1.
A. D. M. Briggs, A. Mizdrak, P. Scarborough. A statin a day keeps the
doctor away: comparative proverb assessment modelling study. BMJ, 2013; 347 (dec17 2):
f7267 DOI: 10.1136/bmj.f7267
