An apple a day really does keep the doctor away. That is the succinct conclusion of a new study from the University of Oxford, where researchers have determined that a daily apple may rival preventative medicine when it comes to easing the burden of cardiovascular disease. Aside from adding some scientific evidence to the 150-year-old health proverb, the findings may also illuminate cheaper and safer lifestyle changes for at-risk individuals.

Today, healthy lifestyle choices like proper exercise and nutrition are typically considered the first steps toward a lower risk of cardiovascular disease. Still, many physicians also prescribe statins — a class of drugs that lower cholesterol levels and protect against atherosclerosis, or thickening of the arteries. Previous studies have found a clear correlation between these drugs and a general reduction in vascular mortality. Published in the Christmas edition of the journal BMJ, the current study sought to determine whether the proverbial daily apple can have a similar protective effect.

“‘An apple a day keeps the doctor away,’ a public health message delivered by parents and teachers since the 19th century, is an example of how concise, clear, and accurate Victorian health promotion can truly stand the test of time, whereas other Victorian practices — such as the use of leeches in primary care — have fallen away,” the researchers wrote. "We set out to test how almost 150 years of Victorian wisdom might compare with the more widespread use of statins in primary prevention.”

To investigate, the study authors looked at UK population datasets as well as the results of previous research efforts assessing the link between apples, statins, and health. In their mathematical model, subjects either consumed an apple or a statin a day. The team assumed a 70 percent compliance rate.

They found that offering a daily statin to 17.6 million more adults would reduce the current number of cardiovascular deaths by 9,400. Similarly, offering a daily apple to every UK citizen over 50 was associated with 8,500 fewer cardiovascular deaths. “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,” the researchers concluded.

That said, the researchers stress that the study should not be understood as a call to substitute preventative medicine with apples. Instead, the results should simply illuminate the many health benefits that arise from small dietary changes. “The Victorians had it about right when they came up with their brilliantly clear and simple public health advice,” lead author Adam Briggs said in press release. “While no-one currently prescribed statins should replace them for apples, we could all benefit from simply eating more fruit."

Source: Adam D M Briggs, Anja Mizdrak, Peter Scarborough. "A statin a day keeps the doctor away: comparative proverb assessment modelling study." BMJ 2013;347:f7267 doi: 10.1136/bmj.f7267