Apples effect on cholesterol

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Apples and Cholesterol: Effects on Total and LDL Cholesterol

Multiple studies show that eating whole apples can lower total and LDL (“bad”) cholesterol levels in humans. Consuming about two to three apples per day for several weeks has been linked to reductions in total cholesterol by 5–8% and LDL cholesterol by up to 14.5% in mildly hypercholesterolemic adults, with some studies also reporting increases in HDL (“good”) cholesterol by over 15% 15610. These effects are most pronounced when whole apples are consumed, rather than apple juice or processed apple products 169.

Apple Components: Fiber and Polyphenols in Cholesterol Management

The cholesterol-lowering benefits of apples are mainly attributed to their fiber (especially pectin) and polyphenols. These compounds work together to reduce cholesterol absorption in the gut and improve cholesterol distribution in the blood 178. Polyphenol-rich apple varieties, such as Annurca and Renetta Canada, have shown particularly strong effects in clinical trials, with results comparable to some cholesterol-lowering medications 2610.

Apple Processing: Whole Apples vs. Apple Juice

The form in which apples are consumed matters. Whole apples and apple pomace (the fibrous remains after juicing) lower cholesterol, while clear apple juice does not and may even increase LDL cholesterol. This is likely because juice lacks the fiber and some polyphenols found in the whole fruit 19. Filtered apple juice may also raise triglyceride levels, which is not desirable for heart health 19.

Mechanisms: How Apples Lower Cholesterol

Research in both humans and animals suggests that apples lower cholesterol by increasing the excretion of bile acids and cholesterol in the feces, reducing cholesterol absorption, and altering liver metabolism to favor cholesterol breakdown 124. Apple polyphenols can also inhibit the oxidation of LDL cholesterol, which is important because oxidized LDL is a key factor in the development of atherosclerosis (hardening of the arteries) 37. Additionally, apple polyphenols may inhibit CETP activity, which helps improve the balance between HDL and non-HDL cholesterol .

Animal Studies: Supporting Evidence

Animal studies reinforce these findings, showing that apple consumption leads to significant reductions in plasma and liver cholesterol, improved lipoprotein profiles, and increased antioxidant protection 147. These effects are linked to both the fiber and polyphenol content of apples.

Conclusion

Eating whole apples regularly can help lower total and LDL cholesterol, improve HDL cholesterol, and provide antioxidant protection, all of which contribute to a reduced risk of cardiovascular disease. The benefits are strongest when apples are consumed whole, due to the combined effects of fiber and polyphenols. Apple juice, especially clear juice, does not offer the same cholesterol-lowering benefits and may even have adverse effects on blood lipids. For best results, include whole apples as part of a balanced diet to support healthy cholesterol levels and heart health.

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Most relevant research papers on this topic

Mini-review: The effects of apples on plasma cholesterol levels and cardiovascular risk – a review of the evidence

Apples have a 5-8 % reduction in plasma cholesterol levels, potentially reducing cardiovascular disease risk, while apple juice may have adverse effects on triglyceride levels.

Systematic Review

2009·

39citations

·E. N. Jensen et al.

A Boost in Mitochondrial Activity Underpins the Cholesterol-Lowering Effect of Annurca Apple Polyphenols on Hepatic Cells

Annurca apple polyphenols lower cholesterol levels by promoting mitochondrial respiration, lipolysis, and fatty acid -oxidation, rather than statins.

In Vitro StudyVery Rigorous Journal

2019·

25citations

·E. Sommella et al.

Apple peel bioactive rich extracts effectively inhibit in vitro human LDL cholesterol oxidation.

Apple peel extracts, particularly quercetin-rich and triterpene-rich, effectively inhibit human LDL cholesterol oxidation in vitro, potentially reducing atherosclerotic plaque formation.

In Vitro Study

2013·

59citations

·S. Thilakarathna et al.

Apple favourably affects parameters of cholesterol metabolism and of anti-oxidative protection in cholesterol-fed rats

A moderate supply of dessert apples improves cholesterol metabolism and oxidative stress prevention in cholesterol-fed rats, despite low fiber supply.

Highly Cited

2001·

95citations

·Olivier Aprikian et al.

EFFECT OF APPLES ON SERUM CHOLESTEROL LEVELS IN HUMANS

Eating at least two apples per day for a month significantly lowers serum cholesterol levels in men aged 30 to 50 years.

1977·

28citations

·T. Gormley et al.

Two apples a day lower serum cholesterol and improve cardiometabolic biomarkers in mildly hypercholesterolemic adults: a randomized, controlled, crossover trial

Daily consumption of two PA-rich apples improves cholesterol levels and vascular function in mildly hypercholesterolemic individuals.

RCTVery Rigorous Journal

2019·

68citations

·A. Koutsos et al.

Evaluation of cardiovascular protective effect of different apple varieties - Correlation of response with composition.

Apples, particularly Bravo de Esmolfe and Malápio Serra, can lower cholesterol levels and improve oxLDL levels, potentially due to their high fiber and polyphenol content.

Highly Cited

2012·

85citations

·A. Serra et al.

Apple polyphenols inhibit plasma CETP activity and reduce the ratio of non-HDL to HDL cholesterol.

Apple polyphenols improve cholesterol distribution in lipoproteins by inhibiting plasma CETP activity, without affecting total cholesterol levels.

Non-RCTAnimal StudyHighly Cited

2008·

85citations

·C. Lam et al.

Intake of whole apples or clear apple juice has contrasting effects on plasma lipids in healthy volunteers

Clear apple juice may not be a suitable substitute for whole apples in cholesterol-lowering effects, as it lacks the fiber component necessary for this effect.

Non-RCTHighly Cited

2013·

154citations

·G. Ravn-Haren et al.

Annurca (Malus pumila Miller cv. Annurca) apple as a functional food for the contribution to a healthy balance of plasma cholesterol levels: results of a randomized clinical trial.

Daily consumption of Annurca apples significantly reduces total and low-density lipoprotein cholesterol levels and increases high-density lipoprotein cholesterol levels, contributing to the prevention of cardiovascular disease risk through normal diet.

RCTRigorous Journal

2017·

39citations

·G. Tenore et al.

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