Fruits · Fruit
Apples
Malus domestica · also called Apple, eating apple, manzana (Spanish)
The apple is the fruit of a tree in the rose family. The flesh and usually the skin are eaten. A medium apple has about 95 calories and 4.4 g of fibre. Large studies link fruit-rich diets with lower heart disease, but that is an association, and trials of apple products show only small changes in cholesterol. The main cautions are itchy-mouth allergy to raw apple in people with hay fever, and not eating the seeds.
General information, not medical advice. Last substantive update · Not medically reviewed. A named clinician has not signed off on this page. How this page is made
About Apples
The apple is an everyday, fibre-rich fruit. Research on eating apples is mostly observational, and trials of apple products show small changes, so it is best seen as a nutritious food rather than a proven remedy.
What it is
The apple (Malus domestica) is the fruit of a tree in the rose family, which also includes pears, peaches and cherries. The flesh and usually the skin are eaten.
A medium raw apple (182 g) provides about 95 calories, 4.4 g of fibre and 18.9 g of natural sugars, plus small amounts of vitamin C and potassium (USDA). It is a moderate source of fibre and a small source of most vitamins.
What the research shows
Large studies that followed people over time link higher fruit and vegetable intake, including apples and pears, with lower rates of heart disease and early death. People who eat more fruit may differ in other ways, so this is not proof.
A pooled analysis of 18 trials of whole apple, extract and juice found small, not clearly significant falls in total and LDL cholesterol overall. Blood sugar, blood pressure and inflammation markers were mostly unchanged.
Studies of eating habits suggest slightly lower diabetes risk with more fruit, but the apple-specific findings rest on few studies. Claims about cancer, memory and other uses rest mostly on cell and animal work.
Whole apple versus juice and extracts
Trials of cholesterol mixed whole apples with extracts and juice, so they do not show what one apple does. Juice has less fibre than the fruit, and in diabetes studies fruit juice went the opposite way to whole fruit.
The US FDA sets an action level of 10 parts per billion for inorganic arsenic in apple juice. Extracts and apple cider vinegar are different products and are not covered on this page.
At a glance
Traditional uses history, not proof
- Eaten fresh, cooked, dried or as juice and sauce
- The saying "an apple a day" is popular, but no source we read documents its origin
Studied for research
- Heart disease and early death in diets rich in fruit, apples and pears, low certainty
- Blood cholesterol in trials of apple products, low certainty
- Type 2 diabetes risk, very low certainty
- Cloudy apple juice and heart-risk markers, very low certainty
- Fullness in children, very low certainty
Main compounds
- Dietary fibre (about 4.4 g in a medium apple)
- Polyphenols, a large family of plant compounds
- Vitamin C, potassium and small amounts of other nutrients
- Amygdalin, found in the seeds
Common forms
- Fresh apple with skin (the form the nutrition figures describe)
- Cooked, canned or frozen slices; sauce and puree
- Dried apple
- Apple juice, clear or cloudy
- Apple extracts (not the same as the fruit)
Research links: NHS: Food allergy · Cholesterol and apple products, meta-analysis (Frontiers in Nutrition, 2022) · Fruit, vegetables and heart disease (International Journal of Epidemiology, 2017) · USDA FoodData Central: raw apple with skin · Research Library · Genes & Biomarkers Library
What it is and its history
- Accepted scientific name
- Malus domestica
- Naming authority
- (Suckow) Borkh. (GBIF accepted, usageKey 3001244)
- Synonyms
- Malus pumila (used as an alias in the existing nutrient-graph summary; not checked in GBIF)
- Common names
- Apple (English); Manzana (Spanish)
- Family or group
- Rosaceae (rose family), which also includes pear, peach, plum and cherry.
- Classification
- Plantae > Tracheophyta > Magnoliopsida > Rosales > Rosaceae > Malus > Malus domestica
- Native range
- Not verified from a source read.
- Habitat
- Not verified.
- What it looks like
- Roots: Not verified.; Stems: Not verified.; Leaves: Not verified.; Flowers: Not verified.; Fruit: A "pome" fruit: the flesh and usually the skin are eaten; seeds sit in a central core (existing site summary; the fruit type is not re-sourced).
- Cultivation
- Not verified from a source read.
- Harvest and processing
- Eaten fresh, or as frozen or canned slices, dried rings, juice, sauce or puree (existing site summary).
- Look-alikes and adulterants
- Name: Pear (Pyrus communis); Note: A different fruit in the same family, often grouped with apple in studies ("apples and pears"). Evidence for one is not evidence for the other.
- Sustainability and conservation
- Not assessed.
Photographs
Traditional use and history history, not clinical proof
| Tradition or era | Documented use | Source |
|---|---|---|
| Everyday fruit | The saying "an apple a day" is popular, but no source read documents its origin. Fruit-rich diets are recommended in public health guidance; this is not a claim that apples treat disease. | NOT verified (no source read) |
Traditional use shows how it was used. It does not show that it works or is safe today.
What is inside, and how it may work
What it contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.
Main compounds
| Compound | Family | Where it is concentrated | Activity studied | Level of evidence |
|---|---|---|---|---|
| Dietary fibre | carbohydrate | Flesh and skin 2.4 g per 100 g; about 4.4 g in a medium apple (USDA) | Provides fibre in the diet. Not tested here as a treatment. 16 | Composition data |
| Polyphenols | plant compounds | Mainly skin and flesh (not verified) | Reviews describe antioxidant and other effects, much of it from lab and animal work. 11 6 | Lab and animal, with some human trials |
| Amygdalin | cyanogenic glycoside | Seeds and kernels | Breaks down to hydrogen cyanide after eating (see safety). 5 | Review of cell and animal studies |
Mechanisms, receptors and pathways
| Target or pathway | Gene or receptor | What was found | Level |
|---|---|---|---|
| Antioxidant and cell-signalling effects of apple polyphenols | Described by reviews as likely routes behind possible heart and other effects; evidence is mainly from cells and animals. 11 6 | Lab and animal |
Absorption, metabolism and elimination
- Absorption
- Not researched.
- Distribution
- Not found.
- Metabolism
- Amygdalin is broken down to benzaldehyde and hydrogen cyanide after oral intake (review).
- Elimination
- Not found.
- Bioavailability
- Not established.
Isolated compounds versus whole extracts
Cholesterol trials pooled whole apples, apple extracts and apple juice, so their results do not show what one whole apple does. Juice has less fibre than the fruit, and in diabetes studies fruit juice went the opposite way to whole fruit. Extracts and apple cider vinegar are different products and are not assessed here.
Nutritional composition
Per 100 g of raw apple with skin (USDA FoodData Central, SR Legacy): 52 kcal, 85.6 g water, 0.26 g protein, 0.17 g fat, 13.8 g carbohydrate of which 10.4 g are sugars, and 2.4 g fibre. A medium apple (182 g) provides about 95 kcal, 4.4 g fibre and 18.9 g sugars. Small amounts of vitamin C (8.4 mg per medium apple), potassium (195 mg), copper (0.05 mg), vitamin K (4.0 micrograms), vitamin E (0.33 mg) and folate (5 micrograms DFE). An apple is a moderate source of fibre and a small source of most vitamins. Per-portion figures are calculated from the per-100 g values. Values vary with variety, ripeness and storage.
3 low certainty3 very low certainty1 not enough evidence
What was looked at
The 7 benefits and uses checked for Apples, each with how strong the evidence is. Tap one to open it.
- Heart disease and early death (diets rich in fruit, apples and pears)Low certainty
- Blood cholesterol (whole apple, apple extract and apple juice trials)Low certainty
- Type 2 diabetes risk (fruit and apple intake)Very low certainty
- Blood sugar, insulin, blood pressure and inflammation markers (apple product trials)Low certainty
- Feeling full and weight (children, apple slices, puree and juice)Very low certainty
- Cloudy apple juice and heart-risk markersVery low certainty
- Cancer, memory, asthma, bone, skin and other claimsNot enough evidence
Lab markers tracked in the studies
LDL cholesterolTotal cholesterolHDL cholesterolBlood glucoseC-reactive protein (CRP)
What is Apples good for?
The main studied uses and how strong the human evidence is for each. Most results are links seen in eating habits or small changes in lab markers, not proof that apples prevent or treat a disease.
Benefits, one by one
Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.
Heart disease and early death (diets rich in fruit, apples and pears)
Low certaintyIn large groups of people followed over time, those who ate more fruit and vegetables, including apples and pears, had lower rates of heart disease and early death. This is a link seen across diets, not proof that apples themselves protect the heart.
1 studiesEating whole apples as part of the diet.
Studies, doses and limits
What the trials found
A 2017 review of 95 prospective studies found that fruit and vegetables combined went with lower cardiovascular disease and early death, and that apples and pears separately showed inverse associations with cardiovascular disease and all-cause mortality.
Results
Lower risk in people who ate more fruit. Apples and pears were grouped together, so apples alone are not isolated.
Effect sizes as reported
Fruit and vegetables combined, per 200 g a day: cardiovascular disease RR 0.92 (0.90-0.95), all-cause mortality RR 0.90 (0.87-0.93). No apple-only figure in the abstract.
Why this rating
Observational data only. People who eat more fruit may differ in other ways. Apples are grouped with pears, and the strongest numbers are for all fruit and vegetables together.
Form and dose studied
Eating whole apples as part of the diet.
Who was studied
Adults in cohort studies.
Limits
Association, not cause. Apple-specific effect size not given in the source read.
Why researchers looked
Apples are one of the most widely eaten fruits, and fruit-rich diets have long been linked with better heart health.
Traditional use
"An apple a day" is a popular saying. It is a saying, not evidence.
Proposed mechanism Preliminary mechanism
Possible routes include fibre, potassium and plant compounds called polyphenols. These ideas come largely from lab and animal work and are unproven in people.
A proposed mechanism does not show that the effect happens in people.
None specific to this finding.
Blood cholesterol (whole apple, apple extract and apple juice trials)
Low certaintyIn trials of apple products lasting at least a week, total and LDL ("bad") cholesterol fell by a few points, but not by a statistically clear amount overall. The fall was clearer against a placebo and in people who started with high cholesterol. HDL ("good") cholesterol dipped slightly.
1 studiesWhole apple, extract and juice, pooled. The result does not show what…
Studies, doses and limits
What the trials found
A 2022 meta-analysis pooled 18 randomised trials of whole apple, apple extract and apple juice together.
Results
Small average falls in total and LDL cholesterol, not significant overall; significant against placebo and in people with high starting levels. HDL fell a little, which is not a hoped-for change.
Effect sizes as reported
Total cholesterol -2.69 mg/dL (95% CI -5.43 to 0.04); LDL -2.80 mg/dL (-5.78 to 0.17); HDL -1.04 mg/dL (-1.79 to -0.29).
Why this rating
Small changes, confidence intervals touching zero overall, short trials, and the trials mix whole apples with extracts and juice.
Form and dose studied
Whole apple, extract and juice, pooled. The result does not show what one apple does.
Who was studied
Adults in randomised trials, including people with high cholesterol.
Limits
Marker only; no heart outcomes. Products differ. At least one week of intake.
Why researchers looked
Apples contain fibre and polyphenols that might affect blood fats.
Proposed mechanism Preliminary mechanism
Soluble fibre and polyphenols are suggested routes. Not tested in this analysis.
A proposed mechanism does not show that the effect happens in people.
None specific.
Type 2 diabetes risk (fruit and apple intake)
Very low certaintyIn long-term studies of eating habits, people who ate more fruit had a slightly lower chance of developing type 2 diabetes, and apples showed a similar pattern. The authors say the apple findings rest on few studies. Fruit juice and fruit drinks went the other way.
1 studiesWhole apples as part of the diet. Fruit juice showed the opposite pat…
Studies, doses and limits
What the trials found
A 2021 review of 23 cohort studies reported a weak inverse link between fruit intake and diabetes, with inverse links for apples and for apples with pears, and positive links (higher risk) for fruit juice and fruit drinks.
Results
Slightly lower risk with more fruit. Apple-specific findings were based on few studies.
Effect sizes as reported
All fruit, high vs low intake: RR 0.93 (95% CI 0.90-0.97, 20 studies). No apple-only figure in the abstract.
Why this rating
Observational; the apple results come from few studies, as the authors themselves state.
Form and dose studied
Whole apples as part of the diet. Fruit juice showed the opposite pattern.
Who was studied
Adults in cohort studies.
Limits
Association, not cause.
Why researchers looked
Whole fruit has fibre and a modest effect on blood sugar compared with sugary drinks, so researchers have asked whether eating it changes diabetes risk.
Proposed mechanism Unknown
Not established.
A proposed mechanism does not show that the effect happens in people.
People with diabetes should ask their care team about fruit and juice in their own plan.
Blood sugar, insulin, blood pressure and inflammation markers (apple product trials)
Low certaintyIn the same trial analysis that looked at cholesterol, blood sugar, insulin, blood pressure and C-reactive protein (an inflammation marker) were mostly unchanged by apple products.
1 studiesWhole apple, extract and juice pooled.
Studies, doses and limits
What the trials found
A 2022 meta-analysis of 18 randomised trials of whole apple, apple extract and apple juice found the other markers "mostly unaffected".
Results
No clear effect found.
Effect sizes as reported
Individual numbers for these markers are not in the abstract.
Why this rating
Short trials of mixed apple products; the abstract gives few details. Absence of a clear effect here is not proof of no effect.
Form and dose studied
Whole apple, extract and juice pooled.
Who was studied
Adults in randomised trials.
Limits
Mixed products; abstract only.
Why researchers looked
Apples are often said to help blood sugar and blood pressure.
Proposed mechanism Unknown
Not applicable; no clear effect was found.
A proposed mechanism does not show that the effect happens in people.
None specific.
Feeling full and weight (children, apple slices, puree and juice)
Very low certaintyIn one small laboratory study, young children felt similarly full after apple slices, apple puree or apple juice with the same energy. Boys adjusted what they ate at the next meal more precisely than girls. This says nothing yet about weight.
1 studiesApple slices, puree and juice, matched for energy.
Studies, doses and limits
What the trials found
A 2026 crossover study of 64 children aged 4 to 6 compared apple slices, puree and juice against no preload.
Results
Satiety was 112% for slices, 121% for puree and 120% for juice, not significantly different. Boys compensated almost perfectly for slices (99%), girls less so (125%).
Effect sizes as reported
p > 0.05 between forms; sex difference p < 0.05 versus control.
Why this rating
One small, single-meal study in young children.
Form and dose studied
Apple slices, puree and juice, matched for energy.
Who was studied
Children aged 4 to 6.
Limits
One meal; laboratory; no weight outcome.
Why researchers looked
Researchers wanted to know whether the form of a food changes how filling it is.
Proposed mechanism Hypothesis
Not established. The authors suggest girls may respond more to learned or social cues and boys to body signals; this is their idea, not a finding.
A proposed mechanism does not show that the effect happens in people.
None specific in the source read.
Cloudy apple juice and heart-risk markers
Very low certaintyA review of 20 human trials of apple juice, mostly cloudy juice, reported better markers of heart disease risk, mainly oxidative stress. Juice is not the same as eating the fruit and has less fibre.
1 studiesJuice, mostly cloudy.
Studies, doses and limits
What the trials found
A 2022 review of 20 interventional studies of apple juice concluded that juice in moderation had positive effects on cardiovascular risk markers, particularly oxidative stress.
Results
Markers improved in the direction the authors describe as positive.
Effect sizes as reported
No pooled numbers in the abstract.
Why this rating
Narrative review of mostly small marker trials; no health outcomes.
Form and dose studied
Juice, mostly cloudy.
Who was studied
Adults and others in varied trials.
Limits
Juice, not whole apple; markers only.
Why researchers looked
Juice is a common way people take in apple compounds.
Proposed mechanism Preliminary mechanism
Polyphenols and antioxidant activity are the proposed route; mostly shown in the lab.
A proposed mechanism does not show that the effect happens in people.
Juice adds sugar without most of the fibre; see the safety tab for the arsenic limit.
Cancer, memory, asthma, bone, skin and other claims
Not enough evidenceReviews list many possible benefits of apples and their plant compounds. Much of it comes from cells and animals, and the reviews do not separate it clearly from human studies, so these are not shown benefits.
2 studiesApples, apple products, extracts and single compounds.
Studies, doses and limits
What the trials found
Two reviews (2011 and 2023) describe associations and lab findings. Neither is a trial showing a disease outcome in people.
Results
Lab and animal findings, and some associations.
Why this rating
Mixed, mainly lab and animal evidence; no human outcome trials were found in the sources read.
Form and dose studied
Apples, apple products, extracts and single compounds.
Who was studied
Mixed.
Limits
Cannot separate human from lab evidence in the abstracts.
Why researchers looked
Apples are rich in polyphenols, which are active in the lab.
Proposed mechanism Preliminary mechanism
Antioxidant, anti-inflammatory and cell-signalling effects of apple compounds, shown mainly in cells and animals.
A proposed mechanism does not show that the effect happens in people.
None specific.
Connections to the rest of health
How Apples connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.
Explore every connection: goals, body systems, organs, symptoms, genes
A. Wellness goals
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Heart Health | Potential benefit | Low certainty | Heart disease and early death (diets rich in fruit, apples and pears): In large groups of people followed over time, those who ate more fruit and vegetables, including apples and pears, had lower rates of heart disease and early death. This is a link seen across diets, not proof that apples themselves protect the heart. Cloudy apple juice and heart-risk markers: A review of 20 human trials of apple juice, mostly cloudy juice, reported better markers of heart disease risk, mainly oxidative stress. Juice is not the same as eating the fruit and has less fibre. | 2 10 |
| Cholesterol Balance | Potential benefit | Low certainty | Blood cholesterol (whole apple, apple extract and apple juice trials): In trials of apple products lasting at least a week, total and LDL ("bad") cholesterol fell by a few points, but not by a statistically clear amount overall. The fall was clearer against a placebo and in people who started with high cholesterol. HDL ("good") cholesterol dipped slightly. | 7 |
| Blood Sugar Balance | Potential benefit | Very low certainty | Type 2 diabetes risk (fruit and apple intake): In long-term studies of eating habits, people who ate more fruit had a slightly lower chance of developing type 2 diabetes, and apples showed a similar pattern. The authors say the apple findings rest on few studies. Fruit juice and fruit drinks went the other way. | 4 |
| Blood Sugar Balance | Low certainty | Blood sugar, insulin, blood pressure and inflammation markers (apple product trials): In the same trial analysis that looked at cholesterol, blood sugar, insulin, blood pressure and C-reactive protein (an inflammation marker) were mostly unchanged by apple products. | 7 | |
| Weight Management | Very low certainty | Feeling full and weight (children, apple slices, puree and juice): In one small laboratory study, young children felt similarly full after apple slices, apple puree or apple juice with the same energy. Boys adjusted what they ate at the next meal more precisely than girls. This says nothing yet about weight. | 9 |
B. Body systems
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Cardiovascular System | Biological association | Low certainty | Studied for: Heart disease and early death (diets rich in fruit, apples and pears) Studied for: Blood cholesterol (whole apple, apple extract and apple juice trials) | 2 7 4 10 |
| Digestive System | Biological association | Very low certainty | Studied for: Feeling full and weight (children, apple slices, puree and juice) | 9 |
E. Health conditions
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Food allergy | Adverse effect or risk | Documented risk | Pollen-food allergy can cause an itchy mouth after raw apple; severe reactions are uncommon but need emergency care. Pollen-food allergy can cause an itchy mouth after raw apple. Preparation or compound: Raw apple |
15 1 |
I. Biomarkers
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| LDL cholesterol | Biological association | Low certainty | Measured in trials: lowered slightly. A lab change is not the same as a health benefit. | 7 |
| Total cholesterol | Biological association | Low certainty | Measured in trials: lowered slightly. A lab change is not the same as a health benefit. | 7 |
| HDL cholesterol | Biological association | Low certainty | Measured in trials: lowered slightly. A lab change is not the same as a health benefit. | 7 |
| Blood glucose | Biological association | Low certainty | Measured in trials: no clear change. A lab change is not the same as a health benefit. | 7 |
| C-reactive protein (CRP) | Biological association | Low certainty | Measured in trials: no clear change. A lab change is not the same as a health benefit. | 7 |
L. Active compounds
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Dietary fibre | Biological association | Composition data | Provides fibre in the diet. Not tested here as a treatment. Preparation or compound: Flesh and skin |
16 |
| Polyphenols | Biological association | Lab and animal, with some human trials | Reviews describe antioxidant and other effects, much of it from lab and animal work. Preparation or compound: Mainly skin and flesh (not verified) |
11 6 |
| Amygdalin | Biological association | Review of cell and animal studies | Breaks down to hydrogen cyanide after eating (see safety). Preparation or compound: Seeds and kernels |
5 |
Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 25, 2026).
Evidence at a glance: what the research found for 7 outcomes
Each outcome below is one thing researchers measured. Certainty is how far the evidence can be trusted, not how well it works. The full studies are on the next tab.
The evidence
The research centre for Apples. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.
Evidence by outcome
Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).
How we rate evidence
High certainty
Several well-run trials or reviews agree; further research is unlikely to change the picture much.
Moderate certainty
Good trials point the same way, but some doubt remains.
Low certainty
Small, short or inconsistent trials. The finding could change with better research.
Very low certainty
Very little or very weak human data. Treat as a possibility only.
Mixed findings
Trials or reviews disagree with each other.
Not enough evidence
Not enough human research to say either way.
Evidence against
Good research found no benefit, or found harm.
We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We started from our existing apple summary, re-read the USDA FoodData Central record, and read PubMed abstracts and the NHS and FDA pages. Only abstracts were read for studies. Items we could not verify are flagged in the research gaps.
Study library: every study we checked 16
| Study | Design | People | Product, dose, length | Result |
|---|---|---|---|---|
| Al-Shaikhly 2024 An International Delphi Consensus on the Management of Pollen-Food Allergy Syndrome: A Work Group Report of the AAAAI Adverse Reactions to Foods Committee. J Allergy Clin Immunol Pract · PMID 39488768 · DOI |
Expert consensus (Delphi) |
Panel of allergists, researchers and nutritionists from 25 institutions in 11 countries | n/a |
After two rounds the panel agreed on 14 statements. They advise avoiding the raw food that caused the reaction but not other possibly cross-reactive fruits and vegetables, and recommend adrenaline (epinephrine) auto-injectors for people with severe symptoms beyond the mouth and throat. Consensus statements, not a trial Methods, limits and fundingOutcomes: Consensus statements on managing pollen-food allergy syndrome Limitations: Expert opinion. Apple is not named in the abstract. Funding and conflicts: Several panel members declared industry consulting or research support (listed in the paper) Read: abstract |
| Aune 2017 Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol · PMID 28338764 · DOI |
Systematic review (observational cohort studies) |
95 prospective studies (142 publications) of fruit and vegetable intake in adults | Usual dietary intake of fruit and vegetables; apples and pears grouped as one fruit type fruit (flesh and usually skin) Follow-up varied by study · vs Lower intake |
For fruits and vegetables combined, each 200 g a day went with a lower risk: relative risk 0.92 for coronary heart disease, 0.84 for stroke, 0.92 for cardiovascular disease and 0.90 for all-cause death. Inverse associations were seen for apples and pears with cardiovascular disease and all-cause mortality (the abstract gives no apple-only figure). Fruit and vegetables combined, per 200 g/day: cardiovascular disease RR 0.92 (95% CI 0.90-0.95); all-cause mortality RR 0.90 (0.87-0.93) (0.90-0.95 (cardiovascular disease, combined)) Methods, limits and fundingOutcomes: Cardiovascular disease, total cancer, all-cause mortality Limitations: Observational: shows an association, not cause. Apples are grouped with pears, and the headline numbers are for all fruit and vegetables together. Heterogeneity was high for some outcomes (I2 up to 83%). Funding and conflicts: Not stated in the abstract read Read: abstract |
| Chmielewski 2026 Pesticide Residues in Apples and Pears: A Deterministic Assessment of Chronic Exposure and Non-Carcinogenic Risk for European Consumers. Molecules · PMID 41828764 · DOI |
Dietary risk assessment (Polish monitoring data, 2022) n/a |
Polish official monitoring results for apples and pears sampled in 2022, combined with consumption scenarios for children and adults | Pesticide residues on apples and pears fruit Chronic-exposure model · vs Acceptable daily intake |
For all detected pesticides and all scenarios the hazard quotients were well below 1. Highest exposure was for apples in children (quotients about 0.01 to 0.05; hazard index below 0.1). The authors conclude current residues do not pose a relevant non-cancer health concern, while children show higher relative exposure than adults. Hazard quotients about 0.01-0.05 (children, highest scenario); hazard index < 0.1 Methods, limits and fundingOutcomes: Hazard quotient and hazard index versus acceptable daily intake Limitations: One country, one year of monitoring, non-cancer risk only; a modelling study, not a health study. Funding and conflicts: Authors declared no conflicts; funders had no role (per the paper) Read: full-text (PMC abstract) |
| Halvorsen 2021 Fruit and vegetable consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of prospective studies. BMJ Nutr Prev Health · PMID 35028521 · DOI |
Systematic review (observational cohort studies) |
23 prospective cohort studies of fruit and vegetable intake and type 2 diabetes | Usual dietary intake; subtypes include apples, apples and pears, fruit juice fruit Cohort follow-up · vs Lower intake |
Higher fruit intake went with slightly lower diabetes risk (relative risk 0.93). Inverse associations were seen for apples and for apples and pears; fruit juice and fruit drinks went the other way. The authors say most subtype results rest on few studies and need more research. All fruit, high vs low intake: RR 0.93 (95% CI 0.90-0.97, 20 studies). Apple-specific figure not in the abstract. (0.90-0.97 (all fruit)) Methods, limits and fundingOutcomes: Type 2 diabetes risk Limitations: Observational association. Apple subtype findings come from few studies, per the authors. Funding and conflicts: No competing interests declared Read: abstract |
| He 2020 Amygdalin - A pharmacological and toxicological review. J Ethnopharmacol · PMID 32114166 · DOI |
Review of cell and animal studies (110 papers) mixed |
In vitro and in vivo studies of amygdalin | Amygdalin, a cyanide-releasing compound found in Rosaceae plants including apple, mostly in seeds and kernels seed (kernel) |
Amygdalin is found in Rosaceae plants such as peach, plum, loquat, apple and bayberry, most of all in apricot kernels. After oral intake it breaks down to benzaldehyde and hydrogen cyanide, which causes the toxicity. The abstract gives no figure for apple seeds. Qualitative Methods, limits and fundingOutcomes: Pharmacology and toxicology of amygdalin Limitations: About the compound, not apple seeds specifically. Mostly cell and animal evidence. Funding and conflicts: Not stated in the abstract read Read: abstract |
| Hyson 2011 A comprehensive review of apples and apple components and their relationship to human health. Adv Nutr · PMID 22332082 · DOI |
Narrative review mixed |
Clinical, cell and animal data on apples and apple products | Apples and apple products fruit and products Varied Varied · vs Varied |
Apple exposure has been associated with beneficial effects on the risk, markers and causes of cancer, cardiovascular disease, asthma and Alzheimer disease, with possible links to several other outcomes. Proposed mechanisms include antioxidant, antiproliferative and cell-signalling effects. Qualitative Methods, limits and fundingOutcomes: Cancer, cardiovascular disease, asthma, Alzheimer disease, diabetes, weight, bone, lung and gut outcomes Limitations: Older (2011), a narrative review; associations and mixed-quality evidence. Does not prove prevention. Funding and conflicts: Author declared no conflicts of interest Read: abstract |
| Kim 2022 Metabolic and Cardiovascular Benefits of Apple and Apple-Derived Products: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Nutr · PMID 35449537 · DOI |
Systematic review and meta analysis of RCTs |
18 randomised trials of whole apple, apple extract or apple juice (searched to May 2021) | Whole apple, apple extract and apple juice, pooled together fruit, extract, juice (mixed) Varied; at least one week of apple consumption At least 1 week · vs Control or placebo, varied |
Total cholesterol fell by 2.69 mg/dL and LDL by 2.80 mg/dL, both non-significant overall. Against a placebo control the falls were significant, and people with high starting levels did better. HDL fell by a small, significant 1.04 mg/dL. The other markers were mostly unaffected. TC -2.69 mg/dL (95% CI -5.43 to 0.04); LDL -2.80 mg/dL (-5.78 to 0.17); HDL -1.04 mg/dL (-1.79 to -0.29) (TC -5.43 to 0.04; LDL -5.78 to 0.17; HDL -1.79 to -0.29) Methods, limits and fundingOutcomes: Total cholesterol, LDL, HDL, triglycerides, glucose, insulin, C-reactive protein, systolic and diastolic blood pressure Limitations: Mixes whole apples with extracts and juice, so it does not show what one apple does. Short trials. Marker outcomes only. Funding and conflicts: Authors declared no commercial or financial conflicts Registration: PROSPERO CRD42020215977 Read: abstract |
| Noel 2025 A systematic review/meta-analysis of xenobiotics in apple products highlights lack of compliance with European Food Safety Authority Regulation. Compr Rev Food Sci Food Saf · PMID 40091751 · DOI |
Systematic review and meta analysis of contaminant testing n/a |
90 articles on pesticides, mycotoxins and heavy metals in apple products, assessed against EU limits | Apples and apple products (contaminant testing) fruit and products · vs EU maximum residue limits |
Overall, 42.8% of checks exceeded the limits (51.6% for pesticides, 42.55% for heavy metals, 40.2% for mycotoxins). The rate was 12.5% in North America and higher in the Middle East (65.2%), Africa (50%), Asia (43.9%), Europe (37.5%) and South America (33.3%). Over 60% of the 92 pesticides considered are banned in the EU. 42.8% of checks above limits overall Methods, limits and fundingOutcomes: Share of checks above maximum residue limits Limitations: Pools many testing studies of differing quality; the studies may have targeted suspect samples; limits are safety margins, so exceeding one does not itself mean illness. Funding and conflicts: Authors declared no conflicts of interest Read: abstract |
| Reigh 2026 Effects of apple form on satiety in 4-6 year-old children: possible evidence of sex differences. Appetite · PMID 40816534 · DOI |
Crossover trial |
64 64 children (32 girls), mean age 5.9 years, five laboratory visits |
Apple slices, apple puree or apple juice, matched for energy and energy density (a no-preload visit as control) fruit A set preload before a meal (trial detail, not advice) Five visits about a week apart · vs No preload |
Food form did not change satiety: 112% for slices, 121% for puree and 120% for juice (not significant). Boys compensated almost perfectly for slices (99%); girls less so (125%). Satiety 112% (slices), 121% (puree), 120% (juice); p > 0.05 between forms Methods, limits and fundingOutcomes: Satiety, measured as how much children ate at a following meal Limitations: Single meal, young children, laboratory setting with visual cues masked and eating rate controlled. Not a weight study. Funding and conflicts: Authors declared no financial interest or conflict Read: abstract |
| Vallee Marcotte 2022 Health Benefits of Apple Juice Consumption: A Review of Interventional Trials on Humans. Nutrients · PMID 35215471 · DOI |
Narrative review of interventional trials |
20 human interventional studies of apple juice (from 67 retained) | Apple juice, mainly cloudy juice juice "In moderation" per the authors; varied Varied · vs Varied |
Cloudy apple juice was linked with better markers of cardiovascular disease risk, particularly oxidative stress, with other markers also reported. Qualitative; no pooled numbers in the abstract Methods, limits and fundingOutcomes: Markers of cardiovascular risk, oxidative stress, inflammation, blood fats and diabetes Limitations: Juice is not the whole fruit and has less fibre. Review without pooled analysis; marker outcomes. Funding and conflicts: Authors declared no conflict of interest Read: abstract |
| Zhang 2023 Does an apple a day keep away diseases? Evidence and mechanism of action. Food Sci Nutr · PMID 37701204 · DOI |
Narrative review (clinical, epidemiological, cell and animal studies) mixed |
Studies found in PubMed, January 2012 to May 2022; human, cell and animal work mixed | Apples and apple products (juice, puree, pomace, dried apple, extracts and single compounds) fruit and products Varied Varied · vs Varied |
The authors say apples and apple products have protective effects against heart disease and cancer and for a range of other uses, through mechanisms such as blood-vessel protection, lipid lowering and antioxidant effects. The abstract does not separate human evidence from cell and animal evidence. Qualitative Methods, limits and fundingOutcomes: Cardiovascular disease, cancer, mild cognitive impairment, skin, hair and others Limitations: Mixes products and study types, including cell and animal work. A review does not show cause and effect in people. Funding and conflicts: Authors declared no conflicts of interest Read: abstract |
| s-fda-arsenic-apple-juice FDA guidance for industry: Action Level for Inorganic Arsenic in Apple Juice · Source |
Regulatory guidance n/a |
Methods, limits and fundingRead: full-text | ||
| s-fda-produce-safely FDA: Selecting and Serving Produce Safely · Source |
Official consumer guidance n/a |
Methods, limits and fundingRead: full-text | ||
| s-gbif-malus-domestica GBIF Backbone: Malus domestica (Suckow) Borkh. (usageKey 3001244) · Source |
Reference database n/a |
Methods, limits and fundingRead: full-text | ||
| s-nhs-food-allergy NHS: Food allergy · Source |
Official health guidance n/a |
Methods, limits and fundingRead: full-text | ||
| s-usda-fdc-171688 USDA FoodData Central: Apples, raw, with skin (FDC 171688, SR Legacy) · Source |
Food composition database n/a |
Methods, limits and fundingRead: full-text |
What we do not know yet
- No trial has tested whole apples alone for heart disease, stroke or diabetes outcomes.
- The large studies group apples with pears and other fruit.
- Pregnancy, breastfeeding, choking risk for young children, dental effects and bloating (FODMAP) were not researched.
- The size of the cyanide risk from apple seeds was not found.
- No source was found on medicine interactions with apples as a food.
How new research is added
New studies are found by a saved PubMed search and placed in a review queue before the page changes.
Lab markers
What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".
Metabolic 4
LDL cholesterol
Lowered slightly in trials
The so-called bad cholesterol carried in the blood.
Low certaintyResults and what it means
Why it was measured
A common heart-risk marker.
Statistical vs. clinical meaning
A small change; no one knows if it changes heart outcomes.
Safety implication
None specific.
| Study | Result | People | Product |
|---|---|---|---|
| 7 | -2.80 mg/dL overall (95% CI -5.78 to 0.17, not significant); significant against placebo and in high starting levels | Adults in 18 trials | Whole apple, extract and juice pooled |
Total cholesterol
Lowered slightly in trials
All cholesterol carried in the blood.
Low certaintyResults and what it means
Why it was measured
A common heart-risk marker.
Statistical vs. clinical meaning
Small and not clearly different from zero overall.
Safety implication
None specific.
| Study | Result | People | Product |
|---|---|---|---|
| 7 | -2.69 mg/dL overall (95% CI -5.43 to 0.04, not significant); significant against placebo | Adults in 18 trials | Whole apple, extract and juice pooled |
HDL cholesterol
Lowered slightly in trials
The so-called good cholesterol.
Low certaintyResults and what it means
Why it was measured
Higher HDL is usually seen as favourable.
Statistical vs. clinical meaning
A small fall, in the opposite direction to the hoped-for effect. Its meaning is unknown.
Safety implication
None specific.
| Study | Result | People | Product |
|---|---|---|---|
| 7 | -1.04 mg/dL (95% CI -1.79 to -0.29), a small significant fall | Adults in 18 trials | Whole apple, extract and juice pooled |
Blood glucose
No clear change in trials
The amount of sugar in the blood.
Low certaintyResults and what it means
Other 1
C-reactive protein (CRP)
No clear change in trials
A blood marker of general inflammation.
Low certaintyResults and what it means
Safety
What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.
Main points to know 3
- Raw apple can cause an itchy mouth in people with pollen allergy. Some people with hay fever react to raw fruit, including apple, with an itchy mouth and throat. The NHS calls this oral allergy syndrome (pollen food syndrome): it is not usually serious, and well-cooked fruit helps. An international expert panel (2024) advises avoiding the raw food that caused the reaction, not every possibly related fruit. Rarely, reactions go beyond the mouth. Authoritative guidance 15 1
- A serious allergic reaction is an emergency. Swelling of the lips, face, tongue or throat, wheezing, trouble breathing, dizziness or fainting after eating can be a serious allergic reaction. Call emergency services (911 in the US, 999 in the UK). People who have had severe symptoms may have been prescribed an adrenaline auto-injector; the panel recommends them for severe cases. Authoritative guidance 15 1
- Do not crush and eat apple seeds. Apple belongs to the rose family, which makes a compound called amygdalin, mostly in seeds and kernels. A review says that after eating, amygdalin breaks down to hydrogen cyanide, which causes its toxicity. The review does not give a figure for apple seeds, so the real risk from the few seeds in a swallowed core is not quantified here. Do not eat large numbers of crushed seeds. Review 5
Side effects 3
| Effect | How often | Severity and recovery | Evidence |
|---|---|---|---|
| Itchy mouth and throat after raw apple (pollen-food allergy) Common in people with hay fever. No frequency was in the sources read. | Not established | mild, usually Usually settles quickly; the NHS says well-cooked fruit and vegetables help. | Authoritative guidance 15 |
| Severe allergic reaction (anaphylaxis) The expert panel calls this a rare chance for people with pollen-food allergy. | Not established | severe Needs emergency treatment. | Authoritative guidance 1 15 |
| Foodborne illness from unwashed or poorly handled fruit FDA says harmful bacteria can contaminate produce in the field or after harvest. | Not established | mild to severe Varies | Authoritative guidance 13 |
Liver
No liver injury linked to eating apples was found in the sources read. LiverTox was not checked.
How often. No frequency found.
This is a safety connection. It is not evidence that Apples supports liver health.
Medicines and supplements 1
| With | Why it matters | Importance | Evidence | What to do |
|---|---|---|---|---|
| Prescription and over-the-counter medicines prescription | No source read describes a medicine interaction with eating apples. Juice, extracts and other products were not checked for interactions. | None found Not enough evidence | A pharmacist can check your own medicines. Ask before using concentrated apple extracts. |
Who should check first 2
| Situation | Advice | Evidence |
|---|---|---|
| Known allergy to apple that causes swelling or trouble breathing | Avoid apple and get an allergy assessment. Follow your own emergency plan. | Authoritative guidance 15 1 |
| Pollen-food allergy with a raw-apple reaction | The 2024 expert panel advises avoiding the raw food that caused the reaction. The NHS says well-cooked fruit often helps. | Authoritative guidance 1 15 |
Overdose, product quality and regulators
Summary. Apple flesh is an ordinary food. The one toxicity concern in the sources read is amygdalin in seeds.
Animal. Not reviewed.
Human doses studied. Trials used whole apple, extract or juice for a week or more with no safety problem reported in the abstracts read.
Overdose response. Not found.
Genotoxicity. Not reviewed.
Toxic or hazardous parts. Seeds contain amygdalin (a cyanide-releasing compound). Leaves, bark and twigs were not checked.
Apples can carry pesticide residues and, like any raw produce, bacteria. Monitoring in Poland found residues within safe limits; a worldwide review found many checks above EU limits in some regions.
Pesticide residues, Polish monitoring (2022). All risk quotients were well below 1, and the authors saw no relevant non-cancer concern for adults or children. Children had higher relative exposure. 3
Pesticides, metals and mould toxins worldwide. A 2025 review of 90 articles found 42.8% of checks above EU limits overall; 12.5% in North America and higher elsewhere. Testing studies may focus on suspect samples. 8
Arsenic in apple juice. The US FDA has an action level of 10 parts per billion for inorganic arsenic in apple juice, to help protect public health. 12
Bacteria on produce. FDA says to wash produce under running water, even if you will peel it, without soap or produce wash. Washing reduces bacteria but does not eliminate them. Refrigerate pre-cut produce at 40 F (about 4 C) or below. 13
| Body | Action | Date |
|---|---|---|
| FDA (US Food and Drug Administration) (United States) | Action level of 10 ppb for inorganic arsenic in apple juice source | 2023 |
| FDA (United States) | Consumer advice on washing and storing fresh produce source | 2026-10-25 (page read) |
| NHS (UK) (United Kingdom) | Describes oral allergy syndrome and lists signs of a serious allergic reaction source | 2026-10-25 (page read) |
When to get medical help
- Swelling of the lips, face, tongue or throat
- Trouble breathing, wheezing or a tight throat
- Feeling faint, dizzy or collapsing after eating
- Spreading hives or a swollen face after eating apple
- Dizziness, headache, fast breathing or confusion after eating a large number of crushed apple seeds
Stop using the product and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.
General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.
Frequently asked questions
What are apples good for?
Do apples lower cholesterol?
A pooled analysis of 18 trials of whole apple, extract and juice found small falls in total and LDL cholesterol that were not clearly significant overall, though significant against placebo. HDL dipped slightly.
Do apples help prevent heart disease?
Large studies link more fruit, including apples and pears, with lower heart disease and early death. They cannot show that apples are the cause.
Do apples affect type 2 diabetes?
How many calories and how much fibre are in an apple?
USDA lists a medium raw apple with skin (182 g) at about 95 calories, 4.4 g of fibre and 18.9 g of natural sugars.
Is apple juice as healthy as a whole apple?
Why does raw apple make my mouth itch?
When is an apple reaction an emergency?
Are apple seeds poisonous?
Apple seeds contain amygdalin, which breaks down to hydrogen cyanide after eating. The review we read gives no figure for apple seeds, so do not eat large numbers of crushed seeds.
Should I wash apples, and do they have pesticides?
Does apple juice contain arsenic?
The US FDA has an action level of 10 parts per billion for inorganic arsenic in apple juice, to help protect public health.
Do apples interact with medicines?
We did not find a source describing a medicine interaction with eating apples. A pharmacist can check your own medicines.
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Editorial transparency
- Written by
- AlternativeMed editorial team. Research compiled with AI assistance, then checked against the sources listed.
- Medical review
- None. This page has not been reviewed by a physician or pharmacist.
- First published
- 2026-10-25
- Last substantive update
- 2026-10-25
- How we research
- We started from our existing apple summary, re-read the USDA FoodData Central record, and read PubMed abstracts and the NHS and FDA pages. Only abstracts were read for studies. Items we could not verify are flagged in the research gaps.
- How we rate evidence
- See "How we rate evidence" in the Evidence tab.
- Independence
- No product is promoted on this page. No affiliate links are shown.
Sources 16
Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.
- Al-Shaikhly T, Cox A, Nowak-Wegrzyn A, et al.. An International Delphi Consensus on the Management of Pollen-Food Allergy Syndrome: A Work Group Report of the AAAAI Adverse Reactions to Foods Committee.. J Allergy Clin Immunol Pract. 2024. PMID 39488768. DOI 10.1016/j.jaip.2024.09.037. (abstract)
- Aune D, Giovannucci E, Boffetta P, et al.. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies.. Int J Epidemiol. 2017. PMID 28338764. DOI 10.1093/ije/dyw319. (abstract)
- Chmielewski J, Gworek B, Florek-Luszczki M, et al.. Pesticide Residues in Apples and Pears: A Deterministic Assessment of Chronic Exposure and Non-Carcinogenic Risk for European Consumers.. Molecules. 2026. PMID 41828764. DOI 10.3390/molecules31050767. (full-text (PMC abstract))
- Halvorsen RE, Elvestad M, Molin M, Aune D. Fruit and vegetable consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of prospective studies.. BMJ Nutr Prev Health. 2021. PMID 35028521. DOI 10.1136/bmjnph-2020-000218. (abstract)
- He XY, Wu LJ, Wang WX, et al.. Amygdalin - A pharmacological and toxicological review.. J Ethnopharmacol. 2020. PMID 32114166. DOI 10.1016/j.jep.2020.112717. (abstract)
- Hyson DA. A comprehensive review of apples and apple components and their relationship to human health.. Adv Nutr. 2011. PMID 22332082. DOI 10.3945/an.111.000513. (abstract)
- Kim SJ, Anh NH, Jung CW, et al.. Metabolic and Cardiovascular Benefits of Apple and Apple-Derived Products: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.. Front Nutr. 2022. PMID 35449537. DOI 10.3389/fnut.2022.766155. (abstract)
- Noel A, Gueant-Rodriguez RM, Cachard O, et al.. A systematic review/meta-analysis of xenobiotics in apple products highlights lack of compliance with European Food Safety Authority Regulation.. Compr Rev Food Sci Food Saf. 2025. PMID 40091751. DOI 10.1111/1541-4337.70153. (abstract)
- Reigh NA, Rolls BJ, Baney BA, et al.. Effects of apple form on satiety in 4-6 year-old children: possible evidence of sex differences.. Appetite. 2026. PMID 40816534. DOI 10.1016/j.appet.2025.108269. (abstract)
- Vallee Marcotte B, Verheyde M, Pomerleau S, et al.. Health Benefits of Apple Juice Consumption: A Review of Interventional Trials on Humans.. Nutrients. 2022. PMID 35215471. DOI 10.3390/nu14040821. (abstract)
- Zhang Y, Zeng M, Zhang X, et al.. Does an apple a day keep away diseases? Evidence and mechanism of action.. Food Sci Nutr. 2023. PMID 37701204. DOI 10.1002/fsn3.3487. (abstract)
- . FDA guidance for industry: Action Level for Inorganic Arsenic in Apple Juice. . . (full-text)
- . FDA: Selecting and Serving Produce Safely. . . (full-text)
- . GBIF Backbone: Malus domestica (Suckow) Borkh. (usageKey 3001244). . . (full-text)
- . NHS: Food allergy. . . (full-text)
- . USDA FoodData Central: Apples, raw, with skin (FDC 171688, SR Legacy). . . (full-text)
Where to buy
Check the label first. Whatever you buy, look for these:
- Unsweetened with no added sugar, if you want the fruit alone
- Sulfur dioxide (sulfites) listed on the label: some people react
- A best-by date and a resealable bag
- Dried fruit is high in sugar and calories, so watch portions
Talk to a pharmacist or doctor before you start any supplement, especially if you take medicines. See the Safety tab for interactions.
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