Apple

Last Editorial Review: 6/11/2021
Other Name(s):

Abilde, Almindelig Aeble, Apfel, Apfelbaum, Äppel, Äppelträd, Apple Tree, Eble, Echter Apfelbaum, Iabloko, Iablonia, Jablon Domáca, Kultur-Apfel, Maça, Maçanzeira, Maceira, Macieira, Malus domestica, Malus malus, Malus pumila, Malus sylvestris, Manzana, Manzano, Mela, Melo, Paratiisiomena, Ping Guo, Pomme, Pommier, Pomo, Pommier Commun, Pyrus malus, Ringo, Seiyou Ringo, Tarhaomenapuu, Tuffahh, Žlahtna jablana.

Overview

Apple is the fruit from an apple tree. People eat apples as a normal part of the diet, but apples are also used as medicine.

Apples are used to control diarrhea or constipation; and for the softening, passage, and collection of gallstones. They are also used to prevent cancer, especially lung cancer. Other uses include treating cancer, diabetes, dysentery, fever, heart problems, warts, and a vitamin C-deficiency condition called scurvy. Some people also use apples for cleaning their teeth.

How does it work?

Apples contain pectin, which helps bulk up the stool to treat diarrhea and constipation. Apples also contain some chemicals that seem to be able to kill bacteria. Apple peel contains a chemical called ursolic acid that is suspected to have a role in building muscle and metabolism.

SLIDESHOW

Vitamin D Deficiency: How Much Vitamin D Is Enough? See Slideshow

Uses & Effectiveness

Possibly Ineffective for...

  • Ulcers in the small intestines. Some research suggests that taking apple pectin twice daily for 6 months does not reduce ulcer recurrence in people with previous ulcers in the small intestines.

Insufficient Evidence to Rate Effectiveness for...

  • Hay fever (allergic rhinitis). Early research suggests that taking a specific drink (Applephenon, Asahi Food and Healthcare Ltd) containing certain chemicals from apples, called polyphenols, daily for 4 weeks reduces symptoms of hay fever, such as sneezing and swelling inside the nose.
  • Hair loss in men. Early research suggests that applying a product containing procyanidin B-2, a chemical in apple, to the scalp might increase hair growth in men with hair loss.
  • Cancer. Early research suggests that eating one or more apple daily might be linked with a lower risk of developing foodpipe (esophageal), colorectal, or voice box (larynx) cancer.
  • Diabetes. Early research suggests that replacing white wheat flour in bread with powdered, dehydrated apple does not improve blood sugar in people with type 2 diabetes.
  • Diarrhea. Some early research suggests that taking a specific combination product containing apple pectin and German chamomile by mouth for 1-3 days might reduce the number of stools and improve symptoms in children with diarrhea. Other research suggests that drinking apple juice might actually worsen episodes of diarrhea in infants.
  • Swelling of the small intestine (enteritis). Early research suggests that drinking apple powder dissolved in boiling water for 10-12 days might reduce flatulence, sweating, and fatty stools in people with enteritis.
  • Softening and passing gallstones. Some early research suggests that drinking apple juice for 7 days and then adding olive oil on the seventh day before going to bed might soften gallstones and help them leave the body in a bowel movement.
  • Lung cancer. There is some early evidence that eating more apples might lower the risk of developing lung cancer.
  • Mercury toxicity. Early research suggests that taking apple pectin for 60 days might help remove mercury from the body and improve symptoms in children with mercury poisoning.
  • Weight loss. Some early research suggests that eating apples three times per day might modestly increase weight loss over a period of 12 weeks.
  • Metabolic syndrome.
  • Fever.
  • Heart problems.
  • Scurvy.
  • Warts.
  • Cleaning teeth.
  • Diarrhea.
  • Constipation.
  • Other conditions.
More evidence is needed to rate apple for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Side Effects

Apples are LIKELY SAFE for most people, as long as the seeds aren't eaten. No side effects are generally known or expected to occur with apple fruit or apple juice.

The apple seeds, however, contain cyanide and are poisonous. Eating enough seeds (in one case, one cup of apple seeds) can cause death. The cyanide is released in the stomach as the seeds are digested, so it may take several hours for the symptoms of poisoning to appear.

Apple polyphenols are POSSIBLY SAFE when taken by mouth or applied directly to the skin, short-term.

QUESTION

Next to red peppers, you can get the most vitamin C from ________________. See Answer

Special Precautions & Warnings

Pregnancy and breast-feeding: Apple is safe in amounts found in food, but there's not enough information to know if it's safe in the larger amounts that are used as medicine.

Children: Apple pectin is POSSIBLY SAFE when taken by mouth, short-term.

Allergy to apricot and related plants: Apple may cause an allergic reaction in people who are sensitive to the Rosaceae family. Members of this family include apricot, almond, plum, peach, pear, and strawberry. If you have allergies, be sure to check with your healthcare provider before taking apple.

Diabetes: Apple, especially apple juice, can increase blood sugar levels. Monitor your blood sugar carefully if you use apple products and have diabetes.

Interactions


Atenolol (Tenormin)Interaction Rating: Major Do not take this combination.

Apple juice can decrease how much atenolol (Tenormin) your body absorbs. Drinking apple juice along with atenolol (Tenormin) might decrease the effectiveness of atenolol (Tenormin). To avoid this interaction, separate taking this medication from consuming apple juice by at least 4 hours.


Fexofenadine (Allegra)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Apple juice can decrease how much fexofenadine (Allegra) your body absorbs. Drinking apple juice along with fexofenadine (Allegra) might decrease the effectiveness of fexofenadine (Allegra). To avoid this interaction, separate taking this medication from consuming apple juice by at least 4 hours.


Medications for diabetes (Antidiabetes drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Consuming apples and drinking apple juice might increase blood sugar levels. Diabetes medications are used to lower blood sugar. Consuming apple or apple juice along with diabetes medications might interfere with blood sugar control. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.


Medications moved by pumps in cells (Organic Anion-Transporting Polypeptide Substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some medications are moved by pumps in cells. Apple juice might change how these pumps work and decrease how much of some medications get absorbed by the body. This could make these medications less effective. To avoid this interaction, separate taking these medications from consuming apple juice by at least 4 hours.

Some of these medications that are moved by pumps in cells include bosentan (Tracleer), celiprolol (Celicard, others), etoposide (VePesid), fexofenadine (Allegra), fluoroquinolone antibiotics, glyburide (Micronase, Diabeta), irinotecan (Camptosar), methotrexate, paclitaxel (Taxol), saquinavir (Fortovase, Invirase), rifampin, statins, talinolol, torsemide (Demadex), troglitazone, and valsartan (Diovan).


Medications used for high blood pressure (Antihypertensive drugs)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

Consuming apple and cherry juice might increase blood pressure in some people. Drinking apple juice while taking medications for lowering blood high blood pressure might interfere with blood pressure control. Monitor your blood pressure closely. The dose of your blood pressure medication might need to be changed.

Some medications used for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.

Dosing

The appropriate dose of apple depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for apple. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

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References

Aggarwal, B. B. and Shishodia, S. Molecular targets of dietary agents for prevention and therapy of cancer. Biochem.Pharmacol 5-14-2006;71(10):1397-1421. View abstract.

Akazome, Y. Characteristics and physiological functions of polyphenols from apples. Biofactors 2004;22(1-4):311-314. View abstract.

Anderson, J. W., Gustafson, N. J., Bryant, C. A., and Tietyen-Clark, J. Dietary fiber and diabetes: a comprehensive review and practical application. J Am Diet Assoc 1987;87(9):1189-1197. View abstract.

Arranz, I., Derbyshire, M., Kroeger, K., Mischke, C., Stroka, J., and Anklam, E. Liquid chromatographic method for quantitation of patulin at 10 ng/mL in apple-based products intended for infants: interlaboratory study. J AOAC Int 2005;88(2):518-525. View abstract.

Asp, N. G., Agardh, C. D., Ahren, B., Dencker, I., Johansson, C. G., Lundquist, I., Nyman, M., Sartor, G., and Schersten, B. Dietary fibre in type II diabetes. Acta Med Scand Suppl 1981;656:47-50. View abstract.

Ballot, D., Baynes, R. D., Bothwell, T. H., Gillooly, M., MacFarlane, B. J., MacPhail, A. P., Lyons, G., Derman, D. P., Bezwoda, W. R., Torrance, J. D., and . The effects of fruit juices and fruits on the absorption of iron from a rice meal. Br J Nutr 1987;57(3):331-343. View abstract.

Bandazhevskaya, G. S., Nesterenko, V. B., Babenko, V. I., Yerkovich, T. V., and Bandazhevsky, Y. I. Relationship between caesium (137Cs) load, cardiovascular symptoms, and source of food in 'Chernobyl' children -- preliminary observations after intake of oral apple pectin. Swiss.Med Wkly. 12-18-2004;134(49-50):725-729. View abstract.

Beier, R. C. Natural pesticides and bioactive components in foods. Rev Environ Contam Toxicol. 1990;113:47-137. View abstract.

Bell, J. A. and Whiting, S. J. Effect of fruit on net acid and urinary calcium excretion in an acute feeding trial of women. Nutrition 2004;20(5):492-493. View abstract.

Brown, K. L. Control of bacterial spores. Br Med Bull 2000;56(1):158-171. View abstract.

Campbell, G., Pickles, T., and D'yachkova, Y. A randomised trial of cranberry versus apple juice in the management of urinary symptoms during external beam radiation therapy for prostate cancer. Clin Oncol.(R.Coll Radiol.) 2003;15(6):322-328. View abstract.

Castillo-Zamora, C., Castillo-Peralta, L. A., and Nava-Ocampo, A. A. Randomized trial comparing overnight preoperative fasting period Vs oral administration of apple juice at 06:00-06:30 am in pediatric orthopedic surgical patients. Paediatr.Anaesth. 2005;15(8):638-642. View abstract.

Dennison, B. A. Fruit juice consumption by infants and children: a review. J Am Coll Nutr 1996;15(5 Suppl):4S-11S. View abstract.

Duro, D., Rising, R., Cedillo, M., and Lifshitz, F. Association between infantile colic and carbohydrate malabsorption from fruit juices in infancy. Pediatrics 2002;109(5):797-805. View abstract.

Enomoto, T., Nagasako-Akazome, Y., Kanda, T., Ikeda, M., and Dake, Y. Clinical effects of apple polyphenols on persistent allergic rhinitis: A randomized double-blind placebo-controlled parallel arm study. J Investig.Allergol.Clin Immunol. 2006;16(5):283-289. View abstract.

Fan, A. M. and Jackson, R. J. Pesticides and food safety. Regul.Toxicol.Pharmacol 1989;9(2):158-174. View abstract.

Freese, R., Vaarala, O., Turpeinen, A. M., and Mutanen, M. No difference in platelet activation or inflammation markers after diets rich or poor in vegetables, berries and apple in healthy subjects. Eur J Nutr 2004;43(3):175-182. View abstract.

Gallus, S., Talamini, R., Giacosa, A., Montella, M., Ramazzotti, V., Franceschi, S., Negri, E., and La, Vecchia C. Does an apple a day keep the oncologist away? Ann Oncol. 2005;16(11):1841-1844. View abstract.

Grudeva-Popova, J. and Sirakova, I. Effect of pectin on some electrolytes and trace elements in patients with hyperlipoproteinemia. Folia Med (Plovdiv.) 1998;40(1):41-45. View abstract.

Hoekstra, J. H., van den Aker, J. H., Ghoos, Y. F., Hartemink, R., and Kneepkens, C. M. Fluid intake and industrial processing in apple juice induced chronic non-specific diarrhoea. Arch Dis Child 1995;73(2):126-130. View abstract.

Howell, A. B., Reed, J. D., Krueger, C. G., Winterbottom, R., Cunningham, D. G., and Leahy, M. A-type cranberry proanthocyanidins and uropathogenic bacterial anti-adhesion activity. Phytochemistry 2005;66(18):2281-2291. View abstract.

Hughes, J. A., West, N. X., Parker, D. M., Newcombe, R. G., and Addy, M. Development and evaluation of a low erosive blackcurrant juice drink. 3. Final drink and concentrate, formulae comparisons in situ and overview of the concept. J Dent 1999;27(5):345-350. View abstract.

Jensen, M. E., Donly, K., and Wefel, J. S. Assessment of the effect of selected snack foods on the remineralization/demineralization of enamel and dentin. J Contemp.Dent Pract 8-15-2000;1(3):1-17. View abstract.

Kamimura, A., Takahashi, T., and Watanabe, Y. Investigation of topical application of procyanidin B-2 from apple to identify its potential use as a hair growing agent. Phytomedicine. 2000;7(6):529-536. View abstract.

Kang, J. Y., Tay, H. H., Guan, R., Math, M. V., Yap, I., and Labrooy, S. J. Dietary supplementation with pectin in the maintenance treatment of duodenal ulcer. A controlled study. Scand J Gastroenterol 1988;23(1):95-99. View abstract.

Ko, S. H., Choi, S. W., Ye, S. K., Cho, B. L., Kim, H. S., and Chung, M. H. Comparison of the antioxidant activities of nine different fruits in human plasma. J Med Food 2005;8(1):41-46. View abstract.

Laberge, I., Griffiths, M. W., and Griffiths, M. W. Prevalence, detection and control of Cryptosporidium parvum in food. Int J Food Microbiol. 1996;32(1-2):1-26. View abstract.

Lazareva, E. B., Spiridonova, T. G., Chernega, E. N., Plesskaia, L. G., Grunenkova, I. V., Smirnov, S. V., and Men'shikov, D. D. [Topical pectins for the treatment of burn wounds]. Antibiot.Khimioter. 2002;47(9):9-13. View abstract.

Maekawa, N., Mikawa, K., Yaku, H., Nishina, K., and Obara, H. Effects of 2-, 4- and 12-hour fasting intervals on preoperative gastric fluid pH and volume, and plasma glucose and lipid homeostasis in children. Acta Anaesthesiol.Scand 1993;37(8):783-787. View abstract.

Massey, L. K. and Kynast-Gales, S. A. Substituting milk for apple juice does not increase kidney stone risk in most normocalciuric adults who form calcium oxalate stones. J Am Diet Assoc. 1998;98(3):303-308. View abstract.

Mayer, B., Schumacher, M., Brandstatter, H., Wagner, F. S., and Hermetter, A. High-throughput fluorescence screening of antioxidative capacity in human serum. Anal.Biochem 10-15-2001;297(2):144-153. View abstract.

Mayne, P. D., McGill, A. R., Gormley, T. R., Tomkin, G. H., Julian, T. R., and O'Moore, R. R. The effect of apple fibre on diabetic control and plasma lipids. Ir J Med Sci 1982;151(2):36-41. View abstract.

Mee, K. A. and Gee, D. L. Apple fiber and gum arabic lowers total and low-density lipoprotein cholesterol levels in men with mild hypercholesterolemia. J Am Diet Assoc 1997;97(4):422-424. View abstract.

Naguib, M., Samarkandimb, A. H., Al-Hattab, Y., Turkistani, A., Delvi, M. B., Riad, W., and Attia, M. Metabolic, hormonal and gastric fluid and pH changes after different preoperative feeding regimens. Can J Anaesth. 2001;48(4):344-350. View abstract.

Nesterenko, V. B., Nesterenko, A. V., Babenko, V. I., Yerkovich, T. V., and Babenko, I. V. Reducing the 137Cs-load in the organism of "Chernobyl" children with apple-pectin. Swiss.Med Wkly. 1-10-2004;134(1-2):24-27. View abstract.

Nobigrot, T., Chasalow, F. I., and Lifshitz, F. Carbohydrate absorption from one serving of fruit juice in young children: age and carbohydrate composition effects. J Am Coll Nutr 1997;16(2):152-158. View abstract.

Parsons, S. R. Effects of high fiber breakfasts on glucose metabolism in noninsulin-dependent diabetics. Am J Clin Nutr 1984;40(1):66-71. View abstract.

Paut, O. and Camboulives, J. [Perioperative fasting in children: current data]. Arch Pediatr 1995;2(8):774-782. View abstract.

Pirich, C., Schmid, P., Pidlich, J., and Sinzinger, H. [Lowering cholesterol with Anticholest--a high fiber guar-apple pectin drink]. Wien.Klin Wochenschr. 1992;104(11):314-316. View abstract.

Shah, M., Griffin, I. J., Lifschitz, C. H., and Abrams, S. A. Effect of orange and apple juices on iron absorption in children. Arch Pediatr Adolesc Med 2003;157(12):1232-1236. View abstract.

Simpson, R. W., McDonald, J., Wahlqvist, M., Balazs, N., and Dunlop, M. Effect of naturally occurring dietary fibre in Western foods on blood glucose. Aust N Z J Med 1981;11(5):484-487. View abstract.

Slifko, T. R., Smith, H. V., and Rose, J. B. Emerging parasite zoonoses associated with water and food. Int J Parasitol. 2000;30(12-13):1379-1393. View abstract.

Smith, M. M., Davis, M., Chasalow, F. I., and Lifshitz, F. Carbohydrate absorption from fruit juice in young children. Pediatrics 1995;95(3):340-344. View abstract.

Sobolev, M. B., Khatskel', S. B., and Muradov, A. I. [Enterosorption by nonstarch polysaccharides as a method of treatment of children with mercury poisoning]. Vopr.Pitan. 1999;68(1):28-30. View abstract.

Splinter, W. M., Stewart, J. A., and Muir, J. G. Large volumes of apple juice preoperatively do not affect gastric pH and volume in children. Can J Anaesth. 1990;37(1):36-39. View abstract.

Splinter, W. M., Stewart, J. A., and Muir, J. G. The effect of preoperative apple juice on gastric contents, thirst, and hunger in children. Can J Anaesth. 1989;36(1):55-58. View abstract.

Takahashi, T., Kamimura, A., Yokoo, Y., Honda, S., and Watanabe, Y. The first clinical trial of topical application of procyanidin B-2 to investigate its potential as a hair growing agent. Phytother.Res 2001;15(4):331-336. View abstract.

Tanabe, T., Ebina, M., Ishihara, H., Matsuki, A., Oshima, S., and Fukushi, S. [Preanesthetic meals in elective surgical patients]. Masui 1997;46(6):788-792. View abstract.

Tanabe, T., Hashimoto, Y., Sugihara, K., Miyata, A., Maeda, A., Ishihara, H., and Matsuki, A. [The effect of preoperative oral fluid intake on the volume and pH of gastric contents in elective surgical patients--a comparison of tea with apple juice]. Masui 1996;45(8):967-970. View abstract.

Tariq, M. and Beg, M. H. A foreign body in the bronchus still presents problems. Int J Clin Pract 1999;53(1):81-82. View abstract.

Tazawa, K., Yatuzuka, K., Yatuzuka, M., Koike, J., Ohkami, H., Saito, T., Ohnishi, Y., and Saito, M. [Dietary fiber inhibits the incidence of hepatic metastasis with the anti-oxidant activity and portal scavenging functions]. Hum Cell 1999;12(4):189-196. View abstract.

Teff, K. L., Devine, J., and Engelman, K. Sweet taste: effect on cephalic phase insulin release in men. Physiol Behav 1995;57(6):1089-1095. View abstract.

Vahteristo, L., Kariluoto, S., Barlund, S., Karkkainen, M., Lamberg-Allardt, C., Salovaara, H., and Piironen, V. Functionality of endogenous folates from rye and orange juice using human in vivo model. Eur J Nutr 2002;41(6):271-278. View abstract.

Valenkevich, L. N. [Apple powder in the treatment of patients with chronic enteritis]. Vopr.Pitan. 1993;(3):24-27. View abstract.

Valois, S., Costa-Ribeiro, H., Jr., Mattos, A., Ribeiro, T. C., Mendes, C. M., and Lifshitz, F. Controlled, double-blind, randomized clinical trial to evaluate the impact of fruit juice consumption on the evolution of infants with acute diarrhea. Nutr J 2005;4:23. View abstract.

Vincent, R. D., Jr., McNeil, T. J., Spaid, C. L., MacMahon, F. R., Maxwell, S. J., Brenner, J. S., and Schryer, V. L. Does 360 ml of apple juice ingested before elective surgery worsen gastric volume and acidity in patients given acid aspiration prophylaxis? J Clin Anesth. 1991;3(4):285-289. View abstract.

Visvanathan, R., Chen, R., Horowitz, M., and Chapman, I. Blood pressure responses in healthy older people to 50 g carbohydrate drinks with differing glycaemic effects. Br J Nutr 2004;92(2):335-340. View abstract.

Wakhloo, A. K., Beyer, J., Diederich, C., and Schulz, G. [Effect of dietary fat on blood sugar levels and insulin consumption after intake of various carbohydrate carriers in type I diabetics on the artificial pancreas]. Dtsch.Med Wochenschr. 10-19-1984;109(42):1589-1594. View abstract.

Yanagida, A., Kanda, T., Tanabe, M., Matsudaira, F., and Oliveira Cordeiro, J. G. Inhibitory effects of apple polyphenols and related compounds on cariogenic factors of mutans streptococci. J Agric.Food Chem 2000;48(11):5666-5671. View abstract.

Yaneva, M. P., Botushanova, A. D., Grigorov, L. A., Kokov, J. L., Todorova, E. P., and Krachanova, M. G. Evaluation of the immunomodulatory activity of Aronia in combination with apple pectin in patients with breast cancer undergoing postoperative radiation therapy. Folia Med (Plovdiv.) 2002;44(1-2):22-25. View abstract.

Young, J. F., Nielsen, S. E., Haraldsdottir, J., Daneshvar, B., Lauridsen, S. T., Knuthsen, P., Crozier, A., Sandstrom, B., and Dragsted, L. O. [Polyphenolic antioxidants in fruit juice. Urinary excretion and effects on biological markers for antioxidative status]. Ugeskr.Laeger 3-6-2000;162(10):1388-1392. View abstract.

Young, J. F., Nielsen, S. E., Haraldsdottir, J., Daneshvar, B., Lauridsen, S. T., Knuthsen, P., Crozier, A., Sandstrom, B., and Dragsted, L. O. Effect of fruit juice intake on urinary quercetin excretion and biomarkers of antioxidative status. Am J Clin Nutr 1999;69(1):87-94. View abstract.

Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.

Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. View abstract.

Balay, K. S., Hawthorne, K. M., Hicks, P. D., Griffin, I. J., Chen, Z., Westerman, M., and Abrams, S. A. Orange but not apple juice enhances ferrous fumarate absorption in small children. J Pediatr Gastroenterol Nutr 2010;50(5):545-550. View abstract.

Becker B, Kuhn U, Hardewig-Budny B. Double-blind, randomized evaluation of clinical efficacy and tolerability of an apple pectin-chamomile extract in children with unspecific diarrhea. Arzneimittelforschung 2006;56(6):387-393. View abstract.

Butland BK, Fehily AM, Elwood PC. Diet and lung function decline in a cohort of 2512 middle aged men. Thorax 2000;55:102-8. View abstract.

Castleman M. The healing herbs, the ultimate guide to the curative power of nature's medicines. 2nd ed. New York, NY: Bantam Books, 1995.

Conceição de Oliveira M, Sichieri R, Sanchez Moura A. Weight loss associated with a daily intake of three apples or three pears among overweight women. Nutrition 2003;19:253-6. View abstract.

Cummings, J. H., Branch, W., Jenkins, D. J., Southgate, D. A., Houston, H., and James, W. P. Colonic response to dietary fibre from carrot, cabbage, apple, bran. Lancet 1978;1(8054):5-9. View abstract.

Davidson MH, Dugan LD, Stocki J, et al. A low-viscosity soluble-fiber fruit juice supplement fails to lower cholesterol in hypercholesterolemic men and women. J Nutr 1998;128:1927-32. View abstract.

de la Motte S, Bose-O'Reilly S, Heinisch M, Harrison F. [Double-blind comparison of an apple pectin-chamomile extract preparation with placebo in children with diarrhea]. Arzneimittelforschung 1997;47(11):1247-1249. View abstract.

Dekkers R. Apple juice and the chemical-contact softening of gallstones. Lancet 1999;354:2171.

Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. View abstract.

Jeon H, Jang IJ, Lee S, et al. Apple juice greatly reduces systemic exposure to atenolol. Br J Clin Pharmacol 2012 May 11. doi: 10.1111/j.1365-2125.2012.04324.x. [Epub ahead of print]. View abstract.

Kamath AV, Yao M, Zhang Y, Chong S. Effect of fruit juices on the oral bioavailability of fexofenadine in rats. J Pharm Sci 2005;94:233-9. View abstract.

Kunkel SD. Elmore CJ, Bongers KS, et al. Ursolic acid increases skeletal muscle and brown fat and decreases diet-induced obesity, glucose intolerance and fatty liver disease. PLoS One 2012;7:e39332. View abstract.

Le Marchand L, Murphy SP, Hankin JH, et al. Intake of flavonoids and lung cancer. J Natl Cancer Inst 2000;92:154-60. View abstract.

Lust J. The herb book. New York, NY: Bantam Books, 1999.

Mahalko JR, Sandstead HH, Johnson LK, et al. Effect of consuming fiber from corn bran, soy hulls, or apple powder on glucose tolerance and plasma lipids in type II diabetes. Am J Clin Nutr 1984;39:25-34. View abstract.

Rodriguez J, Crespo JF, Lopez-Rubio A, et al. Clinical cross-reactivity among foods of the Rosaceae family. J Allergy Clin Immunol 2000;106:183-189. View abstract.