“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.
Lifestyle changes (such as increasing levels of physical activity or changing diet) are the recommended first step for primary prevention of cardiovascular disease.
Increasingly, however, doctors prescribe statins to patients with high cholesterol and other risk factors for cardiovascular diseae.
This has led to calls to use statins for cardiovascular disease prevention at the population level, particularly for people aged 50 years and over.
But here is the thing: Prescribing either an apple a day or a statin a day to everyone over 50 years old is likely to have a similar effect on population vascular mortality.
It has been estimated that choosing apples rather than statins may avoid more than a thousand excess cases of myopathy and more than 12,000 excess diabetes diagnoses due to the side effects of statins (UK figures).
Resource: A statin a day keeps the doctor away: comparative proverb assessment modelling study
BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f7267 (Published 17 December 2013)