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An Apple a Day May Not Keep the Doctor Away, Study Says

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This Aug. 30, 2012, file photo, shows a variety of apples in Concord, N.H. A study published Monday, March 30, 2015, in JAMA Internal Medicine challenges the old adage: "An apple a day keeps the doctor away," finding daily apple eaters had just as many doctor visits as apple shunners. (AP Photo/Matthew Mead)

This Aug. 30, 2012, file photo, shows a variety of apples in Concord, N.H. A study published Monday, March 30, 2015, in JAMA Internal Medicine challenges the old adage: “An apple a day keeps the doctor away,” finding daily apple eaters had just as many doctor visits as apple shunners. (AP Photo/Matthew Mead)

LINDSEY TANNER, AP Medical Writer

CHICAGO (AP) — An apple a day doesn’t necessarily keep the doctor away. That’s according to proverb-busting research that found daily apple eaters had just as many doctor visits as those who ate fewer or no apples.

The findings don’t mean apples aren’t good for you but they do underscore that it takes more than just one kind of food to make a healthy diet and avoid illness.

About one-third of the adults studied said they had no more than one doctor visit in the previous year; the remainder reported at least two visits. A preliminary analysis found apple eaters had slightly fewer visits than apple avoiders — those who ate less than one daily or no apples. But that difference disappeared when the researchers considered weight, race, education, health insurance and other factors that can influence frequency of medical visits.

More about the study, published Monday in JAMA Internal Medicine:

STUDY DETAILS

The researchers looked at data on about 8,400 U.S. adults who took part in government health surveys in 2007-08 and 2009-10. The adults answered questionnaires that included queries about foods they’d eaten in the previous 24 hours and medical care in the past year. About 9 percent of adults studied ate the equivalent of at least one small apple daily. Those who ate less than that were considered apple shunners.

Apple eaters had more education and were less likely to smoke than apple shunners, and fewer of them were white. Apple eaters were slightly less likely to use prescription drugs, but the study lacks information on use of over-the-counter medication and alternative medicine.

STUDY LIMITATIONS

Adults’ food choices in the previous 24 hours don’t necessarily reflect usual eating habits. The study lacks information on other foods people ate and it isn’t rigorous enough to determine whether people who choose to eat apples are healthier or unhealthier than those who don’t. The reason for the reported doctor visits also isn’t included in the study.

Lead author Matthew Davis, a health services researcher at the University of Michigan, said while the study questions the proverb, “to really disprove it, you would need a different study design.”

HOW ‘BOUT THEM APPLES?

Apples are a good source of vitamin C; one medium apple has about 100 calories and provides nearly 20 percent of the daily recommended amount of fiber. Apples also contain small amounts of vitamin A, calcium and iron.

The proverb is thought to have originated in Wales in the 1800s. Apples, which have a long shelf life, were likely one of the few fruits that were available throughout the year, said Alice Lichtenstein, a Tufts University professor of nutrition science and policy. She wasn’t involved in the study.

Nutritionists generally agree that apples can be a good food choice. But, said Dr. Steven Zeisel, director of the University of North Carolina’s Nutrition Research Institute, “One apple isn’t going to be enough to make a difference unless it’s part of a healthy food pattern.”

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Online:

JAMA Internal Medicine: http://jamaiunternalmedicine.com

USDA-apples:  http://tinyurl.com/p5hpz6m

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

Copyright 2015 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Community

It’s Time to Lose Weight Before the Holidays

Licensed internist Dr. H. Geoffrey Watson has joined gastroenterologist Dr. Ralph Peterson at Oakland’s MacArthur GI to address the rising obesity epidemic. With U.S. obesity rates reaching 42.4%, the clinic offers supervised weight-loss programs and screenings for fatty liver disease. Treatments include dietary counseling and various medications, such as GLP-1 receptor agonists, which regulate digestion and appetite. As certain populations continue to be disproportionately affected by chronic health conditions, medical experts are highlighting new tools available to help patients reach their goals before the holiday season. Read more.

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Dr. H. Geoffrey Watson. File photo.

Dr. H. Geoffrey Watson, a licensed internist, has joined renowned gastroenterologist Dr. Ralph Peterson at MacArthur GI in Oakland to address obesity, provide supervised weight-loss programs including GLP-1 therapy, and screen for and treat fatty liver disease.

The Obesity Epidemic

Obesity is associated with numerous chronic health problems, including hypertension, diabetes, heart disease, sleep apnea, asthma, depression, joint disorders, fatty liver disease, and high cholesterol. Its causes include genetics, environment, stress, medication side effects, hormonal imbalances, and other factors.

Since 1999, the prevalence of obesity in the United States has risen from 30.5% to 42.4%. Childhood obesity rates are also climbing, with approximately 19.3% of children and adolescents now affected.

Measuring Obesity: Body Mass Index

Obesity is measured using a formula called the Body Mass Index (BMI). You can calculate your own BMI on most smartphones by searching “BMI calculator” and entering your height and weight. A BMI of 25 to 29.9 is classified as overweight, and a BMI of 30 or greater is classified as obese.

Populations Disproportionately Affected

Obesity affects certain populations at higher rates. Among U.S. adults, obesity prevalence is 49.9% in Black adults, 45.6% in Hispanic adults, 41.4% in White adults, and 16.1% in Asian adults.

Treatment Options

A variety of treatments are available for obesity, including dietary counseling, exercise programs, bariatric surgery, and anti-obesity medications.

Common oral medications include:

• Adipex (phentermine): A stimulant that works by suppressing appetite.

• Contrave (bupropion/naltrexone): A combination of an antidepressant and an anti-addiction medication that helps control appetite and cravings.

• Qsymia (phentermine/topiramate): A combination of a stimulant and an anti-seizure medication that reduces appetite and cravings.

GLP-1 Receptor Agonist Therapy

Glucagon-like peptide-1 (GLP-1) receptor agonists were originally approved to treat type 2 diabetes. GLP-1 is a hormone produced naturally by the body that regulates digestion, blood sugar, and appetite by communicating with GLP-1 receptor cells throughout the digestive tract. These medications reduce cravings, appetite, and food intake by influencing the hunger hormones ghrelin, which stimulates hunger, and leptin, which signals fullness.

What We Offer

Drs. Peterson and Watson provide FDA-approved tirzepatide injections, a GLP-1 receptor agonist medication indicated for weight management. Each patient receives a comprehensive history and physical examination to ensure the safety and appropriateness of the medication as part of an overall weight-loss protocol. Dr. Peterson also offers ultrasound screening for fatty liver disease.

We look forward to helping you reach your weight-loss goals and feel your best this holiday season.

H. Geoffrey Watson, M.D., runs the MacArthur GI Clinic at 10520 MacArthur Blvd., Oakland, CA. He can be reached at (510) 562-7467.

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Community

Allen Temple Baptist Church Hosts Free Prostate Cancer Screenings on Oct. 17

The summit’s mission is to reduce the impact of prostate cancer through education, early detection, research, and support. It is presented in partnership with The Oakland Institute of Health, Inc., SCAN, Brotherhood of Elders Network, UCSF Helen Diller Family Comprehensive Cancer Center, Alameda County Public Health Department, Stanford Medicine Cancer Center, Impact Oakland Now, Bay Area Umoja Health, Bay Area Black Nurses Association, Inc., and 100 Black Men of the Bay Area, Inc.

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The Prostate Cancer 2500™ Care Summit brings together health systems, community organizations, and survivors to put early detection within reach

Black men in America are diagnosed with prostate cancer more often than other men and are about twice as likely to die from it. Early detection changes that outcome.

On Saturday, Oct. 17 from 10 a.m. to 2 p.m., Allen Temple Baptist Church will host the Prostate Cancer 2500™ Care Summit (#PC2500), a free event open to the entire community.

. Attendees can receive prostate cancer screenings and health consultations on site, learn about prevention and nutrition, ask medical experts questions in an interactive Q&A, and hear from survivors who will share their stories and offer support.

Screening is recommended beginning at age 45, and at age 40 for Black men with a family history of prostate cancer. All men are welcome, and families are encouraged to attend.

The summit’s mission is to reduce the impact of prostate cancer through education, early detection, research, and support. It is presented in partnership with The Oakland Institute of Health, Inc., SCAN, Brotherhood of Elders Network, UCSF Helen Diller Family Comprehensive Cancer Center, Alameda County Public Health Department, Stanford Medicine Cancer Center, Impact Oakland Now, Bay Area Umoja Health, Bay Area Black Nurses Association, Inc., and 100 Black Men of the Bay Area, Inc.

For more information prior to the event, reach out to Rev. Charlotte Y. Williams at (510) 604-5242 | cwilliams@allen-temple.org

For more information on the day of the event, reach out to Deacon Dwight Williams (510) 501-1650 dwight.williams@allen-temple.org. The church is located at 8501 International Blvd., Oakland, CA 94621 The service is free and free parking and refreshments will be provided. The site is accessible to persons with disabilities. To pre-register, go to Allen-Temple.org

Allen Temple Baptist Church was organized in 1919 in Oakland. For 107 years, ATBC has served as a bright beacon of faith, hope, and love beyond its’ four walls. Allen Temple is committed to sharing the love of God and the message of Good News throughout the world. We welcome people of all ages and cultural backgrounds as we joyfully celebrate worship and fellowship, and carry out ministries of evangelism, discipleship, education, community outreach, and global missions. Allen Temple’s holistic, prophetic and social justice ministries address the needs of the whole person as well as the whole community. Dr. Jacqueline A. Thompson.

Rev. Charlotte Y. Williams is the minister and director of Communications at Allen Temple Baptist Church.

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Business

OP-ED: Proposition 44 Would Put a Price on Trust

The danger in Proposition 44 is not only its 90 percent figure. It is that the meaning of “qualifying” spending will be worked out later. A clinic preparing a budget today may not know whether a navigator, health educator, transportation program, outreach worker, technology upgrade, or other patient-support service will be counted the way it expects. Yet the financial consequence of getting it wrong could be immediate.

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Oakland’s public conversation about health care must begin with a simple truth: a doctor’s appointment is not the same thing as access to care.

For a mother juggling work and child care, access may mean a text-message reminder, a bus pass, an evening appointment, or someone who can explain what Medi-Cal covers. For an older patient managing diabetes, it may mean help scheduling a specialist visit and understanding new medications. For a family that has been dismissed or misunderstood in medical settings, access may begin with meeting a community health worker who knows the neighborhood, speaks their language, and treats their concerns with respect.

Community health clinics make that kind of care possible. They are part medical provider, part navigator, part educator, and part trusted local institution. Proposition 44 threatens to narrow the definition of what counts as patient care in a way that could undermine the very supports that allow patients to receive it.

The statewide measure would require covered nonprofit community clinics to spend at least 90 percent of their annual revenue on health care or qualifying program services. The ballot measure directs the Attorney General to establish more detailed guidance on what expenses qualify. Clinics that do not meet the threshold could face penalties for the difference. The Legislative Analyst’s Office reports that affected clinics currently spend an average of about 80 percent of revenue on health care services.

A percentage may look like a clean measure of accountability. But health care is not cleanly divided between what happens inside an examination room and everything that enables a patient to enter one.

Consider the work that happens before and after a visit. Clinic staff maintain confidential patient records. They follow up after missed appointments. They keep information systems secure. They recruit and train employees in an expensive and competitive health care labor market. They coordinate referrals, process claims, purchase supplies, maintain buildings, and make certain that patients are not lost somewhere between diagnosis and treatment.

Oakland families should not be asked to accept the fiction that these functions are unrelated to care.

The danger in Proposition 44 is not only its 90 percent figure. It is that the meaning of “qualifying” spending will be worked out later. A clinic preparing a budget today may not know whether a navigator, health educator, transportation program, outreach worker, technology upgrade, or other patient-support service will be counted the way it expects. Yet the financial consequence of getting it wrong could be immediate.

The Legislative Analyst’s Office says clinics falling short of the requirement could be required to pay the shortfall amount to the state and could seek to recover the money only if they show compliance within five years. The same analysis estimates state enforcement costs in the low tens of millions of dollars annually, supported by fees.

That is a troubling arrangement for organizations that are expected to provide care to people with the fewest alternatives.

Oakland has learned that trust is not built through slogans. It is built when a patient is listened to, when a parent can secure an appointment for a child, when a clinic returns a call, and when a person receives help without being shamed for their income, insurance, language, immigration history, or prior experience with the system.

For Black residents in particular, trustworthy care is not an abstract goal. Persistent inequities in health outcomes and patient treatment are real. Community-centered clinics can help bridge the gap with culturally responsive staff, patient navigators, behavioral-health programs, and partnerships that understand the conditions shaping health outside the clinic door.

Proposition 44 could pressure providers to treat those supports as expendable because they do not fit neatly into a state-enforced formula. That would be a mistake.

Accountability is necessary. Clinics that receive public resources should be transparent, well governed, and focused on their mission. But good oversight asks whether patients are being served well, whether money is managed responsibly, and whether communities can obtain needed care. It should not rely on a rigid ratio that may punish clinics for doing the hard work of reaching people who need more than a brief medical encounter.

A broad coalition of providers and community organizations opposes Proposition 44, including the California Primary Care Association, the California Medical Association, the California Hospital Association, Planned Parenthood Affiliates of California, and the California Teachers Association.

Oakland needs health policy that expands the circle of care. Proposition 44 risks drawing that circle smaller.

The Oakland Post editorial board urges a No vote on Proposition 44.

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