Trial reportEuropean journal of nutrition2013
Intake of whole apples or clear apple juice has contrasting effects on plasma lipids in healthy volunteers.
Trial report in European journal of nutrition, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
71 citing papers in PubMed, 10 syntheses or guidelines pooled it, 159 citations in OpenAlex.
- Pooled it
- Fructose-containing food sources and blood pressure: A systematic review and meta-analysis of controlled feeding trials.PloS one · 2023Pooled it
- Pooled it
- Pooled it
- Metabolic and Cardiovascular Benefits of Apple and Apple-Derived Products: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Frontiers in nutrition · 2022Pooled it
- 100% Fruit juice intake and cardiovascular risk: a systematic review and meta-analysis of prospective and randomised controlled studies.European journal of nutrition · 2021Pooled it
- Impact of Whole, Fresh Fruit Consumption on Energy Intake and Adiposity: A Systematic Review.Frontiers in nutrition · 2019Pooled it
- Food sources of fructose-containing sugars and glycaemic control: systematic review and meta-analysis of controlled intervention studies.BMJ (Clinical research ed.) · 2018Pooled it
- Review of 100% Fruit Juice and Chronic Health Conditions: Implications for Sugar-Sweetened Beverage Policy.Advances in nutrition (Bethesda, Md.) · 2018Pooled it
- Fruit Juice and Change in BMI: A Meta-analysis.Pediatrics · 2017Pooled it
- Trial
- Trial
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- Two apples a day modulate human:microbiome co-metabolic processing of polyphenols, tyrosine and tryptophan.European journal of nutrition · 2020Trial
- Two apples a day lower serum cholesterol and improve cardiometabolic biomarkers in mildly hypercholesterolemic adults: a randomized, controlled, crossover trial.The American journal of clinical nutrition · 2020Trial
- A Healthy Balance of Plasma Cholesterol by a Novel Annurca Apple-Based Nutraceutical Formulation: Results of a Randomized Trial.Journal of medicinal food · 2017Trial
- Differences in pharmacokinetics of apple polyphenols after standardized oral consumption of unprocessed apple juice.Nutrition journal · 2015Trial
- Review
- The Effect of Apple and Pear Cultivars on In Vitro Fermentation with Human Faecal Microbiota.Microorganisms · 2025Article
- Sustainable Exploitation of Apple By-Products: A Retrospective Analysis of Pilot-Scale Extraction Tests Using Hydrodynamic Cavitation.Foods (Basel, Switzerland) · 2025Article
11 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeFruit consumption is associated with a decreased risk of CVD in cohort studies and is therefore endorsed by health authorities as part of the '5 or more a day' campaigns. A glass of fruit juice is generally counted as one serving. Fruit may cause protection by affecting common risk factors of CVD.
methodsApples are among the most commonly consumed fruits and were chosen for a comprehensive 5 × 4 weeks dietary crossover study to assess the effects of whole apples (550 g/day), apple pomace (22 g/day), clear and cloudy apple juices (500 ml/day), or no supplement on lipoproteins and blood pressure in a group of 23 healthy volunteers.
resultsThe intervention significantly affected serum total and LDL-cholesterol. Trends towards a lower serum LDL-concentration were observed after whole apple (6.7%), pomace (7.9%) and cloudy juice (2.2%) intake. On the other hand, LDL-cholesterol concentrations increased by 6.9% with clear juice compared to whole apples and pomace. There was no effect on HDL-cholesterol, TAG, weight, waist-to-hip ratio, blood pressure, inflammation (hs-CRP), composition of the gut microbiota or markers of glucose metabolism (insulin, IGF1 and IGFBP3).
conclusionsApples are rich in polyphenols and pectin, two potentially bioactive constituents; however, these constituents segregate differently during processing into juice products and clear juice is free of pectin and other cell wall components. We conclude that the fibre component is necessary for the cholesterol-lowering effect of apples in healthy humans and that clear apple juice may not be a suitable surrogate for the whole fruit in nutritional recommendations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.