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Searches across PubMed, Embase, Cochrane, and Web of Science cover studies up to August 4, 2020, applying strict inclusion criteria on intervention duration, intervention type, trial design, and measured outcomes. Compared with controls, apple or apple polyphenol groups show higher high-density lipoprotein and lower C-reactive protein, supporting a reduced CVD risk profile.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/apple-or-apple-polyphenol-consumption-improves-cardiovascular-disease-risk-factors-a-systematic-review-and-meta-analysis/542813/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/apple-or-apple-polyphenol-consumption-improves-cardiovascular-disease-risk-factors-a-systematic-review-and-meta-analysis/542813.png","ImageObject",300,407,{"name":92,"@type":93},"Connor ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-10-11",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the document’s main research question about apple intake?","Question",{"text":112,"@type":113},"It examines whether consuming apples or apple polyphenols improves cardiovascular disease risk factors.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which study types and time frame were included in the meta-analysis?",{"text":117,"@type":113},"The analysis includes randomized controlled trials with an intervention time of more than one week, searched up to August 4, 2020.",{"name":119,"@type":110,"acceptedAnswer":120},"What biomarkers improved in the apple or apple polyphenol group versus controls?",{"text":121,"@type":113},"The meta-analysis reports higher high-density lipoprotein levels and lower C-reactive protein levels in the intervention group.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},542813,1791830108,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},687207022233,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","R e v i e w s i n C a r d i o v a s c u l a r M e di c i n e  \nSystematic Review  \nApple or apple polyphenol consumption improves cardiovascular disease risk factors: a systematic review and meta-analysis  \nXiaoqing Zhu 1 ,†, Guanhua Xu 1 ,†, Wangyan Jin 1 , Yingying Gu 1 , Xuhua Huang 1 , Lidan Ge2 , *  \n1 Department of Critical Medicine, The First People's Hospital ofXiaoshan District, 311200 Hangzhou, Zhejiang, China  \n2 Department of Geriatrics, The First People's Hospital ofXiaoshan District, 311200 Hangzhou, Zhejiang, China  \n*Correspondence: [gelidan0571@126.com](gelidan0571@126.com) (Lidan Ge)† These authors contributed equally.  \nDOI:10.31083/j. rcm2203089  \nThis is an open access article under the CC BY 4 .0 license ( [https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/)) .  \nSubmitted: 20 April 2021 Revised: 29 June 2021 Accepted: 6 July 2021 Published: 24 September 2021  \nMany fruits and vegetables have been found to have a protective effect against cardiovascular diseases. We conducted a systematic review and meta-analysis to determine the relationship between apple or apple polyphenol intake and cardiovascular disease risk. The PubMed, Embase, Cochrane, and Web of Science databases were searched up to August 4, 2020 . Studies that had an intervention time of >1 week; used apple or apple polyphenols as the intervention; were designed as a randomized controlled trial; and measured blood pressure, cholesterol, and blood glucose levels were included. The meta-analysis showed that the group with apple or apple polyphenol intake had significantly higher high-density lipoprotein levels (standardized mean difference [SMD] = 0.34, 95% confidence interval [CI][0 .01, 0 .67], p = 0 .0411, I2 = 77%, random-effects model) and significantly lower C-reactive protein levels (SMD = –0.43, 95% CI [–0.65,–0.20], p = 0 .0002, I2 = 18%, fixed-effects model) than the control group, indicating that the intervention reduced the risk of cardiovascular diseases. Apple or apple polyphenol intake is associated with a reduced risk of cardiovascular diseases. These results are consistent with the old saying that eating an apple a day can help keep the doctors away.  \nKeywords  \nApples; Apple polyphenols; Cardiovascular disease; Blood pressure; Cholesterol level; Blood glucose level  \n1. Introduction  \nAccording to the World Health Organization, cardiovascular diseases (CVDs) are currently the leading cause of death worldwide [ 1] . High blood pressure, smoking habit, high cholesterol level, diabetes, overweight or obesity, anda sedentary lifestyle can all negatively influence cardiovascular health. Population-wide strategies to address behavioral risk factors such as an unhealthy diet and obesity can help prevent most CVDs. Some studies have shown that the consumption of plant products such as fruits and vegetables is associated with a reduction in the risk of CVD development [2] . Moreover, some studies proposed that the intake of certain single nutrients (such as vitamin C) at the level naturally  \npresent in plants is related to a reduction of disease risk; however, these associations cannot explain the protective effect of plant foods on health [2] . Therefore, it is speculated that other nonnutritive components in plants, such as polyphenols, may also play a role in the reported beneficial effects of plant foods [3, 4] . Polyphenols are naturally occurring components in many plant-derived foods [5] . Many in vitro and animal studies have shown that polyphenols may be beneficial for cardiovascular health [6–9] .  \nApples are a good source of various nutrients, including vitamin C and a variety of polyphenols [10] . For a longtime, apples have been considered to have health-promoting effects, as illustrated by the old saying that “an apple a day keeps the doctor away”. One previous study has reported results consistent with this old saying. The study showed that higher dietary intake and/or higher blo","cbCais9JWFzfGT4M","https://ap.wps.com/l/cbCais9JWFzfGT4M","pdf",3476298,"English","# Introduction\n## Materials and methods\n### Search strategy","[{\"question\":\"What is the document’s main research question about apple intake?\",\"answer\":\"It examines whether consuming apples or apple polyphenols improves cardiovascular disease risk factors.\"},{\"question\":\"Which study types and time frame were included in the meta-analysis?\",\"answer\":\"The analysis includes randomized controlled trials with an intervention time of more than one week, searched up to August 4, 2020.\"},{\"question\":\"What biomarkers improved in the apple or apple polyphenol group versus controls?\",\"answer\":\"The meta-analysis reports higher high-density lipoprotein levels and lower C-reactive protein levels in the intervention group.\"}]","Apple or apple polyphenol consumption improves cardiovascular disease risk factors - a systematic review and meta-analysis | PDF",1791755177,23]