An apple a day keeps the doctor away: inter-relationship between apple consumption, the gut microbiota and cardio-metabolic disease risk reduction

Evidence suggests that a high intake of fruits and vegetables may decrease the risk of chronic diseases, including cardiovascular disease, and that components such as polyphenols and fiber may play a key role in reducing disease risk factors. Apples are among the most frequently consumed fruits in the world and an important source of polyphenols and fiber. Their consumption has been associated with beneficial lipid changes, delayed glucose response, antioxidative and anti-inflammatory properties, reduced blood pressure and effects on gut microbiota composition. However, many of these effects are not well explored and the specific mechanisms are unclear. This chapter will describe human intervention studies, animal and in vitro studies investigating the impact of apples and apple components on cardio-metabolic disease risk factors and possible mechanisms linked to the gut microbiot