Thursday, 19 December 2013

An Apple A Day...

Research has once again shown the benefit of eating fruit or vegetable.  Yesterday the news media was full of headlines like this:

“Fabulous” I thought.  “I wonder where this research came from?”   

So I decided to follow the research back to its origins - a fairly straightforward task.  It turns out that the research was published in the British Medical Journal’s Christmas edition – a traditionally light-hearted edition often with slightly less-than-serious research articles.

For example, here is a selection of the titles of other articles in the Christmas 2013 edition:

The good news is that many of the articles are open access so you could download them and use them with students to show what a research paper looks like and how they are structured.  The light-hearted topics means that they are more ‘accessible’ than traditional research papers, but are still structured in the same way.  It could also be used to look at how computer modelling is used to look at the potential effectiveness of medical interventions without actually carrying out the intervention.

If you want to do that then the link to the apple story is here.

I heard/read a number of comments about the value of prescribing an apple instead of statins, such as this tweet:

I wondered about the cost-effectiveness of prescribing an apple a day to the population over 50 (around 21 million people according to this source).  Pleasingly, the authors of the paper actually calculate the cost of prescribing statins (to everyone over 50 who isn’t already taking them for other medical reasons) and the cost of prescribing apples.

Cost of additional Statins: £180 million
Cost of apples: £260 million

So, if the NHS were to prescribe apple, which I envisage to be a little like fruit time in primary school, it would cost more than £80 million MORE than prescribing statins.  

Of course, the statins have additional side effects which would have to be taken into account.  The authors also assumed that calorie intake would remain the same if everyone ate an apple, but that might not be the case, so the side effects from that should also be considered.

Interesting questions to ask:

  • Why might people be happy to pay for an ‘apple a day’, but not a ‘statin’ a day?
  • Could/Should the NHS prescribe fruit&vegetables in the same way that they prescribe medications?
  • The authors assume a 70% compliance rate in eating the apple – is this realistic?
  •   Should researchers spend time writing light-hearted research articles?
  • Why did the news media pick up on the story, and report it without comment on the reasons why it was written?
 Enjoy, and do let me know if you use this in class.