My last few blog posts have all been about apples. Therapeutically, the most common way I recommend apples in my practice is as stewed apples. If you have been watching the BBC TV programme Doctor in the House, this might all sound very familiar as Dr. Chattergee uses this approach in episode 4 of series 2.  Let’s look at what beneficial effects eating stewed apples can have on the body.

Dr. Michael Ash, DO, ND

One of my favorite educators in functional medicine and nutrition is Dr. Michael Ash. He is an osteopath, naturopath, and nutritionist. He is the guy behind the scenes of Doctor in the House, the UK BBC TV program with Dr. Chatterjee. Michael Ash works with Dr. Chatterjee to figure out the clinical mechanisms going on with illnesses in the program patients and then explores safe, innovative clinical decisions that may have been missed in conventional care. If you haven’t seen Doctor in the House, get over to BBC iplayer and take a look. You’ll need a VPN (virtual personal network) to view it if you are in the US. I use Tunnelbear. It’s a great programme.

When he’s not working on television programmes, a significant part of Dr. Ash’s research is on the importance of mucosal tolerance in the gut. He wrote an excellent paper on the use of stewed apples – the inspiration for this blog post.  I urge you to read the full paper: https://www.nutri-link.co.uk/documents/apple_tolergenic_food.pdf

In it, he gives a recipe to follow, explains the components that provide beneficial effects, and discusses how this simple food can make a significant difference. Dr. Ash has been using stewed apples therapeutically for more than 30 years. He initially used them with children, including freezing them into lollipops or popsicles to encourage the children to eat them.  Here are the key points from the paper.

Infographic showing 5 health benefits of apples from CALMERme.com

Let’s look at what some of these mean.

What are the mucosa and mucosal immune tolerance? 

Mucosal tissue

Mucosal tissue refers to the “wet” tissues in our body that are bathed in mucus. The largest area of mucosal membranes in the body is found in the gut (other mucosal areas include the lungs and respiratory system and the genitourinary tract). The whole digestive tract is the area where our body meets non-human things, like the foods we ingest.

These mucosal surfaces, therefore, act as the first line of defense for the body. Indeed, mucosal membranes hold many of the secrets as to why people don’t feel well for long periods of time i.e., chronic diseases.  

Mucosal immune system and mucosal tolerance

Mucosal tissues have their own immune system. In fact, the mucosal immune system in the gastrointestinal tract is 60-75% of the total immune system of the body. Our immune system is a defense system, ready to protect us by attacking anything foreign i.e., non-human, in our body. Foods we eat can be seen to be foreign as they contain proteins which differ from our own proteins. Every time we eat leads to a decision for this immune system – should it attack/destroy or ignore this foreign thing?  Consequently, the mucosal immune system is often referred to as the immune system that has to make more “decisions” each day than the rest of our body’s immune system makes in its lifetime.

Where does the microbiota (gut bacteria) fit in?

In addition to responding or not to food, the gut mucosa also has to factor in all the bacteria and micro-organisms that are in the digestive tract – our gut microbiota. Our microbiota is vital for our health, so we don’t want the immune system to destroy it. This is part of mucosal tolerance too.

The foods we eat not only nourish us but are essential as nutrient sources for our microbiota too. When the microbiota is in a favorable environment and well fed, it produces metabolites from the food, including short-chain fatty acids (SCFA). These SCFAs (butyrate, acetate, propionate) heal the body in many ways both locally in the gut and throughout the body. They even cross into the brain and can change brain tissue.  

Microbiota food

The food source most favored by microbiota is fiber – found in plants. Our ancestors typically ate 100-120g of fiber a day. Today, the standard amount of fiber consumed in diets is a mere 10-15g/day!  Those poor, hungry gut micro-organisms! We aren’t supporting them with such low fiber levels. 

Both fruit and vegetables are great sources of microbiota-loving fiber. 

Some of the best vegetables for microbiota food sources are cruciferous vegetables and those with bitter tastes. Specifically, cabbage, cauliflower, onions, carrots, peas, beetroot, and squash.  

As far as fruits go, apples are a great microbiota food source, especially due to the soluble fiber pectin in apples.  

There are two main effects of the fiber in these foods. Firstly, they nourish the microbiota to make the SCFA which have many beneficial effects on the body. Secondly, the fiber acts as a switch to genes in the body, to switch off inflammation. It also sends messages to the immune system to make us more tolerant of our environment. 

Do the apples need to be stewed? Is it more than just the apples?

What Dr. Ash has found is that it is the preparation and combination of ingredients that helps e.g., adding cinnamon to reduce blood sugar effects, peeling the apples so they are easier to digest, cooking to release the pectin, etc. Yes, we can still get some benefits from eating raw apples, but stewing them according to his recipe increases their effects.

For many of my clients, I find having them prepare and eat stewed apples according to the paper,  significantly improves their health. It’s great as an initial kick-start to healing. 

A side benefit of cooking stewed apples is that taking the time to cook the apples also helps people get back into the kitchen. It’s a simple recipe, so something easy to cook from scratch. This isn’t just opening a jar or applesauce and using that. It’s about taking the time to look after yourself. And once you start with stewing apples, you’ll see the effects of whole foods on your health and feel empowered to try more recipes.

Read the paper and see if eating (and preparing!) stewed apples might help you.  https://www.clinicaleducation.org/resources/reviews/is-this-a-perfect-functional-meal-for-mucosal-tolerance/

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