An Apple a Day Keeps the Doctor Away: A Fresh Look for Breast Cancer Survivors

By Tamar Rothenberg, MS, RDN

A breast cancer survivor recently asked me what food I would suggest for breast cancer survivorship if I could only suggest one.

That really stumped me! But I enjoy an intriguing challenge.

What then did I recommend? Broccoli, flaxseed, chia, or mushrooms? While these are perfectly wonderful foods, they didn't make my list of the ONE food.

You might be shocked that I went back to the basics. I chose an apple a day for breast cancer survivors. A fresh, entire apple with its peel on. The one that, according to the proverb, keeps a doctor away and the same one that appears in Snow White.

Origins and evolution of an apple a day

The saying “An apple a day keeps the doctor away” is a classic example of folk wisdom that combines rhyme, simplicity, and a health message — all of which helped it become embedded in popular culture.

The phrase also reflects early public health efforts to promote preventive care through diet. In a time before widespread access to healthcare, simple messages like this helped guide everyday choices. Over time, the apple became a kind of “mascot” for healthy eating.

Though not scientifically literal, it reflects the idea that a healthy diet (symbolized by the apple) can help prevent illness.

The earliest version appeared in Wales in the 1860s, a region known for its apple orchards and traditional use of apples in daily life. The 1866 version, “Eat an apple on going to bed, and you’ll keep the doctor from earning his bread,” was part of a broader tradition of rhyming proverbs used to teach health and moral lessons. The phrase morphed into “An apple a day keeps the doctor away” by the early 20th century, and its catchy rhythm and wholesome image became a health slogan.

Why an apple a day?

Apples have long symbolized health and vitality. They're rich in fiber (especially pectin), vitamin C, antioxidants, and phytochemicals — all of which contribute to heart and gut health, reduced inflammation, and blood sugar regulation. While no single food can prevent illness, apples are a strong example of nutrient-dense, whole foods that support overall health.

Modern perspective on a apple a day

Today, we understand that health is influenced by the overall dietary pattern, not just one food. Still, the proverb persists because it captures the essence of preventive health in a relatable, memorable way.

So while it’s not a scientific claim, it’s a cultural shorthand for: Eat more whole, plant-based foods — and you may not need the doctor as often.

An apple a day for breast cancer survivors: A survivor’s spin on an old saying

Apples are rich in fiber, antioxidants, and phytochemicals— nutrients that help:

• Lower inflammation

• Support immunity

• Promote gut and heart health

Apples are rich in flavonoids. They are among the most potent and abundant antioxidants, with more than 4,000 flavonoids identified in plant foods. Apples provide 15% of the recommended daily value for fiber (a thriver superfood!) as well as a good amount of vitamin C and potassium. When you consume the skins of apples, you're not only getting extra fiber but also an array of phytochemicals (antioxidants)!

What an apple a day means for survivors

For breast cancer survivors, nutrition matters. Whole, plant-based foods — like apples — help support:

• Healing

• Energy

• Reduced recurrence risk

• There is evidence of longer living with higher versus lower intake levels of apples

• Several studies show higher bone density with eating apples (and other studies do not show this result.)

Specifically:

• Apples offer fiber and compounds that hop a ride with gut microbes to reduce the risk of cancer. 

• Studies have linked apples with a lower risk of the estrogen receptor-negative (ER-) form of breast cancer.

But wait, there's more! Slower declines in lung function are associated with eating at least five apples weekly compared to none.

The real message of an apple a day

It's not just about apples — it's about daily choices that nourish your body. Let food be part of your healing.

• More than just apples: Apples symbolize the power of everyday foods to support health. They're packed with fiber, antioxidants, and phytochemicals—all of which may help lower inflammation and support immune function.

• Why it still matters: For breast cancer survivors, what you eat plays a key role in recovery and long-term wellness. No single food is a cure, but a diet rich in whole, plant-based foods — including apples — can support your body and help reduce the risk of recurrence.

• Bottom line: It’s not about the apple — it’s about choosing nourishing foods every day to help keep you thriving.

Recipe tips for an apple a day

Which variety is your favorite? Honeycrisp, Granny Smith, Gala, Fuji, or Pink Lady? Here are some of my favorite ways to include apples:

• Enjoy sliced with peanut butter and a sprinkle of hemp seeds

• Add to Thanksgiving stuffing

• Make an apple chutney as a topping for your favorite animal or plant protein

• Added to a salad to cut the bitterness of other ingredients such as kale or broccoli

Try this simple "apple pie" topping for anything from waffles and pancakes to overnight oats:

Apple Pie Topping

1. Heat about 2 cups of water in a small saucepan. Add two chopped apples and a teaspoon of pumpkin pie spice.

2. Cook until the water has evaporated and the apples are softened and fragrant. Depending on the firmness of your apple, you may need to add more water during cooking.

The sweetest health benefits of an apple a day

• Why the apple? Apples were symbolic of good health — rich in fiber, vitamin C, and antioxidants. They became a stand-in for the idea of nutritious, everyday food.

• Public health: The saying gained popularity in the early 1900s, promoting diet as a form of prevention long before modern medicine emphasized it.

• What it really means today: One apple won’t prevent illness, but a diet rich in whole, plant-based foods can support long-term health and reduce disease risk. Food matters!

Want to know more about how you can get the nutrition your body needs to reduce breast cancer? As a registered dietitian nutritionist who works with people experiencing cancer, I’d love to help. I offer clients support to plan, shop, and prepare more nutritious and healthy meals for themselves or their families. Here is my link to book a chat about my nutrition package.

References

1. Aune D, Giovannucci E, Boffetta P, et al. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol. 2017;46(3):1029-1056.  (PubMed)

2. Butland BK, Fehily AM, Elwood PC. Diet, lung function, and lung function decline in a cohort of 2512 middle aged men. Thorax. 2000;55(2):102-108.  (PubMed)

3. AICR/WCRF. Diet, Nutrition, Physical Activity and Cancer: A Global Perspective, 2018.