Apple and pear: one small trial and a lot of cohorts

The strongest trial on this pair is small and narrow. Over 12 weeks, 49 overweight women aged 30 to 50 with high cholesterol in Rio de Janeiro lost 2.7 lb (95% CI 0.97 to 4.1; metric: 1.22 kg, 0.44 to 1.85) eating three apples or three pears a day, against 1.9 lb (0.88 kg) on three oat cookies (P = 0.004). Everyone in it was already on an energy-reduced diet, and the apple and pear arms were pooled, so it cannot say which fruit did anything. Everything larger here is observational. Across three US cohorts, 207,241 people followed for 32 years, apples and pears ranked first among 19 fruits and vegetables rated high in metabolic quality. Eating a greater share of such produce went with a hazard ratio of 0.85 for major chronic disease (95% CI 0.81 to 0.90) in the stratum that ate least of it and 0.89 (0.84 to 0.94) in the stratum that ate most. The pear samples USDA analyzed held more fiber than the apple samples, but the cultivars are not matched. Total fiber was 3.1 g per 3.5 oz (100 g) in raw Bartlett pears and 2.6 g in green Anjou pears, against 2.1 g in raw Fuji apples. Soluble fiber across those six Bartlett samples ran from 0 to 1.0 g, a spread that says more about the assay than about pears. A medium apple weighs 7.1 oz (200 g) in the US survey table and a pear 180 g, so one piece of either is close to a fifth of a kilogram of fruit.

How much is actually in it

• USDA analyzed samples put total fiber at 3.1 g per 3.5 oz (100 g) in raw Bartlett pears against 2.1 g in raw Fuji apples, and pear soluble fiber ran from 0 to 1.0 g across six samples. — USDA FoodData Central Foundation Foods, analyzed samples of raw pears and raw apples (n = 6 pear samples, 8 apple samples) Evidence E source
  Pear total fiber 3.1 g per 3.5 oz (100 g) (2.5-3.7), pear soluble fiber 0.3 g (0.0-1.0), pear insoluble fiber 2.8 g (1.7-3.7), apple total fiber 2.075 g (1.89-2.32), green Anjou pear 2.636 g (2.21-3.13)
• The UK composition table puts a raw pear at 44 calories and 2.7 g of fiber per 3.5 oz (100 g), with 11.3 g of sugars of which 6.9 g is fructose. — CoFID 2021 record for Pears, average, raw, flesh only, code 14-365 (n = 1 composite record) Evidence E source
  Per 100 g energy 44 calories, AOAC fiber 2.7 g, NSP fiber 1.6 g, total sugars 11.3 g, fructose 6.9 g, glucose 3.2 g, potassium 105 mg, water 85.2 g

What a real portion looks like

• In 36,037 adults of the EPIC calibration survey, apples and pears were the largest single food source of flavan-3-ols everywhere except the UK, where tea took that place. — 36,037 adults aged 35 to 74 in 10 European countries, one standardized 24-hour dietary recall each (n = 36,037) Evidence C source
  Total flavan-3-ol intake from 124.8 mg per day in Greek women to 453.6 mg per day in UK health-conscious men, with non-citrus fruits the top contributor outside the UK
• In the USDA survey food table a medium raw apple weighs 7.1 oz (200 g) and one raw pear weighs 6.3 oz (180 g), so one piece of either is close to a fifth of a kilogram of fruit. — USDA FNDDS household measures, Apple, raw, code 63101000 and Pear, raw, code 63137010 Evidence E source
  Apple 165 g small, 200 g medium, 242 g large, 295 g extra large, 125 g per cup, pear 180 g per fruit and 125 g per cup

What your body absorbs

• In a randomized crossover feeding study in 10 adults, a diet built on apples, pears, potatoes and carrots raised urinary excretion of the lignan enterodiol against the basal diet (P = .03). — Seven men and three women aged 20 to 35, each eating four controlled 9-day diets in random order, with urine collected over the last 3 days of each period (n = 10) Evidence B source
  Higher enterodiol excretion on the high vegetable and fruit diet, P = .03, and lower equol excretion on that diet, P < .01

What cooking and storage change

• By the USDA retention table fresh non-citrus fruit keeps 80 percent of its vitamin C and 60 percent of its folate when baked, and 70 percent and 50 percent when stewed, while minerals survive in full. — USDA Table of Nutrient Retention Factors Release 6, group Fruits and Fruit Juices, method codes 151 and 155, table dated Sep-75 Evidence E source
  Baked vitamin C 80 percent retained and folate 60 percent, stewed vitamin C 70 percent and folate 50 percent, iron, magnesium, phosphorus and zinc 100 percent in both

What it does to your health

• In a 12-week randomized trial in 49 overweight women, three apples or three pears a day went with 2.7 lb (1.22 kg) of weight loss against 1.9 lb (0.88 kg) on oat cookies. — Hypercholesterolemic overweight non-smoking women aged 30 to 50 in Rio de Janeiro, randomized to apples, pears or oat cookies three times a day for 12 weeks (n = 49 randomized of 411 recruited) Evidence B source
  Fruit group -2.7 lb (95% CI 0.97 to 4.1; metric: -1.22 kg, 0.44 to 1.85) versus oat group -1.9 lb (0.82 to 4.7; metric: -0.88 kg, 0.37 to 2.13), difference P = 0.004
• Across three US cohorts with 207,241 people followed 32 years, apples and pears came first among the 19 fruits and vegetables ranked high in metabolic quality, and eating a higher share of such produce went with a hazard ratio of 0.85 for major chronic disease. — 207,241 participants of the Health Professionals Follow-up Study, Nurses Health Study and NHSII followed for 32 years, with biomarkers in 41,714 (n = 207,241) Evidence C source
  HR 0.85 (95% CI 0.81-0.90) in the lowest quantity stratum and 0.89 (0.84-0.94) in the highest, all P-trend < 0.001
• In 50,019 US nurses followed 24 years, apples and pears were among the fruits tied to less diverticulitis, with a hazard ratio of 0.95 for each extra daily serving of whole fruit. — 50,019 women of the Nurses Health Study aged 43 to 70 and free of diverticulitis at baseline, followed from 1990 to 2014 (n = 50,019 women, 4,343 incident cases) Evidence C source
  HR 0.95 (95% CI 0.92-0.98, P-trend < 0.001) per one serving per day of whole fruit, HR 0.86 (0.78-0.95) for the top quintile of total fiber
• In the EPIC cohort of 341,519 people followed a median 13.4 years, high intake of apple and pear together with banana, mushrooms and onion went with a 0.58 hazard ratio for Crohn disease. — 341,519 European adults with baseline food frequency questionnaires, 149 incident Crohn disease and 379 ulcerative colitis cases over a median 13.4 years (n = 341,519) Evidence C source
  Pooled apple/pear, banana, mushroom and onion intake aHR 0.58 (95% CI 0.33-1.02, P trend 0.03), fourth versus first quartile
• In 272,098 EPIC women with 10,979 breast cancers, apple and pear intake was one of three dietary factors tied to lower risk, with a hazard ratio of 0.96 per one standard deviation of intake. — 272,098 women of the European Prospective Investigation into Cancer and Nutrition with a median 15 years of follow-up, replicated in 2,368 cases of the Netherlands Cohort Study (n = 272,098 women, 10,979 cases) Evidence C source
  Apple/pear HR 0.96 (95% CI 0.94-0.99) per 1 SD increment, fiber HR 0.96 (0.94-0.98), carbohydrates HR 0.96 (0.95-0.98)
• In 77,335 US adults, the top fifth of flavonoid intake went with 0.81 odds of subjective cognitive decline, and apples and pears were among the foods carrying that association. — 49,493 women of the Nurses Health Study followed 1984 to 2006 and 27,842 men of the Health Professionals Follow-Up Study followed 1986 to 2002, with cognition self-reported in 2008 to 2014 (n = 77,335) Evidence C source
  Pooled OR 0.81 (95% CI 0.76, 0.89) for the highest versus lowest quintile of total flavonoid intake, odds and not risk

Safety, limits and interactions

• In 2,447 Swedish eight-year-olds, apple and pear intake was inversely associated with rhinitis, asthma and sensitization, and most of that association disappeared once children with food-related symptoms were excluded. — 2,447 eight-year-old children of a Swedish birth cohort, with parental questionnaires and allergen-specific IgE from blood samples (n = 2,447) Evidence C source
  Total fruit and rhinitis OR 0.62 (95% CI 0.45-0.86, P for trend .002) for the highest versus lowest quartile, with apple and pear associations moving toward the null after exclusion
• Half of the children with rhinitis in a Swedish cohort of 2,447 were sensitized to birch pollen, which the study says may cross-react with apples. — 2,447 eight-year-old Swedish children with allergen-specific IgE measured at age 8 (n = 2,447) Evidence C source
  50 percent of children with rhinitis sensitized to birch pollen
• FDA treats apple juice with 50 micrograms of patulin per kilogram or more as adulterated. — Single strength apple juice, reconstituted apple juice concentrate and the apple juice component of products containing apple juice, United States Evidence E source
  Action level 50 micrograms per kilogram, equal to 50 parts per billion

What people believe that the data does not support

• The European Union allows one health claim for pectins, the soluble fiber of apples and pears, and it is about keeping blood cholesterol normal. — EU Register on nutrition and health claims, snapshot 2026-09-21, claim POL-HC-6437 (n = 2330 claims in the register, 262 authorized) Evidence E source
  Authorized wording is that pectins contribute to the maintenance of normal blood cholesterol levels
• The claim that pectins induce satiety was refused in the European Union, so the usual line about an apple filling you up has no legal backing there. — EU Register on nutrition and health claims, snapshot 2026-09-21, claim POL-HC-7734 (n = 2330 claims in the register, 2067 rejected) Evidence E source
  The wording induce satiety sensation carries the status Non-authorized

Who this works differently for

• Among 575 Norwegian women, daily eating of apples, pears, oranges or bananas rose from 24 percent before pregnancy to 41 percent in early pregnancy. — 575 healthy nulliparous Norwegian women answering a food frequency questionnaire at a median gestational week 15 (n = 575) Evidence C source
  Daily fruit eating 24 percent before pregnancy versus 41 percent in early pregnancy, P < 0.01
• When adults ate one apple, one pear and 6.8 fl oz (200 ml) of orange juice a day for 26 days, plasma antioxidant capacity rose in non-smokers and did not move in smokers. — Chronic smokers and non-smoking healthy adults eating a pear, an apple and 6.8 fl oz (200 ml) of orange juice daily for 26 days (n = not stated in the abstract) Evidence C source
  Total antioxidant capacity up in non-smokers only, total and LDL cholesterol up in non-smokers and down in smokers

What is still unknown

• Eight of the nine reference layers hold no record of the pair apple and pear under that name, and no trial in our corpus has measured how well the body takes up their polyphenols. — Layers searched on 2026-09-25 for apple | pear: USDA composition, CoFID, FNDDS, USDA retention R6, NHANES, 21 CFR 101, EU claim register, drug interaction layer, PubMed corpus version pubmed:468905 (n = 0 records under the paired name in 8 of 9 layers) Evidence E source
  Zero absorption studies in the corpus, zero safety records, zero kidney records, zero US health claims for pectin, and two meta-analyses outside the corpus that could not be quoted

The bottom line

In the EPIC calibration survey, 36,037 adults each gave one standardized 24-hour recall, and apples and pears were the largest single food source of flavan-3-ols in every country except the UK, where tea took that place. That describes what people eat rather than what it does to them. Cooking costs less than most people fear, and the table behind that number is old. For fruit as a group, baking keeps 80 percent of the vitamin C and 60 percent of the folate, stewing keeps 70 and 50 percent, and iron, magnesium, phosphorus and zinc survive in full. Those factors were set for the whole category of fruits and juices in a table dated 1975, not for apples or pears by name. Two entries in the EU register are worth knowing before you read a label. Pectins, the soluble fiber of both fruits, carry an authorized claim about maintaining normal blood cholesterol, but the claim belongs to the substance and needs a quantity threshold, so a whole apple does not inherit it. The wording that pectins induce satiety was refused. Refused means the evidence did not reach the bar at the time it was assessed, and not that nothing happens. The safety axis is thin, and nothing in it is about a whole fruit in a healthy adult. Birch pollen may cross-react with apple, and half of the children with rhinitis in a Swedish cohort of 2,447 eight-year-olds were sensitized to birch. In that same cohort some children reported food-related allergic symptoms and had to be excluded from the analysis, which is what an allergy to these fruits looks like inside a survey. The cross-reaction is described in the literature rather than measured by a food challenge, so if pollen season makes your mouth itch, raw apple is a question for an allergist. The only numeric limit either fruit has applies to juice. The FDA treats apple juice at 50 micrograms of patulin per kilogram or more as adulterated, which is a threshold for pulling a batch and not a daily dose for a person, and patulin gathers in bruised and rotting fruit. For the pair itself we found no interaction record and no kidney record in any layer. In those same Swedish children, apple and pear intake tracked with less rhinitis, asthma and sensitization, and most of the association moved toward nothing once children with food-related symptoms were left out. The authors read that as children avoiding the fruit that makes their mouth itch. Among 575 Norwegian women, daily eating of apples, pears, oranges or bananas rose from 24 percent before pregnancy to 41 percent in early pregnancy (P < 0.01), which is a fact about behavior and says nothing about the baby. When adults ate one apple, one pear and 6.8 fl oz (200 ml) of orange juice a day for 26 days, plasma antioxidant capacity rose in non-smokers and did not move in smokers. In the same study total and LDL cholesterol rose in the non-smokers and fell in the smokers. That study was not randomized, the abstract never says how many people took part, and the orange juice cannot be separated from the fruit. The basics are missing. No study in our corpus has measured how well the body takes up the polyphenols of either fruit, and eight of the nine reference layers hold nothing at all under the paired name, including the USDA composition table this page would normally draw.

Sources

1. aplpr-daily-r4-13 · reference dataset
   Pears, raw, bartlett: Fiber, total dietary 3.1 G range 2.5-3.7 median 3.1 n=6 · Fiber, soluble 0.3 G range 0.0-1.0 n=6 · Fiber, insoluble 2.8 G range 1.7-3.7 n=6 · Pear, Anjou, green, with skin, raw: Fiber, total dietary 2.636 G range 2.21-3.13 n=8 · Apples, fuji, with skin, raw: Fiber, total dietary 2.075 G range 1.89-2.32 n=8
   USDA FoodData Central, Foundation Foods, release 2026-04-30 · checked 2026-09-25
2. aplpr-daily-r4-14 · reference dataset
   Pears, average, raw, flesh only, CoFID 14-365: Energy (kcal) 44 · AOAC fibre (g) 2.7 · NSP (g) 1.6 · Total sugars (g) 11.3 · Fructose (g) 6.9 · Glucose (g) 3.2 · Potassium (mg) 105 · Water (g) 85.2
   CoFID 2021, Public Health England, code 14-365 · checked 2026-09-25
3. aplpr-daily-r4-08 · dietary survey
   Except for the UK, non-citrus fruits (apples/pears) were the highest contributors to the total flavan-3-ol intake. Tea was the main contributor of total flavan-3-ols in the UK.
   Br J Nutr, 2012 · checked 2026-09-25
4. aplpr-daily-r4-16 · reference dataset
   FNDDS 63101000 Apple, raw: 1 small 165 g · 1 medium 200 g · 1 large 242 g · 1 extra large 295 g · 1 slice 25 g · 1 cup 125 g; FNDDS 63137010 Pear, raw: 1 fruit 180 g · 1 slice/chunk 25 g · 1 cup 125 g
   USDA FNDDS 2021-2023, codes 63101000 and 63137010 · checked 2026-09-25
5. aplpr-daily-r4-02 · crossover feeding trial
   All subjects consumed four experimental diets in an assigned random order: a controlled basal diet, a legume/allium diet (containing garbanzo beans, garlic, and onions), and diets low or high in vegetables and fruits (containing apples, pears, potatoes, and carrots). ... Subjects excreted more of the lignan enterodiol on the high vegetable/fruit diet compared with the basal and legume/allium diets (P = .03)
   J Am Diet Assoc, 1995 · checked 2026-09-25
6. aplpr-daily-r4-15 · reference dataset
   USDA-RETN-R6:151 FRUITS,FRESH(NOT CITRUS),BAKED, group Fruits and Fruit Juices: vitamin_c_mg 80% retained, folate_total_ug 60%, thiamin_mg 80%, potassium_mg 90%, iron_mg 100%; USDA-RETN-R6:155 FRUITS,FRESH(NOT CITRUS),STEWED: vitamin_c_mg 70% retained, folate_total_ug 50%, thiamin_mg 80%, potassium_mg 90%, iron_mg 100%
   USDA Table of Nutrient Retention Factors, Release 6, 2007, Retn_Codes 151 and 155 · checked 2026-09-25
7. aplpr-daily-r4-01 · randomized trial
   After 12 wk of follow-up, the fruit group lost 1.22 kg (95% confidence interval = 0.44-1.85), whereas the oat group had a non-significant weight loss of 0.88 kg (0.37-2.13). The difference between the two groups was statistically significant (P = 0.004).
   Nutrition, 2003 · checked 2026-09-25
8. aplpr-daily-r4-03 · cohort study
   Of 52 FV items, 19 were identified as high-metabolic quality (top 5: apples/pears, iceberg/head lettuce, raw spinach, alfalfa sprouts, and eggplant/summer squash). ... In each quantity level stratum (quartiles Q1-Q4), comparing the highest to the lowest quality proportion quartiles, the hazard ratio (HR) (95% confidence interval [CI]) were 0.85 (0.81-0.90), 0.86 (0.82-0.90), 0.84 (0.80-0.89), and 0.89 (0.84-0.94), all P-trend < 0.001.
   Am J Clin Nutr, 2024 · checked 2026-09-25
9. aplpr-daily-r4-04 · cohort study
   Furthermore, intake of total whole fruit intake and specific fruits such as apples/pears and prunes were associated with reduced risk of diverticulitis with a multivariable hazard ratio for diverticulitis of 0.95 (0.92-0.98; P-trend < 0.001) for every serving increase of total whole fruit intake per day.
   Am J Gastroenterol, 2019 · checked 2026-09-25
10. aplpr-daily-r4-05 · cohort study
    Pooled consumption of apple/pear, banana, mushrooms, and onion/garlic was associated with a lower risk of CD (fourth vs first quartile aHR 0.58; 95% CI: 0.33-1.02, P trend 0.03).
    Am J Gastroenterol, 2026 · checked 2026-09-25
11. aplpr-daily-r4-06 · cohort study
    whereas higher intakes of fibre, apple/pear, and carbohydrates were associated with a lower risk of breast cancer (HRs per 1 SD increment = 0.96, 95% CI 0.94-0.98; 0.96, 95% CI 0.94-0.99; and 0.96, 95% CI 0.95-0.98, respectively).
    Breast Cancer Res, 2020 · checked 2026-09-25
12. aplpr-daily-r4-07 · cohort study
    In a comparison of the highest vs the lowest quintiles of total flavonoid intake, the pooled multivariable-adjusted odds ratio (OR) of 3-unit increments in SCD was 0.81 (95% confidence interval [CI] 0.76, 0.89). ... Many flavonoid-rich foods such as strawberries, oranges, grapefruits, citrus juices, apples/pears, celery, peppers, and bananas, were significantly associated with lower odds of SCD.
    Neurology, 2021 · checked 2026-09-25
13. aplpr-daily-r4-09 · cross-sectional study
    In analyses of individual foods, intake of apples/pears and carrots was inversely associated with rhinitis, asthma, and atopic sensitization. ... After exclusion of children who reported food-related allergic symptoms, most of the observed inverse associations moved toward the null and became nonsignificant.
    J Allergy Clin Immunol, 2011 · checked 2026-09-25
14. aplpr-daily-r4-10 · cross-sectional study
    Fifty percent of the children with rhinitis were sensitized against birch pollen, which may cross-react with apples and carrots.
    J Allergy Clin Immunol, 2011 · checked 2026-09-25
15. aplpr-daily-r4-19 · agency guidance
    FDA has established an action level for patulin in apple juice of 50 micrograms per kilogram (50 parts per billion)
    FDA, Guidance for Industry: Juice Hazard Analysis Critical Control Point Hazards and Controls Guidance, First Edition, 2004 · checked 2026-09-25
16. aplpr-daily-r4-17 · claim register entry
    POL-HC-6437 Pectins Pectins contribute to the maintenance of normal blood cholesterol levels Authorised
    EU Register on nutrition and health claims, claim POL-HC-6437, snapshot 2026-09-21 · checked 2026-09-25
17. aplpr-daily-r4-18 · claim register entry
    POL-HC-7734 Pectins Induce satiety sensation Non-authorised
    EU Register on nutrition and health claims, claim POL-HC-7734, snapshot 2026-09-21 · checked 2026-09-25
18. aplpr-daily-r4-11 · cross-sectional study
    The percentage of women consuming FV daily or more frequently in the following categories increased from pre-pregnancy to early pregnancy: vegetables on sandwiches (13 vs. 17%, p <0.01), other vegetables (11 vs. 14%, p = 0.01), fruits (apples, pears, oranges or bananas) (24 vs. 41%, p < 0.01), other fruits and berries (8 vs. 15%, p < 0.01) and fruits and vegetables as snacks (14 vs. 28%, p < 0.01).
    BMC Pregnancy Childbirth, 2017 · checked 2026-09-25
19. aplpr-daily-r4-12 · controlled trial
    Fruit consumption increased TAC in non-smokers, but not in smokers. In non-smokers, total cholesterol, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol increased significantly; while in smokers, total cholesterol and low-density lipoprotein-cholesterol decreased.
    Int J Food Sci Nutr, 2010 · checked 2026-09-25
20. aplpr-daily-r4-20 · search record
    apple | pear: USDA composition 0 records · CoFID 0 under paired name · FNDDS 0 · retention R6 0 · NHANES 0 ranked nutrients · 21 CFR 101 0 for pectin · EU register 0 under fruit name · interactions 0 · corpus axis 2 query 0 of all types · corpus safety slice 0 · corpus kidney slice 0
    Bioma research layers, snapshot 2026-09-25 · checked 2026-09-25