A Comprehensive Narrative Review Designed to Evaluate the Health Benefits of Apples and Their Derivatives, with a Focus on Cardiovascular Disease (CVD) Prevention, Metabolic Regulation, and Chronic Disease Mitigation

Cardiovascular diseases (CVDs), including coronary artery disease, cerebrovascular disease, and peripheral arterial disease, are projected to cause 23.6 million deaths annually by 2030, largely driven by oxidative stress, endothelial dysfunction, inflammation, and metabolic disturbances. This review systematically explores the role of apples and apple-derived products in mitigating risk factors associated with CVDs and other chronic diseases. Apples are rich in bioactive compounds—particularly polyphenols, dietary fiber, triterpenes, and vitamins—that exert antioxidant, anti-inflammatory, lipid-lowering, endothelial-protective, and glycemic-regulating effects. Evidence from epidemiological studies, in vitro models, animal experiments, and clinical trials suggests that regular apple consumption can improve cardiovascular health, lower cholesterol, reduce inflammatory markers, enhance glycemic control, and provide neuroprotection. Additionally, apples have shown potential in cancer prevention, cognitive health, and hair loss treatment due to their antioxidant and signaling-modulatory properties. However, the efficacy of different apple forms (e.g., whole fruit vs. juice) varies significantly, with whole apples offering the greatest benefits. This review also highlights the growing interest in apple by-products such as pomace and cider vinegar for their functional food potential. Overall, apples represent a promising, accessible dietary strategy for preventing chronic diseases and promoting long-term health.