By T. Jared Bunch, MD
Published Dec 19, 2014
Most people have heard the advice, “An apple a day keeps the doctor away.” This bit of advice is over a century old. The first version recorded was in the 1866 edition of Notes and Queries which states, “Eat an apple on going to bed, and you’ll keep the doctor from earning his bread.” In general, substituting a fiber-rich apple for high calorie foods, sweets, or processed products with high-fructose corn syrup is a great idea. Apples are also good sources of vitamin C, they clean our teeth, help with colon health, and they may help lower risk of dementia. However, even if you eat an apple daily, it is still a good idea to see your primary care doctor for regular check ups.
Tomatoes for Heart Health
I want to propose a new twist on the age-old advice. Rather than an apple, let’s use a tomato. Rather than a general doctor, let’s substitute a heart doctor. Maybe all along the advice should have been, “A tomato a day keeps the heart doctor away.”
You may be asking, why a tomato? Tomatoes are a very nutritional food source rich in anti-oxidants, vitamin A and C, folic acid and beta-carotene. They are also rich in a substance called lycopene. Lycopene is a bright red carotene that gives tomatoes their color. Lycopene can also be found in other fruits and vegetables such as watermelon or red carrots. In an average diet, tomatoes account for more than two-thirds of your lycopene consumption.
Evidence From Studies of Tomato and Lycopene
It may surprise you, but because of lycopene there are many studies that have tested the role of tomato consumption on heart health and heart disease risk factors. Here is a breakdown of what we know:
Oxidized LDL. LDL is the bad part of our cholesterol. When it becomes “oxidized” due to a process called oxidative stress, oxidized LDL leads to cholesterol accumulation that forms plaques in the arteries of our bodies, in particular the coronary arteries. These plaques can rupture and cause a heart attack. In studies of healthy people, as well as those with type 2 diabetes, consumption of tomatoes or tomato products decreased levels of oxidized LDL.
Body Inflammation. Markers of inflammation in our body have been shown to be associated with risk of heart disease, heart attack, stroke, and atrial fibrillation. Tomato consumption has been shown to reduce some of these markers of inflammation suggesting an improvement in inflammatory status particularly in overweight and obese people.
Blood Pressure. In patients with pre-high blood pressure (prehypertension) or hypertension, tomato and tomato product consumption has a modest lowering effect on both systolic and diastolic blood pressure. This can be seen as early as 8 weeks after starting frequent consumption.
Potential benefit after a heart attack. In two animal studies, rats were either treated with lycopene or a placebo for 30 days. After 30 days, a heart attack was caused in all the rats. Those rats treated with lycopene had a better blood pressure and less heart tissue/cell loss if they had received lycopene. These interesting findings need to be studied in humans to see if our bodies and hearts respond in a similar manner.
Improved survival in patients with heart failure. In a study of 212 patients with heart failure, higher lycopene intake from tomatoes was associated with improved survival. In fact, patients with low lycopene intake were 3.3 times more likely to die compared to those with high lycopene intake.
Reduced risk of stroke. In a study of 1,031 men from Finland, high lycopene consumption from tomatoes was associated with a significantly lower risk of stroke compared to men with a low consumption. In this study, stroke risk was reduced by 65 percent with high lycopene consumption.
Overall, these studies suggest that the tomato is a great healthy choice for our hearts and may as part of a healthy lifestyle reduce risk of heart disease. Some of these studies show the greatest benefit after early disease has developed, so it is never too late to make these lifestyle choices.
I am often asked if a supplement is as good as the food source. Or in other words, is a lycopene pill a good substitute for eating the tomato itself? Although there is evidence to support lycopene supplements for heart health, when all the evidence is examined eating a tomato is the better choice.
So, when planning your diet, remember a tomato a day just may keep the heart doctor away.