Abstract Evidence suggests that a diet high in fruits and vegetables may decrease the risk of chronic diseases, such as cardiovascular disease and cancer, and phytochemicals including phenolics, flavonoids and carotenoids from fruits and vegetables may play a key role in reducing chronic disease risk. Apples are a widely consumed, rich source of phytochemicals, and epidemiological studies have linked the consumption of apples with reduced risk of some cancers, cardiovascular disease, asthma, and diabetes. In the laboratory, apples have been found to have very strong antioxidant activity, inhibit cancer cell proliferation, decrease lipid oxidation, and lower cholesterol. Apples contain a variety of phytochemicals, including quercetin, catechin, phloridzin and chlorogenic acid, all of which are strong antioxidants. The phytochemical composition of apples varies greatly between different varieties of apples, and there are also small changes in phytochemicals during the maturation and ripening of the fruit. Storage has little to no effect on apple phytochemicals, but processing can greatly affect apple phytochemicals. While extensive research exists, a literature review of the health benefits of apples and their phytochemicals has not been compiled to summarize this work. The purpose of this paper is to review the most recent literature regarding the health benefits of apples and their phytochemicals, phytochemical bioavailability and antioxidant behavior, and the effects of variety, ripening, storage and processing on apple phytochemicals. Background In the United States, as well as in most industrialized countries, cardiovascular disease and cancer are ranked as the top two leading causes of death. The causes of both diseases have been linked to lifestyle choices, and one of the most important is diet. It has been estimated that a healthy diet could prevent approximately 30% of all cancers [1,2]. High cholesterol and obesity are greatly influenced by diet and lifestyle and are costing the United States billions of dollars in health related expenses. High cholesterol, a risk factor for cardiovascular disease, is commonly treated with statin drugs, and it has been estimated that the United States will spend 30 billion dollars per year on cholesterol treatment by statin drugs [3]. In 1998, obesity, a risk factor for cardiovascular disease, cancer, and diabetes, has been estimated to cost the United States over 92 billion dollars per year [4]. Understanding the effects of diet on chronic disease may greatly aid in the prevention of chronic disease. As children, many of us were told to "eat your vegetables because they are good for you", and the adage "an apple a day keeps the doctor away" is still quite popular. Recently, many studies have provided the scientific backing for
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