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Should I eat fruit?

 

Being a nutritionist, I am often asked that question.

Why isn’t it obvious that everyone should (or should not) eat fruit? It's because there is a lot of conflicting information “out there”.

For example:

Many websites say to stay away from fruit because of their effect on blood sugar.

But, a search of PubMed for fruit and health conditions produces a list of articles that overwhelmingly say that fruit is beneficial.

 

 

My perspective on eating fruit...

These factors need to be considered:

1. 1.Total sugar content of fruit (eat less sweet, or dried fruit)
    
   

2. 2.Fructose content (favour lower fructose content fruits)
    
   

3. 3.Quantity of vegetables (eat more veggies)
    
   

4. 4.Context (general maintenance vs specific health conditions)
   

 

1. Total sugar content

 

 

Potential problems often cited with fruit are tied to their SUGAR and FRUCTOSE content.

The sugar in fruit comes mainly from:

1. •glucose (simple sugar)
   

2. •fructose (simple sugar)
   

3. •sucrose (glucose + fructose linked together)
   

4. •starch (many glucoses linked together)
   

Fruits that are higher in total sugars and starches may affect blood sugar levels.

 

Excess energy (even from fruit sugars) can ultimately be turned into fat by the body, or prevent fat burning.

 

 

 

2. Fructose content

 

 

Glucose and fructose have different responses in the body...

Glucose:

1. •promotes the feeling of satiety (stop eating!).
   

Fructose:

1. •does not promote feelings of satiety to the same degree (keep eating!)
    
   

2. •leads to the formation of fat that damages liver cells (fatty liver disease)
   

 

Fruit vs High Fructose Corn Syrup

 

The main health problems associated with fructose are associated with consumption of High Fructose Corn Syrup (HFCS) and not fruit.

 

The amount of fructose in fruit is typically much lower than in junk foods.

For example...

 

Fructose content: Apple vs Cola

Medium-sized apple (223g) – 13.6 g of fructose
Small cola (16 oz/.474L) – 30.1 g of fructose

Calculated fron nutrition data – http://ndb.nal.usda.gov/

 

 

 

Limiting total fructose may be beneficial

 

There is evidence that reducing total fructose – including that from fruit may be beneficial.

 

 

Obesity and diabetes rates were low with total fructose intake below 40 grams per day
American Society for Clinical Nutrition 2008
How safe is fructose for persons with or without diabetes?
http://ajcn.nutrition.org/content/88/5/1189.full

Dr. Mercola recommends limiting daily fructose intake to less than 25 grams per day
Sugar: Eliminate This ONE Ingredient and Watch Your Health Soar, May 02, 2011
http://articles.mercola.com/sites/articles/archive/2011/05/02/is-sugar-toxic.aspx

 

A rough guide to fructose content of fruit:

1. •below 2 g per serving – limes, lemons, cranberries, prune, apricot
    
   

2. •between 3 and 4 g per serving – raspberries, clementines, kiwi, blackberries, cherries
    
   

3. •between 4 and 7 g per serving – pineapple, tangerine, peach, orange, papaya
    
   

4. •between 7 and 10 g per serving – banana, blueberries, apple
    
   

5. •above 10 g per serving – watermelon, pear, raisins, grapes, mango, dried fruits
   

Adapted from: http://articles.mercola.com/sites/articles/archive/2011/05/02/is-sugar-toxic.aspx

 

 

 

3. Quantity of vegetables

Many (if not most) studies that attributed health benefits to fruit included BOTH fruits and vegetables and did not consider the effects of them individually.

 

So, it is possible a large part of the benefits came from the vegetables and not necessarily the fruit.

 

 

Vegetables have many of the same nutrients as fruit, and typically have less sugar.

 

It might therefore be better to think...

“veggies and fruit” versus “fruit and veggies”

 

 

 

 

4. Context – fruit and health conditions

General health and fruit

Published research overwhelmingly supports the consumption of fruit BUT also recommends eliminating or limiting fruit juices.

Blueberries, grapes and apples decreased risk of type 2 diabetes. Fruit juices increased risk.
BMJ. 2013 Aug 28;347:f5001. doi: 10.1136/bmj.f5001.
Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies.
Muraki I, Imamura F, Manson JE, Hu FB, Willett WC, van Dam RM, Sun Q.
http://www.bmj.com/press-releases/2013/08/29/researchers-find-link-between-blueberries-grapes-and-apples-and-reduced-ri
 

 

Diabetes and fruit

General recommendations:

1. •limit quantity of fruit to a few servings per day
   

2. •eat less starchy/sugary fruits and more berries
   

3. •eat more vegetables
   

Many studies show fruit to be beneficial or have no negative impact.

 

 

Vegetables and fruit decrease risk of Type 2 diabetes
Diabetes Care. 2012 Jun;35(6):1293-300. doi: 10.2337/dc11-2388. Epub 2012 Apr 3.
A prospective study of the association between quantity and variety of fruit and vegetable intake and incident type 2 diabetes.
http://care.diabetesjournals.org/content/31/7/1311.full
 

INTERESTING...

No reduced incidence of type 2 diabetes from fruit, vegetables, or fruit and vegetables combined. BUT did show green leafy vegetables decreased risk significantly!

BMJ. 2010; 341: c4229.
Published online 2010 August 18. doi:  10.1136/bmj.c4229
PMCID: PMC2924474
Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis
http://www.bmj.com/content/341/bmj.c4229

 

 

Intestinal bacterial overgrowth and fruit

(e.g.candidiasis)

The general consensus is to limit all fruit so as to not feed “bad” bacteria and fungus.

However for better long-term resolution it may be more beneficial to:

1. •include low small amounts of fruit – like berries
   

2. •eliminate starchy and sugary fruits
   

3. •avoid all fruit juices
   

 

Elimination of fruit juices required to address candida overgrowth
The Journal of Orthomolecular Medicine Vol. 14, 4th Quarter 1999
Candida Albicans: The Hidden Infection
James A. Jackson, Ph.D., BCLD; Hugh D. Riordan, M. D.;Ronald Hunninghake, M. D.; Chris Revard, BS(CLS)
http://orthomolecular.org/library/jom/1999/articles/1999-v14n04-p198.shtml

 

 

Weight loss and fruit

TWO approaches regarding fruit:

1. for moderate weight loss:

1. •a few servings of fruit per day
   

2. •avoid fruit juices
   

3. •eat lots of veggies
   

2. for accelerated weight loss:

1. •eliminate all fruit – which can prevent ketosis
   (ketosis = burning fat for energy instead of sugar)
   

2. •eat a variety of coloured, low-starch vegetables
   

3. •also, avoid all grains and starches
   

 

Cancer and fruit

 

TWO approaches regarding fruit:

1. use fruit (and vegetables):

1. •to support overal nutrient status, detoxification and cleansing – especially as fresh-squeezed juices
   

        
2. avoid fruit:

1. •avoid fruit (and all starches) to induce ketosis
   

Note:
– cancer cells starve without sugar
– body cells can survive without sugar
 

    
Vegetables and fruit show protective effect in certain cancers
Nutr Cancer. 1992;18(1):1-29.
Fruit, vegetables, and cancer prevention: a review of the epidemiological evidence.
Block G, Patterson B, Subar A.

http://www.ncbi.nlm.nih.gov/pubmed/1408943
 

 

Ketogenic diet effective against malignant brain cancer
Epilepsy Res. 2012 Jul;100(3):310-26. doi: 10.1016/j.eplepsyres.2011.06.017. Epub 2011 Aug 31.
Is the restricted ketogenic diet a viable alternative to the standard of care for managing malignant brain cancer?
Seyfried TN, Marsh J, Shelton LM, Huysentruyt LC, Mukherjee P.

http://www.ncbi.nlm.nih.gov/pubmed/21885251

 

 

 

Want to know more?
 

A good article discussing some of the problems with the fructose discussions:

 

Huffington Post Healthy Eating
Fructose, Fruit, and Frittering
David Katz, MD
Posted: 08/02/2013 3:12 pm

http://www.huffingtonpost.com/david-katz-md/fructose-fruit_b_3694684.html

 

 

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