What You Need to Know About Fruit in the Diabetes Diet

What You Need to Know About Fruit in the Diabetes Diet

The place of fruit in the diabetes diet has been exhaustively studied, but is still a subject of lively debate. No one seriously questions that antioxidant and fiber content in fruit benefits individuals with diabetes (not to mention everyone else). However, fruit also contains the simple sugar fructose, which can cause an unhealthy insulin response and complicate diabetes management. As you might expect, not all fruits are created equal, balance is all, and the devil is in the details.

Tell me about fruit — the good, the bad, and the ugly.

  • The good — Fruits contain fiber. A medium raw apple has only 70 calories but 4.0 grams of fiber. Fruits also contain antioxidants and other phytonutrients. That same medium apple is a source of hundreds of phytochemicals, including 10 mg of quercetin, which benefits cardiorespiratory health and normalizes blood pressure.
  • The bad — Fruits are rich in simple sugars, which complicate regulation of blood glucose, a particularly dangerous problem for diabetics. Some researchers have suggested that high-fructose foods pose an additional risk by increasing uric acid and suggest sharply limiting fruit intake to avoid complications.
  • The ugly — Hybridization has resulted in fruits that are much sweeter than their forerunners several generations ago, in an attempt to appeal to the palates of consumers who’ve grown used to sugar-laden snacks and artificial sweeteners. Many people are getting their fruit servings as pre-sweetened juices with added high-fructose corn syrup, essentially ruining a good thing.

What do the experts say about fruit for the diabetes diet?

There is no firm consensus among researchers. For those who count carbohydrates, it is commonly recommended to limit serving size to 15 grams of carbs or less. For fresh berries or melons, that means eating about ¾ to 1 cup per serving, but when eating fruit with higher fructose content, ½-cup servings are more appropriate. Sugar-packed dried fruit servings should typically be two tablespoons or less. 

If you use the glycemic load of carbohydrates to guide your dietary selections, you must be attentive not only to portion size but also GI values of choices. However, the matter is not that simple, according to a 2013 Harvard School of Public Health (HSPH) study. The study concluded that irrespective of GI, apples, grapes, and blueberries are particularly beneficial to individuals who are pre-diabetic or have type 2 diabetes. HSPH researchers hypothesized that anthocyanins in grapes and blueberries, and quercetin in apples, may have been adequate to override any problems created by the fruits’ higher fructose content.

The HSPH study found that eating at least two servings of apples, blueberries, or grapes each week reduced type 2 diabetes risk over 20% more than eating less than one serving per month. On the other hand, drinking a ½ cup or more of fruit juice daily increased risk more than 20%.

The same study concluded that eating whole fruits in moderation benefitted health when compared to avoiding them altogether. The message seems clear: eat small servings, monitor blood sugar response, and avoid fruit juices altogether. Think of it as a sweet reward when you’re battling a difficult disease!