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Why people with type 2 diabetes should still eat fruit

We know that excessive fructose, which is in every food that lists ‘sugar’ as an ingredient, can harm our bodies—but what about fruit? If you have type 2 diabetes it’s important to understand how the fructose in fruit affects your blood sugar levels so that you can make the right choices when you’re eating and find balance in your day-to-day life.
Annabel Nicholson
5/18/2022
10
min read
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Quick summary

  • The naturally-occurring fructose in fruit is very different to the refined fructose that’s added to foods like fizzy drinks and fast food
  • There’s no reason why people with type 2 diabetes should cut out fruit, it just needs to be enjoyed in moderation
  • The antioxidants, vitamins, minerals, and fibre in fruit are essential for overall health
  • It’s best to eat the whole fruit rather than drinking fruit juice
  • A portion of fresh, dried, or tinned fruit should fit in the palm of your hand

Keeping your blood glucose levels stable is an essential part of managing type 2 diabetes and can be achieved with a range of techniques, including exercise and medication. Diet is a major component of controlling blood glucose levels, but there’s no one way to eat if you have type 2 diabetes. Instead, you will want to find an approach that suits you and includes foods you like to eat. 

Banning entire food groups is dangerous, and takes away the pleasure of cooking, eating, and sharing the joy of food with others. Instead, finding balance—and things you love to eat—can help a type 2 diabetes treatment plan stick for the long term. Knowing what kinds of sugars are in your food and how they affect your condition is an excellent starting point. 

We know that excessive fructose, which is in every food that lists ‘sugar’ as an ingredient, can harm our bodies—but what about fruit? Is the fructose in grapes, for example, worse for you than the fructose in a chocolate bar studded with raisins? And are there any kinds of fructose in fruit that are harmful to people with type 2 diabetes?

We’ll be digging into the finer points of what happens to your body when you eat fruit, which fruits are best for people with type 2 diabetes, and how you can fit fruit into your day-to-day life. Because—spoiler alert!—there’s absolutely no reason why you should cut out fruit if you have type 2 diabetes. Nature’s sweet treats are packed with nutritional value and are to be enjoyed, like all things, in moderation. Arming yourself with information about how fruit affects your blood sugar levels and which fruits are best for you will help pave the way for a (genuinely delicious!) diet plan that works just for you. 

Naturally occurring fructose is very different to added, processed fructose, which is converted into fat in the liver

Harvard Health Publishing

What kind of sugars do fruits contain?

Fruit contains two types of sugars: glucose and fructose. Each type will vary, but typically, fruit contains equal amounts of glucose and fructose. However—and it’s a big however—the naturally occurring fructose in fruit is very different to refined and added fructose in foods like fizzy drinks, sweetened yoghurt, baked goods, and fast food. Our bodies metabolise highly processed fructose much more quickly, and if consumed in large amounts, heads to the liver where it is converted into fat.[1]

So what happens to your body when you eat fruit?

The body deals differently with fruits and the naturally occurring fructose they contain. When you eat fruit, it takes a while for the chains of sugar to be broken down by your digestive system and enter your bloodstream, meaning they rarely cause sudden blood sugar spikes. Most fruits have a low to medium glycaemic index, so they don’t raise your blood sugar levels anywhere near as quickly as other foods containing carbohydrates, like white bread or biscuits. A gentle rise in blood sugar is followed by a steady decrease. Eating too much fruit in one sitting could elevate your blood sugar too much, which comes with its own set of risks. It’s worth noting here that everyone responds to food differently, so you could try measuring your blood sugar levels before and after eating certain types of fruit to find out how your body reacts.

The benefits of being a fruit fan

Fruit is good for everyone, especially people with type 2 diabetes. One study found that people with diabetes who ate fresh fruit 3 days per week had a lower risk of vascular complications, including stroke.[2] Here are even more reasons to stock up:

🍇 You get an almost instant hit of antioxidants

Antioxidants are magical natural molecules that work like mops in the body to clean up free radicals, which lead to disease development and advanced ageing. Fruit is packed with these immune-boosting, cancer-busting, anti-ageing little gems. The general rule of thumb is the darker coloured the fruit (think red, purple, and blue), the more antioxidants it contains. As each type of fruit contains different antioxidants, try eating a variety throughout the week to get a decent hit of all kinds. 

🍊 It provides you with a tasty dose of vitamins

We’d be here for days if we tried to list all the vitamins and minerals in fruit, but it’s safe to say they’re full of folate, vitamin C, and potassium. These are essential for your body's functions and metabolic processes, and can help boost overall health.

🍌 It’s packed with fibre, which can help prevent blood sugar spikes

Fibre (sometimes known as roughage) is the part of plant-based foods that can’t be fully broken down by your digestive system. It helps nourish good gut bacteria and keep your digestive systems regular. Constipated? High-fibre foods should help you along. It’s especially beneficial for people with type 2 diabetes because it slows down digestion which prevents blood sugar spikes. Studies have also found that it may also help pull cholesterol away from the heart and increase feelings of fullness, so you’re less likely to reach for the snacks between meals.[3] 

An easy way to get as much fibre as possible? Save yourself the effort of peeling and eat the fruit skin! Berries, apples, pears, and even kiwis all have tasty peels. Cooking and juicing fruit, or making smoothies with it breaks down the fibre structures, which makes digestion easier, but means sugars are more ready for absorption and can rapidly increase blood sugar levels.

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Which fruits are best for people with type 2 diabetes?

In short, whole fresh fruits are the best way to eat these naturally sweet treats— they’re unrefined and therefore much better for you. Interestingly, eating whole fruits like blueberries, grapes, and apples has been associated with a lower risk of type 2 diabetes, while drinking fruit juice is associated with a higher risk.[4] If you’re looking to cut down on your sugar intake, try swapping dessert or sugary snacks with whole fruits. 

Drinking fruit juice has been associated with a higher risk of type 2 diabetes

Muraki et al., BMJ

What fruit needs eating in moderation?

Dried fruit is made by taking the water out of it, meaning you get a much more concentrated hit of fructose. They’re definitely not to be avoided, but keep an eye on how much you’re eating—the recommended portion is one tablespoon. Tinned fruit is a good addition to your pantry, although the ones tinned in natural juice are better than those in syrup. Packaged juices and smoothies might sound healthy but they contain a lower amount of healthy nutrients and a much higher dose of (not always natural) sugar, meaning your blood sugar levels will rocket, so moderation with these is key.

How to reach your five-a-day

A portion of fruit should fit in the palm of your hand. Spread your intake throughout the day so as to avoid a big blood sugar increase. Here’s a few easy ways to incorporate fruit into your week:

  1. Reduce the amount of cereal you have in the morning and add a banana into the mix (or try topping peanut butter on toast with slices of banana!)
  2. Enjoy a fruit salad and natural yoghurt after lunch
  3. Snack on frozen berries, whole fruit, and small amounts of dried fruit if you get peckish between meals
  4. Satisfy the post-dinner sugar craving with a few chocolate-covered strawberries

As well as being delicious and helping to reduce your overall sugar intake, fruit is packed with life-prolonging vitamins and minerals. Once you know the basics of portion control, and the importance of variety, eating fruit really is a no-brainer.

References

[1] Abundance of fructose not good for the liver. Harvard Health Publishing. Retrieved 31 March 2022. Accessible here.

[2] Du H., Li L, Bennett D, Guo Y, Turnbull I, et al. (2017). Fresh fruit consumption in relation to incident diabetes and diabetic vascular complications: A 7-y prospective study of 0.5 million Chinese adults. PLOS Medicine 14(4): e1002279. Accessible here

[3] Goya Wannamethee, S., Whincup, P.H., Thomas, M.C., et al. (2009). Associations Between Dietary Fiber and Inflammation, Hepatic Function, and Risk of Type 2 Diabetes in Older Men: Potential mechanisms for the benefits of fiber on diabetes risk. Diabetes Care 32(10):1823–1825. Accessible here

[4] Muraki I., Imamura F., Manson J. E., et al. (2013). Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ 347(5001) Accessible here.

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