Eating Fruit When You Have Diabetes

Fruit is not forbidden but some choices are better than others

If you have diabetes, chances are someone has mentioned you should avoid eating fruit. In truth: Whole, fresh fruit is packed full of fiber, vitamins, minerals, and antioxidants, making fruits a nutrient-dense food group that can certainly be part of a healthy diabetes treatment plan.

People with diabetes should be cautious, however, as certain fruit choices may affect blood sugar levels more than others. It's important to learn which fruits affect you the most, plus how to make smart decisions about which fruits you consume, and understand proper portion sizes.

All About Fructose

The sugar found in fruit is called fructose, which is metabolized quickly by the liver. In the process of its breakdown, fructose is capable of bypassing a rate-limiting enzyme (a single step which limits the rate of the entire sequence) that signals when cells have had too much sugar.

Skipping past this limiting step is the danger in consuming a lot of fructose at once (such as when drinking beverages sweetened with high-fructose corn syrup, for example) , but this is less likely when you're consuming whole, fresh fruit. Several studies have shown that fresh fruit consumption is not associated with a significant negative impact on blood sugar control.

Fresh fruit is full of fiber, minerals, and antioxidants, which may all work together to support healthy glucose regulation. One large study discovered that people with diabetes who consumed fresh fruit at least three days per week had a lower risk of death and vascular complications than those who rarely or didn't consume fresh fruit.

But depending on the respective fiber and fructose levels, certain fruits may cause your blood sugars to rise at a quicker pace than others.

The tricky part of measuring a blood sugar response is that everyone responds to food differently. While one person may be able to eat bananas without any issue, another may find that bananas cause their blood sugar to jump.

Testing your blood sugar before and after eating fruit can help you to determine which fruits are best for you.

Fiber

The fiber found in fruit, both soluble and insoluble, can help prevent blood sugar spikes by slowing down the metabolism process, may aid in pulling cholesterol away from your heart, and increase feelings of fullness, resulting in less food intake.

The fiber content may change depending on the state of the fruit itself—factors such as freshness and how it is prepared (steamed, baked, etc.) can all affect this. Fresh, whole fruit has the most fiber because the cell walls are intact. Cooking breaks down the fiber structures in the fruit and while this can make the body's metabolism job easier‚ it also means the sugars are more readily available for absorption.

A large review study found that high-fiber diets (including fiber from supplements and/or food) can reduce hemoglobin A1C levels by 0.55% and fasting plasma glucose levels by 9.97 mg/dL, improving blood sugar control.

Your best bet is to look for fruits with edible peels, such as apples, pears, and berries, and to limit those that need to be peeled, such as bananas and melons.

Antioxidants

Fruits of darker hues—such as deep reds, purples, blues—are typically rich in antioxidants. Antioxidants are plant-based compounds that work to fight free radicals in the body, helping the body repair from all types of stress.

These pigments are courtesy of a compound called anthocyanin, which research suggests may help fend off chronic diseases like cardiovascular disease. The more colorful your food, the more antioxidants it likely boasts. Skipping out on fruit altogether means you'd be missing out on these plant powerhouses.

Types of Fruit to Limit

There are a few forms of fruit that should only be consumed in limited amounts if you have diabetes. Dried fruits, fruit juices, and fruits that may be high in sugar and low in fiber should generally be limited or avoided.

Dried Fruit

Dried fruit, while delicious in trail mix and on salads, is a super-concentrated form of whole fruit that goes through a drying process, which results in a food that it's higher in carbohydrates per serving than fresh, whole fruit. Dried fruits may also contain added sugar and could be lower in fiber if the peels have been removed.

Just one ounce of raisins (two tablespoons) contains 100 calories, 23 grams of carbs, and 18 grams sugar. This yields almost 5 teaspoons of sugar. In contrast, one cup of fresh grapes contains 62 calories, 16 grams of carbs and 15 grams of sugar.

Juice

Even juices made from 100% fruit juices can cause glucose spikes. The body doesn't have to do a great deal of work to break down the sugar in juice, thanks to the removal of nearly all fiber. Juice, therefore, is metabolized quickly and raises blood sugar within minutes.

Juice can also tack on extra calories without affecting your satiety and therefore can work against weight loss efforts and can even promote weight gain.

Researchers in one study found that consumption of whole fruits such as blueberries, grapes, and apples was associated with a reduced risk of type 2 diabetes, whereas consumption of fruit juice was associated with a higher risk of type 2 diabetes.

Instead, try cutting fruit juice with water to reduce the amount you're drinking, opt for a green juice made from vegetables, or swap fruit juice entirely for whole fruit—fresh or frozen—wherever you can to reap the big benefits of fiber and nutrients.

High-Glycemic Fruit

The glycemic index (GI) is a ranked list of how certain foods will affect your blood sugar. The glycemic index can vary based on several factors, such as how much of a fruit you're eating, and how that fruit is prepared, but it can be helpful when meal planning with diabetes. It's important to know that the riper a fruit is, the higher its glycemic index, which means that fruit will raise your blood sugar more than a food with a low glycemic index.

Though the glycemic index is not a perfect system, people with diabetes should reference it when selecting fruit to eat, as the higher the GI index, the more likely your choice will interfere with your glycemic (blood sugar) control.

Foods high on the glycemic index are ranked at 56 and above.

  • Pineapple (GI = 56)
  • Banana (GI = 58)
  • Watermelon (GI = 72)

Low-Glycemic fruit

Foods considered to have a low GI value are ranked at 55 and below.

Types of Fruit to Include

There's no "good" or "bad" fruits (or foods, for that matter), but if you're looking to get the most nutritional value, set your sights on fruits that are very high in fiber. For example, you can eat 1 1/4 cup of strawberries for 60 calories, 15 grams carbs, 3.5 grams fiber, and 7.5 grams sugar, or only 1/2 medium banana which is 60 calories, 15 grams carbs, 2 grams fiber, and 8 grams sugar.

Consuming more fruit may also improve inflammation, a major issue in chronic diseases such as type 2 diabetes. A higher intake of fruit and vegetables results in reduced inflammatory markers and an improved immune cell profile, according to one review which examined 83 separate studies.

It's also important to choose a wide variety of fruit—one study found that a greater variety in fruit, vegetables, and combined fruit and vegetables was associated with a lower risk of type 2 diabetes.

Berries, such as strawberries, blueberries, and blackberries, may provide particularly valuable health benefits for people with diabetes and other metabolic conditions. Berries are rich in vitamin C, folic acid, fiber, and anti-inflammatory phytochemicals, and studies have shown that a diet rich in berries is associated with a decreased risk of type 2 diabetes, as berries may help with both glucose metabolism and body weight regulation.

Additionally, citrus fruit such as oranges, grapefruit, lemons, and limes contain a high amount of vitamin C along with vitamin A and potassium. The phytonutrients found in citrus have been shown to reduce inflammation, reduce cell damage, and protect against cardiovascular disease as well.

Keep an Eye on Portions

When choosing fruit, try to stick with one fruit serving per meal or snack.

Keep in mind that one serving of fruit equals about 15 grams of carbohydrates. How much of each fruit you can eat within that one-serving limit will depend on the type of fruit. Here's a list of what is considered one serving for common whole fruits: 

  • 1 small piece (4 ounces) apple, orange, peach, pear, or plum 
  • 1/2 medium banana
  • 2 small or 1 large tangerine (4 ounces total)
  • 2 small (2 ounces each) kiwi 
  • 4 small (1 ounce each) apricots
  • ~1 cup of melon (cantaloupe, watermelon, or honeydew)
  • 17 small grapes or cherries 
  • 1/3 medium mango
  • 1 1/4 cup strawberries
  • 3/4 cup blueberries
  • 1 cup raspberries or blackberries

You'll have a better chance at controlling your blood sugar if you avoid dried fruit and juice, and pair your fruit with a protein and/or fat, like topping cottage cheese with pineapple, adding berries to a protein smoothie, or dipping apple slices into nut butter or tahini.

A Word From Verywell

If you're following a diabetes-friendly meal plan, there's no real reason why you should avoid fruit altogether. Rich in vitamins, minerals, and fiber, fresh fruit can be a powerhouse of nutrition, as long as you keep portions in check. Make sure to work with a dietitian or nutritionist to determine what a smart intake of fruit looks like for you.

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