Should Diabetics Eat Fruit?
This is a tricky question. On the one hand, most of the calories in fruit come from carbohydrates which of course is something diabetics have to watch very closely or their blood sugar may spike. Additionally, most fruits have a high glycemic index compared to low carb high protein foods. On the other hand, some fruits are extremely high in antioxidants, vitamins, minerals, and fiber if eaten in their unadulterated raw form. There is no question that fiber helps regulate blood sugar. Scientific studies are rapidly proving the powerful health benefits of antioxidants. These include antioxidants that help regulate insulin and help our cells become more sensitive to insulin, i.e. they help reverse diabetes. They also include antioxidants that help fight off health complications that diabetics are more susceptible to including heart disease, premature aging, stroke, and cancer. The pectin found in apples has been shown to improve glucose metabolism. Early studies show grapefruit can also lower blood sugar.
My take on this is that most diabetics should eat fruit BUT they should be very prudent about how they go about it. The primary purpose of this article is to give those with diabetes (and those who love them) practical information they can use to make wise decisions about which fruits they eat and how to eat them.
One important caveat: From a strict botanical perspective, some foods which we call "vegetables" are technically fruits but I am not including a discussion of these in this article. I do want to mention that many of these "vegetable fruits" are superstars in the diabetic diet. For example, a medium-sized peeled cucumber which is technically a fruit has only 3 net carbs and an extremely low glycemic load of 1 plus they are chock full of nutrients and fiber.
What Are the Best Fruits For Diabetics?
The best fruits for diabetics, taking all important factors into consideration, are berries. Relative to other fruits, berries are low carb and have a low glycemic index (20 - 45 GI, usually on the lower end of this). They are also exceptionally high in fiber and antioxidants. Within the most common berries consumed in the US, raspberries and blackberries have less carb and a lower glycemic index than blueberries but you can adjust your serving size to compensate for this. For example, a 100 gram serving (about 2/3 cup) of raspberries or blackberries has approximately 6 net carbs whereas the same volume of blueberries has 12 net carbs. So, if you're keeping your carbs super low you may want to reduce your serving size of blueberries to 1/3 - 1/2 cup.
Diabetics Should Favor Fruits That Are Relatively Low Carb, Have a Relatively Low Glycemic Number, and Are Relatively High In Fiber
Besides berries which I've identified as the #1 choice overall, a small serving of apples (12-26 g/fruit), citrus (8-22 g/fruit), and stone fruits (1-19 g/fruit) a few times a week can be part of a healthy diet for most diabetics. These fruits have a relatively low glycemic index and relatively low carb per fruit. Stone fruits are fruits that have a single large pit (the "stone") in the middle with a sweet fleshy outer layer around it. These include cherries (1 g/fruit), peaches (11-19 g/fruit), plums (7 g/fruit), apricots (3 g/fruit), and nectarines (12-13 g/fruit). For your easy reference, I've included the estimated range of net carbs in grams per fruit. If you're on a really low carb diet (less than 30 carbs per day usually) or you are gaining unwanted weight, you may have to really curtail fruits. It is interesting to note that stone fruits are all members of the genus Prunus which also includes almonds, a superstar in the diabetic diet, and that a peach pit looks a lot like an almond shell. The edible skins of fruits tend to be very high in fiber so be sure to eat your apple peels and that fuzzy peach skin!
Cantaloupe (aka ground melon), watermelon, and pineapple are examples of fruits that are very high in carb so you might want to eat them only occasionally.
Bananas Are Very Popular In the American Diet But...
Bananas are the most popular fruit in America, even surpassing apples and oranges. However, bananas have 17-31+ grams of carb and have an average glycemic index of 55 which can be much higher with a really ripe super sweet banana (the way I like 'em). If you really miss banana, I recommend eating them only 1-2 times a week and eating only half a banana as a single serving. Plus, you can pick out small bananas when you shop to lower the carb.
Diabetics Should Avoid Fruit Juice and Dried Fruit
Even if you drink the unsweetened kind, fruit juice contains little to no fiber and is very high in sugar with a high glycemic index. Because of this, even a small amount of juice can play haywire with your blood sugar levels. Plus, when you drink juice, you miss out on many nutrients you'd have in the actual whole fruit. Dried fruit highly concentrates the sugar and should therefore definitely be avoided by diabetics.
Eat Fruit With Other Foods
This is a very important point so pay close attention. When diabetics eat foods that are higher in carbs and have a higher glycemic index such as fruits, they should always try to eat some protein and healthy fat along with it. The protein and fat balances out the effect of the carbohydrates in the fruit and you will get less of a spike in your blood sugar. A really good combination seems to be eating fruit with nuts. You can also combine eating fruit with some low carb yogurt, cottage cheese, hard cheese, or eat your fruit as part of a full meal. I love eating a small bit of fruit as a dessert. Use common sense though. If your meal already has a significant number of other carbs (like grains), you may want to skip the fruit.
Try To Eat Fruit Earlier In the Day
It seems that for most diabetics fruit has less effect on their blood sugar levels if they eat it earlier in the day. So, try to eat your fruit as part of your breakfast or lunch. This is especially true if you are experiencing the "dawn phenomenon" where your early morning blood sugar readings are much higher than they were when you went to bed. In this case, you should definitely avoid eating fruit at night and see if that makes a difference.
Pay Attention To Your Whole Diet and Keep It In Balanced
Let's say you go on a beautiful summer picnic and you splurge on some very sweet watermelon (yum!). To compensate, you may want to watch your carbs more carefully for the rest of the day and maybe eat a lower carb dinner. If you just have to have a banana with your breakfast (I suggest eating half of a small banana), try to eat a lower carb lunch and limit your other carbs at breakfast.
Pay Very Careful Attention To Serving Size
The phrase "eat in moderation" takes on new meaning for the diabetic. Food is medicine for the diabetic and can even reverse diabetes if you know what to eat and stick to it but it can also exacerbate the disease if you eat the wrong foods. When it comes to eating carbohydrates, no matter how healthy food item is, serving size is the most important factor. Yes, fruits are healthy in many ways but if you are diabetic, it is crucial you do not over-indulge in fruit. Doing so bcould result in a huge spike in your blood sugar, and worse, if you over-indulge too often you could make your cells less receptive to insulin.
I know the natural tendency of most Americans is to pick out larger sized fruit, which is why cultivators select for it. However, a simple trick for diabetics who want to limit their carbs is to pick out smaller fruit. It is generally just as tasty as the bigger fruit. Let me give you a few examples to illustrate the carbs you can save by doing so. A six inch banana has 17 net carbs whereas a nine inch banana has 31 net carbs. That's a 14 carb difference! That's very significant. Even if you eat just half a banana, that's still a 7 carb difference. Try to pick out small bananas. A small tangerine is only 9 net carbs (clementines are only 8 net carbs) whereas a large tangerine is 14 net carbs. You may even want to pick tangerines over oranges because even a small orange is 16 net carbs which is more than the largest tangerine. If you really want to limit your carbs, you may want to pick apricots and plums (3 and 7 net carbs respectively) over peaches and nectarines (11-19 net carbs). It's hard to resist eating the entire peach and it's awfully messy to slice and leave half (but possible). With cherries, you can simply count out the number of cherries by the number of carbs you can afford since they are 1 net carb per cherry. How convenient of them (smile).
Be Careful, You May Be Eating More Carbs Than You Think
I think many diabetics and low carb dieters grossly underestimate the net carbs in the fruit they eat. There are many reasons for this.
It is easy to be fooled when you look up the nutritional values of fruit. The value you get is probably an average value. The average may not be as big or as ripe as the fruit you are actually eating. The tests may have been conducted with a different species or variety that is more or less sweet or has more or less fiber than the fruit you are actually eating. There is a lot of variation between varieties in fruit and it can make a HUGE difference in the actual nutritional values. Even if you are comparing the exact same variety/species, your fruit may have been grown in a different soil type. Bottom line, you need to take the nutrition values you find for fruit with a grain of salt and be very aware that the values can vary greatly - much more so than with other types of foods like meat and dairy.
Cultivators and food science geeks play with genetics of fruits in an effort to make us, the sugarophilic super size that please consumers that we are, happy. I've read that the sugar content in cantaloupe doubled between 1950 and 1999. The values for fruit in the USDA Food Database were recently updated because they were so underestimated because fruits have gotten so much bigger and sweeter.
When you pick out fruit, don't you tend to pick out the ripest, sweetest, most tantalizing fruit you can find? I know I do. In general, as a fruit ripens its carb quantity goes up, especially if it ripens before it is picked. Have you ever heard anyone say, "That fruit was as sweet as candy?"
Know Your Own Body
There seems to be more variability in how diabetics respond to fruit than just about any other food type. For some diabetics, eating a whole apple seems to be just fine while with others eating just half an apple can send their blood sugar soaring through the roof. For this reason, you need to do some very careful testing to see how your body responds to fruit so you will know what quantities and which fruits you can eat without causing ill effects. You'll want to keep the testing as simple as possible. Measure out a certain quantity of fruit, perhaps a half cup or whole cup of a fruit you'd like to eat, and test your blood sugar just before you eat it and then again 1.5 hours after you eat it. Compare these readings to what happens when you eat a low carb high protein snack at the same time of day under as many of the same conditions as possible. You can try increasing or decreasing the amount the next day depending on the initial result and you can try other favorite fruits. Keep in mind that many other factors such as other foods you eat around the same time, how much exercise you've recently gotten, how much sleep you had the night before, how stressed you are, what you do in that 1.5 hours between tests, etc, etc can all affect the results so you'll want to test more than once to see how consistent your results are. If your blood sugar does spike after eating a reasonable portion of fruit, I encourage you to re-test in a month or two if you adhere to a good and consistent low carb diabetic diet and make other healthy lifestyle changes during that time such as getting more exercise, sleeping more, and lowering stress. Once the body has had time to heal itself, i.e. once you've had time to reverse your diabetes, you will likely be less insulin resistant (this is what happened to me) and your body may be able to handle reasonable portions of fruit (and a few other carbs) without the spikes in blood sugar.
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