What Fruits Should Diabetics Avoid?
Fruits often get a bad reputation in the world of diabetes, and many believe they are completely off-limits. While fruits are a source of carbohydrates -- the nutrient responsible for affecting blood sugar -- their carbs are from natural sugar and can be incorporated into a healthy meal plan. However, like all carbohydrates, they should be consumed strategically for the person with diabetes. Some fruits will affect blood sugar more than others, because of their higher glycemic index.
Fiber, Vitamins, Minerals and Antioxidants
Both the American Diabetes Association and the Academy of Nutrition and Dietetics recommend that people with diabetes consume a varied diet with foods from all food groups, including fruit 134. Most fruits are a good source of fiber, which actually helps control blood sugar and is necessary for digestive health. The fiber in fruit may even help lower cholesterol, high levels of which tend to go hand in hand with diabetes. Additionally, fruits contain many vitamins, minerals and antioxidants necessary for good general health and disease prevention.
- Both the American Diabetes Association and the Academy of Nutrition and Dietetics recommend that people with diabetes consume a varied diet with foods from all food groups, including fruit 1.
- Most fruits are a good source of fiber, which actually helps control blood sugar and is necessary for digestive health.
Glycemic Index and Fruit
The Glycemic Index for Fruits
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While there is little dispute regarding the benefits of fruit in a healthy diet, many find that fruits with a higher glycemic index raise blood sugars more. The glycemic index, or GI, is a numerical system that measures a food's effect on blood sugar compared to pure glucose, of which the reference point is 100. Foods with a value of 55 or less are considered low GI; those with a value of 56 to 69 are medium; and 70 or more are high. High GI fruits include melons, pineapple and very ripe bananas, while the vast majority fall into the low and medium categories. Juices have a higher GI because of liquid's ability to be a absorbed more rapidly into the bloodstream and their lack of fiber.
- While there is little dispute regarding the benefits of fruit in a healthy diet, many find that fruits with a higher glycemic index raise blood sugars more.
Portion Sizes Still Matter
Although the GI may be a helpful tool in meal planning, most experts still agree that the quantity of carbohydrate is equally, if not more, important than type. For example, a person may choose an apple over a banana for its low GI. However, in today's world of mega portions, a large apple can easily account for three or four servings of carbohydrate. A serving of carbohydrate, fruit or otherwise, is equal to 15 grams. For a whole fruit, like an apple or peach, this is about the size of a tennis ball. For frozen or canned fruit in water, the serving is ½ cup. Other common serving sizes are ¾ to 1 cup for berries or melon, 2 tablespoons for dried fruit, and 1/3 to ½ cup for 100 percent fruit juice.
- Although the GI may be a helpful tool in meal planning, most experts still agree that the quantity of carbohydrate is equally, if not more, important than type.
- However, in today's world of mega portions, a large apple can easily account for three or four servings of carbohydrate.
The Bottom Line
Blood Sugar & Honeydew
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The American Diabetes Association recommends using the GI as a method of "fine-tuning" a meal plan after understanding the basics of carbohydrate counting, because many other factors affect the glycemic effect of a particular fruit 14. For instance, eating a fruit alone as a snack will raise blood sugar more quickly than if eaten in the context of a protein-rich meal. However, as a general rule, choosing low and medium GI fruits while limiting juices and high GI fruits can help manage blood sugar levels for many diabetics.
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References
- American Diabetes Association: Glycemic Index and Diabetes
- Harvard Health Publications: Glycemic Index and Glycemic Load for 100+ Foods
- Academy of Nutrition and Dietetics: Eating Right with Diabetes
- American Diabetes Association: Making Healthy Food Choices
- American Diabetes Association. Glycemic index and diabetes.
- Rizkalla SW. Health implications of fructose consumption: A review of recent data. Nutr Metab (Lond). 2010;7:82. doi:10.1186/1743-7075-7-82
- Du H, Li L, Bennett D, et al. Fresh fruit consumption in relation to incident diabetes and diabetic vascular complications: A 7-y prospective study of 0.5 million Chinese adults. PLoS Med. 2017;14(4):e1002279. doi:10.1371/journal.pmed.1002279
- Wannamethee SG, Whincup PH, Thomas MC, Sattar N. 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. 2009 Oct 1;32(10):1823-5. doi:10.2337/dc09-0477
- Silva FM, Kramer CK, de Almeida JC, Steemburgo T, Gross JL, Azevedo MJ. Fiber intake and glycemic control in patients with type 2 diabetes mellitus: a systematic review with meta-analysis of randomized controlled trials. Nutr Rev. 2013;71(12):790-801. doi:10.1111/nure.12076
- Wang PY, Fang JC, Gao ZH, Zhang C, Xie SY. Higher intake of fruits, vegetables or their fiber reduces the risk of type 2 diabetes: A meta‐analysis. Journal of Diabetes Investigation. 2016 Jan;7(1):56-69. doi:10.1111/jdi.12376
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- Harvard Health Publishing. Use glycemic index to help control blood sugar. Updated Aug. 13, 2012.
- Koloverou E, Panagiotakos DB. Macronutrient composition and management of non-insulin-dependent diabetes mellitus (NIDDM): A new paradigm for individualized nutritional therapy in diabetes patients. Rev Diabet Stud. 2016;13(1):6-16. doi:10.1900/RDS.2016.13.6
- Hosseini B, Berthon BS, Saedisomeolia A, Starkey MR, Collison A, Wark PA, Wood LG. Effects of fruit and vegetable consumption on inflammatory biomarkers and immune cell populations: a systematic literature review and meta-analysis. The American Journal of Clinical Nutrition. 2018 Jul 1;108(1):136-55. doi:10.1093/ajcn/nqy082
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- Centers for Disease Control and Prevention. Carb Choices. Updated March 21, 2019.
- American Diabetes Association. Glycemic index and diabetes.
- Wang PY, Fang JC, Gao ZH, Zhang C, Xie SY. Higher intake of fruits, vegetables or their fiber reduces the risk of type 2 diabetes: A meta‐analysis. Journal of Diabetes Investigation. 2016 Jan;7(1):56-69. doi:10.1111/jdi.12376
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Writer Bio
Heather Muñoz is a Registered Dietitian who obtained her bachelor's and master's degrees in nutrition and dietetics. She has worked at a world-renowned hospital as a Clinical Dietitian, and has experience in a variety of domains including weight loss (surgical and non-surgical), general health/wellness, diabetes, oncology, geriatrics, organ transplant and more. She currently maintains a nutrition/food blog.