Yes, they can!
It’s a shame that this question needs an answer. Luckily, an evidence-based answer exists.
I have the privilege of dispelling myths about nutrition. Sometimes addressing these myths feels like a full-time job. “Fake news” isn’t limited to the world of politics. It’s also running rampant in the world of nutrition. I hate to say it, but the lack of physicians with training in nutrition contributes to the problem. Further, the average person’s lack of access to qualified dietitians also isn’t helping anything.
As a gastroenterologist who specializes in nutrition, people with diabetes frequently ask me about what they can eat. I’ve noticed avoiding fruit is a recurrent topic during these discussions.
Somehow, the belief that fruit is diabetic kryptonite has been trending for years. The last time someone asked me about a diabetic diet, they proudly told me they hadn’t had fruit in 10 years. They even reached out an enclosed fist for a fist bump of approval. At that moment, I had a ‘physician dilemma.’ Should I shatter his preconceived notions of what constitutes a healthy diet? Or, should I just have just given him a fist bump and glibly went about my business.
Well, my grandmothers always told me to ‘tell the truth and shame and devil.’ Hence, I passed up the fist bump and gave him an apple and some knowledge instead. I told him it’s definitely safe for him to eat fruit even with diabetes. In this post, I break down the 5 reasons why folks with diabetes can eat fruit.
1. The medical guidelines for diabetes encourage a diet that contains fruits.
Carbohydrate intake from vegetables, fruits, legumes, whole grains, and dairy products, with an emphasis on foods higher in fiber and lower in glycemic load, is preferred over other sources, especially those containing added sugars.
The guidelines don’t suggest a specific amount of carbs that a person with diabetes should eat. However, they emphasize that people with diabetes benefit from an overall healthy pattern of eating such as the Mediterranean diet or plant-based diets. Each of these patterns of eating includes fruit.
2. Many fruits have a low glycemic index
Glycemic index is a marker of how foods raise one’s blood glucose after ingestion. Foods that have a high glycemic significantly increase blood sugar levels. Low glycemic foods have a smaller impact on blood glucose levels. Despite the naturally occurring sugars within fruits, may fruits have a low glycemic index.
Low GI Foods (55 or less)
- 100% stone-ground whole wheat or pumpernickel bread
- Oatmeal (rolled or steel-cut), oat bran, muesli
- Pasta, converted rice, barley, bulgar
- Sweet potato, corn, yam, lima/butter beans, peas, legumes, and lentils
- Most fruits, non-starchy vegetables and carrots
Medium GI (56-69)
- Whole wheat, rye, and pita bread
- Quick oats
- Brown, wild or basmati rice, couscous
High GI (70 or more)
- White bread or bagel
- Corn flakes, puffed rice, bran flakes, instant oatmeal
- Short grain white rice, rice pasta, macaroni and cheese from mix
- Russet potato, pumpkin
- Pretzels, rice cakes, popcorn, saltine crackers
- melons and pineapple
3. Eating fruits may decrease the risk of developing diabetes.
A study published in 2014 demonstrated that eating fruit may lower the risk of developing diabetes. The researchers behind the study analyzed a combination of studies that included over 400,000 participants. They sought to understand whether or not consuming fruit decreases the risk of diabetes. The researchers found that each serving of fruits per day may lower the risk of diabetes by 6%.
4. Eating fruit may decrease the risk of cardiovascular complications from diabetes
Most people with diabetes are concerned that eating fruit will worsen their blood glucose control and put them at risk for complications associated with diabetes. A recent study out of China suggests that fruit consumption may do the exact opposite. In the study, researchers had almost 500,000 people fill out questionnaires assessing their dietary habits.
- In those individuals who already had diabetes prior to the start of the study, consuming fresh fruit more than three days a week was associated with a 17% lower relative risk of dying from any cause and a 13%–28% lower risk of developing diabetes-related complications affecting large blood vessels (e.g., ischaemic heart disease and stroke) and small blood vessels (i.e., kidney diseases, eye diseases, and neuropathy) than those who consumed fruit less than one day per week.
5. Some foods increase the risk of developing diabetes—fruits aren’t one of them.
Obviously, processed foods with a lot of sugar aren’t good for people with diabetes. Honestly, they aren’t good for anyone (check out my post on sugar).
Sugar isn’t the only food should worry people with diabetes.
In 2013, a study in JAMA showed that red meat should be the radar of anyone with diabetes. The study revealed that “increasing red meat intake of >0.5 serving/d was associated with a 48% elevated risk [of developing diabetes].”
Similarly, another study demonstrated that eating too many potato-based foods may contribute to the risk of developing diabetes. The study revealed that each increment of 3 servings of potatoes per week might increase the risk of developing diabetes in 4 years by 4%.
What’s the bottom line?
- Diabetics should consume some fruit as part of a varied diet.
- Don’t overdo it. Eating 10 pineapples every day is probably not going to bring down your hemoglobin A1C.
- Likewise, you are probably not doing yourself any favors by avoiding fruit like the plague.
- Most fruits have a low glycemic index.
- Be careful with fruits with a high glycemic index like melons and pineapples.
- Focus on reducing foods associated with developing diabetes—sugary beverages, red meat, potatoes, etc.
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I am a physician and trained chef. I specialize in gastroenterology and nutrition. Currently I work as the Associate Director of Adult Nutrition at the University of Chicago.