Fruit, Fructose & Diabetes

I’m a big advocate of good, single ingredient eating as much as possible. Every good nutritional coach, book or article I’ve ever read on the matter agrees that eating real food is far more beneficial for you than anything processed. I’ve never been a fan of meal replacement shakes or anything similar – I don’t believe it provides the same nutritional qualities as actual food.

And it makes sense really? Surely something grown out of the ground, plucked from a tree or has flown, ran or swam is better for our health than something created from a test tube.

Fruit and vegetables is something that comes high up the basic healthy foods list. “Eating one of your five-a-day” is a common phrase when it comes to starting out eating a healthy and balanced diet and they’re easy to get, especially in these summer months! Fruit is a wonderful source of vitamins, mineral and antioxidants. However, many fruits are high in simple sugars – so as diabetics we need to keep an eye on how much we are eating!

To start with I thought it best to just explain what “sugar” actually is with a little bit of geeky science.

It’s a carbohydrate and it’s a mixture of carbon, hydrogen and oxygen and there are many different types of natural sugars. The simplest sugars are called “mono-saccharides” and these include Glucose (diabetics – we all know this one) and Fructose. Fructose comes in several different forms such as in fruit and honey.

Work is still being done to understand how the entire human body uses different forms of sugar. What we do know is that glucose and fructose are both absorbed directly from the intestines with Glucose being available immediately for the body to use and fructose undergoes a process by the liver where it is either converted into glucose, stored as glycogen or turned into fat (which over time can cause “fatty liver”).

As Fructose does not cause an immediate rush of glucose to the body, it can be used as a glucose replacement in certain aspects of the human diet such as sweeteners (including their use in fructose-sweetened drinks). However, recent research as indicated that over-consumption can lead to your body developing an over-developed appetite (which led to an increase in calorie intake) as well as decreased insulin sensitivity and an increase in fat storage around the belly area. The current information stands that it is best to avoid “high-fructose” based drinks or food.

(I love this little image – Credit to Kifydiabetes for it!) 

But does the same information apply to fruit in diabetes?

Well for starters, research done here in the UK has shown that a study of almost 6000 non-diabetics who consume a portion of fruit 5 of more times per week had a slightly lower HbA1c (5.33 against 5.43) which suggest that a good level of fruit consumption may protect against the onset of Type 2 diabetes – although it can also be suggested that eating fruit links with a healthy lifestyle. (1)

So what about those of us who are currently diabetic?

Well, a study involving a select group with a diet of low Glycaemic index (GI) fruits versus a high GI high fibre diet showed a reduction in HbA1c levels, an increase in healthy cholesterol and a reduction in blood pressure. (2)

Source: http://www.the-gi-diet.org/lowgifoods/
What we can deduce from all of this is that blood sugars can be controlled better depending on what type of fruit you’re eating. All different types of fruit have a wide mixture of vitamins and minerals which are crucial in blood glucose control as well as including antioxidant, anti-inflammatory and/or anti-cancer benefits.
So in summary, it seems logical that consuming a large amount of fructose-sweetened drinks will cause a high number of problems to our bodies. However, a diet rich of fruit (and vegetables) will always be recommended. But, like everything in our diets, moderation is key! It seems that the current level of understand is that it is beneficial to eat 2-3 portions of fresh, whole (and if possible) organic and low GI fruits per day.
If you’d like to read more about Diabetes & Fruit, Diabetes UK have a great section on the matter here!
 

(1) Sargeant LA, Khaw KT, Bingham S, et al. Fruit and vegetable intake and population glycosylated haemoglobin levels: the EPIC-Norfolk Study. Eur J Clin Nutr. May 2001;55(5):342-348. 

(2) Jenkins DJ, Srichaikul K, Kendall CW, et al. The relation of low glycaemic index fruit consumption to glycaemic control and risk factors for coronary heart disease in type 2 diabetes. Diabetologia. Feb 2011;54(2):271-279.

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Dan has been a Type 1 Diabetic for over 5 years and writes about his experiences with Type 1, nutrition, exercise and living an overall healthier life with diabetes on his blog and via his social media platforms.

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