Good news for fruit lovers everywhere: eating fresh fruit is associated with a lower risk of diabetes and a lower risk of complications if you already have the disease, according to a new study published in PLOS Medicine.
Featured recipe: Fresh Fruit Salad
If you've been steering clear of fruit because of the sugar content, there's no reason to do so, according to this study. Over a seven-year time period, researchers analyzed the diet and health outcomes of more than 500,000 Chinese adults. The researchers found that higher fruit consumption was not associated with higher blood sugar, even for people with diabetes. Adults who consumed fruit more frequently actually had a lower risk of developing diabetes.
The study only analyzed fresh fruit consumption, not dried fruit or fruit juice, so we turned to a few registered dietitians and certified diabetes educators to clarify the best and worst fruits, appropriate serving sizes, and how many carbohydrates you should get from fruit each day.
First it's important to note that "diabetes care is individualized," says Staci Freeworth, RD, CDE, and professor of nutrition at Bowling Green State University. This is why it is important for people with diabetes to see a certified diabetes educator (CDE). These specialists can break down how many carbohydrates you should be eating each day based on your individual needs and health history.
Recipe to Try: Purple Fruit Salad
Whether you have diabetes or not, the consensus from dietitians is the same regarding which fruits are best to eat.
"The best fruits for everyone to eat are the ones that create the least influence on blood sugar, often termed 'low glycemic load,'—even if you don't have diabetes," says Daphne Olivier, RD, CDE, founder of My Food Coach. "These include fruits with rich, deep colors such as blueberries, blackberries, raspberries, dark cherries and kiwi. The rich color is a result of antioxidants—which we know help to neutralize free radicals—but there are also other benefits to antioxidants that we cannot explain."
Amber Gourley, MS, RD, of the Disobedient Dietitian agrees: "As a general rule, I tell my clients to go for darker-colored fruits. Studies show that Americans don't get enough dark purple and red fruits, and these fruits contain some of the best sources of anti-inflammatory antioxidants."
Eat More of These Fruits:
• Dark cherries
Recipe to Try: Pineapple & Avocado Salad
One caveat: no fruit is "the worst." All fruit delivers fiber and nutrients and can be part of a healthy diet. However, bananas, pineapples and mangoes get a bad rap for their higher sugar content compared to berries.
Don't avoid them altogether, though. Instead, the focus should be on decreasing how quickly your blood sugar rises. For example, if you eat a banana by itself, your blood sugar will rise fairly quickly. "But if you pair fruit with foods that have healthy fats in them, such as blueberries with walnuts or apricots with mozzarella cheese, you will decrease the influence of the fruit on your blood sugar," Olivier says. "These fats slow down the absorption of the glucose from fruit and prevent your blood sugar from spiking as high." Nuts and nut butters, plain yogurt, cheese and even avocado will all help blunt your blood sugar response when eating fruit, due to their protein and fat content.
The advice you've heard to eat the whole fruit instead of drinking fruit juice follows the same reasoning. "The whole fruit has fiber, which is lost in the juice," Gourley says. Fiber helps slow the absorption of the sugar. "It's also easy to consume far more carbohydrates than necessary when drinking fruit juice," she says.
The same goes for dried fruit: "Dried fruit is a great snack, but 1/4 cup has 15 grams of carbohydrates, so I suggest using dried fruit on salads or mixed into plain yogurt instead of eating it alone," Gourley says.
The U.S. Dietary Guidelines recommend that adult men and women consume on average two cups of fruit per day. A one-cup serving would be one piece of fruit, like an apple or peach, or one cup of cut-up fruit. Specific guidelines and amounts can be found at ChooseMyPlate.gov.
Olivier says, "In general, having about a handful size of fruit three times daily is appropriate." Just remember to pair it with protein or fat. "An apple as a snack can raise blood sugar faster than an apple with almond butter," she says.
Whether you have diabetes or not, fruit is your friend. Branch out from apples and bananas, and eat a variety of fruits, especially blue, red, and purple fruits like berries, which are high in antioxidants and raise blood sugar the least. Try not to eat fruit alone. Pair it with a healthy fat like nuts or nut butter to slow digestion and the rise of blood sugar. Consume dried fruits and fruit juice in moderation, and if you have diabetes, remember to count the total grams of carbohydrates, not just the grams of sugar.