From health.harvard.edu
A handful of strawberries on a hot summer day or a crisp apple in the fall delights our tastebuds. A diagnosis of type 1, type 2, or gestational diabetes doesn’t mean you have to give up these basic pleasures. In fact, eating whole fruits is a key part of a diabetes-healthy diet.
How fruit affects blood sugar
Eating sweet, ripe fruit does not affect the body the same way as processed, sugary foods such as cake, white bread, or candy. Fruit sugars are wrapped in a protective package of fibre and water, and surrounded by healthful plant components like antioxidant polyphenols, vitamins, and minerals. Fibre slows the flow of sugars into our bloodstream, resulting in a gradual rise and fall. In fact, a meta-analysis of nineteen randomized controlled trials published in Frontiers in Endocrinology that looked at people with diabetes found that eating whole fresh and dried fruit in moderation significantly decreased fasting blood glucose.
Contrast this with foods and beverages full of added sugars — fruit drinks, soda, and cookies, to name a few — that contain high amounts of sugar with minimal to no fibre, resulting in an immediate blood sugar punch.
Each person’s reaction to fruit can vary, however. Nancy Oliveira, a registered dietitian and manager of the nutrition and wellness service at Brigham and Women's Hospital, recommends people with diabetes use their continuous blood glucose monitor (CGM) to monitor how they react after eating a specific fruit. (If you don’t have a CGM, test your blood sugar one to two hours after eating fruit using a traditional glucometer.) Oliveira explains, “People can have unique responses to fruits based on their metabolism, but it also depends on what you eat fruit with.” For example, adding fruit to a bowl of starchy cereal is more likely to cause a blood sugar spike than eating fruit alongside a handful of nuts.
Can fruit be part of a balanced diet for someone with diabetes?
Fruit absolutely can be part of a balanced diet for someone with diabetes. A systematic review and meta-analysis of observational studies published in Nutrition Reviews found that people with diabetes who ate more fruit were less likely to die from cardiovascular disease and all other causes. (Observational studies cannot prove cause and effect.)
Still, moderation is key, and people with diabetes should pay attention to how much fruit they’re eating. “I tell patients it is possible to eat too much fruit at one sitting,” says Oliveira. She advises patients to have up to three servings of whole fruit a day, but to space them out throughout the day.
In addition to sugar, people with diabetes need to consider calorie consumption. Weight loss is an effective way for a person with prediabetes to slow or stave off the onset of diabetes if they are overweight. So if you eat more fruit, make sure you consume fewer calories from other foods.
Best fruits for diabetes
All fruits are nutrient-dense, fibre-rich, minimally-processed carbohydrate sources, and are fair game for someone with diabetes.
Fruits lower in sugar include berries, kiwis, and clementines. The American Diabetes Association recommends berries and citrus fruits in particular.
Oliveira says not to get too wrapped up in checking the glycemic index or glycemic loads of various fruits. “It’s not a very practical tool,” she says, because the amount of fruit and accompanying foods can alter blood sugar response. It’s better to check your blood glucose meter and see how your own body reacts.
Fruits to eat in moderation to avoid blood sugar spikes
Any whole fruit is okay in moderation. Oliveira also recommends unsweetened frozen fruit, which, she says, “can be a good choice because you’ll get whole fruit.” Dried fruit is okay too, as long as you have a small serving, which ranges from two tablespoons to 1/4 cup. If you choose canned fruit, which has been processed and doesn’t contain as much fiber and nutrients, make sure it’s packed in water or juice, but not syrup. (The can should say “packed in its own juices,” “no added sugar,” or “unsweetened.”)
How to enjoy fruit for better blood sugar control: Portion sizes and pairings
Aim for up to three servings of fruit, spread out over the day. One serving of most fruits is 1 cup or one medium whole fruit. For denser fruits like bananas or mangos, a serving size is 1/2 cup.
Eating fruit alongside food with fat or fibre can slow the rise in blood glucose. For example, try an apple with peanut butter, or an orange with a handful of almonds or a small piece of cheese. “Pairing fruits with foods that contain fibre, protein, and fat slows digestion,” says Oliveira. “This might prevent a blood sugar spike.”
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