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Fruits & Diabetes: Friends or Foes?

Diabetes Mellitus (DM) commonly referred to as diabetes is one of the most rampant chronic conditions affecting humans today. It occurs when the pancreas does not secrete enough insulin or when the cells of the body become resistant to insulin. It is a lifestyle disorder in which the body struggles to control the levels of blood sugar but is unable to do so due to unhealthy eating, exercising and stress management habits.

We all know that eating fruit is a delicious way to satisfy hunger and maintain a healthy lifestyle. Although we know fruits and vegetables are good for us, people with diabetes are often told they should avoid fruits because they are too sweet or contain sugar. All fruits contain natural sugars along with a good mix of vitamins, minerals and fibres. As a nutritionist, the question that I get asked most often is “I am diabetic, can I eat fruits?” So, are fruits really advisable for you if you have diabetes?

 

In this blog post, I hope to shed some light on the important issue of fruit intake for people with diabetes. First, let me explain two key concepts related to diet and diabetes: Glycemic Index and Glycemic Load.

Glycemic Index (GI)

GI is a number that gives you an idea about how fast your body converts the carbohydrates in a specific food into glucose. Two foods with the same amount of carbohydrates can have different glycaemic indices based on whether they contain more of simple sugars or complex sugars.

The smaller the number, the more time the body takes to convert it into glucose and so the more desirable for diabetic individuals.

55 or less = Low (most desirable in diabetics)

56 to 69 = Medium (less desirable in diabetics)

70 or higher = High (least desirable in diabetics)

The purpose of knowing the GI is to eat foods that are less likely to cause sudden steep increases in blood glucose levels. If you have diabetes, you must choose low GI foods in your daily diet. Research has proven that a low GI diet not only helps keep your blood glucose and blood cholesterol under control but also reduces insulin resistance and thereby the risk of complications likes heart attack and stroke. A recent research article explains how a low GI diet can help people with diabetes manage their blood sugar better https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006296.pub2/full.

Glycemic index of some fruits:

 

Glycemic Load (GL)

The GL of a food item is a number that indicates how much that food will raise a person’s blood glucose level after eating it and it is mostly based on the glycemic index (GI). Large research trials have shown that people who consumed lower glycemic load diets were at a lower risk of developing diabetes and heart disease https://www.ncbi.nlm.nih.gov/pubmed/23364021

The formula for calculating the GL of a particular food or meal is:

Glycemic Load = GI x Carbohydrate (g) content per portion ÷ 100.

Foods with a GL below 10 are regarded as “low” and those with a GL above 20 as “high”. Examples are:

Low GL foods: Apples, Pears, Oranges, Grapes, Peaches, Strawberries, Tomatoes and Watermelon

High GL foods: Dates, Raisins, Dried fruits.

Here’s a look at some common myths about fruit intake and diabetes:

Myth – Fruits are not suitable for diabetic patients

Fact – If you want to manage your blood glucose, cholesterol level, blood pressure and body weight you must include fruits in your daily diet. In fact, most fruits have low to medium glycemic index. (Refer glycemic index above)

Myth – Diabetic patients can have added sugar in the form of brown sugar, sugar substitutes etc.

Fact – All added sugars should be avoided. Alternatively, you can opt for a sugar-free balanced healthy diet. Natural sugars are present in fruits, vegetables and milk so you can go with natural sugars instead of adding sugar to your diet.

Myth – Diabetic patients can eat special ‘diabetic’ foods available in the market

Fact – ‘Diabetic-friendly’ labelling tends to be used on sweets, biscuits and similar foods that are generally high in fat and sugar. As a dietician, I wouldn’t recommend eating sugar-free diabetic foods like diabetic sweets, biscuits and beverages. They have been found to worsen your diabetes and also lead to complications of liver, kidneys etc. Opting for natural foods is the best.

Myth – Fruit juices are safe for diabetic individuals

Fact–Fruit juices are to be avoided mainly because juices lack the goodness of fibre present in the whole fruit and quite often extra sugar and preservatives are added. Fresh home-squeezed juices without any added sugar and with the pulp are preferred to readymade juices. However, nothing to beat the fruit eaten as a whole.

Myth – You should stay away from chikoos, mangoes and bananas

Fact – These fruits are by themselves a treasure trove of nutrition and there is no need to consider them a taboo. But portion size is very important while taking these fruits to manage your blood glucose levels. In fact, grapes and bananas are very beneficial because they are high in fibre, low in fat and full of vitamins and minerals. Mangoes too are rich in nutritive content. And all these fruits protect against heart disease, cancer and certain digestive problems.

The longstanding concern amongst our people is that fruits contain high levels of natural sugars which will inevitably increase blood glucose level. Due to the low glycemic index of most fruits they do not lead to a sharp rise in blood glucose levels. In contrast, processed foods like white bread, packaged sugary drinks, chocolate, biscuits, cakes etc. have a very high GI and are definitely to be avoided.

As a dietician, my advice would be to keep a food diary to help track your fruit and vegetable consumption, as well as the other foods that you eat in a day. In this way, you can get professional help to ensure the intake of a well-balanced diet that helps nourish your body and keep your diabetes under control.

Dietary Tips to Control Blood Glucose:

  • Try to eat whole fruits as much as possible, as some nutrients are lost in fruit juices
  • Add a wide variety of fruits – rainbow colours – in your daily diet to prevent chronic diseases like high blood pressure, heart diseases, stroke, obesity, constipation and certain cancers
  • Avoid excessive intake of dried fruit because it has high GI value
  • Avoid health drinks, aerated drinks and packed drinks.

Incorporating fruits into your diet is the best way to lower the risk of various health problems. Whether you have diabetes or not, you need to consume a healthy portion, that is at least 5 portions of fruits and vegetables, every day.