Fruit

Roaming down the supermarket aisle, a sea of colors and shapes beckons to be inspected. Bright red and green shiny apples glisten in the light, plump strawberries beg to be tasted, and freshly cut bowls of melon and pineapple wait to satiate after the warm sun of midday. For those who are working on their health, however, there may be a pause at the reach toward that inviting piece of fruit.

Questions could flood the conscientious shopper. “Will this ruin my diet? What about my sugar?”

And that reach may be persuaded to be no more than a pause, foregoing any fruit in that day’s purchase.

“A lot of people think the only form of sugar in fruit is fructose,” says Tama Rodriguez, RDN, Certified Diabetes Care and Education Specialist (CDCES), Eisenhower Diabetes Education Services.

“It’s actually a combination of glucose and fructose,” she adds. “Fruit is made up of simple carbohydrates but it is considered a complex carbohydrate because of the fiber content.”

Complex carbohydrates are preferred because of the added benefit of fiber. Rodriguez advises to aim for 20 to 30 grams of fiber each day.

“There are more nutrients in fruit,” she says. “If you’re hungry, eat a banana or an apple versus grabbing a bag of chips.”

Rodriguez regularly advises those on their health journey in weight management and those tasked with managing prediabetes or diabetes. She practices what she preaches, having managed her own Type 1 diabetes for more than 40 years.

Some patients may strive to avoid fruit, but it’s actually the opposite that Rodriguez recommends.

“We know there are a lot of nutrients in different fruits that are not in other foods - a lot of vitamins and minerals, a lot of fiber. Probably the biggest benefits of fruit are disease prevention and that some of the minerals and vitamins are antioxidants. For those with diabetes, ideally we are controlling the quantity of total carbohydrates, fruit being one of those sources.”

Rodriguez says the U.S. Department of Agriculture (USDA) recommendation for fruit intake is two to four servings a day. Her recommendation to patients with diabetes will be modified based on their lifestyle.

“There are advantages to specific fruits with less of a glycemic index, like berries, with not as much of a rise in blood sugar in general,” she says. “If we look at continuous glucose monitoring and blood sugar levels, eating a piece of fruit versus eating a potato, we know that there’s a little slower rise in blood sugar.”

A serving of fruit - about 15 grams of carbs - could be any of the following:

• a small apple
• a medium orange
• 17 small grapes
• a half cup of small berries
• a cup of large berries like strawberries
• half a banana

Another way to mitigate the carbs: pair a serving of fruit with a protein or a healthy fat to slow the body’s absorption of the sugar.

“If you have a couple pieces of fruit a day, it’s a lean snack with no fat and many nutrients you wouldn’t get from other foods,” explains Rodriguez. “Some people argue they could get those in a multivitamin and don’t want to bother with cutting up fruit, but it’s not going to be absorbed as well as a piece of fruit that came naturally from a source in nature.”

The USDA makes a few recommendations, including fruit at breakfast, taking fruit on the go or as a snack and keeping fruit on hand at home as ways to easily reach for that healthy serving.

Instead of worrying about fruit choices, Rodriguez advises reaching out to a primary care physician for a referral to a registered dietitian for personalized goal setting. This may involve out-of-pocket costs depending on insurance and the patient’s health concerns.

“Everyone is so different in terms of what their needs are, but also what their goals are,” says Rodriguez. “People find they do better when they have accountability knowing that they’re going to be checking in with someone again.”

“We are expected to be able to do all of this on our own,” she adds, “and the truth is people just do better with support. Having a little bit of backup and accountability is more likely to lead to success in moving toward healthy behaviors.”

What about fruit juice or dried fruit?

Imagine drinking a six-ounce glass of orange juice. How many oranges were squeezed to make that amount?

“Do you usually sit down and eat four or five oranges? No,” says Tama Rodriguez, RDN and Certified Diabetes Care and Education Specialist (CDCES), Eisenhower Diabetes Education Services. “That’s a lot of concentrated calories going down easily. If you’re drinking it, you’re probably going to get many more calories and simple carbohydrates than recommended.”

Dried fruit - two tablespoons of raisins with about 15 grams of sugar - is also concentrated carbohydrates. While it feels like moderation, the truth is that the calories add up quickly.

What to do instead? Rodriguez advises skipping the juice and dried fruit, and reach for a fresh piece of fruit.