Is the Sugar in Fruit Bad for People with Diabetes?

0:00
Welcome back to another episode of the Diabetes Digital Podcast.

We’re so excited to be here and today we are talking about a subject that comes up all the time as dietitians.

There’s a lot of fear mongering online about this with fruit and diabetes.

0:16
And can people with diabetes eat fruit?

Like, is the sugar in fruit going to have this huge detrimental impact on your blood glucose?

We’re going to break it all down today with one of our amazing diabetes digital dietitians who Wendy’s going to introduce.

0:32
But first, I’m going to tell you what we’re going to cover in this episode about fruit and diabetes.

So we’ll talk about the difference between added sugars and natural sugars.

We’re going to get into glycemic index and glycemic load and whether or not those are important for people with diabetes.

We’ll also talk a little bit about how the body processes sugar and what are some of the benefits of eating fruit for people with diabetes.

0:55
We’ll get into fruit juice and a bunch of other myths.

So this is a really great episode.

You’re going to want to make sure to tune until the very end and share it with a friend who might find this information helpful.

Welcome to the Diabetes Digital Podcast.

I’m Wendy.

And I’m Jess, and we’re best friends, registered dietitians and diabetes educators.

1:14
Through our telehealth platform, Diabetes digital.co, we offer accessible and personalized virtual nutrition counseling for people with diabetes and pre diabetes.

Visit diabetesdigital.co that’s CEO, to book your first appointment.

We accept insurance and offer affordable self pay options.

1:30
Now let’s get into today’s episode.

So for today we have one of our in house dietitians, Carmelita Lombera.

She is a UC Berkeley graduate with a Bachelor of Science in Nutritional Sciences.

She’s built a diverse career as a health coach, fitness nutrition specialist, group fitness instructor and registered dietitian.

1:51
She provides support and education both in English and Spanish on diabetes management.

And we are just so thrilled to have her be part of our team.

Carmelita, welcome to the podcast.

Hola Guacho gusto.

Very happy to be here.

So excited to talk about fruit.

2:07
Yes, always.

I.

Know.

Exciting topic.

Yeah.

So that many that we spoke about there being a lot of fear around eating fruit if you have diabetes and a lot of people think that, you know, cutting all fruit out or certain fruits that are associated with being higher in sugar content is a good move if you have diabetes.

2:28
Can you talk to us about what the difference is between natural occurring sugar in fruit and added sugars like maybe what you would find in the soda, et cetera?

Yes, natural sugars occur naturally in the food.

So like for example fruits have sugar in them so we don’t need to add whereas processed or packaged foods will have sugars added to them and one way to know if something has an added sugar is by looking at the nutrition facts or you can also look at the ingredients list.

2:58
So if somebody is picking up the Nutrition Facts label on the back of their food item, what exactly are they looking at?

Yeah, so on the nutrition facts, it’ll show you the calories and then it’ll show you where it’s getting the calories from.

And if you’re focusing on added sugars, you’ll see it listed underneath carbohydrates.

3:17
So underneath carbohydrates, it’ll say sugars, and that could be referring to natural sugars that you find in fruits.

But then underneath, now they have to list added sugars.

So sometimes you might see a product where it’ll say 10 grams of sugar and 9 grams of added sugars.

3:33
So that’s just letting us know that of those ten, nine of them have been added to this food.

OK.

Is there a recommendation?

Do you know of how much added sugar the general consumer should have per day?

I’ve seen recommendations for men and for women.

3:50
So generally speaking, for a woman it is recommended to try to limit added sugars to less than 24g for the day, or about 6 teaspoons.

For men, the recommendation is to limit their added sugars to less than 36g or 9 teaspoons per day.

4:07
That may be a lot of math for people.

So what I usually will do when I’m looking at the label is I’ll look at the percentage and if it has a percentage that’s greater than 20, that just signifies that it’s high and that specific nutrients.

4:22
So it could be high in in added sugars if the percentage is let’s say 2425%.

I love that.

So simple and easy to follow.

OK.

So let’s talk a little bit about glycemic index and glycemic load because I feel this will tie into the conversation of fruit and how those things will impact glycemic index and load.

4:44
But I think for people who are like, huh, what are those even?

Can you give us a little bit of background?

Definitely.

The glycemic index is looking at how quickly a food raises your blood sugar over a period of time, and we usually will measure it in up to two hours.

5:00
So let’s say you eat something.

The glycemic index will rate that on a scale of one to 100 with pure sugar glucose being 100.

So let’s say something has a glycemic index of five, then that would be considered low.

Whereas something like a fruit may have a glycemic index of 50, which may mean that it raises the blood sugar faster than the other foods.

5:24
Something interesting about glycemic index is that there’s different things that can affect it.

For example, foods that are processed because they’re broken down already, they actually have a higher glycemic index.

So some people will notice that if they eat instant potatoes versus whole baked potatoes, their blood sugar goes up faster.

5:44
Same thing with like instant oats.

People may notice that their blood sugar goes up faster versus if they’re having old fashioned oats.

Cooking can also affect the glycemic index.

So for example, if something is not cooked entirely, so like al dente pasta or parboiled rice, it actually has a lower glycemic index.

6:05
So that’s one way to be able to incorporate those foods if that’s something that you want to do.

And then also if you combine these foods that have a higher glycemic index with foods that have fiber, fats or protein, that can also help too slow down how quickly it raises the blood sugar and and reduce the glycemic index.

6:26
Glycemic load is similar, but it’s actually looking at the speed and the amount of carbohydrates.

So some people feel that the glycemic load is it gives you a fuller picture as to what kind of impact that’s having on your blood sugar.

I’ll share an example.

I’ve worked with patients where they avoid eating watermelon.

6:44
They’ve told me like, Oh no, watermelon has a high glycemic index.

I can’t eat that.

But then when we break it down, we actually realize that it has very little carbohydrates.

Water is in the name, right?

And so it doesn’t have as high an effect on the blood sugar as we would expect.

7:02
So that’s the difference between the glycemic index and the glycemic load.

Yeah.

And I also think that everyone has their own unique reaction to different types of carbohydrates.

So for people that have diabetes, what I’ve seen is that they start getting stressed out with, OK, well, what is the glycemic globe?

7:19
What number does it fall on in the index?

You know, sometimes I don’t think it’s like too helpful for the everyday person to focus on what those numbers are because, you know, you might react differently to a food that’s supposed to be raising your blood sugar is a lot per these, you know, indexes and things like that.

7:36
You know, it’s always important, As for everything when it comes to nutrition, to individualize.

Definitely, yeah.

So not avoid things because you’ve heard that it has a high glycemic index or high glycemic load, or vice versa.

You do more foods that you you feel are low and then maybe that may not be the most balanced diet.

7:55
For you exactly Now is there a difference with how the body processes different types of fruit?

Because you know some foods they have more fiber than others.

You mentioned watermelon has a higher water content, so is there a difference there and how it could affect your blood sugars?

8:10
There is.

So we do see that foods or fruits that are higher in fiber, like for example raspberries, they have like 7 grams of fiber in One Cup.

People will find that that doesn’t affect their blood sugar as much as if they had a cup of cherries, which tend to have more more fructose and which is why they taste so good.

8:30
That’s super helpful.

And I’m also curious to know are there benefits to eating fruit or like I know that there are, but I want you to talk about that because so many people with diabetes specifically will avoid fruits.

But can you talk about why fruit should not be avoided in some of the nutrition they provide?

8:48
Definitely fruits and vegetables both have fiber, but the difference is that that fruits will also help with blood sugar.

So with diabetes, I see that one of the challenges is not having lows and not having highs, right?

9:04
And for a diabetic, the highest risk is being hypoglycemic.

That can lead to other severe health issues and become a medical emergency and so so fruit can be very beneficial for that.

Me personally, I I try to have a fruit if I know I’m my blood Sugar’s starting to drop and and I need something to keep it steady.

9:23
So not something that’s going to make it spike, but keep it nice and steady so that I’m able to focus and do my day-to-day activities.

Another thing I notice with people is if they cut out fruits, they tend to replace that with other sweets because naturally, like our palates are designed to enjoy all those different tastes, right?

9:42
And so if we avoid that entirely, it can lead to disordered eating patterns.

So I feel like that can also be a major benefit for including fruits for for small diabetes and for general population.

Yeah, yeah, that’s a great point.

9:58
And I wanted to bring up fruit juice because I think mentioning juice and diabetes in the same sentence as like a no, no.

Is it OK for people that have diabetes to drink juice?

And is there a difference between, I don’t know, conventional juice and 100% natural juice?

10:18
Juice can be included.

It doesn’t have as much fiber as the whole fruit itself, so some people may find that if they’re having more juice than the actual whole fruit, their blood sugars may be more elevated.

But I do recommend juice if someone is having like an episode of hypoglycemia or if they’re really struggling with keeping their blood sugar stable.

10:39
And I do see a difference to where people who have juice that may have other added sweeteners like high fructose corn syrup.

Sometimes that can make their blood sugar spike up even faster, so opting for ones that are 100% fruit juice may be more beneficial for them too.

10:57
OK, great.

And then for juice, do you recommend a serving size for folks or we’re going to get more into serving size the fruit, but an exchange or something that people can wrap their mind around?

Because I feel like often times, you know, you might go to a restaurant and they’ll they’ll serve you a pretty big portion and I just want to talk a little bit about that.

11:21
Because it’s so concentrated, you do really have to watch your portions, and if you were to have 8 oz, that might be too much.

So for most people, 4 oz.

Or half a cup per day would be considered about equivalent to one serving of fruit.

And I will say one thing to do.

11:36
If you do go out and you want to have a little bit of that juice, but you don’t want it to spike your blood sugar too much.

My favorite thing is to have a glass of seltzer water and then just add maybe like half a cup of pineapple juice or orange juice to that.

You get the bubbles.

11:51
It tastes like a cocktail, except you know the effects of a cocktail.

You’re hydrated and it it’s it’s not going to spike your blood sugar as much as having like a, you know, a sugary drink.

I love that idea.

That sounds really refreshing.

Yeah, I.

Recently did that and I was like oh this is so good.

12:07
I had like a mango juice and then I added some seltzer and it was it was perfect.

It was like the perfect combo.

Now, are there fruits that should be avoided?

Or can people with diabetes include all fruits into their diet?

That’s a really good question because I’ve run into people where they are avoiding certain fruits.

12:26
They they don’t eat bananas or mangoes because they are higher in carbohydrates.

However, you can still include them.

Some people will opt to have a smaller portion, or sometimes you can pair it with other foods, like foods that have proteins such as yogurt or cottage cheese, or healthy fats like nuts and seeds or nut butters.

12:49
I also like to include fruit as a dessert because you’re having your whole meal right there that has the protein and the fiber and those healthy fats, and so if you combine it together as a dessert, that also helps to keep your blood sugar stable.

Oh, that’s such a great tip.

And is there anything else?

13:05
I know you mentioned a couple right now, but anything else that people with diabetes can do to include fruit in their diet without spiking blood sugar?

Another thing that they can do is making sure to pair it with protein and healthy fats.

So for example, if if I’m going to have a banana, I’ll try to have that with my Greek yogurt and and you know, dressing it up in a way.

13:29
Or if it’s like a lower glycemic fruit like berries, you can allow yourself to have a a larger portion of that.

But also dressing it up with some whipped cream and some crushed nuts and, you know, really making it like a a decadent type of dessert can be one way to keep the blood sugar a little bit more stable.

13:49
Oh my God, thank you for reminding me about that dessert.

I used to have that all the time.

I totally forgot about.

I’m going to get that this weekend.

Is there a thing as too much fruit?

Because I, you know, for some people they maybe enjoy having fruit salads for breakfast and they’re not necessarily incorporating like yogurt or healthy fats and things like that.

14:10
So what are the guidelines around how much fruit someone should have if they have diabetes?

Yes, that’s a great question because there is such thing as so much of anything, right?

And so with fruits, usually two to three servings a day is recommended for most people and it depends on the type of fruit.

14:26
So for example, a fruit like mango, one serving is actually half the mango.

So I’ve run into the challenge where like I was eating 2 mangoes and thinking like oh this is this is it’s fruit, this is healthy.

And then watching my blood sugar go up and and not realizing that wait a second, I’m actually eating 4 fruits at the same time right now.

14:45
But just by making that small adjustment, you can still enjoy the fruit and still keep your blood sugar within a healthy range.

And is there a standard serving size for most fruits or is it different for every single thing like a cup, 2 cups or like how do you typically tease that out with your patients?

15:06
Yeah, usually a serving size is is like one small fruit.

So like let’s say it’s an apple or an orange, like about the size of a tennis ball would be considered one serving for those types of fruits.

But it let’s say it’s something that’s chopped up, half a cup would be considered one serving for most fruits.

15:24
So I think that could be like the easiest way to watch portions, but for example like strawberries, if if you were to do a full cup of strawberries, that’s going to end up having about the same amount of carbohydrates as as half a cup of a higher glycemic fruit.

15:41
Like I keep saying mango but or a banana could be another example.

The take away is you could have more strawberries and that’s the same.

It might have, again, everything’s individual, but might have the a similar impact to a lesser amount of a different fruit that is potentially higher in sugar.

16:02
Yeah, OK.

Now, something that I hear all the time from people is, oh, well, I can’t have fruits after a certain time, usually, like after 6:00 PM or something like that.

And, you know, I’ll be like, oh, well, why?

And they’ll say, oh, well, something about the digestion.

And I really don’t understand it.

16:19
And I don’t know that they do either.

That’s another big misconception that, you know, there’s certain times that you should eat fruit during the day.

So what are your thoughts on that?

But that’s a really good question because I mean, I’m trying to think like where they would come to that consensus.

And the only thing that I can think that might make sense for them is they’re thinking, OK, fruit raises my blood sugar and and so maybe I don’t want to take nap or eat fruit after dinner because it’s going to raise my blood sugar.

16:45
Maybe that’s what they’re thinking.

But you can eat fruit any time of the day.

Some people may need it more in the morning time because that’s when they like to pair it with other foods and it just it fits their lifestyle better.

Me personally, I love having fruit after dinner.

17:01
It’s a great dessert and I also like having fruit in between meals too.

So like anytime there’s a longer gap between my meals, like let’s say between lunch and dinner, If I’m eating lunch at 12, I’m not having dinner till 6:00.

I’m going to need something around 3:00-ish and and that’s usually one of my body is asking for something.

17:18
And so I always plan to have apple or berries or a banana or something like that during that time of day.

It helps with the blood sugar, it helps it from dropping too low and then also from spiking too high.

I.

Love that advice.

17:35
Now in wrapping, can you talk about just some practical takeaways for someone who’s listening and they’re like, OK, fruit?

Yeah, sounds good.

What are like one or two thoughts you can leave people with in terms of tips for incorporating fruits into their diabetes management plan?

I would say that fruits are a great source of energy and they’re packed with vitamins and minerals that help to support your body beyond just our metabolism.

18:02
I mean there’s nutrients in there that our body can use like building blocks for our hair and our DNA synthesis and all these other things that we always sometimes may overlook.

And then just keep in mind that you know fruit is is sweet and and that’s OK we need something to sweeten our life from time to time and and you know that’s why our body was designed to to consume it and say that I I think that by having that state of mind it makes you less fearful about incorporating these things and having a more well balanced diet.

18:33
Love it.

And can you let people know if they’re listening to this and they’re like, oh, I want to work with Carmelita, How do I sign up?

Yeah, how can they work with you via diabetes?

Digital.

Yeah, Check out our website Diabetes Digital and you’ll you can look on there and complete the intake form and get set up with your first session.

18:54
We try to meet with patients once a week or every other week depending on their needs and their insurance coverage.

But I love it because we do the zoom sessions and you can get really creative with it.

I’ll have people where we look at labels from their pantry or we’ll work on meal prepping and it’s a very personalized.

19:14
So I I see a lot of value on it and my my clients seem to be improving with it too, so it’s a great support system As for anyone out there who’s looking for that extra help.

Carmelita, thank you so much for joining us today.

Our listeners are going to absolutely love this episode and we’ll.

19:32
Catch you later.

Bye thank you.

Bye, bye.

Thanks for joining us for today’s episode.

If you’re interested in nutrition counseling with one of our expert dietitians to help improve your pre diabetes or diabetes, visit us@diabetesdigital.co.

19:49
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20:09
We’ll catch you later.

Bye.