How much fruit is too much?

Regardless of the type of diet followed, pretty much everyone can agree that eating vegetables is a good idea. However, when it comes to fruit, there is a much louder, contentious debate going on. On one hand, you have the keto folks arguing that the sugar in fruit will cause spikes in blood glucose and lead to weight gain. On the other hand, you have plant-based diet adherents stating that fruit helps with weight loss and is essential for meeting nutrient needs. So, who’s right – is fruit good or bad for our health? Are we missing out on anything if we avoid fruit? And, most importantly, what does the research have to say about weight, diabetes, and fruit intake?

Fruit and Diabetes

Type 2 diabetes is a chronic disease where insulin, which is used to bring sugar from our bloodstream into our body cells, doesn’t work as it is supposed to. As a result, sugar in our blood (which comes from either our liver or the food we eat) can start to rise and cause damage throughout the body. While a poor diet can lead to conditions (such as obesity or high cholesterol) that can increase the risk for type 2 diabetes, diet alone does not cause diabetes (1). However, once diabetes has developed, proper nutrition is essential to managing the condition and preventing long-term complications.

Since foods rich in carbohydrates are readily broken down to glucose, it has been said that individuals with type 2 diabetes should be mindful of their carbohydrate intake and limit sources of “simple sugars”, including fruit. However, the results of 3 long-term studies consisting of 187,382 male and female participants showed that a greater consumption of whole fruits – in particular, blueberries, grapes, and apples – was associated with a lower risk of type 2 diabetes, while fruit juice was associated with a higher risk (2). An updated meta-analysis also supported this finding, reporting that individuals with higher fruit intake had a lower risk of type 2 diabetes and the consumption of 200 g per day of fruit (equal to 1 ¼ cup blueberries or grapes, 1 medium apple, or 1 large banana) resulted in a 13% lower risk of developing type 2 diabetes (3).

Fruit and Weight Gain

In today’s dieting world, carbohydrates have become synonymous with weight gain and, as a result, many people keep fruit at a distance. Yet, after decades of nutrition research, we still haven’t discovered the diet that results in permanent weight loss (as it seems that total calories are more important than macronutrient distribution).

What we learned from years of research is that is isn’t necessary to cut fruit out of your diet to lose weight. A systematic review that included 16 observational and prospective studies found that greater fruit intake was associated with significant weight loss, a lower risk of overweight or obesity, and a lower increase in body weight in 11 of the 16 studies (4). In the remaining 5 studies, no association between fruit and weight (i.e. loss or gain) was noted (4).

The Benefits of Eating Fruit

Based on the available scientific data, it appears that there are more reasons to eat fruit than to avoid it. Also, considering that only 12% of Americans are eating the recommended 1 ½ to 2 cups of fruit per day (5), it seems unlikely that the rise in rates of chronic diseases are because we are eating too much fruit.

So why should you eat fruit? Well, besides being delicious, fruit provides us with essential vitamins and minerals, including dietary fibre, folate, potassium, B vitamins, copper, and magnesium (6). In addition, fruit is rich in antioxidants which help to fight the damage caused by free radicals (7). Finally, a typical serving of fruit (1/2 cup) contains only about 60 calories and contains no saturated fat, trans fat, or sodium.

Daily Recommendations for Fruit

Few countries make specific recommendations on consuming fruit, opting instead to provide a recommendation for fruits and vegetables combined. For example, the World Health Organization (WHO) recommends 400 g (or 5 “portions”) of fruits and vegetables per day to reduce the risk of chronic disease and ensure adequate nutrient intake (8). However, more may be better when it comes to fruits and vegetables, as was shown in a 2014 cross-sectional study where consuming more than 7 servings of fruits and vegetables per day was associated with a 42% reduced risk of premature death (9).

An equally valid question is can you eat too much fruit? Unfortunately, based on negligible scientific evidence, it’s difficult to answer this question. While there are some individuals following a predominantly fruit diet (‘fruitarians’) that claim to be in optimal health, there are no corroborating studies to verify this. However, given that excessive fruit intake can cause gas, bloating, cramping, and diarrhea, fruit intake tends to be self-limiting.

As a final note, if you’re hesitant about adding fruit to your diet, start by incorporating 2 servings per day, while keeping your calorie target constant in Cronometer. Use the “Notes” section to add in any physical sensations you notice and pay attention to your nutrient reports to see if the addition of fruit results in an overall more nutrient-dense diet.

 

 

Susan Macfarlane is a Registered Dietitian Nutritionist utilizing cronometer.com to help run a busy private practice in Ontario, Canada and blogs regularly for cronometer.com

References:

  1. Diabetes Canada. Are you at risk? (n.d.) Available from: https://www.diabetes.ca/about-diabetes/risk-factors/are-you-at-risk
  2. Muraki I, Imamura F, Manson JE, Hu FB, Willett WC, van Dam RM, et al. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ. 2013 Aug 28;347:f5001. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23990623
  3. Li S, Miao S, Huang Y, Liu Z, Tian H, Yin X, et al. Fruit intake decreases risk of incident type 2 diabetes: an updated meta-analysis. Endocrine. 2015 Mar;48(2):454-60. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/25074631
  4. Alinia S, Hels O, Tetens I. The potential association between fruit intake and body weight–a review. Obes Rev. 2009 Nov;10(6):639-47. https://www.ncbi.nlm.nih.gov/pubmed/19413705
  5. Centers for Disease Control and Prevention (CDC). Only 1 in 10 Adults Get Enough Fruits or Vegetables. 2017 Nov. Available from: https://www.cdc.gov/media/releases/2017/p1116-fruit-vegetable-consumption.html
  6. United States Department of Agriculture (USDA) – Choose My Plate.gov. Nutrients and Health Benefits – Why is it important to eat fruit? 2015 June. Available from: https://www.choosemyplate.gov/fruits-nutrients-health
  7. National Center for Complementary and Integrative Health. Antioxidants and Health. 2013 Nov. Available from: https://nccih.nih.gov/sites/nccam.nih.gov/files/Antioxidants_09-15-2015.pdf
  8. World Health Organization (WHO). Promoting fruit and vegetable consumption around the world. (n.d.) Available from: http://www.who.int/dietphysicalactivity/fruit/en/
  9. Oyebode O, Gordon-Dseagu V, Walker A, Mindell JS. Fruit and vegetable consumption and all-cause, cancer and CVD mortality: analysis of Health Survey for England data. J Epidemiol Community Health. 2014 Sep;68(9):856-62. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/24687909

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