Can I eat fruit with diabetes?
As you hopefully know by now I’m happy to take questions from you all and I often use this to help steer my blog posts. One question coming up frequently is whether you can eat fruit if you have diabetes. This usually comes up in the context of type 2 diabetes but I have had it come up in type 1 also.
I have blogged on this extensively in a previous post, which you can find here.
However, I know when searching through blog posts to answer your questions you just want to see it spelt out. Rather than have it embedded in some other post.
The fruit question is a tricky one. In a word, yes you can eat fruit! It is a healthy food group and provides so many different nutrients and fibre.
Why the question in the first place?
Fruit has sugar. Sugar is mostly the nutrient associated with diabetes. Particularly in type 2. Therefore, it seems reasonable to think fruit will push up glucose levels.
If eaten in large quantities it will. Absolutely.
In fact any carbohydrate containing food will increase your glucose levels. All carbs are turned into glucose when we eat them.
Carbohydrate is an umbrella term and so includes many different types of foods. These include starchy carbohydrate, fruit, processed sugar, milk sugars, beans, pulses, lentils and even vegetables. This doesn’t mean you can’t eat these. What it does mean though, is you need to be careful of how much you are eating. Especially with the foods with lots of carbs in them.
Your blood glucose response is directly related to the amount of carbohydrate you eat. Fruit has a comparatively low carbohydrate content compared to starchy carbs. Even bananas.
High carb foods are usually the more starchy foods like rice, pasta, cereal and potatoes and highly processed foods like sweets, chocolate, juices and sauces.
So it is funny to focus on fruit intake yet neglect the other sources of carbs that often have a much higher carb content.
Granted some fruits have a higher carb content compared to other fruits. Examples include bananas, grapes and dried fruit but if eaten in a portion controlled manner they are fine.
Portions sizes are 2 small fruits like a kiwi, 1 medium fruit like an apple or around a quarter of a large fruit like a mango. Try to eat no more than medium to small bananas, a handful of loose fruits like grapes and/or berries and a half a handful if dried fruit at a time.
With type 2 diabetes carb portions are the most important element. If you eat 3 or 4 fruits in one sitting this will result in a lot of carbohydrate being eaten in one sitting. However, if you spread out your fruit intake throughout the day aiming for 1 portion at a time it is unlikely your levels will spike because of the fruit.
See the bigger picture
The amount of times I hear patients tell me a healthcare professional has told them to cut out bananas is amazing. Just bananas. Nothing else. Then they go home and have a massive plate of pasta or rice or continue eating everything else.
Remember, your glucose levels relate directly to the amount of carbohydrate you eat. So it is the total amount of carbs that is important. Whether that comes from starch, fruit, sugar or milk sugars.
So if you eat rice with dinner, followed by some crisps, fruit and a chocolate bar, you have eaten quite a lot of carb at that meal.
Sometimes this can lead people down a path of cutting out healthy foods such as fruit or slow releasing starchy foods.
Whereas just reducing the portions of carbohydrate at the meal would have done the trick. If you want to improve your glucose levels after meals, it’s down to you to decide which type of carbs you want to reduce or cut out.
I’m always weary of isolated thinking focusing solely on glucose levels because it can lead to healthy foods being cut out. Fruit compared to crisps or chocolate will be much more nutritious even if they have the same amount of carbs. Therefore, I’d recommend reducing the crisps or chocolate before reducing fruit in your diet.
I often say to patients, if you have high glucose levels fruit is unlikely your problem. Although there are always the odd exception when I see a patient having 8+ fruits per day.
Note for people on rapid acting insulin
One portion of fruit as a snack will unlikely require any rapid acting insulin. This is because there isn’t enough carb to cause a spike and/or the background or previous rapid insulin will pick it up.
If fruit is added to a meal you may need to account for it using carbohydrate counting.
Some people do need to take some rapid acting insulin for fruit but this is a very personal. Experience will help identify whether you need insulin or not.
Exchanging any carb containing food for non carb based foods will help improve your glucose response after the meal. I’d recommend starting with foods like chocolate and crisps because these are low in nutrients.
However, I appreciate these foods are tasty and I would struggle to cut them out. So if you are going to have them, perhaps reduce the amount of starch on your dinner plate or elsewhere in your diet to help compensate for this.
Less carb doesn’t always mean less food. Food swaps allow you to keep similar meals portions but help glucose levels remain stable. Simply reducing the carbohydrate foods and replacing them with foods that have a very limited or no effect on glucose levels like vegetables, poultry, meat, fish, beans, pulses lentils, can be a good solution.
Vegetables, beans, pulses and lentils do contain some carbs but you would need to eat literally tons of them before they spike your glucose levels. They are also very nutritious and full of fibre.
Another good option is mixing foods like rice and pasta with vegetable alternatives such as cauliflower rice or courgetti. If like me you don’t quite have a taste to completely replace the rice or pasta, just a 50/50 split can make a big difference. This means you can have bigger portions but with less carbs and calories.
Therefore, replacing reducing the total carbs in your diet is the way to enjoy various types of carbohydrate containing foods.
I hope that’s useful and let me know if you have further questions.