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Fruitphobia: Why Fear of Fruit is Fruitless

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Recently someone posted this question on my Facebook page:

“Hey Laura, I would love to hear about what you think of fruit? In my nutrition class today (I’m going to be a NTP) they demonized carbs all day and specifically fruit. I know going low carb caused major problems like HA and adrenal problems. It’s hard sitting in class all day hearing how carbs (even from whole foods) will cause insulin resistance and weight gain etc.”

I had already been planning to write a post about fruit but reading this made me pretty angry. Especially knowing that it’s coming from a nutrition education program that many people go through to get “accurate” alternative nutrition information. (But that’s another story for another day.)

The question is this: is there any evidence whatsoever that whole, fresh fruit consumption will cause insulin resistance, weight gain, or any specific health problem at all?

Should We Fear Fruit?

If you’ve been following me on social media for any time in the last few months, you’ll have seen that I don’t shy away from carbs. And fruit is no exception – I’ve been known to eat 3-4 bananas in a day, and have no qualms about digging into a big bowl of fruit salad.

Not much compares to a juicy red strawberry, fresh picked blueberries, or a ripe slice of pineapple. When I’ve traveled to tropical locations around the world (Australia, Hawaii, Costa Rica, Nicaragua, etc.), I greatly appreciate the fresh local fruit served at meals and snacks. Not only is it completely normal to enjoy good fruit, but for the majority of people it’s perfectly healthy to do so!

Unfortunately, as I’ve been working with clients who have been sucked into the low-carb Paleo dogma, I see more and more fear of fruit as being an unhealthy source of sugar and an unnecessary part of a healthy diet.

I’ve had several clients who were terrified to eat more than a half a banana in an entire day. Not only is this “fruitphobia” completely unnecessary, but it could actually be harmful to overall health.

Some dogmatic paleo advocates encourage a limited fruit intake and often recommend sticking to small portions of low sugar fruits like berries. They see fruit as simply unnecessary sugar, only to be enjoyed on special occasions. They say the sugar in fruit is addictive and that fruit is far too easy to overeat. Bananas might as well be Skittles for the negative way that many Paleo devotees view them.

The Paleo community prides itself on promoting nutrient-dense foods, and yet this misguided view totally ignores the vitamins, minerals, fibers/prebiotics, antioxidants and polyphenols that are present in fruits.

Further, fruit is fairly low calorie, making it far more nutrient-dense than the beloved bacon and coconut oil that so many Paleo advocates use with abandon in their recipes and meal plans.

You’re not a “sugar addict” because you enjoy fruit. We have been hard-wired to enjoy sweet tasting foods. This innate attraction to sweet foods successfully guided our ancestors in fulfilling their carbohydrate and nutritional needs through fruit and even natural sugars like honey.

While the added sugars in today’s processed foods, such as high fructose corn syrup, may be affecting our rates of chronic disease, to apply this concern to all foods that contain fructose is absurd.

By seeing fruits as an indulgence and not a major component of your diet, you are missing out on a delicious way to fuel your body with the carbohydrates, fibers, polyphenols, vitamins, and minerals you need for optimal health.

And for my clients who need more carbohydrates to support their activity levels, the avoidance of fruit could not only be unhelpful, it could potentially cause long-term harm from inappropriate carbohydrate restriction.

But what about fructose?

Fructose in significant excess is a problem. High fructose has been found to lead to insulin resistance, obesity, type 2 diabetes and high blood pressure in rodent studies. High fructose diets are associated with these health conditions through fructose’s possible role in creating metabolic endotoxemia in the body.

Endotoxins are inflammatory compounds released by gut bacteria which induce fatty liver and systemic inflammation. Very high doses of fructose seem to disrupt the delicate balance in the microbiome, which can certainly wreak havoc on your health.

With this in mind, most health experts agree that avoiding processed sugars, especially high fructose corn syrup, is a good strategy for optimizing health. But, this anti-sugar movement has led some to believe that all sugars, even the natural fructose found in fruits, will have the same health effects in the body of high doses of isolated fructose.

After all, if fructose is dangerous, and fruit contains fructose, doesn’t that mean fruit is therefore unhealthy to eat?

This interpretation of fructose fails to account for the dose and the source of the fructose. In these studies, researchers usually isolate fructose and have their subjects ingest large doses that would be nearly impossible to replicate when eating a whole foods diet.

If the research is epidemiological, they are looking at populations consuming high amounts of fructose in sugar-sweetened beverages and processed foods. The fructose in fruit is minimal compared to the high isolated doses in a can of soda.

For example, soda contains a sugar ratio of 60% fructose to 40% glucose. One 20 oz bottle of coke contains roughly 36 grams of fructose. Compare that to a banana, which contains 7 grams of fructose, a cup of strawberries with 4 grams fructose, or a medium sized apple with 13 grams fructose.

When was the last time you ate 4-5 bananas in one sitting? Or even 3 apples? Yet I’m sure there are many people out there who wouldn’t find consuming a few 20 oz bottles of soda daily a challenge.

It’s far easier to get a hit of fructose from a high consumption of HFCS-sweetened sodas than it would be from even the biggest fruit salad you could think of.

Not to mention, the fiber and nutrients paired with the fructose in fruit creates a much different blood glucose response compared to added dietary fructose from processed foods. Fructose-sweetened food and drinks have been shown to impair glucose tolerance (among genetically susceptible individuals), while whole fruits do not.

4 Big Reasons To NOT Skip Fruit

1. Fruits have more polyphenols than veggies.

Polyphenols are plant compounds that have strong antioxidant and anti-inflammatory benefits. Polyphenols influence gene expression in a way that suppresses inflammation in the body.  This epigenetic action seems to play a key role in polyphenols ability to prevent diseases like cancer, neurological disorders and cardiovascular diseases. Polyphenols also have anti-microbial properties that can help us fight off infections.

Different fruits contain different types of polyphenols with slightly different benefits, so getting a wide variety can maximize the health benefits. One of the biggest issues with the anti-fruit movement is the dismissal of the high polyphenol content of fruits in comparison to veggies. In a study that identified the top 100 foods with the highest polyphenol content, fruits accounted for 10 of the top 12 richest polyphenol foods. Incredibly, the globe artichoke was the only vegetable that made it into the top 30.

By reducing the variety and/or quantity of your fruit intake, you are missing out on the consumption of these health-promoting polyphenols.

2. The fibers and prebiotic action of fruits help support your microbiome.

Fruits are abundant in soluble fibers that will foster the health of your gut. The fermentation of soluble fibers by beneficial bacteria in the gut creates short chain fatty acids – like butyrate – that are the preferred fuel of the cells lining the colon. SCFAs are essential to maintaining the integrity of the gut lining. (“Leaky gut” anyone?) Specific short chain fatty acids produced by gut bacteria have even been shown to reduce the risk of gastrointestinal disorders, cancer and cardiovascular diseases.

In addition, a recent study suggests that polyphenols effectively modulated bacteria in the gut, with a prebiotic action towards good bacteria and a targeted attack of pathogenic gut bacteria with the antimicrobial compounds they create.  The synergy of the prebiotic selectivity and the fuel provided by the soluble fiber in fruit make them powerful and positive influences on the microbiome.

3. Fruit is a nutrient dense, portable carbohydrate source.

Fruits are a great source of carbohydrates to fuel our bodies while also providing us with more vitamins, minerals and phytochemicals than most other complex carbohydrate sources. Each fruit contains a unique set of benefits, so it is important to eat a wide-variety of fruits. Here is an excellent infographic that shows some of the unique benefits of different fruits.

In addition, people with gut disorders may only tolerate simple sugars in fruits versus complex carbohydrates. Certain therapeutic diets like SCD and GAPs protocols, which limit complex carbohydrate intake can be effective short term plans to treat certain GI disorders like Crohn’s Disease, Ulcerative Colitis, IBS and dysbiosis. Once the gut lining heals up and dysbiosis is addressed, these people can usually tolerate more complex carbohydrates again. But until their gut heals, less fermentable fruits are typically the most tolerated carbohydrates and can help individuals meet their carbohydrate needs during the early phases of gut remodeling.

The portability of fruits make them a great snack option when you are on the go! When you don’t have the time or kitchen to cook a sweet potato or rice, fruit is a great option to keep your tank full throughout the day. There are some days I eat 4 or 5 servings of fruit (or more!) because I’m on the road or simply too busy to cook a starch with my meal.

4. Fruits have been shown to prevent (not cause) disease.

Despite the claims that fruits will cause the blood sugar swings and inflammation that are possible from high levels of added sugar consumption, there has not been any evidence (that I am aware of) to support these theories. Actually, most studies show the contrary, with individuals consuming a greater quantity and variety of fruit intake showing a reduced incidence of type 2 diabetes and cardiovascular disease. And as I mentioned earlier, the polyphenols and fibers in fruit could have benefits in preventing many forms of cancer, despite their higher sugar content.

If you’re avoiding fruit for a fear of diabetes, heart disease, or cancer, you’re doing so based on inaccurate guidance!

Is fruit for everyone?

A healthy person usually can reap the health benefits of fruits by eating between 3-5 servings a day, but there are a few special considerations when a more cautious approach to fruit may be warranted. People with fructose intolerance, severe gut imbalances and metabolic disorders may not be able to tolerate the same variety or quantity of fruits as a generally healthy person.

If you have any of these issues, then it may be best to experiment to find the right types and quantity of fruit that is right for you. Work with a nutritionist to establish how much, and what types of fruit would work best for your individual needs.

The Bottom Line on Fruit

Enough with the fear of fruit!

Fruit’s high polyphenol content, high fiber and vitamin/mineral content make it an essential part of a healthy and enjoyable diet. Not only are they incredibly nutritious and satisfying, but they can provide a lot of pleasure in a healthy diet and should not cause you any guilt.

Now you tell me: do you eat fruit? Why or why not?

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  1. I definitely include fruit in my diet. I tend to eat berries (local when in season, frozen the rest of the year), stone fruits, some tropicals (love my pineapples and mangos), and the occasional apple. I have a slight oral allergy to bananas, but if i freeze them it seems to alleviate the itchy mouth/lips issue, so once in a while I’ll throw a frozen banana into a smoothie for some resistant starch. At one point in my 20s I was very nearly an inadvertent fruitatarian! Now I take a more balanced approach, but still eat a fair amount of fruit for a primal gal. I guess the NC heat and humidity make it even more appealing as a food choice.

  2. I love fruit and thought the “antifruit” propaganda was sheer silliness. I don’t eat as much fruit as I’d like to. Organic fruit isn’t cheap! But I certainly eat as much as I can afford to buy! And it’s reassuring to know, at 56, that my memory wasn’t playing tricks on me all these years because organic fruits and vegetables taste like what I remember then tasting like when I was a kid! Delicious and with the proper texture! How anyone can eat a conventionally grown red delicious apple is beyond my understanding. Yuck! I’d prefer a juicy bunch of grapes or a bowl of cantaloupe or watermelon to a soda or handful of Oreos any day of the week. Now, if only fresh pineapple didn’t give me mouth ulcers. Sigh!

  3. Great article Laura- But i have to say I too am studying to be an NTP and have NEVER heard any of my teachers or material say that fruit is bad or that carbs are bad. As a matter of fact they advocate a 40% carb, 30% fat and 30% protein diet ratio as a starting point. Everyone has their own bio-idividuality so again, this is just a starting point. Whoever posed that question must have misunderstood what they were hearing and should ask questions. NTA has a very balanced approach to nutrition and does not suggest to cut out any food groups unless there is a food sensitivity or intolerance that could be contributing to the problem.

    I think this fear of fruit stems from the Paleo community and not the NTP program.

    1. I was about to type the exact same thing.
      I have never heard in any of my classes to stay away from fruits, they encourage them.

  4. I am truly amazed by this article. I have different issues for my personal well being that I believe has suffered due to 20-30 mgs of carbs for a year straight. I am slowly bring back the carbs. Even in my appearance I noticed more line in my face in one year. Before the low carb I was juicing fruits and veggies. What a difference in my face the change this past year made on my face.

  5. I am new to your blog and just have to say how refreshing it is to read your posts. I am a microbiologist and a health-nut/nutrition “aficionado” and I love that you include science based articles and research in your posts. I recently started a whole30 and transitioned into a paleo lifestyle with some exceptions, and feel as though there are always SO many rules listed without any solid evidence to ever back it up. So much conflicting information. Thank you for sharing your knowledge and for your lack of “this is the only way” approach to your posts. Love them!

    1. Thanks Alicia! I try to make sure my recommendations are both open-minded and evidence-based. Happy to have you here!

  6. I really love your non dogmatic approach to nutrition. Having said that, I do tend to overeat fruit, especially during the summer when it’s fruit season (watermelon, grapes, cherries!!!), and I gain a lot of weight because of that. Also, my H A1C goes up. I do feel like I’m addicted to fruit (sugar in general, but I don’t eat refined sugar), so I have to be careful. However, I’m wondering if the weight gain is because I also eat lots of fat – isn’t high fat plus high sugar a recipe for disaster?

    1. If you’re doing both high fat and a lot of fruit, it’s most likely an excess of calories that’s leading to weight gain. Have you tracked your diet at all to see what your intake is?