People with diabetes need to carefully control their diet in order to keep their blood sugar levels in a healthy range.
When you eat carbohydrates, your body breaks them down into sugar, which enters your blood in order to be used as fuel. For diabetics, who cannot process blood sugar effectively, carbohydrates can raise blood sugar, and because of that, many diabetics try to limit or count carbs, including sugar and other carbs, like those from fruit or grains.
Fruit is a carbohydrate that contains sugar, and it may spike blood sugar levels if eaten excessively. However, fruit also has a high fiber content, and eating lots of fiber can regulate blood sugar levels and even help prevent type 2 diabetes.
Overall, healthy carbohydrates that contain fiber — like fruit — have much less impact on blood sugar than carbohydrates with no fiber, like soda or candy. Here’s why fruit can be a safe and appropriate option for diabetics.
Diabetics should be conscious of their fruit intake, but overall, fruit is still a healthy and important part of any diet for managing diabetes.
“There is a myth that fruit is sugar and shouldn’t be eaten if you are diabetic, but that isn’t quite true,” says Susan Besser, MD, a primary care physician in Maryland. “Yes, it is a carbohydrate and one should eat it in moderation, but it is actually a healthy carbohydrate and metabolized much better than other carbs like cakes, cookies, or candies.”
In fact, research has linked fresh fruit consumption to improved health for diabetics. A study published in the Public Library of Science in 2017 followed half a million Chinese men for seven years, asking about their fruit intake and measuring their blood sugar levels.
The researchers found that higher fresh fruit consumption was associated with a significantly lower risk of developing diabetes. And even for people with existing diabetes, those who ate more fresh fruit had a lower risk of death or developing serious health complications. The study concluded that diabetics should not be told to limit fresh fruit intake.
Moreover, consuming fruit at a young age may even reduce the risk of developing type 2 diabetes at a later age. For example, a study published in the Journal of Nutrition in 2018 found that lowering saturated fat intake and increasing fruits and vegetables in children ages 8 to 10 years old may improve insulin sensitivity, reducing the risk of type 2 diabetes.
Another study, published in the European Journal of Nutrition in 2019, examined the amount of flavonoids — chemical molecules found in fruits — eaten during the teen years and compared that with blood sugar data during adulthood. Researchers found that teens who ate more fruit and vegetables had a lower risk of type 2 diabetes as adults.
In saying fruit can be healthy for diabetics, “I am referring to fresh fruit, not canned or processed and not dried fruit,” Besser says. “Those have a higher sugar content, as the water has been removed, so you tend to eat more volume of dried fruit compared to fresh, and this will cause sugar spikes.”
And even among fresh fruits, certain types are best, depending on their sugar and water content, as well as a measurement called the glycemic index (GI).
This scale measures how quickly foods will cause blood sugar levels to rise, with a higher number indicating a more rapid spike in blood sugars, which can be dangerous for diabetics.
Foods with a GI of 55 or less, which includes many fruits, are considered low-GI foods, which are more beneficial than high-GI foods for regulating blood sugar.
The following fruits have a low GI:
These fruits have a higher GI and sugar content:
But GI isn’t everything — water content also matters. For example, even though watermelon has a high GI, it can still be a relatively safe option because it’s made up of 92% water.
“It is laden with sugar, but due to its high water content, the amount of sugar per serving ends up being reasonable,” says Orville Kolterman, MD, chief medical officer at Pendulum, a company that makes products to help control glucose levels.
Fruits can also affect diabetics in different ways, depending on their specific circumstances. The best way to know how each fruit will affect your body is to check your blood sugar right before and 1 to 2 hours after eating fruit to see how you personally respond.
“The secrets to success for patients with diabetes are to pick fruits which are low in sugar content and control the portion size that is ingested,” Kolterman says.
Portion control is important when eating fruit, according to the American Diabetes Association (ADA). While it can vary depending on the size and type of fruit, in general, a single portion of fruit — one piece of whole fruit or a 1/2 cup of sliced fruit — contains roughly 15 grams of carbohydrates, which is considered one carb serving.
Most adults with diabetes should eat 3 to 4 carb servings per meal and 1 carb serving per snack, though you should check with your doctor to develop an individualized eating plan. The ADA recommends “exchanging” carbohydrates from dairy or grains if you’re going to eat a piece of fruit. This ensures that you’re still limiting your carbohydrate intake.
Overall, speaking with your doctor or a registered dietitian can help you craft an eating plan — including fruit — to meet your specific needs.