Health and wellness touch each of us differently. Here is one story.
Many people living with diabetes tend to avoid or limit their fruit intake as they feel it can spike their blood sugar.
As type 1 veterans, we’ve researched, experimented, and researched some more. Over time, we’ve discovered a simple strategy that works for us and allows us to eat as much fruit as we want — in a safe and healthy way.
Every person living with diabetes has to discover what works for them. But before you deprive yourself of all the goodness and amazing health benefits of fruit, get to know the details.
Getting the facts on fruit
Fruit as sugar
As tempting as it can be to label fruit as “sugar,” it’s important to know the specifics.
Eating fruit isn’t the reason why people have blood sugar issues — but fruit will affect blood sugar.
Fruits contain a naturally occurring and simple sugar called fructose. However, unlike many processed and refined foods with simple sugars, fruit contains an exceptionally high density of micronutrients, including:
Micronutrients are some of the most powerful components of whole foods. When you minimize your fruit intake, you limit the opportunity for all tissues in your body to absorb valuable anti-inflammatory micronutrients that are required for optimal tissue function and longevity.
And while fruits contain natural sugars, they also minimize your risk for premature death and decrease your risk for cardiovascular disease.
Years ago, we set out to find out: Is there a way for those living with diabetes to reap the benefits of fruit?
For us, the answer is definitely yes. The key is knowing how much to eat and how to pair fruit with healthy fats and proteins.
Fruit as carbohydrate
People with diabetes need to manage their carbohydrate intake, regardless of what type of carb it is. It’s crucial to know how many carbohydrates you’re consuming in one meal.
A single serving of fruit can contain 15 to 30 grams of carbs, depending on the type.
So while consuming fruit is incredibly healthy for anyone — including people with diabetes — knowing how many carbs you’re consuming is essential for those living with diabetes.
Fruit and fat
Consuming fruit with a protein, healthy fat, or both can bring down the Glycemic Index of fruit, which has a more positive effect on blood sugar. Combining fruits and fats also helps you feel full and avoid overeating.
The current recommended daily fat intake is 20 to 35 percent of total calories, with a focus on unsaturated fats. We do about half of that. Below, we outline how and why this has worked for us.
Again, diabetes management is a personal thing, but we’re living and thriving on this plan. (It was also examined in a 2012 study with positive results.)
Balancing carbohydrates, fat, and protein when eating more fruit
An important part of increasing our fruit intake was learning how to effectively balance carbohydrate, fat, and protein intake overall. Here’s how we ensure that we meet our fat and protein requirements while eating more carbohydrate-rich fruit.
Eliminate ‘empty’ carbs
In addition to fruit, we eat multiple servings of nutrient-dense foods packed with anti-inflammatory phytochemicals, including starchy and non-starchy vegetables and legumes (beans, lentils, peas).
We eliminated nutrient-poor, carbohydrate-rich foods, such as:
- refined breads
- traditional pastas
- glucose and fructose-sweetened beverages
These “empty” foods are often low in micronutrients and fiber, resulting in rapid blood sugar swings that can increase insulin resistance and the need for oral medications and insulin.
Explore plant proteins
There are two types of protein in food: animal protein and plant protein. It’s important to obtain a sufficient amount of protein every day, because every cell in our bodies contains protein in the form of enzymes, cell surface receptors, membrane proteins, and DNA protectors.
The type of protein you consume is extremely important. A diet high in animal protein promotes weight loss but can increase risk for many chronic conditions, including:
- insulin resistance
- heart disease
For those reasons, we both adopted a plant-based, whole-food diet that meets or exceeds recommended protein intakes without increasing our risk for chronic disease.
Understand the 3 types of fat
It’s important to differentiate between fat types and how they influence insulin resistance and diabetes risk.
There are three classes of fats: trans fat, saturated fat, and unsaturated fat.
Trans fats occur naturally. They’re present in very small quantities in beef, pork, lamb, butter, and milk (between 1 to 10 percent of all fat), but the overwhelming majority of trans fats are found in products containing partially hydrogenated vegetable oils. Think cakes, pies, cookies, doughnuts, crackers, microwave popcorn.
These can elevate your LDL cholesterol, reduce your HDL cholesterol, and increase your risk for cardiovascular disease.
Saturated fats generate a lot of debate about whether they improve or worsen the risk for diabetes. Proponents of low-carb diets like paleo and keto argue that diets high in saturated fat promote optimal metabolic health and improve diabetes health.
Fans of plant-based, whole-food diets (like us) contend that diets high in saturated fat increase your risk for diabetes-related problems, including:
- high blood sugar
- insulin resistance
- weight gain
- increased fasting blood sugar and insulin
- high cholesterol
- coronary artery disease
- chronic kidney disease
Unsaturated fats include essential fatty acids (EFAs). Meeting EFA requirements is important as they regulate many critical physiological functions, including:
- blood clotting
- blood pressure control
- cell division
- pain control
There are two “parent” EFAs your body can’t manufacture, so they must come from your diet:
Our low-fat, plant-based, whole-food diet contains significantly less ALA and more LA than typical Western diets.
But eating sufficient ALA is easy for us as all whole, plant foods contain small amounts of ALA. The National Institutes of Health guidelines for ALA consumption is 1.6 grams per day for men and 1.1 grams per day for women.
Increasing our fruit intake with diabetes
Having experimented with fruit intake and coached thousands of others through the process, these are our tips for increasing your fruit intake without experiencing frustrating high blood sugar. We can’t say this will work for everyone living with type 1 diabetes, but it’s worked for us.
We dropped our total fat intake to between 10 and 15 percent of total calories. For most people, that translates to a maximum of 20 to 30 grams of fat per day. We use a food tracker on our mobile devices to make sure our fat intake is in this range. Current recommendations are higher than this, but it’s worked for us.
We use the following table to determine fat target based on total calorie intake:
|Total daily calorie intake (kcal)||Suggested total fat intake (grams)|
We increased our intake of legumes (beans, lentils, and peas) in substitution for the fat-rich foods we previously ate. By doing this, we remain full as our total fat intake drops significantly. We aim to eat 1 to 2 cups per day for best results and never get tired of eating them. The recipe options are endless!
After four to seven days, we began increasing our intake of fruit and monitoring our two-hour postprandial (post-meal) blood sugar to ensure it was well-controlled. Reducing our total fat intake following steps 1 and 2 maximizes our chances of keeping stable blood sugar while eating multiple pieces of fruit per meal.
Over the course of two to four weeks, we aimed to eat approximately 5 to 15 servings of fruit per day for optimal energy levels and micronutrient intake.
If you choose to try this, don’t be in a rush to increase your fruit intake too fast. Take your time and only increase your fruit intake as your total fat intake stabilizes over time.
We remained consistent in our approach and our eating patterns. Blood sugar is a reflection of the consistency in your approach to food, so we do our best to resist “cheat days” or high-fat meals as they’re likely to cause very high blood sugar within 6 to 12 hours after that meal.
For those who do eat a high-fat meal occasionally, we suggest simply returning to a low-fat, plant-based, whole-food diet and remaining as consistent as possible, then watching as your insulin sensitivity increases once again.
Fruit has so much to offer in the way of brain and body benefits, including for those who must watch their blood sugar levels closely. We’ve found a way to eat more of it while managing our health and hope our step-by-step plan can provide some insights for others living with diabetes.
Cyrus Khambatta, PhD, and Robby Barbaro are the co-founders of Mastering Diabetes, a coaching program that reverses insulin resistance via low-fat, plant-based, whole-food nutrition. Cyrus has been living with type 1 diabetes since 2002 and has an undergraduate degree from Stanford University and a PhD in nutritional biochemistry from UC Berkeley. Robby was diagnosed with type 1 diabetes in 2000 and has been living a plant-based lifestyle since 2006. He worked at Forks Over Knives for six years, is studying toward a master’s in public health, and enjoys sharing his lifestyle on Instagram, YouTube, and Facebook.