Forbidden fruit? There’s a way out for diabetics

Though doctors routinely suggest eating fruits, anything consumed in excess will only worsen one’s health — especially for people with diabetes. This article provides insights related to fruits for diabetics.

Bengaluru resident Radha (name changed on request) learnt it the hard way last year: her blood sugar levels shot up dangerously and she landed in the emergency room. The 62-year-old, who had had diabetes for the past 10 years, assumed that consuming seasonal fruits would not affect her sugar levels. So, she ate two to three mangoes daily for a week, leading to a jump in her blood sugar.

“My sugar levels have always been in control, and I follow a good diet,” Radha told Happiest Health. “I love seasonal fruits like mangoes, watermelon and muskmelon, which I eat every year. It had never affected my sugar levels. Last summer, I ate too many mangoes and watermelons and also had fruit juices along with my lunch.”

But one day, started to sweat a lot and felt very tired. “I checked my sugar levels using the glucometer we keep at home,” she says. “But when the numbers did not appear on the device’s screen and it indicated ‘HI’, I assumed it to be an error in the reading. Post lunch, I couldn’t do any work and just sat at home taking heavy breaths. Then my family took me to hospital and the doctors informed me that my blood sugar levels had shot over 600.”

Later, the doctor told Radha that HI indicates high blood sugar, which is often above a reading of 600–750 depending on various brands and machines. “The doctor said the fruits I had eaten had high glycaemic index (GI). Since I had also skipped walking for a few days, it led to an increase in the blood sugar levels and I had to be put on insulin,” says Radha.

Moderation is key

Any fruit can be eaten in moderation, says Dr Loveleena Munawar, consultant, Dr Mohan’s Diabetes Specialities Centre, Chennai, Tamil Nadu. She says fruits for diabetes that have a high GI — which increases blood glucose levels hours after eating them – need to be consumed with a combination of other fruits, say, as part of a fruit bowl.

“High-GI fruits should not be taken as a separate snack and should be taken only in moderation,” Dr Munawar says. “However, low-GI best fruits for diabetics can be consumed in plenty. People who love eating high-GI fruits need to balance them with nuts, curd or protein. For example, one can have an entire mango and reduce the number of chapatis/rotis or skip a meal to balance the diet. They could also exercise more and have the fruit along with milk or combined with low GI fruits.”

Dr Arun Shankar, medical director and chief diabetologist, Jothydev’s Diabetes and Research Centre,  Thiruvananthapuram, Kerala, says people with diabetes can include list of fruits for diabetics to eat in their diets in moderation. “Eating fruits may lower the risk of heart disease, cancer and stroke, and boost overall health. That’s important because diabetes is linked to a higher risk of heart disease and other problems,” he said.

Experts who spoke to Happiest Health pointed out that bananas — a moderate-GI fruit that varies with variety — can be eaten by those with diabetes.

Looking at fruits for diabetics: carbohydrates angle

He says people should consider limiting the amount of processed fruits such as apple sauce and fruit juices on the menu because these have had their fibre removed. “One serving of fruit has 15gm of carbs. But the serving size can be very different depending on the type of fruit. Fruits have carbohydrates and a form of natural sugar called fructose, which can raise the blood sugar levels. But fruits can still be part of your meal plan. They are full of vitamins, minerals and powerful plant compounds called phytochemicals. Some fruits do contain more sugar than others, but that doesn’t mean you shouldn’t eat them if you have diabetes,” says Dr Shankar.

According to Diabetes UK, the amount of carbohydrate a person consumes has the biggest effect on their blood glucose levels after eating. A portion of fruit, such as a medium apple, generally contains 15gm to 20gm carbs, a chocolate muffin has 55gm carbs and a 500ml ordinary fizzy drink has 54gm carbs. It is better to reduce the intake of chocolate, sugary drinks, cakes and other snacks than of whole fruit when trying to restrict one’s carb intake to help manage blood glucose levels.

Dr Shankar says mangoes are loaded with a variety of essential vitamins, minerals and fibre. “Over 90 per cent of the calories in mango come from sugar, which is why it may contribute to increased blood sugar in people with diabetes. However, this fruit also contains fibre and various antioxidants, both of which play a role in minimizing its overall blood sugar impact. Still, it should be kept in mind that people’s physiological responses to food vary. Thus, while mango can certainly be considered a healthy carb choice, it’s important to evaluate how you respond to it personally to determine how much you should include it in the diet,” he says.

Portion control

Busting a myth, Dr Munawar says many people believe Java plum (also known as jamun fruit) — which has low GI — to be an anti-diabetic  fruits for people with diabetes and presume that it brings down sugar levels. “There is no evidence that the fruit helps in bringing down the sugar levels. However, Java plum seeds are established for anti-diabetic medicine. The Java plum is a low-GI fruit and one can eat them in plenty, but not in excess. Any fruit eaten in excess can spike sugar levels,” she says.

Geethu Sanal, chief dietitian, Jothydev’s Diabetes and Research Centre, Trivandrum, Kerala, says that the best way to minimize high-GI fruits’ blood sugar effects is portion control.

“Eat mangoes in slices (two to three slices) rather than juices. Practising moderation, monitoring portion sizes and pairing this tropical fruit with protein-rich foods are simple techniques to improve your blood sugar response if you plan to include mango in your diet,” she says.

She says people with diabetes can have almost all fruits in moderation. But one needs to limit the quantity of certain fruits for diabetic patients that have got more sugars than others.

Fruit-wise

The total amount of carbohydrates in fruits affects the body’s blood sugar levels. One serving of fruit contains 15gm of carbohydrates. (The serving size may vary.) Here are examples of one serving of some fruits:

• One medium apple
• ½  banana
• One medium orange
• ¾ cup blueberries
• ½  mango
• Three dates
• One medium peach
• Three pieces of jackfruit
• 15 grapes
• One medium guava

High GI and low GI fruits for diabetics

While high-GI fruits need to be eaten in moderation, low-GI fruits can be had in plenty

High GI

• Watermelon
• Muskmelon
• Mango
• Papaya
• Pineapple
• Grapes

Low GI

• Cherries
• Apple
• Pears
• Strawberries
• Blueberries
• Guava
• Grapefruit