As someone with a family history of type 2 diabetes, the topic is always at the forefront of my mind. And although I’ve managed to avoid it, as a coach it still affects me. Having worked with many athletes who have type 2 diabetes or are at risk, it’s something that needs to always be considered. Insulin control isn’t just important for people who want to lose weight, but the challenges of managing insulin with diabetes in the picture become substantially more difficult and more important.
One thing most people know is that insulin responds to carbohydrates, and because diabetes is a metabolic disease centered on the insulin systems of the body, control of carbohydrate intake is paramount. A study this month in the Nutrition Journal examined the consumption of fruit in regards to diabetes.
Many doctors recommend the restriction of fruit intake to their patients afflicted with diabetes, and researchers wished to find out if this was a valid method of improving diabetes symptoms. Fruit is healthy, but amongst natural foods, it does tend to be higher in carbohydrates. By restricting fruit, you lose beneficial nutrients, but you also reduce carbohydrate intake, leaving doctors and diabetics with a dilemma.
The researchers looked at two groups of diabetic subjects. Both groups received medical care but with differing advice regarding fruit intake. Every patient completed the trial, and all but one followed the guidelines for eating fruit. Participants in the high fruit group were allowed more than two pieces of fruit a day, while those in the low fruit group were allowed no more than two pieces of fruit per day.
The high fruit group increased fruit intake from previous to the study by an average of 125 grams a day, which is about as much as a small apple. The low fruit group decreased intake by about 51 grams, which is only around half a cup of apples. These aren’t earth shattering differences in fruit amounts, but on average the difference between their respective adjustments was about the size of one standard piece of fruit.
The researchers examined waist circumference, body weight, and HbA1c, which is the amount of hemoglobin in your blond bonded with glucose. Each is a predictor of diabetes and the severity of existing diabetes cases. When the results came back there was no difference in any of those areas in either group, and in fact, both groups had a reduction in HbA1c.
Now, it’s important to be careful about what exactly is being studied. When you think about it, you’ll notice this study has as much to do with adherence to advice as it does with fruit intake. The difference of fewer than 200 grams of fruit total between each group is only about as much as a medium-sized apple a day. (And you know what they say about eating an apple every day.) The carbohydrate difference there was only perhaps about 25 grams daily, and that’s just in fruit. Since the fruit was higher in fiber, and the study wasn’t controlled for total carbohydrate intake, we need to examine the impact of these results with a fine-tooth comb.
With adherence to standard advice, there is no difference in markers of diabetes. However, this isn’t free license for a diabetic to go crazy eating fruit non-stop. Remember, carbohydrate intake is and will always be a necessary component to control for a diabetic. Eating one piece of fruit a day will probably give a diabetic health benefits, but beyond that, total dietary carbohydrate is probably more important.
1. Allan Christensen, et.al., “Effect of fruit restriction on glycemic control in patients with type 2 diabetes – a randomized trial,” Nutrition Journal, 12:29 (2013)
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