• Jamie Sculley, ND

Is the Sugar in Fruit Bad for You?



A common question you might be wondering about as you're eating healthier is whether fruit is "allowed." One goal of clean eating is to reduce sugar consumption so you might be wondering if fruit, which contains sugar, can be a part of a healthy diet.


In this post I'll talk about the sugar found in fruit called fructose, how it's different from what we know as sugar, and whether fruit can be a part of a healthy diet. I'll also give some low sugar fruit options if you're wanting to reduce your overall sugar or fructose intake.



What is Fructose?

Fructose is also known as "fruit sugar" because fruits are a major source of this sweetener. There are two other sugars that are a part of this conversation: sucrose and glucose. Sucrose is what we know as table sugar and is made up of 50/50 fructose and glucose. Glucose is a simple sugar and is what our cells take in for energy.


Fructose is found in foods like fruits and fruit juices; sweeteners like sugar, agave, and honey; and sugar sweetened beverages like soda. It's also found in high fructose corn syrup (HFCS) where it makes up 55% of HFCS and glucose makes up the remaining 45%.



How Is Fructose Metabolized?

Even though fructose is a sugar, it's metabolized differently than sucrose. This difference is why there are some negative health risks from eating too much fructose.


When we eat fructose it's poorly absorbed in our digestive system and needs to be processed by our liver because our cells can't use fructose like they can glucose. Our liver needs to metabolize fructose first and convert it to glucose so our cells can take it in for energy.


The liver can turn the fructose into fat, which can lead to fatty liver disease. It can also create cholesterol, especially the LDL (bad cholesterol), which is more likely to lead to blocked arteries and heart disease.


Fructose doesn't stimulate insulin release as much as glucose does, which is why it may be a better option for those with diabetes. But this also means that fructose doesn't lower ghrelin, our hunger hormone, so we remain hungry. It also means that our satiety hormone, leptin, stays low, meaning we don't feel full. Both of these mean that we continue to eat because our brain doesn't realize we're full. This can lead to overeating and obesity, which can lead to insulin resistance and diabetes.


Fructose can also lead to increased uric acid production and gout by creating a precursor to uric acid.


Possible Health Risks of Excessive Fructose Intake

  • Non-alcoholic fatty liver disease

  • High cholesterol (especially LDL or "bad" cholesterol)

  • Overeating

  • Obesity

  • Insulin resistance and diabetes

  • Cardiovascular disease

  • Metabolic disease

  • High blood pressure

  • Gout



Can Fruit Be Part of a Healthy Diet?

With all of this being said, I think fruit can be a healthy part of your diet. That's a scary list of possible health risks, but the key word here is "excessive" fructose intake. When you compare the amount of fructose in fruit to that in processed foods and soda, fruit is a minor source of fructose. You'd have to eat a lot of fruit for it to be excessive!


Fruit isn't entirely made up of fructose. It has many other benefits going for it like vitamins, minerals, antioxidants and fiber. Eating a few pieces of fruit per day is unlikely to cause health issues or negatively affect your blood sugar.


Excessive fructose intake from processed foods, soda, and sweetened beverages would greatly increase your fructose intake and, over the long term, put you at risk of those diseases. Eating fruit may actually be beneficial in that case because you'd be getting nutrient dense fruits in your diet, too.



High and Low Fructose Foods

If you don't absorb fructose well or want to reduce your consumption, here are two lists of foods that contain high and low amounts of fructose.


High Fructose Foods

  • Fruits: mangoes, grapes, pears, apples

  • fruit juices

  • fruit smoothies

  • honey

  • agave nectar

  • soda and sweet beverages (may contain HFCS)

  • processed and packaged foods (many contain HFCS)

  • sweetened yogurt

  • dressings and condiments


Low Fructose Foods

  • Fruits: strawberries, raspberries, blackberries, grapefruit, clementines, lemons, limes, pineapple

  • meat

  • vegetables



Summary

Fructose is also known as "fruit sugar" but can be found in foods other than fruit. Fructose is metabolized differently than sucrose. It's poorly absorbed in the digestive tract and metabolized by the liver. It also doesn't have the same effects as sucrose on our insulin or hunger signals. Possibly health risks of having too much fructose intake are non-alcoholic fatty liver disease, high cholesterol, obesity, insulin resistance, diabetes, cardiovascular disease, metabolic disease, high blood pressure and gout. Fruit can be part of a healthy diet because it's not a large source of fructose and has benefits like fiber and nutrients. High fructose foods include some fruits, fruit juices/smoothies, honey, agave, soda, yogurt and dressings. Low fructose foods include some fruits, meat and vegetables.



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In health,

Dr. Jamie




Resources

George A Bray, How bad is fructose?, The American Journal of Clinical Nutrition, Volume 86, Issue 4, October 2007, Pages 895–896, https://doi.org/10.1093/ajcn/86.4.895


Hannou, S. A., Haslam, D. E., Mckeown, N. M., & Herman, M. A. (2018). Fructose metabolism and metabolic disease. Journal of Clinical Investigation,128(2), 545-555. doi:10.1172/jci96702





This website is not intended for the purpose of providing medical advice. All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.


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