How Much Fruit is Too Much?

How Much Fruit is Too Much?
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Does the threshold for toxicity of fructose apply to fruit or just to added industrial sugars such as sucrose and high fructose corn syrup?

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Previously, I explored how adding blueberries to our meals can actually blunt the detrimental effects of high glycemic foods; but how many berries? The purpose was to determine the minimum level of blueberry consumption at which a consumer may realistically expect to receive antioxidant benefits after eating blueberries with a sugary breakfast cereal. If we eat a bowl of corn flakes with no berries, within two hours, so many free radicals are created it puts us into oxidative debt. The antioxidant power of our bloodstream drops below where we started from before breakfast as the antioxidants in our bodies get used up. And a quarter cup of blueberries didn’t seem to help much. But a half cup of blueberries did.

What about fruit for diabetics? Most guidelines recommend eating a diet with a high intake of fiber-rich food including fruits, because they’re so healthy—antioxidants, anti-inflammatory, improve artery function and reduce cancer risk. However, some health professionals have concerns about the sugar content of fruit, and therefore recommend restricting the fruit intake. OK, let’s put it to the test. Diabetics were randomized into two groups–one told to eat at least two pieces of fruit a day, and the other told at most, two fruits a day. The reduce fruit group reduced their fruit. It had, however, no effect on the control of their diabetes or weight–"and so the intake of fruit should not be restricted in patients with type 2 diabetes."

An emerging literature has shown that low-dose fructose may actually benefit blood sugar control. So having a piece of fruit with each meal would be expected to lower, not raise, the blood sugar response. The threshold for toxicity of fructose may be around 50 grams. The problem is that’s the current average adult fructose consumption. So the levels of half of all adults are likely above the threshold for fructose toxicity, thanks to industrial sugars like table sugar and high fructose corn syrup, and adolescents currently average 75.

Is that limit for added sugars or for all fructose? If we don’t want more than 50, and there’s about 10 in a piece of fruit, should we not eat more than five fruits a day? Quoting from the Harvard Health Letter, "The nutritional problems of fructose and sugar come when they are added to foods. Fruit, on the other hand, is beneficial in almost any amount." What do they mean almost? Can we eat ten fruits a day? How about twenty fruits a day? It’s actually been put to the test.

Seventeen people were made to eat twenty servings a day of fruit. Despite the extraordinarily high fructose content of this diet, presumably about 200 grams a day—8 cans of soda worth—the investigators reported no adverse effects (and possible benefit actually) for body weight, blood pressure, and insulin and lipid levels (fats in the blood) after three to six months. More recently, Jenkins and colleagues put people on about a twenty-servings-of-fruit-a-day diet for a few weeks, and no adverse effects on weight or blood pressure or triglycerides, and an astounding 38-point drop in LDL cholesterol.

There was one side effect, though. Given the 44 servings of vegetables they had on top of all that fruit, they recorded the largest bowel movements apparently ever documented in a dietary intervention.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to vic xia via flickr.

Previously, I explored how adding blueberries to our meals can actually blunt the detrimental effects of high glycemic foods; but how many berries? The purpose was to determine the minimum level of blueberry consumption at which a consumer may realistically expect to receive antioxidant benefits after eating blueberries with a sugary breakfast cereal. If we eat a bowl of corn flakes with no berries, within two hours, so many free radicals are created it puts us into oxidative debt. The antioxidant power of our bloodstream drops below where we started from before breakfast as the antioxidants in our bodies get used up. And a quarter cup of blueberries didn’t seem to help much. But a half cup of blueberries did.

What about fruit for diabetics? Most guidelines recommend eating a diet with a high intake of fiber-rich food including fruits, because they’re so healthy—antioxidants, anti-inflammatory, improve artery function and reduce cancer risk. However, some health professionals have concerns about the sugar content of fruit, and therefore recommend restricting the fruit intake. OK, let’s put it to the test. Diabetics were randomized into two groups–one told to eat at least two pieces of fruit a day, and the other told at most, two fruits a day. The reduce fruit group reduced their fruit. It had, however, no effect on the control of their diabetes or weight–"and so the intake of fruit should not be restricted in patients with type 2 diabetes."

An emerging literature has shown that low-dose fructose may actually benefit blood sugar control. So having a piece of fruit with each meal would be expected to lower, not raise, the blood sugar response. The threshold for toxicity of fructose may be around 50 grams. The problem is that’s the current average adult fructose consumption. So the levels of half of all adults are likely above the threshold for fructose toxicity, thanks to industrial sugars like table sugar and high fructose corn syrup, and adolescents currently average 75.

Is that limit for added sugars or for all fructose? If we don’t want more than 50, and there’s about 10 in a piece of fruit, should we not eat more than five fruits a day? Quoting from the Harvard Health Letter, "The nutritional problems of fructose and sugar come when they are added to foods. Fruit, on the other hand, is beneficial in almost any amount." What do they mean almost? Can we eat ten fruits a day? How about twenty fruits a day? It’s actually been put to the test.

Seventeen people were made to eat twenty servings a day of fruit. Despite the extraordinarily high fructose content of this diet, presumably about 200 grams a day—8 cans of soda worth—the investigators reported no adverse effects (and possible benefit actually) for body weight, blood pressure, and insulin and lipid levels (fats in the blood) after three to six months. More recently, Jenkins and colleagues put people on about a twenty-servings-of-fruit-a-day diet for a few weeks, and no adverse effects on weight or blood pressure or triglycerides, and an astounding 38-point drop in LDL cholesterol.

There was one side effect, though. Given the 44 servings of vegetables they had on top of all that fruit, they recorded the largest bowel movements apparently ever documented in a dietary intervention.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to vic xia via flickr.

Doctor's Note

Cutting down on sugary foods may be easier said than done (see Are Sugary Foods Addictive?),  but it’s worth it. This video is part of an intermittent series on the dangers of high levels of fructose in added sugars. See the first two installments in How Much Added Sugar Is Too Much? and If Fructose is Bad, What About Fruit?

That’s where I show the berry-blunting effects.

What’s this about being in oxidative debt? See my three-part series on how to pull yourself out of the red:

Ironically, fat may be more of a problem when it comes to diabetes than sugar; see:

If you haven't yet, you can subscribe to my videos for free by clicking here.

242 responses to “How Much Fruit is Too Much?

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  1. Makes perfect sense. Fruit: Fructose, fiber, vitamins, minerals, flavonoids, lignans, stilbenes, phenolic acids. No doubt that polyphenols prevent (and treat) various diseases. On the other hand, breakfast cereals: Sucrose, high fructose corn syrup, salt, trans fat, artificial color, artificial flavor, artificial sweetener, bleaching agent, preservative, stabilizer, white flour and a flavor enhancer – Bon appetit….




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    1. Well I purchase a breakfast cereal that contains no added sugar (only
      what’s already in the dried Goji berries), no added salt, no corn syrup,
      only trans fats if they’re already present in the nuts & cereals
      present, no stabilizers no white flour (no wheat in fact) certainly no
      flavour enhancers. This is the way it comes out of the box. It has way
      more fibre than any fruit. I think if you’re going to make a comparison
      like this you need to specify a fruit by name and a cereal by name, like
      apples compared to Froot Loops. Rolled oats is also a breakfast cereal.




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      1. But that fiber is not water rich, thus it causes a mucousal reaction, which certainly does not aid in digestion, absorption or utilization of the the nutrients listed on the side of the box.




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        1. That might be a reason as to why some people have digestion irritation after having a lot of nuts and seeds. Barely any water content compounded with the inability to chew thoroughly.




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      2. Which cereal is naturally hydrated and not processed? Cereals all have natural flavors (a toxic substance) and a host of fillers and the so called fiber will surely impact the colon especially when consumed with any MILKS like dairy, almond, soy or rice.




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  2. These studies seem to be repeating what Walter Kempner, M.D. did many years ago with the rice diet at Duke University which started in 1939. This is where he fed patients only rice, fruit, juice and sugar and they lost hundreds of pounds of weight, reversed their chronic kidney disease and a whole host of other chronic problems. Simply put we should live Fruitastic lives. Again thanks for this great Fruitastic eduvideo!




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    1. This is a lie and that study was a fallacy. There were many things covered up in that study including the fact that not everyone followed it. The people who didn’t follow it lost weight while the others who did, gained. The entire study was grouped as a whole and called it proof so to speak. Proof of what though? A diet high in rice, fruit juice and sugar, causes weight gain? Then yes it proved that, but that’s not what it they reported.




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      1. I have used the rice diet and it works like magic. You will lose faster ad Greeley better than any other way. Plant based is the only way to real health.




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      1. I was very happy after subtitles became available again after the change to Vimeo. Most of the times there are short references in the videos where it is good to know which exact sentence is said at an exact moment, so subtitles are extremely useful.




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    1. Fruitarian diets are dangerous in the long-run and lead to major nutritional deficiencies such as zinc, selenium, EPA/DHA and iodine. Not to mention very low-fat diets are bad for overall cognition and hormonal functioning. Fatty fruits like avocado contain way more omega-6’s than omega-3’s, furthering hindering ALA to EPA/DHA conversion (on top of the very low amounts of dietary ALA to begin with). The whole anti-fat/low-fat dogma days are coming to an end. Inflammation causes heart disease, not fat or cholesterol. That is all.




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      1. Flax for omega 3 and Brazil nuts for the rest. Fruitarian doesn’t mean you ONLY eat fruit, my friend. Did you really come to Nutritionfacts.org to say that cholesterol does not cause heart disease?




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        1. If you think cholesterol causes heart disease, please take no offense but you are simply ignorant on the subject. Cholesterol is drawn to protect from excess inflammation, it is not the CAUSE. Inflammation from toxic fats such as trans fats or overcooked animal products, rancid oils, excessive omega-6’s, etc. is what causes heart disease, not fat in general. You’d still need to account for iodine, sodium, and balance out your O3:O6 ratio for optimal conversion considering ALA to EPA/DHA conversion rates are very low. Higher for women than men, however.




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        2. The above poster is talking about DIETARY cholesterol and fat. The FDA agrees with him as they just removed cholesterol limits from its dietary guidelines. So yes, the cholesterol that we eat does NOT cause heart disease.

          The above poster has it right. Inflammation causes the liver to produce LDL cholesterol to patch the lesions caused by the inflammation, a little like a band-aide. When the inflammation subsides the liver sends out HDL cholesterol to remove the LDL patch and everything goes back to normal. Why HDL is “good”: it’s cleaning up the patches and suggests there is not chronic inflammation.

          Heart disease starts with chronic inflammation. The liver does not send out HDL to remove the LDL patch because the inflamed state has not been reduced and in fact sends out more LDL because there are more lesions from the constant inflamed state.

          The unremoved LDL cholesterol is what clogs the arteries and they are a symptom of inflammation as the poster above stated.




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          1. Arto Beck: I recommend you take a look at this article which explains how the FDA got to their initial conclusion (which later got reversed): http://blogs.bmj.com/bmj/2015/04/28/neal-d-barnard-and-angela-eakin-yes-cholesterol-matters/. Very important details. As they say, the devil is in the details.
            .
            And, as it turns out, when it came to the final/actual guidelines that got released (as opposed to the preliminary floater ideas), the FDA did the very opposite of removing cholesterol limits form its dietary guidelines. The FDA got forced to actually acknowledge the science. In the end, the FDA strengthened their warning about cholesterol. You can read about it here: http://www.pcrm.org/USDA And here is a quote:
            .
            The Guidelines state: “As recommended by the IOM, individuals should eat as little dietary cholesterol as possible … Strong evidence from mostly prospective cohort studies but also randomized controlled trials has shown that eating patterns that include lower intake of dietary cholesterol are associated with reduced risk of CVD, and moderate evidence indicates that these eating patterns are associated with reduced risk of obesity. … Dietary cholesterol is found only in animal foods such as egg yolk, dairy products, shellfish, meats, and poultry.”
            .
            Sometimes the truth really does win. The problem is that many websites and the media didn’t bother to report what actually happened. If I were you, I’d be darn mad that the sources I rely on for good information did not inform me of this situation. Perhaps it is time to get some reliable sources of information!




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            1. Thanks for the info as it reminds me never use a coincidental confirmation to make a point, especially when it is from the USDA. Very helpful to remind me and everyone that when a big (fill in the blank) group agrees with you it’s probably for the wrong reasons.

              I will still agree with the above poster that the causes of arterial cholesterol have little to do with dietary cholesterol and everything to do with inflammation.

              You can point to study after study, as we alternatives have ours as well now, and especially with prospective cohort studies (which seem to be the majority of the studies they are referencing in your article), you will find that it’s almost impossible to make properly controlled study on humans for dietary habits to prove anything. There is always more than 1 dietary variable especially in prospective cohort studies, that render the experiment a non-controlled study and open to interpretation.

              As in the case of this video above. The Jenkins study is titled “high-fiber vegetable, fruit and nut diet”. That is 3 variables with different nutrient components with fiber being the common denominator. But we’ve got Dr. Gregor here inferring it as proof we can “eat all the fruit that you want” (over 200g/day of fructose in one stated example), 20 seconds after hearing the toxicity level of fructose is 50g/day. How is that possible? Then we are distracted with poop jokes to avoid the elephant-in-the-study fact and contradiction to good science that not only were there were vegetables and nuts in the study, the vegetables were at 10x the recommended serving or the practically impossible 6lbs/4kg per day.

              So you might be able to say that fiber negates the effect of super-high fructose toxicity but any concrete determination about fructose toxicity (and the point of this video) is scientifically moot.

              And again this article is spreading the same problems that the USDA has. So many posters are commenting for joy and telling their friends that they can up their fructose level with fruits, don’t worry about fructose toxicity, because this Dr. said so on this website that gives “nutrition facts.” It’s a .org for fruits sake, they can’t be misleading us!

              I understand the public’s frustration because they are getting it (badly) from all sides, this video included. You can see a small population of commenters who believe as I do throwing up their hands at such unscientific reasoning perpetuating poor nutrition. Shortly the public can get a combination scientific, historical, traditional and engineering perspective on nutrition and finally have some guidelines on what to do.




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              1. Well put! This conversation is an example of how we can find some common ground. Let’s all do our best at not letting our egos get I the way of our view of reality. I agree the liver is key. thanks to fruitarians and there focus on fruits, we learn more about fruits benefits instead of only hating on them like some anti carb people do. And thanks to the fat lovers, we are reminded that eating fat does not necessarily mean you will die of heart disease, cholesterol and saturated fats through diet do not raise blood sugar levels for most people…. And thanks to both fruitarians and paleo people, we know that you better be nice to your liver in order to control inflammation, regulate hormones, and control blood sugar.




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              2. The fructose toxicity level mentioned in the video refers to high fructose corn syrup (industrial fructose), not the fructose that comes from injestion of whole fruits. If anyone has a reference to a reputable study that report deleterious effect of high amounts of whole fruit consumption, can you please let me know?




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      2. Joe, inflammation doesn’t appear from no where. Possibly the single greatest cause of inflammation is animal-based food.




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      3. Who says you can’t take supplements as a fruitarian? :) Leafy greens have an amazing 3-6 ratio and should be a large part of any balanced fruitarian diet by volume.




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  3. Woot, so glad to see this one finally as I saw it coming. Here are shots from yesterday on cronometer. I average about 319grams of sugar from fruit per day and I often have people questioning it being too much. I think we all know it is fine, assuming our variety gets us the nutrients we need. But I’m glad to hear our thoughts are correct so far.




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    1. You said that paramount in a diet is one that “gets us the nutrients we need”. Fruits have a low nutrient density (variety of nutrients), low quantity (absolute levels of each/any) and poor nutrient/calorie, nutrient/sugar ratios next to vegetables, legumes, and for those that eat them animal products.

      The banana that you eat so much of is double the average fruit in the quantity of fructose, and only average or worse than the average fruit in the 20 major vitamins and minerals. It’s supposedly high potassium content as well as higher than average-fruit magnesium content might be high for fruits but both are below the average quantities for vegetables.

      In fact there is no vitamin or mineral that exists in higher quantities in normal fruits than in vegetables, and most vegetable vitamin and minerals averages are 2x or more than fruits. Except of course sugars, carbs and calories where the average fruit has 3x the amount in that category.

      My numbers are based on the USDA nutrient values and comparing 22 fruits and 29 vegetables. When I say “normal” fruits I exclude the exotics like camu camu (8x the vitamin C of parsley)




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      1. And yet while the fruits do have low nutrient quantity, they are there. And you can get enough of the nutrients you need eating fruit.




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      2. I think the line between fruit and vegetable is kind of indistinct. As I understand it, a fruit contains its seeds within its body. Fruits are squash, snow peas, tomatoes, eggplant, etc.




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    1. Hi David. I am not sure about a sweet spot for consumption? To me it seems the more red and processed meat consumed increased total mortality, compared with those eating the least meat.




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        1. On a cursory glance of the paper, the spot you mention is not really much different than its neighbors. What’s not clear is why there are no confidence intervals on that intake level. It seems they might have chosen a singular data point on that level to represent a consistent reference and it was probably the smallest point in the set. However, there should still be confidence intervals. Even looking at the table, though, you see those singular reference points, in most cases, fall inside the 95% confidence limits for both the category before and after. If the confidence bounds were included, that would happen for all cases. The difference there is not statistically significant and what seems to be a “sweet spot” is probably an artifact of how they chose that reference point.




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            1. Based on nothing other than that paper, what I would conclude is that there is an obvious upward trend in effect (hazard ratio) associated with increased meat consumption, but I could not reasonably conclude that there is some point where the effect increases with decreasing meat consumption (i.e. there is a “good” amount of meat to consume). That’s a conclusion unwarranted given the uncertainty in the data.

              In general though? I believe what you said is probably true and that’s how I view eating meat, but I haven’t done any thorough analysis of the literature. You’ll have to ask the nutritionfacts.org guys. :-)




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        2. I think I see what you were reading. You are right, when the consumption dropped in some categories to 0.0-9.9 g/d there was an up-tic, but I don’t think it reached statistical significance therefore it could have been due to chance. Then I see the researchers discuss this more, ” The EPIC results
          do not show the lowest relative risks (RRs) for subjects in
          the lowest meat intake category, but a slight J-shaped
          association with the lowest risk among subjects with low-to-moderate
          meat consumption. This was observed for
          red meat and poultry. Also, taking into account the
          results from the studies that evaluated vegetarian and
          low-meat diets, it appears that a low – but not a zero –
          consumption of meat might be beneficial for health. This
          is understandable as meat is an important source of
          nutrients, such as protein, iron, zinc, several B-vitamins
          as well as vitamin A and essential fatty acids (linoleic acid
          and to a minor extent eicosapentaenoic and docosahexaenoic
          acids also). A sub-optimal supply of some of these
          nutrients due to an unbalanced type of vegetarian diet
          seems possible and might be associated with an increased
          risk for morbidity and mortality. However, support for
          this hypothesis from the literature is not strong, especially
          when looking at the population level. Alternatively,
          subjects with very moderate meat consumption may
          be the group with the highest proportion of healthconscious
          subjects who also try to optimize their diet (as
          part of a healthy lifestyle).
          In contrast to the US results, we observed a consistent
          association between processed meat consumption and
          total mortality but not between red meat consumption
          and total mortality. Processed meats such as sausages, salami
          and bacon have a higher content of saturated fatty
          acids and cholesterol than fresh red meat; the latter is
          often consumed after removing the visible fat tissue,
          whereas the proportion of fat in sausages often reaches
          50% of the weight or even more. Both high saturated fat
          and cholesterol intake have been found to be related to
          the risk of coronary heart disease”




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          1. I guess if one is thinking objectively, it is possible (based on these findings) to see how diets like DASH, Mediterranean and Paleo garner some merit. BTW, thank you so much for your in depth response :)




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          2. So basically, if we eat well balanced vegan diet, it should be good. We can get protein, iron, zinc, several B-vitamins

            as well as vitamin A etc from other sources rather than the rotting animal flesh.




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  4. This is wonderful to know as I care for a diabetic who has now reversed it. I would like to know if diabetics can consume dates. And if yes, how many?




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    1. I was a severe type 2 diabetic and I reversed it with high fruit diet. I was off my blood sugar medication in only 10 days. However, I was not able to eat dates for about 30 days. After about 30 days, my insulin response to dates is very good and I can eat as many as I like. I highly recommend waiting until your diabetes is completely gone for a month before trying to eat dates, and check blood sugar when you add them to see how you respond.




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    2. Hi Arun. I think It depends on the person and the quantity of dates eaten. Some diabetes may experience extremely high bursts of sugar pending current glycemic levels and medications if they overdo dates. For most, dates should be fine, but i think it depends on other foods eaten in the diet. Dates do have fiber and other nutrients that can be helpful. Someone mentioned them below (Thank’s Mark!), I’ll share here.

      Thanks,
      Joseph




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      1. Hi Joseph. Thank you for your answer. No, we don’t go overboard with dates, but do like to sweeten our occasional dessert with them.




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      2. So tell me if this is correct–The glucose in fruits, not the fructose, causes the blood sugar spikes but polyphenols seem to help control those spikes. The problem with too much fructose is that it can increase uric acid, causing gout (and any other problems?) . Plus, fructose doesn’t cure hunger (doesn’t induce a satiety response). Is that correct?




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        1. I just re-read Dr. Greger’s earlier post on fruit juices. Darryl points out that 25 grams of fructose is about all we humans can absorb at one time–and that malabsorption at higher doses could cause intestinal problems. From those fructose charts referred to somewhere above, it seems that eating a piece of fruit is well below the 25g limit (Exception: a cup of raisins has a whopping 43 grams–not to mention its glycemic impact).

          Could you tell us how much fructose is in a cup of orange juice, apple juice and my current favorite, blueberry juice?




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      1. Hi Charles. The diabetes was reversed by strictly adhering to a whole foods plant based no oil diet. And we ave been on it since January 2014.




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  5. Why did the ultra high fruit [fruit sugar] diets not result in adverse effects?

    I understand there’s something ‘bad’ about added sugars, but what’s going on, what’s difference does it make to our bodies?




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    1. I used to have severe type 2 diabetes and I checked my blood sugar often. If I ate an ear of GMO corn, my blood sugar would spike to 300! I can several ears of organic corn and my blood sugar stays around 100. Something about the fructose is altered in GMO corn and GMO sugar beats, which affects the way the liver processes it. High amounts of GMO fructose causes liver problems and high blood sugar. I eat unlimited amounts of non-GMO fruit daily, and it healed my type 2 diabetes and my blood sugar is perfect now.




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      1. And, that is why I think any study on food should make the distinction between GMO/non-GMO foods and grass fed vs conventionally fed meat. I think it can change the outcome, and isn’t appropriately conclusive.




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    2. the difference is all the other good stuff inside the fruit. We find new micro nutrients all the time. So all plants can easily have many things in them that we just haven’t found yet or things we have found that are great for us and not present in refined products.




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        1. I don’t think so. Fruits have natural sugars that work with their fibrous environment. Adding plain sugar to high fiber foods is not the same thing, and as Jay M and MIkeOnRaw pointed out it may be the phytonutrients (antioxidants) that are helping, as well.




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      1. If you mind me asking, how severe were you and can you tell me what foods did you specifically eat? Can you eat like a normal person such as 2 cups of brown rice or other things like that?




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  6. Dr. G, this reminds me; I just tried one of the breakfasts you said you had on a Google talk: sweet potato (but I used kabocha squash,) dried berries etc. (I used frozen blueberries, black raspberries, and blackberries,) and cinnamon. It was simple to fix and great! I’d like to hear more of what you eat.




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  7. The video mentions benefit from berries to wheat and rye, and then 75 g or 1/2 C of blueberries to a typical high-carb low-fat sugary breakfast cereal. Should we expect negative ORAC before introducing blueberries to a healthier breakfast, such as oats, cashew milk, almonds, apples, fresh ground spices, flax, and a Brazil nut?




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    1. Not sure I would expect negative ORAC values, but perhaps very low. ORAC levels alone are not something to base our food choices, as I don’t think they take into account other variables (protein, calcium, fiber, etc). Of course, good to boost our antioxidants from whole food sources.




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    2. I’m not an expert by any means, but for myself, grain and vegetable based breakfasts don’t do me any harm. So adding fruit can only be extra goodness to your anti-ox levels.




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  8. I eat a diet very high in fruit, which cured my severe type 2 diabetes. However, I am still having very high uric acid levels. Does a high fruit diet cause high uric acid? I have tried remedies such as alkaline water, cherries, yoga, eating more leafy greens, drinking 3 liters of water a day, but my uric acid level is still too high. I have been vegan over 2 years, and I only eat fruits, veggies, leafy greens, and nuts. How do I lower my uric acid?




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    1. Sorry to hear you’re having that problem. I don’t have an answer for you, but I have a question. You don’t list whole grains or legumes & pulses (beans, peas, lentils, etc.), are these in your diet? I’m wondering if that type of fiber and other nutrients they provide might help, as suggested by this study on pub med. http://www.ncbi.nlm.nih.gov/pubmed/12350076
      I’m not sure if you’re limiting some plant foods because of potential purine content. I’ve seen comments elsewhere that purines from plant foods do not affect the body the same way as those from animal products. So I wonder if it’s like protein and iron where the plant sourced ones don’t seem to negatively affect much, but the animal ones do.




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      1. >>>I’m not sure if you’re limiting some plant foods because of potential purine content. I’ve seen comments elsewhere that purines from plant foods do not affect the body the same way as those from animal products.

        Right plant purines seem safe:

        http://www.nejm.org/doi/full/10.1056/NEJMoa035700.

        “We did not find a significant association between gout and the consumption of purine-rich vegetables, either as a group or individually. The variation in the risk of gout associated with different purine-rich foods may be explained by the variation in the amounts and types of purine content and their bioavailability for purine-to-uric-acid metabolism.5,17-21 It has been suggested that moderation in dietary purine consumption is indicated for patients who habitually eat large amounts of purine-containing foods, of either animal or vegetable origin3,4; however, our results suggest that this type of dietary restriction may be applicable to purines of animal origin but not to purine-rich vegetables.”




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    2. I’ve read that high levels of fructose increase uric acid levels although I have no information on fructose from fruit vs. high fructose corn syrup. Cf.
      http://www.wiley.com/WileyCDA/PressRelease/pressReleaseId-105115.html

      Other than cherries, there is evidence that vitamin C (~ 500 mg per day) can lower uric acid levels.

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169708/
      http://www.ncbi.nlm.nih.gov/pubmed/18464304

      although I read one article that says this is not so if one already has gout.

      Coffee (including decafe) has also been reported by Dr. Choi et al. to lower uric acid levels. Cf.

      http://www.ncbi.nlm.nih.gov/pubmed/17530681

      Different supplements are recommended but personally I don’t trust the ingredients although perhaps there are reliable cherry extract supplements on the market (there’s a limit to how many cherries I can eat!).

      As you likely know there are other factors to consider, e.g. BMI and exercise.




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    3. Very high fructose and fruit (apple) intake both increase plasma uric acid; a few studies 1, 2 suggest this accounts for the increase in plasma antioxidant capacity with fruit intake. At lower doses, the evidence is more equivocal 3.




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        1. Kidney stones and gout. On the other hand uric acid is also the predominant extracellular direct antioxidant, and high levels may be protective in Parkinson’s and Alzheimer’s – some take inositol to raise their uric acid.




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    4. > I have been vegan over 2 years, and I only eat fruits, veggies, leafy greens, and nuts. How do I lower my uric acid?

      I also following a high-carb, low-fat, low-protein diet based almost exclusively on fruits and veggies and my uric acid is at the low end of the range. If your diet is high in fruits, I would try reducing fats overall (including from nuts) and eat most of your fruits away from your veggies by at least several hours.




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      1. I also do high-carb, low-fat, low-protein, between 80/10/10 to 90/5/5. My fat is about 10-20g a day naturally occurring in fruits and veggies. Sometimes I do have a small amount of chia seeds or 1 brazil nut for selenium, but I do not add fats like avocado or nuts. Any nuts and seeds (which is an extremely small amount) would be with my evening salad, not sweet fruits.




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      2. >>. try reducing fats overall (including from nuts) and eat most of your fruits away from your veggies by at least several hours.

        I’m a vegan and have an also issue from time to tme with high uric acid (typically high normal at 6.3) and rare gout attacks (so I assume from time to time my uric acid level goes up much higher).

        I’d like to understand the reasoning behind your two suggestions (reduce fats, eat fruit at a different time than veggies). Thanks.




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    5. yes I have had high uric acid levels since going plant based 3 yrs but so far no serious gout that I havent been able to ward off with colchicine.




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      1. That’s one approach but for me personally I’d rather restrict fruit high in fructose or sucrose (which breaks down into fructose and galactose).

        I’ve read a recommendation that those with high uric acid should restrict fructose intake from all sources to no more than 25 mg/day. It’s easy to exceed that if you eat a lot of fruit high in fructose (and sucrose). However I have not been able to find a trusted medical reference for the 25 mg/d restriction.




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  9. Note…typo in the transcript: “…they recorded the largest bowl movements apparently ever documented in a dietary intervention.” Should be “bowel”. Great video, have often wondered if I’m eating too much whole fruit. Look forward to part 2.




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    1. I eat a lot of fruit daily and sometimes wonder/worry about this too. But whenever I go in for my annual physical my sugar blood levels are normal and my triglycerides are low. So, this is just more good news.




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  10. As part of my diet I drink 10 oz of organic pomegranate juice and 10 oz of organic tomato juice, along with 4 servings of fruit. Am I over doing it.




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    1. Sounds like you’re overdoing the juice, not the fruit, which are two different things. You might want to watch Dr. Greger’s video on it here: http://nutritionfacts.org/video/juicing-removes-more-than-just-fiber/ There’s others you can search for here too.

      I’ve seen more and more articles on the negative impacts of juice vs whole food. Sometimes it provides positives but I’ve never seen anyone talk about what you get from juice that you don’t from the same amount of real fruit (or veggies). The lost fiber takes with it some nutrients and more importantly, it frees the sugar, which is normally bound to the fiber, to rush rapidly into your liver and pancreas. Not a good thing.




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      1. The thing is sometimes it is hard for some of us to get in all of the fruit – it can be a lot to eat – particularly for those of us who are underweight and trying to gain (it takes me forever to eat), so juice makes it possible to at least get some of the nutrients, but fruit juice even without added sugars still tend to be high in sugars.




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    2. Good question. I think it depends on other foods eaten throughout the day. This doesn’t seem dramatically high to me, especially if you feel good while consuming that amount and appear in good health :)




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      1. Sorry I forgot to add that my diet is for an indolent tumor, my study says no sugar, but I have been had good results with my course of action on active surveillance for several years now.




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        1. Best to ask doctor or a dietitian who knows more about your case. I can help you find one if needed? Whole foods are best to obtain the nutrients. Mark G put a link to a video below. Juicing removes the fiber and polyphenols which are both cancer fighters. If you can do more whole foods that is a great start! AICR has a great write-up titled: Does Sugar Feed Tumors?, if interested. Warm wishes let me know how else I can help?




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  11. It would be interesting to see a live debate between Dr, Greger and Dr. Mercola. Dr. Mercola says to only eat 15 grams of fruit max a day and to eat unlimited coconut oil. He seems to have a big crowd of loyal followers.




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    1. In my personal experience, I used to eat meat (only organic) and coconut oil as my only oil. I still had severe type 2 diabetes. When I cut out the meat and oil and I increased my fruit, my type 2 diabetes went away very quickly. That is my personal experience. Yes, that would be an interesting debate, I would watch that.




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  12. Dr. Greger, I know this is off topic but I wish you would address this issue that I have been reading about in the press recently. Here is a Harvard Health letter on Cholesterol guidelines being changed. Dietary Cholesterol is no longer a problem according to the panel.

    http://www.health.harvard.edu/blog/panel-suggests-stop-warning-about-cholesterol-in-food-201502127713?utm_source=twitter&utm_medium=socialmedia&utm_campaign=021315kr1&utm_content=blog
    In the past, I know you have presented some interesting information on this topic that contradicts the direction that they are going in. I would like to know what your current thinking is on this topic.




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    1. Hi AA. It’s important to note the new DGFA are not written in stone, and they may change. In the article, “Keep in mind that this isn’t a done deal. The panel, which is formally known as the 2015 Dietary Guidelines Advisory Committee, makes recommendations for the next guidelines update, but these recommendations aren’t always followed.”

      Dr. Greger and Dr. Barnard touch on the cholesterol debate in their testimonies. Dr. Greger testifying at the DGFA meetings? It was just a few days back. This may help. I think he is at 2:06:00 . Another speaker is Dr. Barnard who address the issue at hand. He is probably like 15 min before Dr. Greger. He addresses the AHA/ACC report directly and Dr. Greger follows-up on it. That may help? FYI someone mentioned the timing is before 2:06:00. Try starting the video around 1:50:00.




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      1. Joseph Gonzales, thank you for your reply, I can see that Dr. Greger feels strongly about this issue, because he invested the time to do this. Are there any good videos on this site that explain the other side of the argument? I am curious how the pro dietary cholesterol members reached their conclusion.




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        1. Check out Harvard’s site ( i think they discuss eggs) and other studies in Pubmed. You are happy to share any findings :) I know Dr. Greger talks about the egg and beef industry and you can search website for those videos. One I found on eggs.




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    1. Although fruit is sweet and honey is sweet, they are not the same: contrast their fiber and micronutrient profiles to see why. Therefore, it seems (to use your words but with one important one added), “Honey over oatmeal” not “good.”




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            1. Jen1, I know what you mean about how blackstrap molasses taste can overpower the fruit a bit. Have you ever gotten to try the #1 natural sweetener? I was very surprised how much I like it. Goes with everything. Where I live, date sugar is expensive, so I usually buy it in bulk online (just a little tip in case you’re interested :) –Jen2




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        1. Adding sweetener (honey, molasses, sugar) doesn’t seem necessary to me anymore from the standpoint of palatability. (Twenty years ago it seemed necessary–but no longer.) The grain (whether cooked or right-out-of-container rolled oats or cooked steel-cut oats) plus fruit and, occasionally, cinnamon/vanilla extract is my daily breakfast. It’s plain but satisfying. Dr. McDougall would agree!




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    2. Not sure, olhg1. The best sweeteners (as in most nutritious) contain trace minerals and vitamins/phytonutrients such as date sugar and molasses. However, you are free to choose any type of sweetener you enjoy. The Fruit suggestion is a good one, too.




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  13. Yeah, tell me all about it !! I have been vegan for 30+ years and eat
    enormous amounts of fruit. I also manage to clog the water closet
    practically every time I have a bowel movement. I’m not exaggerating
    when I say that I hesitate to flush until I am well clear of the bowl
    and have a way out of the bathroom quickly! Whew! But I also frequently
    have more than one bowel movement a day, which I think is more natural
    and thus healthier. Apples, berries, bananas, raisins, strawberries,
    peaches, apricots, papaya (!!), grapefruit, many, many oranges,
    cherries, all the time all year around. Yes, fruit good methinks.




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  14. this video was exactly what i needed
    thanks a lots

    by the way is possible that a lots of fruits inflame my wounded knee?




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    1. If you have an allergic reaction to certain types than maybe. Some folks are sensitive to citrus, apple skins, and bananas. We saw this more so in study participants with pain (migraine headaches or rheumatoid arthritis) Nutrition intervention for migraine: a randomized crossover trial. Not sure you would even know without a fairly drastic elimination diet. If pain is so severe and you suspect certain foods (like fruit) causing this inflammation than it may be wise to consider playing around with diet, but honestly I would say very small chance the fruit is inflaming your knee. Thanks for the good question.

      Best,
      Joseph




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  15. This is extremely good news. Dr. Greger comes up with so many really useful videos. Humans have a natural proclivity for fruit, and being great apes, it only makes sense we should consume a lot of them. I feel healthier just even looking at one of those photos that are jam-packed with an assortment of colorful fruits and veggies.




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  16. I’m so glad you covered this! I’ve always thought it was mad when I hear about people who try not to eat fruit because of the sugar. Happy to have this video to back it up. Thank you.




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  17. Why does John McDougall only recommend 2 servings of fruit per day for weight loss? “Keep fruits to one or two a day. Fruit is largely simple sugar and people can easily eat 10 to 20 servings a day without a guilty thought – after all, fruit is healthy. In truth, fruits should be thought of as healthy desserts, made largely of sugar and water (but with lots of wholesome nutrients).” https://www.drmcdougall.com/misc/2005nl/050100pupushing.htm




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    1. Good question. The short answer is I am not sure? I know he has a forum, too ;) I am sure other members may know more. Keep in mind Dr. McDougall counsels folks with specific illnesses and has established a specific program. Dr. Greger discusses the latest research that may apply more to the general population. Diet is very personalized. Some folks don’t function well eating tons of fruit. Some folks do! If these studies hold true, more fruit (especially whole fruit) doesn’t seem to be a problem. I think the U.S. has more of a problem under consuming fruit, so I am not worried about portion control. This study is a large randomized trial on 300 obese or diabetic participants. Half were asked to follow a strict low-fat plant-based diet with no portion control or changes (so no restrictions on fruit). A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study. The results were very positive as many participants reduced their body weight and improved blood sugar control. So perhaps looking at the diet as a whole is more important than focusing on “how many servings of fruit per day is good”? From these studies in the video it is shocking how much was really consumed! For more on fruit If Fructose is Bad, What About Fruit? and a Ask the Doctor Q&A: How much fruit is safe to consume?. Hope that helps.

      Thanks!
      Joseph




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    2. Dr. McDougall is talking to people who need to lose weight and have a difficult time controlling their eating. Fruit is healthy but to pig out on it “eat 10 to 20 servings a day without a guilty thought” will not be as successful in losing that weight.

      And to address why he is strong on starches is they are filling, satisfying and nutritious. Also, provide energy.




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  18. I have a question. One prominent cardiologist recently posted that drinking smoothies was actually BAD because it separates the fiber from the fructose, and that chewing fruit was necessary to retain the healthy effects on blood sugar etc. because it is necessary to start the digestion in the mouth (I don’t remember all of the details). Do you have a comment on this? I do drink smoothies, because I have trouble eating enough fruit, but don’t want to actually do this if it is unhealthy. Thanks :)




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    1. It is a common question. I haven’t seen any research to support it. As I dietitian who loves to hear when people feel better from eating a more healthful diet I am less concerned about food preparation, and more concerned with simply eating whole foods. If smoothies help folks obtain nutrients then great. If others want to chew, awesome! Dr. Greger addresses this in his Q&A are green smoothies good for you? And I follow-up to a similar question, here. That may help. Again, great question and thanks for posting!

      Joseph




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      1. This is a summary of what I saw. I guess the article had to be removed because the discussion got a bit nasty. I would like to point out that I am using whole fruit and green leaves in them, and I am assuming other folks are blending whole fruits. I know that sugar spikes, and the insulin release that follows cause inflammation, which I am trying to avoid. I was under the impression that a smoothie, still being the whole fruit would help with this. Thanks for answering. I really appreciate you taking the time. :-)

        Why I Stopped Drinking Green Smoothies
        Written by Lindsay S. Nixon

        When I was at HTLA, delicious green smoothie in my hand, Dr. T. Colin
        Campbell told me not to drink them. I was crushed, heart-broken!

        Of course I wanted to know why — why shouldn’t I drink them? Aren’t they super healthy?

        Turns out they’re not.

        Dr. Campbell explained it to me very scientifically, and truth be told,
        a lot of it went over my head, but what I did pick up was I needed to
        chew my food and eat it whole — that smoothies, and juices, ruined the
        nutritive properties and it was far better for me to chew my spinach
        then pulverize and drink it.

        I’d heard this all before — from
        Dr. Essy, but after hearing it from both of them, I finally accepted
        what I didn’t want to believe: green smoothies were out.

        Quoting
        Dr. Essy: “Avoid smoothies. The fiber is so finely pureed that its
        helpful properties are destroyed. The sugar is stripped from the fruit,
        bypasses salivary digestion and results in a surge of glucose and the
        accompanying fructose contributes to inflammation and hypertension.”

        Similarly, here are his thoughts on juices: “Do not juice. You lose all
        the fiber and benefits.” With respect to fruit juice, “Drinking fruit
        juice is like pouring the sugar bowl down your throat. It is fine to eat
        the whole fruit. Do not drink the juice.”

        After I succumbed to
        this realization, I called a friend of mine who promotes green smoothies
        as her job, to get her take. Truthfully, I think I was hoping she’d
        tell me the doctors were wrong, and that it was okay to still drink
        them, but I was surprised when she agreed with them whole heartedly. She
        also told me that smoothies are 100 calories more than if I had eaten
        the fruit and greens whole. This I couldn’t believe — HOW is that even
        possible?! but she explained it to me: I’d burn 100 calories chewing the
        food (and then the digestive process of chewed food vs. predigested
        food).

        This got me thinking and I started taking a look at the
        smoothies I’d been drinking. They were all full of healthy, nutritious
        foods — like kale or spinach, mango or apples, dates and water, flax or
        hemp seeds… but they were easily 400 to 800 calories a pop… and I
        could suck them down so fast — I could never physically eat 400 or 800
        calories of whole food like that, and if I did, I’d be stuffed, and
        while smoothies left me feeling full, it wasn’t to the same level as a
        salad. I started to believe what the doctors had told me….

        So
        that’s when I put my blender away and stopped drinking smoothies. At
        first I missed them, but I’ve found that I feel fuller, and more
        energetic if I just eat the greens and bananas whole. I also used to
        have a mild sugar crash if my smoothie was really fruit heavy, and that
        doesn’t happen when I eat the fruit by itself.

        All and all I
        feel like a smoothie once in a while as a treat is probably fine; and I
        do think that if the choice is a green smoothie, or no greens at all,
        it’s better to go for the smoothie, but my plan is to eat my greens and
        fruits whole, whenever possible.

        Note: In addition to Dr.
        Campbell & Dr. Essy, Dr. McDougall, Dr. Klapper, Dr. Sultana, Dr.
        Lederman (FOK), Dr. Goldhammer and Jeff Novick are also in agreement
        here about smoothies. See Natala’s comment below for a very detailed
        explanation (she is a member of the Essy team/E2 Team), as well as links
        to studies and articles. (Thx N!)

        Note: a lot of people have
        asked about soups and hummus; Dr. Essy graciously responded on his
        Facebook page (I’m paraphrasing here) “The main difference is people are
        not drinking hummus and they are not consuming nearly the amount of
        calories at once; with soups, they are eating it slow, with a spoon and
        generally while also eating something else) and soups tend to be
        vegetable-based without fruit (unlike smoothies). Work on eliminating
        liquid calories for juices and smoothies and if you are still concerned,
        work on other things like soups, but smoothies/juices cause the most
        damage, so start there.”




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        1. I think when it comes to smoothies we should approach it with a bit more critical thinking than smoothies = calorie/sugar bombs = bad.

          Lindsey frames her article around such an obviously false dichotomy. She suddenly realizes that her smoothies are 400-800 Calories, so she must stop drinking them. What? What about a smoothie with 4 cups of greens, a cup of fruit, and a couple teaspoons of chia seeds. When I make smoothies that’s what I use and by my calculations it’s about 160 Calories.

          She goes on to reference a 100 Calorie difference in whole fruit vs blended fruit. Is that based on a 100 Calorie smoothie or a 1000 Calorie smoothie? That would be relevant information to know. And even so, for a certain parts of the population, the extra calories may not be a negative. Obviously to anyone trying to lose weight, yes, but for those who are at a desirable weight and even for those who struggle to gain weight or have trouble with large volumes of food (e.g. sick, elderly), this could even be a positive. Frankly, Lindsey sells 1200 Calorie meal plans for adults which she even claims to follow herself (as a relatively tall, active adult) and once wrote a blog entry about an episode of her “binging” on baby carrots. To me this indicates disordered thinking and perhaps her perspective on caloric intake should not be considered sound advice for the general population.

          In regards to Dr. E’s advice, again I think this perspective is again lacking in nuance and critical thinking. Really, works towards eventually limiting even hummus and blended soups? Where is his position on 100 Calorie smoothies? I consume more calories in a serving of hummus than I would in a smoothie. “Soups are eaten with other things”. When I make a smoothie it’s often with breakfast or dinner, so what does that mean? Most importantly, where is the evidence that these smoothies will in fact cause harm? I think reminding people to consume a reasonable number of calories is prudent, and people should be aware of potential issues and monitor their own weight, blood pressure, triglycerides, etc. and obviously adjust their diets accordingly. But putting additional limitations on what most current SAD eaters/potential WFPB eaters already envision as being a very restrictive diet, without solid evidence to back it up could be potentially harmful.

          I’m not saying I’m convinced that smoothies are absolutely good, but general WFPB diet principles are evidence based, while this particular topic seems to be lacking in that area, and is instead based largely on an appeal to authority.




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        2. Personally, I started using smoothies as a shortcut when learning to eat WFPB, weeks before making any other changes, and they definitely had enormous benefit in my numbers and how I felt! Anecdotes mean nothing I know, but I know plenty of other people who never did more for their SAD diet than add a daily smoothie, and continue to do so because of the results, so I really don’t think they are a negative at all. I used to be diabetic and I will always have to be careful, but even high fruit smoothies don’t spike my glucose, but juices will, so I am either an exception, or they may just be rationalizing.




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  19. My wife has always had high triglyceride levels. She was on statins because her resulting cholesterol was too high.

    Since 2011 we have changed to WFPB no/lo SOS diet. Yet my wife’s triglycerides were still too high and her doctor didn’t want to take her off the statins. He said she wouldn’t be able to lower her triglycerides with diet alone but he allowed her to stop taking the statins for 3 months to see what she could do.

    We found the answer on Dr. McDougall’s website. He mentioned that if you’re having difficulty getting your tryglercide levels down you might have to limit your fruit intake.

    My wife has always been a big fruit eater and hated the idea of giving up fruit.

    From the internet I was able to print out for her a list of all fruit by how much fructose each type of fruit contained. She just ate fruit from the bottom of the list, the fruits with the lowest amount of fructose.

    Much to her doctors surprise, her trygliceride levels finally came down.




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    1. Wow! Great story thanks for sharing this experience. Perhaps this shows everyone varies a bit and anecdotally if triglycerides remain high perhaps lowering fruit intake may help?

      Thanks for you comment.
      Joseph




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    2. Nutritarian, I agree with the brilliant Joseph :) Other factors that help normalize triglycerides are exercise, getting to a healthy body weight, and avoiding alcohol. Certain foods that you might also already be including (like flax, grapefruit, and amla have also been proven to help lower triglycerides. Hope your wife’s triglycerides stay low! Great to hear about both of your healthy lifestyle choices! :)




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    3. This is for sure right about triglycerides. I experience the same problem. After fruit I have diminished blood flow to my arms and legs. Fruit is not harmless by my experience. And Don Forrester, MD., who volunteers for NF observed this in his cardiac patients at McDougall center.




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      1. Except, as I understand it, that smoothies don’t allow for the initial stages of personal processing: chewing, mixing with saliva, the effect of mouth bacteria and or enzymes (I’m fuzzy on that) in preliminary digestion.




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        1. I thought that too. And it makes sense salivary amylase would not be as effective or utilized without chewing. I guess I am fuzzy as well! I think the most important question to ask: where is the research to support the claims that smoothies are bad? I am not saying never chew again, but maybe smoothies are generating a poor buzz based on science that has not been conducted? Not sure.




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          1. Well, there’s always “If it gets you to consume more greens/fruit” it’s prolly to the good. I’ve seen recommendations to ‘chew’ your smoothies, especially from Katherine Kyle of http://www.greenthickies.com/about/, whose ‘thickies’ incorporate oats. Chewing smoothies boils down to working each mouthful around in there a bit before swallowing, as opposed to pouring them in and swallowing immediately. I ran across her then blog early on. Though with no medical or scientific credentials, she seems well informed, focussed now as a weight-loss expert/coach.




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  20. I sat down at the computer and began to chow down on the delicious chunks of fresh pineapple I had hacked off from its mother ship. Total bliss! And then I found Dr. G’s video on fruit. How apropos is that? :-)




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  21. I have to follow a low FODMAP diet because of painful bloating and IBS. Not everyone can tolerate fruit. Also, the video doesn’t emphasise how important fibre is in moderating the sugar content in fruit, which is why whole fruits are preferable to juiced. This film does, however:

    https://youtu.be/6uaWekLrilY




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  22. I was a FlexFruitarian for a couple of years, got good and skinny real easy-but had to eat a LOT and every few hours. Flexitarian now.




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  23. I found myself eating more whole wheat pasta and bread, and paying for it with poor progress reports from my bathroom scale so I went back to my practice of doing green smoothies for breakfast and vegetables stir steams for dinner and I now am back in fighting trim again.

    There is something wonderfully energizing about pounding down 6 oz of spinach that has been well blended with a variety of seeds, fresh seasonal fruit, a banana. carrot and some ice cubes. I can feel the goodness radiating through my veins as a drink it down.

    I am probably getting more fresh fruits and vegetable for breakfast than most American get all week long. It’s sad really.




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  24. What happens in one’s body when their diabetes is “cured.” Does the pancreas regenerate itself? Are dormant islets of Langerhans jump-started to put out insulin again? What about the role of the liver? Anyone know??




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    1. Type 2 diabetics have a functional pancreas, in fact, often it is pumping out large amounts of insulin. The problem isn’t the pancreas, it is too much fat in the cells that won’t allow the insulin to do it’s job. Type ! diabetics are often helped greatly by a plant based diet, but rarely “cured” because they no longer produce insulin.




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  25. I’m now at peace knowing that the sugar coming from fruits is not actually bad. For 2 years now, I have embraced a fish, brown rice, vegetables and fruits diet due to CA diagnosis back in late 2012. My rad onco challenged me to take meat, processed sugar and dairy, among others, out of my diet, and double or triple my vegetables and fruits intake. Since it’s more convenient for me to juice or make a smoothie of at least 2 fruits and 1 vegetable in the morning, I do just that. Then, I bring some other fruits to eat in between work. A colleague commented that I am getting too much sugar just the same despite taking processed sugar out of my diet since 2 years ago. After watching this video, I am now at peace. Thanks, Dr. Greger! :-) … And I would like to add that from 130 lbs at the time of diagnosis, my weight went down after about 6 months and has been stable at about 110 lbs.




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  26. I had at chuckle at the end when the discussion turned to a ‘negative’ impact of the consumption of large quantities of fruit and veggies – the largest bowel movements ever recorded! Can I get a witness?




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    1. Why don’t you ask him? He has a website and there is no need for Dr. Greger to report the results of clinical studies, after he has interacted with other medical professionals to make sure they agree with the results of the study.
      Sometimes a medical professional makes recommendations on the basis of experience and strongly held beliefs, not on the basis of the results of studies.
      Take the question to that doctor. Don’t ask him to come here and argue his point for your clarification.




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        1. Okay, so do you want me to go to Dr. Forrester’s website and ask him…. No wait! You are the one with the credentials, Joseph, why don’t yo go tell him to come to this site and explain why he is recommending something that this study shows might be wrong.
          I didn’t know he did that, and as I told Victor, sometimes professionals have strongly held beliefs that can stand in the way of a study, But if you have a relationship with Dr. Forrester, instead of taking the question to the doctor then you make Dr. Forrester come here and explain himself.
          I am always open to being ignorant or wrong about any subject and I did say that Dr. Forrester doesn’t have to come hree and explain himself and I did guess he probably wouldn’t. But that’s what Victor wanted. If you can make that happen it would be great.
          I know nothing really.
          We can all ask questions, but we should make sure that the answer addresses the issue as well. In as kind and thoughtful a way as possible, of course
          So make it happen for Victor and me (I guess). That would be really cool!




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          1. :-) I only meant that Victor is free to ask any question. I’m not sure Dr. Forrester’s experience in the field about fruit. I just know we love when we helps respond to questions on NutritionFacts! Sorry if my comment was misleading. I agree with you that if someone has questions for particular docs the best route is to contact them.




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  27. I really want Dr Greger to do a video on calories, I’ve learnt so much over the last year since becoming vegan and I’m fully on the bandwagon with whole foods, fruit etc but the one thing i just can’t seem to find the answer on is ‘how many calories should we be eating’ i have an extremely sedentary job and i rarely exercise I’m 5ft 2 so do i really need 2000 calories a day or am i ok living off 1500 like i am? It is just so confusing, i want to do whats right for my body. If i eat in excess of 2000 why would i gain weight > and if i did then why would i if i am eating whole foods? if anyone has any good video or explanation on if we really need to eat for our height, weight, activity level??? People comment below because it is rather frustrating when people say you need less if your less active or less if your small and then someone tells you the opposite




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  28. Huh. My mother in law had horrible blood test results so her doc sent her to the Diet of Hope weight loss clinic where they told her to cut all fruit out of her diet. Is this clinic behind the times or might there be another health reason for cutting fruit?




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  29. Twenty servings of fruit a day is healthy for you? OMG. I think ‘Freelee the Banana Girl’ is the poster child for this study. She does eat a lot and a good variety of fruit on most days when she’s not eating 50 bananas to prove the point that fructose from whole fruits is not bad for you. More fruit should mean less sodium consumed and a more balanced electrolyte profile from one’s diet, so that seems to be an important aspect of it, too for heart health. I suspect it also helps those with fluid retention issues, and may be a factor was to why the people in the study are losing weight, waist circumference, etc., when they eat 20 servings of fruit a day..?




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  30. My nutritionist Anne-Marie told me not to eat more than 3 fruits a day, because of the risk of having «yeast infection» or «mushrooms» (I hopeI have the right word because I’m a French person… sorry if not but I hope you understand what I say)…




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  31. Wow, incredible. I just stumbled across your videos and it’s like–FUCKING FINALLY!–evidence-based videos on nutrition that SHOW you the actual quote from the study. . .man this is amazing!

    Well done. Thanks a bunch man!




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  32. So how is the amount of fructose measured say by per gram of a certain fruit? So if you chose a banana, If your banana (unpeeled) weighed 100 grams, how do you equate that into the amount of fructose in it?




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  33. Dr. Greger, I watched your video ( https://www.youtube.com/watch?v=nU_RkeA88DY ) and was wondering if the same results happen for refined white table sugar and sugars like unrefined organic coconut sugar. I’m wondering because 1-2 times a day I drink a hot carob drink with 1 tablespoon unrefined organic coconut sugar, water, and cashew milk. Would a drink like this without berries, have a negative effect on my blood sugar even though I use unrefined organic sugar?




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  34. “The nutritional problems come when the fructose….are added to foods” Does this mean I might be in trouble when I drink only smoothies (always combined a lot of fruits + green leaves) from 8am-6pm? as I see green leaves as ‘food’ ;-)
    Also someone warned me that due to these fruitgreens smoothies, they cause fermentation and liver damage. Do I need to worry?




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    1. Why would this cause fermentation, because you are combining fruits with the greens? Would fermentation not be an issue if you were eating them separately?




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      1. @Shaneq, I have no clue, I’ve been warned by several people but when I asked them why, they couldn’t explain, only told me that it is a common situation with a high fruit intake.
        Actually now that I read my post, these are 2 separate questions. The first one is a question as a response to the video. The second one (“also…….”) is separte one and should be: can a high fruit intake cause any liver damage due to fermentation




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  35. Fruit as a whole food is the best food for people. Since i’ve learned to eat fruit meals at least twice a day i feel better and better. I add 1 meal of veggies every evening. Now i just need to learn how to avoid stress.




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  36. Natural (none Genetically Modified) RAW Fruits, vegetables and nuts. As soon as the PHD lab technicians (secretly) attack genes of fruits and contaminate our fruits and vegetables (in 10 years or so), Raw Vegans will also get fat and die of cancer stroke and heart attack just like the rest of population if not at higher rates. Enjoy your natural, organic, raw fruits and vegetables while it lasts in this short historical time period, before it is stolen from us by FDA and other evil monsters.




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  37. “the nutritional problems of fructose-and of table sugar, which is another form of sugar called sucrose…” is there research about how lactose fits into to these ideas?




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  38. People also do not like to spend so much time in the bathroom. That’s another reason why they do not eat fruits and vegetables. Yes, I’ve heard people say that.




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    1. This makes no sense. The only reason people spend “so much time in the bathroom” is because their fiber-depleted diets make the passing of feces a slow, difficult, and often painful process. Those who eat a high-fiber diet & drink enough fluid spend little time in the bathroom (in & out quickly–in more ways than one), and it’s likely their total time for defecation is (far) less for 2 to 3 times per day than for 1 the slow/difficult/painful visit once a day of those consuming a fiber-poor diet. Recommended: John McDougall’s book _Dr. McDougall’s Digestive Tune-Up._




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  39. If your trying to lose weight, any fruit is too much. If your otherwise healthy and active; just enough fruit to keep you fueled and to satisfy your sweet tooth will do.

    Some fruit comes with a host of benefits like anti-oxidant properties (like berries), while other fruits don’t really offer anything ideal (tropical fruits). Sugar is sugar though, so if your sensitive to it and over weight, you shouldn’t eat it.




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  40. I eat a lot of whole fruit, 20 bananas a day. I have read that as long as the fruit is not separated from it’s fiber and eaten in whole form it does not cause blood sugar problems. I keep getting warned by anti-sugar people that fructose is bad for the liver and causes fatty liver. Again is this only for refined fructose and not fructose with the fiber intact? I would really like to put this one to bed once and for all thanks.
    Are there any medical studies on liver fuction from consuming natural whole fruit?




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    1. I’m no expert, but I think for the majority of healthy people, eating whole fruit is a positive, and it is not the same as added, manufactured fructose, as the video states. I think however, older people or people who already have medical issues may have to still experiment with how well they tolerate larger amounts of fruit. We are all human, but with different circumstances.




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  41. Hello,

    The effects of apricot kernels and its anti cancer properties has been documented….but what about other seeds? Cherry, apple, peach etc.

    doing a generic Google search, some pages claim that consuming seeds is toxic and harmful.

    The bible mentions in various versus to eat the fruit and seed. Any insight or information would be awesome. Thank you for your time!!!

    Chris




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    1. I would take serious caution here regarding apricot pits. An accidental swallow of an apple seed is not the same as cooking-up apricot pits (or however they are used). Just don’t think the science is there and I see more reviews on toxicity then benefits. This is old but relevant review discussing the lack evidence for vitamin B17. From my understanding folks tout apricot pits for their B17 content, but this is not factual or scientific from what I gather. Perhaps a better citation, here, as a site user pointed out a while back. Hope this helps. Thanks for reposting your question.




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  42. YaYY! Im so happy, I thought my fruit smoothies on top of my juicing greens were bad for me. I am more than happy that I can have more than one smoothie




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    1. That’s not recommended as a smoothie has separated the fiber from the fructose BEFORE it gets into your digestive system. The fiber, as stated in this video, is what minimizes the effects of fructose.

      Always better to eat high fructose fruits rather than juice them. And only eat a lot if you ALSO eat 2x the vegetables as this video shows.




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  43. For some fruits, I buy frozen, but organic, at my health food store. I wonder if there is added sugar if you buy fruit frozen in bags and if you consider it nutritious. Sometimes I read that Dr. Greger uses frozen fruits in some of his recipes, like his pink drink. Thank you!




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  44. Hmmmmm . . . Obviously a whole food plant based diet wins once again :D I still can’t help wondering if the 100+ grams of fructose per day consumed on a high fruit high raw diet is healthy in the long term though since fructose is processed by the liver and involves different hormonal signaling than glucose.




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  45. I’m so glad to hear this. A different vegan doctor on the web was saying that those with high cholesterol should have much less than three fruits a day. But do you think everyone’s different? Why is it that some people go on low carb diets and see their cholesterol drop? I know this is foolish if they do it with animal products, since they dramatically increase their chance of heart disease and cancer.




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  46. I’m seeing conflicting information here that does NOT support what the Dr. is saying. Put aside that the first “no amount of fruit is too much” study referenced (briefly) was from 1971… I’m sure there is something newer that relates to our current state of nutrition. And then the Dr. mentions the Jenkins study of 2001.

    But how does the Jenkins study prove anything about increased fruit servings? If you read the study’s title in the background (High fiber vegetable, fruit and nut diet) the only solid conclusion you can come to is that there are no bad effects from extremely large doses of a “high-fiber vegetable, fruit and nut” diet.

    Why does no one question the fact that the vegetable servings were 10x the normal and 2x the amount of fruits? First, how many people do you know who eat more than 6lbs/4kg of vegetables? Try none. In what scientific world is that a controlled experiment? How can you establish the fruit’s impact apart from the vegetables and nuts, the vegetables from the fruits and nuts, etc.? There are three variables that could be affecting/not-affecting the results and yet the narrator unscientifically uses the study to claim that 20 servings of fruits (234g/day fructose) has no adverse effect.

    Another point I’m struggling with is that fructose toxicity is initially stated as a fact and then having it magically disappear even at 4x this toxicity level inside of fructose fruits. How does a molecule lose that acute toxicity? Is there a fructose antidote in the fiber? Again why does no one question this miracle?

    The obvious story here and worth a rigorous scientific experiment is that high amounts of VEGETABLES can do amazing things besides large bowel movements … like counteracting what should be high fructose toxicity.




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  47. Based on some research…

    Fructose Toxicity…

    At high intakes fructose can be quite harmful. Here’s a brief list.

    • In the gut, fructose promotes gut permeability and poisoning of the body by endotoxemia.

    • In the liver, fructose promotes fatty liver disease and metabolic syndrome.

    • Fructose disposal generates uric acid, which can cause gout or kidney stones.

    “High fructose intake therefore leads to an accumulation of uric acid crystals in the joints, causing intense pain, a condition called gout. People with impaired fructose metabolism get gout at a high rate. Fructose, by way of uric acid, may be a major cause of kidney disease.”

    http://www.ncbi.nlm.nih.gov/pubmed/18258933?dopt=AbstractPlus
    http://www.ncbi.nlm.nih.gov/pubmed/2236043?dopt=AbstractPlus
    http://www.ncbi.nlm.nih.gov/pubmed/17921363?dopt=AbstractPlus

    • If the liver can’t dispose of fructose quickly enough and the blood level becomes elevated, it promotes cancer.

    http://www.ncbi.nlm.nih.gov/pubmed/20647326?dopt=AbstractPlus

    • High doses of fructose clearly promote obesity in clinical trials and in animal studies.

    Given the known dangers of high fructose consumption, it seems prudent to minimize fructose intake.

    Uh, there was a lot more I could have posted, but I doubt anyone is going to read it anyhow.




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  48. I ate a high carb, low fat diet that included 20 portions of fruit a day for over a year. I stopped when I got a xanthelsma on my eye which is a permanent and unsightly cholesterol deposit. After much research I deduced I had pre-existing low thyroid function and it was February so not much sunlight, cholesterol is a precursor to vitamin D right? I guess I also added coconut sugar to smoothies (Jeepers, what was I thinking?!). I’m now low fruit, paleo vegan (nuts, beans etc, but no/little grain). I have pre-ordered the book and hope to find the answers on the best diet in there… hopefully I won’t die whilst I’m waiting! But I’m actually not feeling great, so I’m looking forward to making some changes to my current diet!!




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  49. I eat tons of fruit and vegetables as a vegan. Just like what the video said, I have to go to the toilet every couple hours. The abdomen sometimes bloats significantly!




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  50. I recently encountered an unusual case. A person in his 20s who is eating ONLY fruits since he was 15 years old. Every several weeks he eats only ONE kind of fruit. He is spending most of his time in front of the computer searching and reading about nutrition. He is currently in relationship, sustains himself, is not neglected but is very thin. I was wondering is he suffers from an eating disorder (I encountered the term orthorexia)? How does this extreme diet affects is health? For instance, it is known that B12 deficiency can cause severe mental disorders. What about other deficiencies? What is the risk that this fruitarian diet pose? Noam Drigues, MD (Psychiatrist)




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  51. Thanks so much for the excellent presentations of important information. I can’t say how grateful I am that this resource is available to me when ever I need it….which is frequently!




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  52. But what about uric acid? My husband has still high uric acid with a whole food plant based diet, no sugar added, and every morning frozen cherries added to his müsli. Could it be too much fruit (since the beans shouldn’t alter the uric acid level?)? Now in summer we eat lots of melons, watermelons.




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    1. You can gain weight eating too much of anything, so yes, if you eat huge quantities of fruit, it could cause you to gain weight. However, that’s not anything specific to fruit; that’s just having more calories than your body needs. It’s much harder to gain weight (i.e. be overweight) on a WFPB diet than on the Standard American Diet because whole plant foods are rarely calorie dense (exceptions are avocados and nuts), unlike burgers, fries, soda…




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  53. For me, the video does not quite answer the question it raises:-
    1) it seems that fructose is
    much more effective than glucose in creating AGEs by
    cross-linking proteins – see the link at
    http://www.ncbi.nlm.nih.gov/pubmed/16583308
    Should we worry about how much fruit we eat in one sitting?
    2) It seems that pancreatic cancer cells thrive far more on fructose than glucose
    – see the link at http://www.ncbi.nlm.nih.gov/pubmed/20647326
    3) Even though there may by no sugar spike after consuming a large amount
    of fruit, the pancreas still needs to produce insulin to process the glucose,
    and the liver still needs to metabolize the fructose. Are these two organs not
    stressed by a large amount of fruit eaten in one sitting?
    4) Glucose is an upregulator for mTOR, so this could lead to
    accelerated aging.




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  54. It’s a pity that in the cited study, they spoiled the starch based diet by adding so much dairy. Otherwise, we would have had a direct two week comparison of the two popular nutritional philosophies – “the starch solution” promoted by Dr. McDougall and the raw diet advocated by Dr. Graham and the raw movement. This way, the slight lagging of the starch based diet can be explained by the delitarious effects dairy and olive oil.




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  55. I have noticed that as an early atherosclerosis sufferer (reversing thanks to Dr. Greger) if I consume too much fruit the insides of my blood vessels feel like ground glass is scratching them from the inside out. If I remove all fruit except 1-2 cups of blueberries a day I can avoid this scenario for weeks at a time.

    I thought fructose in fruit was supposed to be neutralized by the vaso protective phytonutrients and antioxidants?

    If I try to have more than 40-50 grams of fructose in fruit or more a day I can quickly get the ground glass feeling again in my blood vessels if I try to increase my fruit intake.. I am a low oil, no sugar vegan – so why does my vascular system get so inflamed when I try to eat more fruit?




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  56. OK I have a question I just can’t seem to settle in my mind… I have watched all of your videos on fruit, and I totally agree about the difference between fructose and whole fruit. My question is about triglycerides. I don’t have high triglycerides, but I don’t want them either. Some plant based doctors say no more than 2-3 servings of fruit a day. I was considering going to a high raw, high fruit diet (raw til 4) like Dr. Graham described, but I’m honestly nervous about what it would do to my triglycerides. Do you have any wisdom? Who do I believe? Dr. Graham who insists that, no, tons of fruit every day is fine, or other plant based docs who say too much is really bad?




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    1. Hi, stradless05, I am Christine, a NF volunteer. Dr. Greger recommends the Daily Dozen for a balanced, whole-food, plant-based diet. This includes 3 daily servings of beans, 1 of berries, 3 of other fruit, 1 of cruciferous vegetables, 2 of greens, 2 of other vegetables, 1 T of flaxseeds, 1 serving of nuts, 3 of whole grains, 5 of beverages, and 1 “serving” of exercise. There is a free app for smart phones to help you identify foods, serving sizes, and to track intake. More information on the app is available here: http://nutritionfacts.org/2015/12/31/free-app-for-android-and-iphone-and-top-10-videos-of-2015/ From my perspective, it is all about balance.




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  57. I have a condition called fructose malabsorption. A glass of apple juice, or a few dried pineapple slices, or about 10 cherries will have me crawling to the bathroom, in severe pain from my clavicle to my hips. It has something to do with methane and my small intestine not being able to absorb more than a certain amount of fructose per hour. I think it is 25 ____. Grams? I just avoid those fruits and keep fructose kind of low. I used to wake up with severe pain on my left side that could last for hours and some of it was the gas build up. I think this was from the fructose. Not sure. But this malady is rarely mentioned and it took a long time before I found the right term for it, by Googling something like “pain while drinking apple juice” and I found several people with the same condition. Usually the advice is totally wrong: “eat more fruit and vegetables, eat organic, eat more bananas,” etc.
    I am a 7 year vegan (for the animals) who eats starches and veges and very few fruits. It works for me!




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  58. Ahhh P-Values there show extreme significance or no significance for many of those attributes … that chart actually shows regardless of the hypothesis saying no signifance change occurred is impossible … thanks anyways … very convincing for someone not knowledgeable about statistics.




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