Diabetics Need Not Restrict Fruit Intake, RCT Suggests
Marlene Busko
March 08, 2013
Contrary to popular belief, advising patients who are newly diagnosed with type 2 diabetes to limit their fruit intake does not improve glycemic control, according to a new study published online March 5 in Nutrition Journal.
Researchers in Denmark randomized 63 patients to high fruit or low fruit intake, and after 12 weeks, the 2 groups had similar drops in glycated hemoglobin (HbA1c) levels, weight, and girth.
"We conclude that advice to restrict fruit intake as part of standard [medical nutrition therapy] in overweight adults with newly diagnosed type 2 diabetes mellitus [TDM2] does not improve glycemic control, body weight, or waist circumference," the group, with lead author Allan S. Christensen, from the Department of Nutrition, Regional Hospital West Jutland, Denmark, writes.
"Considering the many possible beneficial effects of fruit, we recommend that fruit intake should not be restricted in T2DM subjects," they add.
Patients with diabetes are usually advised to eat more, varied, fiber-rich fruits and vegetables; high fruit intake, however, has been linked to lower risk of cardiovascular disease and some cancers.
Some health professionals remain concerned about fruit's high sugar content and tell diabetic patients to avoid eating too many fruits, despite a lack of any trial evidence.
Christensen and colleagues conducted what they believe is the first randomized intervention study to examine this.
They enrolled patients with newly diagnosed type 2 diabetes who had been referred for nutritional counseling. The patients were an even mix of men and women, with a mean age of 58 years and a mean body mass index (BMI) of 32. They met with a dietitian and filled in a 3-day food diary at the beginning and end of the study.
All received standard medical nutrition therapy. However, the 32 subjects in the low-fruit-intake group were advised eat no more than 2 pieces of fruit a day, whereas the 31 subjects in the high-fruit-intake group were told to indulge in 2 or more pieces of fruit a day.
A piece of fruit was defined as the amount that contained about 10 g of carbohydrate — for example, an apple (100 g), half a banana (50 g), or an orange (125 g). The subjects were also instructed to eat whole fruit, skip dried fruit, and not drink fruit juice.
The patients were compliant. Over the 12 weeks, on average, fruit consumption rose from 194 g/day to 319 g/day in the high-intake group and decreased from 186 g/day to 135 g/day in the low-intake group.
Patients in the high-fruit-intake group had a significant drop in HbAIC levels, from 6.74% to 6.26%. They also lost about 2 kg (from 92 kg to 90 kg) and trimmed their waist by about 4 cm (from 103 to 99 cm). However, similar results were obtained by patients in the low-fruit-intake group, and there were no significant between-group differences in these 3 outcomes.
"When changing the fruit intake, other changes in the diet most likely occur, and this would explain [the reason for] no difference in [these outcomes]," Christensen and colleagues speculate.
Marlene Busko
March 08, 2013
Contrary to popular belief, advising patients who are newly diagnosed with type 2 diabetes to limit their fruit intake does not improve glycemic control, according to a new study published online March 5 in Nutrition Journal.
Researchers in Denmark randomized 63 patients to high fruit or low fruit intake, and after 12 weeks, the 2 groups had similar drops in glycated hemoglobin (HbA1c) levels, weight, and girth.
"We conclude that advice to restrict fruit intake as part of standard [medical nutrition therapy] in overweight adults with newly diagnosed type 2 diabetes mellitus [TDM2] does not improve glycemic control, body weight, or waist circumference," the group, with lead author Allan S. Christensen, from the Department of Nutrition, Regional Hospital West Jutland, Denmark, writes.
"Considering the many possible beneficial effects of fruit, we recommend that fruit intake should not be restricted in T2DM subjects," they add.
Patients with diabetes are usually advised to eat more, varied, fiber-rich fruits and vegetables; high fruit intake, however, has been linked to lower risk of cardiovascular disease and some cancers.
Some health professionals remain concerned about fruit's high sugar content and tell diabetic patients to avoid eating too many fruits, despite a lack of any trial evidence.
Christensen and colleagues conducted what they believe is the first randomized intervention study to examine this.
They enrolled patients with newly diagnosed type 2 diabetes who had been referred for nutritional counseling. The patients were an even mix of men and women, with a mean age of 58 years and a mean body mass index (BMI) of 32. They met with a dietitian and filled in a 3-day food diary at the beginning and end of the study.
All received standard medical nutrition therapy. However, the 32 subjects in the low-fruit-intake group were advised eat no more than 2 pieces of fruit a day, whereas the 31 subjects in the high-fruit-intake group were told to indulge in 2 or more pieces of fruit a day.
A piece of fruit was defined as the amount that contained about 10 g of carbohydrate — for example, an apple (100 g), half a banana (50 g), or an orange (125 g). The subjects were also instructed to eat whole fruit, skip dried fruit, and not drink fruit juice.
The patients were compliant. Over the 12 weeks, on average, fruit consumption rose from 194 g/day to 319 g/day in the high-intake group and decreased from 186 g/day to 135 g/day in the low-intake group.
Patients in the high-fruit-intake group had a significant drop in HbAIC levels, from 6.74% to 6.26%. They also lost about 2 kg (from 92 kg to 90 kg) and trimmed their waist by about 4 cm (from 103 to 99 cm). However, similar results were obtained by patients in the low-fruit-intake group, and there were no significant between-group differences in these 3 outcomes.
"When changing the fruit intake, other changes in the diet most likely occur, and this would explain [the reason for] no difference in [these outcomes]," Christensen and colleagues speculate.
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