A question about fruit

[Lilian]

My sister was telling me that her HbA1c has gone up considerably. She said she did not know why. She does exercise a lot, does not eat bread, pasta, rice, potatoes, cakes, biscuits etc. but what she does eat a lot of is fruit. She has fruit with porridge for breakfast. She has fruit as a snack. She has fruit in salads. She said she has to have something sweet after a meal, and again it is fruit. Whole fruit not juice. She also has something she makes with cocoa and low sugar jam every day. I mentioned it is probably because she has too much fruit. She sent me a copy of a Diabetes UK page that says people should eat more fruit and vegetables including people with diabetes. She has taken that to mean she can eat even more fruit without harm. She wont listen to me now because Diabetes UK says it is OK. She also says she has heard porridge is good for breakfast for a diabetic, and as she does not eat any other high carbohydrate foods that should not be a problem. However, I pointed out she does have a problem because her blood glucose is going higher. I just do not know what to say to her. I cannot compete with the official Diabetes UK page.

 

[pm133]

My sister was telling me that her HbA1c has gone up considerably. She said she did not know why. She does exercise a lot, does not eat bread, pasta, rice, potatoes, cakes, biscuits etc. but what she does eat a lot of is fruit. She has fruit with porridge for breakfast. She has fruit as a snack. She has fruit in salads. She said she has to have something sweet after a meal, and again it is fruit. Whole fruit not juice. She also has something she makes with cocoa and low sugar jam every day. I mentioned it is probably because she has too much fruit. She sent me a copy of a Diabetes UK page that says people should eat more fruit and vegetables including people with diabetes. She has taken that to mean she can eat even more fruit without harm. She wont listen to me now because Diabetes UK says it is OK. She also says she has heard porridge is good for breakfast for a diabetic, and as she does not eat any other high carbohydrate foods that should not be a problem. However, I pointed out she does have a problem because her blood glucose is going higher. I just do not know what to say to her. I cannot compete with the official Diabetes UK page.

I was warned by my diabetes nurse to be careful with fruit because it can be high in carbs and can cause fast glucose spikes.

What you could advise her is to test her levels before her meal and then 1 or 2 hours afterwards to see which foods, if any, cause big spikes.

Do you have a link to that advice she has been given? I'm very surprised she is being advised to eat that quantity of fruit.

ETA. Just found the page. She may not be interpreting the advice properly. They are talking about fruit being better than cake for example. They are NOT advocating eating half the Tesco fruit aisle every day. 2 normal sized bananas will have more carbs than 100g of Galaxy milk chocolate as an example. Whilst the bananas are generally more healthy, you can't escape the carbs. I get away with this because as Type 1, I can take insulin to cover it. If she's Type 2 she'll struggle.

It might be worth buying a blood glucose meter and getting her to start testing as I suggested above. She will struggle to argue against hard evidence of high blood sugar readings.
An alternative approach would be to get her to weigh her food and accurately record the carbs count each day. If she's hitting over 150g per day as a Type 2, that will help her see where the issue is and which foods are carb heavy.

 

[Drummer]

Oh wow - she is eating so much high carb stuff - the porridge, the jam, and the fruit - if she can see her levels going up now, all she needs to do is cut the carbs and she will see changes pretty quickly. They do say seeing is believing.

 

[Inka]

Somewhere it specifies that fruit shouldn’t make up more than X amount of the recommended daily fruit and veg intake. When people hear “Eat more fruit and veg” they always seem to home in on the ‘fruit’ bit and forget the veg. It’s veg that we should be eating more of mainly.

A blood sugar meter will show her what she’s can cope with, including the porridge. Even if she can eat a little fruit, she might find that certain fruits work better than others.

 

[Lilian]

This is what she is relying on https://www.diabetes.org.uk/guide-t...-with-diabetes/food-groups/fruit-and-diabetes Third paragraph down.

 

[Inka]

This is what she is relying on https://www.diabetes.org.uk/guide-t...-with-diabetes/food-groups/fruit-and-diabetes Third paragraph down.

Yes, but it goes on to give further clarification, so I’d draw her attention to that. It’s also talking about things to cut out first from your normal diet:

The amount of carbohydrate you eat has the biggest effect on your blood glucose levels after eating. A portion of fruit, such as a medium apple, generally contains about 15 to 20g carbs, a chocolate muffin has 55g carbs and a 500ml ordinary fizzy drink has 54g carbs. It is better to reduce your intake of chocolate, sugary drinks, cakes and other snacks than whole fruit when trying to restrict your carb intake to help manage your blood glucose levels. For people who follow a low-carb diet, it is important to identify the sources of carbs that are not healthy and cut those down first.

It is very unlikely that you need to reduce your fruit intake but you could keep a food diary to check how often and how much fruit you are eating. Many people eat fruit infrequently, but tend to have larger portions when they do eat them, so some people find that it is easy to overdo the dried fruit, grapes and tropical fruits.

If you consider a serving of dried fruit is only a tablespoon and packs in 20g carbs total sugar, you can see how easily this happens.

Be mindful of your serving sizes too – a large banana counts for one and half portions of fruit and contains about 30g carbs.

 

[rebrascora]

I agree that this info is unhelpful and very misleading. It says to spread your fruit intake out throughout the day, suggesting that you eat more than one portion of fruit and the final paragraph is headed...

How can I bump up my fruit intake?​

which totally gives the wrong impression that there is no upper limit.

I have to say this sort of outdated (in my opinion) information is what discourages me from supporting Diabetes UK.
Diet is a fundamental issue with diabetes (particularly Type 2) and the message has to be clear. We all know that the sugar in fruit does count and that it increases your BG levels. Yes it is better to eat an apple than a slice of cake but carbs are carbs and they get broken down into glucose just the same and by the sound of it this information is putting your sister and most likely many other people at risk. I would even go so far as to say it is potentially harmful information as it stands.

 

[Inka]

@rebrascora I don’t agree it’s harmful but I do agree that a few additions could be made to make it clearer, eg differentiating between Type 1 and Type 2, emphasising carbs a little more, and explicitly saying that if you’re a diet-only Type 2, for example, you obviously need to watch your blood sugar and your total carb amount wherever they come from. It does kind of say that, but not clearly enough.

However, I think we underestimate just how rubbish some people’s diets are, so replacing sugary processed c**p with fresh fruit might be a good starting place and would cut their carbs as the article tries to demonstrate.

Clearly if someone is diet-only and their blood sugar isn’t in range, they need to look at their diet and make appropriate adjustments. I think this article could have been tweaked a little to make things clearer, but that would never ever stop me supporting Diabetes UK - that’s uncalled for.

 

[everydayupsanddowns]

Sorry to hear you are having difficult conversations with your sister @Lilian

Does she seem to want to reduce her HbA1c?

I wonder if the changes she has already made seem to be as much as she can beat and the thought of dropping some of the fruit (which she clearly loves!) feels a bit too much to bear?

Has her fruit intake increased recently? And did it coincide with her HbA1c rise? Could she keep a food diary to begin to see the total carb-load around various times. As the Diabetes UK page says,

The amount of carbohydrate you eat has the biggest effect on your blood glucose levels after eating.​

​

So it might help to see where the sources are carbohydrate are concentrated (though I think, from what you have said we could guess!).

 

[Lilian]

I did suggest to her that she gets a tester @everydayupsanddowns. As that is really the only way she can see what she can tolerate, as everyone is different.

 

[grovesy]

I did suggest to her that she gets a tester @everydayupsanddowns. As that is really the only way she can see what she can tolerate, as everyone is different.

As I have said many times , I have found over the years I have had to adjust what I eat as my tolerances gave changed.

 

[Lilian]

As I have said many times , I have found over the years I have had to adjust what I eat as my tolerances gave changed.

Yes, that is also a consideration, and another reason why type 2's need testers as well, especially when the HbA1c, which is supposed to be tested every three months, now stretches out to over a year.

 

[Mark C]

I was diagnosed in August and my finger prick tests show that the very worst single item I've eaten since for my glucose levels was a single lunchbox-sized banana. Shame for me because I ate two a day previously but I learnt quickly that they are just not something I can have now.

 

[trophywench]

A thing I've been having trouble with eating since they invented the BG meter in the 1970s - before that it wasn't apparent. Like certain other things - just packing in eating an item I wasn't particularly fond of anyway so NP, more recently though I sometimes have about an inch of the one my husband is eating if I just happen to fancy a taste. (He's always amazed at how little I want - and that applies to all food.)