The Health Effect of Eating Fruit (“Is Fruit just sugar?”)

Is there a difference between eating fruit, and eating refined, carbohydrates, like candy or soda, Or is it all the same because they’re all sugars? Fortunately, we have dozens of clinical trials where scientists gave people these different food sand observed their health effects. Studies have found that replacing some of the common sources of carbohydrate in people’s diets, like refined starch, for example, with fruit results in a reduction in hemoglobin, A1C, glycated hemoglobin, whereas replacing it with sugar sweetened beverages like soda or with sweets or desserts, refined carbohydrates does not have that effect.

Even in trials.

That added fruit to the regular diet, so not a replacement, but an addition. No detriment was seen to glucose or insulin levels, whereas trials that add sugar, sweetened beverages like soda see an elevation of those metrics Trials have also reported the effect of these different foods on lipids, like cholesterol and whole apples can help reduce both total cholesterol and LDL cholesterol when compared to an artificial apple. Drink made from concentrate so a more refined carbohydrate, even though both groups were matched for total sugars

So, it’s another indication that the source of carbohydrates does matter: It’s not all the same One study had an interesting observation. This reduction in cholesterol was seen with apples and also with cloudy apple juice, but not with clear apple juice. So cloudy juice still contains some small, solid particles, so it’s unstrained, and so it has more fiber and antioxidants than clear juice, where those solid particles have been filtered out.

So, this trial suggests that these particles and these nutrients may be responsible for this cholesterol.

Lowering effect Inflammation some trials have looked at inflammation as well, and some inflammatory markers can be reduced by adding fruit to a diet, but not by adding sugar-sweetened, beverages or sweets or desserts. These more refined carbohydrates

Blood pressure, similar overall, adding fruit to a diet, can help lower blood pressure, but not adding sugar, sweetened beverages or sweets or desserts. One trial tried to figure out what is it about fruit, exactly that has, this blood pressure, lowering effect and in this trial, they actually used juice, orange juice, specifically, probably because it’s easier to match the controls.

So, the intervention, group drank orange juice about half a liter a day and the control group drank the same amount of a control drink that was more refined but matched for overall carbohydrate content and overall calories, and they did see some blood pressure lowering effect of the orange juice specifically diastolic blood pressure Was significantly reduced whereas the control drink did not have this effect? So, then they tried to figure out exactly what molecules in the orange juice might have this effect. So, they added this flavonoid. This phytonutrient called hesperidin to the control drink, and they added the same amount that would be present in half a liter of orange juice

So, they tried to match the two drinks for hesperidin and, interestingly, that was enough to get that blood pressure lowering effect with the control drink. So, this trial is kind of a one-off.I haven’t seen other studies doing the same thing and it’s a bit of an artificial experiment. But interesting result suggesting again this idea that, it’s not just carbs…, what else is in the food? The whole food package probably matters. Satiety, feeling of fullness, also been reported in.

Some trials eating apples raises satiety for a couple hours following ingestion and it also reduces food intake in the subsequent meals, whereas sugar, sweetened beverages, soda does not, have this satiating effect.

In fact, trials where fruit replaced some of people’s regular carbohydrate sources and even trials. Where fruit was added to the regular diet, do not show increases in body weight or body fat.

If anything, we tend to see a bit of weight loss, so one large systematic review went over 41 randomized trials, and they found that fruit promotes weight maintenance or even modest weight loss. Whereas in trials where sugar sweetened beverages, soda is added, we tend to see weight gain Now, obviously there’s a limit to this phenomenon: Fruit, isn’t magic, So if I just eat all of my regular diet and, I throw kilos of fruit on top and I don’t take anything out yeah, I’m going to overeat calorie sand, I’m going to gain weight.

But this seems very unusual, we just don’t see that happening in these trials And, what’s probably going on, is that fruits decently satiating for the number of calories that it contains Its decently calorie dilute so it helps people maintain body weight or even lose little bit.

It’s not that it’s impossible to gain weight by eating fruit, but it seems unusual, doesn’t seem to happen to most people.

Soothe evidence we’ve looked at so far, some heterogeneity from trial to trial depending on the specifics. That’s always the case, but overall, pretty consistent pattern with fruit intake, of either maintenance or improvement of physiological parameters, whereas with sugar, sweetened beverages and refined sources of carbohydrate.

If anything, we tend to see parameters get worse.

Now. So far, everything we’ve looked at are randomized trials, but there’s also a large number of long-term observational cohorts following large numbers of people over long periods of time. And basically, they find that people who eat more fruit have, lower risk of coronary heart disease, lower risk of stroke, lower risk of colorectal cancer and lower all-cause mortality total death.

And.

This is after statistical adjustment, for obvious confounders, like smoking, exercise BMI age, So taking those off the table, the effect still survives These statistical adjustments, are not perfect Nothing’s, perfect Randomized, trials aren’t perfect either, But we want to be looking at different lines of evidence And if they agree, if they point in the same direction that raises our confidence in this direction of effect, These benefits in terms of risk of heart disease, cancer and mortality, they accumulate and then, they plateau around 200 to 300 grams a day.

Of fruit intake.

So that’s like an apple and a half two apples a day: It’s nothing!

So, the main bang for our buck seems to be when you go from nothing or very little intake to some. So, we don’t need to obsess over this or stuff ourselves with fruit to the point of vomit couple pieces of fruit over the course of the day, together with the rest of, a healthy diet, that’s what the evidence pointing to Now, the more specific we get with the question, the more uncertainty there is, that’s always the case. So, for example, we don’t have a randomized trial for every type of fruit out there in every exact amount, but the point of the video is that we have abundant evidence showing over and over that there’s substantial difference between eating fruit, eating these sources of whole carbohydrates and eating more refined, carbohydrates.

Things like soda or candy. Some of you may think it’s crazy that we’re even making this video may think it’s unnecessary, but we still get this question here and there.

I still see people kind of confused about this on social media and we can’t make informed decisions unless we have access to the information Becoming familiar with the scientific results a little bit helps us understand why all these recommendations all over the world by every panel of scientists keeps encouraging certain foods and keeps discouraging others.

It’s nonrandom on a more general level. Imagine for a second that somebody told you all fat’s the same. All fat is bad, doesn’t matter if it’s almonds, or olive oil or trans fats or bacon.

It’s all exactly the same physiologically. Nobody would take that seriously right.

It’s very similar suggesting that. All carbohydrates are the same.

Now why does fruit have such different physiological effects from refined, carbohydrates, like soda organdy. Several possibilities have been suggested and investigated. We already touched a little bit on the other components of these sources. Of carbohydrate, like fiber, like polyphenols these molecules, can affect absorption rate in the gut and. They can also affect the speed with which food moves through the gut, and that in turn, can affect your blood levels of glucose and insulin.

Fiber also helps with satiety It has a satiating effect that helps people eat less calories.

Overall. Another interesting factor is eating rate.

The speed with which we eat, and we tend to earless calories from solid food, especially food that forces us to chew a lot and finally another component that is rich in fruits.

That we haven’t talked about is potassium, which is known to help lower blood pressure.

What, if you have diabetes? Is fruit still safe or should you be scared? We actually touched on that question in a previous video and here’s a lot more on carbohydrate quantity and quality and fat quantity and quality and how to navigate all those questions. Check. Those out I’ll see you over there.

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