My nutrition guru, Dr. Michael Greger, does an update of the empirical literature each year to offer the latest in dietary research.  He has just released a new video on his website, about fructose.  What follows is the transcript of the video which can be seen HERE.



Transcript: If Fructose is Bad, What About Fruit?

If the fructose in sugar and high fructose corn syrup has been considered alcohol without the buzz in terms of the potential to inflict liver damage, what about the source of natural fructose, fruit?

Only industrial, not fruit fructose intake was associated with declining liver function. Same thing with high blood pressure. Fructose from added sugars was associated with hypertension; fructose from natural fruits is not. If you compare the effects of a diet restricting fructose from both added sugars and fruit to one just restricting fructose from added sugars, the diet that kept the fruit did better. People lost more weight with the extra fruit present than if all fructose was restricted.


These deleterious effects of fructose were limited to industrial fructose, meaning table sugar and high fructose corn syrup, with no evidence for a negative effect of the fructose in whole fruit. This apparent inconsistency might be explained by the positive effects of other nutrients (e.g., fiber) and antioxidants in fresh fruit.

If you have people drink a glass of water with three tablespoons of table sugar in it, which is like a can of soda, this is the big spike in blood sugar you get within the first hour. Our body freaks out and releases so much insulin we actually overshoot, and by the second hour we’re relatively hypoglycemic, dropping our blood sugar below where they were when we started out fasting. In response, our body dumps fat into our blood stream as if we’re starving, because our blood sugars just dropped so suddenly.

What if you eat blended berries in addition to the sugar? They have sugars of their own in them, in fact an additional tablespoon of sugar worth, so the blood sugar spike should be worse, right? No, not only no additional blood sugar spike, here’s the critical part, no hypoglycemic dip afterwards. Blood sugar just went up and down without that overshoot, and without the surge of fat into the blood.


This difference may be attributed to the semisolid consistency of the berry meals, which may have decreased the rate of stomach emptying compared with just guzzling sugar water. In addition, the soluble fiber in the berries has a gelling effect in our intestines that slows the release of sugars. To test to see if it was the fiber, they repeated the experiment with berry juice that had all the sugar but none of the fiber. As you can see, a clear difference was observed early on in the blood sugar insulin responses. At the 15 minute mark, the blood sugar spike was significantly reduced by the berry meals but not by the juices, but the rest of the beneficial responses were almost the same between the juice and the whole fruit, suggesting that fiber may just be part of it. It turns out there are fruit phytonutrients that inhibit the transportation of sugars through the intestinal wall into our blood stream. Phytonutrients in foods like apples and strawberries can block some of the uptake of sugars by the cells lining our intestines.


Adding berries can actually blunt the insulin spike from high glycemic foods. Here’s what white bread does to our insulin levels within 2 hours after eating it. Eat that same white bread with some berries, though and you’re able to blunt the spike. So even though you’ve effectively added more sugars, in the form of berries, there’s less of an insulin spike, which has a variety of potential short and long-term benefits. So if you’re going to make pancakes, make sure they’re blueberry pancakes.

Video Sources

R Torronen, M Kolehmainen, E Sarkkinen, K Poutanen, H Mykkanen, L Niskanen. Berries reduce postprandial insulin responses to wheat and rye breads in healthy women. J Nutr. 2013 Apr;143(4):430-6.

R Torronen, M Kolehmainen, E Sarkkinen, H Mykkanen, L Niskanen. Postprandial glucose, insulin, and free fatty acid responses to sucrose consumed with blackcurrants and lingonberries in healthy women. Am J Clin Nutr. 2012 Sep;96(3):527-33.

S Petta, G Marchesini, L Caracausi, F S Macaluso, C Camma, S Ciminnisi, D Cabibi, R Porcasi, A Craxi, V Di Marco. Industrial, not fruit fructose intake is associated with the severity of liver fibrosis in genotype 1 chronic hepatitis C patients. J Hepatol. 2013 Dec;59(6):1169-76.

R H Lustig, Fructose: It’s “Alcohol Without the Buzz. Adv Nutr. 2013 Mar 1;4(2):226-35.

K Johnston, P Sharp, M Cliffor, L Morgan. Dietary polyphenols decrease glucose uptake by human intestinal Caco-2 cells. FEBS Lett. 2005 Mar 14;579(7):1653-7.

S Manzano, G Williamson. Polyphenols and phenolic acids from strawberry and apple decrease glucose uptake and transport by human intestinal Caco-2 cells. Mol Nutr Food Res. 2010 Dec;54(12):1773-80.

M Madero, J C Arriaga, D Jalal, C Rivard, K McFann, O Perez-Mendez, A Vasquez, A Ruiz, M A Lanaspa, C R Jimenez, R J Johnson, L G Lozada. The effect of two energy-restricted diets, a low-fructose diet versus a moderate natural fructose diet, on weight loss and metabolic syndrome parameters: a randomized controlled trial. Metabolism. 2011 Nov;60(11):1551-9.

R J Johnson, T Nakagawa, L G Sanchez-Lozada, M Shafiu, S Sundaram, M Le, T Ishimoto, Y Y Sautin, M A Lanaspa. Sugar, uric acid, and the etiology of diabetes and obesity. Diabetes. 2013 Oct;62(10):3307-15.