Mitch sat in my office, looking much the same as he had on prior visits.
At 5 ft 7 inches, he weighed a comfortable 159 lb, though he did have a small visible “paunch” above his beltline.
I had been seeing Mitch for his heart scan score of 1157 caused by low HDL of 38 mg/dl, severe small LDL (87% of total LDL), and lipoprotein (a).
Part of Mitch’s therapeutic program was elimination of wheat, cornstarch, and sugars, the three most flagrant triggers of small LDL particles, and weighing his diet in favor of oils and fats to reduce Lp(a). However, Mitch somehow failed to follow our restriction on fruit, which we limit to no more than two 4 oz servings per day, preferably berries. He thought we said “Eat all the fruit you want.” And so he did.
Mitch had a banana, orange, and blueberries for breakfast. For lunch, along with some tuna or soup, he’d typically have half a melon, a pear, and red grapes. For snacks, he’d have an apple or nectarine. After dinner, it wasn’t unusual for Mitch to have another piece of fruit for dessert.
Up until Mitch’s last visit, he’d had blood glucose levels of 100-112 mg/dl, above normal and reflecting mild insulin resistance and pre-diabetes. Today, on his unlimited fruit diet, his blood sugar: 166 mg/dl–well into diabetes territory.
I helped Mitch understand the principles of our diet better and advised him to reduce his fruit intake to no more than the 2 small servings per day, as well as sticking to our “no wheat, no cornstarch, no sugar” principles.
While fruit is certainly better than, say, a half-cup of gummy bears (84.06 g carbohydrates, 50.12 g sugars), fruit is unavoidably high in carbohydrates and sugars.
Take a look at the carbohydrate content of some common fruits:
Apple, 1 medium (2-3/4″ dia)
19.06 g carbohydrate (14.34 g sugar)
Banana, 1 medium (7″ to 7-7/8″ long)
26.95 g carbohydrate (14.43 g sugar)
Grapes, 1 cup
27.33 g carbohydrate (23.37 g sugar)
Pear, 1 medium
25.66 g carbohydrate (16.27 g sugar)
Source: USDA Food and Nutrient Database
Fruit has many healthy components, of course, such as fiber, flavonoids, and vitamin C. But it also comes with plenty of sugar. This is especially true of modern fruit, the sort that has been cultivated, hybridized, fertilized, gassed, etc. for size and sugar content.
When you hear such conventional advice like “eat plenty of fruits and vegetables,” you should hear instead: “eat plenty of vegetables. Eat a small quantity of fruit.”
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