This video clip is taken from episode #194 – How Fructose Drives Metabolic Disease with Rick Johnson, M.D., originally released on February 7, 2022.

SHOW NOTES

Whole, fresh fruit

• Natural fruits are different; they have much less fructose in an individual fruit
  • Fruit juice is made from multiple fruits
  • Eat an orange and it has 6-8 grams of fructose, closer to 6 g of fructose and some glucose
  • Rick thinks natural fruits are fine, even for someone with NAFLD (fatty liver)
• There are certain fruits that are high in sugar— mangoes, figs, dates
  • Figs are very, very enriched in fructose; fFigs are probably something that we should avoid
• Apples and pears, plums, tend to be fairly high, around 9-10 grams
• Bananas are fairly high glycemic; they have a fair amount of fructose, but it’s probably in the range of 6-8 grams
• Most fruits are between 3-9 g, 10 g max, with the average being 4-6 g (see the table below)
• Some fruits have much less sugar— kiwi and berries (strawberries and blueberries)
  • People  should be encouraged to eat these

Figure 10. Fructose content per serving of fruit.  Image credit: Nature Wants Us to Be Fat

• Rick did a study, they gave people a low sugar diet that was low in refined sugar and low in high fructose corn syrup
  • Published in Metabolism in 2011, 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
  • One group got natural fruit, but was low sugar and low fructose
    • It was sort of a modest total fructose intake
  • The other group was restricted too
    • It was a low fructose diet that was low fructose in all aspects
  • They found equivalent improvement in metabolic syndrome in both groups

“The presence of natural fruit did not block the ability of the low sugar diet to improve metabolic syndrome” – Rick Johnson

• Peter notes, “The takeaway here is don’t drink it and don’t consume added sugar, and I think this is a difficult thing for people to differentiate. So added sugar is when a food has sucrose or high fructose corn syrup.  These are typically the most common agents that are added to the food. So if you go and get a jar of pasta sauce, they have added sugar to it.”
  • This is not the sugar naturally present in the tomatoes; it’s deliberately added to make it taste sweeter
  • Rick agrees
• Remember the intestine acts as a shield for 4-6 grams of fructose
  • Eating 4-5 g of fructose in a fruit is okay because the intestine’s going to provide protection
  • In addition, there is fiber in a natural fruit and that slows the absorption so the concentration of fructose that goes to the liver is lower
    • This results in less ATP depletion

Dried fruit

• Peter asks about dried fruits.  How does apple chips compare to a whole apple, when considering equal amounts of calories?

“The trouble with dried fruit is that it still has all the fructose, but a lot of the good things are removed… Dried fruit is sort of like candy.” – Rick Johnson