An interesting article popped up online overnight concerning whether or not the consumption of fruit can lead to weight gain. At face value, it could be one of those polarising pieces where both sides of the argument are claiming a blanket recommendation – either fruit consumption always makes you increase in body fatness, or oppositionally, all fruit consumption is entirely healthy and should be further encouraged. Except it isn’t anything of the sort. If one reads through it carefully, one can see that those in the “fruit can make you fat” camp are actually suggesting that context matters. And while, as best I can tell, none of the main players in this piece have any affiliations with any paleo paradigm, they address one of the common stumbling blocks for those jumping on the paleo bus – to fruit or not to fruit?
First the article – edited to stick to the most salient points…
It is a controversial concept that riles nutritionists but Rod Tayler’s theory that restricting fresh fruit in the diet can result in weight loss has been borne out by the experiences of participants in a trial he is running at the Epworth Hospital in Melbourne.
Dr Tayler believes the biggest driver behind the rapid rise in the nation’s girth is sugar, not fat. Fruit, he says, is full of it – a 150 gram apple contains four teaspoons of sugar.
He acknowledges that regular consumption is fine for anyone without a weight problem, but believes fruit needs to be cut out to lose kilos, along with alcohol and refined carbohydrates.
”There is nothing of nutritional value in fruit that you do not get from vegetables,” he said.
Dr Tayler’s quest was spurred by a dramatic rise in the number of overweight people presenting for surgery in the past 10 years. Although he has no formal training in nutrition, he started researching published scientific articles about obesity after reading the former lawyer David Gillespie’s book Sweet Poison. Gillespie’s book tells how he lost 40 kilograms after cutting out sugar.
Dr Tayler, an anaesthetist, initiated the Epworth Sweet Study last December and now has more than 100 participants, mostly health employees.
His unorthodox ideas about fruit have support from Ken Sikaris, the director of chemical pathology at Melbourne Pathology, who has a particular interest in blood sugar levels in the overweight and obese.
Dr Sikaris said the population falsely believed fruit was a ”safe haven”. Australian dietary guidelines recommend two pieces of fresh fruit a day.
”Some people mistakenly think that if two is good then four is better, but that is just not the case,” he said.
Fruit was traditionally small and seasonal and used to fatten people and animals during summer for the winter ahead.
”But we never have a winter any more, fruit is refrigerated and flown in from all over the world so we can have it all year round,” he said.
Let’s jump in at this point and look at some of the statements made. First, the comment regarding fruit as a safe haven. In my experience, both with my own eating and in working with other individuals as a nutritionist, this statement is absolutely correct. People have the perception that fruit is a free pass… that one can snack on fruit, ad libitum because, well, it is fruit, and fruit is a healthy whole food. Within both official public health recommendations and those made within the popular media, such as this article (where the vast majority of the public get their nutritional information), it is not uncommon to always read of “fruitsandvegetables” as if they are the same entity and entirely inseparable in terms of their impact on our biology and health outcomes. Both are plants, sure. But then wheat is a plant and nobody argues that wheat and vegetables are the same thing do they… Don’t answer that.
The point is, fruit, especially the modern stuff that has had its sweetness and sugar levels jacked up, can cause some individuals with underlying metabolic problems a few issues if they are relying on fruit too heavily. For someone just off the street and without the foggiest idea with regard to a paleo template, actual fleshy fruit is likely the least of their worries, so I’m not going to write with these people in mind. I’m going to focus on those who have (mostly) stripped all of the processed crap-in-a-box out of their diet, and have created a void in energy intake.
Obviously, I am going to advocate that this void be filled with good fats, quality sources of animal protein, perhaps some starchy root vegetables, and plenty of leafy greens. In practice, however, whilst most
women people are good at removing the processed grains from their diet and jumping on the low-carb wagon, they are decidedly average at loading enough fat and protein into their diet to compensate. This means that they go through the day feeling hungry and dissatisfied and wondering just what quick and easy “paleo” snacks they can fill up on. Enter fruits and nuts.
Now, the initial removal of the main problematic foods gets them so far. But then progress begins to stall and they may even slip backward. Then what? In my mind, this becomes the time that you seriously need to question whether even what might be considered a modest intake of “healthy and nutritious” fruit (and nuts, if they are being equally leaned on), is preventing these individuals from making progress. Maybe it is time that they swap some of these fruits out in exchange for more vegetables and starchy root tubers. Afterall, as Dr Tayler states above ”there is nothing of nutritional value in fruit that you do not get from vegetables.”
The article touches on the subject of seasonality. I don’t want to get too bogged down in this concept as I know a couple of very bright minds who are likely to tackle this topic in more depth and with more finesse than I ever could. However, if we accept that foods that would have been available only on a relatively seasonal basis, are able to signal to our biology and initiate a response appropriate to the season, then what signal might have the availability of fruits (and perhaps even nuts in an overlap) have sent to our physiology about the impending winter? What physiological response do we see in those animals who gorge themselves on fruits in the late summer, early autumn months?
From the article: “Fruit was traditionally small and seasonal and used to fatten people and animals during summer for the winter ahead.”
As one might expect, suggesting that over-doing the fruit intake might be leading to body issues with some individuals, isn’t going to be a popular stance within conventional circles. Here is that response;
However, the nutritionist Rosemary Stanton argues there is no evidence people need to cut down on fruit, and points out that Dr Tayler’s sweet study has not been published in a medical journal.
”I think what they are doing is mixing up fruit and fruit juice,” Dr Stanton said. ”It’s pretty hard to consume five apples at once but it’s easy to consume them as a glass of fruit juice, and fruit juice is not much different to soft drink.”
Dr Stanton said it was a struggle to get most people to eat the recommended two pieces of fruit a day.
”You can have too much of a good thing but most people don’t and the danger when you give out a message that fruit is somehow bad is that the people who are eating none or one piece will eat less and instead will eat chips and biscuits and things like that,” she said.
She suggested participants in Dr Tayler’s study were more likely to have lost weight because they reduced their kilojoule intake from sources such as fruit juice, alcohol and refined carbohydrates rather than fresh fruit.
I really do think Dr Stanton is talking about an entirely different subset of the population, perhaps even the dominant type. This is the type I see in the supermarket every week, with virtually no plant-matter in their trolley at all, low quality meat such as sausages, litres of soft drinks, margarine, and virtually every permutation of grain product possible. Do we need to worry about them overdoing the fruit? Probably not.
But what about those who, as I’ve already discussed, are eating relatively clean (paleo or otherwise), but putting away up to half a dozen serves of fruit per day in the belief that this is healthy? Would four apples per day really be too much? Well if this is adding up to 16 teaspoons of sugar per day (~80g), on top of some of the other sources, then perhaps it is. Particularly when we start to look at those who might carry a degree of metabolic derangement. It is quite possible that this level of fruit intake in someone with metabolic issues could be the equivalent of 2-3 times this amount for someone who is more metabolically robust (these numbers are for illustration of my point only).
But one of the study participants, Mary McPherson, 60, is convinced of its merits, having lost 10 kilograms gradually over six to eight months. She reduced her fruit consumption from four or five pieces a day to two pieces – ”some berries and a banana, I can’t go without a banana a day” – and instead filled up on dry roasted almonds. Occasional sweet cravings were satisfied with a single piece of dark chocolate.
Ms McPherson also followed Dr Tayler’s advice to reduce refined carbohydrates such as white rice, pasta and potatoes, replacing them with brown rice and sweet potatoes – though refused to give up her two glasses of wine with dinner.
”The surprise was just how big a role sugar played in increasing my weight. I don’t think people understand that. I didn’t and I’ve been working [as a nurse] for a long time.”
You can see from the highlighted statement above that this contradicts Dr Stanton’s stance that people don’t often consume such high levels of fruit. But they do and people (patients and health professionals) need to be open to the fact that such a high fruit intake might be an issue that needs addressing or at least be open to trialling a lower intake.
The likes of the Whole30 programme suggests keeping a tight rein on fruit intake for the very reason that over-consumption of fruit may unsettle an individual’s attempts to establish a new equilibrium, and Mark Sisson recently reviewed his Primal Blueprint food pyramid to reflect a new understanding on the role fruit plays in our diet.
My thinking on certain foods has changed over the years, and this is my acknowledgment of that. Fruit, while an awesome, delicious method of seed dispersal that I’m glad plants employ, may not be right for everyone in unlimited quantities…
…instead of fruits and vegetables (including starchy tubers and roots, presumably) being lumped together, I separated them. Why? Well, a fruit is not a vegetable is not a potato. They all rely on photosynthesis, leaves or leafy-like things, water, a good loamy, nutrient-rich soil, and the caring hand of either Mother Nature or a grizzled farmer to come into existence, but they confer very different metabolic and health effects.
So again, and at the risk of sounding like a broken record, context matters. Fruit can be a healthy part of an individual’s diet, but not such that a high consumption of fruit displaces more appropriate foods that may confer more benefit. People need to be mindful of the biological signal that all foods, and the interactions these foods have with the likes of activity levels and modes, sleep quality and quantity, and season, etc., send to your biology. Even though a food group is “natural”, “healthy”, and “paleo”, it won’t always mean no thought should be given to tempering your intake of it.