I’m a doctor, not a nutritionist. But I am certified with the T. Colin Campbell Center for Nutrition Studies, which means I have far more training in nutrition than most other doctors who have completed their medical schooling.
Still, I often have to bite my tongue when there is a possible nutritional solution to a medical problem or at minimum, a more comprehensive response when my patients say things like, “I don’t eat much fruit. Too much sugar.”
If I didn’t clamp down on a response to that one, I might scream, or spend the next hour discussing why they are misinformed. Which I can’t do if I want to make enough money to keep the practice in business.
Instead I’m going to vent here and then offer a perspective I hope my patients will see. And don’t get me wrong, I am more than open to helping my patients alter their diets to improve their health, but that’s usually a separate visit (from a billing perspective).
My personal opinion on this is the whole problem started when people started lumping bad carbs with good carbs. Here’s what I mean. Back in the “old days” maybe about 60 years ago, people ate fruits and vegetables and hearty carbs like whole wheat bread and rice and beans, what I’m calling good carbs. But if it didn’t come as directly from the ground or a tree as possible, I’m calling that a bad carb.
In the late 1940s and throughout the 1950s the frozen food market started to take off, due to better refrigerated transport. But those good foods, fruits and vegetables preserved and packaged as close to picking as possible, led to new ideas with packaged food. Kind of like a gateway drug.
By the 1960s bad carbs started multiplying and moving in like drug-addled relatives who attract like-minded friends. Think any kind of processed food: chips, crackers, cookies, breakfast cereal, frozen convenience foods and all kinds of snacks. If you were born after 1970, like I was, you probably can’t even imagine a world without these foods. But prior to the 1960s most meals and snacks were homemade, not from convenience mixes.
With this deluge of bad carbs, suddenly people started calling all carbs bad carbs. It didn’t help that the “low carb” Atkins diet, made popular in 1972, came on the scene about the same time.
But carbs are not the bad boys people make them out to be.
High-carb weight-loss diets made of “good” carbs work. For example, a National Institutes of Health diet-and-weight-loss trial published in 2015, showed that the low-carb/high-fat diet group lost less fat than the high-carb group. Other weight loss studies found similar results and lots of health benefits (like improved blood sugar control for people with diabetes) for those on the high (good) carb diets.
My favorite part is that these results were positive even when the study participants didn’t exercise. (Although there are so many other health benefits to exercise. Don’t let this be a reason to keep you from moving your body!)
The USDA “Choose My Plate” guidelines state that the average adult should eat 1.5 to 2 cups of fruit per day. But if you’re like most Americans — like most of my patients — you don’t get that much on an average day. Why?
For some of you it may be because you fear the sugar in fruit.
But don’t confuse the sugar in fruit with industrial sugar, i.e., refined fructose (like corn syrup and white sugar). Those sugars are associated with hypertension and blood sugar spikes and other ill health effects.
However, research has demonstrated repeatedly that fructose within the whole fruit is associated with benefits. In fact, adding berries to a high glycemic food can actually help to blunt the insulin spike you would get from eating such a food alone.
Here are a couple of studies to show you more.
One study had 17 people eat twenty servings a day of fruit for three to six months. Even though they were eating about 200 grams a day of fructose (about eight cans of soda worth) the investigators reported no adverse effects. In fact, the researchers observed health benefits.
Another study put people on a similar diet and there were no adverse effects on weight, blood pressure or triglycerides. However, there was an amazing 38-point drop in LDL cholesterol.
The only side effect was with all that fruit---plus the 44 servings of vegetables they had---the research participants recorded some of the largest bowel movements ever documented in a dietary trial.
That leaves some of you with the question of why many people do so well on low-carb diets.
My opinion is it’s not because they limit fruits and some vegetables, but because such diets cut out most of the bad carbs (along with many of the good carbs). Such diets also encourage people to eat two of the healthiest foods: berries and greens, as well as other fruits and vegetables deemed “safe.”
Those few things alone will lead to better health and weight loss, especially if someone has been eating a lot of bad carbs prior to starting the low carb diet.
So eat your fruit if you want, along with your vegetables and a variety of whole foods. And if anyone questions you, just say doctor’s orders.1
DISCLAIMER: THIS SUBSTACK DOES NOT PROVIDE MEDICAL ADVICE.
The information, including but not limited to text, graphics, images and other material contained within this Substack, are for informational purposes only. In addition, the physician who “writes” material for this Substack is a product of the author’s imagination. Even if she were real, however, no material on this site is intended to be a substitute for medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care professional with any questions you have regarding a medical condition or treatment and before undertaking a new health care regimen. Never disregard professional medical advice or delay in seeking it because of something you’ve read on this site. And eat your fruits, vegetables, legumes and whole grains. (Dr. Sarah had to add that last sentence. She likes having the last word.)