Is too much fruit bad for you?

This article was written by one of our regular contributors; registered dietitian – Maeve Hanan.

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There are mixed messages about whether fruit is good or bad for us, as although fruit is nutritious it also contains natural sugars. This article will get to the bottom of this common question. 

How Much Fruit is Recommended?

Some countries differentiate between the daily recommended intake of fruit and vegetables. For example, the Australian guide to healthy eating recommends at least 2 portions of fruit per day and at least 5 portions of vegetables per day (1). 

This isn’t the case in the UK where the recommendation is at least 5 portions of a variety of fruit and vegetables each day, limiting fruit juice and shop-bought smoothies to 150ml per day (2). 

A portion of fruit is:

• 80g of fresh, canned or frozen fruit – this is roughly a small handful or the size of your palm i.e. 2 small fruits (like satsumas or kiwis), 1 medium fruit like an apple or pear, a large slice of pineapple or melon
• 30g of dried fruit – this is roughly a heaped tablespoon
• 150ml of fruit juice or shop-bought smoothies (once per day)

Most people in the UK don’t meet the recommended intake of fruit and vegetables. A survey from 2018 in England found that only 28% of adults were having five portions of fruit and vegetables per day, with an average inateck of 3.7 portions per day (3). 

Nutritional Benefits of Fruit

The exact nutritional composition varies between different types of fruit, but in general fruit provide a variety of important nutrients such as:

• Fibre: Most people don’t eat enough fibre, but this is vital for digestive health and consuming enough fibre is linked with a lower risk of diseases like heart disease, type 2 diabetes and bowel cancer (4). 
• Vitamin C: Fruit is a great source of vitamin C. This nutrient is an antioxidant that plays an important role in our immune system, maintaining healthy tissues, wound healing and it also boosts iron absorption from plant-based foods. 
• Potassium: This mineral is found in a variety of fruit. Potassium is needed for maintaining fluid balance as well as muscle contraction, nerve, heart and kidney function.  
• Beta-carotene: This form of vitamin A is found in mango, apricot, cantaloupe melon and papaya. Beta-carotene is converted by the body into the active form of vitamin A which is called retinol. Vitamin A plays an important role in night vision, fertility, immunity, skin and membrane health.
• Folate: Folate is involved in cell division, the creation of DNA and red blood cells, and neural tube development of a foetus. This nutrient is found in oranges, papaya, cantaloupe melon and bananas. Important: women who could get pregnant are advised to take a folic acid (synthetic form of folate) supplement rather than relying on only dietary sources of this nutrient. 
• Vitamin E: This vitamin is found in kiwi, mango and tomato. Vitamin E is an antioxidant that also plays an important role in our immune system, eye and skin health, blood clotting and blood vessel function. 
• Polyphenols: These compounds act as antioxidants to help to balance free radical levels and inflammation in the body. Polyphenols are found in a variety of fruit, but berries are a particularly good source.

Certain dried fruit also provide other minerals. For example dried figs are high in calcium and dried apricots, dried figs and raisins are a good source of iron. 

Regular fruit consumption has been associated with a lower risk of heart disease, cancer and early death (5, 6). More research is needed into the impact of individual types of fruit on health, but as outlined above we get different nutrients from different types of fruit so consuming a good variety of fruit currently seems to be the most important factor. Consuming a variety of plants is also great for gut health and microbiome diversity.   

Of course, we can’t get all of the nutrients that our body needs from fruit alone. So filling up on a lot of fruit at the expense of consuming an overall balanced diet isn’t a good idea. For example, those with an eating disorder can have a higher risk of bulking up their diet with too much fruit (and vegetables) which can push out other important food groups. But consuming a few portions of fruit each day along with a variety of other foods as part of a balanced diet is good for our health.

But What About the Sugar Content?

Although fruit contains natural sugars, the amounts are much lower than processed sweet foods like cakes, chocolate and sweets. 

The UK government recommends limiting free sugar intake to less than 5% of daily energy (7). Free sugars are “added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and unsweetened fruit juices” (4). This works out as around 7 teaspoons of sugar per day (i.e. 30g) for those 11 years old and older.

But this advice to limit sugar intake doesn’t apply to the sugar we get in whole fruit, as this type of sugar is naturally bound within the cellular structure of the fruit which makes it act differently in our body than free sugars. As well as providing a host of important nutrients, the sugars in fruit don’t hit our blood stream as quickly as sugary drinks or sweets. Related to it’s fibre content, fruit tends to have a low to moderate glycemic index; this is a measurement of how quickly food spikes our blood glucose levels, the higher the score the faster the increase in blood glucose level. See here for more information about glycemic index. 

Blending and juicing releases some of the natural sugars from the structure of fruit which create free sugars. Some of the fibre can also be removed during this process; particularly with juicing and producing shop-bought smoothies as these are usually strained which removes some of the fibre. Although juices and shop-bought smoothies contain free sugars, they are still a good source of a variety of vitamins and minerals. Therefore we are advised to limit our intake of these drinks to 150ml per day in order to get the nutritional benefits without consuming a high intake of free sugar.  

Dried fruit is a more concentrated source of natural sugars than fresh fruit because of the amount of water that has been removed. So a portion of dried fruit is 30g, in comparison with 80g for fresh fruit. It’s advised to consume dried fruit at meal times in order to reduce the risk of tooth decay due to its stickiness and sugar content. However some scientists have highlighted that there is a lack of evidence that dried fruit increases the risk of dental health issues (8, 9).   

One of the common arguments for eating less fruit is because it contains a sugar found called fructose. Although a high intake of fructose has been linked with liver damage and metabolic issues like heart disease (10, 11), these studies have used high-fructose corn syrup which is very different and much more concentrated than consuming fructose from fruit. And as outlined above, consuming fruit is actually linked with improved health, including a lower risk of heart disease. 

Summary

Although fruit contains natural sugars, this is bound within the structure of fruit so it hits our bloodstream more slowly than sugary food and drinks. As fruit juice and shop-bought smoothies contain free sugars we are advised to limit these to 150ml per day. Dried fruit is a more concentrated source of natural sugars, so the recommended portion size is smaller than fresh fruit. 

So there is no need to fear or avoid fruit. In fact it’s an extremely healthy food, and many people would benefit from adding more fruit to their diet. As with any food, there’s a balance to be struck as filling up on too much fruit can push out other nutritious foods, but having a few portions per day is a good idea as part of a balanced diet.  

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References:

1. “Eat For Health Australian Dietary Guidelines: Summary” [Accessed December 2021 via: https://www.eatforhealth.gov.au/sites/default/files/content/The%20Guidelines/n55a_australian_dietary_guidelines_summary_131014_1.pdf]
2. NHS Website “The Eatwell Guide” [Accessed December 2021 via: https://www.nhs.uk/live-well/eat-well/the-eatwell-guide]
3. NHS Digital Health Survey “Fruit & vegetables” [Accessed December 2021 via: http://healthsurvey.hscic.gov.uk/data-visualisation/data-visualisation/explore-the-trends/fruit-vegetables.aspx]
4. SACN (2015) “Carbohydrates and Health” [Accessed December 2021 via: https://www.gov.uk/government/publications/sacn-carbohydrates-and-health-report]
5. Aune, D., Giovannucci, E., Boffetta, P., Fadnes, L. T., Keum, N., Norat, T., … & Tonstad, S. (2017). Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose-response meta-analysis of prospective studies. International journal of epidemiology, 46(3), 1029-1056. [Accessed December 2021 via: https://pubmed.ncbi.nlm.nih.gov/28338764/]
6. Wallace, T. C., Bailey, R. L., Blumberg, J. B., Burton-Freeman, B., Chen, C. O., Crowe-White, K. M., … & Wang, D. D. (2020). Fruits, vegetables, and health: A comprehensive narrative, umbrella review of the science and recommendations for enhanced public policy to improve intake. Critical reviews in food science and nutrition, 60(13), 2174-2211. [Accessed December 2021 via: https://pubmed.ncbi.nlm.nih.gov/31267783/]
7. Gov.uk Website “SACN’s sugars and health recommendations: why 5%?” [Accessed December 2021 via: https://www.gov.uk/government/publications/sacns-sugars-and-health-recommendations-why-5]
8. Sadler, M. J. (2017). Dried fruit and dental health–how strong is the evidence?. Nutrition Bulletin, 42(4), 338-345. [Accessed December 2021 via: https://onlinelibrary.wiley.com/doi/abs/10.1111/nbu.12294] 
9. Sadler, M. J., Gibson, S., Whelan, K., Ha, M. A., Lovegrove, J., & Higgs, J. (2019). Dried fruit and public health–what does the evidence tell us?. International journal of food sciences and nutrition, 70(6), 675-687. [Accessed December 2021 via: https://pubmed.ncbi.nlm.nih.gov/30810423/]
10. Stanhope, K. L., Schwarz, J. M., & Havel, P. J. (2013). Adverse metabolic effects of dietary fructose: results from recent epidemiological, clinical, and mechanistic studies. Current opinion in lipidology, 24(3), 198. [Accessed December 2021 via: https://pubmed.ncbi.nlm.nih.gov/23594708/] 
11. Jensen, T., Abdelmalek, M. F., Sullivan, S., Nadeau, K. J., Green, M., Roncal, C., … & Johnson, R. J. (2018). Fructose and sugar: A major mediator of non-alcoholic fatty liver disease. Journal of hepatology, 68(5), 1063-1075. [Accessed December 2021 via: https://pubmed.ncbi.nlm.nih.gov/29408694/]