Apples, blood sugar and diabetes

Apples are delicious, nutritious and convenient to eat.

Studies have shown that they have several health benefits.

Yet apples also contain carbs, which impact blood sugar levels.

However, the carbs found in apples affect your body differently than the sugars found in junk foods.

This article explains how apples affect blood sugar levels and how to incorporate them into your diet if you have diabetes.

Apples Are Nutritious and Filling

Apples are one of the most popular fruits in the world.

They're also highly nutritious. In fact, apples are high in vitamin C, fiber and several antioxidants.

One medium apple contains 95 calories, 25 grams of carbs and 14% of the daily value for vitamin C (1).

Interestingly, a large part of an apple's nutrients is found in its colorful skin (2).

Furthermore, apples contain large amounts of water and fiber, which make them surprisingly filling. You're likely to be satisfied after eating just one (3).

BOTTOM LINE:Apples are a good source of fiber, vitamin C and antioxidants. They also help you feel full without consuming a lot of calories.

Apples Contain Carbs, as Well as Fiber

If you have diabetes, keeping tabs on your carbohydrate intake is important.

That's because of the three macronutrients — carbs, fat and protein — carbs affect your blood sugar levels the most.

That being said, not all carbs are created equal. A medium apple contains 25 grams of carbs, but 4.4 of those are fiber (1).

Fiber slows down the digestion and absorption of carbs, causing them to not spike your blood sugar levels nearly as quickly ( 4).

Studies show that fiber is protective against type 2 diabetes, and that many types of fiber can improve blood sugar control (5, 6).

BOTTOM LINE:Apples contain carbs, which can raise blood sugar levels. However, the fiber in apples helps stabilize blood sugar levels, in addition to providing other health benefits.

Apples Only Moderately Affect Blood Sugar Levels

Apples do contain sugar, but much of the sugar found in apples is fructose.

When fructose is consumed in a whole fruit, it has very little effect on blood sugar levels (7).

Also, the fiber in apples slows down the digestion and absorption of sugar. This means sugar enters the bloodstream slowly and doesn't rapidly raise blood sugar levels (4).

Moreover, polyphenols, which are plant compounds found in apples, also slow down the digestion of carbs and lower blood sugar levels (8).

The glycemic index (GI) and the glycemic load (GL) are useful tools to measure how much a food affects blood sugar levels (9).

Apples score relatively low on both the GI and GL scales, meaning that they cause a minimal rise in blood sugar levels (10, 11).

One study of 12 obese women found that blood sugar levels were over 50% lower after consuming a meal with a low GL, compared to a meal with a high GL (12).

BOTTOM LINE:Apples have a minimal effect on blood sugar levels and are unlikely to cause rapid spikes in blood sugar, even in diabetics.

Apples May Reduce Insulin Resistance

There are two types of diabetes — type 1 and type 2.

If you have type 1 diabetes, your pancreas does not produce enough insulin, the hormone that transports sugar from your blood to your cells.

If you have type 2 diabetes, your body produces insulin but your cells are resistant to it. This is called insulin resistance (13).

Eating apples on a regular basis might reduce insulin resistance, which should lead to lower blood sugar levels (8, 14).

This is because the polyphenols in apples, which are found primarily in apple skin, stimulate your pancreas to release insulin and help your cells take in sugar (2, 8).

BOTTOM LINE:Apples contain plant compounds that may improve insulin sensitivity and reduce insulin resistance.

The Antioxidants Found in Apples May Lower Your Risk of Diabetes

Several studies have found that eating apples is linked to a lower risk of diabetes (2, 15).

One study found that women who ate an apple per day had a 28% lower risk of type 2 diabetes than women who didn't eat any apples (16).

There are multiple reasons apples might help prevent diabetes, but the antioxidants found in apples likely play a significant role.

Antioxidants are substances that prevent some harmful chemical reactions in your body. They have numerous health benefits, including protecting your body from chronic disease.

Significant amounts of the following antioxidants are found in apples:

• Quercetin: Slows down carb digestion, helping prevent blood sugar spikes (17).
• Chlorogenic acid: Helps your body use sugar more efficiently (18, 19).
• Phlorizin: Slows down sugar absorption and lowers blood sugar levels (20, 21).

The highest concentrations of beneficial antioxidants are found in Honeycrisp and Red Delicious apples (22).

BOTTOM LINE:Eating apples on a regular basis may help prevent type 2 diabetes, as well as keep your blood sugar levels stable.

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Should Diabetics Eat Apples?

Apples are an excellent fruit to include in your diet if you have diabetes.

Most dietary guidelines for diabetics recommend a diet that includes fruits and vegetables (23).

Fruits and vegetables are full of nutrients such as vitamins, minerals, fiber and antioxidants.

In addition, diets high in fruits and vegetables have repeatedly been linked to lower risks of chronic disease, such as heart disease and cancer (24, 25, 26).

In fact, a review of nine studies found that each serving of fruit that was consumed daily led to a 7% lower risk of heart disease (27).

While apples are unlikely to cause spikes in your blood sugar levels, they do contain carbs. If you're counting carbs, be sure to account for the 25 grams of carbs an apple contains.

Also, be sure to monitor your blood sugar after eating apples and see how they affect you personally.

BOTTOM LINE:

Apples are highly nutritious and have a minimal effect on blood sugar levels. They are safe and healthy for diabetics to enjoy on a regular basis.

How to Include Apples in Your Diet

Apples are a delicious and healthy food to add to your diet, regardless of whether you have diabetes or not.

Here are some tips for diabetics to include apples in their meal plans:

• Eat it whole: To reap all of the health benefits, eat the apple whole. A large part of the nutrients is in the skin (2).
• Avoid apple juice: The juice does not have the same benefits as the whole fruit, since it's higher in sugar and missing the fiber (28, 29).
• Limit your portion: Stick with one medium apple since larger portions will increase the glycemic load (11).
• Spread out your fruit intake: Spread your daily fruit intake throughout the day to keep your blood sugar levels stable.

Take Home Message

Apples do contain carbs, but they have a minimal effect on blood sugar levels when eaten as a whole fruit.

They are highly nutritious and a great choice for a healthy diet.

An evidence-based article from our experts at Authority Nutrition.

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More than an apple a day

Which Fruit is better than Statins at reducing Cholesterol?

Right now you are probably expecting to read about some incredibly exotic and equally expensive tropical fruit that is unlikely to appear on the shelves at Supervalu anytime soon – but no! In fact the fruit in question is the humble apple.

That’s right, recent research has found that just two apples a day can help keep bad cholesterol away! And unlike statins, apples also raise good (HDL) cholesterol and contribute to weight loss.

Dr Bahram H. Arjmandi, director for the Centre for Advancing Exercise and Nutrition Research on Aging at Florida State University even goes as far as to state “I consider apples a magic food. I buy a bag a week and try to eat two per day. I am convinced this is what I should do if I want to remain healthy.”

The cholesterol lowering properties of apples appear to be due to their high levels of pectin, a type of soluble fibre found under the skin, which binds to cholesterol in the gut and transports it out of the body. We have known about the benefits of pectin for a number of years but many researchers, including Dr Arjmandi, have been surprised by recent research demonstrating just how effective apple pectin actually is at removing excess cholesterol from the body.

In one recent study involving 160 women between the ages of 45 and 65 it was found that women who ate 2 apples per day on top of their usual diet experienced a 23% decrease in LDL “bad” cholesterol, and increased their HDL “good” cholesterol by 3–4%. This level of reduction would be very hard to achieve using either drugs or exercise.

Many people do not realise that most of the cholesterol in our body does not come from food but is, in fact, manufactured in the liver. Therefore reducing high cholesterol foods will not always impact on overall cholesterol levels as the problem may be simply an overproduction of cholesterol in the body itself. Statin drugs, such as Lipitor and Crestor, reduce cholesterol by blocking an enzyme needed to make it. The problem is that statins can be hard on the liver, which is why people who take them must have a blood test periodically to make sure their liver is not becoming irritated and inflamed. It is also suggested that these drugs can reduce levels of the essential nutrient Co enzyme Q10 in the body. This nutrient is vital for energy production in the body and low levels (as can occur in individuals taking statins) can lead to fatigue and muscle weakness. Some healthcare professionals also believe that whilst statins may reduce cholesterol, a potential cause of heart disease, they can negatively impact on the heart muscle due to their impact on CoQ10 – remember that the heart is a muscle that requires an awful lot of energy to keep beating!

Dr Arjmandi puts it very simply. “The liver is one of the largest organs in the body, and it can remain pretty functional if only 50 percent of it stays healthy. You do not see an abnormality in the blood unless you do substantial damage to the liver. Drugs have their place, but if you have to check your liver enzymes, that means the drug is doing something not so good for you, and I don’t understand why we would go for drug therapies when eating two apples a day reduces LDL cholesterol so effectively. Eat apples and you not only don’t harm your liver, but you substantially benefit your health.”

So why aren’t apples prescribed for high cholesterol as avidly as statin drugs? Statins account for about 6.5% of all drug sales in the U.S and earn drug companies about $26 billion per year. You would have to sell an awful lot of apples to make that kind of money!

The even better news is that apples are not alone in their cholesterol lowering prowess. So if you suffer from high cholesterol or want to prevent it in the future try adding as many foods as you can from the list below to your daily diet:

• Walnuts, almonds and other nuts
• Oats, oatmeal and oat bran
• Oily fish
• Olive oil
• Pulses
• Garlic
• Onions
• Whole grains
• Avocado

Pretty easy really!

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