Photo by Mali Maeder

We eat a pretty healthy diet, mostly plant-based with occasional seafood. Like most of us, we enjoy the occasional birthday cake or dessert at special meals, but we try to avoid eating foods high in sugar. However, our high fruit intake has always given us some concern, because our fruit contains sugar.

We all know that sugar can be bad for us, and excess consumption can lead to serious health conditions, such as coronary heart disease and diabetes. So, we wondered how the sugar we obtain from fruit compares with other sugars. Seeking answers, we found a recent prospective cohort study [1], “Associations of Dietary Sugar Types with Coronary Heart Disease (CHD) Risk” published in The American Journal of Clinical Nutrition has provided some answers.

This is not a small study. It followed 76,815 women (Nurses’ Health Study, 1980-2020) and 38,878 men (Health Professionals Follow-up Study, 1986-2016) accounting for sugar and carbohydrate intake, including total fructose equivalents (TFE), total glucose equivalents (TGE) and other sugar types.  The findings were quite interesting!

The conclusion was that “Intakes of TGE, total sugar, added sugar, and fructose from added sugar and juice were associated with higher CHD risk, but TFE and fructose from fruits and vegetables were not.”


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The key takeaway is that naturally occurring sugar (fructose) when accompanied by fiber slows the processing of sugar in the digestive tract, limiting spikes in blood glucose. Conversely, fructose from added sugar and juice was associated with a higher risk of coronary heart disease. Take, for instance, the blueberry. According to the USDA, one cup of raw blueberries contains 15g of sugar, providing 84 calories, but it also provides almost 4g of fiber, 1g of protein and a whole host of great vitamins and minerals. So it would be incorrect to compare a cup of blueberries to, for instance a candy bar with 15g of sugar. The glycemic load of blueberries (a measure of how much a food will raise blood sugar levels) is below 10, quite low on the scale.

And this is where a lot of the diet tracking apps and websites seem to get it wrong. As this study points out, tracking total sugar is not the same as tracking added sugar. This is where your Nutritionist comes in. A Nutritionist can help you understand the difference in the kinds of sugars and the effect they have on your health.

So in general, the results of this study would tell us to get our sugars from fruits, which contain fiber and other essential ingredients. And limit foods with high amounts of added sugars. It’s not the absolute number that is important – it is how it is made up!

1. The American Journal of Clinical Nutrition (Volume 118, Issue 5, November 2023, Pages 1000-1009)

Note: This post is not to be construed as medical advice. I am not a physician, nutritionist, or health professional
and do not provide medical or nutritional advice. If you need such advice, please consult a health professional.