A Matter of Life

Don’t Resist Mangoes

Dr Ambrish Mithal is chairman and head, Endocrinology and Diabetes Division at Medanta, The Medicity, Gurgaon
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The truth about diabetes and fruits

IT HAS BEEN said that fruits are nature’s candy. Their inherent sweetness makes them a delight for the senses. In India, guavas, oranges and kinnow dominate the winters, while summer brings with it a whole range of luscious juicy fruits such as mangoes, litchis and melons. Others like papaya and apple are consumed throughout the year. Mango is India’s favorite fruit—‘the king of fruits and the fruit of kings’. We are the world’s largest producer and consumer of mangoes. Each of its variety has a distinct taste, flavour, colour and consistency. Mango lovers are fanatic about their love for their favorite variety. It’s a fierce kind of loyalty—much like a Tendulkar fan will be loath to admire Lara, a Bombay Alphonso lover will never admit to liking the Lucknow Dussheri.

Fruits are healthy food. They are full of vitamins, minerals, antioxidants and loaded with fibre. They possess anti-cancer properties, lower blood pressure, and protect the heart. But fruits are sweet, which make them so desirable in the first place. And mangoes are the sweetest. Aren’t people with diabetes supposed to avoid sweet? The traditional school of thought recommends limited fruit consumption in diabetes. Mango has long been considered to be a prohibited fruit for diabetes patients. However, this view has been challenged. Most recently, a so-called ‘celebrity’ dietician was heard screaming hysterically in a WhatsApp video about the benefits of mangoes for diabetes. This attention-seeking, ludicrous video, short on facts and based on an individual’s opinion, created a stir on social media, so much so that my colleagues in Mumbai had to issue a press release to counter these claims.

What, then, is the truth? Should people with diabetes eat fruits, in particular, mangoes? Fruits are not banned for diabetics, even though they are sweet. Fruits have sugar but also fibre, which slows down sugar absorption. The impact on blood sugar level depends on the amount of carbohydrate in a fruit. One serving of fruit should contain 15 grams of carbohydrates. The portion size is determined by the amount of carbs the fruit contains. If it is a low carb fruit (for example, strawberries and peaches), you can eat a larger portion. Most importantly, fruits should be part of your meal plan, and not add-ons. They should preferably be consumed as a snack between meals and not dessert, since they will add to the calorie load. In addition, the 15 gm carbs that you consume in one serving of fruit should be factored into your total allocated carbs for the day. Let’s take the popular banana as an example. Half a medium-sized banana, which provides 15 gm carbs, is recommended. Some other examples of fruit servings that contain 15 gm carbs are a cup of strawberries or blackberries (jamun is used in Ayurveda for treating diabetes), one-and-a-quarter cup of cubed watermelon, and about half a cup of cubed mango, one-third cup of cubed chikoo, or three quarters of a cup of cubed pineapple.

It is good to consume proteins like yogurt, milk or nuts with fruits. Makes a great meal nutritionally – fruits don’t have proteins--and is filling. It is best to consume fresh fruits rather than canned or processed fruits, many of which have added sugar. A popular myth about fruits pertains to juices. The juice industry has, for years, promoted fruit juices as healthy. In India, it is a tradition to offer fresh citrus fruit juice (orange, sweet lime or kinnow) to the sick in the belief that juice is the extract of all the goodness of fruits and will help in health and recovery. Extracting the juice takes away the fibre and some of the minerals, and leaves you with just plain fruit sugar—even if sugar has not been added externally. Without fibre, this sugar will be absorbed rapidly, causing a spike in sugar level. A glass of juice often requires three to four fruits—which means more sugar without any fibre. The much-hyped fruit juices are not very different from colas when it comes to calorie and sugar content. Juices are not recommended—a much better way is to consume the whole fruit instead. Because of their fibre content, whole fruits typically have a medium or even low glycemic index (a value assigned to foods based on how slowly or quickly those foods increase blood glucose levels), which means that they raise the sugar slowly in comparison to juice.

Which brings us back to mangoes. Those with controlled diabetes can have mangoes. The key is the portion size. About half a medium-sized mango will provide the recommended 15 gm carbs. That should be your allowance for the day. For many of us, it’s a challenge to limit mango intake. Tutor your mind into accepting the rationing. It’s better than not having mangoes at all.