Is consuming fruits and veggies particularly high in fructose unhealthy?

Question

I've done quite some research on this matter, but still cannot reach a confident conclusion.

The idea is a diet consisting of whole foods is generally a healthy one, and a diet high in sodium, sugar, and trans-fat is not.

Some nutritionists argue that high consumption of fruits and veggies are healthy in spite of having high fructose, due to fiber.

If that's case, I know that fiber helps slow the absorption of sugar to prevent hyperglycemia and food coma after meals, and ultimately helps to reduce the odds of the formation of type 2 diabetes and obesity.

The others argue that high consumption of fruits and veggies (particularly high in fructose) are unhealthy for you regardless.

While fruits and veggies offer benefits and risks,

Benefits: phyto-, macro-, micro- nutrients, protein, etc.

Risks: sugar (mostly), sodium

my understanding is that it's generally healthier to choose foods with a ratio of fiber higher than their sugar contents. So does that mean as long as the fruits you consume meet the safe ratio, it's safe to consume indefinitely without risks?

For all nutritionists and dietitians out there, I just want to hear your thought on this.

Answer 1

Fructose intake from any source, including fruits, does not seem to be unhealthy until consumed in usual amounts. Fructose intake >100 g/day can increase LDL and triglyceride levels, which are risk factors for coronary heart disease (2008, 2013). It is hard to get >100 g of fructose/day just by eating fruits but easier by drinking certain beverages.

Fruits high in fructose (grams of fructose per serving of a fruit):

• agave = 28 g/150 g
• grapes = 12 g/150 g
• dried figs = 11.5 g/50 g
• pineapple = 11 g/150 g
• apple = 10 g/150 g
• pear = 10 g/150 g
• watermelon = 10 g/250 g
• raisins = 10 g/28 g
• jackfruit = 9 g/100 g
• dates = 9 g/28 g
• persimmon (kaki) = 8 g/150 g
• mango = 7 g/150 g
• dried peaches, apricots, plums = 6 g/50 g

There are no common vegetables high in fructose: tomato and onion have ~2 g per 100 g.

Other foods high in fructose:

• pear juice = 18 g/237 mL
• apple juice = 16 g/237 mL
• cola-type soft drink sweetened by high fructose corn syrup (HFCS) = 15 g/237 mL
• honey = 6-9 g/tbsp

Are fruits high in fructose unhealthy?

Fructose (from any source), when not consumed in excess of calorie needs, does not seem to cause:

• weight gain (2012, 2014, 2015)
• atherosclerosis or diabetes type 2 (2015, 2017)
• non-alcoholic fatty liver disease (2014)
• dental caries (fructose causes less caries than glucose or sucrose - (2010))

Fruits, when not consumed in excess of calorie intake, do not seem to cause:

• dental caries (2016)
• increased triglyceride levels (2015, 2018)
• other conditions listed under "fructose" intake

Fiber from fruits may slow down the absorption of fructose, but even fructose alone is slowly absorbed; it's glycemic index is only 19 (glucose GI = 100, sucrose GI = 65) (Glycemic Index Foundation).

Eating fruits/vegetables with high fiber and low sugar content may contribute to high fiber and low sugar diet, so it may be a reasonable choice. I wouldn't overthink this, though; it may be more important how much fiber and sugar you get per day rather than from a single fruit.

Why would one want to avoid fruits?

• People who try to lose weight. Fruits (and other sweet foods) may stimulate sugar craving leading to excessive calorie intake. You can eat vegetables instead: you can get all the fiber and essential nutrients and very little sugar/fructose this way.
• People with fructose malabsorption. Unabsorbed fructose causes bloating and loose stools.