ISLAMABAD: Apples are a nutritious snack, but are the sugars and carbohydrates in an apple good or bad for blood sugar and insulin levels if a person has diabetes? According to the American Diabetes Association, although they contain sugars and carbohydrates, eating apples and other fruit is not a problem for a person with either type 1 diabetes or type 2 diabetes. Apples contain a different kind of sugar to foods with added sugar, and they also contain fiber and nutrients. A person with diabetes should be aware of how apples affect them in order to include this fruit in a diabetes-healthy diet. In this article, we look at the effects of apples and other fruit on diabetes symptoms. The fiber in apples may help to slow the absorption of sugars in the body. People with diabetes must watch their carbohydrate intake to make sure their blood sugar levels stay stable throughout the day. It makes sense, then, to monitor any foods that contain carbs and sugars. According to the US Department of Agriculture (USDA), there are about 25 grams (g) of carbs in total in a medium-sized apple, and around 19 g of that is sugar. Most of the sugar in an apple is in the form of naturally occurring fructose, however, and this may have a different effect on the body than other sugars. Also, fructose is different to the refined and processed sugars found in packaged foods such as chocolates and biscuits. A recent review posted to the American Journal of Clinical Nutrition found that replacing glucose or sucrose with fructose led to less sugar and insulin in the blood stream after a meal. The USDA report that a medium apple contains around 4 g of dietary fiber, and this fiber may help slow the absorption of sugars in the body, which could help prevent spikes in sugar and insulin. In addition, pairing fruits with a healthy fat or protein can also lower the spike in blood sugar and make a person feel fuller for longer. Altogether, apples may have a relatively low impact on the insulin and blood sugar levels in the body and are considered a low-glycemic fruit suitable for people with diabetes. It is still essential for someone to monitor any changes they have after eating an apple, so they know what to expect in their body when they do so. Many people love apples for their simplicity, but they are also very nutritious. One medium apple contains around 100 calories, 25 g of carbohydrates, and nearly 20 percent of the daily recommended value for fiber. The flesh and skin of apples contain water, vitamins A and C, and other antioxidants and trace minerals. A person feels fuller after eating an apple due to the combination of fiber, water, and nutrients. This may be why so many people enjoy apples as quick snacks to hold them over between meals. Specific flavonoids, such as quercetin found in apples may, in fact, protect a person from diabetes. A review from 2011 reports that eating apples is associated with a lowered risk of diabetes. Eating a varied diet rich in vegetables and fruit, including apples, is good for everyone but maybe even more important for a person with diabetes or a high risk for the disorder. A diet rich in vegetables and fruits is beneficial for everyone, and certain fruits provide more benefits than others, particularly for a person with a chronic health condition. Eating fruits in their whole, raw form provides the most benefits because when the fruit is processed, the fibers, antioxidants, and other nutrients may be reduced. Compared to many other fruits, berries have a lower level of sugar. Berries have lower levels of sugar than some other fruits. They are naturally high in antioxidants, flavonoids, and nutrients which helps boost the body’s immune system and overall health. Like apples, cherries contain quercetin, which may be beneficial for a person with diabetes. It is possible to buy berries fresh or frozen. Dried versions may be less filling but are also a healthy option, though someone with diabetes should look out for fruit products that have sugar added, as this is not always obvious. Any fruit should be fine for a person with diabetes, as long as they do not have an allergy. A person should monitor how different fruits affect their symptoms and blood sugar, as each person’s sensitivities may be different. For some, fruits that are higher in sugar may need to be eaten less or avoided, depending on how they affect the blood sugar. Fruit juices that contain 100 percent real fruit should be okay for a person with diabetes, though they may wish to limit their intake, as fruit juices may contain a higher concentration of sugar and less fiber than fresh fruits. This can cause a higher spike in blood sugar. Four ounces of fruit juice contains about 15 g of carbohydrates. Being mindful of total carbohydrate intake during the meal is important to manage diabetes, and including fruit juice in your carbohydrate tracking is essential. Fruit juices with added sugars should be avoided. Some fruit juices may start as fruit, but the process of turning them into juice may remove much of the fiber and nutrients. What is left after processing is often higher in both sugar and calories than the fruit itself. Other “fruit juices” contain little to no real fruit. Reading the ingredients and focusing on 100 percent real juices is crucial to ensure a higher nutrient intake. Published in Daily Times, May 27th 2018.