The Case For and Against Fruits: Are Fruits Healthy? Are They Good for a Diet? Is There A Best Time To Eat Them?

Fruits have been around a really long time. Most anthropologists and evolutionary biologists believe that the diet of early man consisted mainly of fruit, until such time when we diversified our food consumption by becoming hunter-gatherers and then eventually farmers. Even as access to fruits sometimes became limited due to climate change, it never completely disappeared from the human diet. But some people now argue that it should.

The anti-fruit crowd highlight four major arguments against fruits available today.

Argument 1: Fruits are contaminated and nutritionally depleted.

First, they claim that fruits have been so genetically modified and tainted by man-made chemicals that they no longer contain sufficient nutrients to meet human needs for such nutrients or that you should only eat them if they are organic. These arguments are usually put forth by pill-pushers who want you take to a pill instead of, or in addition to eating fruits.  To the former point, I say that my own extensive review of the scientific literature supports that fruits have been altered, but that they still contain more than sufficient nutrients to meet our daily needs, particularly if you eat even a few servings per day.

As to the organic issue, it's really a question of money. No rational person can argue that there is something good to be gained from eating something that has been exposed to pesticides, herbicides, fungicides, and other man made chemicals, and/or has been genetically modified.  Although the specific harms from these chemicals is still hotly debated, if you can afford to avoid them, you should surely do so, especially the Environmental Working Group's "Dirty Dozen." (See http://www.ewg.org/foodnews/)  If not, then rinse very carefully. I tend to rinse my blueberries at least three times under pressure before having them for breakfast.


Argument 2: Fruits are high in a sugar called fructose and that is not good for your liver, lipid levels, and diabetes

The next reason often given for avoiding fruits is their high fructose content. First of all, not all fruits have the same amount of fructose (For a more detailed description of how the body processes fructose, please read the American Journal of Clinical Nutrition primer found at

http://ajcn.nutrition.org/content/86/4/895.full)

To summarize the primer, the pancreas doesn't react to fructose until is is metabolized like it does to sucrose and glucose. Moreover, we don't need any dietary fructose to function.  However, even though fruits have fructose, the fructose is interwoven with the fruits' fiber and is therefore digested more slowly than fructose from other sources. Please note, fructose and high fructose corn syrup are two completely different beats. The latter should be viewed as extremely harmful like a man with a loaded gun.

Therefore, contrary to the advice of pundits that state you can eat all the fruits you want because of the robust nutrient content including various vitamins, minerals, antioxidants and other synergistic nutrients, fruits should be a staple of a healthy diet, but only eaten in moderation. Weight Watchers is simply wrong to assign fruits '0' points, In fact, type two diabetics are told to limit their fruit intake to no more than 15 grams at a sitting because more than that may be problematic. (That's a whole other topic for another day.)

Nevertheless, fruits have plenty to offer, particularly in regards to antioxidants, but do note, that many, if not most, of the same healthy nutrients found in fruits can also be found in vegetables. For examples, the beta-carotene in melons can be found in carrots and yams; lycopene in watermelon can be found in tomatoes (although technically a fruit because it grows on trees,); anthocyanins in blueberries can be found in eggplant; phytosterols and polyphenols can be found dispersed in both groups. The list goes on.

Fruit skins can be good sources of insoluble fiber, helping move things along in the gastrointestinal track and can also contain flavonoids, which are plant secondary metabolites that have antioxidant capabilities that may diminish inflammation. Fruits are also contain other not as fully studied nutrients, like pectins, B-Cryptoxanthin, and A-carotene, which can be in apples. As with other nutrients, they also occur in vegetables.  One area of limited research is the synergistic affects of all the different nutrients found in all the different fruits.  Either way, fruits are a tasty and sweet alternative to less desirable man-sweetened foods.

Argument 3: Fruit calories add to weight gain

The final argument against fruits is the calories they contain. It's true, virtually everything we eat contains calories and fruits are no exception. Even though the theorem of calories in/caloires out is not perfect because not all calories are processed the same because of the fiber content of the food they come from, it is true that fruits, if eaten in large quantities can contribute to weight gain.  It's not the fruits themselves that are causing the weight gain; its the totality of what you are eating.  So as long as you go easy on other foods, your weight loss plans can easily accommodate some measured amount of fruit calories.

Argument 4: They can only be eaten before meals as they will ferment in your intestinal tract after meals

It is simply a myth that you can't eat fruit after meals. You can.  The fermentation arguments are pue rubbish. I searched the entire clinical study database back to the 1950s and couldn't find a single valid study to support such nonsense.
(Don't take my word for it. Read this from the University of Missouri:

http://extension.missouri.edu/cass/documents/Nutrition%20and%20Health/New%20trend%20of%20eating%20fruit%20only%20on%20an%20empty%20stomach%20is%20poor%20advice.pdf

The flip-side: Eat only fruits

Some people have gone to the other extreme and have taken to a mostly fruit diet. Steve Jobs tried and failed to cure his cancer with a mostly fruit only diet.  (See my previous blog on fruits and cancer prevention, which can be found at http://mdprevent.blogspot.com/2012/11/do-fruits-and-vegatables-prevent-cancer.html)

These fruit obsessed dieters claim they possess more energy and feel healthier. This is not surprising because the fructose in fruit is a carbohydrate that fuels energy. But as I wrote above, too much fructose is not a good thing as it can overwhelm the liver and eventually raise blood glucose to levels that precipitate large amounts of insulin release that can predispose to diabetes. Fructose breaks down to substances that can lead to glucose or blood sugar production.

My four golden rules of eating healthy

So in summation, let me finish with my four golden rules of eating healthy.

1. Don't eat more than you need to feel reasonably full.
2. Make sure that the combination of foods eaten over a course of a week contain all the essential nutrients your body needs to function properly.
3. Avoid or severely limit exposure to chemicals and highly processed ingredients stripped of most nutrients, and definitely avoid products that contain many of such ingredients rolled into one.
4. Loosely monitor your total salt, fat, sugar of any kind including fructose, and calorie intake to levels that work for your body. If you are not sure what those levels are, discuss them with your physician.

The final analysis

Fruits have been a staple of the human and pre-human diet for time immemorial.  Yes, its true that fruits may not be of the same nature and quality than they were tens or hundreds of thousands of years ago, but they are still awfully darn good. They offer many key essential nutrients, but as with most foods, you can overdue eating them.  They are a good part of a comprehensive approach to healthy eating.

By the way, do avoid fruit juices that are robbed of most of the fruits' fiber and have concentrated fructose.  However, contrary to the popular belief, the reason to avoid fruit juices is not because fruit lose most of their nutritional value during the juicing process. (See
http://www.ncbi.nlm.nih.gov/pubmed/9806122)

So now that you know the facts, you can figure out when and how much to eat, and enjoy fruit on your own.  Bon Appetite.

Is it safe to take advice from the Dr. Oz Show? Judge says it's at your own risk.

America's Doctor?

Since his earliest appearances on The Oprah Winfrey Show, Dr. Mehmet Oz is often referred to in the media as America's Doctor.  With his weekday daytime TV show reaching an estimated hundreds of thousands of households (although reported to be dwindling), a significant number of Americans have come to take advice from him as if he was their personal doctor. They have opened their hearts and minds to him as if he were the doctor who examined them, knows their medical history, overall lifestyle, and daily psycho-social challenges, and has assumed responsibility for their health; a doctor who only has their best interests at heart. In an era of ubiquitous health advice found on the web, in print media, and TV, and an increasing reliance on such advice by the general populace, it would not seem to be too far-fetched to take medical advice from Oz, a licensed and practicing physician who can legally dispense such advice. Or would it be?


My Doctor Said...

One gentleman named Frank Dietl, 76, who lives in Southampton, New Jersey, thought it was safe to take such advice. Not a good move. Here’s what happened to Frank after watching the April 17, 2012, episode of the NBC show titled "Dr. Oz's 24-Hour Ultimate Energy Boost Plan," during which Oz offered advice on what he called "my night sleep special." 

Oz’s advice centered on a "Knapsack Heated Rice Footsie," a pair of socks with uncooked rice -- "just enough to fill the toe of the sock" -- and heated in a microwave oven. He told his audience to "put this in the microwave until it's warm [and then]…put the socks on your feet and go to bed.”  According to Oz, "when you do this and lie for about 20 minutes with those socks on in bed, the heat will divert blood to your feet to your heat" and "when your feet get hot, guess what happens to your body. It gets cold. Your body will automatically adjust its core temperature and as it gets cooler, you're going to be able to sleep better because your body has to be cold in order to be sleepy. He recommended this in combination with a cup of Rooibos Tea to reduce "tensions, headaches and irritability," would help facilitate sleep. He went on to add that "If you can do this the right way, you're going to be thanking me for years to come."  

Dietl, a diabetic with peripheral neuropathy in his feet, which means he has loss of sensation, followed Oz's advice thinking it applied to him because Oz made no verbal disclaimers (discussion ahead on Oz's written disclaimers). The result was that due to Dietl's inability to feel that the socks were too hot, he suffered third degree (the worse type of) burns.  He sued Dr. Oz and his producers and distributors -- including co-defendants NBC, Sony Pictures Television, ZoCo Productions and Oprah Winfrey's Harpo Productions-- claiming that Oz neglected his "duty and obligation to warn viewing audience as to the possible effects of following the advice offered" and "to warn against certain effects of said medical advice as to those persons suffering from other additional medical conditions."

Specifically, the civil lawsuit filed in a New York State court stated that "Dietl was severely injured, bruised, and wounded, suffered, still suffers and will continue to suffer for some time physical pain and bodily injuries and became sick, sore, lame and disabled and so remained for a considerable length of time." 

Oz Is Not Your Doctor

Six months later, in October 2013, Oz deservedly had the lawsuit against him dismissed because the judge in the case felt that no doctor-patient relationship existed between Dr. Oz and his studio audience.  According to Judge Saliann Scarpulla who wrote in a brief decision dismissing the claim, the plaintiff, "Dietl has pointed to no authority that would lead this court to find a duty of care between a television talk-show host and his vast home-viewing audience, and Dietl fails to convince this court that creating such a duty would be sound public policy."

At the hearing, Dietl's attorney told the judge that what the plaintiff was arguing was not a "quasi physician-patient relationship" but that Oz still breached a duty of care by providing negligent medical advice. Specifically, Dietl believes that Oz should have warned the audience of the dangers related to the at-home remedy if not properly prepared as well as the dangers if the audience had prior medical conditions.

The judge, however, still believed this argument amounts to one of a physician-patient relationship and was unwilling to accept a legal theory that would create a duty of care just because a physician looks into a camera and addresses an unseen audience.

For once, I have to side with Dr. Oz and agree with the judge. 

The Oz Disclaimers

I think Dietl's first mistake was not heeding the fine print on the disclaimer that flashes on the screen at the end of each Dr. Oz Show episode.  Here's the disclaimer:

“Please note: This show is only intended to provide general information and is not specific medical advice.  You should consult with your own healthcare professional before altering or beginning any course of treatment.  ZoCo is not responsible for any losses, damages or claims that may result from your medical decisions and you are strongly encouraged to do your own research prior to any medical decisions you make." 

On Oz's website, which contains summaries of his shows plus other info, the disclaimer goes even further, when it states "This website is for informational and entertainment purposes only and is not a substitute for medical advice, diagnosis or treatment."

Now try to imagine your reaction if your own doctor made such statements to you. Some people may say that these disclaimers are merely a protection against lawsuits in a highly litigious society and Dr. Oz really does want you to take his advice--given all the research he claims has been done by his "team" in vetting such advice--without consulting anyone else. If you’ve watched his show then you heard him say words like "I'm telling you what to do."  

Should You Take Medical Advice From the Dr. Oz Show?

Nevertheless, a judge says the Dr. Oz Show does not have a doctor-patient relationship with you. The disclaimers on the show and website state that Oz and his guests don't expect you to take their medical advice without first consulting a legitimate source. The disclaimer states don't just take their word on anything, do your own research. 


Dietl’s second mistake was taking medical advice from a TV show that offers such advice for “entertainment purposes only” and may not care what happens to you if you take such advice because if it did, the show would otherwise explain the associated dangers like you may burn yourself. Or when Oz says everyone should take a baby aspirin, he would warn about possible bleeding and other horrible side effects (like one I got).

I think the facts are clear. The Dr. Oz Show is pure entertainment and as the show displays on its own, the info provided “is not specific medical advice” and “you are strongly encouraged to do your own research prior to any medical decisions you make  

Finally, really good advice from the Dr. Oz Show.