Does an Apple a Day Keep the Doctor Away? Debunking Myths About Fruit

By Roberta Alessandrini, PhD
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When it comes to maintaining a healthy diet, vegetables often steal the spotlight, while fruit sometimes gets a bad rap due to its higher sugar content. This misconception has left many people wondering if they should be cautious about consuming fruit. This blog post debunks common myths about fruit, shedding light on the truth behind its nutritional value.

Myth 1: Fruit isn’t that healthy

The World Health Organization and the World Cancer Research Fund recommend consuming at least 400 grams (approximately 5 portions, in total) of fruit and vegetables per day. Many studies have shown that this is the minimum intake to reduce the risk of common NCDs such as cardiovascular disease, cancers and premature death (1-3).

Healthcare professionals usually recommend the widely used rule of thumb of “two portions of fruit + three portions of vegetables daily”. A portion is approximately 80 grams of fruit or veg per day, or to simplify, a “fistful of fruit or veg”. However, the exact portion size can vary depending on the specific fruit. Here are some general guidelines for common fruits:

  • Apples, oranges, and similar-sized fruits: A medium-sized fruit such as an apple, orange, or pear is typically considered to be one portion.
  • Berries and grapes: A portion of smaller fruits like berries (strawberries, blueberries, raspberries) or grapes is usually considered to be around one small cup or a handful.
  • Bananas: A medium-sized banana is typically considered to be one portion.
  • Melons and pineapple: A portion of larger fruits like watermelon, cantaloupe, or pineapple is usually considered to be around one small cup of diced fruit.
  • Citrus fruits: For citrus fruits like grapefruits or mandarins, one portion is usually equivalent to one fruit.

Fruit is generally consumed raw. As cooking fruit or vegetables can deactivate some of their vitamin and phytochemical content, eating raw fruit and vegetables is a good way of getting all the good stuff. On the other hand, vegetables tend to have higher fibre which has been shown to protect against many cancer and cardiovascular diseases. Therefore eating fruit as well as vegetables is a powerful strategy to stay healthy in the long term.

Myth 2: Bananas aren’t good for you

In comparison to other fruits, bananas contain a slightly higher amount of sugars and carbohydrates. Due to this, there is a common misconception that bananas contribute to weight gain, leading some people to avoid them. However, contrary to this belief, bananas offer several health benefits and can be a nutritious choice for various reasons.

Kid with Raspberries
  • Nutrient-rich: Bananas are a good source of potassium, dietary fibre, and antioxidants. Potassium is an important mineral that helps regulate blood pressure, maintain proper heart function, and support muscle and nerve health. Dietary fibre helps to aid digestion, promotes bowel regularity, and helps maintain a healthy gut.
  • Good Sugars: Bananas are a great source of good sugars as they come embedded in the cellular structure of the fruit. Meanwhile, the free sugars commonly found in sugary drinks and sweets are readily absorbed and have been linked to an increased risk of tooth decay and obesity (4,5).
  • Potassium and energy boost: Bananas can provide a quick and easily digestible energy boost and are often recommended as a pre-workout snack or to provide potassium and energy.
  • Heart health: The combination of potassium, fibre, and antioxidants in bananas may contribute to heart health. Potassium helps maintain healthy blood pressure levels, while fibre supports cholesterol management.
  • Convenience: Bananas are a convenient and portable snack option. They come in their own natural packaging and require no preparation. They can be enjoyed for a speedy breakfast on the go, added to smoothies, or incorporated into baked goods as an egg substitute.
  • Cheap: Bananas are often considered a budget-friendly fruit choice, making them accessible to a wide range of consumers.
  • Bowel health: The consumption of bananas can be beneficial for relieving both constipation and diarrhoea (6,7). Compared to green bananas, riper bananas have higher amounts of soluble dietary fibre and less resistant starch and might be beneficial for the treatment of constipation (8).

Overall, bananas are a nutritious fruit choice that can be part of a balanced and healthy diet.

Myth 3: Fruit juice is as healthy as whole fruit

People often consume fruit juice believing that it has the same health benefits as whole fruit. However, whole fruit is a much healthier option for the following reasons.

  • Dietary fibre content: Whole fruits are generally higher in fibre compared to fruit juice. Dietary fibre is essential for digestive health, regulating blood sugar levels, and promoting feelings of fullness (9). Most manufactured fruit juices have had their fibre content reduced or eliminated during the juicing process.
  • Vitamin content: Fruit juice manufacturing involves pasteurisation, a heat treatment process that helps kill the bacteria, yeast, and other microorganisms present in the juice. Pasteurisation aims to make the product safe to consume and extend its shelf life. On the other hand, heat treatments can deactivate some important vitamins such as Vitamin C and bioactive compounds such as those present in fresh fruit (10). Moreover, vitamin content can decrease during storage.
  • Free sugars. Fruit juice contains free sugars, which are sugars that are not included in the cellular structure of food. Free sugar intake increases the risk of tooth decay and unhealthy weight gain (5). Sugar from whole fruit is not considered free sugar. Additionally, some commercial fruit juices may contain added sugars, further increasing their calorie and free-sugar content.
  • Calorie density and satiation: Fruit juice has higher energy density (more calories for a single unit of volume) and it is less filling than whole fruits (11).
  • The act of chewing and the bulk of the fruit can help promote a sense of satiety. On the other hand, it’s easier to consume larger quantities of fruit juice without feeling as satisfied, which can contribute to higher calorie intake if not controlled.
It is worth mentioning that the production of fruit juice can be a way to utilise surplus fruit or fruit with cosmetic flaws (less desirable for direct consumption). However, juice production itself can generate waste, such as discarded peels, pulp, or seeds. It’s crucial for juice producers to implement proper waste management practices, such as composting or repurposing these byproducts for other uses like bioenergy production (12).

Often people consume fruit juice instead of sugary drinks or alcoholic beverages. Avoiding the last two is a wise choice as evidence shows that sugary drinks and alcohol consumption are linked to obesity and cancer (4,13). Consuming fruit juice (better if diluted in water) could be a healthier solution. However, fruit juice should be consumed in moderation.

Overall, whole fruits are generally considered a healthier option due to their higher fibre content, lower calorie density, and additional beneficial compounds.

Myth 4: Fruit pouches are a healthy snack for kids

People who have children or who care for children are familiar with the challenges of feeding fruit and vegetables to little ones. Recently, baby food pouches have become popular as a convenient option for introducing fruit and vegetables to young children. However, fruit pouches do not provide the same nutrition as fresh fruit and vegetables for the following reasons.
Kid with Raspberries
  • Nutrient content: As with fruit juice, fruit pouches contain smaller amounts of dietary fibre, have higher free-sugar content and have been heat-processed, and thus contain fewer vitamins and phytochemicals than fresh fruit (14).
  • Texture: While baby fruit pouches can be a convenient option, it’s important to also expose children to whole fruits as they grow. Chewing and experiencing the textures of whole fruits support oral motor development. Gradually introducing soft, mashed, and small pieces of fruit can help children develop their chewing skills and familiarity with different textures (15).
  • Portion control: Fruit pouches can be consumed quickly, potentially leading to overconsumption if not monitored.

Overall, it is best to offer your child a variety of (appropriately cut or mashed) fruit. Baby pouches should not be considered a replacement for fresh fruit and should be only consumed occasionally.

Myth 5: Some fruits are healthier than others

While many are familiar with the old saying “an apple a day keeps the doctor away”, it is important to eat a diverse range of fruits. Public health authorities emphasise the benefits of consuming a variety of fruit (and vegetables) of different types and colours every day (16). Each colour is associated with a unique combination of beneficial compounds, such as vitamins, minerals, antioxidants, and phytochemicals. Here are some benefits of consuming a variety of colourful fruits:
  • Orange and yellow fruits (e.g. oranges, mangoes) are often high in vitamin C, beta-carotene, and potassium.
  • Red and pink fruits (e.g. strawberries, watermelon) are often rich in vitamin C and antioxidants like lycopene.
  • Green fruits (e.g. kiwi, avocado) provide vitamin K, folate, and various phytochemicals.
  • Blue and purple fruits (e.g. blueberries, grapes) are known for their antioxidants, including anthocyanins (17).

It is difficult to definitively determine which types of fruit are healthier as the benefits of any one type of fruit depend on various factors, including its nutrient content, antioxidant profile, fibre content, and the individual health needs of the consumer. Aim to consume a rainbow of fruits, including berries, citrus fruits, apples, pears, bananas, melons, and other options available to you to maximise the nutritional benefits they provide.

So, do people eat enough fruit?

Data from national surveys and dietary assessments in high-income regions consistently show that a significant proportion of the population falls short of meeting the recommended intake of fruits and vegetables. In European countries, only 12% of adults consume the recommended 5 portions of fruit and vegetables per day; and 1 in 3 people (33%) report not consuming any fruit or vegetable daily (18). In the US, the statistics are very similar as only 12% of adults consume the recommended daily portions of fruit (19).
Kid with Raspberries

In general, consumption of the recommended portions of fruits and vegetables tends to also be low in developing countries (20,21). Access to fresh produce, affordability, and cultural factors can all influence the consumption of fruits and vegetables in these regions. A study including 28 low and medium-income nations reported that only 18% of the surveyed people met the recommended intake of 400 grams of fruit and vegetables daily (21).

Studies have consistently shown that regardless of context, people of a lower socioeconomic status (SES) tend to consume fewer fruits and vegetables compared to those with higher SES (22,23). Lower consumption in these groups is due to many factors such as affordability and availability. Time constraints and cultural factors are also other important determinants (19,20). People with a limited food budget tend to focus on starchy staples and manufactured foods as they are relatively inexpensive, require little or no preparation and have a longer shelf life. Fruit and vegetable recommendations should consider regional and financial accessibility, providing options within the consumer’s budget.

One solution for fruit shopping on a budget is choosing seasonal produce and comparing prices to find the most affordable fruits in the area. Compared to fruit imported from other countries, seasonal fruit is often fresher and may have a lower carbon footprint.

The bottom line

Consuming fruit offers numerous benefits, including essential nutrients, fibre, and antioxidants that support overall health. Fruit is also a source of sugar but this should not be a concern because sugar from whole fruits has not been linked to negative health outcomes. Surveys show that most of us eat too little fruit and we should strive to eat at least two portions a day.

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Ready to improve your nutrition knowledge?

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Mini Modules on Diet-Related Diseases

This series of short modules addresses common diet-related diseases such as heart disease, hypertension and type 2 diabetes. Learn the causes and which patients are at risk, and find out practical solutions to managing these diseases through whole food, plant-based eating.

 

References List:

  1. Aune D, Giovannucci E, Boffetta P, Fadnes LT, Keum N, Norat T, et al. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol. 2017 Jun 1;46(3):1029–56.
  2. Miller V, Mente A, Dehghan M, Rangarajan S, Zhang X, Swaminathan S, et al. Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study. Lancet Lond Engl. 2017 Nov 4;390(10107):2037–49.
  3. Wang DD, Li Y, Bhupathiraju SN, Rosner BA, Sun Q, Giovannucci EL, et al. Fruit and Vegetable Intake and Mortality. Circulation. 2021 Apr 27;143(17):1642–54.
  4. Morenga LT, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ. 2013 Jan 15;346:e7492.
  5. Guideline: sugars intake for adults and children [Internet]. [cited 2023 Jun 1]. Available from: https://www.who.int/publications-detail-redirect/9789241549028
  6. Bae SH. Diets for Constipation. Pediatr Gastroenterol Hepatol Nutr. 2014 Dec;17(4):203–8.
  7. Falcomer AL, Riquette RFR, de Lima BR, Ginani VC, Zandonadi RP. Health Benefits of Green Banana Consumption: A Systematic Review. Nutrients. 2019 Jun;11(6):1222.
  8. Kumar* KPS, Bhowmik D, S.Duraivel, M.Umadevi. Traditional and Medicinal Uses of Banana. J Pharmacogn Phytochem. 2012;1(3):51–63.
  9. Barber TM, Kabisch S, Pfeiffer AFH, Weickert MO. The Health Benefits of Dietary Fibre. Nutrients. 2020 Oct 21;12(10):3209.
  10. Martí N, Mena P, Cánovas JA, Micol V, Saura D. Vitamin C and the role of citrus juices as functional food. Nat Prod Commun. 2009 May;4(5):677–700.
  11. Flood-Obbagy JE, Rolls BJ. The effect of fruit in different forms on energy intake and satiety at a meal. Appetite. 2009 Apr;52(2):416–22.
  12. Kandemir K, Piskin E, Xiao J, Tomas M, Capanoglu E. Fruit Juice Industry Wastes as a Source of Bioactives. J Agric Food Chem. 2022 Jun 15;70(23):6805–32.
  13. Rumgay H, Shield K, Charvat H, Ferrari P, Sornpaisarn B, Obot I, et al. Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study. Lancet Oncol. 2021 Aug 1;22(8):1071–80.
  14. ‘As sugary as Cola’: Dentists call for sweeping action on baby pouches. BDJ Stud. 2022 Jul 29;1–1.
  15. Mura Paroche M, Caton SJ, Vereijken CMJL, Weenen H, Houston-Price C. How Infants and Young Children Learn About Food: A Systematic Review. Front Psychol [Internet]. 2017 [cited 2023 Jun 19];8. Available from: https://www.frontiersin.org/articles/10.3389/fpsyg.2017.01046
  16. Wholegrains-veg-and-fruit.pdf [Internet]. [cited 2023 Jun 5]. Available from: https://www.wcrf.org/wp-content/uploads/2020/12/Wholegrains-veg-and-fruit.pdf
  17. Kalt W, Cassidy A, Howard LR, Krikorian R, Stull AJ, Tremblay F, et al. Recent Research on the Health Benefits of Blueberries and Their Anthocyanins. Adv Nutr Bethesda Md. 2020 Mar 1;11(2):224–36.
  18. How much fruit and vegetables do you eat daily? [Internet]. [cited 2023 Jun 8]. Available from: https://ec.europa.eu/eurostat/web/products-eurostat-news/-/ddn-20220104-1
  19. Lee SH. Adults Meeting Fruit and Vegetable Intake Recommendations — United States, 2019. MMWR Morb Mortal Wkly Rep [Internet]. 2022 [cited 2023 Jun 8];71. Available from: https://www.cdc.gov/mmwr/volumes/71/wr/mm7101a1.htm
  20. Hall JN, Moore S, Harper SB, Lynch JW. Global variability in fruit and vegetable consumption. Am J Prev Med. 2009 May;36(5):402-409.e5
  21. Frank SM, Webster J, McKenzie B, Geldsetzer P, Manne-Goehler J, Andall-Brereton G, et al. Consumption of Fruits and Vegetables Among Individuals 15 Years and Older in 28 Low- and Middle-Income Countries. J Nutr. 2019 Jul 1;149(7):1252–9.
  22. Darmon N, Drewnowski A. Does social class predict diet quality? Am J Clin Nutr. 2008 May 1;87(5):1107–17.
  23. Ball K, Lamb KE, Costa C, Cutumisu N, Ellaway A, Kamphuis CBM, et al. Neighbourhood socioeconomic disadvantage and fruit and vegetable consumption: a seven countries comparison. Int J Behav Nutr Phys Act. 2015 May 22;12(1):68.
  24. Livingstone KM, Burton M, Brown AK, McNaughton SA. Exploring barriers to meeting recommendations for fruit and vegetable intake among adults in regional areas: A mixed-methods analysis of variations across socio-demographics. Appetite. 2020 Oct 1;153:104750.
  25. Yeh MC, Ickes SB, Lowenstein LM, Shuval K, Ammerman AS, Farris R, et al. Understanding barriers and facilitators of fruit and vegetable consumption among a diverse multi-ethnic population in the USA. Health Promot Int. 2008 Mar 1;23(1):42–51.

 

Kid with Raspberries

Author

Roberta Alessandrini, PhD

Roberta is a Medical Content Creator (International Content) at PAN. She is a nutrition scientist strongly interested in promoting plant-based diets as a way to improve our health, spare animals’ lives and reduce the devastating impacts of climate change. Roberta’s professional experience includes health policy, academia, NGOs and community nutrition. She also holds the position of Honorary Research Fellow at Queen Mary University of London.

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