Paul from Facebook asks:
What are your thoughts on fructose? Is it really as bad as Paleo is making it out to be?
Dr. Robert Lustig has worked hard in recent years to demonize fructose, and his efforts have paid off. His YouTube video “Sugar: The Bitter Truth” has over 2.5 million views as of this writing. Lustig et al. claim that fructose is a uniquely fattening poison (when compared to glucose) that is as toxic to the liver as alcohol.
But is this true? Does the current evidence support this position? I’ve changed my views on this over time as I’ve become better acquainted with the literature, so I’d like to share my current understanding with you.
When it comes to fructose, calories matter
There’s no doubt that refined sugar – including fructose – can be problematic. But studies suggest that this is only true when calories are in excess.
This may be the most dangerous aspect of refined sugar: it leads to unintentional overeating. In a recent post on fructose, obesity researcher Stephan Guyenet points out that most people in these studies aren’t deliberately overfeeding. They are inadvertently overfeeding because they aren’t spontaneously compensating for the calories added to the diet via a large fructose- or glucose-sweetened beverage.
This doesn’t happen with fruit or other whole foods that contain glucose or fructose.
When people add a soda or two a day to their diet, they tend not to reduce consumption of other foods, and thus their calorie intake increases.
This is where fructose does appear to be more harmful than glucose. Although people don’t compensate for calories added via glucose or fructose, the fructose-sweetened beverages have more serious metabolic effects.
Is fructose uniquely fattening?
Dr. Lustig argues that, when compared to glucose, fructose is uniquely fattening. He claims that fructose is the most efficient substrate for de novo lipogenesis (DNL), which is the process by which the liver converts carbohydrates to fat.
However, Dr. Lustig relies on animal evidence that doesn’t apply to humans. There’s a big difference between mouse carbohydrate metabolism and human carbohydrate metabolism. When mice are on a high-carbohydrate diet that doesn’t provide excess calories, it’s common to see DNL rates of 50 percent and up. In other words, they are efficient at converting carbohydrates into fat, even when they’re not overeating. (1)
But in humans on an isocaloric diet (without excess calories), de novo lipogenesis falls into the range of 10 to 20 percent. The conversion of carbohydrate is less efficient in humans than it is in mice.
The research in this area is robust and uncontroversial. Nearly 50 controlled feeding studies have been performed on various aspects of cardiometabolic control. Most investigators working in this field believe that DNL in humans is negligible in response to fructose, and doesn’t comprise a significant source of dietary calories.
There’s another problem with extrapolating the animal evidence to humans in this case. The mice in the studies Lustig cites are eating huge amounts of fructose: up to 60 percent of total calories. You’d have to drink more than four 44 ounce Super Big Gulps a day to get that much fructose. Ain’t gonna happen.
According to researcher Dr. Sievenpiper in an interview with science writer David Despain at Evolving Health, the 50th percentile intake for people in the U.S. is 49 grams per day, which works out to 10 percent of total calories. Even the 95th percentile intake of 87 grams per day doesn’t exceed 20 percent of calories. That’s a lot of fructose, but it’s nowhere near the 60 percent of calories fed to mice.
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Is fructose an evil toxin?
Dr. Lustig refers to fructose is a “poison” that is nearly as toxic to the liver as alcohol. But again, human evidence doesn’t support this claim.
In a recent paper, Dr. Luc Tappy and colleagues labeled acetate, fructose and different metabolites with stable isotope tracers so they could see how fructose is metabolized in the human body. (2) They found that 50 percent ends up as glucose, 25 percent goes to lactate and greater than 15 percent goes to glycogen. The remainder is oxidized directly (to CO2 through the TCA cycle) and a small portion – as low as 2-3% – is converted to fat via de novo lipogenesis.
Glucose and glycogen are easily processed by the body, and 2-3% conversion to fat is not significant. And while some have claimed that lactate may be problematic, a paper published more than a decade ago contradicts this. (Hat tip to Evelyn from CarbSane.) According to the authors:
The bulk of the evidence suggests that lactate is an important intermediary in numerous metabolic processes, a particularly mobile fuel for aerobic metabolism, and perhaps a mediator of redox state among various compartments both within and between cells… Lactate can no longer be considered the usual suspect for metabolic ‘crimes’, but is instead a central player in cellular, regional and whole body metabolism.
Translation: lactate from fructose isn’t a problem.
What does this mean for you and fructose?
Fructose-sweetened beverages like soft drinks and juice cause metabolic problems when calories are in excess, and studies have shown that people are not likely to compensate for the additional calories they get from such beverages.
I don’t think there’s any basis for avoiding whole fruit simply because it contains fructose. As I’ve shown in this article, there’s nothing uniquely fattening or toxic about fructose when it isn’t consumed in excess. And since whole fruit contains fiber and other nutrients, it’s difficult to eat a lot of fruit without simultaneously reducing intake of other foods.
Fruit has been part of the human diet for longer than we’ve been, er, human. We’re well-adapted to eating it, and capable of processing the fructose it contains. (Unless you are FODMAP intolerant – but that’s a different issue entirely.)
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I am so glad to read this. I have been paleo for a little over a month and I do not use any type of sugar at all. I have used honey on maybe one or 2 occasions, and maple syrup once. So it is not a big problem for me, however, I am a fruit fiend. I have cut way back and mostly use raspberries, strawberries and blueberries, and since it is now in season cantaloupe which are all on the lower sugar side. I had someone tell me, sugar is sugar is sugar, whether it is fruit, table sugar, agave or anything else. I have been feeling guilty about my fruit, but I wont any more. Love your info by the way. I follow you on FB and email. I appreciate you putting out free information for my health!
Thanks for helping to dispel the myth about fructose! I’ve grown so tired of all the dogma!
Great minds apparently think alike. Stephan Guyenet also recently posted on fruit/fructose here: http://wholehealthsource.blogspot.com/2012/05/how-bad-is-fructose-david-despain.html
This post is based on information from Stephan’s article, which I referenced, as well as an article by Evelyn at CarbSane, which I also referenced. They’re both excellent sources for this kind of information.
Oops, sorry for the redundancy. Guess I read too fast and either missed or forgot the reference to Stephan’s article.
I’ll try to make up for that faux pas by adding that for those interested in more info on fruits, Denise Minger, Chris Masterjohn, Staffan Lindeberg, MD PhD and Katharine Milton, PhD, are also good sources of info on the topic. For example, Dr. Lindeberg reported in Food and Western Disease: Health and Nutrition from an Evolutionary Perspective on p. 51 that wild fruits tend to contain a HIGHER, rather than lower, ratio of fructose:
“Fruits, which have likely been consumed in large quantities by our primate ancestors, differ from other edible plants in that they contain appreciable amounts of fructose, a monosaccharide, which typically constitutes 20-40% of available carbohydrates in wild fruits (456, 932, 1226) and 10-30% in cultivated fruits (1275). A daily fructose intake below 60 g, which is considered to be safe, corresponds to 4-5 kg of pineapples (1568, 1857). Approximately two-thirds of dietary fructose in the US population is provided by non-natural foods and additives, mainly sucrose and high fructose corn syrup (1390).
Dr. Milton pointed to higher levels of sucrose in cultivated vs. wild fruits: “One important difference between wild and cultivated fruits is that sugar in the pulp of wild fruits tends to be hexose-dominated (some fructose and considerable glucose; Table I) while that of cultivated fruits tends to be highest in sucrose, a disaccharide.” (Milton, Katherine, PhD, 1999. Nutritional characteristics of wild primate foods: do the diets of our closest living relatives have lessons for us? Nutrition, 15(6): p. 490, http://nature.berkeley.edu/miltonlab/pdfs/nutritionalchar.pdf.)
So there are multiple possible reasons for why wild and heritage varieties fruits aren’t as bad as table sugar, HFCS, sugar-sweetened beverages and such, and the all “fructose” = poison meme does seem to be an oversimplification.
The more I think about this post the more I see the data is based on acute responses but this is a chronic problem. That’s what Dr. Lustig argues. There is no risk if there is no exposure. Fructose as well as wheat are ubiquitous (major exposure, major risk) to our society.
My take away from Lustig lectures and articles is that chronic fructose intake is dangerous for people who are glycogen repelete, which describes the majority of the population. I can’t comment on the science on way or the other as I don’t have the background in biochemistry, but the most persuasive part of Lustig’s take on fructose is his clinical experience. What often seem to find is we have academic research that may be “correct”, but has little relevance in clinical environments because of the confounding factors that clinicians often run up against. Can the average paleo follower tolerate the occasional dose? Probably, as they are most likely to be relatively healthy and are managing many of the other risk factors which could lead to fructose “toxicity”.
On the other hand, talk of prohibition etc. is ludicrous, Just when the public seems to become aware of the terrible problems associated with all types of prohibition, to be calling on to add to damage it does to society is dangerous. When sugar is outlawed, only criminals will consume sugar.
From my reading, Lustig isn’t talking about banning fructose, just treating it more like alcohol.
Heroin is outlawed. Do only criminals use it?
I appreciate the balance that I’ve been seeing from you, Robb Wolf, the Hartwigs, etc. The hardline stance of Lustig, especially when he started talking legislation/regulation of fructose was over-the-top. That said, when Lustig talked about the metabolization of fructose in the liver resulting in uric acid production at the 58 minute mark of The Bitter Truth lecture, a lightbulb went off for me. As a gout sufferer for decades, I immediately eliminated added sugar from my diet with the idea that if I had an overproduction issue with uric acid, I should be able to resolve that issue by removing the likely source of the overproduction. I was able to stop taking allopurinol and haven’t had a gout attack since. A few months later, I went full paleo and felt even better, but the elimination of added sugar (I still ate whole fruit), took care of gout for me, so kudos to Lustig for at least getting my attention to try something. It could be a different mechanism entirely that led to a gout cure, but I’m sticking with the idea that fructose/sugar in general appeared to be a bad idea for me.
The research on fructose, uric acid and gout is mixed. I plan on covering this in a future article.
Fruit consumption is not the root cause of gout, but supplying extra fuel, esp glucose/pufas, to an immune system that is already at defcon 5 is not good. However, it is better to eliminate the things that are triggering the immune system. In my experience, the foods that trigger the immune system the least are fruits and veggies. Some of the worst offenders are dairy, processed foods and animal products.
Is the paleosphere moving towards the ‘nothing is inherently harmful to health’ idea?
Pretty sure most people with agree that vegetable/hyrogentaded oil, soybeans, and a number of other shit food is pretty unhealthy.
Chris, This is technically a great article and I wouldn’t doubt your research. Yet there are other important aspects of fructose you didn’t speak to that Dr. Lustig does. I really wish you would have prefaced this article a little better in that regard. Dr. Lustig has always pointed out fructose is poison to metabolically broken people, leptin resistant mainly. You could have brought up the fact that fructose is addictive and lights up the reward centers in the brain. Eating/drinking doses that are not in natures packaging (even a small glass of juice) could cause cravings that lead to the over consumption of calories that sets bad cycles in motion. The poison is in the dose, if addicted then a little gets to be more and more then you’re metabolically broken. That’s Dr. Lustig’s stance. Can an alcoholic have just one drink, sure but its likely to awaken their demons. As he says, “sugar is the alcohol without the buzz”. That’s a risk that should have been prefaced.
Ah there is a buzz. You better believe it!! Someone in the throes of a sugar fest, several times a day occurrence waaaaaaay more often than researchers would like to admit, is exactly as a drunken man. Out of control and loving every drugged minute of it. With self hatred and remorse afterwards…whilst on their way to find their next drink/candybar/Starbucks.
Another excellent well balanced article.
For those that live in the UK that missed the first of the series “The Men Who Made Us Fat” might like to try the BBC I-player here http://www.bbc.co.uk/iplayer/episode/b01jxzv8/The_Men_Who_Made_Us_Fat_Episode_1/ I’m not sure if this is available outside the uk but it features the whole diet problem since Ancel keys and his flawed research that he manipulated to confirm his own theory that fat made you fat. It show the problems caused if you assume all calories are the same. Tests in a laboratoy only show that the test works in a laboratory (in vitro).
My mother spent her life eating ‘low fat’, low sugar, high fibre, ‘healthy’ weight loss food with loads of bran. The last thing any of it ever did was help her loose weight. One of her favorite foods she had given up was sweet corn because it was high in calories. We now know that just because food tested in a laboratory contains x amount of calories, doesn’t mean they’re all available to our digestive system (bioavailable).
My mother’s ‘healthy’ low fat, high fibre, artificially sweetened diet gave her type 2 diabetes and bowel cancer and her weight didn’t go down till the cancer resulted in half her intestines being removed. Not the best way to loose weight!
The above program does focus on high fructose corn syrup and includs interviews with Lustig and other names familiar with visitors to this site and Drs. Mercola and Briffa. The Weston A Price Foundation and George Monbiot even get a mention. As the first of 3 we’re eagerly awaiting the next two.
I understand that sugar IS the casue of all diet problems but that fructose is by far the most damaging of the two types. What people seem to forget is that you don’t have to consume sugar to actually end up with two much in your body. Whether pure carbohydrate like sugar or grains in the form of bread or pasta etc, the body turn these into sugar as well. So while cutting down on sugar is a no brainer, subsituting it for artificial sweeteners or forgetting about those grains make it a pointless excercise.
“I understand that sugar IS the casue of all diet problems ..” Where did you come to this conclusion? It is definitely not “thee” cause to all diet problems. What about PUFAs, intestinal irritants, nutrient deficient processed foods, etc.
Well, thanks for the info. So sugar is the master evil, the root of all diet problems. I always suspected that. My new super healthy diet will consist of hydrogenated soy bean oil, wheat protein and to top it off, grain fiber. I’m sure i’ll loose weight, since it’s a zero carb diet, you know, theres no evil sugars or evil starches.
OK You got me there. Poor choice of words. I still believe its the worst culprit because its in all processed foods, including savoury food. By default the body converts carbs into sugar that you haven’t even taken. I didn’t go down the hydrogenated fat, soy bean oil route because I’m sure most visitors to this site know the dangers of these. Wheat is only 6% protein so not sure if you mean the whole grain or an extract. If you mean the whole grain you’re back on carbohydrates in your fictional diet.
No, I think you will find sucrose in processed foods is the least of your worries. Its all of the other rubbish in it that causes big problems.
“I understand that sugar IS the cause of all diet problems”. I guess someone forgot to tell the long-lived Okinawans whose diet was 85% carb (mostly from sweet potatoes).
The Okinawans are genetic freaks who have traditionally lived in isolation from the rest of Japan. Studies have shown that their genetics help them in preventing inflammatory and autoimmune diseases. In addition, the carbohydrates in Japanese sweet potatoes (which are botanically in the yam family) are higher in amylopectin, which slows the rate of digestion. In addition, traditional Okinawans simply eat fewer calories than the average person due to a cultural practice of eating until you are only 80 percent full called Hara Hachi Bu. Moreover, when Okinawan leave their isolated villages, they adopt all sorts of modern habits, and they shorten their lifespans.
In short, Okinawans are outliers and not relevant to the rest of us.
I’m not sure what to think about this,
the conclusion of this Blogpost, as I understand it, is that a glas of Juice and some Fruit is okay and good for us. As someone who recently found to paleo I totally agree with that but I don’t see that Lustig nor the paleo-community said otherwise, as I understood it. Lustigs scientific evidence may be lacking, but his general statement that HFCS and sucrose is the huge problem is absolutely correct IMO.
You can’t combat terrible science with not-so-terrible science. Lustig is incorrect in stating “fructose is as bad alcohol” and has no evidence to prove it. Everyone states that HFCS is bad – for the most part – so I rather someone who’s honest and factually correct be at the forefront of the natural foods movement. My main grievance with Lustig, is his want to legislate against HFCS. Prohabition is not only idiotic, but immoral.
I’m totally against prohibition, but I think that removing the tax subsidies for corn farmers would be a start in the right direction. Why are out tax dollars spent to enable farmers to grow HFCS, and then we turn around and try to tax the end result to convince kids not to drink soda? It seems the only ones who benefit from this are the gov’t bureaucracies.
In complete agreement
We are paying for idiots who ingest hfcs and dose it out to their offspring. We support these ppl thru legislated robbery of our paychecks to fund social services. If the kids are born into a solvent family then when they are disabled due to their stupid lifestyle choices and go on SSI and Medicaid, Medicare etc, we pick up the tab, then if not before.
If the govt can legislate theft of my paycheck, then it can legislate poison as illegal.
What about the claim that when the glycogen stores of the liver are full, excess fructose is converted to triglycerides? Would that be a reason to eat your fruits BEFORE your other carbs during a meal.
It would only matter temporarily, which isn’t clinically relevant. At the end of the day, it’s energy in versus energy out. Our body is constantly storing and burning fat.
Could you please share your thoughts on fructose’s role in candida?
Chris! Hello, my friend. Any thoughts on the Ray Peat/Josh Rubin take on Fructose and sugar in general? Ray emphasizes the importance of sugar intake, specifically as it relates to its role in combatting the stress response. Their take on gluconeogenesis makes sense to me, and more and more of my former “Paleo” friends are now drinking OJ daily…
IMO, a diet high in fruits should be relatively low in fat & proteins. A diet high in fats & proteins should be relatively low in sugars of any type including from fruit.
I recall Lustig saying that the fiber in fruit and vegetables was enough to counteract the fructose contained within. The same couldn’t be said about juice. But that doesn’t mean people tuned that part out either.
How about raw honey? I removed all cane sugar and now bake with raw honey….good idea, bad idea, limits on how much I should feed my family??
Mark Sisson has a great post on honey that you might want to check out.
raw honey + baking = not raw honey. yay
Try this http://blog.cholesterol-and-health.com/2010/10/high-fructose-corn-syrup-is-sweet.html
Enjoyed the post, Chris. Always appreciate your balanced and reasoned approach. Any plans to do a post comparing natural fructose to high fructose corn syrup?
Shouldn’t there be a mention of eating locally and in season in the article? Vitamin D is important in processing sugar so February in Seattle probably isn’t optimal for eating a bunch of sugar regardless of its form.
Eating locally is good for the earth,the economy and probably for the nutritional value of the food, but it doesn’t make sense to avoid some food(s) because they are out of season. Up north where I am, we’d be subsisting on snow for 6 months of the year. My recent ancestors are from Europe in a place where it’s much warmer, so what is available there is a much different diet than what I can grow here. But where did they come from? Humans can adapt to eating a lot of different foods. Thank goodness someone had the good sense to introduce sushi in Canada 🙂
i’m appalled that the “ancestral health” community is embracing sugar to the extent it is. sugar has so many downsides, …where is this coming from??? and differentiating between fruit, corn syrup and sucrose-sweetened treats is rather ridiculous in this era of bred-for-sweetness fruits. in a banana there are about 45g of non-fiber carbs — that’s equal to about a quarter-cup of sucrose, with a comparable breakdown of glucose to fructose.
furthermore, fruit is a traditional tool to encourage appetite. add to this the fact that a lot of people have fructose-absorption issues. i think it’s irresponsible to recommend fruit to people who need to lose weight, especially as a between-meal snack!
tess:
I don’t believe that Ray Peat qualifies as a practitioner of “ancestral health” unless you’re from the late Miocene.
JS
Wow don’t freak out! Fruit does not cause people to be fat!
I eat 4-5 servings of fruit a day, and I’ve lost 60 pounds. Thanks for telling me how I’m doing it all wrong! From BMI = 34 to currently 26. That last 10 pounds is tough, I’ll have to try to eat more fruit!
And how’s your diet going?
Julie just curious what else you are eating/what kind of exercise are you doing to have lost those 60 pounds?
i don’t have too many hard/fast rules. I’m not paleo – eat lots of beans, a bit of meat, a bit of whole grains, too much dairy, lots of fruits/veggies, coffee with regular white sugar. I rarely eat out, and I try my best to eat only when hungry, and not stuff myself, nor eat huge portions. If I eat a big late lunch, I may just have fruit or salad for dinner, I no longer force myself to eat just because it’s mealtime, or anything but hunger. I go to the gym a few days/week, cardio, strength training, yoga, and I do about 80% of my transportation by bike or walking. It’s slow but steady, what tends to screw me up is alcohol and restaurant food (big heavy portions). And my co-workers candy bowl, which i finally had to nix altogether, hardly like the stuff yet I couldn’t keep it to just one stupid way-too-sweet mini Reeses Cup, started eating up to three daily, so now I don’t even start.
Honestly, this isn’t about fruit – it’s about fructose. There’s a difference. Lustig says that fruit in moderation is OK because it has all its fiber. We’re talking about the copious amounts of HFCS that is in processed food – including juice.
Exactly, Jane. I believe that if fruit was the only source of fructose than there probably wouldn’t be any cravings for junk food. My mom says, “Fruit is food, vegetables are medicine.” Of course, I can’t resist to add that proteins and fats are essential.
Your mom is right. Fruit & veggies are food & medicine in one. These foods are not the cause of health problems.
But that’s what I take issue with. The comment that fruit is only okay because of the fiber implies that the fructose it contains is harmful, but the fiber somehow cancels that out. But the research I pointed to in this article shows that fructose is not a problem unless calories are in excess.
One thing I would have liked to see you present, Chris, was what feedback you have from your clients in relation to the fruit issue?
I personally have to be pretty careful with fruit, as it can work out as an ‘avalanche’ food for me. Once I get started, i can find it hard to stop…
This is especially the case with chopped fruit salad, but much less the case with whole fruit eaten one at a time, and don’t even get me started on dried fruit!
I appreciate your thoughts,
George
I also have a history of bad problems from fruits, but I found that there are dramatic differences in effects between various fruits. I’d be curious to learn which specific fruits affected you badly, George. Thanks.
Hi paleophil,
Right now, I’m not totally sure about the finer details, as this is pretty new to me.
It’s only since going totally paleo (2 weeks) that I’ve noticed it. But…
It seems that the higher the sugar content, the greater the avalanche. So dried fruit comes tops, then things like mango, with berries coming last, but not really by much.
I suspect that some part of it that I’m still going through a sort of mental detox and in the process of learning new eating habits; using fruit to try and capture some of the experience I got with grains, probably. I’ll know more when my eating is more under control and I get a sort of background reading of my psyho-emotional state that allows me to more closely appreciate the varying effects of different fruits.
Hope this helps,
George
Thanks George, that’s pretty well in line with my experience, except I find that certain berries and fruits (wild Maine blueberries–fresh in season and frozen ones year-round are available locally–wild black and red raspberries, wild and organic blackberries, wild river grapes, lemons, limes and certain other fruits) seem to be substantially less of a problem for me than dried fruits, mango, bananas, oranges, pineapple, papaya, green grapes, pears, and apples.
Dried fruits seem to be the biggest offenders for me, possibly due to the concentrated sugars and the tendency to eat way more calories and grams of sugar at a sitting when eating dried than fresh fruit, and who knows, maybe even the heating of the fruits by commercial dehydrators at who-knows-what temperature. I don’t think the sulfur dioxide in the preserved dried fruits affects me significantly, though I’m not certain. Interestingly, the cheapest, most commonly served fruits all seem to give me problems. I wonder how many people judge all fruits based on them?
I do think that my carb tolerance has improved some during the last couple years, but I’m still far less carb-tolerant than average. I’ve been doing a Paleo/ancestral-type diet since 2004.
Good luck,
Phil
Fresh fruits are packed with water which expands the stomach and limits the quantity ingested.
Everything in moderation even that which is nutrient dense and whole foods.
If you eat a bag of lollies you are going to have issues, if you eat a whole case of mangoes you are going to have issues.
Chris
What I take from this is exactly what you said that fructose becomes a problem when calorie intake is too high.
In short if people are overeating irrespective of what eating style you have, Paleo, Zone, Vegan, Vegetarian, Raw food your calories will be more than the energy you are expending and you will put on weight. Obviously this is subjective to lots of variables but overeating is still overeating.
An average banana has about 30g of sugar, if I’m not mistaken… And this meme about modern fruit being bred for sugar; weren’t there plenty of fruits in ‘paleo’ times with sugar in them too? Of course, they wouldn’t be avaiable year round, but that’s not what we’re talking about here…
As for the ‘irreosnibsility’ of this article- isn’t it clearly stated that this recommendation isn’t for anyone with glucose toelrance issues etc…
Outside of the tropical zone, humanity had little opportunity to eat fruit, except, as you note, seasonally (summer to early fall). Those fruits, tropical ones excepted, though, were not very sweet. Apples, in particular, were somewhere between bitter and tart.
But those tropical exceptions do raise an interesting question: how much of them did Neanderthals and early modern humans eat?
http://nutritiondata.self.com/facts/fruits-and-fruit-juices/1846/2
About the same sugar content as a sweet potato…
Great post, Chris! It is refreshing to see these distinctions (real vs processed food, animal vs human). All too often I think that people are quick to draw conclusions without regard to context.
Chris,
What fruits do you recommend in terms of overall health and longevity? I have heard that many fruits today have been bred to be large and very sweet, but this doesn’t necessarily mean nutrient dense. I tend to go with things like cranberries, wild blueberries, goji berries, raspberries, pink guava, and dragonfruit.
Thanks,
Eric
My diet consists of mostly fruit and some veggies. In order to get enough calories and maintain weight, I tend to rely on the fruits that have more sugar (bananas, mango, papayas) not less (berries).