Is fruit really good for you and should you have 5 A Day?
06:00, 18 February 2020
updated: 08:04, 19 February 2020
Kent has been known as the Garden of England for hundreds of years due to its fruit-growing prowess.
Four of the UK's largest growers are based in the county, and local businesses supply up to 70% of the national apple crop, playing a major role in an industry worth around £400 million a year.
Thousands of jobs in the county are also dependant on how the fruit industry performs locally and nationally, so what if the positive image of fruit changed?
Dr Antony Gustin, co-founder of US-based nutrition company Perfect Keto, and nutritional science researcher Chris Irvin, are part of a growing movement of health professionals questioning the advice surrounding eating fruit and the "5 A Day" concept.
They raise concerns about the sugar content of fruit in their recently-published book Keto Answers.
"Fruit doesn't just contain any sugar, it contains a special sugar known as fructose, a sugar that most people refer to as a 'healthy sugar' because it is found in fruit," it says.
"Here's the problem fructose fails to trigger the release of hormones and neurotransmitters in your brain to signal that you're full.
"When you eat fruit as a stand-alone snack, you'll probably feel full for half an hour. After that hunger sets in again.
"Fruit doesn't have enough fat or protein to keep you satiated.
"The combination of sneaky fructose and blood sugar spikes (followed by dips) is a recipe for disaster.
"This inadvertently prevents weight loss for many people.
"Fructose is also known to cause bloating since it is not efficiently absorbed by the small intestine.
"This leads to gas and abdominal discomfort.
"And thanks to the magic of agricultural research and development, today's fruits are bigger and sweeter than ever."
They argue the same nutritional benefits of fruit - minus the high sugar content - can be obtained by switching to alternatives such as avocados, spinach, asparagus, and artichoke.
In conclusion, they say people should consume only moderate amounts of fruit and when they do stick to avocados, berries, cherries, cranberries, and coconuts.
Dr Gary Fettke, a senior orthopaedic surgeon, is another health expert to have questioned the health benefits of fruit.
"It's fascinating when you look back and see how much propaganda is around the term fruit," he said.
"I propose our recommended intake of fruit is one of the greatest marketing campaigns of the last few decades.
"Our fruit is no longer natural, it's been manipulated - increasing the sugar content acts as a great preservative, decreasing the fibre improves shelf life and transportability.
"Chemicals are used in agriculture from seed to harvest and beyond.
"Juicing fruit adds chemicals, drying fruit has added chemicals, and every step of the way something happens all so we can indulge in a sweet hit all year round in a most unseasonable fashion."
Dr Fettke, who is based in Australia where he set up the Nutrition for Life - Diabetes and Health Research Centre, says the "5 A Day" concept was effectively "made up" during a meeting of the US National Cancer Institute and 40 major players in the food industry in 1992 to promote fruit and vegetables as a way of preventing cancer.
"There's certainly no science behind it at all," he said during a speech which has been viewed more than 290,000 times on YouTube.
He also pointed to the European Prospective Investigation into Cancer and Nutrition (EPIC) study involving 521,000 people in 10 EU countries over a 15-year period, which showed no conclusive evidence fruit and vegetable intake, at any amount, prevents cancer.
“The last 45 years we've actually increased our intake of fruit and vegetables, as we've been advised," he said.
"However, our health has deteriorated the same timeframe - obesity, diabetes, cardiovascular disease, dementia, and cancer rates, have all gone up - modern diseases out of control.
"I realise that causes are multifactorial, but certainly increasing in our fruit intake hasn't solved anything."
Quoting the US Department of Agriculture figures, Dr Fettke said leafy green vegetables have gram for gram greater concentrations of Vitamins A, B, C, E, and K1 than most fruit, while pointing out Vitamin D and K2 is not found in either fruit or vegetables.
Referring to minerals, he said leafy green vegetables have higher amounts of calcium, magnesium, potassium, iron, and fibre, than most fruit and more phytonutrients [believed to help prevent diseases].
He also referenced the findings of a University of Oslo study showing dark chocolate has more antioxidants than fruit - and coffee has nearly five times the amount.
Dr Fettke pointed out the amount of sugar in fruit was another concern - given the white stuff is linked to obesity, inflammation, and modern diseases.
"Coca Cola has about 10% sugar content, it varies a bit from country to country," he said.
"Apples are 10% sugar by weight, bananas are high at around 12% sugar by weight and up to 21% depending on the ripeness.
"Avocado is down at 0.7%, strawberries at around 4.6% and fruit juices are the same as soft drinks but without the fibre.
"Commercial dried fruit is just concentrated sugar and has the 'benefits' of added chemicals."
He pointed out while sugar from natural sources such as fruit maybe absorbed into the body more slowly the glycaemic load [the rate it will raise a person's blood sugar levels] remains the same.
"Our fruit is no longer natural, it's been manipulated... chemicals are used in agriculture from seed to harvest and beyond..."
This is important because spikes and crashes in the long term can raise the risk of developing type 2 diabetes.
Dr Fettke's views may be considered extreme by many, but the issue of sugar in fruit was given prime time exposure on the BBC programme The Truth About Carbs.
It tested the reaction of volunteers' blood sugar levels when consuming various forms of sugar, including fruit, honey, bread, potatoes, rice, and sugar cubes, and showed each of these led to significant spikes.
A bowl of strawberries was found to have had the smallest effect on the body.
Fruit growers in Kent were reluctant to comment about the concerns raised, saying it was not up to them to provide health advice.
Public Health England, which issues healthy eating advice, also declined to respond to specific points raised by KentOnline.
Instead it referred us to the Eatwell Guide it publishes to give consumers a pictorial guide of a balanced diet.
First promoted in 2007 by the Food Standards Agency and revised in 2016, it encourages people to base meals on potatoes, bread, rice, pasta, and other starchy carbohydrates, and eat at least five portions of fruit and vegetables a day.
The NHS also maintains fruit and vegetables should be eaten as part of a healthy, balanced diet.
"Evidence shows there are significant health benefits to getting at least five portions of a variety of fruit and vegetables every day," it says on its website.
"The 5 A Day campaign is based on advice from the World Health Organisation (WHO), which recommends eating a minimum of 400g of fruit and vegetables a day to lower the risk of serious health problems, such as heart disease, stroke, and some types of cancer."
Trudie France, head of the adult speech and language therapy and clinical nutrition and dietetics service at Kent Community Health NHS Foundation Trust (KCHFT), said: "Our advice with regard to healthy eating remains the same i.e. people should eat a balanced and varied diet that includes plenty of fruit and vegetables."
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