assorted fruit with a sign that says fructose

What Fruits To Eat on Keto

blog fructose fruit insulin resistance nafld Jul 06, 2021

 It is easy to learn about what fruits to eat on Keto (berries, sometimes called "little fruits"). Even for low carb the list is easy: Just go light on tropical fruits and dried fruits and eat others in moderation (I counsel my clients to have no more than 2 a day). 

Here is your roadmap to this blog:

Don't have your head in the sand about fruit and stubborn weight loss

My lightbulb moment

Eating fruit on keto

Fruits to eliminate or limit even if you are eating low carb

Snack substitutions 

The more serious issue with fruit

Non-Alcoholic Fatty Liver Disease (NAFLD)

Stop Dieting

Don’t have your head in the sand about fruit and stubborn weight loss.  

While you are following a low carb eating style, you can have fruit.  However, I think the biggest downfall of some of the popular diets is that fruit is unlimited. For instance,

  • A cup of grapes is 29 carbohydrates, and
  • Half a medium cantaloupe is 23 carbohydrates.

(You might say – who eats a half a cantaloupe?  If you are my age – in your 60s, surely you remember putting cottage cheese in the well of half a cantaloupe!)

  • A fresh Bartlett pear is 25 carbohydrates
  • A small banana  is 24 carbohydrates
  • A medium Granny Smith apple is 24.1 carbohydrates
  • 1 cup of cherries is 22.1 carbohydrates
  • 1 cup of watermelon is 11.6 carbohydrates
  • A medium navel orange is 17.6 carbohydrates
  • Two clementines is 18 carbohydrates
  • 1 large grapefruit is 26.8 carbohydrates

The reason fruits are not allowed on Keto and should be limited for low carbohydrate eating is because they are made up of fructose, sucrose and glucose, and therefore most carry a high carbohydrate load.

One difference here with low carb vs. keto is that fruit in moderation is allowed on low carb, while on keto, typically, only berries are allowed. Limit your fruits to very low carbohydrate ones (the lower carb count indicates less sugar) and limit the amount you eat in a day to no more than one or two. Forget the gigantic fruit salads you think are so wonderful!  

It is important to build an awareness and a mindfulness when you reach for fruit. The  carbohydrate count alone can get in the way of successful weight loss, but there are things much more sinister lurking in fruit sugar.

My lightbulb moment

During the summer of 2016, a friend of mine was telling me about the Atkins induction phase. I heard "no fruit" and was completely turned off. I'm not going there. Nope. Never.  But I did, for the first time, start looking into what low carb means.  

When I listened to Why We Get Fat and What to Do About It by Gary Taubes, everything finally fell into place for me, and I immediately gave up fruit and started Keto. It was over a year before I even ate a berry! 

I finally understood why I never lost a pound even though I faithfully followed a Paleo lifestyle for years.  It was all the sugar in the unlimited fruits I was eating along with other allowed elements of Paleo, including no limit on root vegetables, nuts, honey, etc.  The fruit-to-insulin connection and then what insulin is responsible for, opened my eyes and enabled me to begin Keto. 

Eating Fruit on Keto

  • If you have decided to do Keto, I ask my clients to cut out fruit. 
  • I would further suggest that they not have berries early in their transition to Keto
  • But if they must, I ask them to please limit berries to ½ cup per day.
  • You may want to do some investigation on your own.
  • For instance, blueberries are higher in sugar than other berries so try to go with raspberries, strawberries or blackberries. 
  • Keto allows the juice of fresh lemons and limes because the sugar/carbohydrate count is very low. 
  • However – and not that anyone would – please don’t drink a glass of pure lemon or lime juice! 
  • A couple of tablespoons of these juices throughout the day to flavor your foods and beverages are okay. 

What if you eat a lot of fruit?

  • If you are doing Keto and you are concerned about your reliance on fruit, don’t have fruit for a day or two. 
  • Then a week. 
  • Then before you know it, you won’t miss it at all. 

I remember when I started, I told my friend, “I can’t imagine never eating another piece of watermelon for the rest of my life.”  The rest of your life is a long time.  Don’t look at that now. 

If you have type 2 diabetes, insulin resistance or any other form of metabolic disorder, these can almost always be healed with a well-formulated Keto diet. 

  • There might come a time when you can have a piece of fresh fruit and not have your insulin and blood sugars go all wonky. 
  • More importantly, there will be a time, once you are not only physically healed but emotionally healed as well, when you can have a piece of fruit and not have the craving monster plague you. 

But for right now, for just this day in front of you, don’t reach for that piece of fruit. 

  • Trust me on this, please. 
  • I went through my first three summers of Keto without a piece of watermelon and I survived. 
  • The first summer I enjoyed some watermelon and I did not feel the need to binge on an entire serving plate of watermelon and other fruits.
  • When I measured my blood glucose in the evening it was all good which indicated that my insulin resistance was healing!
  • Yours will too.

Why berries are allowed on Keto

  • Berries, in contrast to some other fruits, in moderation (about ½ cup), not only have much less sugar but their glycemic load is also low.
  • They will very slowly, if at all, raise a person’s blood glucose level. 
  • They are loaded with phytonutrients.
    • Phytonutrients are natural compounds that have antioxidant and anti-inflammatory properties that help support a healthy body.

However, many doctors call berries "little fruits" because they still carry a warning about fructose as do other fruits. They should be eaten in strict moderation if at all.

Fruits to eliminate or limit even if you are eating Low Carb

The sweeter the fruit and the more concentrated the fruit, the higher the concentration of sugar. 

Tropical fruits

Tropical fruits are very sweet (and thus very high in carbohydrates). Some of the most popular that you would recognize are:

  • Banana
  • Mango
  • Papaya
  • Pineapple

Less common, but still popular, tropical fruits are:

  • Dragon Fruit
  • Durian Fruit
  • Lychee
  • Star Fruit 
  • Mangosteen

Dried fruits

Dried fruits are very high in sugar because they are concentrated.

  • For instance, one cup of grapes is 29 carbohydrates, but a cup of raisins (not even "packed") is 115 carbohydrates.
  • A little sprinkling (like "ants on a log") is okay here and there but a baggie full of raisins or dates is not a wise choice for a snack.

If you are taking the low carb path (rather than keto) in your journey

  • There is no “rule” to eliminate fruit
  • Keep your fruit intake to those with lower carbohydrate counts such as
    • grapefruits
    • melons.
  • Learn which are the high-sugar fruits
    • grapes
    • bananas
    • dried fruits
    • etc.
  • Do your best not to have them.
  • And, just as with Keto, have the only juices you use be for flavoring, not drinking.

The carbohydrates and fructose do not concern me if you limit them, but they may keep sugar cravings alive. If you are still battling the sugar demon it might work in your favor to eliminate all fruits and berries for a while. You can always add them back once you no longer have cravings that take you off course. 

Snack substitutions 

Are you used to taking a piece of fruit for a snack?  That was the hardest for me, even more than giving up those fruit salads and plates of fresh watermelon.  Once you start working on Step 5 (high fat) of my Transitions Program, you most likely will not have the urge to snack anymore, at least not because of hunger (eating from boredom or habit is another issue!).  Here are some ideas for snacks:

  • Salami & cheese, or just a piece of string or hard cheese
  • Celery and cream cheese or unsweetened nut butter
  • Broth with butter – don’t laugh – sometimes I will have that when I “need” a snack. Often, I have that and find myself so full and satisfied, I don’t even want my next meal!
  • Nuts
  • Kale or spinach smoothie (no fruit!)
  • Roast beef rollup
  • Hard boiled eggs

You can see that there is plenty to reach for and it doesn’t have to be an apple or banana!  As you cut out fruit your need to snack on it will lessen.

The more serious issue with fruit

It is not just the carbohydrate count

Fructose, specifically, puts a heavy burden on the liver which is why there is the connection to NAFLD.  No cell in the body can directly use fructose so it goes directly to the liver and can be responsible for problems you may be having with losing weight, and particularly belly fat. 

More serious than belly fat? Yes! There is a more serious concern with fruit that goes beyond their carbohydrate count which increases insulin which increase belly fat. 

  • Fructose, one of the sugars in fruit, cannot be used by your cells for energy. 
  • Fructose goes directly to the liver to be metabolized.
  • It is ultimately one of the major causes of Non-Alcoholic Fatty Liver Disease (NAFLD) which is linked to early death, diabetes and heart disease.
  • Fruit also makes you more insulin resistant
  • It raises your triglycerides
  • It increases inflammation 
  • It has a terrible effect on your cholesterol.

More and more studies are being done on this. There are already many animal studies, but the link is so strong and interesting that more human studies are also being conducted.

These studies include

  • Learning about the difference between fructose in fruits, HFCS (high-fructose corn syrup) and combinations of fructose and glucose. 
  • From where things stand now, many researchers consider fructose to be a liver toxin because of the work the liver has to do to metabolize it. 

Non-Alcoholic Fatty Liver Disease (NAFLD)

  • Virtually unknown before 1980, Non-Alcoholic Fatty Liver Disease (NAFLD) now affects up to 30% of adults in the United States and other developed countries.
  • And of those, between 70% and 90% are obese or have diabetes.

Non-Alcoholic Fatty Liver Disease (NAFLD) is when too much fat builds up in liver cells.

  • NAFLD, often reversable, is the most common liver disease in adults and children in Western countries.
  • It is difficult to predict. 
  • It is often not detectible except for blood tests and imaging.
  • It can, however, lead to impairment of the liver.

NAFLD is also linked to an increased risk of other diseases, including

  • heart disease
  • diabetes
  • kidney disease

NAFLD is caused by many factors including

  • obesity
  • excess belly fat
  • insulin resistance
  • high intake of refined carbohydrates
  • sugary beverage consumption  
  • impaired gut health.

It is time to make the connection between Non-Alcoholic Fatty Liver Disease and fruit. While you are working to correct these situations, let your liver “rest” and don’t tax it by making it necessary to work to rid itself of fructose.


The best way to get out of diet prison is to stop eating the foods that keep your cravings and hunger alive.

  • The sugar in fruit is bound to keep cravings and hunger alive.
  • Aside from sugar cravings, fruit can make you hungry because your cells are not getting the benefit of energy coming from the food.  
  • In addition, fruits, because of their sugars, will raise your insulin which will make you hungry.
  • Remember the lock-and-key lesson where if you have insulin resistance the insulin will not be able to unlock the cell to let the glucose in to be used as energy.
  • Therefore, not only will you be hungry from too much fruit, you will be tired!

Rules of thumb to stay out of diet prison

  • Learn what fruits to eat on keto
  • If you are eating keto don't eat any fruit except berries in limited amounts.
  • If you are eating low carb please limit your fruits to one or two a day.
  • I would also say to limit tropical fruits to no more than once a week, or even less often than that.
  • If carbohydrate counts aren't enough to make you pull back your hand from the fruit bowl, it is time to make the connection between Non-Alcoholic Fatty Liver Disease and fruit.

Sugar begets sugar cravings. The more sugar you eat in the way of fruit, the harder it will be to stay out of diet prison. 

Learn more about this with my book and course:

Book Breaking Free From Diet Prison: Common Sense Keto and Low Carb 

Course Breaking Free From Diet Prison: The Roadmap to Low Carb and Keto Success

 Here is your bonus guide to help you understand why you want sugar.

The Brilliance of Chocolate Cake

Tips for Keeping a Food Journal - Part 1

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