Fruit vs. fruit juice: is all sugar created equal?

A new review compares fruit, fruit juice, sugary beverages and honey.

We all know that too much sugar isn’t good for our health. This is hardly exciting news worth batting an eyelid over. 

But, there are some foods that contain sugar that are shunned by some people, but don’t necessarily need to be. I’m talking about fruit, of course, particularly fruits that are packed full of gut-friendly fibre and polyphenols like apples and berries. 

If we wanted to indulge in a traditional reductionist approach, like many do as it’s the easy option, we could look at the total amount of sugar in, say, an apple and compare it to the sugar in apple juice. We might find quite similar amounts and advocates of juice would say that it contains vitamin C. So today, I want to talk about why it matters where sugar comes from.

Not all sugar is created equal

Photo by Isabella Fischer

A recent review by Prof. Javier Gonzalez from the University of Bath, who is also a member of the Scientific Advisory Board at ZOE, looks at the evidence around the impact of sugar from different sources on cardiometabolic health. 

In the paper, Javier focuses on fruit vs. fruit juice, but also includes research about the effects of honey and sugar-sweetened beverages (SSB) that aren’t fruit juice.

He found that, unsurprisingly, sugar-sweetened beverages come out right at the bottom, and are linked with greater risk of death, weight gain and higher fasting blood sugar and insulin levels. 

With regards to everyone's favourite sugar – honey – there is some research that indicates that it might slightly lower fasting blood sugar levels and possibly increase inflammation, but none of this research is of particularly good quality. 

Now it gets interesting. When we compare fruit and fruit juice, like an apple and apple juice as I mentioned, the whole fruit clearly comes out on top, with lower inflammation, blood pressure, body weight and better blood sugar control. 

But there are studies that claim that fruit juice may also have health benefits, such as lowering blood pressure, weight and inflammation, even if other studies show regular consumption is associated with higher fasting blood sugar and HbA1C (a marker of long term blood sugar levels).