Grapefruit is known for its slightly sweet and slightly bitter taste and is loved by many. But if you live with diabetes, is grapefruit a good fruit to eat?
Grapefruit has unique and negative interactions with at least 85 drugs, including common diabetes medications such as metformin and statins.
In this article, we will explore the health benefits of grapefruit, the pros and cons of eating them, and how (and if so!) you need to incorporate them into your diet.
What is grapefruit?
Grapefruit is actually a natural hybrid of Jamaican sweet oranges and Indonesian pomelos, making it a delicious food to eat as a breakfast, lunch or a dessert or quick vegan snack that doesn’t require temperature control.
What are the health benefits of grapefruit?
Full of vitamins and minerals
Grapefruit, like all citrus fruits, comes with an excellent source of vitamin C (one grapefruit has nearly a day of vitamin C!) and A, vitamin B6, potassium, and even magnesium.
It also contains a lot of antioxidants that can help your body’s immune system fight colds and viruses.
Typical grapefruit has just 100 calories, 25 carbohydrates and more than 4 grams of fiber, and is always stuffed.
Hypoglycemic index
Grapefruit is low in the glycemic index and is at 25 years old. This means eating grapefruit does not spike your blood sugar levels quickly and it is fairly easy to administer insulin.
A 2013 study found that eating grapefruit was significantly associated with a reduced risk of developing type 2 diabetes.
Grapefruit is low in calories and is filled with fiber and water, making it a great food to eat if you are considering losing weight.
Reduced stroke risk
Eating compounds found in citrus fruits such as flavonoids, oranges, grapefruits and lemons has been shown to significantly reduce the risk of ischemic stroke among women.
A study conducted by the American Heart Association found that the risk of stroke was 19% lower among women who consumed the highest amounts of citrus fruits, such as grapefruit, during their diet!
Potassium in grapefruit also contributes to lower blood pressure, reducing both the risk of stroke and heart disease. This is important for people who are important to those with diabetes.
Cancer prevention
Eating a diet high in antioxidants can help you fight the formation of free radicals that can cause cancer.
Grapefruit is full of vitamin C, an important antioxidant for cancer prevention, with only one full grapefruit containing an average of 68.8 mg.
The recommended daily dose of Vitamin C for women is 70 mg and 90 mg for men.
Grapefruit, along with tomatoes, is also an excellent source of lycopene, which has been shown to prevent prostate cancer.
Intestinal health
Grapefruit is rich in healthy fiber, keeps it regularly and helps digest it. One standard size grapefruit comes in 4 grams of fiber.
The daily recommended amount of fiber for women is 21-25 grams per day, while men should aim for 30-38 grams per day.
Therefore, one grapefruit can meet 10-19% of your daily fiber needs.
Eating enough fiber can prevent constipation and can also help prevent gastrointestinal cancer, including colorectal cancer.
The disadvantages of eating grapefruit
Grapefruit seems like the perfect food, right? Well, grapefruit is not the right food for everyone.
Below are some questions you should be aware of when deciding whether to incorporate grapefruit into your diet.
Potentially dangerous drug interactions
Grapefruit is unique in that it has enzyme-linking ability. This means that certain drugs can be passed through the GI tract faster than usual to the bloodstream, increasing the amount of drugs in the bloodstream, which can potentially be dangerous.
According to the FDA, it is especially important to consult your doctor before eating grapefruit if you are using any of the following prescription medications:
- Statins (used to lower cholesterol)
- Corticosteroids (to treat Crohn’s disease or ulcerative colitis)
- Specific psychopharmaceuticals (SSRIs used to treat depression)
- Calcium Channel Blocker (used to lower blood pressure)
- Antihistamines (used to treat allergies)
- Drugs that treat abnormal heart rhythms
- Immunosuppressive drugs
Not all drugs in the above categories interact with grapefruit. The interaction with grapefruit juice is drug-specific and not drug category-specific.
Work with your doctor if you are unsure of the drug interactions you may experience when you want to include grapefruit in your diet.
Grapefruit and metformin
Metformin is not degraded by enzymes in the same way as the drugs mentioned above, so absorption of metformin is not directly affected by eating grapefruit.
A 2009 study in rats showed some evidence that combination of grapefruit and metformin increases liver metformin accumulation, leading to increased lactate production, and increased risk of lactic acidosis.
However, since the same effect has never been observed in humans, it is generally considered safe to eat grapefruit while taking metformin.
For more information about the side effects that you may have to take metformin, read our comprehensive guide, “Side Effects of Metformin: Things You Need to Know.”
Skin cancer
Several studies have shown a correlation between very high citrus intake and malignant melanoma.
This particular longitudinal study has been conducted over 26 years and found that those who consumed the highest amount of citrus fruit had a higher incidence of malignant melanoma, but further research is encouraged to strengthen the link between the two.
Kidney complications and potassium intake
If you live with kidney disease or are struggling with kidney infections, you may want to limit the amount of grapefruit you eat.
Kidney damage makes it difficult to achieve excess potassium from the blood, and high levels of potassium in grapefruit can further complicate this.
Very high levels of potassium in the blood are fatal.
If you have kidney disease, consult your doctor/nutritionist to understand the safe potassium to consume daily.
Sweet and bitter pairing
Grapefruit is the infamous bitter fruit. This is great. Because it has lower carbohydrates and more fiber than many other fruits, making it a great snack for people with diabetes.
But the bitterness may all come with costs. Grapefruit is usually eaten by sprinkling sugar on top. This can significantly increase the amount of carbohydrates you must take insulin, and even risk experiencing hyperglycemia (hyperglycemia).
Be careful of what you’re eating grapefruit. Always explain it when counting and measuring diabetic medications like insulin.
Balance of grapefruit in your diet
Grapefruit is a relatively low carbohydrate fruit (25) with a lower glycemic index, which can be a healthy snack for many, but it also contains protein fat and zero grams. This can cause blood sugar spikes in some people.
Eat grapefruit and Other foods that contain both protein and fat can help balance your diet. Think of it as eggs stuffed with grapefruit (protein and fat), or as sugar-free, full-fat Greek yogurt (protein and fat).
Furthermore, the high acidity of grapefruit can cause acid reflux and heartburn in some people, degrading the enamel of the teeth, causing sensitivity and potential decay.
Conclusion
The relatively low carbohydrate, high fiber content and hypoglycemic index of grapefruit make it a suitable snack for people with diabetes. It is high with many vitamins, minerals and antioxidants, and can improve blood pressure and heart health, is ideal for intestinal health and may help prevent certain cancers.
However, some studies have found that it can increase the incidence of melanoma, not suitable for people with compromised immune renal function, and may interact with the specific prescription drugs to ingest.
If you are unsure of the drug interactions you experience when eating grapefruit, check with your doctor.
Grapefruit can also exacerbate acid reflux and heartburn conditions, and its acidity can erode the enamel of the teeth.
Moderation is important, so if you choose to incorporate grapefruit into your diet, work with your care team to find a balanced way to add this fruit to your life, keeping both diabetes and overall health goals in mind.
If a Grapefruit and Diabetes overview is helpful, you can also enjoy these articles.
