I am going to be addressing many Frequently Asked Questions about the Autoimmune Protocol in some posts over the next few months.  If you have a question that you think should be answered, you may e-mail me at thepaleomommy@gmail.com.

I get asked about fruit on the AIP very frequently.  I am intentionally vague with my recommendations for and against fruit in the Autoimmune Protocol because tolerance and need are highly variable.  The short answer is, it’s individual.

I will, of course, be going into extreme detail to answer this question in my book.  However, I feel like this question also needs to be answered here.

There are a couple of factors that are going to determine whether or not fruit is okay or beneficial for you to include in your diet, which fruits and how much fruit.

Many autoimmune diseases are very sensitive to blood sugar changes. This is more likely to be true if you’ve had a history of obesity or metabolic derangement. In that case, limiting to one serving of fruit with each meal seems to work well.  Lower sugar fruits like berries tend to be better for blood sugar regulation.  Berries are also high in several vitamins and antioxidants, which can be very beneficial for resolving inflammation.  Other good low-sugar fruits include grapefruit (one of my personal favorites) and other citrus,  melons (except watermelon), kiwis, apricots, and tart green apples.

For others with better blood sugar regulation, fruit can be an important source of carbohydrates in the absence of starchy vegetables. Because of the high frequency of gut dysbiosis in autoimmune disease, most people with autoimmune diseases need to be very careful about starchy vegetables, at least at first.   But, going too low carbohydrate can also be problematic (increases leptin resistance which stimulates inflammation).  So, increasing fruit intake can be very helpful for anyone who is  underweight to normal weight (and not needing to lose weight) but who also doesn’t tolerate starchy vegetables.  In this case, higher sugar fruits and larger portions are typically well tolerated.  High glucose content fruits will be the most helpful for those who want to gain weight.  These include bananas, grapes, apricots, figs, plums, cherries, and pineapple.  Citrus, berries and melon (except watermelon) also tend to have more glucose than fructose.

Fructose contributes more to inflammation than glucose.  So, keeping portions of very high fructose content fruits on the small and infrequent side is a good idea even for those who don’t have FODMAP sensitivities (they aren’t explicitly banned, but do be aware of how you feel after you eat them).  These include mango, red apples, papaya, and watermelon.  Dried fruits tend to concentrate the sugars so extra caution is required in terms of portion size.

As a quick aside (but seems relevant here), starches are avoided for everyone with overgrowths (bacterial or yeast), which is the majority of those with autoimmune diseases.  But, some people suffer undergrowths in which cases starches are very valuable (starches tend to be high in “prebiotics” which is anything hard for you to digest but easy for your gut bacteria to digest). That mostly applies to people with gut disorders like celiac disease and IBD, but also anyone who has frequent diarrhea as a symptom of their disease.

More information on starches:

• Modifying Paleo for Small Intestinal Bacterial Overgrowth
• Fruit and Starchy Vegetables with Small Intestinal Bacterial Overgrowth

More information for anyone who is underweight:

• How to Gain (or Maintain) Weight on The Autoimmune Protocol

More information about my book:

• Announcing My Book: The Paleo Approach–Reverse Autoimmune Disease and Heal Your Body