Speaker 1
If you scroll social media long enough, you've probably heard someone say that fruit is bad for us. You know, this thing that we've been told is healthy our whole lives, it's actually really bad for you, they say. Today, we're going to discuss a clip that talks about that exact topic. So, first, we're going to watch this entire 60-second clip, and then we're going to pause, take a breath, look what's actually going on.
Speaker 2
So, let's dive in. Grapes are the worst fruit you could ever eat. Fruit has been sold to us as healthy and nourishing, even by people who used to be carnivore. But the opposite is true.
Speaker 3
Fruit is clearly beneficial for the human body. It's very hard to make an argument that fruit is harmful.
Speaker 2
Last night, my husband and I left work and went to the sauna. My blood sugar leaving the sauna was seventy eight. On the way home, we stopped by the grocery store and grabbed some ribs. And he picked up a healthy snack. Guess what? Whole food, unprocessed, healthy snack shot my blood sugar up to 225. Grapes. The worst part is, I know that for every minute my blood sugar is that high, my brain is making a few tau proteins. The mechanism behind dementia. On top of that, I know that the excess glucose in my circulation will be converted to fructose, which is preparing my body for winter and to store fat. Fruit is evil.
Speaker 1
All right, there you have it. That was something, that's for sure. So, this video that we're going to discuss here, as always, anything I do and talk about, it is not a personal attack on anybody. It's just more, hey, I see these things in nature. I want to bring them forward and talk about them because people are going to come in the clinic with this. They're going to have seen this and want to talk to their clinician about this. Or maybe you saw this as a consumer and said, What the heck's going on? So, this is coming from Dr. Boz or Annette Bosworth, who's an internal medicine doctor by training. Currently, she has a private practice where she focuses exclusively on like medabacultic health and the ketogenic world. If you look at her social media, it's pretty consistent with videos similar to this, in that there are some controversial takes for sure. And yeah, really in the low-carb world, she's an advocate for using continuous glucose monitors or CGMs. To monitor her and her patients' blood sugars, and she believes that spikes in the blood sugar are problematic pretty much regardless of how long they last, you know, even if a normal spike up and down, even if other metrics like A1C are within normal limits. So, her perspective is very, very important. When looking at that. So that's kind of the background. As always, no personal attacks here. This is just more of a hey, looking through this from a critical lens. What does this information say and how can we talk about it? First, let's watch that first claim all over again.
Speaker 2
So, here we go. Grapes are the worst fruit you could ever eat.
Speaker 1
All right, so just starting there right away: grapes are the worst fruit you could ever eat. I know social media needs a good hook to grab attention, and that's definitely a good one. So, props to her. But from the first sentence here, you know, there's some agenda to the short, right? Like, nobody's just coming out with that to say that. And to make this claim is actually pretty wild. So, for every person on earth. Grapes, they're the worst fruit you can eat. No nuance, no understanding what type of grapes, what situation, just all awful for you. It's black and white, that's what the internet loves. And the idea that there's a worse fruit because Overall, like that's an interesting idea in general, right? So, food and responses are so personal, which she's a big advocate of, you'll see. But big sweeping claims like this are great for social media, right? People love black and white. We've seen it time and time again: the more confident you are in something and the more conviction you have behind it, the more someone's going to believe you and kind of trust you as an expert. And once again, I get it. This is a YouTube short, right? It's meant to be catchy and punching, and nuance is not rewarded, but. Nuance is my thing. So that's what we're going to talk about today. Let's dive in, look at her next ones here.
Speaker 2
Fruit has been sold to us as healthy and nourishing, even by people who used to be carnivore. But the opposite is true.
Speaker 3
Fruit is clearly beneficial for the human body. It's very hard to make an argument that fruit is harmful.
Speaker 1
And so now we're moving on to the second claim that it's sold as healthy and nourishing. As for most things, we're missing a lot of nuance here, right? So, yes, people do say that fruit can be part of a healthy diet. Like, that's a pretty common claim. I'll give her that. But her saying that it's actually not healthy, that requires a big burden of proof, that's for sure. I think overall the claim she's saying there. And then, when she's talking about former carnivore people, that is Dr. Paul Saladino, formerly known as Carnivore MD, who's now since backed off on that and said, hey, actually, fruit can be a good thing. And he is actually a proponent of fruit. And so. We're starting to see a little schism here in the keto/slash carnivore world saying, Hey, you know, who's right and whatnot? But it's interesting, there are shots fired across the aisle in the animal-based world. And what we're seeing, unfortunately, is that if someone doesn't behave accordingly to the party lines, they're cast out, saying, hey, actually, that's no, you're no longer like a true prophet. But there's definitely lots of division and some controversy on What institutes a perfect diet? Can you have fruit? Can you not? So that's kind of what she's talking about there. That's a whole other topic we don't need to get into. But let's talk, look at our next claim.
Speaker 2
Last night, my husband and I left work and went to the sauna. My blood sugar leaving the sauna was seventy eight. On the way home, we stopped by the grocery store and grabbed some ribs. And he picked up a healthy snack. Guess what? Whole food, unprocessed, healthy snack shot my blood sugar up to 225. Grapes.
Speaker 1
Okay, so claim three here. She's sharing her personal story about grapes, right? The scariest food out there. It sounds so powerful, right? Hey, I was looking at it and I saw and it shot up. And it can even be scary to someone who doesn't understand that, right? You're just scrolling, oh my goodness. That seems so high. That has to be dangerous, right? Well, maybe it will. So, let's say overall here, what is she reporting? She's reporting her blood sugar went to 225. That is an objectively high number. I'm not saying that wasn't true. I'm not saying that at all. I definitely believe it's true because of reasons I'll talk about in a second. But if you saw that number every single time you checked your blood sugar, you know, day after day, I would want to investigate that. I would be worried. In fact, that would be in the diabetic range, right? So anything above 200, we tend to think. Hey, we probably shouldn't have that high of a response. If a patient showed me that, I'd be like, Yeah, you got my attention. We need to look. However, as always, and we'll see here, there's more context that we need, right? So, we're not looking at just a normal everyday response. This has kind of been prime for this, let me tell you. So, This short produced a lot of controversy on her channel. And based off of this, there were thousands of comments. And she actually made a response video to this because it was so controversial, right? That's kind of the whole goal: let's make it controversial and revealed some very, very important information. So, first, She does eat a ketogenic diet. So she's been on a strict keto for a long time, and at this specific instance, she was coming off a prolonged 48-hour fast. So she had a long fast. So she hadn't eaten for a long time, and her baseline diet is keto. That is very, very important. And let me explain. Second, the bit of information she didn't reveal is that the grapes that she were eating weren't just any grapes. They were the cotton candy grapes, which, you know, if you've ever had them, they taste like cotton candy and they're insane, but they're selectively bred for extreme sweetness and have a higher sugar content. So. Demonizing all grapes seems like a bit of a stretch or potentially a bit misleading. And so, I do want to look at actual nutritional differences, though, right? So, let's talk about grapes versus These cotton candy grapes doesn't make a difference. Will it matter? Well, the answer is yeah. So, a standard cup of, let's say, green grapes has about 15 grams of sugar. A cup of cotton candy grapes has about 27 or 28 grams of sugar, so almost double the amount. Fiber both have very low amounts of fiber, right? So, about one gram per cup. So, not a lot. There's very little fiber there to slow down absorption. So, that's why people do say, like, they're the worst for you because there's not a lot of fiber. That's the general claim: if there's no fiber, you can't slow it down, you're gonna spike out. But I also want to talk about glycemic index and glycemic load. So, we've probably heard these terms before, but glycemic index measures how quickly a carbohydrate-containing food raises your blood sugar. So, index is how fast. While glycemic load is actually different. So the index of both of them is actually kind of relatively similar, right? So the speed is there, but load is probably the more important thing. And that accounts for the volume of carbohydrates in a serving. So regular grapes have a low glycemic load around eight. Because of the cotton candy grapes, though, they're genetically made for this. They have nearly double the carbohydrates with essentially zero fiber, and so their glycemic load is significantly higher around 15 to 16, which kind of classifies them as medium or high. So regular grapes were classified as low. These are classified as medium to high. And on top of that, we need to talk about the physiology that's actually happening in her body when she does this. So, when you are in ketosis or a prolonged fasting state, certain things happen. There's a well-documented physiological phenomenon known as physiological insulin resistance. Or adaptive glucose sparing. So it almost looks like you have insulin resistance, but you don't really. It's just how you've kind of set up the system by fasting or eating low carb. It's very interesting. You first have peripheral DOM regulation, right? So when carbohydrate intake is severely restricted, like the situation she's currently in, your peripheral tissues, primarily skeletal muscles, shift to metabolizing free fatty acids and ketones. So, to preserve the glucose we need for things that need them, like the brain and erythrocytes, where they have to have that, skeletal muscle down-regulates glute-fluorotransporters and expression in the cell. So, usually, glute-fluor is responsible for bringing in blood sugar. Here, they kind of down-regulate to keep it around so your brain can get it, and the red blood cells. And the muscles essentially refuse to take the glucose. On top of that, we also Inside the pancreas have changes. They are having a delayed first phase insulin response. So the incretin effects, which when we eat food, that expresses that GLP, GIP. It's blunted because the gut hasn't seen a carbohydrate load in quite some time. So essentially, it turns it down and saying, hey, we're not seeing these, we don't need it, we're not ready for it. So the beta cells are unprimed for a big glucose load. So, what happens when you introduce a rapid-absorbing glucose load like grapes or any sort of simple sugar in the world? You can use that into a system that has already down-regulated everything. It's not ready for it, it has a delayed insulin response. You're going to get an exaggerated, massive post-pranial glucose excursion. Like, this was almost expected. That's the big thing here. It's not like, oh my goodness, what happened? Like, no, she knew this was going to happen. Everyone would expect something like this. Now, is 225 the number you expect? Not necessarily, but you're going to expect that because your body's just not ready for it. And it is. Totally normal and expected, right? That's the big thing you see in these low-carb worlds is that your body's not ready for it. You're not primed. And yeah, if you eat carbohydrates a couple times here and there, you're going to get back to it. You're going to be fine. Like you're not insulin sensitive, or you're not insulin resistant in the sense of like, well, this is pathologic and diabetes. But it's predictable. And so, this 225, huge, right? Completely predictable of an extreme dietary state. That's essentially what it comes down to. It's not pathological incineral resistance, and it certainly isn't proof that grapes are the worst fruit ever. And so For this, I'm really challenged by that, right? At best, we're saying she's probably not diving into the nuance. At worst, it's intentionally misleading people to push an agenda. Right? Because if you just saw that and say, oh, this, I don't know, this person's done a ketogenic diet, just a regular diet, all that stuff. And then, oh my goodness, 225, like grapes are terrible. So I'll let you decide what the intent was, but that's just what I wanted to mention. Now let's move on to the next claim.
Speaker 2
The worst part is, I know that for every minute my blood sugar is that high, my brain is making a few tau proteins. The mechanism behind dementia.
Speaker 1
She says, for every minute my blood sugar is high, my brain is making tau proteins. The mechanism behind dementia. Man, that's terrifying because nobody wants dementia, right? We need to take brain health seriously. That is. Absolutely true, right? We know we do not want that for ourselves, our patients, for family members, anything like that. And there is a very real link between chronic metabolic syndrome, like type 2 diabetes, and Alzheimer's. Some people even say we should call it type 3 diabetes because of the association. However, chronic high blood sugar is indeed bad for the brain. So, we know that, right? That's fair to say. But here is the issue we have, right? We're applying this too broadly. She's conflating a chronic disease state. Spanning decades with an acute 10-minute post-meal spike. Is that the same thing? I would argue it's not. And so, we're going to talk a little bit here. I am not a neurobiologist, that is not my area of specialty, but I've kind of done some research for this, and this is what I kind of learned. And so, first, let's establish a baseline, right? So, tau is a protein that is primarily expressed in the neurons. In a healthy physiological state, its job is to regulate the stability and assembly of axonal microtubules, facilitating intercellular transport. So that's its main job. It's not inherently a dementia protein. It is a critical structure component of the healthy nervous system. So that's number one. And the video also fundamentally conflates chronic tau issues with acute and To form Alzheimer's, right? When you have Alzheimer's, you're going to see these things called neurofibrillary tangles. That's the pathology we see, right? And that's usually from when we have these tau proteins that are hyperphosphorylated. So that's kind of the setting. We have this chronically over time becomes these tangles that is associated with dementia. People even argue: is that actually the cause of Alzheimer's? Who knows what? We'll talk about that in a future one if we want to, but that is what we see. However, when I was researching this and looked at what happened in acute stresses, so you can have acute stress or transient hyperglycemia. You do have tau phosphorylation. That can happen, but it seems to be reversible and actually serves in an essential protective role. It helps down-regulate mitochondrial respiration to limit reactive oxygen species. And prevent acute oxidative damage. So that's what's happening. There are multiple ways Tau is cleared. So the video implies that once Tau is made, it's permanent. And this completely ignores, I think. Just normal physiology and what's happening. If Tau becomes damaged or needs to be removed, the brain does have multiple mechanisms that can sweep it away and remove it. So I'm not going to go through the different ones, but there are multiple mechanisms that can do it. But so. Overall, though, stating that for every minute my blood sugar is high, my brain is making tau proteins that cause dementia. That's an overstatement. So, can you be making some tau proteins? Yeah, it's mechanistically plausible with Hut. You know, hyperglycemia, but is it causing Alzheimer's? I have no indication that that's actually true, especially in a transient state, right? Um, so a transient spike from eating a handful of grapes does not permanently break. The brain's natural clearance system and does not produce immediate or initiate dementia. That's not necessarily how it works. And I'm, once again, not a neurobiologist, so if I misunderstood this. Please enlighten me. Let me know in the comments that I'm wrong. I get that all the time that I'm wrong. So just let me know. It's no different. But from what I've seen here, this doesn't tell the whole story. Another issue I have though with this is that it's kind of cherry-picked, this specific example, right? So, if I made a video about highly elevated LDL or Apo Bean, I bet you a lot of money, the low-carbohydrate community would have a counter-argument saying, hey, whoa, whoa, whoa, you can't look at a transient number, a single reading, and tell the whole picture of heart disease. Like, that's not fair. Well, That's the same thing for blood sugars. Well, if you look at one reading, that does not necessarily mean that that is going to equate to future outcomes, whether it's dementia or heart disease or whatnot. So, just understanding that things are much more complex than we like and make them believe, but that's not good for social media, right? There's a reason that I don't have hundreds of thousands of followers because I try to have nuance, and nuance isn't that cool. It's not that great. I would love it, but it's not that catchy. It's not great for scrolling. So. Let's go on to the next claim.
Speaker 2
On top of that, I know that the excess glucose in my circulation will be converted to fructose. Which is preparing my body for winter and to store fat.
Speaker 1
All right, so the claim here is that excess glucose converts to fructose, preparing the body for winter and fat storage. And There is a kernel of truth that fructose can indeed add on fat tissue. That absolutely can happen. But what we're kind of referencing here, that could. When I was researching this, it seems like there's an idea behind this called the fructose survival hypothesis, made popular by a nephrologist named Dr. Richard Johnson out of Colorado. And the idea is that fructose specifically helps trigger fat storage in the preparation for hibernation in mammals. That's what we're looking for. And to me, it's kind of interesting. Once again, we're missing a little context, right? Because I was doing some research. I'm like, okay, this is interesting. I've heard this before that fructose is inherently bad, and I've seen that theory before. And there is some truth to it. But when I went back, I looked at Dr. Johnson, I found a transcript, and he said that the whole fruit doesn't seem to trigger the switch. And here's a quote, actually, I found like an interview transcript. Here's an actual quote from him. He says, When you eat moderate amounts of fructose in natural fruit, the body deactivates the fructose so you don't get a lot of sugar going into the system. And he said, actual fruits contain so many things besides fructose that are good fruit. Like potassium and vitamin C, fiber, which slows absorption, and then flavanols, which can also counter the effect of fructose. And so, overall, he doesn't seem that fruit is evil. He's saying, hey, there's this unique mechanism that can go there. And whole unprocessed foods exist in a beautiful matrix, right? You can't separate the sugar from the grape and from the fiber and the polyphenols, and there's multiple things. It's not just like straight sugar, it's sugar and other things. And so, could you make an argument that maybe cotton candy grapes are Bread, so they're a little worse and they're not great for you. Yeah, I think you could do that, but that's not the argument she's making. It's that fruit overall is not good. And yeah, I think it's just very intriguing to say. And the last thing she says, I do want to talk right here.
Speaker 2
This is what she's going to say: fruit is evil.
Speaker 1
Fruit is evil. That's a big claim to end a video, and it's a great way. I'll be honest with you. The scripting is wonderful in terms of if you want to get people to feel emotion, that's a great way to do it. But for me, I just find this unnecessary, right? If you're trying to educate someone, that's the main goal of the healthcare provider, right? Is to educate. We are teachers. If you're trying to educate someone, language like this is completely unnecessary, in my opinion. It's inflammatory and meant to be panic-inducing and isn't conducive to education or nuance. but rather to scare someone into a specific stance you want. So on top of that, it sounds scary, but it doesn't even make sense. It doesn't make sense. Fruit is an inanimate object, it has no morality. Fruit can only be fruit. It can't be anything else. For example, what you could say, and I'm not saying this is true, but what you could say is that it's evil to intentionally mislead people on an internet video. That would be an appropriate use of the word in context because that is a moral statement, and someone has a capability of exhibiting morality. That is a possibility. I'm not saying that, I'm not saying that she's evil, but people can be evil, right? That's a thing. Fruit can't be, they're just what they are. And so it's a big, big claims. And overall, this was a challenging video for me to make. I found myself getting frustrated while I watch it, not because of who made it, I don't care, but because of how it was made, right? So I understand the game of social media. I do this. I've been doing this for years. I get it. Sometimes my thumbnails and titles are designed to catch someone's attention or get a click. Totally understand that. But this was made to be as controversial and countercultural as possible. So, and on social media, unfortunately, I've seen it. Anytime I post something semi-controversial, not intentional, but the topic that's controversial, it gets the biggest views that I've seen. Like, that happens all the time. And it's. How the metrics work, it's how you get rewarded. You'll see it all the time: echo chambers work. So, if you know somebody's going to be inflammatory, it will actually work for you. So, she knows this and is playing into it to increase her reach. Which, if your goal is to spread the message, I see why you do that. I'm not saying there's any fault in that by any means. I'm not saying her intentions are bad. The problem I have is when you do something like this with no nuance, you're intentionally misleading people, right? This is a physician, right? And the words they carry have a lot of weight. Dr. Baz has helped so many people. You go through the comments, and she's helped thousands, thousands of people. So I'm not discrediting that. At all. But when you say things, there are expectations, and people kind of lean into that. And so you're setting people up for a scenario where you're saying, hey, everyone else is wrong. I know I'm right. I have the authority. I got the white coat, all that stuff. You have to think about it. And once again, I know she's. Helped a ton of people, and I'm not downplaying that. However, for me, language is just a little too extreme, right? My whole goal, my whole goal as a physician, is to make sure my patients understand both sides of Things, right? You start a medication, there's good and there's bad. You start a diet, there's good and there's bad. As long as you understand the entire, you know, spectrum of what might happen, and then you make a decision, that's totally great. Like, if you want to have eat a low-carbohydrate diet, That's wonderful. There's lots of data supporting that. That can be helpful for you, and that can be good. But I want you to understand that there are also a lot of people over here who eat a wide variety of things, also have a healthy diet. And so, to pretend like that doesn't exist is interesting to me. Like, this has to be the way, well, we have like literal examples of people doing the other way, and it works. And so, it's just one of those things. If you find a dietary pattern that works for you, that's great. That's wonderful. To me, I don't treat diet as religion. It can kind of work for multiple people, multiple different ways, but that's what it is. But I do want to end on a positive note here, kind of a takeaway from this, right? So, how do we make sense of all this? Well, let's break it down for the minimalists here and for the optimizers. So, if you're a minimalist and you say, eh, I want to do a little bit here, the foundational truth is that whole fruit appears to be protective long term. Large-scale data shows that regular fruit eaters have lower risk of diabetes and cognitive decline. Overall, it seems fine for you. Go ahead, enjoy your fruit. And if you're really worried about other things, make sure you're locking in everything else, right? Your sleep, your exercise. Eating a generally healthy pattern overall, those are probably the best things we can do for overall health and brain health. But if you're an optimizer and want to optimize your blood sugars, or you use a CGM to check your sugars. Feel free to do that. That's fine and see where you go. Like, if you are a normal person eating well and your blood sugar spikes to 225 eating grapes, maybe we need to reconsider. We need to look at other things: are you truly Insulin resistant, other, but that's going to be helpful to know, right? I'm not saying you shouldn't use CGMs, that's not the case. I don't think you need to, but you don't. I'm not saying you can't do that. If you're going to do that and it spikes a little bit, maybe pair your fruit with some protein or fat or go on a short walk after. All those things can be helpful in blunting glucose spikes. And so. Yes, there's a lot more to life though than a single number on a glucose monitor, right? So eat your grapes if you want to. Movement is very helpful, all those things. But remember that health should add to your life and not consume it. But that's going to be it for today. Thank you so much for stopping by. If you appreciated this or found it helpful, it'd mean the world to me if you share this with a friend. But that's going to be it. Get off your phone, get outside, have a great rest of your day. We'll see you next time.
