Posted by My OB said WHAT?!?.
Jan
25
Posted by My OB said WHAT?!?.
“…Don’t Do That! Fruit Has Calories!”
“Oh! Don’t do that! Fruit has calories!” – OB to mother who declined a stool softener because she was not constipated and told the OB that she ate plenty of fruit and vegetables.
There are 44 comments to this post.
And have you EVER seen someone get obese JUST from eating lots of fruit and veggies?
(Disclaimer: I am not judging obese people. I am one, but I have to say that fruit didn’t do it … cheese did 
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Veronica Reply:
January 25th, 2012 at 5:55 pm (Quote)
mmm cheese. Ever notice how if something doesn’t take really good, adding cheese always makes is better?!
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Dreamy Reply:
January 25th, 2012 at 7:00 pm (Quote)
Well, not “get” obese, but stay obese… I know plenty of fat vegans (and they’re not all eating loads of tortilla chips).
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Jerry Reply:
January 25th, 2012 at 8:08 pm (Quote)
I still say that fruit does not make you “stay” obese unless you are eating ONLY fruits (which you shouldn’t do anyway) and have a medical condition. Many fruits are low in fat or fat free and only contain between 50-150 calories. Perhaps eating a lot of fruit in addition to an unhealthy diet would keep you obese as it is still calories. I am a vegetarian and have been vegan for several long periods of time. There are plenty of fattening vegan foods out there (hence my weight problem). When I eat a whole food diet consisting of about 60% fruits, 20% veggies, and 20% grains I loose weight like crazy.
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Dreamy Reply:
January 25th, 2012 at 8:29 pm (Quote)
You are not everybody. Some people are actually “obese” (a designation determined strictly by height and weight numbers and nothing more, BTW) no matter what they eat. Unless they starve themselves, and even then, it would take sustained, actual starvation. Just like some people are very thin, more or less regardless of what they eat. Most of us have more “control” over our weights, but for the most part, only within about a 40 pound range (notice I said most and most). But I know more than a few people who eat anywhere from 1200-2000 calories per day of almost exclusively whole grains, veggies and just a bit of fruit and are obese– some “morbidly obese” (again, just based on height and weight, because that’s all BMI is). Heck, I am “obese,” although I rarely wear a dress size in double digits. But that’s neither here nor there.
Not everyone who is obese is not exercising and/or is eating unhealthfully, too much, too little, or just “wrong.” There must be a name for this cognitive bias… That is, though most people have some control over their weights (again, FTMP, only to a degree), that doesn’t mean that most people who are obese in an anti-fat culture have the same control (I mean biologically). In fact, in an anti-fat culture, where most people actively desire to be thinner, the opposite would generally hold true.
Like most people aren’t allergic to peanuts. But if you find 100 people who don’t eat peanut butter, you’re going to see a really disproportionate number of people with peanut allergies. We don’t say, “Well, the vast majority of people in general aren’t allergic to peanuts, therefore very few peanut-butter-haters are allergic– most of them probably just don’t like the taste.” Or, “I didn’t like peanut butter but I’m not allergic, therefore the vast majority (or all) people who don’t like peanut butter should eat just a tiny bit of peanut butter every day until they learn to love it, like I did.” Or whatever.
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Jespren Reply:
January 25th, 2012 at 7:31 pm (Quote)
Not ‘get obese’ but fruits do have a lot of sugars (good for you natural sugars, but still quick burning calories). I had a prolonged fruit craving one time where I pretty much lived on nothing but fruit for a good two weeks (and boy did it taste good! Until I got protein starved!) And gained over 5 lbs. You can gain weight on pretty much anything if you eat enough of it.
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Why are SO many doctors obsessed with constipation? My first OB was on my case all the time because what’s regular for me isn’t the exact middle of the bell curve. My daughter’s former urologist puts all his patients on laxatives, including those with chronic diarrhea! Her GI doctor says that constipation has very little to do with how often one goes but with how easily. If you’re an every-other-day sort of person but don’t strain, that can still be “regular”.
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Tee Reply:
January 25th, 2012 at 5:36 pm (Quote)
Why in the world would a urologist be prescribing laxatives? And please tell me that your daughter found a new urologist right away?!
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Jen Reply:
January 25th, 2012 at 6:33 pm (Quote)
Many times, bowel and bladder issues go together–if you’re holding one in, you’re holding in the other, and a full bowel can press on a full bladder and cause problems, etc. But this practice (we’ve seen both urologists at different points) is absolutely obsessed with the bowel issues to the point of ignoring the bladder issues. And yes, we’ve found a new urologist. We fought with the first practice for months, and the new guy had my DD in surgery 4 days after the first appointment. She hasn’t had a single problem since.
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Tee Reply:
January 25th, 2012 at 7:09 pm (Quote)
I’m pretty familiar with urologists because I battle chronic kidney stones but I have to say, I never heard of that! Thanks for answering my questions… I so enjoy learning new things. I’m glad ya’ll were able to find a new doctor that helped your daughter quickly!
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Alyson Miers had this to say,
Jan 25, 2012 @ 5:27 pm (Quote)
Are you, Doctor, actually discouraging your pregnant patient from eating fruit? On the basis of…”calories”? With all the crap that’s available for people to put in their bodies at a moment’s notice, you’re warning your patient off of the calories in FRUIT? Did I just read that right?
There go some more of my brain cells…
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Okay, got to admit that this one made me bust out laughing! Last time I checked, all food has calories! And fresh fruit is a pretty decent thing to eat, pregnant or not. And what the heck do calories have to do with being constipated?
Himmel!
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okay not sure what the food guide say’s in other countries but in Canada it says that women are to eat 7-8 servings of fruit & vegetables a day and Pregnant and breastfeeding women need more calories. Include an extra 2 to 3 Food Guide Servings each day. so is this doctor off is rocker or what ?
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This OB definitely misspoke, but pregnancy is a diabetogenic state and you really do want to minimize the amount of sugar you take in. Eating a large variety of vegetables gets you the same nutrition as fruits, but without the sugar. Too much sugar can increase the baby’s insulin levels and lead to hypoglycemia right after birth, as well as high birth weight. Some fruit is fine, but since pregnancy increases your insulin production and therefore makes you crave sugar, it’s a good idea to limit it!
That being said . . . somehow I doubt this OB went through the trouble of explaining that to this pregnant mama. After all, explaining and educating puts power in the mother’s hands, and we can’t have that, can we? *eyeroll*
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Mama Wrench Reply:
January 25th, 2012 at 7:40 pm (Quote)
Fruits are also extremely nutrient dense, and you need to eat a LOT of fruit to create the same pancreatic overload of processed sugars that most of us overconsume. And you can get just as much sugar from certain vegetables as fruits — beets, carrots and sweet potatoes are EXTREMELY nutrient dense but have as much sugar as an equivalent serving of most fruits. As long as Mom isn’t washing down all those fruits and veggies with a litre of Coke and a slice of chocolate cake, she’s probably not going to eat herself into GD unless she’s predisposed to it anyway.
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Emily D. Reply:
January 25th, 2012 at 9:50 pm (Quote)
For the most part I agree with you. However, the carbohydrates in most vegetables (beets and sweet potatoes included) tend to be in a more complex form than those in fruits. If your body has to work to break down the carbohydrates, then they are released more slowly into the bloodstream and do not create the same reaction from the pancreas. Fructose is a fantastic source of energy and fruits are great in moderation, but one or two per day is plenty for the pregnant mama, especially if she is at risk for GDM. The thing is, a LOT of women are predisposed to GDM and you don’t always know ahead of time!
The big difference between the vegetables you mentioned and fruits is the type of sugar. Yes, they have the same type, but the difference is in the chemical composition. The majority of the carbohydrates in fruits comes in the form of fructose, which is a monosaccharide. This means that it is formed of a single ring of carbon atoms, bonded to functional groups consisting of H and OH (hydrogen and hydroxy groups). The single ring can enter the bloodstream directly without being broken down first, and will have the same effect on the pancreas as glucose and galactose, which are the other two digestible monosaccharides found in our diet.
The other major sugar that is found in plants is sucrose, which is a disaccharide, meaning it is formed by a glycosidic linkage between two different hydroxycarbon rings. In order to enter the bloodstream, the body had to expend some energy to break sucrose down into its component pieces (glucose and fructose) in the duodenum of the small intestine.
Take a look at this chart:
http://en.wikipedia.org/wiki/Fructose#Fructose_and_starch_functionality_in_food_systems (compiled from values given on the USDA website)
As you can see, while vegetables on the whole have the same carbohydrate content as fruit, their sugar levels are on average lower. While fruit sugar load is in the 8-12% range (on average), vegetables are in the 4-7% range (again, on average). This means that vegetables tend to present more of their carbohydrates in the form of oligo- or polysaccharides, which require more time and energy to digest and therefore do not create sudden fluctuations in blood sugar levels.
So while I agree that fruit is better for you, I have to disagree with your argument that vegetables have as much sugar as fruit, and that they affect the pancreas in the same way. As far as I’ve studied, that is simply not true and the numbers contradict it.
(And they say midwives don’t have an adequate science background!)
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Tee Reply:
January 25th, 2012 at 10:05 pm (Quote)
This was really interesting to read, Emily! Thank you for posting it!
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Emily D. Reply:
January 25th, 2012 at 11:24 pm (Quote)
You’re welcome! I’m a serious science geek. Was all ready to go to medical school to become an OBGYN when I realized I didn’t actually want to sell my soul to allopathic medicine. Now I’m studying to be a midwife, and I find that all that crap I learned in college is actually really, really helpful. Who’da thunk it? 
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first time mommy had this to say,
Jan 25, 2012 @ 8:31 pm (Quote)
And I am only supposed to drink diet water too?
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Tee Reply:
January 25th, 2012 at 10:06 pm (Quote)
“Diet water.” That made me spit my not-so-diet lemonade all over the computer monitor. Thanks a lot!
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Jena Reply:
January 26th, 2012 at 4:09 am (Quote)
Aspartame: artificial sweetener of champions! And pregnant women!
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Because you should never consume anything that is A. Natural or B. has calories…? Um, what?
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