There seem to be only three things the many disparate nutritional philosophies agree on. Whether it’s the low-carb Paleo vegetarian Mediterranean or simply “balanced diet” camp proponents support more home cooking and less reliance on packaged and processed foods; advocate olive oil as a healthy choice for dietary fat; and emphasize consumption of fresh fruits and vegetables. Indeed it would be difficult to mount an argument against such seemingly innocuous advice. By default more meals prepared at home from whole food ingredients means fewer refined carbohydrates and industrial seed oils and fewer unpronounceable and potentially problematic additives. Good quality olive oil is high in polyphenols and is a good source of healthy monounsaturated fats. But what about that third piece of advice? Are fruits and vegetables all they’re cracked up to be?

Before this inflammatory question provokes a heated debate let’s clarify the terms. Fruits and vegetables can absolutely be part of a healthy diet. But it’s time for a semantic shakeup. With as many as 50% of Americans currently diabetic or pre-diabetic—many of whom aren’t even aware that they have these issues—the emphasis should be placed on vegetables over fruit.

That the phrase “fruits and vegetables” has become entrenched in our minds is due simply to linguistics; the words roll off the tongue more smoothly in that order. “Fruits and vegetables” is easier to say than “vegetables and fruits.” But biochemically speaking it’s odd that these foods are almost always mentioned together as if they are nutritionally equivalent and belong in the same category by default. Just because they both come from plants doesn’t mean they have the same effects upon the body’s physiology and satiety hormones. After all broccoli and popcorn are both “plant foods” but we could hardly keep a straight face trying to say they have more in common than that.

Owing largely to the work of Robert Lustig MD fructose has gotten a very bad reputation in the past few years. And not just added fructose such as in soft drinks and juices sweetened with high-fructose corn syrup. People concerned about their health have also begun to fear the naturally occurring sugar in fruit with a higher fructose content such as apples bananas and grapes. 

Whole unprocessed fresh fruits have been part of the human diet for millennia. Raspberries pears peaches watermelon and other fruit are refreshing delicious and deliver a wide array of essential nutrients and beneficial phytochemicals. While many people have no reason to eschew these sweet pick-me-ups there are however patient populations who might be well advised to limit fruit consumption at least for some period of time. Individuals with intractable blood sugar and insulin dysregulation may get better results opting for the majority of their produce coming from non-starchy vegetables instead of fruits. (For example asparagus eggplant and zucchini as opposed to starchy tubers and higher-carb winter squashes.) Patients with fatty liver may also benefit from reducing the fructose load of their diet including that from natural sources. 

To be clear fruit is not “dangerous” or unhealthy; like so much in health and nutrition it’s about context. Whether certain foods are appropriate depends on someone’s current health metabolic state and goals for the future. The optimal strategy for one person might be radically different from what’s best for someone else. The problem with putting fruit first in “fruits and vegetables” is that it gives the average consumer a false sense of the importance of fruit in the everyday diet. Fruit is after all “nature’s candy” and historically it was not available year-round in all climate zones. (It is thanks only to modern shipping and preservation technology that one can purchase papayas and bananas at a supermarket in Canada in the dead of winter.) Moreover laypeople might not make a distinction between fresh unprocessed fruits—with their full complement of fiber enzymes and nutrients—and fruit canned in syrup fruit smoothies and pasteurized shelf-stable juice all of which are blood sugar bombs masquerading as health food. 

No one need worry about developing nutrient deficiencies if they moderate their fruit intake or perhaps even avoid fruit altogether. There’s no such thing as a “cantaloupe deficiency.” The body does not require fruit; it requires vitamins and minerals and there are no nutrients fruit provides that can’t be found just as abundantly in vegetables. Contrary to what the popular media would have us believe orange juice is not the only source of vitamin C in the edible plant kingdom. Great sources of vitamin C—without the blood sugar spike—include red bell peppers broccoli Brussels sprouts cabbage and kale most of which provide larger amounts of other vitamins and minerals than are found in many fruits. It’s easy to go overboard on juice smoothies and even pre-cut fruit salad but few people are likely to “overindulge” in green or cruciferous vegetables. “Vegetables and fruits” might be more of a tongue-twister than “fruits and vegetables” but let’s start emphasizing vegetables first.