Fruit and the Autoimmune Protocol


One of the most common questions I get asked is “How much fruit should I include on the Autoimmune Protocol?”. Just having completed the 21 Day Sugar Detox, I have a renewed perspective on the role of sugar in the form of fruit in my diet. The answer isn’t simple, so I thought I would dedicate a post to it.

First off, fruit itself is not restricted on the Autoimmune Protocol. Different varieties of fruit (especially colorful ones) come loaded with vitamins, minerals, and antioxidants which are a great compliment to a healing diet. While fruit can have a lot of sugar, that in itself is not reason enough to avoid it. When we eat fresh, whole fruit, we are getting the nutrients in a nice little package with fiber, nutrients, and water.

Worried about the sugar content in fruit? Sarah Ballantyne, in The Paleo Approach (p.123) advises limiting fructose between 10-20 grams per day. Taking that into consideration, that is about 2-5 servings, depending on the fructose content of a particular fruit (here is a link to a nice table).

Dried fruit, however, can be problematic because of its high glycemic load, and should be reserved for the occasional treat. I find dried fruit particularly easy to over eat and only reserve the use of say dates in a dessert or something, never as a snack.

What if I react to fruit? This is another question I get asked often. Even though fruit is allowed, some people have GI symptoms when eating it. This is usually a sign that dysbiosis, or an imbalance in gut flora is present. If this is due to SIBO (Small Intestine Bacterial Overgrowth), a person might react to fruits high in FODMAPs, like apples, pears, peaches, grapes, and watermelon. Some people also have fructose malabsorption, which would mean that they don’t tolerate any foods with a high fructose content. If you don’t tolerate fruit for a reason you suspect is not an allergy, I would suggest finding a practitioner and getting tested for FM or gut pathogens that could be contributing to your symptoms. Aglaee Jacob’s book, Digestive Health With Real Food is an excellent resource for anyone trying to troubleshoot digestive issues.

Fruit’s affect on blood sugar balance. One reason to restrict fruit might be if you have issues with blood sugar regulation. If you find yourself shaky, crabby, with a headache, or ravenous between meals, and those feelings are relieved by grabbing a banana… I hate to tell you that you aren’t doing yourself a favor. This doesn’t mean to starve yourself through a low-blood sugar crash, by any means! A better idea would be a small meal with fat and protein—think half a sausage patty and some guacamole, leftover veggies cooked in coconut oil, or vegetable chips and pate. I have a personal rule that I never consume fruit between meals without some sort of fat—this means a scoop of coconut concentrate on an apple. After my vegan days, my body knows all to well what it is like to be on that blood sugar roller coaster, and I am not going back!

Your personal threshold. Having said all that, its best to find an amount of fruit that works for you and your healing process. I think 2-5 servings of fruit is a reasonable amount, but I also recognize that some people do better with either no fruit or more than that amount. After my experience completing the 21 Day Sugar Detox, I realized that I do better restricting my fruit intake but not restricting my starch intake. This means, for me that I eat only a piece of fruit a day, if that, but I am sure to eat some starchy vegetables like squash, sweet potato, plantain, taro, or yam at 2 or 3 of my meals.

I also like to let my intake of fruit wax and wane with the seasons. Right now, there isn’t a lot of fruit in season, save for citrus. I have been enjoying a lot of grapefruit, since that was allowed on the 21 Day Sugar Detox. I’m sure in summer, I will be enjoying berries and stone fruit, as they come in to season here in the Northwest.

I hope that helps clarify some of the confusion over sugar, and if you have any more questions be sure to ask away in the comments!

How much fruit do you eat on the Autoimmune Protocol?


  1. Diana says

    Hi, Mickey. I’m on my second month on AIP and Paleo in general. I’m used to eat lots of fruits. But I started cutting my fruits portions after I found your blog and then Sara’s. So now I either eat couple servings with breakfast or don’t eat them at all. I’m a little confused about peaches for example. They have much lower fructose content then apples, the same time they’re on FM list. So if I have problem with digestion, I need to pay attention to FM list too?

    • says

      Hi Diana,
      I wouldn’t say if you have digestive issues you need to stay away from all fructose–some people have fructose malabsorption, or SIBO, which calls for a therapeutic diet (and treatment in the case of SIBO). Peaches and apples should be fine for most people, but if you notice your GI symptoms worsening when you eat them it might be something to look in to!

      Hope it helps!


  2. says

    Hi Mickey,

    I am the same way, as far as the starch thing. I can tolerate some fruit in the day, but if I don’t get enough starch, I can get a little hypoglycemic. This is especially true for how I start the day. I have to have some starch at breakfast, and the breakfast that has been working for me recently is your carrot and sweet potato “chilli”. I am not a big fan of sweet potatoes, but they are perfect in this recipe and the balance of protein, fat and starch seems to work great for me.


  3. Billye says

    I have Hashimoto’s and was told to stop eating grapefruit so I haven’t had it in years. I also found out recently to not have vegetables with goitrogens. I am currently taking armor thyroid but recently started the AIP diet so I am hoping to be able to control my thyroid through diet. Do you still have kale and spinach? Can I have grapefruit again??

      • Bridget says

        Careful, grapefruit interferes with a lot of medications, that may be why your doc told you to avoid. Check your Rx descriptions to see if it is contraindicated, quite a few ‘slow release’ meds can become ‘fast release’ in the presence of highly acidic fruit.

    • kaitlyn says

      I have also been instructed to stay away from grapefruit (which I LOVE) because it has a negative interaction with many medications, specifically thyroid hormones. Even the info that comes with the pills will tell you this. Basically it will inhibit your absorption of the pill, but many resources I’ve found online say it’s fine to have it at least 4-6 hours after you take your pill.

      • says

        Kaitlyn, would you believe I have never heard of this? I wouldn’t say I eat a lot of grapefruit, but I do have it occasionally. It makes sense that if it does have an effect, it wouldn’t be a problem if you waited a few hours for your medication to absorb.

        Thanks for letting me know!


  4. Kat says

    I have FODMAP and get terrible gas when I eat complex carb sources like winter squash (and sweet potatoes and yams give me a reaction) so I’ve been struggling for some time to get enough carbs on my paleo. I’ve started adding berries in the morning and I’m still wiped out all day. Is it okay to get more of my carbs from low glycemic fruits in this case? I have dysbiosis so for a long time I was avoiding fruits and just doing winter squash but the indigestion was so bad it was keeping me up at night. Since I cut winter squashes I’m not having that problem. Currently I eat between 6 and 12 ounces of blueberries (with avocado or coconut.) Not sure how much is too much/too little when it comes to fruit/carbs on the AIP.

    • says

      That sounds like quite the predicament. I also feel awful when I cut my carbs too much. Have you seen a doc to diagnose and treat your dysbiosis? Cutting carbs isn’t always an effective way of getting rid of pathogens. We all have different thresholds for carb amounts that put us into ketosis or not, but chances are if you feel tired the berries are not enough. I hope you find some answers soon!


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