High-Dose Fructose Can Cause or Worsen Insulin Resistance (But Fruit Is Okay)

fructose and insulin resistance

High-dose fructose can cause or worsen insulin resistance, abdominal weight gain, fatty liver, heavy periods, and PCOS.

High-dose fructose comes from processed table sugar (sucrose), high-fructose corn syrup, and even some natural sweeteners such as agave, coconut sugar, dates, dried fruit, and fruit juice.

Whole fruit is healthy and does not cause insulin resistance because 1) whole fruit contains only low-dose fructose, and 2) fruit also provides beneficial nutrients, fibre, and polyphenols that counterbalance the negative effects of fructose.

How high-dose fructose drives or worsens insulin resistance

Fructose has a relatively low glycemic index compared to glucose and so is less stimulating to insulin. That’s a good thing and low-dose fructose has been shown to improve insulin sensitivity especially in the context of high physical activity.

Furthermore, most fructose is converted to glucose and organic acids in the small intestine before it can reach the liver or microbiome.

High-dose fructose overwhelms the small intestine’s ability to convert fructose to glucose resulting in fructose reaching the liver and microbiome and inducing intestinal permeability, oxidative stress, inflammation, and fatty liver—all leading, in turn, to an increased risk of insulin resistance.

fructose small intestine
Jang, C. et al. The Small Intestine Converts Dietary Fructose into glucose and organic acids. Cell Metabolism, 2018

According to Princeton researcher Joshua D. Rabinowitz:

“There is a fundamental physiological difference in how smaller and larger amounts of sugar are processed in the body.”

“Fructose from moderate amounts of fruits will not reach the liver. However, the small intestine probably starts to get overwhelmed with sugar halfway through a can of soda or large glass of orange juice.”

How much fructose is okay?

You don’t need to avoid all fructose. Fructose is a normal and healthy component of fruits and vegetables.

You may not even need to avoid high-dose fructose if you’re active and don’t overeat because high-dose fructose is only a problem in the context of high-calorie intake and low physical activity. That means you probably get away with some low-sugar desserts such as homemade crumble or coconut cream blended with banana and frozen berries.

If you’re not active, however, or if you have insulin resistance, you should definitely think about reducing high-dose fructose. And that means avoiding sweet drinks and desserts, even desserts made with many so-called “natural sugars.” Read: Reverse insulin resistance in 4 easy steps.

👉🏽 Tip: The only way to know if you have insulin resistance is to test the hormone insulin. Having polycystic ovaries means nothing and can actually be associated with hypothalamic amenorrhea or undereating.

I know getting off sugar can be hard. Here is the plan I use with patients.

How to overcome sugar cravings

  • Eat enough protein, especially with your first meal because protein is highly satiating and will reduce cravings.
  • Eat full, satisfying meals that include all three macronutrients: protein, starch, and fat. In other words, don’t attempt to restrict calories or carbs during the time that you’re trying to get off sugar.
  • Get enough sleep, because sleep reduces sugar cravings.
  • Supplement magnesium, because it helps sleep and reduces cravings.
  • If you need a sweetener while you adapt to a low-sugar diet, try the natural sweeteners stevia or xylitol.
  • Pick a start date during a lower-stress time in your life.
  • Go cold turkey off all desserts and dessert-type foods for four weeks.
  • Know that intense cravings will subside after twenty minutes.
  • Know that all cravings will subside after seven days.
  • Know that by reversing insulin resistance you will help to prevent cravings from coming back.
  • Know that you’re okay. You’re not a bad person just because you crave sugar or binge on sugar.

If you find that giving up sugar is really, really hard and that you continuously relapse, consider that you may have a true sugar addiction and reach out for help.

Ask me in the comments.

103 thoughts on “High-Dose Fructose Can Cause or Worsen Insulin Resistance (But Fruit Is Okay)”

  1. Hi Lara, loving your new book, thanks for your great work in this space. Do you know much about the effectiveness of Myo-inositol to treat insulin resistance?

  2. Hi Lara, I really hope you see this comment.
    I saw here that a lot of people could have PCO’s post pill. And I saw here that you say that insulin resistance causes PCO’s in some people. In my researches, insulin is totally correlated with acne and hormonal imbalance (because can improve the testosterone levels and all that stuffy), which can causes acne, alopecia, hisurtism. Even if I don’t have insulin resistance, an low carb diet or paleo (In Brazil we say low carb), is not going to help me to pass trough this post pill acne? I’m confusing in this question. (I’m not saying cutting all the carbs, but cutting sugar, refined carbs, and prefer to eat vegetables, sweet potato, pumpiking…)
    I don’t know if I have PCO’s (I’m 50% sure that I don’t have or I had an PCO’s post pill) but I notice when once I was dealing with acne that high carb foods was getting this worst.

    • depends whether there’s insulin resistance or not. If there is, then yes, I think 1 kg could be too much fructose. Depending on the type of fruit.

  3. Hi Lara, no sadly my period did not come and still has not come (I’m also not pregnant – just recently took a pregnancy test) so I think my LH is just high. Do you think if my fasting insulin is 4.6 that I still need the glucose insulin challenge just to make sure that I don’t have insulin resistance?

    • Hi, I have perfect fasting glucose and insulin but challenge test showed perfectly that I have insulin resistance. So I can confirm what Lara says that fasting tests may not be enough. The only thing I can add is that after about 1 hour after meal I became very sleepy and always had to have a coffee.

  4. Hi Laura,

    I am trying to figure out if I have insulin resistant PCOS or post-pill PCOS. My fasting insulin is 4.6, so it is well below the level that you said would indicate insulin resistance. However, I also believe in your book that you could detect mild insulin resistance through the insulin glucose challenge? Should I have that done as well? I ask because I also had slightly elevated ALT and LDL cholesterol on a recent blood test (which was verified on a subsequent test). My androgen levels are: DHEA- 326.9, testosterone – 40, androstenedrone – 171. My LH to FSH ratio also indicates PCOS 18:5. I also recently got off of Junel (BCP) about 4 months ago after taking it for 3.5 years continuously. Before that, my periods were much more regular (I never tracked them, but I know they happened more often than they do now – which appears to be cycles of over 50 days!) Anyways, I have contacted your assistant because I would like to schedule a skype appointment with you if at all possible!

    • when did your period come after that LH/FSH reading? (ie. if your period came about 2 weeks later, that high LH would be a normal ovulatory surge).

  5. Always love your informative articles. I’m trying to figure out why I have an elevated fasting blood glucose level but normal A1C. This is always the case. I have not done the fasting insulin test. What are your thoughts about taking the supplement Berberine to help with this? I’ve read good things about it and supposedly it is as effective as Metformin. Thank you Dr. Lara!

  6. When you say dont quit carbs or you may lose your periods, many of us think “”yes please””.

    A better message would be dont quit carbs completely or you may stop ovulating which means you stop getting the best farkin hormone known to women …

    – the calming hormone, the hormone that makes you feel young again, the hormone that makes you look younger, the hormone used to calm your stresses, the legendary hormone Progesterone!

    Thanks to your message over the years, I have put all my focus on ovulating (even though I dont want anymore babies).

    You can reverse insulin resistance/ pre-diabetes and lose weight and be sane by eating gentle carbs from day 8 to 15 of your cycle! You need glucose before ovulating but you dont need it for the rest of your cycle.

    Bonus: I no longer have PMS – Estrogen needs to be opposed by Progesterone.

    Maybe I dont need you anymore Lara but I love reading your posts. You’ll always be the Queen of Hormones! Thank you.

  7. I never eat “desserts”, but I always drink Calcium+VitaminD orange juice, between 2-4 glasses a day. That’s 23g of sugar per serving. I really need something sweet to drink in order to feel satisfied with a meal.. I never realized that could be causing my problems. Not diagnosed as insulin resistant, but definitely believe I am because I’m a tiny person with a very large waist and have a few other symptoms you mention.

  8. I read that maple syrup contains only 1% fructose, the rest is sucrose. So wouldn’t maple syrup be okay to use if using 1/2 tsp in oatmeal?

  9. Lara, I have been following you/reading your blog for several months now. I have followed most of your suggestions for perimenopause/insulin resistance and am doing very well. My question is about my 9 year old daughter. We have seen our pediatrician twice about early puberty–first when breast buds developed right after her 7th birthday and just a month ago. Our pediatrician says she is healthy and developing “early normal,” but suspects she begin menstruating before age 10. I do not want this for her, but feel it’s unstoppable at this point. To humor me her doctor drew a fasting insulin. It was 8.5. Does that mean she is insulin resistant? Of course their range is 3-20, so they are not concerned. She is Turner stage 2 development-wise. Do I need to cut out desserts/treats? It will be hard, but worth it. I was just wanting your professional medical opinion. Thank you!

  10. I have gone sugar free and dairy free and have found lots of great substitutes for my dairy cravings! This involves lots of coconut based products and I know that coconut does have some sugar in. I was wondering on your view of coconut and PCOS/no sugar diet.

    As an example, this is a coconut yogurt product that I absolutely love!

    Coconut Milk (71%), Coconut Water (24%), Cornflour, Potato Starch, Stabilizer (Pectin*), Non-dairy cultures (S.thermophilus + L.bulgaricus. Lactobacillus acidophilus, Bifidobacterium lactis). *from fruit

    Nutritional Information per 100g:
    Energy 543kJ/131kcal Fat 11.5g Of which saturates 10.8g Carbohydrate 5.8g Of which sugars 2.5g Protein 1.2g Salt 0.05g

    • That is absolutely fine! 2.5 grams sugar (1 gram fructose) is almost nothing (And it’s way below the cutoff of 25 grams fructose per day that I describe in my book.)

  11. Dear Lara,

    I have suffered from painful periods all my life. I’m reading your book at the moment. Three months ago, I quit added sugar and one month ago I quit cow’s dairy apart from butter and heavy cream. There’s nearly no processed food in my diet. I do eat dates on some days though. I’ve already seen some substantial improvements (cramps did not require painkillers after quitting dairy) but I’d like to get better still (there are still some cramps and my luteal phase is just ten days). I’ve read that organic blackstrap molasses helps with possible mineral deficencies and I’ve heard quite a women say having a tablespoon a day decreased their pain significantly. It makes sense to me that a “natural” mix of minerals works better than a large number of isolated supplements. However, I’m worried about the sugar content. I don’t have the desire to eat more “sweet” things at all. Would you recommend blackstrap molasses to preempt mineral deficiencies? Thank you so much for all your work, you are a godsend!

    Thank you very much for your help and kind regards,

  12. Hi Lara
    I have high androgens (from a blood test) and cyclical ‘hormonal’ acne and think I may have PCOS because I have most of the symptoms.
    I am vegan and don’t eat any dessert or sugary sweets/drinks but I do eat A LOT of fruit everyday – almost 3 times your recommended amount. I have been advised by a plant-based dietician so I know I am getting enough protein, starch and fibre from whole sources however I plan to get a fasting insulin test ASAP as my acne around my jaw line is still really bad.
    Would you recommend cutting back to the 25-30grams fructose per day straight away (prior to test) or going ‘cold turkey’ on all fructose for four weeks as I have read in your book?

  13. Dear Lara,

    my Mom (71) has found out that she suffers of a fructose problem. Not the insuline one, but a missing enzyme, she seems to not tolerate fructose. (I am sorry, I don’t know the exact English vocabulary.) Her doctor let her breath and measured the gases in the breath.
    As you are so good in gut problems I would like to ask you what you would recommend. Because she was told to not eat fructose, which means she doesn’t eat raw food, almost no vegetables and no fruits. That can’t be healthy in the long run, because that means a diet missing all vitamines and micronutrients. This way she will kill herself.
    Thank you a lot already in advance. 😀
    (After reading your webpage and also your book I couldn’t find your treatment for this kind of disease anywhere but I can’t exclude I was blind…)

    Enjoy your day


  14. Hi Dr Lara!
    I’m 29 and have pcos and have been struggling from hair loss for 5 years with constant alopecia areata and now androgenic alopecia too. I have come off the pill five months ago and my hair seems to be shedding more than ever with my front and part thinning rapidly. I am trying to follow a strict no sugar and low carb etc as per your page. Do you think there’s anything else I can do? Or is losing my hair inevitable? I want to start a family but am worried that I’ll be bald soon. You can imagine how stressful this is for a woman. I feel like I’ve battling pcos my whole life and I’m trying to stay positive for the sake of starting a family but I feel like losing myself. Any further suggestions would be great seeing as you’re the expert in this area. Thank you for the great info and hope on this page.

  15. Hi dr Lara! I have been off the pill for four years and the only way I can control my skin is with very restricted sugar AND carbs, unfortunately. I have no symptoms other than acne, have always been on the thin side and don’t have PSOC. Not sure why I have this stubborn issue but I do and it’s been for over a year. Berberine helped short term but doesn’t work as well as it did initially. If there’s a naturopath in L.A. you’d recommend please let me know 🙂 I miss eating watermelon and cherries!

    • If you have to restrict starch as well, then it’s a sign that something is not right in your digestion. Do you have bloating or possibly SIBO? it’s worth treating that to treat your skin.

      • I don’t have bloating, however I have suspected I may have some kind of parasite (maybe..) but perhaps it’s SIBO. I’ll see what my options are for treating that. Thanks!

        • I’m reading about SIBO–I do occasionally suffer from intense abdominal cramping, usually after a short run. In fact, I have to be careful about not running BEFORE my period starts because it can leave me paralyzed with pain/needing the bathroom very abruptly. Never knew about SIBO, this could be the connection!

  16. What about sucralose? I’m struggling to find something I can drink besides water only. I’ve been drinking Ice because it says zero carbs but is sweetened with sucralose. I don’t have more than 1 a day.

    • You’ll find that once you stop having sweet drinks, you’ll stop wanting them. Then, you will be satisfied with water or sparkling water. In the meantime, if you truly need something sweet, then stevia is the best option. You can have it in sparkling water with lemon or in coffee or tea.
      Sucralose is probably ok–and a lot better than sugar.

  17. Dear Lara, thanks for such great info. I have maybe stupid queastion. I have quited sugar for sever months. But during my husbands birthday party I lost control and have eaten two peaces of cake, some “natural” honey-sweets and quite much fruit. After that I don’t eat desserts again. What harm I made for my organism during that one day? How long does it take to normalise again?

  18. I’m struggling with drinks. I don’t drink coffee, hot tea, or pop. But sometimes I need something besides water. I’ve been drinking lemonade or ICE drinks occasionally, but I know that’s a lot of sugar. Do you have any suggestions?

  19. How long does it take to see the benefits of quitting sugar? I have been completely off sugar for a month, and only consume 2-3 pieces of non-sugary fruits a day. Mainly berries, nectarines, and bananas. I am hoping this can help with persistent scalp and sebum problems that have been going on for almost 2 years (started about 2 months after quitting the pill.) I am also cutting out other inflammatory foods like gluten dairy alcohol. What else can I do besides diet to help stabilize my erratic hormones? There seem to be so many different recommended supplements, and I am afraid of overdoing it. Are there 2-3 that you highly recommend for sebum/scalp/acne and hair loss?

  20. Hi Lara,

    I was diagnosed with fructose malabsorption about 5 years ago so I have been avoiding fructose as much as I can for years. Recently, I’ve been noticing increased urination when I do have even the smallest amounts of fructose. I went off of hormonal birth control about a year ago, had my hormones checked and have high testosterone, and have been charting my cycles for 3 months now which indicate I have a short luteal phase (8 days). Would you say I have insulin resistance and PCOS? How would you proceed if that is the case? Thank you!

  21. Hi Lara,
    Great, timely article for me:) I have breast hypoplasia, suspected IGT and definite low supply (breast feeding my second Bub who is 3 months old). Any chances of an article on this please?!
    I’ve recently found out it may be related to IR so I’m going to investigate and take action, as discussed.
    A quick question on diet in relation to your article…I’m really busy with breastfeeding Bub and I have a wild toddler so very little time. I find a morning smoothie really boosts me and it’s a quick way of getting goodness down. When you say 3 pieces of whole fruit I’m wondering what your take on berries is? How much is a serve and is it counted in the 3 pieces? Any other good, easy quick foods you can recommend?
    Thanks so much,

  22. Hi Lara,

    My doctor prescribed me Prometrium for PCOS, but I have elevated Cortisol. Do you think the Prometrium will be converted to Cortisol and perpetuate the problem?

  23. Dear Dr. Lara Briden,
    Could you please write a post on EVERYTHING you know about high SHBG levels in a young woman (me). How to find the root cause and how to reverse the SHBG to a normal lower level, hopefully with natural methods. I have never been on the pill/contraceptives.

    Wishing you the best,

    • Hi SHBG can be from the following:
      – oral contraceptives
      – overactive thyroid
      – DHEA deficiency
      – vegetarian diet (or high intake of phytoestrogens)

  24. Dear Lara,

    I would like to request a blog post (or posts) on Non Classical Adrenal Hyperplasia. There isn’t much information on how to manage it or how to distinguish it from PCOS. Thank you so much, Tiffany

  25. Hi Lara,
    I’m 18 and have only 4-6 periods per year, so I went to my ob-gyn and had my hormones checked recently. So apparently, my testosterone levels are somewhat too high, so my doctor suggested taking a drug that contains 2g myo-Inositol and 0,2mg folic acid twice a day for 3-6 months. My questions are:
    1) Do I really need the folic acid or can I switch to a drug that only consists of myo-Inositol?
    2) I’m normal weight, but should I try to consume less sugar? Could that possibly help me?

    Thanks a lot!

    • You could be normal weight and still have insulin resistance, which means you have to quit sugar.
      The folate is not a necessary part of the inositol treatment (unless you’re trying for pregnancy)

  26. Hi Dr. Lara,
    I have quit sugar thanks to you, and along with that was taking Vitex for 3 months to regulate my periods. I stopped the Vitex about 5 weeks ago but haven’t gotten my period. Do you recommend I go back on Vitex for another 3 month time span? I was hoping my body would regulate on its own already, and I’m hesitant to rely on Vitex for a longer time span than 3 months. Would love your input.

    Thank you for all that you do, you have been a huge resource for me.

  27. Hi Lara,
    this is a little of topic, but do you have any idea why breasts shrink? I’m 23 but my breasts suddenly look like those of a 14 year old girl. I’m a little underweight but have not lost any wieght recently nor started to exercise and I eat the same. My hormones and thyroid are normal according to bloodtests and I ovulate every month. No PCOS. But I have acne, oily skin and scalp, hairloss and a bit too much bodyhair. Any advice? Thanks!

  28. Lara,

    What is your advice for a woman with PCOS who has normal Testosterone, but elevated DHEAS and DHEA along with IR? It appears to me, that in a few cases, IR may actually be the cause of elevated adrenal androgens, which doesn’t match the current explanation of Ovarian and Adrenal “types.” Any input?

    • If there’s insulin resistance, then there’s probably going to be some degree of ovarian androgen excess. I treat the insulin resistance

      • Would treating the Insulin Resistance decrease the Adrenal Androgen production? Cortisol rhythm is also dysregulated. I assumed the Insulin Resistance was a secondary problem caused by long term Adrenal stress hormone over production.

  29. I have a question for you. I have been sugar free for a year now, and had some major improvements in my hormonal health. I never had any problems show up in my blood work but suffered chronic fatigue, headaches and major hormonal issues. Going sugar free was the answer to my prayers, and helped so many things. I had a huge set back this February when I had to take Prednisone for a few days. A lot of my improvements came back slightly. Bad blood sugar problems, Fatigue and headaches. Then my period got a little wonky. The mood swings have been horrible. I have continued my sugar free lifestyle, but these symptoms still linger. I feel like I should not be having sugar crashes if I dont eat sugar! I am lost as to what steps I can take since I eat no sugar and low carb makes me crazy. Doctors offer no answers for me except putting me on birthcontrol to help the hormones. I refuse to take it. They also seem to think there is no way prednisone did this to me. I know my body, and this steroid messed me up. Your thoughts and advice are greatly appreciated.

  30. Dear Lara, is the 80cm waist a cart Blanche rule? I carry next to no extra flab after two children and yet I have scoliosis and a rotated rib hump. My rib cage touches my iliac crest bones almost precisely and due to this body shape I have never had a nob thick waist even when I was anorexic as a teen. Every time I read that rule about the 80cm waist it stresses me out!

    • Thanks for commenting. No, the 80 cm waist measure is not a hard and fast rule. It’s a guideline and of course, depends on individual build and body shape.

  31. Lara,
    I just wanted to thank you for all of this information you’ve put out for free. I have PCOS and terrible reactions to hormonal birth control. I used to be very heavy and only lost weight due to the birth control covering the hormone issue. After I stopped taking it, my weight started climbing again. I was eating “healthy” and excercising. I found your info and went gluten free, low natural sugars only, and A2 dairy. I’ve lost around 40 lbs that I had regained. My periods are totally normal and track able. I have no remaining syptoms other than a sluggish metabolism and I still enjoy food! So my thanks for your work and being so open handed with it!

  32. Hi Lara! Interesting article! Besides the test you mention for finding out about insulin resistance, is there any other sign to show this abnormality? Thank you!!!

  33. Thanks so much for your great article on fructose. I follow paleo principles based on recommendation from a naturopath to help with gut issues but I definitely am guilty of eating paleo treats over grains or potatoes!

    I also have pcos and suffer from acne so your article was really a lightbulb moment. Don’t know why I continue to think sugars okay given how much research I’ve done to know it’s poison.

    You recommend about 30gm of fructose is ok, how do I measure this?

    • First step, avoid all dessert-type foods. That alone with dramatically reduce your fructose intake.
      Beyond that, you can have dark chocolate. For example, 1 square of 90% cocoa chocolate has about 1 gram of fructose. You can have whole fruit. For example, one pear has 11 grams of fructose. Half a cup of berries has about 7 grams. As I say in the article, 30 grams equates to lots of vegetables and about three servings of whole fruit. But not including dried fruit such as dates or raisins etc.

  34. Thanks for always providing such great info. I love your book and have been almost completely off sugar for a few months now. But also eating healthy carbs and some fruit. I feel so much better and am having a regular cycle. I do use stevia when I need a chocolate fix, and occasionally a sstevia sweetened drink. And I’m wondering what your view on stevia and similar natural sweeteners is?

  35. Hi Lara hope this finds you well. I think quitting sugar is extremely hard. What are your recommendations for supplementation to assist.

    • These are the steps I commonly recommend:
      1. Be fully nourished including meat and potatoes and solid meals.
      2. Get enough sleep.
      3. Take magnesium.
      4. Pick a start date and then strictly avoid sugar for 4 weeks.
      And when it comes to cravings, it’s important to know that they do end. The acute ones rarely last longer than 20 minutes. The worst of them are usually over by about day 3 or 4. Cravings should be completely gone by 4 weeks.

  36. Hi Lara, how does alcohol factor into all of this? I have found my friends are more excepting of me skipping dessert than of me skipping a drink. I have enjoyed having a cocktail here or there since my baby was born but I can see how that would be setting me back.

    Is dry wine better? I don’t really know where to draw the line.

    • Very good question. Yes, if you’re going to drink then a non-sugary drinks like wine is a much better choice than a sugary cocktail.
      That said, I’m becoming more and more convinced that alcohol does bad things to our health and metabolism. I’ve personally gone from being a moderate drinker to almost a complete teetotaler.
      Like fructose, too much alcohol can impair insulin sensitivity and cause other problems.

  37. That’s what I did wrong for 5 years. I thought glucose, fructose and starches were all equal towards my intake of carbs and so I would end up eating the desert over fruit missing out on that wonderful fibre, antioxidants and nutrients.

    This blogpost goes hand in hand with your Gentle Carbs article. That’s my favourite post because I’ve learned I can lose weight by feeding my thyroid rice and potatoes. Yayyyyy to being thin, energetic and healthy because of the reintroduction of non-inflammatory carbs.

    • I do not consider glycemic index or GI a useful concept. Case in point is that fructose is relatively low GI yet it can directly impair insulin sensitivity in the liver.

      Please see my No-Dessert Diet post for this quote from Professor Richard Johnson:

      “There’s a fair amount of evidence that starch-based foods don’t cause weight gain like sugar-based foods and don’t cause the metabolic syndrome [insulin resistance] like sugar-based foods. Potatoes, pasta, rice may be relatively safe compared to table sugar. A fructose index may be a better way to assess the risk of carbohydrates related to obesity.”

      And also, potatoes do not signficantly spike insulin when they’re eaten as part of a meal with protein and vegetables and fat.

  38. Could this make acne worse? I’ve been struggling with cystic acne only right before and during my period. I am vegan and exercise regularly and like to think I eat healthy. I do eat fruit and some sweets though

      • I had acne from age 11. At age 22 it was as bad as ever. I read an article about how traditional cultures don’t have acne but when individuals move to a Western diet it appears. The theory was sugar as the culprit. I decided to eliminate sugar from my diet (only exception was ketchup, because I love it, but don’t eat it a lot) and within a month my skin cleared up, after 10 years of acne. That was 15 years ago and I still keep sugar out of my regular diet, though I make exceptions for desserts on special occasions.

  39. Maybe a bit off topic but concerning sugar and treatment of vaginal yeast infections, would you recommend the same advice (starch ok in moderation)? I have low sugar and low dairy diet in general but struggling to get rid of a yeast infection at the moment.Thanks

    • Starch is fine for yeast infections. You probably also want to look at taking a probiotic like Saccharomyces boulardii, or the Lactobacillus rhamnosus, GR-1 Lactobacillus reuteri, RC-14 I combination I mention in my book.

      • Thank you. I started taking some of them by mouth. Wondering if vaginal probiotics are better, and for how long should we take them to really make a difference. Can the oral probiotics really impact the vaginal flora? It sounds a bit far fetched if I may say so 🙂

  40. Hi Lara, thanks for all of your informative articles! I have limited starch and sugars for the last few months but my insulin is not going down. Can stress play a factor in insulin resistance? I have stage 3 adrenal fatigue. Thanks!

    • Yes, many other factors can affect insulin including stress, sleep, and digestive health. If you suffer HPA axis dysfunction (adrenal fatigue), then you probably shouldn’t reduce starch. Having adequate protein and starch with every meal can help to stabilise your nervous system and promote sleep.

    • Magnesium can also be incredibly helpful for both insulin sensitivity and normalizing the stress response system (adrenal system).
      My routine recommendations for insulin resistance include 1) quit sugar (but usually eat some starch), 2) magnesium, 3) sleep, 4) exercise.

      • Thanks so much for your reply Lara! I shall start eating some starch (gentle carbs as you call them) as well as the other recommendations you suggested. Thanks again!

  41. This is so scientifically wrong. Adrenaline causes insulin resistance – from not getting enough sugar where it has to be released to mobilize sugar from the liver. You really have no idea what you are talking about with this. Please study ray peat or danny roddy or the first diet by sean bissell. Fructose by far is the best form of sugar

  42. I love sugar and desserts. I always crave chocolate. I love fresh fruit too. But desserts always get me. It’s so hard for me to stay away from it. I try to stay away but always give in especially the week before my period. I’ve asked my doctor to test me for it but she only checked glucose which was normal. Had no idea I had to check insulin. I struggle with infertility (luteal phase defect and low progesterone) and I’ve wondered if my sugar intake could be affecting all that. I’ll definitely have to get my insulin tested. Thanks for the post!

  43. Thank you for another wonderful, informative post! Could the slight weight gain I’ve experienced in the past few years be due to insulin resistance? I am thin, haven’t ever had any weight problems, but now that I’m 44, my waist has thickened, and all my excess weight is concentrated there. I exercise and try to eat a healthy, well-balanced diet. I do get terrible sugar cravings before my period and eat “healthy” desserts – all containing the high fructose ingredients you mentioned (honey, dates, etc.) I’ll have to rethink that now! : )

    • It might be worth testing fasting insulin to see where you’re at. Also 44 is getting kind of close to menopause, so that could be a factor. Estrogen improves insulin sensitivity so the loss of estrogen with menopause can cause or worsen insulin resistance. For many women, the menopause transition time is a good time to avoid sugar.

      • Thank you for your reply. I have also enjoyed reading your replies to the other posters. The comment you made about how fructose, though relatively low in its GI, can cause insulin sensitivity in the liver, is what made this whole article make more sense to me. I went back and read your older post on sugar, as well as all the replies, which helped also.

        • Hi Danica,

          Thanks so much for your feedback about what helped you to understand. I’ve just added a little tip to the post about fructose and GI and direct impairment of insulin sensitivity. And I’m going to use that explanation in the sugar section of my new book. It’s comments like yours that help me to improve my own work.


          • Hi Lara I am so shocked by how many problems PCOS and Insulin Resistance can cause in your body. Thanks so very much for doing this Blog and putting up so much information about PCOS and Insulin Resistance and then all the other pathways that it can affect. It is a MineField of issues affecting Hormones and the Liver and the Kidneys and your Heart if we don’t get control of this Insulin Resistance. Well it is a worry, so far my daughter has just had a Saliva Test and Fasting Insulin test and her Insulin is 17 so we have to bring that down. Also my daughter has all the Symptoms of PCOS , Oestrogen Dominance and Insulin Resistance. The supplements she has been taking so far are T-Clear and P-Lift and Oestro-Clear and P2-Detox and now Resist-X and this one is a concern with a high amount of Chromium Picolinate which I read somewhere saying it was not safe, though it is a Metagenics Brand and prescribed by a Naturopath. Exercise is paramount in helping improve this condition. So I am hoping my daughter realizes sooner than later that she needs to stop being a couch potato and to get more active and do some cardio and weight lifting. Otherwise this will be a up hill battle on her part to overcome this. At the moment I cannot make her understand how important this is. Thanks so very much Lara. Look forward to your feedback.

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