ArticlePDF Available

Abstract

Date, the fruit of date palm, is a delicious fruit with a sweet taste and a fleshy mouth feel. Dates have been considered as the staple food in the Arab Gulf regions for thousands of years. The religious-cultural importance of this fruit often creates conflict between persons with diabetes, who wish to consume it in unlimited quantity, and health care professionals, who condemn its consumption. This article provides a balanced, nutrilogic opinion about dates and their consumption in diabetes.
109
THIEME
Brief Communication
Dates and Diabetes
Sandeep Chaudhary1 Aswin Pankaj2
1Department of Endocrinology, NMC Hospital, Dubai,
United Arab Emirates
2Department of Endocrinology, Jupiter Specialty Medical Centre,
Mankhool, Dubai, United Arab Emirates
Address for correspondence Sandeep Chaudhary, MD, DM,
Department of Endocrinology, NMC Hospital, Dubai,
United Arab Emirates (e-mail: sandeepch8j@gmail.com).
Date, the fruit of date palm, is a delicious fruit with a sweet taste and a fleshy mouth
feel. Dates have been considered as the staple food in the Arab Gulf regions for thou-
sands of years. The religious-cultural importance of this fruit often creates conflict
between persons with diabetes, who wish to consume it in unlimited quantity, and
health care professionals, who condemn its consumption. This article provides a bal-
anced, nutrilogic opinion about dates and their consumption in diabetes.
Abstract
Keywords
Arab diabetes
diabetes
glycemic index
glycemic load
medical nutrition
therapy
J Soc Health Diab 2018;6:109–110.
DOI https://doi.org/
10.1055/s-0038-1675670
ISSN 2321-0656.
©2018 NovoNordisk Education
Foundation
Introduction
Phoenix dactylifera (date, date palm) is a flowering
plant species of the palm family, Arecaceae. It has been
cultivated since antiquity for its edible sweet fruit.1 The
daily consumption of dates is deeply rooted in the tradi-
tion of many societies, including those in the United Arab
of Emirates, and has religious sanction as well. It has been
considered as a staple food of the Arab Gulf regions.
Date is a delicious fruit with a sweet, fleshy feeling.
The development of the fruit is classified into four stages:
Kimiri,” “Khalal,” “Rutab,” and “Tamer.”
Dates are consumed in a variety of ways. They are mainly
consumed as fresh (30–40%) or in the dried form (60–70%) at
Rutab (semi-ripe) and Tamar (fully ripe) stages. Little or no
processing is required.
Dilemma in Diabetes
Use of dates as a snack, as often as four to five times per day, is
a part of Arabic culinary tradition. Date fruits are considered
highly nutritious and healthy by the public. Persons with dia-
betes get confused as they receive conflicting messages from
diabetes care providers. Whereas some encourage moderate
consumption of dates, others advise restraint or abstinence
from dates as a means to improve glycemic control.
Nutritional Value
Dates can be considered as an ideal food providing a wide
range of essential nutrients with many potential health
benefits.2 Dates are rich source of carbohydrates, salts, min-
erals, vitamins, fatty acids, and proteins. Dates are also a good
source of dietary fiber, depending on the variety and stage of
ripening (6.4–11.5%).3
Macronutrients
Carbohydrates (sucrose, glucose, fructose), constitute around
70% of the energy of dates. These sugars are responsible for
the sweet taste of dates. The carbohydrate content of dates
depends on the type of date and the degree of ripeness with
the highest concentration at the tamer stage.4
Dates contain almost half of the amount of sugars in the
form of fructose. As fructose is twice as sweet as glucose, it
plays an important role in the flavor and inducing a feeling of
satiety. Dates have been shown to have low to medium gly-
cemic index values, and therefore they may benefit glycemic
and lipid control in diabetes. The low glycemic index of dates
is due to the high fructose and dietary fiber content.5
Dates are a good source of dietary fiber. Dietary fiber con-
tent varies depending on the variety and degree of ripeness,
and it ranges from 6.4 to 11.5%.6 Dietary fiber exhibits many
therapeutic benefits. Higher content of the insoluble fiber
110 Dates and Diabetes Chaudhary, Pankaj
Journal of Social Health and Diabetes Vol. 6 No. 2/2018
induces satiety. It helps in lowering the blood cholesterol lev-
els by preventing cholesterol absorption in the gut. High fiber
is a bulk laxative. It protects the colonic mucosal membrane
by decreasing exposure time to nutrients, as well as binding
potential cancer-causing chemicals passing through the colon.
Protein and lipid are present in minor amounts in dates.
Proteins are found in the date fruit in the range of 1 to 3%.
This percentage is higher than found in common fruits such
as apples, papayas, oranges, bananas, pomegranates, and
grapes. The date flesh and date seed both contain a wide vari-
ety of saturated and unsaturated fatty acids.
Micronutrients
Dates are a good source of many important vitamins and
minerals. Dates contain high levels of selenium, copper,
potassium, and magnesium. They also have moderate con-
centrations of manganese, iron, phosphorus, and calcium.
The high-potassium and low-sodium content of dates help
people with hypertension.7
Dates contain various types of phytochemicals such
as carotenoids and phenolic compounds (flavonoids and
anthocyanins), known as tannins that possess anti-infec-
tive, anti-inflammatory, and antihemorrhagic (prevent easy
bleeding tendencies) properties.8
Dates have also been shown to reduce the oxidative
stress by normalizing the increased hepatic levels of
malondialdehyde (MDA) and by increasing the hepatic
glutathione levels.9
Moderate amount of vitamin A found in dates is known to
have antioxidant properties. It also facilitates healthy vision
and helps maintain health of mucus membranes and skin.
The fruit has adequate levels of B-complex vitamins
(pyridoxine [vitamin B6], niacin, pantothenic acid, ribo-
flavin, and vitamin K). These vitamins act as cofactors in
multiple metabolic pathways that handle carbohydrates,
protein, and fats. Vitamin K is essential for coagulation and
bone health.
Pragmatic Suggestions
Dates can safely be consumed in small quantities.
A single-pitted date weighing around 7.1 g provides 20
calories and should not upset glycemic homeostasis
significantly.
Some suggestions for the safe use of drugs include the
following:
Spread the total quantity of dates to be consumed,
throughout the day.
Replace the seed with low calorie, low glycemic index
foods such as cabbage, almonds, or walnuts.
Eat and chew dates slowly.
Cut dates into slivers to increase the fruit’s surface area.
Use small amounts of date paste in cooking.
Persons with diabetes must be counselled regarding the
harms of excessive intake of dates. However, health care pro-
fessionals should keep in mind the religious-cultural impor-
tance of consumption of dates. This will allow a balanced
approach to the question of whether to consume dates or
not. In general, a “glucologic” policy of moderation should be
followed.
Conict of Interest
None.
References
1 El Hadrami A, Al-Khayri JM. Socioeconomic and traditional
importance of date palm. Emir J Food Agric 2012;24(5):371
2 Vayalil PK. Date fruits (Phoenix dactylifera Linn):an emerging
medicinal food. Crit Rev Food Sci Nutr 2012;52(3):249–271
3 Ahmed IA, Ahmed AW, Robinson RK. Chemical composition
of date varieties as influenced by the stage of ripening. Food
Chem 1995;54(3):305–309
4 Al-Farsi MA, Lee CY. Nutritional and functional properties of
dates: a review. Crit Rev Food Sci Nutr 2008;48(10):877–887
5 Ali A, Al-Kindi YS, Al-Said F. Chemical composition and glyce-
mic index of three varieties of Omani dates. Int J Food Sci Nutr
2009;60(4, Suppl 4):51–62
6 Al-Shahib W, Marshall RJ. Dietary fibre content of dates from
13 varieties of date palm Phoenix dactylifera L. Int J Food Sci
Technol 2002;37(6):719–721
7 Al-Shahib W, Marshall RJ. The fruit of the date pal its pos-
sible use as the best food for the future? Int J Food Sci Nutr
2003;54(4):247–259
8 Biglari F, AlKarkhi AF, Easa AM. Antioxidant activity and phe-
nolic content of various date palm (Phoenix dactylifera) fruits
from Iran. Food Chem 2008;107(4):1636–1641
9 Bastway Ahmed M, Hasona NA, Selemain AH. Protective effects
of extract from dates (Phoenix dactylifera L.) and ascorbic acid
on thioacetamide-induced hepatotoxicity in rats. Iran J Pharm
Res 2008;7(3):193–201
... Foods 2020, 9, 1557 2 of 21 patients with diabetes [14,15]. Additionally, the date palm has numerous therapeutic potentials, including cell reinforcement, anti-mutagenic, antibacterial, antifungal, antitumor, neuroprotective, and gastroprotective properties [16,17]. ...
Article
Full-text available
Diabetes is a chronic metabolic disorder triggered by disturbances in carbohydrate, protein, and lipid metabolisms, where either reduced secretion or sensitivity of insulin is observed coupled with poor glucose control. Date palm fruits are one of the fruits reported to have good potential in diabetes treatment due to its presence of polyphenols exerting strong antioxidant activities. Other possible mechanisms of action include the polyphenolic compounds, which can inhibit enzymes like α-amylase and α-glucosidase. Flavonoids in dates can stimulate β-cells by increasing the number of islets and β-cells, recovering endocrine pancreatic tissues, reducing β-cell apoptosis, activating insulin receptors following the increase in insulin secretion, in addition to improving diabetes-induced complications. In this review, the in vitro, in vivo, and human study-based evidence of date palm as an anti-diabetic fruit is summarised.
Article
Full-text available
One of the healthy lifestyles that continues to grow is consuming healthy food. The consumption of sweet bread in Indonesia continues to increase, and as a result, the cases of people with diabetes mellitus in Indonesia have also experienced a significant increase, for it is not recommended for people with diabetes mellitus to consume excessive amounts of sweet bread. A cinnamon roll is a dough roll sheet consisting of the cinnamon and sugar mixture (raisins or other sweet fruit ingredients) which are sprinkled on top of a thin layer of butter. Cinnamon Java Roll is a modified product of cinnamon roll with cinnamon and palm sugar with lower sugar content due to the ingredients in it, where there is a modification of the ingredients by adding palm sugar which has a lower glycemic index, and the addition of sliced dates as an additional sweetener and almond nuts for nutritional enrichment. One slice of bread contains 137 Cal of energy, 2.59 grams of protein, 4.93 grams of fat, and 22.36 grams of carbohydrates with a sugar content of 8.37 grams/serving (1 slice) and 75.34 grams/recipe (9 slices).
Article
Background: There is a common belief that individuals with type 2 diabetes mellitus (T2DM) must avoid consumption of dates. This article aims to review and discuss the available studies on dates on different variables, specifically blood glucose. Methods: A survey of studies related to the influence of consumption of dates on blood glucose, glycosylated hemoglobin, lipid profile, and body weight was conducted between January 2009 and Nov 2022, using various data bases (PubMed, Medline, Google Scholar and Scopus). Results: The glycemic index (GI) of date varieties ranges from 42.8 to 74.6, and glycemic load (GL) 8.5-24. The glycemic indices of various stages of dates are; Rutab (semi-ripe), 47.2; Tamer (fully ripe, traditionally sun-dried), 45.3, and Tamer (commercial), 35.5. Glucose tolerance-based studies and cross-sectional studies show no significant changes in glycemic indices or association with glycemic worsening with intake of dates. Few randomized controlled trials (RCT) also showed no change in glycemia and weight in the intervention groups consuming dates. Some data (including one RCT) show that the consumption of dates improve total cholesterol and LDL-C. Conclusions: Available studies show that consumption of dates may not lead to impairment of glycemia in patients with T2DM, however, studies have several limitations like small sample size and short duration. More RCTs pertaining to the GI of different date varieties in different amounts are needed.
Article
Full-text available
The date palm fruit is a drupe exhibiting a high diversity in texture, shape, color and chemical composition depending on the genotype, environment, season and cultural practices. The fruit typically characterize the variety. The socio-economic value of dates is particularly known from oases, where date palms grow and fruits were historically the medium of exchange between populations. The geographical distribution of date palm cultivars is not yet well studied and the international demand on some of them will have disastrous impacts on the sustainability of this crop in the long term. This impoverishes germplasm and narrows the diversity grown among oases. In addition, despite the presence of several reports on the chemical composition and the nutritional value of dates, many other potentialities of the fruits remain to be explored. Many claims report on the antibacterial, antifungal, antitumor, antiulcer and immuno-modulatory properties of dates. Recently, the antioxidant activity of some cultivars was investigated and attributed to phenolic compounds. Dates are very rich in phenolics, in quality and quantity, which opens many fields of investigation in terms of new potential uses. This study summarizes the recent progress in date research, providing an up-to-date overview of the worldwide production/commercialization and the traditional and medicinal uses. Other current and future applications of dates also are highlighted.
Article
Full-text available
Date palm is one of the oldest trees cultivated by man. In the folk-lore, date fruits have been ascribed to have many medicinal properties when consumed either alone or in combination with other herbs. Although, fruit of the date palm served as the staple food for millions of people around the world for several centuries, studies on the health benefits are inadequate and hardly recognized as a healthy food by the health professionals and the public. In recent years, an explosion of interest in the numerous health benefits of dates had led to many in vitro and animal studies as well as the identification and quantification of various classes of phytochemicals. On the basis of available documentation in the literature on the nutritional and phytochemical composition, it is apparent that the date fruits are highly nutritious and may have several potential health benefits. Although dates are sugar-packed, many date varieties are low GI diet and refutes the dogma that dates are similar to candies and regular consumption would develop chronic diseases. More investigations in these areas would validate its beneficial effects, mechanisms of actions, and fully appreciate as a potential medicinal food for humans all around the world. Therefore, in this review we summarize the phytochemical composition, nutritional significance, and potential health benefits of date fruit consumption and discuss its great potential as a medicinal food for a number of diseases inflicting human beings.
Article
Full-text available
The ameliorative activity of aqueous extract of the flesh of dates (Phoenix dactylifera L.) and ascorbic acid on thioacetamide-induced hepatotoxicity was studied in rats. Sixty male rats were divided into six equal groups of 10. Two groups were controls, one treated with thioacetamide and one with only distilled water. Two groups received extract of flesh Phoenix dactylifera and intraperitoneal (IP) thioacetamide (400 mg/kg) either before or after administration of flesh extract. Two groups received ascorbic acid and intraperitoneal (IP) thioacetamide (400 mg/kg b.wt.) either before or after administration of ascorbic acid. Liver damage was assessed by estimation of plasma concentration of bilirubin and enzymes activities of aspartate aminotransferase (AST), alanine aminotransferase ( ALT), lactate dehydrogenase (LDH), γ glutamyl transferase and alkaline phosphatase and serum alpha fetoprotein and serum total testosterone. Treatment with aqueous extract of date flesh or by ascorbic acid significantly reduced thioacetamide-induced elevation in plasma bilirubin concentration and enzymes. This study suggests that thioacetamide-induced liver damage in rats can be ameliorated by administration of extract of date flesh and ascorbic acid.
Article
Full-text available
This review article provides information on the nutritional and functional constituents of dates (Phoenix dactylifera L.) and their seeds from over 80 references. Date flesh is found to be low in fat and protein but rich in sugars, mainly fructose and glucose. It is a high source of energy, as 100 g of flesh can provide an average of 314 kcal. Ten minerals were reported, the major being selenium, copper, potassium, and magnesium. The consumption of 100 g of dates can provide over 15% of the recommended daily allowance from these minerals. Vitamins B-complex and C are the major vitamins in dates. High in dietary fiber (8.0 g/100 g), insoluble dietary fiber was the major fraction of dietary fiber in dates. Dates are a good source of antioxidants, mainly carotenoids and phenolics. Date seeds contain higher protein (5.1 g/100 g) and fat (9.0 g/100 g) as compared to the flesh. It is also high in dietary fiber (73.1 g/100 g), phenolics (3942 mg/100 g) and antioxidants (80400 micromol/100 g). This detailed information on nutritional and health promoting components of dates and their seeds will enhance our knowledge and appreciation for the use of dates in our daily diet and their seeds as a functional food ingredient.
Article
Full-text available
The present study evaluated the nutritional quality and glycemic index of three sun-dried date varieties (Khalas, Khsab and Fardh) grown in Oman. Significant (P<0.05) differences were observed in the proximate chemical composition, dietary fiber contents, various sugar fractions and energy value of these dates. The moisture, ash, crude protein, total fat, and nitrogen-free extract values ranged between 18.77 and 23.71 g/100 g date flesh, 1.12 and 1.55 g/100 g date flesh, 1.28 and 1.89 g/100 g date flesh, 1.14 and 2.37 g/100 g date flesh, and 68.53 and 75.37 g/100 g date flesh, respectively. The dietary fiber and total sugar contents ranged between 8.83 and 13.11 g/100 g and between 52.17 and 59.96 g/100 g, respectively. The glycemic index (GI) of different varieties of dates collected from various regions of Oman ranged between 47.6 and 57.7. Overall no significant (P<0.05) differences were observed in the GI values of different varieties of dates. The regional effects on the GI values of dates were also non-significant (P>0.05). An inverse correlation (r(2)) was observed between the fructose fraction and the GI value of dates.
Article
The dietary fiber (DF) content of dates of 13 cultivars obtained from Egypt, Iraq, Iran and Saudi Arabia was reported. All dates were stored in a refrigerator at approximately 5°C before analysis. It was found that the total fiber (TF) content decreased as the dates loses their firmness and soften.
Article
The chemical analysis of fruits from twelve varieties of date palm (Phoenix dactylifera) which are widely consumed in the United Arab Emirates was undertaken, and figures showed that glucose and fructose increase rapidly with maturation from Kimri through Khalal and Rutab to Tamr. Total sugars may represent over 50% of the fresh weight at Tamr, and these values, together with low moisture contents, encourage resistance to fungal spoilage after harvest. Minerals accumulated in the fruits as well, and the date could be an important source of potassium for regular consumers.
Article
The fruits (dates) of the date palm (Phoenix dactylifera L.) contain a high percentage of carbohydrate (total sugars, 44-88%), fat (0.2-0.5%), 15 salts and minerals, protein (2.3-5.6%), vitamins and a high percentage of dietary fibre (6.4-11.5%). The flesh of dates contains 0.2-0.5% oil, whereas the seed contains 7.7-9.7% oil. The weight of the seed is 5.6-14.2% of the date. The fatty acids occur in both flesh and seed as a range of saturated and unsaturated acids, the seeds containing 14 types of fatty acids, but only eight of these fatty acids occur in very low concentration in the flesh. Unsaturated fatty acids include palmitoleic, oleic, linoleic and linolenic acids. The oleic acid content of the seeds varies from 41.1 to 58.8%, which suggests that the seeds of date could be used as a source of oleic acid. There are at least 15 minerals in dates. The percentage of each mineral in dried dates varies from 0.1 to 916 mg/100 g date depending on the type of mineral. In many varieties, potassium can be found at a concentration as high as 0.9% in the flesh while it is as high as 0.5% in some seeds. Other minerals and salts that are found in various proportions include boron, calcium, cobalt, copper, fluorine, iron, magnesium, manganese, potassium, phosphorous, sodium and zinc. Additionally, the seeds contain aluminum, cadmium, chloride, lead and sulphur in various proportions. Dates contain elemental fluorine that is useful in protecting teeth against decay. Selenium, another element believed to help prevent cancer and important in immune function, is also found in dates. The protein in dates contains 23 types of amino acids, some of which are not present in the most popular fruits such as oranges, apples and bananas. Dates contain at least six vitamins including a small amount of vitamin C, and vitamins B(1) thiamine, B(2) riboflavin, nicotinic acid (niacin) and vitamin A. The dietary fibre of 14 varieties of dates has been shown to be as high as 6.4-11.5% depending on variety and degree of ripeness. Dates contain 0.5-3.9% pectin, which may have important health benefits. The world production of dates has increased 2.9 times over 40 years, whereas the world population has doubled. The total world export of dates increased by 1.71% over 40 years. In many ways, dates may be considered as an almost ideal food, providing a wide range of essential nutrients and potential health benefits.