Many people living with type 2 diabetes are making food decisions based on myths rather than evidence, according to a new US survey that highlights a clear gap between confidence and accuracy in nutrition knowledge. The findings suggest that confidently held beliefs about fruit, fat and sugar continue to shape eating habits in ways that may hinder good health.
The research was commissioned by the Avocado Nutrition Center and involved 400 adults without diabetes, 400 adults with type 2 diabetes or prediabetes and 200 registered dietitians. Conducted online in September 2025, the survey examined how people assess nutrition information, what sources they trust and which foods they avoid. The results indicate that misconceptions remain widespread even among those who believe they understand diabetes nutrition well.
Dietitians report that confusion about fruit is one of the most persistent issues, with 97% saying their patients are unsure about which fruits to eat. More than half of diagnosed patients admit they have thought twice about eating fruit. Many respondents assume that natural fruit sugars and added sugars behave in the same way, despite the presence of fibre in whole fruits that slows glucose absorption. Although health organisations encourage the inclusion of fruit in balanced diets, online messages often oversimplify guidance, leading to unnecessary avoidance.
The findings show similar patterns with dietary fat. Almost half of diagnosed patients believe all fats should be limited, and 29% intentionally avoid foods such as avocados and nuts even though these contain unsaturated fats that support blood sugar stability and cholesterol management. Evidence continues to contradict these fears. A 2024 study published in the Journal of the Academy of Nutrition and Dietetics, funded by the Avocado Nutrition Center, found a lower risk of type 2 diabetes among Mexican women who consumed avocados. A 2023 analysis involving more than 6000 Hispanic and Latino adults reported a 28% reduction in the odds of developing type 2 diabetes for regular avocado consumers after factors such as diet quality and activity levels were taken into account.
The survey also sheds light on how people gather information. Many diagnosed patients say they trust healthcare professionals most, yet dietitians report that patients usually refer to comments from friends or family. Seventy percent of dietitians say these informal networks are mentioned most often during consultations. Social media is also influential. Forty percent of people with type 2 diabetes say they have made significant changes to their diets based on online content. Some have adopted restrictive approaches such as avoiding all fruit, despite a lack of supporting evidence. Dietitians warn that these changes can be counterproductive and may undermine the long term management of the condition.
Generational differences are also evident. Younger adults report the highest confidence in their nutrition knowledge but give the least accurate responses. Older adults express lower confidence but answer more accurately. Researchers suggest the contrast may reflect the influence of online content among younger groups compared with older adults who rely more on established health sources.
The survey identifies sugar as the most misunderstood nutrient, according to 52% of dietitians, with fat following at 21%. Common misconceptions include the belief that natural and added sugars are identical, that all fruit raises blood sugar to an unsafe level and that all fats should be avoided. Even among those who describe themselves as very confident, more than half hold incorrect assumptions about how the body processes sugar.
