Problems don’t come with a warning. But, diabetes does! The precursor to diabetes is prediabetes – a condition in which the blood sugar levels are higher than normal but not high enough to be called diabetes (1). The CDC reports that by 2030, about 84 million Americans and 470 million people worldwide will be diagnosed with prediabetes (2), (3). The solution? A smart nutritional and lifestyle strategy to reverse prediabetes.
A prediabetes diet is a holistic approach encompassing diet and lifestyle. It helps overcome the risk of developing type 2 diabetes and health complications and the burden of piling medical bills (4). In this article, diabetes nutritionists share their expert advice on foods to eat and avoid, a sample menu plan, and lifestyle changes needed to reverse prediabetes. Read on to get all the details.
In This Article
What Is Prediabetes? What Causes It?
Prediabetes is a condition in which the blood glucose levels are higher than normal (fasting plasma glucose at 7.0) but not high enough to be diagnosed as diabetes. Diana Gariglio-Clelland (RD, Certified Diabetes Care & Education Specialist) says, “Having prediabetes is a major risk factor for developing type 2 diabetes. Up to 70% of people with prediabetes are estimated to get diabetes in their lifetime, according to an expert panel from the American Diabetes Association.” (5)
What causes prediabetes? Jill Weisenberger (MS, RDN, CDCES, CHWC, FAND, and Author of Prediabetes: A Complete Guide) explains, “Prediabetes is a sign of a greater metabolic problem involving insulin resistance, loss of insulin production, or both.” Insulin is a hormone produced by the pancreas that helps lower blood sugar levels.
- Family history and genetics
- Diet and lifestyle factors (such as physical inactivity)
- Overweight and obesity
- Insulin resistance and early beta-cell failure to produce insulin
Note: Not everyone diagnosed with prediabetes will become diabetic.
Given that there are so many factors that contribute to developing prediabetes, who is at more risk of developing it? Find out in the following section.
Who Is At More Risk Of Prediabetes?
The CDC mentions a list of people who are more likely to develop prediabetes (2). You may develop prediabetes if:
- You are overweight or obese.
- Have an increased waist size (>40” for men and >35” for women).
- Have a strong family history of diabetes.
- Are over 45 years of age.
- Consume a very processed diet.
- Are physically inactive.
- Smoke regularly.
- Have PCOS.
- Have gestational diabetes (diabetes during pregnancy).
- Are African-American, Hispanic/Latino-American, American-Indian, Pacific Islander, or Asian-American.
Before you jump to conclusions, you must know the tell-tale signs of prediabetes and how to confirm it. In the following section, you will learn about the symptoms and diagnosis of prediabetes. Scroll down.
Symptoms And Diagnosis
Unlike many other diseases and conditions, prediabetes does not have any symptoms. However, if you have a family history of diabetes or are overweight or obese, have PCOS, and are over 45 years of age, it is a good idea to get your blood glucose levels checked. Gariglio-Clelland says, “The most accurate way to diagnose prediabetes is through a hemoglobin A1C test, which measures your average blood sugar over the past 60-90 days. A normal A1C is below 5.7, whereas prediabetes is diagnosed with an A1C of 5.7-6.4 (6.5 is the beginning of the diabetes range).”
If you are diagnosed with prediabetes, switch to a prediabetes diet. A study published in the journal Nature confirms that a poor quality diet poses an increased risk of developing prediabetes (7). A study was conducted on the dietary pattern of 1761 Chinese people of 45-59 years of age for over a year. The researchers concluded that a Western-pattern diet posed a higher risk of prediabetes compared to a diet comprising of grains and vegetables (8).
A BMJ analysis reports that a low-calorie and low-carbohydrate diet is a promising nutritional intervention for prediabetes (9). What are these foods that are nutritious yet low in calories and carbs? Which foods are high in carbs? Check out the list of prediabetes foods to eat and avoid below.
Prediabetes Diet Foods List As Per Expert Recommendations
Prediabetes diet is all about making smart food choices. Mary Wirtz (MS, RDN, CSSD) advises, “Consider substituting fresh fruit or a handful of almonds for your nightly bowl of ice cream.” She adds, “Also, there are many nutritious foods to include regularly – vegetables, fruits, grains (ideally whole grains, more than 50% of the time), protein including fish, skinless poultry, beans and lentils, low-fat dairy, and healthy fats.”
Jill Weisenberger (MS, RDN, CDCES, CHWC, FAND, and Author of Prediabetes: A Complete Guide) says, “I always recommend avoiding sugary drinks like sodas and teas. They are linked to an increased risk of prediabetes and type 2 diabetes. I’m a big fan of a Mediterranean-style diet to dial back prediabetes. I also recommend oats and barley because they have the fiber called beta-glucan, which helps improve insulin sensitivity.” Diana Gariglio-Clelland (RD, Certified Diabetes Care & Education Specialist) advises limiting sugar-sweetened beverages, refined carbs like sweets, white bread, etc., and focus on whole foods instead of overly-processed foods that are low in fiber and nutrients.
Keeping the experts’ recommendations in mind, here’s a downloadable list of foods to eat and avoid if you have prediabetes.
Weisenberger also reminds us not to overeat. She says, “Reducing your food intake will lessen insulin resistance even without large amounts of weight loss. For those people with overweight or obesity, I recommend aiming to lose 5-7% of your starting weight.” Also, practice portion control to get maximum benefits. But if you are not sure how to design your diet, here’s a sample prediabetes diet chart to get you started. Take a look!
Sample Prediabetes Diet Chart
|Meals||What To Eat|
|Early Morning (6:00a.m.)||2 teaspoons fenugreek seeds soaked in a cup of water overnight|
|Breakfast (7:00a.m.)||2 soft-boiled eggs (or baked beans) + 4 almonds + 1 cup milk (or soy milk or green tea)|
|Mid Morning (10:00a.m.)||1 cup muskmelon/1 apple + ½ cup plain yogurt|
|Lunch (12:30p.m.)||3-5 oz tuna/chicken/tofu + 1 cup boiled/raw vegetables + ½ cup greens + 350 ml buttermilk|
|Snack (3:30p.m.)||1 cup green tea + 1 digestive biscuit|
|Dinner (6:30p.m.)||1 cup lentil soup with veggies or 3 oz. grilled fish with vegetables + 1 cup milk with a pinch of turmeric before bed|
Apart from eating healthy, you must also tweak your lifestyle. Here’s a list of favorable lifestyle changes that can help reverse prediabetes.
Prediabetes Lifestyle Changes
Data suggests that lifestyle changes decrease the risk of prediabetes progressing to diabetes for about 10 years (10)! Here are the recommended lifestyle changes:
- Exercise Regularly
Exercising is extremely beneficial if you are overweight, obese, or have PCOS. The American Diabetes Association confirms that exercising helps manage blood glucose levels (11). Working out also helps burn calories and improves fitness, balance, limb and eye coordination, reflex, and flexibility. Most importantly, exercising regularly helps release endorphins that improve your mood and mental wellbeing.
Choose an exercise routine that you love, have fun doing, and can adhere to. If you love sports, play sports to stay active. You can choose running, swimming, dancing, bodyweight exercises, weight lifting, HIIT, kickboxing, etc. There is no one-size-fits-all here. Mix up your workout routine (cardio and strength training every alternate day) to get the maximum output.
- Sleep Well
Poor sleeping habits, not getting enough sleep, and sleep disorders are closely related to developing diabetes. Scientists believe a sedentary lifestyle, smoking, increased food intake, insulin resistance, and overuse of alcohol are interlinked with poor sleep quality and diabetes risk (12).
This is another reason to exercise regularly and eat healthily. Rebalancing the hormones, reducing inflammation and hunger hormones, and improving mental wellbeing are key to improving your sleep (13), (14). Turn off your electronic gadgets, read a book, and maintain a strict bedtime to sleep well.
- Reduce Stress
A study found a significant association between hypertension, physical activity, BMI, and diabetes. Scientists found that moderate to high stress levels caused a 2.3-fold increase in the odds of diabetes three years later (15). Reducing stress comes with practice and patience.
For starters, exercise to release the beneficial endorphins. Gradually get into practicing meditation. Pick up a hobby and learn a new skill to keep yourself occupied. Keep short-term goals and reward yourself for every milestone you achieve.
These are the main lifestyle changes that can help you reverse prediabetes and prevent it from progressing to full-blown diabetes. However, are dietary and lifestyle interventions enough? Scroll down to know more.
Are Food And Lifestyle Changes Enough To Reverse Prediabetes?
Food and lifestyle changes are effective most of the time. However, factors leading to prediabetes are complex, and different people respond differently to dietary and lifestyle interventions. Wirtz agrees. She says, “Each individual is truly different, though it [diet and lifetsyle] plays a large role in helping to prevent the progression to type 2 diabetes.”
The best way to know if you are responding to nutritional therapy and lifestyle change intervention is to get your blood glucose checked every four weeks. Talk to your doctor to see if you need to go on medications.
Prediabetes is a condition that needs immediate attention. Act now to potentially reverse prediabetes and prevent its progression to diabetes a few years later. Talk to your doctor to see if you need to go on a prediabetes diet. If yes, give your kitchen and pantry a makeover. Donate all the salty, sugary, high-calorie, and high-carb foods in your house. Exercise regularly, meditate, and sleep well. Adhere to the plan, and you will start reaping the benefits soon.
Expert’s Answers For Readers’ Questions
What are the treatments for prediabetes?
Changing your diet and lifestyle works well to reverse prediabetes. Choose vegetables, low GI fruits, whole grains, lean protein, and healthy fats. Do not consume salty and sugary foods. Exercise regularly, meditate, and sleep well to see improvement.
What are the warning signs for prediabetes?
Fasting plasma glucose at 7.0 is a tell-tale sign that you have prediabetes. You can also experience blurred vision and frequent urination.
What level of A1C is dangerous?
A normal A1C is below 5.7, while prediabetes is diagnosed with an A1C of 5.7-6.4.
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- Healthy Eating for people at risk of diabetes or with prediabetes
- Prediabetes – Your Chance to Prevent Type 2 Diabetes
- Prediabetes: A high-risk state for developing diabetes
- The Effectiveness of Different Diet Strategies to Reduce Type 2 Diabetes Risk in Youth
- Prediabetes: A high-risk state for developing diabetes
- Pathophysiology of prediabetes
- Association between Dietary Quality and Prediabetes based on the Diet Balance Index
- Association between dietary patterns and prediabetes risk in a middle-aged Chinese population
- Dietary and nutritional approaches for prevention and management of type 2 diabetes
- Prediabetes and Lifestyle Modification: Time to Prevent a Preventable Disease
- Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association
- Sleep Duration and Diabetes Risk: Population Trends and Potential Mechanisms
- Oxidative stress and inflammatory markers in prediabetes and diabetes
- Sleep Disturbance Sleep Duration and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation
- Stress increases the risk of type 2 diabetes onset in women: A 12-year longitudinal study using causal modelling