What is the best prediabetes diet? That may be a burning question on your mind if you have been recently diagnosed with prediabetes, or if you have known about your prediabetes for a while now.
Even if you have not been told that you have prediabetes, you could be worried about it, since 90% of the people with prediabetes are unaware that they have it. You are at higher risk if you are over 45 years old, do not get much exercise, have a family history of diabetes, or are African American, Native American, Hispanic/Latino, or Pacific Islander.
What's more is that you are at risk if you are overweight, have high "bad" LDL cholesterol or high triglycerides, or low "good" HDL cholesterol. What these have in common is that you can improve them with diet.
Most people with prediabetes eventually get diabetes, but here's a secret: it doesn't always have to happen. You can prevent or delay type 2 diabetes in large part by following a healthy diet for prediabetes, learning the causes of prediabetes – no gimmicks necessary.
Awareness of prediabetes could be the best thing that ever happened to you. It gives you the chance to find a prediabetic diet that works for your health and for your lifestyle. Once you decide to make those healthy changes, you are more likely to succeed with a support system that works for you, and a health app could be what you need for information and accountability.
Prediabetes Diet Plan
A prediabetes diet plan can help your blood sugars get closer to or even within healthy ranges. In prediabetes, your blood sugar is higher than normal, but still lower than in diabetes. Your doctor may tell you that you have prediabetes if you have:
- Fasting blood sugar level of 100 to 125 mg/dl,
- An oral glucose tolerance test of 140 to 199 mg/dl, or
- Glycated hemoglobin (A1c) of 5.7 to 6.4%.
While you have some insulin resistance, your body is still producing and responding to insulin – and that's great news. It means you can put together a nutritious plan that follows pre-diabetic diet recommendations, and expect better health.
Best Diet Plan to Reverse Prediabetes
A great thing about prediabetes is that it is often reversible. In most cases, you do not even need medications. All you may need are the right diet plan, additional healthy lifestyle choices such as exercising and avoiding smoking, and a lot of dedication and patience.
There is no single best diet plan for prediabetes. If you ask 100 people, "What is the best diet for prediabetes?," you may get 100 different answers – and they may all be correct. Your plan should help you control your weight, provide the nutrients and healthy foods you need to lower risk for diabetes and other chronic diseases, and fit into your lifestyle so that you can make it work for the long term.
Right Weight
Extra pounds are among the most significant modifiable risk factors for prediabetes and diabetes, and the prediabetes diet plan that you choose should help you achieve and maintain a healthy weight. While a "healthy" BMI is considered to be under 25 kg/m2 (that is 155 lb. for a 5'6" woman and 179 lb. for a 5'11" man), it may not be necessary to get under that weight to lower your risk. Losing as little as 5% of your body weight – or 8 to 10 lb. if you weigh 160 to 200 lb. – can decrease diabetes risk.
Right Nutrition
Aside from weight, certain nutrients are linked to improved health and lower diabetes risk. For example, increasing consumption of vegetables, fruits, and beans, eating more whole grains instead of refined, and choosing olive oil can all lower diabetes risk. Limiting sweets, refined carbohydrates such as white bread and pasta, and unhealthy fats from fried foods and fatty meats are examples of dietary patterns to slow any progression of prediabetes.
Right Lifestyle
If you do not follow the diet plan, it will not work. Any diet, no matter how nutritionally perfect, needs to fit into your lifestyle. Your prediabetic diet needs to:
- Include foods you love to eat.
- Allow for indulgences and special occasions, so you can satisfy the occasional craving and fit in a party or work event without going off your diet plan or feeling guilty.
- Rely on "regular" foods and ingredients that your local supermarket carries.
- Require you to spend only the amount of time in the kitchen that you want, rather than requiring gourmet recipes for all three meals.
Low-Carbohydrate and Ketogenic Diets for Prediabetes
Low-carbohydrate diets have gotten a lot of attention recently as strategies for reversing prediabetes. The carbohydrates in your diet that provide calories include sugars and starches. Starches are in grains and flour, beans, and starchy vegetables. Added sugars include sugars in sweets, sweetened foods such as flavored oatmeal and ketchup, and sugar-sweetened beverages such as soda. There are also natural sugars, which are found in nutritious foods such as dairy products and fruit.
Proponents of low-carbohydrate weight loss diets, such as Atkins, claim that the diet can help you lose weight because instead of burning dietary carbohydrates for fuel, you burn body fat because you are eating so few dietary carbohydrates. The diet can help you cut calories by:
- Eliminating or severely restricting high-calorie foods such as sweets and refined carbohydrates.
- Promoting satiety by increasing protein and fat, which are filling nutrients.
- Reducing appetite by reducing the food choices available to you.
Low-Carb Diets and Prediabetes
Sugars and starches that you get from your diet enter your bloodstream as a type of sugar called glucose. In prediabetes, your body has trouble managing the glucose in your blood due to resistance to a hormone called insulin. Normally, insulin is able to help your body keep blood glucose levels in check, but the effect is weaker if you have prediabetes, so blood glucose rises.
There is research supporting reduced-carbohydrate diets in the treatment of prediabetes. Reducing your sugar and starch intake may lower blood sugar levels by preventing as much sugar from going into your blood. It can also help reverse insulin resistance.
Reduced-carbohydrate diets range from moderate to very low-carb. The rest of your calories come from protein and fat, so you might depend more heavily on high-protein and high-fat foods than the average person.
Ketogenic Diet for Prediabetes
A ketogenic diet is a type of low-carbohydrate diet that is on the extreme end. The goal is to limit carbohydrates so much that the body does not have enough glucose – a type of carbohydrate – to fuel the brain normally. Instead, the body shifts to a metabolic state called ketosis, and produces ketone bodies to fuel the brain's activities.
The theory behind a ketogenic diet for prediabetes is that when your body is in ketosis, you can be sure that you do not have excess carbohydrates in your diet. Since carbohydrates in your diet are broken down into glucose that goes into your bloodstream, being in ketosis assures that you are not inundating your bloodstream with excessive amounts of glucose due to the foods you eat.
A ketogenic diet for prediabetes might include about 20 to 50 grams per day of non-fiber carbohydrates, or about 5 to 10% of total calories from carbohydrates. The rest of your calories come from fat and protein. The food choices on this diet are similar to those on other low-carb diets, but you may need to further restrict some of the moderate-carbohydrate options that might be easier to fit in on a more moderate low-carb diet. Examples include fruit (an apple has 24 grams of non-fiber carbohydrates) and starchy vegetables (a half-cup of corn has 15 grams of non-fiber carbs).
Healthy Diet for Prediabetes
A healthy diet for prediabetes does not necessarily need to be low in carbohydrates. According to U.S. News and World Report rankings, the two types of diet for prediabetes and high cholesterol in 2018 are moderate diet patterns. A Mediterranean diet pattern is ranked first, followed closely by the Dietary Approaches to Stop Hypertension, or DASH, diet.
Mediterranean Diet Pattern for Prediabetes
A Mediterranean-style diet is based on traditional eating patterns of Mediterranean countries, especially Greece, southern Italy, and Spain. This way of eating is known for its heart-healthy benefits, but research also shows that it can also help in weight loss and assist in blood sugar control.
Compared to the average American diet, a Mediterranean diet pattern generally includes more:
- Olive oil
- Vegetables
- Legumes (beans, peas, lentils, and soy)
- Whole grains
- Fruits
- Nuts
It includes moderate consumption of poultry and fish, and less:
- Full fat dairy products
- Red meat
- Sweets
DASH Diet for Prediabetes
The DASH diet may have been developed for reducing high blood pressure, but don't let that fool you. The DASH may also be good for weight loss, bone health, mental health, heart health, and prediabetes prevention. To get from an average American diet to a DASH-style pattern, you can:
- Boost your intake of vegetables and fresh fruit.
- Eat more low-fat dairy products and beans.
- Choose whole grains more often.
- Choose fish, poultry, and lean meat instead of fatty red meat or processed meat.
- Reduce the amount of sweets you have.
The DPP Diet and Coaching for Prediabetes
The Centers for Disease Control and Prevention, or CDC, have developed a program with diet and lifestyle changes that has been shown among prediabetes patients to reduce the risk of developing diabetes by over 50%. This program is the Diabetes Prevention Program, or DPP.
Each DPP program includes a year-long lifestyle change curriculum delivered via lessons put together by the CDC. Lesson topics include nutrition, physical activity, managing stress, and fitting your healthy choices into your and your family's lifestyle.
You can find an in-person DPP program to attend, or see whether you are eligible for a digital program. Lark Health Coach, for example, is a CDC DPP program that delivers the program via your smartphone, on your time. Lark also helps with tracking weight, food, and exercise, and customizes the program according to preferences such as low-carb, gluten-free, or vegan.
Lark's prediabetes diet recommendations are consistent with the DPP and include recommendations based off evidence from diets such as the DASH diet and Mediterranean patterns. Your Lark coach, for example, might suggest:
- Choosing fruit instead of dessert.
- Steaming, baking, or grilling instead of frying.
- Using olive oil instead of butter or shortening.
- Trying plant-based proteins or fish sometimes instead of red meat.
- Enjoying your meals and having them in a pleasant environment.
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Sample Diet Plans for Prediabetes
The prediabetes diet plans below are designed to help you lose weight, improve your blood sugar control and overall health, and be easy to follow. Each plan has about 1,200 to 1,400 calories per day. If you need more, you can add in one or more of the healthy snack options listed below the menus. There is are one-week menus for a low-carb ketogenic diet and for a balanced, DPP-based prediabetes diet, and snacks listed for both types of diets.
Be sure to:
- Drink plenty of water.
- Check with your doctor before starting the plan.
- Modify the plan to meet your dietary needs and preferences.
Low-Carb Ketogenic Recipes
Cauliflower Turkey Hash
(Serves 4)
Ingredients
1 lb. cooked fresh or frozen cauliflower, chopped
1 lb. lean ground turkey
1 tablespoon olive oil
1 onion, chopped
1/2 teaspoon dried thyme
1/4 teaspoon pepper
4 eggs
Directions
Heat the oil in a pan. Add the onion and ground turkey; stir until the turkey is browned. Add the spices and cauliflower. Add the eggs and stir until the eggs are cooked.
Spinach Cheddar Frittata
(Serves 4)
Ingredients
1 tablespoon of olive oil
10 oz. frozen cooked or fresh spinach
8 oz. sliced zucchini
4 eggs plus 8 egg whites
4 oz. cheddar cheese
Directions
Cook the vegetables in a hot pan with oil. Mix with the eggs and cheese. Pour into a greased pan, and bake at 400 degrees until the eggs are set, or about 25 minutes.
Chicken Chili
(Serves 4)
Ingredients
1 lb. chicken breast, cubed or shredded
1 T. olive oil
1 onion, diced
1 clove garlic, chopped
1 jalapeno pepper, seeded and chopped
1 cup low-sodium chicken broth
1 cup low-sodium canned white beans
1/2 teaspoon cumin
1/2 cup fresh cilantro
2 oz. shredded cheese
1 avocado, sliced
Directions
Heat the oil in a pan and add the chicken, garlic, onion, and jalapeno. Cook. Add the broth, beans, and cumin, bring to a boil, then simmer for 15 minutes. Stir in the cilantro. Serve, topped with cheese and avocado.
Low-Carb Ketogenic Snacks
1/4 cup cantaloupe and 1 string cheese stick
1 cup cucumber sticks and 1/2 cup plain Greek yogurt
1 oz. almonds
1 cup bell pepper strips and 2 tablespoons hummus
1 string cheese stick or 1 oz. other cheese
1 hard-boiled egg
1 cup cooked broccoli florets with 1 oz. cheese melted on top
1 oz. unsweetened 100% dark chocolate
Caprese salad with 1 oz. mozzarella cheese in small cubes, plus 1/2 cup cherry tomatoes, fresh basil, and 1 teaspoon of olive oil
1/2 can tuna mixed with 2 tablespoons of yogurt and 1 tablespoon of diced celery, spread on hollowed-out cucumber halves or hard-boiled egg white halves.
1 small avocado
Mini skewers with 2 oz. of skinless cooked chicken breast and 1 oz. of mozzarella cheese, both cubed, and button mushrooms.
Add snacks as needed
Balanced DPP Recipes
Oatmeal Pancakes
(Serves 2)
Ingredients
1 cup of rolled or quick-cooking oats
3/4 cup warm milk
2 tablespoons ground flaxseed
1 egg
1/4 cup whole-wheat flour
1 teaspoon baking powder
Directions
Let the oats soak in the milk for 20 minutes. Blend in the other ingredients. Pour in spoonfuls onto a heated griddle with cooking spray, and turn over when edges bubble. Serve warm.
Quinoa Salad
(Serves 4)
Ingredients
2 cups quinoa cooked in low-sodium broth
1/2 onion, diced
2 large tomatoes, diced
1 cup low-sodium canned black or kidney beans
1 tablespoon of lime juice
4 ounces of cheddar or jack cheese
1/2 teaspoon cumin
1 cup of mango or kiwi in pieces
Directions
Combine all ingredients and let sit together until time to serve.
Shepherd's Pie
(Serves 4)
Ingredients
1 lb. peeled and cooked sweet potato
1/4 milk
Dash nutmeg
1/2 cup shredded parmesan cheese
1 diced onion
1 tablespoon olive oil
2 cloves crushed garlic
1 lb. ready to use textured vegetable protein (TVP) or soy crumbles)
1/2 cup low-sodium vegetable broth
12 oz. thawed frozen peas and carrots
Directions
Blend the sweet potato with milk, nutmeg, and cheese. Separately, cook the onions and garlic in a pan with the olive. Mix in the TVP, broth, and vegetables, and spread on a pan. Top with the sweet potato mixture, and bake at 425 degrees until set, about 20 minutes.
Balanced DPP Snacks
Any of the Low-Carb Snacks, plus any of the following…
1 cup raw vegetables, such as broccoli or cauliflower florets, bell pepper strips, or celery, carrot, or cucumber sticks, plus 2 tablespoons of hummus.
1 diced apple or pear in 1/2 cup cottage cheese, cinnamon optional.
1/2 cup fat-free refried beans with 1/2 oz. cheese melted on top, optional salsa and/or diced tomatoes
3 cups of air-popped popcorn plus 1 string cheese stick
1 cup of watermelon mixed with 1 oz. of feta cheese and mint leaves
1/2 can tuna with 1 oz. whole-grain crackers
1/2 whole-grain pita with 3 oz. cooked chicken breast, mustard, and lettuce and tomatoes.
1 cup of edamame in the pods
1 packet plain instant oatmeal made with almond milk, plus 1/2 cup berries
Sources
https://care.diabetesjournals.org/content/34/Supplement_2/S210
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3977406/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865541/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329646/
https://www.healthline.com/nutrition/ketogenic-diet-101#section6
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