Diet for Prediabetes and High Cholesterol

Prediabetes and high cholesterol have a lot in common, starting with how common they are: 1 in 3 American adults has prediabetes according to the Centers for Disease Control (CDC), and 1 in 8 Americans has high cholesterol.

Next, they can both be asymptomatic, so you may not know you have them until they become more serious, such as turning into diabetes or heart disease. They share many risk factors, such as being overweight or obese, having a family history of the condition, or eating a poor diet.

Prediabetes and high cholesterol also share something else. A prediabetes diet can also be a good diet to lower cholesterol. There are not any foods that are good for one condition but unhealthy for the other, so following a diet for one or the other is just fine if you have both, which is what the American Diabetes Association suggests (ADA)!

These are some of the best foods to lower blood sugar and cholesterol and how to fit them into your diet:

1. Whole Grains

Whole grains are consistently linked to lower risk for diabetes and lower cholesterol, as well as lower risk for hypertension and obesity. The tricks are to swap them for refined grains and to keep serving sizes in check. 

Choose instead of:

• White bread
• Pita
• Bagels
• English muffins
• Tortillas
• Rolls
• Refined pasta
• Pretzels and crackers
• Refined breakfast cereals
• White rice

Ways to enjoy:

• Sandwich on 2 slices of whole-grain bread instead of plain bagel.
• Soup with barley instead of pasta.
• Eating 1/2 cup of brown rice instead of 1 cup of white rice.
• Choosing 1 cup of oatmeal (1/2 cup of dry oats) instead of 1 cup of Cream of Wheat (farina).
• Substituting 1 cup of whole-wheat pasta for 1 bowl or plateful of white pasta.

Look for: products with a whole grain listed first; whole-grain bread, pita, bagels, English muffins, tortillas, and rolls; whole-grain pasta; brown rice; quinoa; barley; bulgur; oatmeal; whole-grain breakfast cereal

Watch out for: "multigrain" or other products with refined grains listed before whole grains; sugar-sweetened breakfast cereals and flavored oatmeal; calorie-dense granola

2. Non-starchy vegetables

If you like the idea of all-you-can-eat, non-starchy vegetables are a dream come true. They are so low in calories that it is (almost) always okay to have another serving. 

Choose instead of:

• Starchy sides such as potatoes and rice
• Chips
• Pasta-based bowls or plates

Ways to enjoy:

• Side salads with lettuce, tomatoes, and cucumber
• Main course salads with greens, any other vegetables, and a protein
• Steamed, baked, or grilled vegetables, such as green beans, broccoli, or zucchini.
• Raw vegetables, such as carrots, celery, and bell peppers, for a snack.
• Cooked in soups, pasta sauce, and casseroles.

Look for: lettuce; fresh or frozen spinach, and other greens; tomatoes; bell peppers; mushrooms; onions; eggplant; asparagus; cabbage; cauliflower; broccoli; brussels sprouts; carrots; zucchini; yellow squash; artichokes; snow peas

Watch out for: fried vegetables (such as zucchini stick or tempura); canned vegetables with sugar or salt added; vegetables prepared with cheese or cream (such as cheesy or creamy vegetable soups); salad kits with more croutons, chow mein noodles, bacon, and dressing than vegetables.

3. Monounsaturated Fats

Monounsaturated fats (MUFA) are a major part of the Mediterranean diet, which is known for lowering heart disease risk and may lower risk for type 2 diabetes. Olive oil is the major source of MUFA, traditionally, but there are other sources. The Mayo Clinic advises that MUFAs should be included in your diet.

They are healthiest in small servings, such as 1 to 2 teaspoons of olive oil, and when they substitute for less-healthy components, such as saturated fats. These are some ways to incorporate healthy fats into your diet.

Choose instead of:

• Heavy cream
• Butter
• Palm oil
• Fried foods

Ways to enjoy:

• Olive oil or canola oil instead of butter for cooking and baking
• Olive oil in salad dressings instead of creamy dressings
• Olive oil as a dip for bread instead of spreading butter or mayo
• Sliced avocado instead of cream on top of soup
• Olive oil-based hummus on bread instead of butter

Look for: olive oil; canola oil; avocados

Watch out for: big servings

4. Nuts and peanuts

Nuts and peanuts help lower cholesterol levels by blocking your body from absorbing cholesterol from food. They are linked to lower blood sugar levels and lower risk for obesity even though they are packed with calories and fat. They contain MUFA and other healthy fats and dietary fiber, and can be beneficial in small servings of 1/2 to 1 ounce. 

Choose instead of:

• Chips
• Crackers
• Cream cheese-based dips
• Breadcrumbs

Ways to enjoy:

• Peanut butter and pear sandwich on whole-grain bread
• Peanut butter instead of a creamy dip
• Ants on a log with celery, almond butter, and blueberries
• Cashew chicken stir fry with vegetables
• Sliced almonds on green beans
• Pecan-crusted tilapia instead of breaded, fried fish
• Walnuts in cereal or a fruit salad
• As a crunchy snack instead of chips

Look for: peanuts; peanut butter; cashews, macadamia nuts, Brazil nuts, hazelnuts, pecans, walnuts, almonds, pine nuts; almond and cashew butter

Watch out for: peanut butter with hydrogenated oils and added sugar; trail mix with candy, chocolate, or sugar-sweetened dried fruit

5. Fruit

Fruit makes a great swap for sugar-sweetened foods when you are trying to lower blood sugar and cholesterol. Nutrients such as fiber, potassium, and antioxidants can be responsible for some of its benefits. Since fruit can be high in carbs, it is important to watch serving sizes. These are some ways to use fruit to your advantage.

Choose instead of:

• Sugar-sweetened or starchy desserts
• Snacks

Ways to enjoy:

• Fresh fruit salad for dessert instead of a sugary dessert.
• Frozen pureed banana, with cinnamon or cocoa, instead of ice cream.
• Stewed apples with cinnamon instead of apple pie or baked apples with sugar.
• Berries and nuts for a snack instead of chips or cookies.

Look for: Fresh fruit, especially those high in fiber or lower in carbs, such as apples, pears, strawberries, blueberries, raspberries, blackberries, grapefruit, oranges, tangerines, cantaloupe, watermelon

Watch out for: frozen or canned fruit with added sugars; dried fruit, especially if sweetened (very high in calories and carbohydrates); fruit juice; fruit drinks with added sugars; fruit dishes that are mostly sugar, such as fruit pies and jelly

6. Fish

Fatty fish are uniquely high in heart-healthy fats called long-chain omega-3s, and lean fish have some, too. Eating fish may help lower bad "LDL" cholesterol while raising good "HDL" cholesterol and lowering risk for type 2 diabetes. Fish makes a good protein source.

Choose instead of:

• Red meat
• Poultry with skin
• Deli meats

Ways to enjoy:

• Canned tuna instead of Italian meats in a salad or sandwich.
• Roasted salmon or other fish instead of meat at dinner.
• Tuna or salmon cakes made with oats, instead of ground beef patties.
• Fish with Mexican seasoning in tacos instead of ground beef tacos.
• Instead of beef in a fish stir fry or stew.

Look for: salmon, tuna, mackerel, herring, anchovies, sardines, swai, tilapia, trout, halibut; grilled, baked, or broiled fish; broth-based fish soup

Watch out for: high-mercury species such as tilefish, swordfish, king mackerel, and shark; battered fried fish; fish chowder; tuna salad with mayonnaise; tuna casserole with pasta and cream

7. Plant-Based Proteins

Plant-based proteins are not just better for your blood sugar and cholesterol, but also for the environment, since they take fewer resources to produce. Environmental conscientiousness aside, plant-based proteins are cholesterol-free and often contain dietary fiber. Eating more of them, especially instead of red meat, can help you lower cholesterol and blood sugar.

Choose instead of:

• Red meat such as steak, ribs, and ground beef
• Sausages or hot dogs
• Deli meat
• Chicken and turkey with skin

Ways to enjoy:

• Fat-free pinto beans in a burrito with low-fat cheese
• Bean soup with low-sodium broth and mixed vegetables
• Tofu stir fry
• Lentil soup with low-sodium broth
• Veggie burger instead of beef burger
• Vegetarian chili with beans and (optional) soy crumbles or soy protein
• Taco with soy protein, mexican seasoning, lettuce, tomatoes, and avocado
• Whole-wheat spaghetti or spiralized noodles with tomato sauce and vegetarian meatballs

Look for: tofu, seitan; veggie or bean burgers; textured soy or vegetable protein (TSP/TVP); dried or low-sodium canned beans; lentils; split peas; low-sodium bean, pea, or lentil soup

Watch out for: hidden fats such as lard in refried beans; excessive sodium in meatless sausages or hot dogs

Prediabetes and high cholesterol often go together, but there is plenty of good news. For one thing, they can often be managed to lower the risk for progression to more serious conditions. For another, the same kind of diet can help them both. Lark Diabetes Prevention Program can help with both by providing personalized coaching in a diet and other choices that can fit into your lifestyle. Be sure to check any materials from your health insurance or contact them to see if you may be eligible for unlimited, anytime coaching.