Are your blood sugar levels often higher than usual? Do you have a genetic predisposition for diabetes but haven't been diagnosed with it yourself? Do you feel tired, have blurred vision, and increased thirst? If any of this sounds familiar, you may want to check with a healthcare professional about prediabetes.
Someone is generally diagnosed with prediabetes when they have higher than normal blood sugar levels, but these levels are not high enough to be considered type-2 diabetes. If you're wondering whether you have prediabetes or diabetes, we encourage you to speak with your doctor.
While prediabetes is reversible, remember that it's not a benign condition. Many people assume that prediabetes is not severe because they do not yet have diabetes. But according to the CDC, when someone is diagnosed with prediabetes and doesn't take any action (medication or lifestyle changes), there is a good chance they will develop diabetes within five years.
People with prediabetes have higher than normal blood sugar levels, but this is a simplistic view of the condition. The pathophysiology of prediabetes is more complex, with the condition often beginning with insulin resistance within the body's cells. It means that when you eat carbohydrates, you have to release more insulin to overcome the insulin resistance in your cells.
Think of insulin as a key that allows glucose to move into your cells. Your pancreas secretes insulin from what’s known as Beta cells. Over time, your pancreas cannot keep up with the increased need for insulin, and blood sugar levels start to rise. Remember, although you can't control genetics or family history, there are factors here within your control like your weight, activity levels, and diet.
Still, data from the Diabetes Prevention Program is promising. It focused on participants who were encouraged to make healthy changes to their diet and increase activity. The results found that people diagnosed with prediabetes could reduce their risk of diabetes by 58 percent with specific lifestyle changes. These included improving their diet and starting an exercise program to lose at least five percent of their body weight.
Some of the dietary changes, in particular, included reducing processed foods, eating more fruits and vegetables, and being mindful of food intake. Wondering how to incorporate some of these but don't know where to start? This article will dive into more specifics on what foods to include to prevent diabetes and what foods to limit.
Tips for Healthy Eating if You Have Prediabetes
Whether you know you have prediabetes or suspect you may be at risk, it's a good idea to see what you should and shouldn't include in your diet. Read on for tips and tricks to maintain a healthy, prediabetes-preventive diet.
Eat More Non-Starchy Vegetables
Non-starchy vegetables are lower in carbohydrates than their starchy counterparts. Some starchy vegetables include potatoes (all types including sweet potatoes), corn, beans, lentils, peas, yams, and winter squash (acorn, pumpkin, and butternut). Non-starchy vegetables include carrots, Brussels sprouts, leafy greens, broccoli, mushrooms, tomatoes, peppers, onions, and beets, amongst a few.
But why pick them? Non-starchy vegetables are full of nutrients, including vitamins, minerals, phytochemicals, and antioxidants. Inflammation is a crucial component of diabetes, so eating a diet that can help reduce inflammation can be a helpful way to prevent this disease.
In addition, they have both insoluble and soluble fiber, which can fill you up without adding extra calories to your diet. It also aids in digestion and provides prebiotics, enhancing your gut microbiome. There is increasing research about the link between gut microbiome and diabetes. It suggests that a healthy gut microbiome may help reduce your risk of developing diabetes.
Another thing to note here is that Americans don't have enough vegetables in their diet. The current recommendations are around two to three cups of non-starchy vegetables per day, but a larger amount (approximately three and a half to five cups a day) is likely better for most people!
Add Nuts and Seeds to Your Diet
Do you eat enough nuts and seeds daily? If not, you may want to consider adding them to your diet. Nuts include almonds, walnuts, pecans, Brazil nuts, macadamia nuts, and pistachios. Seeds include pumpkin, chia, flax, sunflower, hemp seeds, and sesame seeds.
Both are nutrient-rich foods that can help with a prediabetic-preventive lifestyle. Seeds, in particular, contain healthy monounsaturated fats and polyunsaturated fats. They're also a good source of fiber and contain vitamins, minerals, phytochemicals, and antioxidants—all part of a healthy diet. There is also some evidence that nuts and seeds can improve cardiovascular health and prevent type 2 diabetes.
Try Food that is Low on the GI Scale
The glycemic index (GI) is a value used to determine how much a food increases blood glucose. It's measured on a scale from 0-100, with 100 being pure glucose. If food is lower on the GI scale, it will likely have a lower glucose response for most people. This lower response is good news for people with prediabetes, who may have decreased insulin sensitivity.
Here is a helpful tool to look for the glycemic index of specific fruits and vegetables. Processed grains such as white bread, white rice, and pastries are higher in GI. Low GI foods are typically those non-starchy vegetables such as broccoli or asparagus we mentioned adding to your diet. It's also possible to combine certain foods to lower your post-prandial responses.
For example, combining a high GI food with protein and/or fat is a good idea. It can help slow your digestion and may reduce your glucose response. Another option is eating the protein food first, followed by the higher GI food. Remember that portion size does matter here, so the protein likely won't help if your portion of the high GI food is more significant.
Eat More Food That is Rich in Fiber
Fiber is also known for slowing down digestion, and it also adds bulk to the foods we eat. Because fiber is not digested in your small intestine, it does not contribute to the calories you eat. Because fiber is not digested like other types of carbohydrates, it is subtracted from total carbohydrates when referencing 'net’ carbs. By adding foods higher in fiber to your daily meals, you can improve cardiovascular health and possibly reduce your risk of developing diabetes.
High-fiber foods include beans, lentils, non-starchy vegetables, nuts and seeds, some fruits, and whole grains like oatmeal, quinoa, and barley. Studies show that fiber reduces cholesterol, fasting blood glucose, and hemoglobin A1C.
Have Whole Fruit Paired with Protein as a Snack if Needed
Fruits are a good source of vitamins, phytochemicals, and antioxidants and are also full of fiber. Fruits also contain sugar, which can increase blood sugar levels, so it's essential to consider the type of fruit, how you prepare it, and how much of it you eat. Good choices include berries, melon, apples, and oranges, as they are higher in fiber.
It's best to limit your fruit juice intake because all the fiber is processed out of it, and it's much higher in sugar. For instance, an eight-ounce glass of orange juice can contain the same amount of sugar as two to three oranges. Dried fruit can also be a challenge because it becomes more concentrated in sugar when taking out the water. Remember that one-fourth cup of raisins contains about the same amount of sugar as a cup of grapes. Dried fruit (like dried cranberries and dried mango) often has sugar added to increase the sweetness. If you have dried fruit, try to find the kind that does not have added sugar, and be mindful of your portion size.
Pairing fruit with protein as a snack or using a portion of fruit as your carbohydrate choice with a meal could be great options for incorporating fruit into your diet. The protein helps slow down your digestion and may help decrease your glucose response from the fruit in that meal or snack.
Limit Grazing and Snacking
Snacks aren't all bad, but it's best to limit the amount of snacking throughout the day. A certain amount of insulin is released each time you eat, which increases if your meal contains carbohydrates. Meals high in protein lead to the release of small amounts of insulin.
When you're looking to preserve pancreatic function, and its ability to release insulin, it's crucial to give the pancreas some time between meals. If you're constantly snacking, your pancreas has to work that much more often to release insulin!
Enjoy Good Quality Protein Sources
Protein does not raise the glucose levels in your blood, so it's a good choice for people with prediabetes. Also, pairing a good quality protein with carbohydrates can help decrease your glucose response to the carbs. It's because protein takes longer to digest and can slow the digestion of food rich in carbohydrates.
Protein-rich foods include meat, poultry, fish, dairy products (cheese, cottage cheese, yogurt), eggs, and tofu/tempeh. Some foods that have protein also contain carbohydrates, including beans and lentils or grains such as quinoa. Nuts and seeds have some protein, but something to consider is that some nuts are higher in carbs than others!
Practice Meal Sequencing
According to some research, eating your protein before your starch or carbohydrates can improve your glucose response and may even help suppress appetite. Consider a meal with steak, Brussels sprouts, and potatoes as an example. In this situation, you would want to eat the steak first, followed by Brussels sprouts (non-starchy vegetables), and finally, the potatoes.
Hydrate, Hydrate, Hydrate!
When you're dehydrated, it can increase the glucose concentration in your blood. This study links dehydration with glucose dysregulation in normal healthy adults. Research also indicates that chronic low water intake can increase the risk of elevated blood sugar and possibly even diabetes. So, staying hydrated can be critical with or without prediabetes.
The daily fluid requirement is probably more than the eight-glass recommendation you've likely heard. And your need for fluid also increases if you live in hot and humid environments. According to US National Academies of Science, Engineering, and Medicine recommendations, men require 15.5 cups of fluid a day, and women need 11.5 cups.
If you have a hard time knowing what 'enough' is when it comes to your water intake, try using a water bottle throughout the day to measure how many ounces you’re drinking. Also, consider flavoring your fluids with a bit of lemon or non-sugar-containing flavoring. If you like carbonated beverages, try seltzer water. Remember that while tea and coffee do contain fluids, caffeinated drinks can also be considered a diuretic, which can increase urination.
Watch Out for Added Sugars and Refined Carbohydrates
Many processed foods contain added sugars. It may even be present in dried fruit, pasta sauce, and canned soups. So, it's vital to look at the label to see if your food contains any added sugars. You'll be surprised how much of it does!
Food packaging can also be deceptive. Things labeled as containing whole grains (like flavored instant oatmeal) can also be full of added sugars. It's also why you should be looking at the nutrition facts label and the ingredient list. Is the first ingredient whole grain? If not, it's likely not a good choice.
Also, watch out for refined carbohydrates—mostly refined grains—which means all healthy ingredients (including the fiber and nutrients) are missing. Refined carbs can increase the food's glycemic index, leading to a more significant glucose response.
Discover Your Personal Carbohydrate Threshold
Everyone responds differently to carbohydrates. In addition, glucose responses may vary for different types of carbohydrate foods. The carb threshold for a meal can also depend on other factors, including how active you are or what food you ate before the meal.
It might be a good idea to find your specific carbohydrate threshold or what amount of carbs you can tolerate without having a larger glucose response. You can do this with a finger-stick device, measuring your glucose around one or two hours post-meal. Still, there are limitations to this method as it does not give you the complete picture. An excellent way to check how you respond is with a continuous glucose monitor or CGM. A CGM will help you see if you have a more considerable glucose spike with a meal containing carbs and how quickly your values return to baseline.
Prediabetes Diet Plan to Use (1,500 calories)
Everyone has unique dietary and energy needs, so this is just a sample plan, but it can be a good starting point if you are looking for some ideas! Read on to add our dietitian, Katie Kissane's helpful prediabetes ideas to your meal plan.
Breakfast parfait with a cup of plain Greek yogurt, ½ cup of blueberries, two tablespoons of walnuts, and one tablespoon of seeds such as chia, sunflower seeds, or flax seeds. Add an optional ¼ teaspoon of cinnamon.
Nutrition: 360 calories, 29 grams of protein, 24 grams of carbohydrates, 18 grams of fat
Two egg muffins.
Nutrition: 200 calories, 16 grams of protein, 8 grams of carbohydrate, 12 grams of fat
A salmon salad with four ounces of salmon (grilled, baked, or smoked), two cups of leafy greens, ¼ cup of sliced cucumbers, seven cherry tomatoes, and a diced carrot. Add a Balsamic vinaigrette dressing made with olive oil, and eat it with a serving of almond crackers (our favorites are the ones from Simple Mills).
Nutrition: 522 calories, 38 grams of protein, 37 grams of carbohydrates, 25 grams of fat
Three to four ounces of lean chili lime flank steak or 1 cup of marinated and scrambled tofu, one cup of cilantro-lime cauliflower, ½ cup of black beans, ½ an avocado, sliced.
Nutrition: 440 calories, 36 grams of protein, 33 grams of carbohydrates, 19 grams of fat
1,522 calories, 119 grams protein, 100 grams carbohydrates, 74 grams fat
Try These Recipes
From a delicious flank steak to some roasted cauliflower and some delicious egg muffins, your prediabetic meal plan can be healthy and tasty. Here are a few of Kissane's favorites, with some modifications, so you can start your meal planning on a delicious note!
Chile Lime Flank Steak
- 3 tablespoons lime juice
- 1 teaspoon raw honey
- 2 cloves garlic, minced
- 1 teaspoon ground chile pepper
- 1 tablespoon dried cilantro or ¼ cup fresh cilantro
- 1 pound flank steak, trimmed
- Combine lime juice, honey, garlic, chipotle pepper, and cilantro in a large zip-top plastic freezer bag; add steak.
- Seal and chill for four hours or overnight.
- Preheat broiler. Remove steak from marinade; discard marinade, then place the steak on a rack rubbed with oil in a broiler pan.
- Broil for five minutes per side or to desired doneness.
- Let it stand five minutes before thinly slicing across the grain.
Pro Tip: You can also use chicken thighs instead of the flank steak.
Cilantro-lime Roasted Cauliflower
- 2-3 cups of cauliflower florets (from 1 pound of cauliflower)
- 1 garlic clove, minced
- 1 tablespoon olive oil
- 1 teaspoon cumin
- Sea salt to taste
- ¼ cup crushed red pepper flakes or cayenne pepper
- 1 teaspoon tablespoon of lime juice
- 1 teaspoon lime zest
- 1 tablespoon chopped cilantro
- Preheat oven to 450 degrees F.
- Place cauliflower florets and minced garlic on a large rimmed baking sheet and drizzle with olive oil.
- Season with cumin, salt, and crushed red pepper or cayenne pepper, and toss the cauliflower until coated.
- Bake in the center of the oven until lightly browned and tender, about 25-30 minutes, turning the florets occasionally until evenly cooked.
- Remove from the oven, squeeze lime juice on top, add lime zest and cilantro, and serve warm.
- 1 bell pepper
- 3 green onion, sliced
- 1-2 tomatoes
- 6 eggs
- A handful of spinach/ leafy greens
- ¼ cup of shredded Monterey Jack or cheddar cheese
- ½-1 teaspoon sea salt
- 4-5 splashes of hot sauce
- 6 slot muffin tin (double that if you double the recipe)
- Muffin cups or nonstick cooking spray
- Preheat the oven to 390 degrees F.
- Wash and dice the pepper, onion, and tomatoes and put them in a large mixing bowl.
- Wash the spinach, lightly chop it and add it to the bowl as well.
- Add the eggs and salt. Mix well.
- Grease the muffin tin with oil and kitchen paper/baking brush and pour the egg mixture evenly into the muffin slots. (If you think they might still stick to the pan, use some muffin cups or cut out some baking paper to use as cups—definitely saves time cleaning up!)
- Layer cheese on the egg mixture before you put it in the oven
- Pop the tray into the oven for 15-18 minutes or until the tops are firm to the touch.
Pro Tip: Crack the egg separately before adding it in. So, if you get a dodgy egg, it won't ruin the entire meal. You can also optionally add in some hot sauce.
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