The Right Prediabetes Diet For 2022
Two years ago, when routine lab tests showed that Joan Shelley, then a 52-year-old Sales Consultant in Atlanta, had a hemoglobin A1C reading of 5.8 percent, barely above normal, she was more confused than shocked because she did not know what to make of the test results.
“You are in a state of intermediate hyperglycemia which is considered prediabetes,” her primary care physician told her. Her A1C test results reaching 6 percent but still below the number that defines diabetes, which is 6.5, revealed that she had higher blood levels than normal but not high enough to be considered diabetes.
“The thought that maybe I’d get diabetes was very upsetting because I am already on cholesterol and high blood pressure medications,” recalled Ms. Shelley, who has no family health history of diabetes and had maintained a healthy lifestyle plus a regular weight. Though she did not show any symptoms at the time, she worried about how quickly it might become diabetes and steps she could take to reverse, prevent, or delay diabetes from developing.
The Centers for Disease Control and Prevention (CDC)Trusted Source estimate that 84 million U.S. adults have prediabetes. Perhaps even more concerning is that 90 percent do know they have the condition.
The key is early intervention — to get blood sugar out of the prediabetes range. Diet is important, and the need to know the right kind of foods to eat by following a healthy diet for prediabetes – no gimmicks required.
How Diet Relates to Prediabetes
There is no gold standard when it comes to the best diet plan for prediabetes. If you poll more than 100 participants in a survey on “What is a recommended diet for prediabetes?” you may get over 100 different answers – and still be right. No matter the diet plan you choose, it should help control your weight, provide the nutrients and healthy foods you need to lower the risk of diabetes and other associated chronic diseases and fit into your lifestyle in the long term.
The University of California (UC) Davis Medical Center study on Healthy Eating for Pre-Diabetes in the Clinical Dietitians, Food and Nutrition Services journal, “people think of carbohydrate as the culprit that causes prediabetes, but the amount and type of carbohydrates consumed in a meal is what influences blood sugar. A diet filled with refined and processed carbohydrates that digest quickly can cause higher spikes in blood sugar. In prediabetes, sugar from food begins to build up in your bloodstream because insulin cannot easily move it into your cells. For most people with prediabetes, the body has a difficult time lowering blood sugar levels after meals. Avoiding blood sugar spikes by watching your carbohydrate intake can help.”
The study also found that “when you eat more calories than your body needs, they get stored as fat. This can cause you to gain weight. Body fat, especially around the belly, is linked to insulin resistance. This explains why many people with prediabetes also have overweight.”
Healthy Eating
The American Diabetes Association in a recent study titled, Eating Right Doesn’t Have to be Boring, “control all risk factors for prediabetes is almost impossible, but some can be mitigated. One key to feeling your best lies in the food you eat. Lifestyle changes can help you maintain balanced blood sugar levels and stay within a healthy weight range. Most importantly, remember that eating well – and adding activity to your daily routine by moving more – are important ways you can manage prediabetes.”
Watch Carbs With the Glycemic Index
The glycemic index (GI) is a tool used to determine how a particular food could affect blood sugar.
Debra Manzella, MS, RN, a clinical educator with Catholic Health System in New York extensive experience in Diabetes Care focused exclusively on the importance of knowing the glycemic index of the carbohydrates as a way to fine tune meals needed to keep the blood sugar within a normal range.
“Foods that are high on the GI will raise your blood sugar faster. When foods rank lower on the scale, they have less effect on your blood sugar spike. Foods with high fiber are low on the GI but those that are processed, refined, and void of fiber and nutrients register high on the GI. Refined carbohydrates rank high on the GI. These are grain products that digest quickly in your stomach. Examples are white bread, russet potatoes, and white rice, along with soda and juice. Limit these foods whenever possible if you have prediabetes,” she explains.
Foods that rank medium on the GI are fine to eat. Examples include whole-wheat bread and brown rice. Still, they aren’t as good as foods that rank low on the GI. Foods that are low on the GI are best for your blood sugar. Learn to incorporate the following items in your diet: steel-cut oats (not instant oatmeal) stone-ground whole wheat bread, non-starchy vegetables, such as carrots and field greens beans, sweet potatoes, corn, pasta (preferably whole wheat),” she adds.
Manzella warns that food and nutrition labels do not reveal the GI of a given item. “Instead make note of the fiber content listed on the label to help determine a food’s GI ranking. Remember to limit saturated fat intake to reduce the risk of developing high cholesterol and heart disease, along with prediabetes. Eating mixed meals is a great way to lower a food’s given GI. For example, if you plan to eat white rice, add vegetables and chicken to slow down the digestion of the grain and minimize spikes,” she shares.
Portion Control
According to a study published in The American Diabetes Association report titled “Glycemic Targets: Standards of Medical Care in Diabetes, good portion control can keep your diet on the low GI. This means you limit the amount of food you eat. Often, portions in the United States are much larger than intended serving sizes,” she says.
“A bagel serving size is usually about one-half, yet many people eat the whole bagel. Food labels can help you determine how much you are eating. The label will list calories, fat, carbohydrates, and other nutrition information for a particular serving. If you eat more than the serving listed, it is important to understand how that will affect the nutritional value. A food may have 20 grams of carbohydrate and 150 calories per serving. But if you have two servings, you’ve consumed 40 grams of carbohydrate and 300 calories,” Manzella urges.
Recent research has shown that eliminating carbohydrates altogether is not necessarily the solution. “A lower carb diet (less than 40 percent carbs) is associated with the same mortality risk increase as a high carbohydrate diet (greater than 70 percent carbs).”
The study noted minimal risk observed when consuming 50 to 55 percent carbohydrates in a day. On a 1600-calorie diet, this would equal 200 grams of carbohydrates daily. It is best practice to spread intake out evenly throughout the day.
This shows parity with the National Institutes of Health Trusted Source and the Mayo Clinic’s recommendation of 45 to 65 percent of calories coming from daily intake of carbohydrates. Individual carbohydrate needs will vary based on a person’s stature and activity level. “One of the best methods to manage portions is to practice mindful eating. Eat when you are hungry and know to stop when you reach your limit. Maintain a relaxed and sitting position when eating and make sure to eat slowly while focusing on the food and flavors,” pointing to this research.
Eat More Fiber-Rich Foods
Fiber offers several benefits like making you feel fuller and longer. It also adds bulk to your diet and help with weight loss. Susan E, Spratt, MD endocrinologist and population health specialist at Duke Health in North Carolina highlights, eating fiber-rich foods can make you less likely to overeat because they easily fill you up and protect against type 2 diabetes. “They also help you avoid the “crash” that can come from eating a high sugar food. These types of foods will often give you a big boost of energy because they contain nutrients such as magnesium and chromium, which help your body regulate blood sugar,” she adds.
“High fiber can be found in foods like beans and legumes, fruits and vegetables that have an edible skin, whole grain breads, whole grains, such as quinoa or barley, whole grain cereals and whole wheat pasta,” she recommends.
Cut Out Sugar-Sweetened Drinks
According to a 2015 study in the National Institute of Health PubMed Central, a single, 12-ounce can of soda can contain 45 grams of carbohydrates. That number is the recommended carbohydrate serving for a meal for women with diabetes. Sugary sodas only offer empty calories that translate to quick-digesting carbohydrates.
Drink Alcohol in Moderation
Researchers found that moderation is a healthy rule to live by in most instances and drinking alcohol is no exception. Many alcoholic beverages are dehydrating. Some cocktails may contain high sugar levels that can spike your blood sugar. According to the Dietary Trusted Source Guidelines for Americans Trusted Source, women should only have one drink per day, while men should limit themselves to no more than two drinks per day.
Drink servings relate back to portion control and following these measurements for an average single drink was actually linked to a lower risk of developing type 2 diabetes: 1 bottle of beer (12 fluid ounces), 1 glass of wine (5 fluid ounces), 1 shot of distilled spirits, such as gin, vodka, or whiskey (1.5 fluid ounces). Keep your drink as simple as possible and avoid adding sugary juices or liqueurs. Keep a glass of water nearby that you can sip on to prevent dehydration. Most importantly, check with your healthcare professional to determine whether alcoholic beverages are safe for you to drink, the study adds.
Eat Lean Meats
As Miho Hatanaka, a registered dietitian nutritionist founder of ZEN Integrative Nutrition & Health, puts it, “meat doesn’t contain carbohydrates, but it can be a significant source of saturated fat in your diet. Eating a lot of fatty meat can lead to high cholesterol levels. If you have prediabetes, a diet low in saturated fat and trans-fat can help reduce your risk of heart disease. It is recommended that you avoid cuts of meat with visible fat or skin.”
“It is important to choose protein sources such as chicken without skin, egg substitute or egg whites, beans and legumes, soybean products, such as tofu and tempeh fish, such as cod, flounder, haddock, halibut, tuna, or trout lean beef cuts, such as flank steak, ground round, tenderloin, and roast with fat trimmed shellfish, such as crab, lobster, shrimp, or scallops turkey without skin low fat Greek yogurt. Very lean cuts of meat have about 0 to 1 gram of fat and 35 calories per ounce. High-fat meat choices, such as spareribs, can have more than 7 grams of fat and 100 calories per ounce,” says Hatanaka
Drink Plenty of Water
Research has shown that water is a better choice to quench your thirst as an important part of any healthy diet. “Drink enough water each day to keep you from becoming dehydrated. If you have prediabetes, water is a healthier alternative than sugary sodas, juices, and energy drinks. The amount of water you should drink every day depends on your body size, activity level, and the climate you live in. You can determine if you are drinking enough water by monitoring the volume of urine when you go. Also make note of the color. Your urine should be pale yellow,” adds Hatanaka.
Exercise and Diet Go Together
Exercise is a part of any healthy lifestyle. It is especially important for those with prediabetes. A lack of physical activity has been linked to increased insulin resistance, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Trusted Source. Exercise causes muscles to use glucose for energy, and makes the cells work more effectively with insulin. The NIDDK Trusted Source recommends exercising 5 days a week for at least 30 minutes. Exercise does not have to be strenuous or overly complicated. Walking, dancing, riding a bicycle, taking an exercise class, or finding another activity you enjoy are all examples of physical activity.
