What to Eat if You Have Prediabetes
You get a call from your doctor telling you your sugar is a little high on your blood test. You don’t have diabetes but will need to watch it. You’re told to cut out sugar, bread and pasta. But now you are in a panic because you don’t know what to eat. Carbs are everywhere! Do you need to cut out carrots? Can you ever eat bread or pasta? And what about wine? The good news is that you can probably eat a lot more than you think. And if you make some lifestyle changes now, you may be able to prevent diabetes. Read my tips on what what to eat when you have prediabetes.
Scary stats about prediabetes
First, a few scary stats. We know diabetes is an epidemic. 29 million Americans have diabetes. But prediabetes is the real epidemic. 83 million people have it. This is 1 in 3 adults. And it’s even higher for adults ages 65 and older – the NIH estimates that 50% of older adults have prediabetes. And only 7% of people with prediabetes know they have it. Many of these people will go on to develop diabetes at some time in their life. But it doesn’t mean it’s inevitable!
Before moving on to my tips, I’d like to explain what it means to be insulin resistant as this occurs in most people with prediabetes and diabetes. When we eat carbohydrates, they break down into sugar in our blood. This happens with all carbs, including candy, juice, fruit, brown rice, potatoes, etc. In response to rising blood sugar levels, our pancreas secretes insulin in attempts to get the sugar out of the blood and into fat and muscle cells to be used as energy. Think of insulin like a “key” trying to unlock the doors to the cells. Sometimes the key isn’t able to unlock the doors because the cells have become resistant to the insulin (called insulin resistance). So the pancreas has to work in overdrive mode and secrete large amounts of insulin. So this large amount of insulin is able to keep blood sugar levels normal … for a while. Eventually the pancreas starts to wear out from having to make so much insulin and your blood sugar starts to rise slightly. This is called prediabete and can eventually lead to full blown diabetes when your pancreas can no longer make adequate insulin to control blood sugar levels. The good news is that you can stop the progression of diabetes with lifestyle changes.
Know your numbers
Since only 7% of people know they have prediabetes, it’s important that you know your blood sugar numbers. Unfortunately, not all physicians discuss these numbers with their patients … unless the numbers are quite high. I feel like the “Prediabetes Police” because I want all patients to know their numbers. If your fasting glucose is 100-125, it can be called prediabetes.A normal level is under 100. If it’s over 126, it would be diabetes. If you are bordereline, you may want to have another test just to make sure. Remember this test should be fasting – no food and only water prior to the test. Another good test is called Hemoglobin A1c. This is a 12 week average of blood sugar. Normal is under 5.7. Prediabetes is 5.7-6.4 and diabetes is 6.5 and higher. You do not have to fast for this test. Now don’t panic if you are on the low end of prediabetes (approximately 5.7-5.9), especially if you are lean, exercising on a regular basis, have a healthy diet and are over the age of 60. Your goal may may just be to prevent it from getting higher. As we age, our bodies don’t produce and utilize insulin as well as it did when we were younger. It is possible that you may not be able to get it under 5.7. But if you are overweight and/or don’t eat a healthy diet or aren’t active, this may be your wake up call to make some lifestyle changes!
Watch my video on What to Eat If You Have Prediabetes
My top 14 tips on what to eat for prediabetes
- Lose weight if overweight. This is the most important tip! A smaller fat cell is much more sensitive to the insulin. Losing 7% of your body weight, can decrease risk of diabetes by 58%.
- Exercise. The goal is to exercise 30 minutes or more most days of the week. You can even split this up into 3 ten minute segments. The ideal exercise program would include a weight training and aerobic component. But this doesn’t mean you have to go to the gym. Just get out and take a brisk walk. Read my previous post on Health Benefits of Walking After Meal for Prediabetes. I find that many people neglect the weight training component. Studies have shown that building lean mass is an important part of decreasing insulin resistance. If you don’t want to go to a gym, try a weight training DVD or exercise on demand program on tv – ideally 2-3x/wk.
- Cut down on sugary beverages such as soda and sports drinks. Even if you don’t drink soda, you still may be consuming too much liquid sugar in the form of flavored waters and juice. One bottle of Vitamin Water has 8 tsp of sugar.
- Choose more whole grains such as quinoa, brown rice, whole wheat pasta, and whole grain bread and less refined carbohydrates such as white rice, white bread and white pasta. Whole grains tend to have a lower glycemic index/load and less of an impact on raising blood sugar. In addition, whole grains contain more nutrients and fiber and help keep you feeling full longer. Of course portion size matters – your restaurant portion of whole wheat pasta can still be the equivalent of eating 8 piece of bread! I find that many people who first find out they have prediabetes try to cut out all grains. This is not sustainable … or necessary! Just keep portions moderate.
- Avoid intake of trans fats as they can worsen insulin resistance – as well as increase risk of heart disease. Instead choose healthier unsaturated fats found in nuts, avocado and olive oil. Snack on a handful of nuts and add avocado to your sandwich instead of cheese.
- Include magnesium rich foods found in leafy greens, nuts and beans. Magnesium has been found to improve insulin resistance. Use spinach as a base for your salad and add some beans. Snack on nuts.
- Make sure your Vitamin D levels are within range. Take a supplement if needed. Low levels of Vitamin D are linked to increased risk of diabetes
- Get adequate sleep (easier said than done!) Studies have linked inadequate sleep to increased risk of diabetes, along with obesity and heart disease.
- Don’t listen to those myths that carrots and wine are full of sugar. Green light on the carrots and enjoy wine in moderation. It’s true that wine is made from sugar, but the sugar turns into alcohol in the fermentation process. Best choices are dry red or white wines as the sweeter ones do contain more sugar. Hard liquor is fine as well but avoid sugary mixers. Read my previous post on Is Wine High in Sugar?
- While fruit contains carbohydrate, this doesn’t mean you have to cut it out. Just use portion control. A few servings of fruit a day is fine, but no need to polish off a pound of grapes at a sitting! I’m not a fan of juice and dried fruit.
- Get up and more during the day. It’s been shown that spending too much time sitting is linked to a two-fold increase in the risk of diabetes. When we sit for long periods of time, enzyme changes occur in our muscles that can lead to increased blood sugar levels. Read my previous post on this.
- If you are already on the thin side, don’t lose any more weight! I find that many of my newly diagnosed prediabetic patients who are thin to start with cut out so many carbs that their weight plummets to an unhealthy low number. This is especially common with my female clients over the age of 60 or so. First of all, there is no need to cut out all carbs as I previously mentioned. Second, if you cut down on carbs, you’ll need to replace those calories with something else. I usually recommend these clients increase their intake of healthy fats such as nuts, nut butters, olive oil and avocado. These foods, especially nuts, may even help reduce risk of diabetes. So keep tabs on your weight and add in these healthy fats as needed to stop weight loss.
- Eat foods that are good for the gut. Studies are linking the health of our gut microbiome to many diseases including diabetes. Plant based foods, especially those high in fiber, help keep a healthy balance of gut bacteria.
- So how many carbs should you eat a day? This is the question I get asked all the time by my patients. As you probably suspected, there is no “one size fits all” answer. It depends on your activity level, age, weight, food preferences and individual metabolism. On average, I suggest 30-45 grams per meal (but some people will need more and others may choose to do less!) But the goal here is not to cut out all carbs and replace it with tons of meat, cheese, high protein energy bars, processed lunch meats, and low carb highly processed snack foods!
I’ve had many clients with prediabetes who have been able to prevent the onset of diabetes by making lifestyle changes. If you would like me to give you tips and personalized meal plans on what to eat if you have prediabetes, call or email me for more info on my counseling sessions. These sessions can be done via phone or Skype if you don’t live in the NYC area. In addition to being a registered dietitian, I am a certified diabetes educator and health and wellness coach.
(212) 879-5167 email: Martha@MarthaMcKittrickNutrition.com
this post was updated 4/5/17
I especially love problem-solving, whether it’s helping women defeat issues plaguing them for years, helping a busy executive find practical ways to get heart healthy, or providing tips to help you reverse diabetes. That’s why I’m on a constant quest to expand my knowledge by staying on top of the latest research.