What diet works best for prediabetes? What foods should I eat?

No one diet fits all.  The best diet for you is a diet individualized for you, based on your calorie needs, metabolic goals, has high quality nutrients, is sustainable, and it tastes good!

When planning meals, think whole plant foods first! Eat a large variety of plant foods – shoot for at least 30 different plant foods each week.  Spices and herbs count as plant foods along with vegetables, fruits, legumes (beans), whole grains, and nuts and seeds. Add meat, poultry, pork, and fish as “accompaniments” to your plant foods. 

Why eat whole plant foods?  One reason is fiber. Fiber helps us feel full longer.  Fiber blocks the absorption of some of fat and calories.  The fiber in plant foods help us eat less and lose weight and keep it off, and A1C goes down!  Eating plant foods have many benefits and fiber is one of them. 

Here’s another reason to eat whole, minimally-processed plant foods.  When minimally-processed, and served as close to possible to their natural state, plant foods have a high amount of nutrients, such as higher fiber carbohydrate, vitamins and minerals, protein, and a little fat, but not a lot of calories. Processed and ultra-processed plant foods (think potato chips) are high in fat, calories, and sodium.  Choose whole plant foods!

Fill up on non-starchy vegetables.  Fill 1/2 of your plate with leafy greens, carrots, summer squash, zucchini, broccoli, asparagus, turnips, onions, garlic, green beans, cucumbers, tomatoes, and the list goes on.  Non-starchy vegetables are low in calories and carbohydrate. 

Eat whole fruits.  Have an apple instead of apple sauce for a snack.  Add high fiber raspberries and blackberries to your cereal and yogurt.  Instead of juice, squeeze fresh lemon, lime, orange, or grapefruit, into water.  

Choose 100% whole grains over refined grains at least 50% of the time, but more often is better!  Whole grains retain all of their nutrients, including protein, antioxidants, fiber, vitamins, minerals, essential fats, and starch.  Refined grains must be enriched to replace some of the nutrients removed by milling. However, the fiber has not been replaced.  Protein is reduced by 25%, and some vitamins and minerals are not replaced.  Whether a grain is whole or refined, it is a starchy food.  Fill 1/4 of your plate with grains, choosing whole grains over refined at least 50% of the time.

Have a plant-based protein – legumes!  Beans including pinto, black, kidney, soy (edamame), and chickpeas, are high in protein, fiber, and carbohydrate, and very low in fat.  Include 2 or 3 cups of legumes throughout the week to increase your fiber and protein intake. 

More plant-based protein?  Crunch some nuts and seeds.  Nuts and seeds are good sources of protein.  Nuts and seeds are high in heart-healthy monounsaturated and polyunsaturated fats.  Nuts and seeds also have fiber along with vitamins and minerals.

Dairy is a great source of protein.  Milk, yogurt, and cheese retain their natural calcium and are high in protein.  Choose low fat or fat free dairy products.  Shoot for 3 servings a day to get calcium and protein.  A serving is  1 cup of milk, 3/4 cup yogurt, or 1-1/2 ounces of cheese. 

Minimize meat, poultry, and pork.  Keep portions to about 3 ounces and fill up on plant protein along with low fat dairy protein.  Fill 1/4 of your plate with protein. 

More animal protein?  Fish is high in omega 3 fatty acids, which is heart-healthy!  Two meals with fish per week will provide omega 3’s.  

One more source of animal protein:  The egg.  Eggs have been given a bad rap for being high in cholesterol.  For most people, it’s not the cholesterol in the egg that raises blood cholesterol and clogs our arteries, but the bacon and sausage that is often served with the egg that contain high amounts of saturated fats.  Saturated fats found in high fat meats, and tropical oils like coconut, palm oil, and palm kernel oil, are high in saturated fat.  Eat much less of these foods, if at all.  The American Heart Association has agreed an egg a day is okay.  Egg are a high quality protein and contain choline, a nutrient essential for brain health. 

Fat is an essential nutrient.  We have to eat fat to be healthy, but not all fats are equal.  Monounsaturated fats, which come from olive oil, avocados, and peanuts, for example, along with polyunsaturated fats from walnuts, and omega 3’s from fish, are heart healthy fats.  Consuming healthy fats in your meal can help keep you full longer.  Saturated fats found in high fat meats, and tropical oils like coconut, palm oil, and palm kernel oil, should be eaten sparingly, or not at all.  

Hydrate, hydrate, hydrate!  Water is the best beverage choice.  Low calorie or no calorie beverages are other good choices.  Non nutritive sweeteners can be used because they keep blood glucose lower.  Please use in moderation. 

What about alcoholic beverages?  Recommendations are to keep alcoholic beverages to 1 or less per day for women and 2 or less per day for men.  Some new information suggests men may benefit from also keeping their alcoholic beverages to 1 or less per day.  Drinking alcoholic beverages adds calories and can affect blood glucose. 

Shake the salt shaker less often.  When you do shake the salt shaker, use iodized salt.  Iodine is a necessary nutrient for good health, especially for thyroid health.  Too much sodium increases blood pressure, causes bloating, increases risk for kidney disease, and heart attack and stroke. Food manufacturers may not use iodized salt in their processed foods, so you may get the negative effects of sodium without the benefits of iodine.  Sodium also occurs naturally in all animal foods, including dairy, meat, poultry, pork, fish, and eggs.  Sodium is found in baked products.  Sodium intake should be less than 2300 milligrams per day.  

A little sugar is okay, but keep it minimal.  Sugar raises blood glucose and A1C.  Sugar causes dental caries. Sugar has a lot of calories for a small amount, so it’s easy to consume a lot of calories without realizing it.  The USDA Dietary Guidelines 2020 to 2025 recommend less than 10% of your calories come from sugar.  The American Heart Association recommends less than 5% of your calories come from sugar.  Sugar is found in many healthful foods, like yogurt and cereal.  Read the labels to find the “Added Sugar.”  Keep grams of sugar per day as low as possible, less than 25 grams to 50 grams per day. 

Bottom line on the diet for prediabetes:  Balance your plate with 1/2 filled with non-starchy vegetables, 1/4 filled with whole grains, and 1/4 filled with protein.  Eat whole fruit everyday.  Have 3 servings of low fat or non fat dairy each day.  Eat protein at every meal, but minimize meat protein, eating only about 6 to 7 ounces per day.  You will get plenty of protein from plant foods, especially whole grains, beans, nuts, and seeds.  Include fish 2 times per week  and eggs in your diet.  Opt for foods with monounsaturated and polyunsaturated fats and minimize foods with saturated fats.  Make water your first choice as a beverage.  Save sugar for dessert and don’t eat dessert every day!  Use less salt, but when you use it, use iodized salt.  Use alcohol in moderation or not at all.