Eating with Prediabetes

The following guidelines summarize the research findings from the Michigan Academy of Nutrition and Dietetics Diabetes Prevention Task Force. These are general health guidelines and are not meant to substitute for care from your doctor and registered dietitian.

We strongly encourage you to work individually with your doctor and registered dietitian since every individual’s health situation is different. Registered dietitians provide custom-tailored medical nutrition therapy (MNT) to help you manage your overall health.

Guidelines for eating with prediabetes

Dietary Fiber

Fiber has been a topic of conversation for decades as it has a much larger role in our health than just preventing constipation. More specifically, it has a role in preventing diabetes. A study done in 2023 reiterates that dietary fiber thwarts insulin resistance and metabolic dysfunction, a common contributor to pre-diabetes and type 2 diabetes. How can you use fiber to your advantage?

Recommendations:

• Aim for filling ½ of a 9-inch dinner plate with non-starchy vegetables.
• Aim for at least 3 servings (½ cup) of legumes or beans per week, and include fruit as a snack regularly.
• Count the number of different plant foods (whole grains, fruits, vegetables, legumes, nuts, seeds) you eat regularly, and challenge yourself to increase the variety each week.
• Increase your fiber foods slowly to avoid gastric distress. Aim for adding 1-2 new fiber foods each week such as chia seeds in your yogurt or flax in your oatmeal.
• Fiber works better when it absorbs water – as you increase your fiber, increase your water intake.
• Try using a digestive enzyme supplement (e.g., Beano) to reduce gas and bloating,
• See your doctor if you have any gastrointestinal disorders before increasing your fiber intake.
• Examples of fiber foods:
  Legumes – black beans, chickpeas, pinto beans, lentils
  Nuts and Seeds –  almonds, pumpkin seeds, sunflower seeds, chia seeds, flax seeds
  Vegetables – broccoli, cabbage, cauliflower, greens, kale, onions
  Fruits – apples, blueberries, oranges, raspberries
  Whole Grains – oats, whole grain bread, whole wheat pasta, quinoa
• Download a PDF of these guidelines

Dietary Fat

When people get a prediabetes or type 2 diabetes diagnosis, they often think it is just a story of just carbohydrates and especially sugar in their diet. However, it is important to also consider the type and quantity of dietary fat. Fats found in oils, butter, cheese, cream, meat, and fish can impact how well our bodies can handle the starch and sugars in our diet. In fact, our research found that replacing even a small amount (5%) of saturated fat can improve blood sugar control.

Check out these general guidelines and remember to always consult your registered dietitian and doctor for what will work best for your specific health situation.

Recommendations:

• Total dietary fat and especially saturated fat (e.g., meat, dairy, coconut and palm oil)  is linked with type 2 diabetes risk. Therefore, when faced with a prediabetes diagnosis, try limiting the amount of saturated fat in your diet.
• Replace saturated fat with polyunsaturated fats to decrease type 2 diabetes risk. For example, drizzle sunflower, almond, safflower or soybean oil over vegetables rather than butter. Add fish to a salad instead of beef or chicken. 
• Eat 20-35% calories from fat. Focus on eating foods rich in mono and polyunsaturated fats such as vegetable oils, nuts, seeds and soy.
• Decrease intake of saturated fats, for example cream soups, cheese, red meat, full-fat dairy desserts.  When having these foods, eat smaller portions.
• When you eat a high-fat meal your body becomes less able to process carbohydrates. Therefore, in situations when you eat a fatty meal (for example, steak, cream-based soup, or fried foods), choose lower carbohydrate sides, such as salad and vegetables.
• Choose a diet rich in polyunsaturated fats which are most linked with lowering diabetes risk. This includes walnuts, flaxseed, pumpkin and sunflower seeds, and tofu.  
• Replace some of your meat intake with vegetarian proteins (tofu, tempeh, seitan) or lower-fat fish: cod, haddock, flounder, scallops, crab, clams, shrimp, lobster, tuna (fresh or canned in water).
• Download a PDF of these guidelines

Meal/Nutrient Timing

• Eat the majority of your food earlier in the day to improve blood sugar control. It is helpful to have a larger breakfast and lunch and a small dinner since your insulin (natural or medication) works better earlier in the day.
• Some, especially those with high morning blood sugar, may need to limit the carbohydrates in their breakfast. For example, eat a larger protein and fat-rich breakfast, such as cottage cheese with chopped nuts and fruit or whole-grain toast with an omelet with vegetables and a side of avocado.
• Another great breakfast strategy is to split the meal into two smaller meals. We recommend making the first meal/snack low-carbohydrate such as a hard-boiled egg or ½ avocado filled with veggie sausage or a ½ apple with 1T peanut butter. Eat the rest of the meal 30-90 minutes later.
• Whenever possible, eat your largest meal around lunch to early afternoon. This meal should contain the most carbohydrates (e.g., grains, pasta, bread, beans/legumes, fruit) of the day.
• Make your dinners light meals such as soup and/or salad. With prediabetes, it is important to reduce evening carbohydrate intake such as starches and sugary foods (cookies, ice cream, cake, candy) since we do not process the carbs as effectively in the later day. 
• Eat your veggies first. Try eating salad, vegetables, and proteins (e.g., meat, fish, tofu, beans) first. Simply eating these foods before your bread, pasta and other starches can improve your blood sugar control.
• Exercise after you eat! Walking for 20 minutes within a half hour of eating improves your blood sugar. 
• Avoid eating within 2-2.5 hours of going to bed. This helps to empty the digestive system before sleeping and can be a great weight-control strategy.
• Download a PDF of these guidelines