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Tips:Healthy Diets for Prediabetes

Tips:Healthy Diets for Prediabetes

1. Low-Carbohydrate and Ketogenic Diets for Prediabetes

Low-carbohydrate diets have gotten a lot of attention recently as strategies for reversing prediabetes. The carbohydrates in your diet that provide weight loss include sugars and starches. Starches are in grains and flour, beans, and starchy vegetables. Added sugars include sugars in sweets, sweetened foods such as flavored oatmeal and ketchup, and sugar-sweetened beverages such as soda. There are also natural sugars, which are found in nutritious foods such as dairy products and fruit.

Proponents of low-carbohydrate weight loss diets, such as Atkins, claim that the diet can help you lose weight because instead of burning dietary carbohydrates for fuel, you burn body fat because you are eating so few dietary carbohydrates. The diet can help you cut calories by:

  • Eliminating or severely restricting high-calorie foods such as sweets and refined carbohydrates.
  • Promoting satiety by increasing protein and fat, which are filling nutrients.
  • Reducing appetite by reducing the food choices available to you.

1. Low-Carb Diets and Prediabetes

Sugars and starches that you get from your diet enter your bloodstream as a type of sugar called glucose. In prediabetes, your body has trouble managing the glucose in your blood due to resistance to a hormone called insulin. Normally, insulin is able to help your body keep blood glucose levels in check, but the effect is weaker if you have prediabetes, so blood glucose rises.

There is research supporting reduced-carbohydrate diets in the treatment of prediabetes. Reducing your sugar and starch intake may lower blood sugar levels by preventing as much sugar from going into your blood. It can also help reverse insulin resistance.

Reduced-carbohydrate diets range from moderate to very low-carb. The rest of your calories come from protein and fat, so you might depend more heavily on high-protein and high-fat foods than the average person.

Low-Carb and Ketogenic Diets for Prediabetes

Foods to Emphasize

Zero-Carb Foods

    • Meat, poultry, and fish
    • Eggs
    • Oils
    • Butter

Low Carb Foods

    • Non-starchy vegetables
    • Full-fat cheese and yogurt
    • Avocados
    • Cheese
    • Nuts and seeds
    • Cream
    • Tofu

Moderate Carb Foods (Low-Carb Diet)

  • Fresh fruit, especially berries
  • Beans, peas, and lentils


  • Has been shown to lower insulin resistance and blood glucose levels (A1c) among individuals with diabetes and prediabetes.
  • Can aid in weight loss due to:
    • Calorie reduction from eliminating sweets and other high-calorie foods.
    • Increased fullness from protein and fat.
    • Reduced appetite from limited food choices.
  • Can be simpler to follow since food choices are more ?black or white? ? off limits or allowed.
  • Avoids unhealthy processed, sugary, and fried foods.
  • Avoiding sugars and starches can help some people avoid sugar cravings.

Foods to Limit or Avoid

  • Fruit juice and dried fruit
  • Most fruit (esp. ketogenic diet)
  • Starchy vegetables (e.g., peas, winter squash, corn, and sweet potatoes)
  • Beans, peas, and lentils (esp. ketogenic diet)
  • Reduced-fat dairy products, including sweetened yogurt (esp. ketogenic diet)
  • Grains (e.g., bread, pasta, rice, cereal, oatmeal, crackers, and pretzels)
  • Processed snack foods, such as potato chips, tortilla chips, and
  • Fried foods, such as doughnuts, French fries, and fried chicken.
  • Sweets (e.g., candy, cake, ice cream, pie, pastries, and cookies)
  • Sugar-sweetened beverages (e.g., soft drinks, energy drinks, sugar-sweetened coffee and tea, and sports drinks)
  • Alcoholic beverages


  • Difficult to limit carbohydrates so much.
    • They taste good.
    • They are in many common foods.
  • Lack of long-term data on health outcomes:
    • Is the high protein content tough on kidneys and the liver?
    • Is it really healthy to give up nutrient-dense foods such as whole grains, legumes, and fruit, which are linked to lower risk for certain diseases, include heart disease and even diabetes?
    • Potentially low in fiber, which aids with fullness, blood sugar control, and heart health.
    • Will you regain weight and reverse health benefits if you add carbs back into your daily menu?
  • Difficulty in following the diet long-term:
    • What will you eat at restaurants and at social events?
    • Are you able and willing to give up so many foods?forever?
  • Risk of eating too much saturated fat from fatty meat and poultry with skin.
  • Can be cumbersome to count grams of carbohydrates.
  • Possibility of trouble exercising due to low energy from lack of glycogen, which is the storage form of carbohydrates in your body.

2. Ketogenic Diet for Prediabetes

A ketogenic diet is a type of low-carbohydrate diet that is on the extreme end. The goal is to limit carbohydrates so much that the body does not have enough glucose ? a type of carbohydrate ? to fuel the brain normally. Instead, the body shifts to a metabolic state called ketosis, and produces ketone bodies to fuel the brain?s activities.

The theory behind a ketogenic diet for prediabetes is that when your body is in ketosis, you can be sure that you do not have excess carbohydrates in your diet. Since carbohydrates in your diet are broken down into glucose that goes into your bloodstream, being in ketosis assures that you are not inundating your bloodstream with excessive amounts of glucose due to the foods you eat.

A ketogenic diet for prediabetes might include about 20 to 50 grams per day of non-fiber carbohydrates, or about 5 to 10% of total calories from carbohydrates. The rest of your calories come from fat and protein. The food choices on this diet are similar to those on other low-carb diets, but you may need to further restrict some of the moderate-carbohydrate options that might be easier to fit in on a more moderate low-carb diet. Examples include fruit (an apple has 24 grams of non-fiber carbohydrates) and starchy vegetables (a half-cup of corn has 15 grams of non-fiber carbs).

3. Mediterranean Diet Pattern for Prediabetes

A Mediterranean-style diet is based on traditional eating patterns of Mediterranean countries, especially Greece, southern Italy, and Spain. This way of eating is known for its heart-healthy benefits, but research also shows that it can also help in weight loss and assist in blood sugar control.

Compared to the average American diet, a Mediterranean diet pattern generally includes more:

  • Olive oil
  • Vegetables
  • Legumes (beans, peas, lentils, and soy)
  • Whole grains
  • Fruits
  • Nuts

It includes moderate consumption of poultry and fish, and less:

  • Full fat dairy products
  • Red meat
  • Sweets

4. DASH Diet for Prediabetes

The DASH diet may have been developed for reducing high blood pressure, but don?t let that fool you. The DASH may also be good for weight loss, bone health, mental health, heart health, and prediabetes prevention. To get from an average American diet to a DASH-style pattern, you can:

  • Boost your intake of vegetables and fresh fruit.
  • Eat more low-fat dairy products and beans.
  • Choose whole grains more often.
  • Choose fish, poultry, and lean meat instead of fatty red meat or processed meat.
  • Reduce the amount of sweets you have.

5. The DPP Diet and Coaching for Prediabetes

The Centers for Disease Control and Prevention, or CDC, have developed a program with diet and lifestyle changes that has been shown among prediabetes patients to reduce the risk of developing diabetes by over 50%. This program is the Diabetes Prevention Program, or DPP.

Each DPP program includes a year-long lifestyle change curriculum delivered via lessons put together by the CDC. Lesson topics include nutrition, physical activity, managing stress, and fitting your healthy choices into your and your family?s lifestyle.

You can find an in-person DPP program to attend, or see whether you are eligible for a digital program. Lark Health Coach, for example, is a CDC DPP program that delivers the program via your smartphone, on your time. Lark also helps with tracking weight, food, and exercise, and customizes the program according to preferences such as low-carb, gluten-free, or vegan.

Lark?s prediabetes diet recommendations are consistent with the DPP and include recommendations based off evidence from diets such as the DASH diet and Mediterranean patterns. Your Lark coach, for example, might suggest:

  • Choosing fruit instead of dessert.
  • Steaming, baking, or grilling instead of frying.
  • Using olive oil instead of butter or shortening.
  • Trying plant-based proteins or fish sometimes instead of red meat.
  • Enjoying your meals and having them in a pleasant environment.

Balanced DPP Healthy Diet for Prediabetes

Foods to Emphasize

  • Vegetables
  • Fish and shellfish
  • Plant-based proteins, such as beans, peas, lentils, tofu, and nuts
  • Whole grains and whole-grain products
  • Healthy fats such as olive oil and avocado
  • Fresh fruit
  • Spices and herbs
  • (In Moderation)
  • Starchy vegetables (e.g., peas, winter squash, corn, and sweet potatoes)
  • Lean animal proteins, such as skinless poultry and eggs.
  • Reduced-fat dairy products, such as low-fat cheese and fat-free cottage cheese and plain yogurt.
  • Water and other low-calorie, hydrating beverages such as decaffeinated green tea.


  • Has been shown to lower insulin resistance and blood glucose levels (A1c) among individuals with diabetes and prediabetes.
  • Based on eating patterns shown to have health benefits such as lowering blood pressure, improving cholesterol levels, and
  • Can aid in weight loss due to:
    • Reminding you to weigh in.
    • Calorie reduction by swapping low-calorie foods such as lean proteins and vegetables, and having smaller portions
    • Swapping empty calories for high-fiber choices such as fruit and whole grains.
  • Simplifies your diet with reminders, tracking, and suggestions for small changes.
  • Better potential for long-term success due to allowances for special occasions and cravings.

Foods to Limit or Avoid

  • Processed meats
  • Fried foods
  • Fatty red meat and poultry with skin
  • Solid fats (e.g., lard and butter)
  • Refined grains (e.g., white bread, pasta, rice, and crackers, and refined cereals)
  • Sweets (e.g., candy, cake, ice cream, pie, pastries, and cookies)
  • Sugar-sweetened beverages, (e.g., soft drinks, energy drinks, sports drinks, and sugar-sweetened coffee and tea beverages)
  • Alcoholic beverages and mixed drinks
  • Sugar-sweetened foods, such as flavored yogurt and oatmeal, and sugary condiments
  • Dried fruit and fruit juice


  • Is less focused on counting calories and grams of carbohydrate, fat, and protein grams ? some people prefer to count.
  • Is not a prescriptive meal plan, so users must decide what to eat rather than expecting to be told what to have at each meal and snack (but you can use the meal plan on this page as a model!).