Are you finding it hard to create a meal plan that supports healthy blood sugar levels? You're not alone. Many people with prediabetes face similar challenges when it comes to managing their condition naturally. This article explores ways to build a balanced meal plan that can support optimal blood sugar management, drawing on NHS guidelines and functional medicine principles.
Understanding Prediabetes
Prediabetes is a metabolic condition characterized by elevated blood glucose levels that are higher than normal but not yet at the threshold for a diabetes diagnosis. It serves as a crucial warning sign, indicating an increased risk of developing type 2 diabetes and cardiovascular diseases. Prediabetes fits into the landscape of type 2 diabetes as a precursor to the disease, representing an intermediate stage between normal glucose metabolism and the development of type 2 diabetes.
Diagnosing Prediabetes
Prediabetes is diagnosed through various laboratory tests that assess blood glucose levels. The commonly utilized criteria include measurements of fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), and glycated hemoglobin (HbA1c) levels.
- FPG levels between 100-125 mg/dL
- OGTT levels between 140-199 mg/dL
- HbA1c levels between 5.7-6.4%
Meeting any of these criteria signifies impaired glucose regulation and an increased risk of developing diabetes.
A Functional Medicine Perspective on Prediabetes
From a functional medicine perspective, prediabetes can be managed to help prevent progression to diabetes through a comprehensive and personalized approach. Functional medicine aims to identify and address the underlying causes and systemic imbalances contributing to the development of prediabetes. This approach recognizes the intricate connections between various bodily systems and focuses on factors such as chronic inflammation, insulin resistance, hormonal imbalances, stress, inadequate sleep, and nutritional imbalances. By addressing these factors through lifestyle modifications, targeted nutritional support, and comprehensive testing, functional medicine offers a proactive and empowering approach to prediabetes management.
Read also: Recipes for Gestational Diabetes
The Prediabetes Diet: A Foundation for Blood Sugar Management
The prediabetes diet focuses on making and maintaining lifestyle changes as a way to support the reduction of the risk of prediabetes progressing to type 2 diabetes. It includes recommendations for consuming whole, unprocessed foods, such as non-starchy vegetables, legumes, whole grains, lean proteins, and healthy fats like olive oil. The diet limits refined carbohydrates, sugars, and processed foods. It also emphasizes low-glycemic foods, which have a minimal impact on blood sugar levels, and anti-inflammatory foods. Adherence to a low-glycemic diet and the Mediterranean diet, both of which are associated with improved insulin sensitivity and metabolic health, may contribute to better glycemic control and reduced risk of developing type 2 diabetes.
Foods to Embrace and Limit
On the prediabetes diet, foods that are generally allowed include non-starchy vegetables, legumes, whole grains, lean proteins, healthy fats, and low-glycemic fruits. These foods may help support blood sugar regulation and provide essential nutrients. Foods that are generally not recommended on the prediabetes diet include refined carbohydrates, sugary foods, processed foods, and high-glycemic fruits. These foods can cause blood sugar spikes and may contribute to metabolic dysfunction and insulin resistance.
Practical Dietary Approaches for Prediabetes
Managing prediabetes through diet is a crucial aspect of supporting healthy blood sugar levels naturally. Several dietary approaches have shown promise in supporting metabolic function and reducing the risk of progression to type 2 diabetes.
Low-Glycemic Diet
A low-glycemic diet focuses on consuming foods that have a minimal impact on blood sugar levels. It emphasizes whole, unprocessed foods such as non-starchy vegetables, legumes, and whole grains while limiting refined carbohydrates and sugars. This approach has been associated with better glycemic control and a reduced risk of developing type 2 diabetes.
Mediterranean Diet
The Mediterranean diet is characterized by high consumption of fruits, vegetables, whole grains, lean proteins, and healthy fats like olive oil. It has been shown to improve insulin sensitivity, lower fasting glucose levels, and reduce the risk of type 2 diabetes. The diet's emphasis on anti-inflammatory foods and its rich polyphenol content contribute to its metabolic benefits.
Read also: Managing Diabetes on Dialysis
Anti-Inflammatory Diet
An anti-inflammatory diet, which often overlaps with the Mediterranean diet, focuses on consuming foods with anti-inflammatory properties. This includes omega-3 fatty acids from fish, nuts, seeds, and olive oil, as well as antioxidants found in fruits and vegetables. Research suggests that anti-inflammatory diets may positively impact insulin sensitivity and reduce inflammatory markers, supporting protection against prediabetes and metabolic dysfunction.
Key Components of a Prediabetes Meal Plan
Emphasize Fiber-Rich Carbohydrates
Carbohydrate intake should emphasize nutrient-dense carbohydrate sources that are high in fiber (at least 14 g fiber per 1,000 kcal) and minimally processed. Dietary carbohydrate includes sugars, starch, and dietary fiber. Higher intakes of sugars are associated with weight gain and greater incidence of dental caries. Conversely, higher intakes of dietary fiber are associated with reduced non-communicable disease and premature mortality occurrence as well as improvements in body weight, cholesterol concentrations, and blood pressure. These benefits with higher fiber intakes have been observed in the general population, for those with type 1, type 2, and pre diabetes, and those with hypertension or heart disease. With this guidance in mind, eating plans should emphasize non-starchy vegetables, fruits, legumes, and whole grains, as well as dairy products with minimal added sugars.
Prioritize Dietary Fiber
Current recommendations from the American Diabetes Association are that adults with diabetes should consume high fiber foods (at least 14g fiber per 1,000 kcal). Current recommendations from the European Association for the Study of Diabetes are that adults with diabetes should consume at least 35g dietary fiber per day (or 16.7g per 1,000 kcal). These two values are aligned, and higher than current World Health Organization recommendations for the general population of at least 25g dietary fiber per day, although all three recommendations recognize a minimum intake level, with greater benefits observed with higher intakes. These values are appreciably higher than current dietary fiber intakes in the United States, which is approximately 16g per day. Higher intakes of dietary fiber are associated with lower all-cause mortality, heart disease, T2 diabetes incidence, and certain cancers such colorectal cancer when compared with lower fiber intakes.
Recommended food sources of dietary fiber are minimally processed whole grains, vegetables, whole fruit and legumes.
Mindful Consumption of Starches and Sugars
Starch comprises most of the carbohydrates consumed globally, and is the storage carbohydrate found in refined cereals, potatoes, legumes, and bananas. Dietary starch intake is rarely directly reported, so the health effects of dietary starch intake are often assessed through key sources, such as refined grains and potatoes. For potatoes, meta-analyses of prospective observational studies have identified the health effects are largely determined by the cooking method. Fried and salted potatoes were associated with higher incidence of type 2 diabetes and hypertension. Boiled and roasted potatoes were not associated with increased or decreased risk to health.
Read also: The Ultimate Guide to Heart and Diabetes Diet
Available evidence from clinical studies does not indicate that the overall amount of dietary sucrose is related to type 2 diabetes incidence, however it is related to body weight gain and increased dental caries. Given the association between excess body weight and type 2 diabetes occurrence, there is rationale to promote a reduction of sugar intake related to diabetes occurrence, and replace sugar-sweetened beverages (including fruit juices) with water or no/low calorie beverages as much as possible.
Fructose consumed in naturally occurring in foods such as fruit, (that also contain fiber) may result in better glycemic control compared with isocaloric intake of sucrose or fructose added to food, and is not likely to have detrimental effects on triglycerides as long as intake is not excessive (<12% energy).
Emphasize Whole Grains over Refined Grains
Whole grains contain high levels of fiber and more nutrients than refined white grains. Eating a diet high in fiber is important for people with diabetes because fiber slows the digestion process. Slower absorption of nutrients helps keep blood sugar stable. Whole wheat and whole grains are lower on the glycemic index (GI) scale than white breads and rice. This means that they have less of an effect on blood sugar.
Good examples of whole grains to include in the diet are:
- Brown rice
- Whole grain bread
- Whole grain pasta
- Buckwheat
- Quinoa
- Millet
- Bulgur
- Rye
Incorporate Fatty Fish
Fatty fish is a beneficial addition to any diet. It contains important omega-3 fatty acids called eicosapentaenoic acid and docosahexaenoic acid. These are sometimes known as EPA and DHA. People need certain amounts of healthy fats to keep their body functioning and to promote heart and brain health. Certain fish are a rich source of both polyunsaturated and monounsaturated fats.
These are:
- Salmon
- Mackerel
- Sardines
- Albacore tuna
- Herring
- Trout
People can eat seaweeds, such as kelp and spirulina, as plant-based alternative sources of these fatty acids.
Include Beans and Nuts
Beans are an excellent option for people with diabetes. They are a source of plant-based protein and can help satisfy the appetite while helping promote digestive health due to their high content of soluble fibers. Beans are also low on the GI scale, which means they may be more effective for blood sugar management than many other starchy foods.
Among the many types of beans are:
- Kidney
- Pinto
- Black
- Navy
- Adzuki
Nuts can be another excellent addition to the diet. As with fish, nuts contain fatty acids that help keep the heart healthy. Walnuts are especially rich in a type of omega-3 called alpha-linolenic acid (ALA). As with other omega-3s, ALA is important for heart health. People with diabetes may have a higher risk of heart disease or stroke, so it is important to consume these fatty acids. A study from 2021 suggested that eating walnuts has links with a lower incidence of diabetes. Walnuts also provide key nutrients, such as protein, vitamin B6, magnesium, and iron.
Choose Citrus Fruits and Berries
Some researchers have found that citrus fruits are rich in many flavonoid antioxidants, such as hesperidin and naringin, which may exhibit antidiabetic effects.
Citrus fruits are also a great source of:
- Vitamin C
- Folate
- Potassium
Berries are full of antioxidants, which can help prevent oxidative stress. Oxidative stress has links with a wide range of health conditions, including heart disease and some cancers. Studies have found that oxidative stress contributes to type 2 diabetes. This occurs when there is an imbalance between antioxidants and unstable molecules called free radicals in the body.
Berries also contain:
- Vitamin C
- Vitamin K
- Manganese
- Potassium
Opt for Sweet Potatoes over White Potatoes
Sweet potatoes rank lower on the GI scale than white potatoes. This makes them a great alternative for people with diabetes, as they release sugar more slowly and do not raise blood sugar as much. They are also a good source of fiber, which also helps with blood sugar regulation.
Sweet potatoes are also a great source of:
- Vitamin A
- Vitamin C
- Potassium
Consider Probiotic Yogurt and Chia Seeds
Probiotics are the helpful bacteria that live in the human gut and improve digestion and overall health. A small 2022 study found that people with type 2 diabetes and obesity who took probiotics supplements for 90 days had better blood sugar levels, higher levels of âgoodâ cholesterol (also called HDL cholesterol), and healthier gut bacteria. A person should consider choosing a plain variety with no added sugar. Probiotic yogurt contains live, active cultures such as Lactobacillus and Bifidobacterium, which it may advertise on the label.
People often call chia seeds a superfood because of their high antioxidant and omega-3 content. They are also a good source of plant-based protein and fiber. In one small-scale trial from 2017, people who had overweight and type 2 diabetes lost more weight after 6 months when they included chia seeds in their diets compared with those who ate an oat bran alternative. The researchers support the beneficial role of chia seeds helping people with type 2 diabetes to manage their weight more effectively. Obesity is a significant risk factor for diabetes, and weight loss can help with improved blood sugar management.
Foods to Limit or Avoid
High GI Foods
One way to manage diabetes with dietary changes is to balance high and low GI foods. High GI foods increase blood sugar more than low GI foods. When choosing high GI foods, limit portions and pair them with sources of protein or healthy fats to reduce their effect on blood sugar and feel fuller for longer.
Foods high on the GI scale include:
- White bread
- Puffed rice
- White rice
- White pasta
- White potatoes
- Chocolate
- Cookies
- Cakes
- Potato chips
- Regular soda
Carb-Heavy Foods
Carbohydrates (carbs) are an important part of all meals. However, people with diabetes may benefit from limiting their carb intake or pairing carbs with a healthy protein or fat source.
Saturated and Trans Fats
Certain fats, such as saturated and trans fats, may increase insulin resistance and contribute to reduced blood sugar management in people with diabetes. Many fried and processed foods, including fries, chips, and baked goods, contain these types of fats.
Refined Sugar
People with diabetes should limit or avoid sources of refined sugar, such as store-bought or homemade sweets, cakes, and biscuits. The American Heart Association recommends consuming no more than 25 g or 6 teaspoons (tsp) of added sugar per day for females, and 36 g or 9 tsp for males. This does not include naturally occurring sugars from foods such as fruit or plain milk.
Sugary Drinks
Drinks that contain a lot of sugar, such as energy drinks, some coffees, and shakes, can disrupt a personâs insulin level, leading to an imbalance.
Salty Foods
The ADA recommends limiting the sodium intake to under 2,300 milligrams (mg) per day, regardless of a personâs diabetes status.
Alcohol
Drinking alcohol in moderation should not carry serious risks for people with diabetes and should not affect long-term glucose management. However, people with diabetes should avoid mixed drinks or cocktails as these often contain added sugars that can lead to blood sugar spikes. People prescribed insulin or insulin secretagogue therapies may have a higher risk of hypoglycemia linked to alcohol consumption.
The Centers for Disease Control and Prevention (CDC) recommends that females who drink alcohol limit it to one drink per day and that males limit it to two drinks per day, regardless of diabetes status.
Lifestyle Modifications for Prediabetes
In addition to dietary changes, lifestyle modifications are crucial for managing prediabetes and supporting the prevention of its progression to type 2 diabetes.
Regular Physical Exercise
Engaging in regular physical activity is essential for managing prediabetes. Aim for at least 150 minutes of moderate-intensity aerobic exercise per week, such as brisk walking, cycling, or swimming. Strength training exercises at least twice a week can also improve muscle mass and metabolic function.
Stress Management
Chronic stress contributes to hormonal imbalances and inflammation, which can exacerbate prediabetes. Implementing stress management techniques, such as meditation, deep breathing exercises, or engaging in activities that bring joy and relaxation, can help mitigate the negative impact of stress on blood sugar control.
Personalization: The Key to Success
When implementing a prediabetes diet, it is crucial to personalize the approach based on each individual's unique biochemistry and needs. A personalized treatment plan considers various factors such as hormonal signaling, gut health, stress responses, and lifestyle factors contributing to metabolic dysfunction. This approach improves patient adherence, targets specific interventions, enhances motivation, and optimizes outcomes, potentially leading to more effective prediabetes management.
The Importance of Healthcare Professional Guidance
It is important for individuals with prediabetes to work closely with a healthcare professional, such as a functional medicine practitioner, who can provide personalized guidance, support, and monitoring throughout their journey to support healthy blood sugar levels naturally.
The Role of Brief Interventions
Brief interventions have previously been shown to be beneficial for those with prediabetes. Brunisholz et al. reported on a DPP for patients with prediabetes which included three different pathways. Patients were allowed to enrol in any or all of the pathways, which included a 2-h introductory class, a medical nutrition pathway (MNT) and a weigh to health pathway (W2H). Similar to the NHS DPP both the MNT and the W2H pathways involved multiple, personalised sessions while the 2-h class was a single session taught to a group of patients and included information on healthy eating and physical activity. There were no differences between pathways in achieving the studyâs primary outcome, which was a 5% reduction in body mass.
Overcoming Misconceptions and Extreme Choices
Some patients when newly diagnosed with pre-diabetes make extreme and unsustainable dietary choices and crash-diets. The main goal should be to prevent diabetes and take steps to assess your diet, maintaining regular exercise, and aiming for a healthy weight. The method matters less than finding an approach you can sustain long-term.
Some patients may think that because fruits are generally considered healthy, they end up eating large amounts of fruit-based foods in a day. While many fruit taste good and are healthy, they contain a lot of sugar, especially if condensed in juice form.
Practical Tips and Recommendations from the NHS and Diabetes UK
Thereâs no special âpre-diabetes dietâ requiring expensive foods or complicated meal plans. The NHS and Diabetes UK recommend a diet thatâs high in fibre from vegetables, fruits, whole grains, and pulses, whilst keeping saturated fat, sugar, and salt to a minimum. Think of your diet as a long-term investment in your health rather than a restrictive regime.
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