Prediabetes Diet: What to Eat, and What to Avoid

Published on 
November 26, 2024
October 4, 2022
Virta Health
Virta Health
Virta Health
Ask Theresa: An advice column

A prediabetes diagnosis can be scary. After all, diabetes is typically thought to be a chronic, progressive condition. You probably have a lot of questions – a big one being “how do I stop this from progressing to type 2 diabetes? What should I do? What can I eat?” It can be overwhelming. But there’s some good news – it is possible to reverse prediabetes and prevent type 2 – and what we eat plays a big role here.

What is prediabetes?

Prediabetes develops when blood glucose (sugar) levels are higher than normal, but not quite high enough to be classified as type 2 diabetes. When glucose levels in the blood start to rise, the body produces insulin  - a hormone that helps glucose enter the cells to be used as energy. In the development of prediabetes, your cells don’t respond to insulin as they should (this is called insulin resistance) and the pancreas responds by making even more insulin. Once the pancreas is unable to keep up, glucose levels continue to rise above normal levels and prediabetes develops. 

The stats are a little scary: some experts estimate that as many as 70% of people with prediabetes will develop type 2 in their lifetime¹. But, this is not inevitable. You can absolutely take control of your health, and prediabetes can be reversed. A major factor in preventing prediabetes from progressing to type 2 is diet – and we’ll get into more detail on that.

What causes prediabetes?

While the exact cause of prediabetes is unknown, lifestyle, family history and genetics can all play a role. But the underlying root issue is insulin resistance - people with prediabetes aren’t processing glucose “normally” anymore. Most of the glucose in our bodies comes from the food we eat, and when someone with prediabetes or type 2 diabetes eats carbohydrates or sugar, it causes their blood sugar to rise above a healthy level.

Diet for prediabetes

One of the most studied diets for reversing diabetes and prediabetes is a low carbohydrate diet² that’s personalized to your carb tolerance. People with a high carb tolerance might be able to eat a carbohydrate-heavy diet and keep their blood sugar in a normal range, but someone with prediabetes and a low carb tolerance may experience chronic blood sugar spikes and struggle with fatigue, weight gain, and more. 

Since carbohydrates turn into sugar in your body, restricting them in your diet can be very successful in reversing prediabetes and preventing its progression to type 2. 

Virta utilizes a “well formulated ketogenic diet” to reverse the progression of prediabetes. This means eating foods that have moderate protein, low carbohydrates, and have an adequate amount of fat to stay full. But it’s not just about the food – it’s about the support. Virta provides 1:1 virtual coaching to help make this lifestyle stick – see if you’re eligible for Virta here.

If you’re following a low-carb diet to reverse your prediabetes, here are a few foods you might want to add to your grocery list – and ones you should limit as much as possible or steer clear of altogether.

What to eat if you have prediabetes

  • Eggs
  • Fish, such as cod, flounder, haddock, halibut, tuna, and trout
  • Lean meats such as chicken, turkey, and lean cut beef
  • Shellfish
  • Greek or full-fat yogurt
  • Nuts and seeds
  • Full fat cheese and cottage cheese
  • Tofu 
  • Butter
  • Almond Butter
  • Coconut milk
  • Asparagus
  • Beets
  • Brussel sprouts
  • Broccoli
  • Carrots
  • Cauliflower
  • Celery
  • Cucumber
  • Eggplant
  • Leafy greens
  • Mushrooms
  • Onions
  • Peppers
  • Radishes 
  • Sprouts
  • Squash
  • Tomatoes
  • Almond and coconut Flour
  • Strawberries
  • Blueberries
  • Raspberries
  • Kiwi
  • Olive Oil
  • Avocado 
  • Heavy cream and half-and-half

What not to eat if you have prediabetes

It’s important to watch your carb intake if you have prediabetes. While some foods like brown rice, potatoes and oatmeal are typically considered “healthy,” they could also spike your blood sugar. That’s why it can be a good idea to use the glycemic index (GI) as a tool to determine how a particular food could affect your blood sugar.

In addition to watching your carb intake and avoiding high GI foods, you also want to avoid these foods if you have prediabetes. 

  • Chips
  • Pretzel
  • Rice
  • Bread
  • Pasta 
  • Candy
  • Desserts and sweets
  • Baked goods
  • Agave
  • Honey 
  • Sugar-sweetened soda
  • Syrups
  • Jams and jellies 
  • Fruit juice 
  • Syrups
  • Sweet tea
  • Bagels
  • Crackers
  • Sugary yogurt
  • Sweetened breakfast cereal 
  • Snack bars 
  • Alcohol 
  • Sugar

Example low-carb meal plan for prediabetes

Here are a few meals you might consider if you have prediabetes and are following a low-carb diet. These meals are all low on carbohydrates and higher on fats that will keep you full for longer.

Breakfast

Scrambled eggs with cheese and sausage

Unsweetened coffee (or sweetened with a 0 carb sweetener like Stevia) with heavy cream

Vegetarian option: Full fat yogurt with berries or coconut flour pancakes

Lunch

Baked salmon with hollandaise sauce, and a side salad made of leafy greens and a full-fat dressing (watch out for any hidden sugars in dressings and sauces!) 

Vegetarian option: Tofu curry made with full fat coconut milk

Dinner

Steak with brussel sprouts

Vegetarian option: Palak paneer or curried cauliflower soup

Dessert

Berries with heavy cream

In Closing

A prediabetes diagnosis can be daunting, but it doesn’t have to mean you will have prediabetes forever, or even progress to type 2 diabetes. 

Making some changes to your lifestyle can effectively reverse prediabetes.

FAQs

Can I eat fruit if I have prediabetes?

Short answer: yes, in moderation. Because fruit is a natural source of sugar, it’s important to limit how much you eat, and choose fruits with lower levels of sugar, like berries and kiwi.

What should people with prediabetes eat for breakfast?

People with prediabetes who are following a low carb diet have lots of options for breakfast, including eggs, meats like breakfast sausage, and full fat yogurts, as well as smoothies that contain low-sugar fruits and veggies.

Can I drink alcohol if I have prediabetes?

For people with prediabetes who are dealing with high blood sugar and choose to drink alcohol, it should be consumed in moderation. There are alcohols that are low in carbohydrates – like vodka and dry wines – but be wary of cocktails with sugary mixers.

This blog is intended for informational purposes only and is not meant to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or any advice relating to your health. View full disclaimer

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Citations
  1. Tabák AG, Herder C, Rathmann W, Brunner EJ, et al. Prediabetes: a high-risk state for diabetes development. Lancet. 2012 Jun 16;379(9833):2279-90. doi: 10.1016/S0140-6736(12)60283-9. Epub 2012 Jun 9. PMID: 22683128; PMCID: PMC3891203.
  2. Evert AB, Dennison M, Gardner CD, et al. Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes Care 1 May 2019; 42 (5): 731–754. https://doi.org/10.2337/dci19-0014

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