More than one in three American adults has prediabetes, a condition marked by too-high blood sugar levels. And while prediabetes can put you on a fast-track to Type 2 diabetes — as well as the health complications that accompany it — unlike diabetes, prediabetes is not just manageable; it’s reversible, according to the Centers for Disease Control and Prevention.
In fact, a 2012 review published in The Lancet concluded that, through lifestyle modifications alone, people with prediabetes can cut their risk of developing Type 2 diabetes by 40 to 70 percent. Those modifications include weight loss, exercise, stress management and improved sleeping habits, but perhaps the most important change you can make when trying to manage or even reverse prediabetes is nutrition, says New York City-based registered dietitian and certified diabetes educator Laura Cipullo, author of “Everyday Diabetes Meals: Cooking for One or Two.”
[See: 10 Myths About Diabetes.]
Below are six nutrition guidelines that can help you lower your blood sugar to put prediabetes in your past.
1. Cut your daily carbohydrate intake. Counting and reducing carbs is a mainstay of managing prediabetes, Cipullo says. She explains that the amount of daily carbohydrates you need varies based on your sex, body size and activity levels. (Men, larger individuals and those who exercise need more carbs.) However, a 2014 review published in Nutrition, Metabolism and Cardiovascular Diseases, which concluded that going low-carb is beneficial for both weight loss and the prevention of Type 2 diabetes, defined low-carb diets as those in which less than 45 percent of daily calories come from carbohydrates.
Based on a 2,000-calorie diet, that translates to eating a maximum of 225 grams per day. (Each gram of carbohydrates contains four calories.)
2. Focus on whole carbs. While some people emphasize the importance of choosing complex carbohydrates over simple ones, an easier, and maybe even more healthful, strategy for those with prediabetes is to emphasize whole, naturally occurring carbs (like whole grains, produce and dairy) over refined, processed ones (like white pasta, soda and sugar), says Dr. Patricia Salber, board-certified internist and founder of “The Doctor Weighs In” blog and podcast.
That’s not to say complex carbs aren’t great; found in foods such as whole grains, beans and vegetables, they are, well, complicated in their molecular structure, meaning your body has to work hard to digest them. As a result, they have lower glycemic index, or GI, ratings, which are values assigned to foods based on how quickly they increase blood sugar levels compared to simple carbs, she says.
However, simple carbs are also found in healthful, natural foods such as dairy and fruit that can and should be part of your diet, according to Salber. Just watch your portions: “The recommended serving size for fruit is one small piece of fruit (think the size of a small fist) or one-half cup of fruit,” says Emmy Bawden, a registered dietitian at Weiss Memorial Hospital in Chicago. “Berries, including strawberries, raspberries and blackberries, and melon are a bit lower in sugar and, as such, the serving size is 1 cup.” FYI, while fresh and frozen fruit are both great options, canned fruit often contains added sugar.
[See: Got Diabetes? Why You Must Protect Your Feet.]
3. Mix up your macros. ” Macronutrients” refers to the three calorie-containing nutrients that people need in large (hence, macro) amounts to live and thrive: carbohydrates, protein and fat. And when you eat these three macronutrients together in a single sitting, it influences how your body digests them, says Cipullo, who recommends making every meal and snack a mix of all three.
“Eating mixed meals and snacks, pairing carbs with protein and fat, slows the digestion of carbohydrates and the release of glucose, or sugar, into the bloodstream,” Cipullo says. So if you want to have the occasional splurge of a high-GI food with simple carbs such as a sugar-laden doughnut, eating it alongside scrambled eggs, which provide both protein and fat, will help lower its glycemic index and its effect on your blood sugar levels. Remember that many foods such as milk, cheese, nut butters and quinoa contain high levels of more than one nutrient, she says.
Also worth noting: While fiber is technically a type of carbohydrate, it can also help slow the digestion of simple carbs in a way that’s similar to protein and fat. That’s why, when it comes to fruit, you should eat the whole fruit, including the peel, rather than drinking fruit juice, which is devoid of fiber.
4. Eat every few hours. “Eating a small meal or snack every four to five hours can help in achieving glycemic, or blood sugar, control,” Bawden says. Cipullo adds that the stomach empties itself every three to four hours, so if you go much longer without eating, your blood sugar levels could nosedive, causing you to overeat at your next meal.
What’s more, by eating regularly throughout the day, you can more easily spread out your carbohydrate intake. “This way, you are never eating a lot of carbohydrates at a time, so your blood sugar doesn’t spike,” Cipullo says. She recommends eating roughly 45 to 60 grams of carbs at every meal and between 15 and 30 grams at every snack.
5. Eat breakfast (one hour after waking). Start your day off right. In a 2015 Diabetes Care study, when people with Type 2 diabetes skipped breakfast, their lunchtime and dinnertime blood sugar levels were 37 and 27 percent higher than on days when they ate breakfast. Interestingly, it wasn’t because they were eating more than usual for lunch and dinner. In the study, participants ate the same lunches and dinners.
However, you don’t need to roll straight out of bed to the kitchen. Blood sugar levels can commonly spike upon waking, so you don’t want to eat carbs right then, which could make your blood sugar and insulin levels go even higher, Cipullo explains. Scheduling in an hour between alarm clock and omelets (go ahead and take a shower and get dressed) gives your body time to level out before you increase your blood sugar with breakfast, she says.
[See: 6 Tips to Keep Diabetics Out of the Hospital.]
6. Avoid both sugar and artificial sweeteners. Artificial sweeteners seem like a great way to cut your sugar habit. “However, research now shows that artificial sweeteners may have indirect metabolic effects that can be detrimental to one’s efforts to lose weight or slow the progression of prediabetes,” Bawden says.
For example, research presented at the 2017 meeting of the European Association for the Study of Diabetes shows that artificial sweeteners, when consumed in large amounts, may impair the body’s response to glucose, or sugar — increasing the risk of Type 2 diabetes. Salber explains that artificial sweeteners may alter the balance of bacteria in the gut, which can impact blood sugar control. They are also linked to decreased satiety and, contrary to what you might think, increased calorie consumption and weight gain, she says.
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Got Prediabetes? 6 Nutrition Tips You Need to Follow originally appeared on usnews.com
