If your doctor says your bloodwork reveals prediabetes, you’re bound to have questions about what’s best to eat. Tara Seymour, an advanced practice clinical dietitian and diabetes educator at Johns Hopkins, provides guidance on how a healthy diet and lifestyle can control — and even help reverse — prediabetes. I included the link to her presentation and full article at the end of this blog! Please take some time to read her in depth report for navigating your nutrition when living with prediabetes! I highlighted some of her main topic points in the article to follow! Be sure to check out the delicious Mediterranean Salmon Bowl Recipe at the very bottom of this blog! You don't want to miss this one- it's healthy and delicious!
Diet for Prediabetes — What foods should I eat?
The key to warding off progression of prediabetes is a balanced approach to diet.
“People with prediabetes do not have to eliminate entire food groups,” Tara Seymour explains. “All foods can fit in the meal plan, and patients should steer clear of fad diets and other strategies that promise quick fixes, since their claims are not supported. We encourage making gradual behavior changes. Small changes can lead to big results.”
With that in mind, she regards the Mediterranean diet as the gold standard for people with prediabetes, with its emphasis on whole grains, lean protein and healthy fats.
She also refers patients to diabetes meal planning recommendations from the Centers for Disease Control and Prevention and a version of the MyPlate guidelines issued by the U.S. Department of Agriculture and adapted by the American Diabetes Association (ADA).
https://www.myplate.gov/eat-healthy/what-is-myplate
Though these resources are not specifically for prediabetes, they can serve as a guide to incorporating healthy choices!
The ADA’s version of the recommendations suggests these proportions for meals:
- 50% of the plate filled with non starchy vegetables, such as leafy greens
- 25% with healthy carbohydrates, such as whole grains like brown rice, farro or quinoa
- 25% with lean protein, such as chicken, turkey, fish or tofu, not fried
Water or another zero-calorie beverage is preferred.
Seymour also recommends:
- Avoiding excessive intake of added sugars by limiting sugary beverages, cakes, cookies, candy and snacks
- Limiting portion sizes of refined carbohydrate foods such as white bread, white rice and white pasta
- Incorporating fiber to reach a goal of 25 to 30 grams per day by eating a variety of fruits, vegetables and whole grains
- Limiting saturated and trans fats by choosing lean protein and low-fat dairy
Foods to Avoid If You Have Prediabetes
“Grapefruit and pomegranate juice can interact with some medications, since they are processed by the same liver enzyme that metabolizes medication. That enzyme is cytochrome P450, which accounts for about 75% of the total drug metabolism performed by the body.”
In addition, Seymour advises care with some nutritional supplements. Ginseng, gingko and garlic are OK in moderation, but high doses of these, as you get in over-the-counter supplements, can cause low blood sugar. “When it comes to supplements,” she says, “it is always important to know your risks and follow the proper dietary protocol by consulting your doctor or dietitian.”
“What should I eat for breakfast if I have prediabetes?”
“Opt for balanced meals that incorporate lean protein, low fat dairy and plenty of fiber,” Seymour advises. “Try cereals with at least five grams of fiber per serving, whole fruits, vegetables and whole grains. If you’re tempted to skip breakfast, try a low carbohydrate meal replacement bar or shake to start your day off right.
“What fruits should I avoid with prediabetes?”
Seymour stresses that all types of fruit are OK and unlikely to be a problem for people who have prediabetes (with the exception of pomegranate juice and grapefruit for people taking certain medications).
“Fruit is a carbohydrate that provides both sugar and fiber,” she says. “You will get more fiber eating whole, fresh fruit than you will by drinking fruit juice.”
“All foods can fit,” she adds. “The key is to watch your portion sizes and read labels of prepared items. Fruit juice and canned fruit may have more sugar.”
A professional can help customize a prediabetic meal plan
Because everyone is different and many people with prediabetes have other health issues, Seymour says it is important to tailor prediabetes food plans to the individual. For instance, patients with high cholesterol may do better with a lower-fat approach, while those with high A1C may benefit from a meal plan that’s lower in carbohydrates.
Working with a doctor or dietitian can be helpful. “People diagnosed with prediabetes can ask their primary care practitioner for a referral to a local registered dietitian,” Seymour says. “That way, they can get individual counseling to achieve their health goals.”
Prediabetes and sugar — How much is too much?
Blood sugar levels are important indications of prediabetes, and it’s no secret that most Americans eat more sugar than they should. Sugar can hide in less obvious places, including processed foods such as breakfast cereals, frozen meals, snacks, sauces and dressings.
Though some sugar is necessary for your body to function, too much can worsen prediabetes. Seymour explains: “Carbohydrates are an important source of energy since glucose [blood sugar] is the preferred molecule to fuel the brain. However, excessive intake of refined carbohydrates from added sugar can cause adverse health effects.
Recommendations for Limiting Sugar
“The World Health Organization advises limiting added sugars to less than 10% of your total energy intake. For added health benefits, you would limit sugar calories to 5% or less of your total.
“For example, for someone on a 2,000-calorie daily diet, if they are following the 10% guideline, they would limit sugar calories to about 50 grams, which is about 12 teaspoons. For the 5%, they would stick to 25 grams, or about six teaspoons.
“The American Heart Association is a little more stringent, and for people at risk for heart disease, including those with prediabetes, it recommends less than six teaspoons of sugar a day for women (about 25 grams) and less than nine teaspoons (about 36 grams) a day for men.”
That’s not a lot. Seymour points out that one can of soda contains about 32 grams of sugar, which is about eight teaspoons.
“We urge our patients to watch what they drink,” Seymour says, noting that sweetened beverages such as sodas, sports drinks, juices and gourmet coffee shop creations account for some of the biggest concentrated sources of added sugar. “Just one of these beverages can take up your entire recommended allotment of sugar for the day ― or even several days.”
The 5-20 Rule
Another way to assess whether a product is overly high in sugar is to read the nutrition label. “The general rule for sugar content is choose products with a sugar content of 5% or less of the daily requirement and avoid items in which the amount of sugar is 20% or more of the daily requirement,” Seymour says.
How to Reverse Prediabetes — Lifestyle
Seymour says switching to well-balanced meals high in healthy, fiber-rich foods, along with incorporating more physical activity, can help people with prediabetes take charge of their health.
“It has been well cited in research studies such as the National Institutes of Health’s Diabetes Prevention Program Outcome Study that incorporating healthy eating habits, weight reduction and increased physical activity can lower your risk of developing type 2 diabetes.
“Additionally, lifestyle changes resulting in modest weight loss have shown to delay the onset of type 2 diabetes by 34% for four years compared to placebo, which was an outcome of the Johns Hopkins’ diabetes prevention program.”
Resources/ Deep Dive article on John Hopkins Medical Center work with Prediabetes.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/prediabetes
Mediterranean Salmon Bowl Recipe!
Mediterranean Salmon Bowl - a healthy easy dinner recipe that is full of flavor, super satisfying and ready in around 30 minutes.
Prep Time: 15 minutes Cook Time: 15 minutes Total Time: 30 minutes
INGREDIENTS
8oz/ 250g salmon filet
1 tsp basil, dry
1/2 tsp crushed red pepper
2 garlic cloves, minced
1 cup broccoli florets
2 tbsp. olive oil
SALAD
1 cup lettuce, chopped
2/3 cup purple cabbage, chopped
handful basil leaves
1/4 cup feta cheese, crumbled
1 tbsp. lemon juice
10 olives, pitted
2 tbsp. hummus or low carb hummus
INSTRUCTIONS
- Rub the salmon with the dried basil, crushed red pepper flakes, and 1 clove garlic. Let it sit like that for a few minutes while you're making the broccoli and the salad.
- For the salad chop the cabbage and massage it in a bowl with the lemon juice. Then add the lettuce, basil, olive oil, feta cheese and 1 clove of minced garlic. Mix everything well together and add salt and pepper if needed. I didn't need to do it, because the feta was very salty.
- For the broccoli, I chopped the florets and stirred them for 2 minutes in a non-stick pan with 1 Tbsp olive oil. Then I turned off the heat and covered with a lid for a few minutes.
- After that, I took out the broccoli and added the salmon to the same pan. I cooked it at medium/medium high and covered with a lid, flipping half-way through. Now, you can use whole salmon filets, I had cut mine into a few chunks as you can see in the pictures. After 6-7 minutes the salmon is ready and you can start arranging the bowl.
- At the bottom, we put the salad, then add the olives, hummus, broccoli and in the middle the salmon. Add salt and pepper to taste!
Enjoy this delicious dish my friends!
Much love,
Katie
RN, CPT, Wellness Coach
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