A Food-Based Approach
Did you know that simply changing the way you eat can put you on the path to reversing your prediabetes? It’s true. And what’s more, many approaches exist. There is no singular “prediabetes reversal diet.” You can find the way that is right for you, that best fits your lifestyle and your food preferences, and still achieve success.
The Commonalities of All Diets that Work
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Eat whole foods and minimally processed foods
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Prioritize protein at every meal, whether from animal or plant sources
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Eliminate ultra-processed foods
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Eliminate added sugars
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Avoid/reduce foods that rapidly digest to sugar, such as high glycemic carbs, refined grains
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Eliminate sweet beverages including pop, fruit juice, sports drinks, and sweet tea or coffee
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Eat plenty of colorful vegetables for adequate fiber and nutrients
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Include healthy fat sources such as olive oil, butter, ghee or nut oils
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Consume little to no alcohol and eliminate intake of sweet alcoholic drinks
Vegan
Vegetarian
Very Low Calorie
Ketogenic
Low Carb
Mediterranean
Getting Started
No matter which dietary approach you decide to follow, eating healthy meals to reverse your prediabetes can be as easy as 1, 2, 3.
AT EACH MEAL
1
Get adequate protein. Aim for about 25 to 40 grams of protein at every meal or about 75 to 160 grams of protein a day. Visually, this is a serving of meat, poultry, fish, seafood, eggs, beans, lentils, or tofu that’s about the size of 1 to 2 decks of cards at every meal. If you’re taller than average, aim for the top of this protein range. Food tracking apps can help you log and understand your daily protein intake.
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Include high-fiber plant foods, such as vegetables and leafy greens that grow above the ground. For fruit, choose high-fiber, low-sugar options like berries. Depending on the approach you choose, you may be able to add other fruits, below-ground vegetables, legumes, and minimally processed grains.
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Add healthy fat, such as olive oil, butter or ghee,in the amount needed to prepare and enjoy your meal.
To set yourself up for success, be sure to clean out your fridge and pantry of all the processed foods that contain sugar, flour, and other refined carbs – especially the ones you find tempting such as crackers, cookies, biscuits, chips, pretzels, breakfast cereals, etc. Some people can leave the dried pasta, rice, or baking supplies in the cupboard for others to use. But if you suspect you might want to whip up a batch or cookies or plate of pasta, either get rid of those items or make sure they’re kept out of your view. For more tips for success, be sure to check out the "Practical Help" tab on this site.
Dietary Approaches for Reversing Prediabetes
Mediterranean Diet
A “Mediterranean diet” is based on the traditional cuisine of people who live in the countries that border the Mediterranean Sea, including Italy, Greece, and Spain.
Mediterranean eating patterns prioritize fresh food over processed foods. Although there is no one Mediterranean diet, nearly all versions contain large amounts of vegetables, fruits, whole grains, fish, legumes, nuts, and olive oil; moderate amounts of eggs, poultry, and dairy products; and smaller amounts of red meat, processed meat, and wine.
Research suggests that a Mediterranean diet may help lower blood sugar levels and improve other health markers.
How To Follow a Mediterranean Diet
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Follow the 1, 2, 3 meal planning method, with:
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adequate protein from animal and plant sources at every meal
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above-ground vegetables as your main source of carbs
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enough healthy fat to feel satisfied, as fat will provide most of your energy
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- Make lower-glycemic fruit choices: Select low-sugar fruits like berries or smaller amounts of medium-sugar fruits like melon, lemons, limes, apples, pears, and peaches rather than high-sugar fruits like mango, grapes, bananas, and dried fruit.
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Moderate your alcohol intake: Limit alcohol (dry wine) intake to 1 glass per day if you are a woman and 2 glasses per day if you are a man.
Low Carb Diet to Reverse Prediabetes
A low carbohydrate, or low carb, diet provides between 30 to 100 grams of net carbs per day. (“Net carbs” are calculated by subtracting the grams of dietary fiber from the grams of total carbs in a food.) This is considerably less than the amount specified in Canada’s Daily Values of 300 grams of total carbs on a 2,000-calorie diet.
Because carbohydrates, when digested, raise blood sugar much more than protein or fat do, a low carb approach can be very effective for lowering blood sugar levels, along with reducing heart disease risk factors. Research suggests you can achieve these benefits without necessarily losing weight. However, a low carb way of eating can also help you lose weight if you need to.
How To Follow a Low Carb Diet
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Follow the 1, 2, 3 meal planning method, with:
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adequate protein from animal and plant sources at every meal
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above-ground vegetables as your main source of carbs and fiber
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enough healthy fat to feel satisfied, not stuffed
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Determine your daily carb target.
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You can start with 30 grams of net carbs per day, 100 grams of net carbs per day, or somewhere in between. Pay attention to how you feel and, if possible, test your blood sugar 1 to 2 hours after eating to see how your body responds to a given level of carbs. (Learn more about testing blood sugar in the Practical Tips for Success section).
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If you only eat above-ground vegetables, your carb intake will be very low. If you include fruit, below-ground vegetables like carrots or sweet potato, or legumes like peas or beans, your carb intake will be moderate to liberal, depending on the amounts of these foods you eat.
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You can use Cronometer, KetoDietApp, or CarbManager to learn how many carbs are in different foods and track your daily carb intake (Learn more about tracking in the Practical Tips for Success section).
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Consider boosting electrolyte intake: If you start eating a diet that contains fewer than 50 grams of net carbs per day, you may experience headaches, fatigue, and other symptoms that are known as the “keto flu.” This occurs when your body’s electrolytes shift as your body transitions from using glucose to using fat and ketones as its main energy source. For further information, and for tips on what to eat and drink to boost electrolytes and minimize symptoms of keto flu, see the description of the ketogenic diet in the next section.
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Talk to your doctor before starting a low carb diet: Although low carb diets are healthy and are safe for most people, it’s important to check with your doctor before beginning, especially if you take blood pressure medication.
What is a Ketogenic Diet?
A ketogenic (or keto) diet is the strictest version of low carb eating. With this approach, you minimize carbohydrates, consume adequate protein, and eat higher amounts of fat.
When you eat very few carbohydrates, your liver begins converting fat into ketones, which your brain and other organs can use for energy. At this point, your body stops using glucose as its main energy source and switches to burning fat as its main energy source. This fat comes from the food you eat, as well as your stored body fat. When you are using fats and ketones as your primary source of energy, you are in a metabolic state called nutritional ketosis.
How To Follow a Keto Diet
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Follow the 1, 2, 3 meal planning method, with:
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adequate protein from animal and plant sources at every meal
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above-ground vegetables as your main source of carbs
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enough healthy fat to feel satisfied, not stuffed
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Boost electrolyte intake: When starting a ketogenic diet, you may experience headaches, fatigue, and other symptoms that are known as the “keto flu.” This occurs in the first week when your body’s electrolytes shift as your body transitions from using glucose to using fat and ketones as its main energy source. Here are some tips to minimize keto flu:
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Salt your food liberally or drink a cup or two of salty broth daily, especially during the first week or two. (Note: If you have hypertension, speak with your doctor before adding salt to your diet).
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Eat foods rich in potassium and magnesium, such as fatty fish, meat, avocados, nuts, seeds, and leafy greens.
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Consider supplementing with 200 to 400 mg of magnesium if you get muscle cramps while on a ketogenic diet.
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Drink a mixture of water, with a dash of salt and a squeeze of lime or lemon.
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Track your daily carb intake (Learn more about tracking in the Tools & Tricks section)
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Talk to your doctor before starting a ketogenic diet: Although ketogenic diets are healthy and are safe for most people, it’s important to check with your doctor before beginning this diet, especially if you take any prescription medication, such as blood pressure medication.
Very Low Calorie Diet
A very low calorie diet is a short-term intervention that may help reverse prediabetes. This approach provides 900 calories per day for 12 weeks and must be supervised by a health professional. After 12 weeks, you transition to a whole-foods, minimally processed diet that you can maintain long-term.
Studies suggest that this approach can lead to weight loss and remission of type 2 diabetes.
How To Follow a Very Low Calorie Diet
Phase 1: Shakes and soups
Start by consuming a maximum of 900 calories a day from commercially prepared shakes and soups that have been specially created to have a specific amount of protein, calories, vitamins, and nutrients.
Phase 2: After 12 weeks, begin following the 1, 2, 3 meal planning method, with:
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adequate protein from lean animal and plant sources
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high-fiber carb sources like vegetables (all types), fruit, nuts, and seeds
Select low-sugar fruits like berries or smaller amounts of medium-sugar fruits like melon, lemons, limes, apples, pears, and peaches rather than high-sugar fruits like mango, grapes, bananas, and dried fruit. -
enough healthy fat to feel satisfied, not stuffed
Phase 3: Custom diet
For maintenance, you will then transition with the help of your health care provider to a personalized diet that supports a stable weight and food that you can eat for the rest of your life. This diet will generally follow the common principles stated above: be a whole foods minimally processed diet, have adequate protein, plenty of vegetable fiber and nutrients, reduce or eliminate added sugars, and reduce or eliminate ultra-processed foods.
Vegetarian Diet
Vegetarian diets exclude meat and fish but, unlike vegan diets, include some animal foods. Lacto-ovo vegetarians eat dairy products and eggs, while lacto vegetarians eat dairy products but do not eat eggs.
Although vegetarian diets for prediabetes and diabetes haven’t been studied as much as vegan diets have, limited evidence suggests that some vegetarian diets may help improve insulin resistance and reduce heart disease risk factors. For people who don’t want to eat meat, a vegetarian approach may also be easier to follow long term than a vegan or 100% plant-based approach.
How To Follow a Vegetarian Diet to Reverse Prediabetes
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Follow the 1, 2, 3 meal planning method, with:
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adequate protein from primarily plant sources, such as tofu, beans, lentils, seitan, and nutritional yeast. Eggs and cheese can be added as protein if desired
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above-ground vegetables as your main source of carbs
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enough healthy fat to feel satisfied, as fat will provide most of your energy
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- Make lower-glycemic fruit choices: Select low-sugar fruits like berries or smaller amounts of medium-sugar fruits like melon, lemons, limes, apples, pears, and peaches rather than high-sugar fruits like mango, grapes, bananas, and dried fruit.
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Supplement with micronutrients as needed. Depending on how many animal products like eggs and dairy that you consume, you may need to supplement your diet with certain vitamins and minerals to ensure your needs are met. These include vitamin B12, vitamin D, calcium, iron, and zinc.
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Consume adequate omega-3 fatty acids. Omega-3 and Omega-6 fats are essential nutrients, meaning you need to get them from your diet because your body can’t make them. Although you can easily get all the omega-6 fats your body needs from a vegetarian diet, it may take some work to ensure your intake of omega-3 fats is sufficient. Vegetarian sources of omega-3 fats include seaweed, algae, hemp seeds, walnuts, chia seeds, and flaxseeds.
Vegan Diet
The terms “vegan diet” and “plant-based diet” are sometimes used interchangeably, but they don’t always mean the same thing. A vegan diet excludes all animal products: eggs, meat, fish, dairy products, gelatin (which is made from animal skin and bones). Plant-based diets may include a small amount of animal products unless it is specified as being 100% plant-based.
A vegan diet that contains highly processed foods and ingredients is unlikely to reverse prediabetes or improve overall health. However, some studies suggest that a whole-foods vegan diet may improve prediabetes by promoting weight loss and improving insulin sensitivity.
How To Follow a Vegan Diet
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Follow the 1, 2, 3 meal planning method, with:
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adequate protein from plant sources, primarily tofu, beans, lentils, seitan and nutritional yeast
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above-ground vegetables as your main source of carbs
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enough healthy fat to feel satisfied, as fat will provide most of your energy
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- Make lower-glycemic fruit choices: Select low-sugar fruits like berries or smaller amounts of medium-sugar fruits like melon, lemons, limes, apples, pears, and peaches rather than high-sugar fruits like mango, grapes, bananas, and dried fruit.
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Supplement with micronutrients: If you follow a vegan diet you will need to supplement your diet with certain vitamins and minerals to ensure your nutritional needs are met. These include vitamin B12, vitamin D, calcium, iron, and zinc.
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Consume adequate omega-3 fatty acids. Omega-3 and Omega-6 fats are essential nutrients, meaning you need to get them from your diet because your body can’t make them. Although you can easily get all the omega-6 fats your body needs from a vegan diet, it may take some work to ensure your intake of omega-3 fats is sufficient. Vegan sources of omega-3 fats include seaweed, algae, hemp seeds, walnuts, chia seeds, and flaxseeds.
Strategies That Can Be Combined With Any Way of Eating
Higher Protein
We’ve emphasized that getting enough protein at meals is important. Could eating even more protein be helpful for reversing prediabetes?
Studies show that increasing your protein intake may help suppress your appetite, prevent muscle loss, and keep your metabolism from slowing down. And there’s emerging evidence that eating a high-protein diet might help reverse prediabetes.
How can you add more protein and still follow your preferred eating approach?
Here are some suggestions:
On a Mediterranean diet, eat larger portions of animal and plant proteins, or high protein plain Greek yogurt, based on your eating preferences.
On a low carb or ketogenic diet, include a larger portion of meat, poultry, fish, seafood, eggs, dairy, or cheese at one or more of your meals.
On a vegan or vegetarian diet, increase your portions of plants that are high in protein but don’t raise blood sugar levels much, such as tofu, edamame, tempeh, seitan, and nutritional yeast.
Intermittent Fasting
Intermittent fasting means going for a period of time without eating or eating very little on some days.
These are the most common methods of intermittent fasting:
Time-restricted eating involves eating only during a specified time, or window, each day. Although the eating window can vary based on personal preference, two popular options are 16:8 and 20:4:
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On 16:8, you fast for 16 hours and eat within an 8-hour window.
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On 20:4, you fast for 20 hours and eat within a 4-hour window.
5/2 fasting involves eating normally 5 days a week and fasting or eating about 500 calories on the other 2 days a week.
Alternate-day fasting involves eating normally one day and fasting or eating about 500 calories the next day.
Several studies suggest that intermittent fasting can improve blood glucose levels and improve insulin sensitivity. And one study found that eating within a 6-hour window and finishing dinner before 3:00 pm improved insulin sensitivity in people with prediabetes – even if they didn’t lose weight.
If you don’t enjoy eating breakfast, or if any of the other methods above sound appealing, consider combining intermittent fasting with your chosen way of eating to reverse prediabetes.