If your doctor diagnoses prediabetes, one way to stem full-blown diabetes is to make immediate dietary changes--reducing sugar and salt and incorporating a greater proportion of fruits, vegetables, and whole grains

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Prediabetes affects approximately 9 percent of Americans and its incidence is on the rise. Fortunately, lifestyle modifications such as exercise and a prediabetes diet can often help people manage prediabetes and prevent them from going on to develop diabetes.

If you have been diagnosed with prediabetes, your healthcare provider will likely refer you to a registered dietitian who will make dietary recommendations based on your activity level, your weight and weight goals, and your nutritional needs. A prediabetes diet is actually a healthy balanced diet well suited for almost all people. It includes nutrient-rich fruits, vegetables, whole grains, proteins, low- or non-fat dairy products, and healthy fats and is low in added sugar, sodium, saturated fats, and overall calories.

Your dietitian may recommend a specific type of meal plan or food monitoring program, such as the glycemic index (GI) method, the carbohydrate counting method, or the food list method.

Glycemic Index Method

Your total carbohydrate consumption affects your blood glucose levels. There are different types of carbohydrates in foods (sugars, starches, and fiber) that can affect your blood glucose level differently. Foods with a high GI (such as white bread or pretzels) are those that tend to raise your blood glucose while those with a low GI (non-starchy vegetables like broccoli) tend to have little effect on your blood glucose. If you choose to follow this method, your dietitian or health care provider can guide you to a list of foods and their glycemic index.

Carbohydrate Counting Method

Because total carbohydrate consumption affects blood glucose levels more than fats or proteins do, it can be helpful to monitor your daily intake of carbohydrates as part of your prediabetes management. Packaged foods will list the total carbohydrate content per serving and your dietitian can help provide you with carbohydrate counts for common whole foods.

It’s best to steer towards complex carbohydrates that are high in fiber such as fruits, vegetables, and whole grains and to avoid the simple carbohydrates such as white rice that are low in fiber and higher in sugars. Your dietitian will help you determine a total carbohydrate goal based on your age, weight, and activity level.

Prediabetes Diet: The Food List Method

This method divides foods up into categories such as proteins, dairy, fats, fruits, starchy and non-starchy vegetables, and carbohydrates. Each category will contain a list of different food choices with an associated serving size that provides the same amount of carbohydrate, protein, fat, and calories. This allows you to plan your meals in order to meet total daily calorie, carbohydrate, protein, and fat goals.

No matter which method you choose, your dietitian will encourage you to maintain a balanced diet that includes the following food groups:

Fruits

Fruits are rich in antioxidants, vitamins, and minerals. For example, citrus fruits contain high levels of vitamin C and berries contain high levels of antioxidants. Fruits are also rich in fiber, which can help control blood glucose levels and reduce your risk of cardiovascular disease.

Fruits also contain naturally occurring sugars. It’s best to eat whole raw or cooked fruit without added sugar. Be wary of canned fruits mixed with sugary syrups. If you eat dried fruits, be mindful that portion sizes are much smaller than those of fresh fruit.

Vegetables

Like many fruits, most vegetables are high in vitamins, minerals, and fiber. For instance, dark leafy greens like kale or spinach are rich in iron, vitamin K, and zinc while sweet potatoes are high in vitamin A and fiber.

For meal planning purposes, vegetables are often divided into starchy and non-starchy categories. Starchy vegetables such as potatoes and squash tend to have more carbohydrates and to be higher on the glycemic index, but they still contain many healthy nutrients and, if portioned wisely, they can be part of a healthy prediabetes diet. Non-starchy vegetables such as Swiss chard, broccoli, and green beans are low in carbohydrates and rank low on the glycemic index. Your dietitian will encourage you to eat raw or steamed vegetables or vegetables cooked in small amounts of healthy fats like olive oil.

Whole Grains

Eating a whole grain means eating every part of the grain: the bran, germ, and endosperm. By eating the entire grain, you are reaping the benefits each part has to offer which includes fiber, vitamins, minerals, and, in some grains, omega 3 fatty acids. Examples include whole grain barley, which provides fiber and potassium; whole oats, which provide fiber and magnesium; and wheat germ, which provides fiber and chromium.

When buying packaged foods advertising whole grain content, be certain to look at food labels and ingredients lists to ensure the whole grain is the main ingredient and that the product is not also high in sugar.

Protein

Protein is an important building block of many different parts of our bodies, from our bones and blood to our muscles and hair. Healthy sources of protein include lean meats, poultry, eggs, and fish. Examples of plant-based proteins include beans (such as pinto, black, kidney, and soy beans), nuts, and lentils, among others.

When incorporating meats or poultry into your diet, most dietitians will recommend trimming the fat and looking for leaner cuts of meat as well as removing the skin from poultry to reduce the fat and cholesterol content. Fatty fish such as salmon, tuna, and mackerel are rich in the heart-healthy omega-3 fatty acids that can help lower triglyceride levels.

Animal or fish sources of protein, unless breaded, do not contain carbohydrates and do not raise blood glucose levels and therefore aren’t assigned a glycemic index score. Plant based proteins do contain carbohydrate and should be factored into carbohydrate counting, though they tend to score low on the glycemic index.

Dairy

Dairy products are not an essential part of our diet, but they are consumed by many people and can be good sources of calcium, vitamin D, and protein. As part of a prediabetes diet, they’re best consumed as skim or low-fat milk and plain non- or low-fat yogurt to minimize the carbohydrate, fat, and calorie intake.

Fats

While saturated fats (such as those found in animal fats, high-fat dairy products, and palm oil) and trans fats (often found in processed foods, shortenings, and margarines) should be kept to a minimum because of their association with heart disease, some mono- and poly-unsaturated fats can be part of a healthy diet.

The mono- and polyunsaturated fats found in foods such as avocados, olive oils, and nuts can be helpful in lowering cholesterol levels and maintaining healthy blood glucose levels. It’s important to remember, though, that fats are high in calories, so a little goes a long way.

Originally published in June 2016 and updated.