One of every three adults in the U.S. has prediabetes, in which blood sugar levels are higher than normal but not high enough to be termed type 2 diabetes.1 After the diagnosis, diabetes experts say they observe two reactions. One is resignation, an ''Oh well, it's inevitable'' approach. The other? "OMG, I have to do something!"
If you fall into the second camp, there is plenty you can do to minimize the risk of the prediabetes progressing to diabetes. What's needed is a ''lifestyle reset," says Jill Wiesenberger, MD, RDN, CDE, FAND, a certified health and wellness coach and certified diabetes educator in Newport News, Virginia, and author of Prediabetes: A Complete Guide.2 The new book is published in collaboration with the American Diabetes Association.
The book, meant for consumers, is a how-to on resetting your lifestyle. That includes exercising regularly, getting to or maintaining a healthy weight and improving your diet. However, instead of just telling people to eat healthier, Wiesenberger suggests incorporating specific foods that have been linked with healthier blood sugar levels.
#1. LEGUMES—Diets rich in legumes—soybeans, black beans, kidney beans, lentils, pinto beans—are good for your blood sugar levels both short-term and long-term. The secret? "Resistant starches," which resist digestion in the small intestine and go straight to the colon, feeding the bacteria in your gut and in the process improve your body's response to insulin. (These resistant starches are also in green bananas, uncooked oats, and potatoes that have been cooked and cooled. Rejoice, potato salad lovers who can control their portions.)
In one study, those who ate the most legumes had a 35% less risk of getting type 2 diabetes over the 4-year follow-up than those who ate the least. The researchers suggest having half a serving of legumes a day to replace bread, rice or a baked potato.3
#2. NUTS—Eating nuts, with their unsaturated fat, protein, fiber, folate and other goodies, can improve blood sugar in those who already have type 2 diabetes, and other research suggests that including nuts in the diet may help prevent type 2 diabetes. In one review, eating about 2 ounces a day of nuts did the trick. 4
#3. YOGURT—One serving of yogurt daily lowered the risk of getting type 2 diabetes by 18% in one study following about 195,000 people for up to 30 years. A number of mechanisms may explain the benefit; one is that eating yogurt is associated with less weight gain, which is a risk factor for type 2 diabetes.5
#4. WHOLE GRAINS—Making a habit of eating whole grains (whole wheat, farro, whole rye, oatmeal, whole-grain barley, wild rice, quinoa) is linked with less diabetes, say the experts who wrote up the 2015 Dietary Guidelines.6
#5. CINNAMON —Sprinkle some on your oatmeal and in your coffee. In one study, researchers reviewed six different studies and found that daily cinnamon sprinkles reduced both A1C and fasting blood sugar slightly. Doses were up to about two teaspoons a day. 7
#6. VINEGAR—Sprinkled on your salad, roasted vegetables, and other foods, vinegar may improve your blood sugar and insulin when you're planning to eat a high-carb meal. In a small study, researchers gave those who had unhealthy insulin sensitivity a drink of apple cider vinegar and water before a high-carb meal and found it helped increase their insulin sensitivity and normalize blood sugar levels. 8
#7. BERRIES—Pick your favorite—blackberries, raspberries, blueberries, strawberries. In one Finnish study, following more than 2300 men, researchers found that men who ate the most berries reduced their type 2 diabetes risk by 35% over the 19-year followup. Those in the high-intake group ate about 2 ounces of berries daily.9
#8. COFFEE—Several studies have found coffee, whether regular or decaf, reduces risk of type 2 diabetes. Some research has found that those drinking 6 or 7 cups a day have about a 35% lower risk of getting diabetes than those drinking less than 2 cups.10 Drink wisely, Weisenberger says. Unfiltered coffee has compounds that raise your bad (LDL) cholesterol, so use a paper filter with methods such as French press. And don't undo the benefits by adding too much sugar, cream or syrup.
#9. TEA—Less than a cup a day reduced diabetes risk by 3% in one study. Six cups cut the risk by 15%. Again, don't load up that cuppa with sugars and saturated fats.11
#10. ALCOHOL—Moderate amounts of alcohol are linked with less type 2 diabetes. Don't go overboard—excess can raise your risk. In a review of published studies looking at more than 477,000 people, researchers found a moderate intake of alcohol was most protective against getting type 2 diabetes. That translates to about 1.5 drinks a day. Note: In the United States, one "standard" drink contains roughly 14 grams of pure alcohol, which is found in: 12 ounces of regular beer (typically 5% alcohol); 5 ounces of wine (about 12% alcohol) and 1.5 ounces of distilled spirits, which is about 40% alcohol. However, it's a good idea to get advice on alcohol intake from your doctor, who knows your personal health history. 12
The foods on Weisenberger's list earn the approval of Amy Hess Fischl, M, RD, LDN, BC-ADM, CDE, a member of the editorial board for OnTrackDiabetes and program coordinator for the Teen in Transit program at the University of Chicago's Kovler Diabetes Center. She reviewed the book but was not involved in its production.
Research over the past decade have shown these foods can reduce diabetes risk, she says.
However, she adds two important caveats: "One food is not the end all, be all, to our eating. It is really [about] overall eating habits. We don't eat enough fruits and vegetables and we eat way too much-saturated fat." The book, she says, will be a great resource for those motivated, "OMG" folks.
The other caveat: Getting regular physical activity, getting to and maintaining a healthy weight and getting enough sleep is also important—all points also covered in the book.
One woman, newly diagnosed with prediabetes, consulted Weisenberger out of frustration. In her 50s, she maintained a healthy diet and weight and walked for at least an hour a day. Yet her A1C was 6.2. A1C is a look back at blood sugars over the past three months. A level of 5.7 to 6.4 is prediabetes; 6.5 and over is type 2 diabetes.
She took Weisenberger's advice to eat three meals a day and snacks when hungry, rather than grazing all day long, her habit. She included the foods on the list as part of a healthy diet. "In three months, her A1C went from 6.2 to 5.4," Weisenberger says. That is a normal A1C.
She can't say it was just the addition of the foods, of course. The woman stopped grazing all day long, too, which can be hard on blood sugar levels. And she added strength training, which can help keep blood glucose levels healthy, Weisenberger says. Overall, the lifestyle ''reset'' is what turned her around, Weisenberger says.
Weisenberger was a consultant on a project for Bush Brothers & Company, the bean maker. Hess-Fischl has no relevant disclosures.