The pre diabetes diet sheet NHS is the ultimate guide to managing your weight and keeping it stable. It includes detailed information on how we can help you to achieve a long and healthy life, based on a healthy, balanced diet and lifestyle.
The Diabetes Diet is a diet where you control your blood sugar levels. Achieving a healthy weight and regulating blood sugar levels requires an individual to eat a variety of different foods and take medications as prescribed by their doctor. But before you start picking up that sugary snack or reaching for that chocolate bar, keep in mind that following the nutrition plan will mean eating less of the foods that increase your blood sugar and more of the healthy plant-based foods that might help in reducing those levels.
Pre Diabetes Diet Sheet Nhs
A pre diabet diet plan is a diet plan that you follow before you develop diabetes. Dieting before you are diagnosed with pre-diabetes has been shown to reduce future risk of developing diabetes.
Although it is becoming increasingly more popular for people to be tested for pre-diabetes and then treat right away, there is no guarantee that this will work. However, by changing your eating habits now, you can prevent the development of the condition altogether.
What is pre diabetes?
Pre diabetes is a term that refers to blood glucose (sugar) levels that are above the normal range but are not as high as levels in Type 2 Diabetes. People who have pre-diabetes are at significantly more risk of developing diabetes.
Our body needs food and nutrients for energy and to keep healthy. Starchy and sugary foods
provide our bodies with the nutrient carbohydrate. When we eat these carbohydrate containing
foods they are broken down in digestion and release glucose into the blood stream. The body uses
this glucose to make energy.
In order for the body to make energy from glucose a hormone called insulin, which is released from an organ in the body called the pancreas, is needed. Insulin acts like a key opening up the body’s cells to allow glucose to enter in and be converted into energy.
In pre-diabetes either people are not producing enough insulin, the insulin is not working properly
(insulin resistance), or a combination of the two. If someone is overweight this can increase their
insulin resistance, making it difficult for their body to cope with glucose released from carbohydrate
How diet relates to prediabetes
There are many factors that increase your risk for prediabetes. Genetics can play a role, especially if diabetes runs in your family. However, other factors play a larger role in the development of disease. Inactivity and having overweight are other potential risk factors.
In prediabetes, sugar from food begins to build up in your bloodstream because insulin can’t easily move it into your cells.
People think of carbohydrate as the culprit that causes prediabetes, but the amount and type of carbohydrates consumed in a meal is what influences blood sugar. A diet filled with refined and processed carbohydrates that digest quickly can cause higher spikes in blood sugar.
For most people with prediabetes, the body has a difficult time lowering blood sugar levels after meals. Avoiding blood sugar spikes by watching your carbohydrate intake can help.
When you eat more calories than your body needs, they get stored as fat. This can cause you to gain weight. Body fat, especially around the belly, is linked to insulin resistance. This explains why many people with prediabetes also have overweight.
You can’t control all risk factors for prediabetes, but some can be mitigated. Lifestyle changes can help you maintain balanced blood sugar levels and stay within a healthy weight range.
Watch carbs with the glycemic index
The glycemic index (GI) is a tool you can use to determine how a particular food could affect your blood sugar.
Foods that are high on the GI will raise your blood sugar faster. Foods ranked lower on the scale have less effect on your blood sugar spike. Foods with high fiber are low on the GI. Foods that are processed, refined, and void of fiber and nutrients register high on the GI.
Refined carbohydrates rank high on the GI. These are grain products that digest quickly in your stomach. Examples are white bread, russet potatoes, and white rice, along with soda and juice. Limit these foods whenever possible if you have prediabetes.
Foods that rank medium on the GI are fine to eat. Examples include whole-wheat bread and brown rice. Still, they aren’t as good as foods that rank low on the GI.
Foods that are low on the GI are best for your blood sugar. Incorporate the following items in your diet:
- steel-cut oats (not instant oatmeal)
- stone-ground whole wheat bread
- nonstarchy vegetables, such as carrots and field greens
- sweet potatoes
- pasta (preferably whole wheat)
Food and nutrition labels don’t reveal the GI of a given item. Instead make note of the fiber content listed on the label to help determine a food’s GI ranking.
Remember to limit saturated fat intake to reduce the risk of developing high cholesterol and heart disease, along with prediabetes.
Eating mixed meals is a great way to lower a food’s given GI. For example, if you plan to eat white rice, add vegetables and chicken to slow down the digestion of the grain and minimize spikes.
Good portion control can keep your diet on the low GI. This means you limit the amount of food you eat. Often, portions in the United States are much larger than intended serving sizes. A bagel serving size is usually about one-half, yet many people eat the whole bagel.
Food labels can help you determine how much you’re eating. The label will list calories, fat, carbohydrates, and other nutrition information for a particular serving.
If you eat more than the serving listed, it’s important to understand how that’ll affect the nutritional value. A food may have 20 grams of carbohydrate and 150 calories per serving. But if you have two servings, you’ve consumed 40 grams of carbohydrate and 300 calories.
Eliminating carbohydrates altogether isn’t necessary. Recent research has shown that a lower carb diet (less than 40 percent carbs) is associated with the same mortality risk increase as a high carbohydrate diet (greater than 70 percent carbs).
The study noted minimal risk observed when consuming 50 to 55 percent carbohydrates in a day. On a 1600-calorie diet, this would equal 200 grams of carbohydrates daily. Spreading intake out evenly throughout the day is best.
This is in line with the National Institutes of Health recommendation of 45 to 65 percent of calories coming from carbohydrates daily. Individual carbohydrate needs will vary based on a person’s stature and activity level.
Speaking to a dietitian about specific needs is recommended.
One of the best methods to manage portions is to practice mindful eating. Eat when you’re hungry. Stop when you’re full. Sit, and eat slowly. Focus on the food and flavors.
Eating more fiber-rich foods
Fiber offers several benefits. It helps you feel fuller, longer. Fiber adds bulk to your diet, making bowel movements easier to pass.
Eating fiber-rich foods can make you less likely to overeat. They also help you avoid the “crash” that can come from eating a high sugar food. These types of foods will often give you a big boost of energy, but make you feel tired shortly after.
Examples of high-fiber foods include:
- beans and legumes
- fruits and vegetables that have an edible skin
- whole grain breads
- whole grains, such as quinoa or barley
- whole grain cereals
- whole wheat pasta
Cut out sugary drinks
A single, 12-ounce can of soda can contain 45 grams of carbohydrates. That number is the recommended carbohydrate serving for a meal for women with diabetes.
Sugary sodas only offer empty calories that translate to quick-digesting carbohydrates. Water is a better choice to quench your thirst.
Drink alcohol in moderation
Moderation is a healthy rule to live by in most instances. Drinking alcohol is no exception. Many alcoholic beverages are dehydrating. Some cocktails may contain high sugar levels that can spike your blood sugar.
According to the Dietary Guidelines for Americans, women should only have one drink per day, while men should limit themselves to no more than two drinks per day.
Drink servings relate back to portion control. The following are the measurements for an average single drink:
- 1 bottle of beer (12 fluid ounces)
- 1 glass of wine (5 fluid ounces)
- 1 shot of distilled spirits, such as gin, vodka, or whiskey (1.5 fluid ounces)
Keep your drink as simple as possible. Avoid adding sugary juices or liqueurs. Keep a glass of water nearby that you can sip on to prevent dehydration.
Eat lean meats
Meat doesn’t contain carbohydrates, but it can be a significant source of saturated fat in your diet. Eating a lot of fatty meat can lead to high cholesterol levels.
If you have prediabetes, a diet low in saturated fat and trans fat can help reduce your risk of heart disease. It’s recommended that you avoid cuts of meat with visible fat or skin.
Choose protein sources such as the following:
- chicken without skin
- egg substitute or egg whites
- beans and legumes
- soybean products, such as tofu and tempeh
- fish, such as cod, flounder, haddock, halibut, tuna, or trout
- lean beef cuts, such as flank steak, ground round, tenderloin, and roast with fat trimmed
- shellfish, such as crab, lobster, shrimp, or scallops
- turkey without skin
- low fat Greek yogurt
Very lean cuts of meat have about 0 to 1 gram of fat and 35 calories per ounce. High-fat meat choices, such as spareribs, can have more than 7 grams of fat and 100 calories per ounce.
Drinking plenty of water
Water is an important part of any healthy diet. Drink enough water each day to keep you from becoming dehydrated. If you have prediabetes, water is a healthier alternative than sugary sodas, juices, and energy drinks.
The amount of water you should drink every day depends on your body size, activity level, and the climate you live in.
You can determine if you’re drinking enough water by monitoring the volume of urine when you go. Also make note of the color. Your urine should be pale yellow.
How will I know if I have prediabetes?
Prediabetes is diagnosed following a blood test because you are unlikely, at this stage, to be presenting symptoms. However, if you are over 45 years old or overweight, have a parent or sibling with type 2 diabetes, have a sedentary lifestyle, have in the past been diagnosed with gestational diabetes or PCOS, or are a certain ethnicity, you may be more likely to develop the condition. If you meet one or more of these criteria and are concerned, contact your GP for further guidance.
Why is prediabetes bad for my health?
If you’ve been told you are prediabetic, this is a warning that you are at increased risk of developing type 2 diabetes, and as a result are more likely to have heart disease or a stroke. It’s estimated that 12.3 million people in the UK are in this category. Being at risk doesn’t mean you’ll definitely develop type 2 diabetes, but it does mean that without changes to your diet and lifestyle you are more likely to.
If you do develop type 2 diabetes, it can significantly impact the quality of your life and reduce your life expectancy. That’s because people with persistently high blood sugar are at risk of damaging their blood vessels and overtime this may lead to issues such as kidney failure, blindness and serious nerve damage.
That said, there are lots of things you can do to reduce your risk or delay the onset of type 2 diabetes.
How does diet play a role in prediabetes?
Research suggests that the amount and type of carbohydrate we eat plays a significant role in whether we develop prediabetes. This is because all carbs are broken down by the body to glucose for energy, the amount of glucose in the blood at any point in time is carefully controlled by the hormone insulin. However, as we age, eating a consistently poor diet, doing little exercise, smoking and our genetics can all make insulin less effective at doing its job.
Many of us think of sugary foods like biscuits, cakes, jam and chocolate when we think of managing diabetes, but starchy foods like bread, rice, pasta and potatoes will also influence our blood sugar. That’s because all types of carbohydrates increase blood glucose levels, although some have a slower effect than others. These slow-releasing foods are a better choice and are typically referred to as low-GI foods, they include foods rich in fibre like wholegrains, beans and pulses.
Understanding the glycaemic index (GI) of foods can be helpful in managing your blood sugar levels, but it is only one tool. Adopting a healthy, balanced diet which includes your five a day (more if possible), lean protein, some fat, and foods which are low in sugar and salt will also support your ability to manage your blood sugar.
What are the key components of the prediabetes diet?
There is no specific diet for prediabetes, but there are some important modifications you can make to your diet. These include:
- Eat more whole fruit and vegetables, especially the non-starchy variety like green leaves, broccoli and asparagus. Other useful inclusions are those rich in a compound called nitrate, these include celery, rhubarb and beetroot – including these may help reduce blood pressure and improve circulatory health.
- Make wholegrains your staple, such as jumbo oats, barley, rye, wholewheat flour, wholegrain rice, especially basmati or wild rice.
- Choose lean sources of protein. These help keep you full and reduce the urge to snack – examples include chicken breast, fish and seafood, legumes, unsalted nuts and seeds.
- Include some dairy such as yogurt and cheese, or fortified plant-based alternatives.
- Minimise refined ‘white’ carbs, sugar, sweetened drinks and starchy veg like potatoes.
- Minimise red and processed meats, aiming to keep within guideline amounts.
- Minimise the saturated and trans fats in your diet, focusing instead on the heart-healthy fats in oily fish, nuts and seeds, as well as fruit like olives and avocado.
- Wise-up on portions – it may be useful to weigh out your pasta and rice until you can gauge the appropriate quantity for a serving.
- Cook clever – avoid over-cooking foods like rice and pasta, instead create more ‘resistant starch’ by cooking, cooling and thoroughly reheating carbs such as rice, pasta and potatoes.
- Plate up perfectly – fill half of your plate with non-starchy vegetables, a quarter with lean protein and the final quarter with wholegrains.
What else should I do if I have been told I have prediabetes?
As well as adopting a healthy, balanced diet, there are a number of other things you can do to reduce your risk of developing type 2 diabetes:
- Being physically active.
- Achieving and maintaining a healthy weight.
- If you’re a smoker, stop.
What does the NHS advise?
The NHS provides the following diet advice for people with diabetes:
- Eat plenty of starchy carbohydrates with a low glycemic index (low GI)
- Increase the amount of fibre in your diet
- Eat plenty of fruit and vegetables – at least 5 portions per day
- Cut down on fat and saturated fat in particular
- Choose foods with unsaturated fat instead – such as vegetable oils, reduced fat spreads, oily fish and avocados
- Choose low-fat dairy products
- Choose lean meat – such as skinless chicken
- Avoid fatty or processed meat
- Eat fish at least twice a week and ensure you have oily fish at least once a week
- Eggs and beans are other good sources of protein
- Cook food by grilling, baking, poaching or steaming instead of frying or roasting
- Avoid fatty or sugary snacks – such as crisps, cakes, biscuits and pastries
- Eat snacks such as fruit, unsalted nuts and low-fat yoghurts
- Cut down on sugar
- Eat less salt – have less than 6g of salt (2.4g of sodium) per day
- Cut down on alcohol
- Don’t skip breakfast
- Keep hydrated – aim to drink between 1.6 and 2 litres of fluid each day
Should I base meals upon starchy carbohydrate?
The NHS advises people, including those with diabetes, to base meals around food with starchy carbohydrate such as:
The problem with this advice is that even starchy carbohydrates with a low GI can have a pronounced effect in raising blood glucose levels.
Starchy carbohydrate may be problematic for many people with type 2 diabetes as carbohydrate requires greater insulin production than fat or protein does. Research studies have shown that greater insulin production increases the effect of insulin resistance.
Should I eat less saturated fat?
The problem with the NHS’s recommendation to eat less saturated fat is that it makes no distinction between different sources of saturated fat.
Saturated fat should be regarded as a healthy form of fat as long as it comes from natural sources such as:
- Meat (unprocessed)
- Olives and olive oil
- Nuts (unsalted) and nut oils
Rather than condemning saturated fat, the NHS should instead advise people to cut down on ‘processed sources of fat’, which include:
Note that many of these foods are high in calories because they are packed with vegetable oil.
Should I eat low-fat products?
Whilst the NHS has taken great trouble to coerce the public to buy low-fat dairy, research studies have shown eating full fat dairy to be just as healthy, if not more healthy.
A notable point about products labelled as low-fat is that many of them have added sugar, salt or other unnatural additives to replace the fat.
Should I eat fruit?
As long as not eaten in excess, fruit is a healthy part of the diet.
Caution should, however, be taken with fruit juice as it has a high sugar content and raises blood glucose levels very quickly.
Food Fact – Dietary Advice for Pre Diabetes
Pre diabetes occurs when blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. People with pre diabetes have an increased risk of developing Type 2 diabetes and are at a higher risk of having heart disease. Making and maintaining lifestyle changes is the most effective way of reducing the risk of pre-diabetes progressing to Type 2 diabetes and heart disease.
Steps towards managing pre DM
· Manage your weight
· Eat well
· Avoid or stop smoking
· Reduce waist measurement (less than 80cm for women / less than 94cm for men)
· Increase physical activity
Manage your weight If you are overweight, losing some weight will help to reduce your blood glucose level. Try to lose weight by cutting down on fatty foods and keeping as active as possible. Aim for weight loss of at least 5% (where appropriate) to reduce risk of Type 2 Diabetes, by reducing your energy (calorie) intake.
· reduce your intake of sugar sweetened beverages and sugary foods
· increase your intake of wholegrain and high fibre foods
· reduce your fat intake, especially saturated fat,
· reduce salt intake
· if you drink alcohol, drink it in moderation
· eat regular meals with a small (fist sized) portion of carbohydrate at each meal
· eat five (handful sized) portions of fruit and vegetables per day
· avoid skipping meals and space your breakfast, lunch and evening meal out over the day, as this helps control your appetite and your blood glucose levels
· reduce red and processed meats
Include starchy carbohydrates at each meal
Carbohydrates provide us with our main source of energy. They are also a source of vitamins and fibre so are an important part of our diet. Most carbohydrates are digested and absorbed as glucose into the bloodstream – some very quickly (sugary foods) and some more slowly (starchy foods) – at each meal resulting in a rise in blood glucose levels. Try to include the slowly absorbed starchy carbohydrates as these do not affect your blood glucose levels as much.
Better choices include:
· basmati or easy cook rice
· grainy breads such as granary, pumpernickel and rye
· new potatoes, sweet potato and yam
· porridge oats, All-Bran and natural muesli
· pulses, e.g. lentils, kidney beans and baked beans.
The high fibre varieties of starchy foods will also help to maintain the health of your digestive system and prevent problems such as constipation. All these different types of carbohydrate will be digested into sugar so limiting portion size is important.
Dairy and alternatives
Aim to include 3 servings of milk, yoghurt, cheese or the calcium enriched non-dairy alternatives (eg soya/rice/nut milks) each day to ensure you have enough calcium in your diet.
Vegetables and fruit
Aim for at least five portions of vegetables and fruits each day (a portion is approximately 1 handful or 80g). Vegetables are lower in carbohydrate and calories than fruit but still high in fibre, vitamins and minerals, so aim to get most of your portions from vegetables or salad. Fruits are high in natural sugars so it is important to spread the portions out throughout the day and have fruit in place of less nutritious sweet foods such as biscuits/cakes/puddings.
Limit processed foods which are high in fat but low in nutritional value eg cakes, chocolates, pastries, biscuits, deep fried takeaway foods. Try Heart healthy oils which are found in the Mediterranean style diet: olive oil, rapeseed oil, nuts, seeds, oily fish. Oily fish such as fresh/tinned/ frozen salmon, mackerel, trout, herring, pilchards and sardines, contain heart-healthy omega-3 fats. Aim for 2 portions per week.
Meat, fish, eggs, beans/pulses, soya/Quorn/tofu provide the body with protein which is important for growth and repair. Include 2-3 servings (a serving is palm sized) each day.
Eating too much salt can raise your blood pressure. A lot of the salt in our diet comes from ready-made, processed foods. Try to reduce the level of salt in your diet by using fewer tinned, pre-packaged and convenience foods, especially ready meals, soups, sauces, crisps and cured meats. Check food labels to choose options that are lower in salt.
If you drink alcohol, drink in moderation No more than 14 units per week (a standard pint of beer/lager/cider =2 units, 1 small (125ml) glass of wine = 1 ½ units, 1 single (25ml) spirits = 1 unit). Try to have some alcohol free days each week.
Have 8-10 glasses of fluid daily. Water is the best drink, but tea, herbal teas, coffee, no added sugar squash and diet fizzy drinks can all count towards the 8-10 glasses. Alcohol does not have to be avoided but should be consumed in moderation.
Is the NHS advice sensible?
Whilst a number of these points are undoubtedly sensible, some of the recommendations have been criticised by patients and some leading UK healthcare professionals.
The following points are sensible:
- Eat plenty of vegetables
- Have sufficient fibre in your diet
- Cut down on sugar
- Cut down on processed meat
- Eat fish regularly
- Cut down on energy dense, processed food – such as crisps, cakes, biscuits and pastries
- Cut down on alcohol
- Cut down on salty processed foods
However, some of the recommendations may inadvertently lead to poorer diet choices.
The recommendations for people with diabetes to eat plenty of starchy carbohydrate and avoid fat from meat and dairy could lead to poorer blood glucose control, particularly in people with type 2 diabetes.