Give prediabetes the boot

Cutting Carbs

Researchers randomly assigned 38 people who had prediabetes and were obese to one of two diets. Each cut 500 calories a day.1

After six months, 14 people had dropped out. However, blood sugar levels in all of the salmon-imageMedremaining 12 people on the higher-protein diet—but in only four of the remaining 12 on the higher-carb diet—had fallen into the normal range. What’s more, the higher-​protein group had lower hemoglobin A1c (a long-term measure of blood sugar) and lower LDL (“bad”) cholesterol, triglycerides, and some markers of inflammation.

Both groups lost the same amount of weight, but people on the higher-protein diet lost only fat, while those on the higher-carb diet lost both fat and muscle.

What to do: If you have prediabetes, try cutting back on carbs. (That will cut your calories and make protein a higher percentage of your diet.) Although this small study needs to be replicated, it’s worth a try. And you needn’t cut all carbs. You can still enjoy vegetables and fresh fruit, with small servings of grains.

Resist Diabetes

Strength training may also help make prediabetes disappear.

The Resist Diabetes trial enrolled 159 sedentary overweight or obese adults with prediabetes in a strength-training program for three months.2 Twice a week, they did 12 supervised exercises (like leg presses, chest presses, and abdominal crunches) for 8 to 12 repetitions each.

Then each participant was given one of two different levels of encouragement for six months, followed by six more months when they were on their own.

After the 15 months, 30 percent of the participants no longer had prediabetes. It made no difference whether they received more or less encouragement.

Although the volunteers didn’t lose weight, their waistlines did shrink. And those who gained the most muscle were the most likely to reverse their prediabetes.

What to do: If you’re not doing strength training, get started. People lose muscle as they age. Building strength is the best way to stop or reverse that loss, whether or not you have prediabetes.



1BMJ Open Diabetes Res. Care 2016. doi:10.1136/bmjdrc-2016-000258

2PLoS ONE 2017. doi:10.1371/journal.pone.0172610.

10 Replies to “Give prediabetes the boot”

  1. Were the carbs in the higher-carb diet processed/refined, as opposed to whole, grains? If so, it would seem that the difference is not necessarily protein v. carbs but rather whole v. processed carbs. (I believe there have been studies – something in the NYT recently? – that compared whole grains v. protein v. fats and found no difference?)

    1. Great question. Thanks for asking! The researchers emphasized carbohydrate sources such as whole grains, fruits, vegetables, and legumes. So even when people with prediabetes were eating high quality carbohydrates, the higher protein diet still produced more beneficial results.

  2. “Cutting carbs” is too general a recommendation. Focus on cutting the less-healthy carbs like soda/juice drinks,/100% juice, other high-sugar foods, and refined grains. Get enough whole grains, whole fruits, veggies (easy on potatoes), and beans. Choose stone-ground whole wheat bread (has a lower glycemic index) due to larger particle size) over regular whole wheat.

    1. The higher carb diet used in this study actually emphasized high-quality carbohydrates and not sugar-sweetened beverages and refined grains. As we say, these results don’t suggest that people need to eliminate carbs, but can still enjoy veggies, fruits, beans, and small servings of grains.

    2. Well, you’re sort of correct. Technically if you only cut the amount of carbs you were consuming but still chose to consume high GI carbs, that would be just about as good as if you were consuming that same (lower) amount and only eating low GI carbs. However people consuming high GI carbs generally find it more difficult to eat less because the blood sugar spike they get from those carbs makes them hungry all the time, so typically the suggestion is to not only cut your carb intake but also make sure your remaining carbs come from healthier sources.

  3. I kicked pre-diabetes recently. I had it for about 2 yrs when I finally started to exercise besides eating fruits and veggies. (Eating more veggies is a work in progress).
    My doctor was quite pleased with me. The high-quality carbs are what helped me. Losing weight also.

  4. I also have High cholesterol… I love dairy, especially cheeses and eggs. Is this a problem if i would eat more protein? I already eat a lot of chicken and some LEAN beef.
    Thank you in advance 🙂

    1. Hi Ida,

      Thanks for your question. Instead of adding more protein from animal sources, try to get more plant-based protein. Think of things like beans, lentils, tofu, edamame, and tempeh. Eggs, cheese, and lean meat can be included in a healthy diet, but if you already eat a fair amount of those types of foods, try to diversify your protein sources. Hope this helps!

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