If you’ve been diagnosed with prediabetes, consider yourself lucky. You have just received a warning that many people don’t get (and instead progress straight to type 2 diabetes). Now you can take steps to reverse the condition and reclaim your health. The following nutrition and lifestyle modifications should be the foundation of your diabetes prevention and treatment plan, regardless of whether you have prediabetes or diabetes. It will be important to monitor your fasting insulin level, which should be between 2 and 4.
The higher your level, the greater your insulin resistance and the more aggressive you need to be in your treatment plan, especially when it comes to altering your diet. If you want the short version… simply swapping processed foods for whole organic foods lower in sugar and sugar-forming carbohydrates -- combined with a few minutes of daily exercise -- will quickly put you on the road to reversing prediabetes. See my nutrition plan for a healthy eating guide. For more specifics, read my diabetes prevention (and treatment) plan that follows.
- Incorporate intermittent fasting.
I strongly recommend incorporating intermittent fasting. This effectively mimics the eating habits of our ancient ancestors, who did not have access to grocery stores or food around the clock. They would cycle through periods of feast and famine, and modern research shows this cycling produces a number of biochemical benefits, including improved insulin/leptin sensitivity, lowered triglycerides and other biomarkers for health, and weight loss. Intermittent fasting is by far the most effective way I know of to shed unwanted fat and eliminate your sugar cravings. Keep up your intermittent fasting schedule until your insulin/leptin resistance improves (or your weight, blood pressure, cholesterol ratios, or diabetes normalizes). After that, you only need to do it "as needed" to maintain your healthy state.
- Swap out processed foods, all forms of sugar—particularly fructose—as well as all grains, for whole, fresh food.
Fructose, grains, and other sugar-forming starchy carbohydrates are largely responsible for your body's adverse insulin reactions, and all sugars and grains—even "healthy" grains such as whole, organic ones—need to be drastically reduced. If you're insulin/leptin resistant, have prediabetes, diabetes, high blood pressure, heart disease, or are overweight, you'd be wise to limit your total fructose intake to 15 grams per day until your insulin/leptin resistance has resolved. For all others, I recommend limiting your daily fructose consumption to 25 grams or less to maintain optimal health. The easiest way to accomplish this is by swapping processed foods for whole, ideally organic, foods.
This means cooking from scratch with fresh ingredients. Processed foods are the main source of all the primary culprits, including high fructose corn syrup and other sugars, processed grains, trans fats, artificial sweeteners, and other synthetic additives that may aggravate metabolic dysfunction. Besides fructose, trans fat (NOT saturated fat) increases your risk for diabetes by interfering with your insulin receptors. Healthy saturated fats do not do this. Since you're cutting out a lot of energy (carbs) from your diet when you reduce sugars and grains, you need to replace them with something. The ideal replacement is a combination of:
- Low-to-moderate amount of high-quality protein. Substantial amounts of protein can be found in meat, fish, eggs, dairy products, legumes, and nuts. When selecting animal-based protein, be sure to opt for organically raised, grass-fed or pastured meats, eggs, and dairy, to avoid potential health complications caused by genetically engineered animal feed and pesticides. Most Americans eat far too much protein, so be mindful of the amount! I believe it is the rare person who really needs more than one-half gram of protein per pound of lean body mass. Those that are aggressively exercising or competing and pregnant women should have about 25 percent more, but most people rarely need more than 40-70 grams of protein a day.
To determine your lean body mass, find out your percent body fat and subtract from 100. This means that if you have 20 percent body fat, you have 80 percent lean body mass. Just multiply that by your current weight to get your lean body mass in pounds or kilos. To determine whether you're getting too much protein, simply calculate your lean body mass as described above, then write down everything you're eating for a few days, and calculate the amount of daily protein from all sources. You can use the chart below to help determine the grams of protein in your food.
Red meat, pork, poultry, and seafood average 6-9 grams of protein per ounce. An ideal amount for most people would be a 3-ounce serving of meat or seafood, which will provide about 18-27 grams of protein |
Eggs contain about 6-8 grams of protein per egg. |
Seeds and nuts contain on average 4-8 grams of protein per quarter cup |
Cooked beans average about 7-8 grams per half cup |
Cooked grains average 5-7 grams per cup |
Most vegetables contain about 1-2 grams of protein per ounce |
- As much high-quality healthy fat as you want (saturated and monounsaturated). For optimal health, most people need upwards of 50-85 percent of their daily calories in the form of healthy fats. Good sources include coconut and coconut oil, avocados, butter, nuts, and animal fats. (Remember, fat is high in calories while being small in terms of volume. So when you look at your plate, the largest portion would be vegetables.)
- As many non-starchy vegetables as you want
- Exercise regularly and intensely.
Studies have shown that exercise, even without weight loss, increases insulin sensitivity. High intensity interval training (HIIT), which is a central component of my Peak Fitness program, has been shown to improve insulin sensitivity by as much as 24 percent in just four weeks.
- Improve your omega-3 to omega-6 ratio.
Most Americans are eating far too many processed and damaged omega-6 fats and far too little omega-3 fats. The main sources of omega-6 fats are corn, soy, canola, safflower, peanut, and sunflower oil (the first two of which are typically genetically modified as well, which further complicates matters). Our bodies evolved for an optimal 1:1 ratio of omega-6 to omega-3. However, our ratio has deteriorated to between 20:1 and 50:1 in favor of omega-6. To remedy this, reduce your consumption of vegetable oils (this means not cooking with them and avoiding processed foods), and increase your intake of animal-based omega-3, such as krill oil. Vegetable-based omega-3 is also found in flaxseed oil and walnut oil, and it's good to include these in your diet as well. Just know they cannot take the place of animal-based omega-3s.
- Maintain optimal vitamin D levels year-round.
Vitamin D is highly beneficial for diabetes. The ideal way to optimize your vitamin D level is by getting regular sun exposure or by using a tanning bed. As a last resort, consider oral supplementation with regular vitamin D monitoring to confirm that you are taking enough vitamin D to get your blood levels into the therapeutic range of 50-70 ng/ml. Also please note that if you take supplemental vitamin D, you create an increased demand for vitamin K2.
- Get adequate high-quality sleep every night.
Insufficient sleep appears to raise stress and blood sugar, encouraging insulin and leptin resistance and weight gain. In one 10-year long study of 70,000 diabetes-free women, researchers found that women who slept less than five hours or more than nine hours each night were 34 percent more likely to develop diabetes symptoms than women who slept seven to eight hours each night.9 If you are having problems with your sleep, try the suggestions in my article "33 Secrets to a Good Night's Sleep." Strive for eight hours of sleep a night.
- Maintain a healthy body weight.
If you incorporate the diet and lifestyle changes suggested here you will greatly improve your insulin and leptin sensitivity, and a healthy body weight will follow in time. As a general guideline, you might find a hip-to-waist size index chart helpful. This is far better than BMI for evaluating whether or not you may have a weight problem, as BMI fails to factor in both how muscular you are and your intra-abdominal fat mass (the dangerous visceral fat that accumulates around your inner organs), which is a potent indicator of leptin sensitivity and associated health problems.
- Optimize your gut health.
Your gut is a living ecosystem, full of both good bacteria and bad. Multiple studies have shown that obese people have different intestinal bacteria than lean people. The more beneficial bacteria you have, the stronger your immune system will be and the better your body will function overall. Fortunately, optimizing your gut flora is relatively easy. You can reseed your body with good bacteria by regularly eating fermented foods (like natto, raw organic cheese, miso, and cultured vegetables).