Prediabetes & Nutrition

18th November 2019

Article by Benjamin Brown

Prediabetes is characterised by higher than normal blood glucose levels and, if undiagnosed and untreated, can develop in to type-2 diabetes. The prevalence of prediabetes in England tripled between 2003 and 2011 with an estimated 7 million people, or 1 in 3 adults, thought to be living with the condition nationally. Many people are completely unaware that they are prediabetic as the condition develops gradually and usually without any warning symptoms. Thus, it comes as quite a shock to become aware of being borderline diabetic as the symptoms of type-2 diabetes start to appear.

Many risk factors are associated with prediabetes and you should get tested if you: have a family history of diabetes, have high blood pressure, raised plasma triglycerides or low HDL cholesterol, or are over the age of 40. However, prediabetes is associated with obesity and central adiposity more than any other risk factor, with one meta-analysis attributing obesity with a seven-fold increase in diabetes risk compared to normal weight. Our modern lifestyles encourage overconsumption of energy dense foods and reduced physical activity and energy expenditure, resulting in a positive energy balance and thus, long-term weight gain. Weight loss, and the prevention of weight gain, is therefore essential to help reduce the risk of prediabetes and to help prevent the onset of type-2 diabetes. However, dietary improvements can also help modulate susceptibility. 

Epidemiological evidence indicates that certain foods can either increase or have a protective effect on diabetes risk. Foods containing simple carbohydrates (white sugar, white rice and white bread) have a high glycaemic index (GI) are broken down relatively quickly. Excessive consumption of these foods can cause an increase in plasma glucose and insulin demand and can result in increased insulin resistance and weight gain. On the other hand, the insoluble dietary fibre found in wholegrains has a protective effect while increased consumption of green leafy vegetables high in magnesium can help increase glucose metabolism. Identifying foods that can be swapped for healthier alternatives (E.g. wholegrain bread instead of white) is a great place to start improving the overall quality of a diet. 

Equally, the Diabetes Prevention Program study identified that prediabetes can be reversed and ultimately prevented from developing in to type-2 diabetes by implementing dietary and lifestyle changes. These changes could be as simple as increasing your level of physical activity and reducing the amount of time spent doing sedentary activities to seeking dietary advice and support. Discussing your relationship with food, level of motivation and current lifestyle with a nutritionist can help to identify and overcome potential barriers while setting achievable and realistic goals. 

Dietary and lifestyle interventions, when carried out under the supervision of a nutritionist, can be hugely successful at achieving sustained weight loss and an overall sense of health, while also improving your relationship with food.  

 

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