Borderline diabetes, also called prediabetes or impaired glucose tolerance, is the condition where your blood glucose levels are unusually high, but not to the extent sufficient for a diagnosis of diabetes mellitus. According to the American Diabetes Association, 57 million people have this condition. About 11 percent of individuals identified as having prediabetes are diagnosed with full blown diabetes within the next three years. Thus, prediabetes is a warning that unless changes to diet and lifestyle occur, diabetes could be in your near future.
Effect of Diet
The American Diabetes Association names making healthy food choices, with the goal of reducing weight by 10 to 15 percent, as one of the most effective ways of preventing prediabetes and diabetes. The additional goals of medical nutrition therapy for diabetes are to maintain normal blood glucose levels, improve blood lipid profile of good and bad cholesterol and maintenance of healthy blood pressure levels. The best evidence suggests that carbohydrates and monounsaturated fats should make up the bulk of the total calories in a prediabetic diet.
Choosing Carbohydrates
The American Diabetes Association believes there is significant evidence that the best carbohydrate food sources for a diabetic diet are whole grains, fruits and vegetables. Thus, it is recommended you eat a variety of different colored fruits, nonstarchy vegetables like carrots, broccoli, spinach or green beans at each meal, and choose whole grains over processed grain products. Note, however, that the FDA allows products with more than 50 percent whole grains to be labeled "whole grain" or "whole wheat" Only products labeled "100% whole grain" are entirely whole-grain products.
Fiber
A study conducted by M. Chandalia and colleagues and published in the "New England Journal of Medicine" in 2000 found that a very high-fiber diet produced a variety of beneficial effects in Type 2 diabetes patients, including improved glycemic control, decreased hyperinsulinemia and lower plasma lipid concentrations. The diet of test subjects included 50 g of total fiber daily from unfortified food products, of which half was soluble and half insoluble fiber. MayoClinic.com says soluble fiber slows the absorption of sugar and cholesterol, giving your body a chance to regulate these substances more effectively. Good soluble fiber sources for diabetes include beans, oats, whole grains and flaxseed.
Fat
The amount of fat in your diet should be tailored to your total caloric needs to maintain an ideal body weight. Individuals trying to prevent or reverse diabetes should restrict their intake of saturated fat such that it accounts for no more than 10 percent of their total caloric intake each day, and some individuals will need to restrict saturated fat to less than 7 percent of total energy intake. Intake of cholesterol should be below 300 mg per day. The majority of your fat intake should be monounsaturated and polyunsaturated fats, which are found in avocados, almonds, pecans, walnuts, olives and canola, olive and peanut oils.
Protein
The American Diabetes Association suggests individuals with prediabetes can continue to enjoy a diet in which 15 to 20 percent of their total calories are derived from protein. However, to limit saturated fat intake, this protein should come from lean meats, fish, vegetarian sources like legumes and low-fat dairy products. High-protein, low-carbohydrate diets are not recommended by the American Diabetes Association because their long-term effects on the blood lipid profile is uncertain.
References
- American Diabetes Association: Prediabetes
- American Diabetes Association: Prediabetes FAQ
- American Diabetes Association: Evidence-Based Nutrition Principles for Treatment and Prevention of Diabetes
- American Diabetes Association: Making Healthy Food Choices
- FDA: Whole Grain Label Statements
- "New England Journal of Medicine"; Beneficial Effects of High Dietary Fiber Intake; M. Chandalia, et al; 2000
