Healthy Eating for people at

risk of diabetes or with

prediabetes
WHAT IS PREDIABETES / AT RISK OF DIABETES

Some patients have a blood sugar level which is higher than

normal but not high enough to be called diabetes.

This is called prediabetes and can be identified by blood sugar

(glucose) tests. It means raised blood sugar and a higher risk
of getting diabetes and heart disease.

Making changes to your lifestyle can delay or even prevent the

development of type 2 diabetes and reduce the risk of heart
disease too. This has now been proven in several large research
studies.

People with prediabetes do not usually have any symptoms and it

can be diagnosed by your practice nurse or general practitioner
using a blood test.

WHAT IS DIABETES?

As you may know, diabetes comes in two types (type 1 and type
2).

Type 2 diabetes is more common and likely to develop as one

gets older around 3 out of every 100 people develop it.

It can develop either because patients with type 2 diabetes have

something called ‘insulin resistance’. This means that their body
does not respond normally to insulin (a hormone produced by the
pancreas gland).

Insulin controls the level of sugar (glucose) in your blood. Over

time, if your blood sugar is high, this damages your blood vessels
and your heart. Or it may develop because the body is not
producing enough insulin.

2
DIETARY ADVICE

The main things to consider are;

• Lose weight if you are overweight or maintain a healthy

weight.

• Reduce the total amount of fat in your diet.

• Replace saturated (animal) fat with monounsaturated fat

(olive, rapeseed and vegetable oils and spreads). These
should still be used sparingly if overweight.

• Include at least one or two portions of oily fish each week.

• Have five or more portions of fruit and vegetables each

day.

• Choose sugar free, diet or No Added Sugar drinks.

• Limit sugary foods.

• Eat 3 meals daily including something starchy such as

bread, potatoes, rice, pasta or breakfast cereals.

• Choose starchy carbohydrate foods with a low Glycaemic

index (GI). (See page 6)

• Reduce salt and salty foods. Flavour foods with pepper,

herbs and spices instead.

3
FRUIT & VEGETABLES
• Choose a wide variety - at least 5
servings every day. A serving is 2-3
tbsp veg, small bowl salad, 1 large fruit,
2 medium fruit, 1 handful grapes or
berries, 1 tbsp of dried fruit, 150ml fruit
juice.
• “Fill-up” on vegetables, cooked or raw
as salads.
• Use fruit for snacks and desserts -
fresh, stewed or canned in natural juice.

MEAT, FISH, EGGS, BEANS AND

OTHER NON-DAIRY SOURCES OF
PROTEIN
• Choose lean meats, fish, chicken and
turkey, eggs, beans or pulses. Trim
off visible fat from meat, remove skin
from chicken.
• Cook without fat or oil.
• Limit sausages, burgers, bacon, pies
and processed cold meats.
• Include unsalted nuts in moderation.
• Include 2-3 portions daily-
• 1 portion is equal to
60–90g lean meat/poultry,
120–150g white fish,
2 eggs (up to 7 per week),
3 tablespoons beans/lentils or dhal,
2 tablespoons nuts/peanut butter.
• For variety, and to protect the heart,
include some OILY FISH. Aim for at
least 1 serving (100-150g) per week.
0.5gram (500mg) /day of omega-3
supplements may be taken, if you do
not like oily fish.
4
FOOD AND DRINK HIGH IN FAT AND /
SUGAR
• Sugar and alcohol are high in calories
down on these particularly if you are o
Avoid adding sugar to cereals and drin
Choose sugar free or diet varieties of
yoghurts and reduced sugar jams.
• Try to avoid adding extra fats and oils
Limit fried food, cakes, pastries, swee
chocolate, biscuits, crisps, cream and
Choose lower fat and reduced sugar a
e.g. Teacake/currant buns.
• Choose an oil/spread containing most
monounsaturated fats. Use sparingly
overweight.
• Try oil free dressings, vinegar and lem
salads. Avoid mayonnaise and salad
ALL FATS SHOULD BE REDUCED IF
OVERWEIGHT

AND DRINK HIGH IN FAT AND / OR
ar and alcohol are high in calories so cut
n on these particularly if you are overweight.
d adding sugar to cereals and drinks.
ose sugar free or diet varieties of drinks and
hurts and reduced sugar jams.
o avoid adding extra fats and oils to cooking.
t fried food, cakes, pastries, sweets,
colate, biscuits, crisps, cream and ice cream.
ose lower fat and reduced sugar alternatives
Teacake/currant buns.
ose an oil/spread containing mostly
ounsaturated fats. Use sparingly if
oil free dressings, vinegar and lemon juice on
ds. Avoid mayonnaise and salad creams.
FATS SHOULD BE REDUCED IF
BREAD, RICE, POTATOES,
PASTA AND OTHER
STARCHY FOODS
• Include low GI options with
every meal.
• Choose multigrain bread and
bran, or oat based cereals.
• Choose basmati rice and
durum wheat or wholegrain
pasta (cook al dente).
• Choose new potatoes over
older varieties. Try sweet
potato for a change.
MILK AND DAIRY FOODS
• Use semi-skimmed or skimmed
milk.
• Buy reduced fat hard cheeses,
reduced fat cheese spreads or
cottage cheese.
• Replace cream/icecream with diet/
light yoghurts.
• Try to include at least 3 portions
daily, to ensure adequate calcium
intake.
• 1 portion is equal to:-
200ml (1/3rd pint) milk,
small pot of yoghurt/fromage frais
25g (1 oz) cheese.
5
HOW TO CHOOSE LOW GI FOODS

Foods with a low glycaemic index (GI) are carbohydrate foods

which are broken down slowly by the body resulting in a more
gradual rise in blood glucose.

The glycaemic index is a measure of how much a food will raise

your blood glucose after eating it.

There are many lists of GI foods available and this can become
confusing since the GI value may differ depending on where the
food tests have been carried out.

The following tips will help you to make the right choice:

• Choose breakfast cereals based on oats or bran.

• Choose wholegrain breads with plenty of visible seeds or
grains.
• Eat plenty of fruit and vegetables - aim for at least five
portions per day. Spread fruit portions throughout the day.
• Include plenty of pulses in your meals, add beans and
lentils to casseroles and other dishes.
• Finish a meal with a piece of fruit or a diet yoghurt.
• Avoid foods which have glucose, maltose or dextrose listed
as one of the first four ingredients.
• Choose durum wheat and wholegrain pasta, and cook al-
dente. Choose basmati rice. Avoid excessive portions of
rice or pasta.
• Choose new potato or sweet potatoes (moderate portion)
over older varieties.
• If you plan to eat a high GI food, try to eat with a low GI food
and this will reduce the GI of the overall meal e.g. add
baked beans to a jacket potato.
• Choose less processed and less refined foods.
6
PHYSICAL ACTIVITY
There is evidence that 30 minutes of physical activity 5 days a
week can help improve your insulin sensitivity and reduce your
risk of developing diabetes and heart disease.

If usually inactive check with your doctor, then try to find ways of
including more physical activity during the day. Try walking
upstairs instead of using lifts or elevators or walking instead of
using the car for short journeys. All activity is beneficial try
walking, cycling, swimming and even housework and gardening.

Increasing your physical activity can also help you to lose weight
and maintain any weight that is lost.

WEIGHT LOSS TIPS

There is evidence that for every kilo of weight loss there is a

significant reduction in the risk of developing diabetes.

Following the advice in this leaflet can help you to lose weight at
a slow and steady rate of 0.5-1kg (1 - 2lb) per week.

The following additional tips will help you further:

• Eat 3 regular meals a day—never miss breakfast.
• Watch your portion sizes– try using a smaller plate.
• Limit alcohol as it is high in calories.
• If you comfort eat or nibble, work out your danger periods/
nibbling times and do something pleasant to distract you
from food e.g. read a book, phone a friend, go for a walk or
have a relaxing bath.
• Pre-plan meals and shop from a list to stop impulse buys.
• Try not to shop for food if you are hungry. Write a shopping
list and stick to it.
• If you want snacks between meals, fruit and diet/light
yogurts are the best choices.

7
SMOKING
Smoking is a major factor contributing to heart disease,
stroke and other health problems.

If you are keen to stop smoking, book in to the stopping

smoking clinic at York House Medical Centre on 01299
827171

or contact

Worcestershire Smoking Advice Service can help. Tel:-

01905 - 760222.

'The Eatwell plate is reproduced with the kind permission of the Food
Standards Agency. This Crown copyright material is reproduced with the
permission of the Controller of HMSO and Queen's Printer for Scotland.'

Adapted from a document kindly produced by:

The Nutrition & Dietetic Department/ Diabetes Team
Worcestershire Acute Hospitals NHS Trust
RD
Date of Production March 2012
Date of Review March 2014