Food Fact: Dietary Advice for Pre Diabetes

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Pre Diabetes occurs when blood glucose levels are higher than normal, but not high enough to be diagnosed as Type 2 Diabetes. People with Pre Diabetes have an increased risk of developing Type 2 Diabetes and are at a higher risk of having heart disease. Making & maintaining lifestyle changes is the most effective way to reduce the risk of Pre Diabetes progressing to Type 2 diabetes.

Risk factors for pre diabetes include:

• being overweight.
• being physically inactive.
• high blood pressure.
• age: risk increases as we age .
• Family history (genetics).
• ethnic background.

HbA1c testing in diagnosing Diabetes:

• HbA1c < 42mmol/mol (6%): non-diabetic
• HbA1c 42-47mmol/l (6-6.4%): pre-diabetes
• HbA1c ≥48mmol/l (≥6.5%): diabetes

Steps towards managing Pre Diabetes:

• manage your weight and reduce waist measurement (<80cm for women and <94cm for men).
• eat well.
• keep active.
• avoid or stop smoking.

Manage your weight

If you are overweight, aiming for a 5% weight loss reduces Type 2 Diabetes risk by 50%. Reduce your calorie intake by cutting down on your intake and keeping as active as possible.

Eat well

• Reduce your intake of sugar sweetened drinks & sugary foods.
• Reduce your fat intake, especially saturated fat Reduce your salt intake.
• If you drink alcohol, drink it in moderation.
• Eat regular meals and have a maximum of 1 fist sized portion of starchy carbohydrates at each meal.
• Choose high fibre, wholegrain sources of carbohydrates.
• Eat five (handful sized) portions of vegetables, salad and fruit per day.
• Avoid skipping meals & space your meals out over the day, this helps to control your appetite and blood glucose levels.

Have a maximum of one fist sized starchy carbohydrate portion per meal

Carbohydrates are the easiest source of fuel for your body and are a source of vitamins and fibre. The high fibre starchy foods help maintain your digestive system and prevent problems such as constipation. Carbohydrates are digested and absorbed as glucose into the bloodstream – some quickly (sugary foods) and some slowly (starchy foods). Choose slowly absorbed starchy carbohydrates as these are converted to glucose at a slower rate. These choices include:

• pasta
• basmati or long grain rice
• grainy breads such as granary, pumpernickel and rye
• new potatoes, sweet potato and yam
• porridge oats, All-Bran and natural muesli
• pulses, e.g. lentils, kidney beans and baked beans.

Reduce salt

Do not add salt to your food and limit the amount of processed foods you eat.

Cut down on fat, especially saturated fat

Choose unsaturated fats or oils, especially monounsaturated fat, e.g. olive and rapeseed oil, as these types of fats are better for your heart. Fat contains a large amount of calories, so eating less can help you lose weight. To cut down on your fat intake here are some tips:

• Choose low fat dairy products: milk, cheese and diet yoghurts.
• Choose leaner cuts of meat and trim off any visible fat/skin (choose white meat / fish instead of red meat or processed meats).
• Grill, steam or oven bake rather than frying or roasting in oil.
• Include low-fat margarines and cooking oils based on unsaturated fats, e.g. olive oil.
• Avoid foods with hidden fats e.g. pastries, pies, cakes and biscuits.
• Try to have 2 to 3 portions of oily fish a week, e.g. mackerel, sardines, pilchards, salmon and trout. They contain a type of fat that is good for your heart.

Drink alcohol in moderation only

No more than 2 to 3 units / day, with no more than 14 units of alcohol per week.

1 unit = ½ pint beer/cider/lager (normal strength), 1 small glass of standard strength wine 8/9% (125ml), 25ml measure of spirits.

Always choose a low calorie / sugar free / diet mixer, e.g. low calorie / diet tonic, diet lemonade / cola.

All types of alcoholic drinks are high in calories, so if you are trying to lose weight it is best to reduce your intake. Try to have at least 2 alcohol free days per week.

Reduced fat and reduced sugar products

Many foods labelled as low fat, but are often high in sugar. Also, low sugar products can be high in fat, so both are best avoided. Keeping a healthy balance can be difficult so using food labels can help to make appropriate choices. Use the following as a guide.

Fat

• A lot (per 100g food): 20 fat or more
• A little (per 100g food): 3g fat or less

Saturated fat

• A lot (per 100g food): 5g saturated fat or more
• A little (per 100g food): 1g saturated fat or less

Sodium

• A lot (per 100g food): 0.5g sodium or more
• A little (per 100g food): 0.1g sodium or less

Sugars

• A lot (per 100g food): 10g sugars or more
• A little (per 100g food): 2g sugars or less

Keep active

Regular physical activity can help with weight management, reducing blood glucose levels and lowering cholesterol levels. Evidence continues to support being physically active every day, working to achieve a minimum of 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity per week.