Dr. Sarah Cimperman, ND
Prediabetes, the state of metabolic imbalance that precedes diabetes, is a growing epidemic. In the United States alone it affects 1 in 3 adults of all ages, 1 in 2 elderly adults, and almost 1 in 4 adolescents.1 The condition is characterized by high levels of blood sugar and/or insulin, the hormone that helps cells in the body absorb sugar from the blood. Sugar in the blood comes from the foods we eat, so eating the right foods is one of the most powerful steps we can take to reverse prediabetes. There are other important steps – like exercising regularly, getting good sleep, managing stress, and undergoing detoxification – but making positive dietary changes is a good place to start.
The most dangerous foods for people with prediabetes contain “fast” or simple carbohydrates that are rapidly digested and quickly absorbed into the blood stream. Unlike “slow” or complex carbohydrates that take hours to fully digest and absorb, fast carbs flood the body with sugar and trigger the release of large amounts of insulin. The top ten worst offenders are natural and artificial sweeteners, baked goods, pasta, breakfast cereals, grains, starchy fruits and vegetables, processed fruit, soft drinks, and milk.
#1 Natural and Artificial Sweeteners
Sweeteners are some of the fastest carbs around. This category includes all foods with added sweeteners, whether natural or artificial. (Artificial sweeteners don’t contain carbohydrates so they don’t raise blood sugar, but studies show that they do raise insulin levels.2) It includes all forms of sugar: white, brown, cane, beet, date, granulated, powdered, and raw. It includes evaporated cane juice, agave, maple syrup, honey, rice syrup, corn syrup, caramel, molasses, and chemical additives like dextrose, maltose, sucrose, glucose, fructose, saccharin, aspartame, and Sucralose.
#2 Baked Goods
This category includes foods made with flour, whether or not they contain gluten, whether they’re made with white flour or whole grain flour, and whether they are derived from wheat or alternative grains like spelt, rice, or quinoa. It includes bread, rolls, wraps, bagels, pretzels, crackers, pizza, pies, cakes, cookies, muffins, pastries, and foods made with bread crumbs.
This category includes all forms of pasta and noodle-based dishes like spaghetti, fettuccine, ravioli, lasagna, noodle soups, and noodle salads. It also includes foods made with rice paper or wonton wrappers or like wontons, potstickers, and spring and summer rolls.
#4 Breakfast Cereals
This includes hot and cold breakfast cereals, whether you pour them from a box or make them yourself. It includes oatmeal, porridge, granola, and granola bars.
It’s true that whole grains like brown rice have a slight advantage over processed grains like white rice and flour, thanks to very small amounts of protein, fat, and fiber in the germ and bran layers. But the bottom line is that they’re still mostly starch. The grain category includes all kinds of rice – white, red, brown, black, basmati, jasmine – as well as wheat berries, buckwheat (kasha), oats, rye, barley, amaranth, millet, quinoa, bulgur, spelt, and corn. It includes processed grains like flour and cornstarch, as well as dishes made with whole grains such as risotto, pilaf, paella, popcorn, rice cakes, polenta, grits, corn chips, tortillas, tacos, and tamales.
Unlike other fruits, bananas contain a lot of starch. This includes all kinds of bananas: small or large, yellow or red. It also includes plantains in all stages of ripeness: green, yellow, and black.
#7 Starchy Vegetables
This category includes carrots, parsnips, turnips, rutabagas, pumpkins, yams, and winter squashes like acorn, butternut, and delicata. It includes potatoes of all kinds: white, yellow, purple, sweet, baked, fried, hash browns, potato chips, Tater Tots, French fries, sweet-potato fries, and foods thickened with potato starch.
#8 Processed Fruit
This category includes all fruit that is sweetened or changed in any way from its original form: jelly, jam, dried fruit, canned fruit, fruit concentrates, and fruit juice, whether ready-made or fresh squeezed.
#9 Soft Drinks
The soft drinks category includes bottled beverages like soda, fruit punch, flavored water, sports drinks, and energy drinks. It also includes tea and coffee, hot or iced, unless they are brewed, unflavored, and unsweetened.
Milk contains a lot of lactose, which is a natural simple sugar. (Fermented dairy products like yogurt and cheese are low in lactose because bacteria consume the sugar.) Milk also contains natural growth hormones that raise insulin levels through mechanisms independent of its sugar content. One study showed that drinking milk doubled fasting insulin levels and the incidence of insulin resistance.3 Milk can also contain genetically modified growth hormones like recombinant bovine growth hormone (rBGH) which are given to cows to increase milk production but they also increase the production of insulin-like growth factors that are secreted into milk. They are not destroyed by pasteurization, and inside our bodies, they can act like insulin and promote insulin resistance.
So what’s good to eat?
A healthy diet for people with prediabetes includes plenty of non-starchy and green vegetables, plant or animal protein with every meal, and plenty of non-inflammatory fats like cold-pressed oils, avocado, olives, coconut, raw nuts and seeds, non-toxic fish and seafood, wild game, and eggs and meat from pasture-raised and grass-fed animals.
- May AL, Kuklina EV, Yoon PW. Prevalence of cardiovascular disease risk factors among US adolescents, 1999-2008. Pediatrics. 2012;129(6):1035-41.
- Liang Y, Maier V, Steinbach G, Lalić L, Pfeiffer EF. The Effect of Artificial Sweetener on Insulin Secretion. II. Stimulation of Insulin Release from Isolated Rat Islets by Acesulfame K (In Vitro Experiments). Hormone and Metabolic Research. 1987;19(7): 285–89.
- Hoppe C, Mølgaard C, Vaag A, Barkholt V, Michaelsen KF. High Intakes of Milk, but Not Meat, Increase S-Insulin and Insulin Resistance in Eight-Year-Old Boys. European Journal of Clinical Nutrition. 2005;59(3):393–98.
Sarah Cimperman, ND is the author of the new book, The Prediabetes Detox: A Whole-Body Program to Balance Your Blood Sugar, Increase Energy, and Reduce Sugar Cravings. She graduated from NCNM in 2002 and has a private practice in New York City. Her expertise has been featured on Fox News and Huffington Post and in Natural Health magazine, Whole Living magazine, and the Well Being Journal, among other publications. Dr. Cimperman also writes two blogs, A Different Kind Of Doctor and The Naturopathic Gourmet.