Updated July 31, 2026

If your doctor says your bloodwork reveals prediabetes, you’re bound to have questions about what’s best to eat. People with prediabetes have fasting blood sugar levels that are elevated, but not to the point that they meet the criteria of type 2 diabetes. 

Evangelina DiSpirito, RDN, LDN, E-RYT 500, is an outpatient cardiac rehabilitation clinical dietitian at Johns Hopkins with more than 25 years of experience in nutrition counseling, including diabetes education. She specializes in helping individuals with prediabetes, diabetes and cardiovascular disease make sustainable nutrition and lifestyle changes to improve blood sugar management, support heart health, and reduce the risk of developing type 2 diabetes.

Diet for Prediabetes — What foods should I eat?

A balanced diet is key to preventing prediabetes from progressing to type 2 diabetes. Rather than eliminating entire food groups or following fad diets, focus on healthy, sustainable eating habits that support long-term blood sugar control.

With that in mind, the Mediterranean diet is recommended for people with prediabetes, with its emphasis on whole grains, lean protein and healthy fats.

Other recommended resources include the diabetes meal planning recommendations from the Centers for Disease Control and Prevention and a version of the MyPlate guidelines issued by the U.S. Department of Agriculture and adapted by the American Diabetes Association (ADA).

The ADA’s version of the recommendations suggests these proportions for meals:

• 50% of the plate filled with nonstarchy vegetables, such as leafy greens
• 25% with healthy carbohydrates, such as whole grains like brown rice, farro or quinoa
• 25% with lean protein, such as chicken, turkey, fish or tofu
• Incorporate fiber to reach a goal of 25 to 30 grams per day by eating a variety of fruits, vegetables and whole grains

Foods to Limit if You Have Prediabetes

In general, many nutrition experts highlight certain foods that tend to spike blood sugar more quickly and are worth limiting. These include:

• Sugary drinks such as soda, sweetened teas, energy drinks, and fruit juices
• Refined carbohydrates like white bread, white rice, pastries, and regular pasta
• Highly processed snacks including chips, crackers and packaged baked goods
• Foods high in added sugars such as candy, desserts and sweetened cereals
• Fried foods that are high in saturated fats and can worsen insulin resistance
• Limit saturated fats like fatty cuts of meat, butter and full-fat diary to support insulin sensitivity and instead have healthy unsaturated fats, such as avocados, nuts, seeds, canola and extra virgin olive oil. 

Prediabetes and sugar — How much is too much?

Carbohydrates are the body’s main source of energy. Glucose (blood sugar) fuels every cell in the body and is the brain’s preferred fuel. While your body needs glucose to function, eating too much added sugar and refined carbohydrates can raise your blood sugar levels and worsen your diabetes.

Blood sugar levels are key indicators of prediabetes, so it’s important to be aware of hidden sources of sugar. Added sugars can be found in many processed foods, including breakfast cereals, frozen meals, protein bars, sauces and salad dressings.

Recommendations for Limiting Sugar

The World Health Organization (WHO) recommends limiting added sugar to less than 10% of your daily calorie intake and ideally to 5% or less for additional health benefits. For someone following a 2,000-calorie diet, this means consuming no more than 50 grams (about 12 teaspoons) of added sugar per day, with an ideal target of 25 grams (about 6 teaspoons). 

The American Heart Association recommends even lower limits, advising women to consume no more than 25 grams (6 teaspoons) of added sugar daily and men no more than 36 grams (9 teaspoons) per day.

Practical Tips for Limiting Sugar

• Choose water or unsweetened beverages instead of soda, sweet tea, energy drinks, and other sugary drinks.
• Read food labels and look for added sugars in packaged foods, snacks, and beverages.
• Eat whole fruits instead of candy, cookies, pastries, or other sugary desserts.
• Choose balanced meals and snacks with protein, fiber and healthy fats to help reduce sugar cravings.
• Limit highly processed foods that often contain hidden sugars and opt for whole, minimally processed foods whenever possible.

What should I eat for breakfast if I have prediabetes?

Choose foods that have lean protein, healthy fats, and high fiber carbohydrates. For example: Oatmeal topped with berries and pumpkin seeds with 1% milk, offer a well-balanced meal.

What fruits should I avoid with prediabetes?

Whole fruits can be part of healthy eating for people with prediabetes because they provide fiber, vitamins and antioxidants. Aim to choose whole fruits instead of fruit juice, which can raise blood sugar quickly. Consult with your healthcare provider regarding grapefruit as it can interact with certain medications.

How to Reverse Prediabetes — Lifestyle

Research studies such as the National Institutes of Health’s Diabetes Prevention Program Outcome Study (DPP) has consistently shown that healthy eating, regular physical activity, modest weight loss can reduce your risk of developing type 2 diabetes by 34% for four years compared to placebo, which was an outcome of the Johns Hopkins’ diabetes prevention program.

Stay active

Physical activity can help prevent diabetes while boosting heart health. People with prediabetes should try to get at least 150 minutes per week of moderate to vigorous exercise or aim for 10,000 daily steps. Be sure to check with your doctor before starting exercise or leveling up your current physical activity.

Small Weight Loss, Big Health Benefits

Even small amounts of weight loss can have a benefit. The ADA states that moderate rate reduction of 5% to 10% of your body weight can significantly lower your A1C level. 

Get Enough Sleep

The relationship between sleep, diabetes, and weight gain is important to understand. Sleep deprivation has been shown to increase people’s cravings for sugary foods, so people with prediabetes should make sure they’re getting seven to eight hours of sleep a night.

Limit Alcohol and Avoid All Tobacco

Limiting alcohol can help improve blood sugar control and reduce the risk of progressing from prediabetes to type 2 diabetes. Alcohol recommendations are no more than one drink per day for women and no more than two per day for men. 

Avoiding all tobacco products is also important, as smoking can increase insulin resistance and raise the risk of diabetes-related health complications.

Stay on Top of Your Numbers

People with prediabetes should be vigilant about their laboratory test results. If you’re at risk or have prediabetes, make sure you follow up with your A1C level with a blood test at least yearly.

Dietary Supplements and Prediabetes

Be cautious with dietary supplements. Some supplements may affect blood sugar and interact with diabetes medication. For example, ginseng, gingko, and garlic have been studied for their potential effects on blood glucose, but the evidence is mixed. In high doses—particularly when taken as concentrated supplements rather than as foods—they may increase the risk of low blood sugar (hypoglycemia) in people taking diabetes medications.

Before starting any vitamin, mineral, herbal, or botanical supplement, talk with your physician, pharmacist, or registered dietitian to ensure it is safe, effective, and appropriate for your individual health needs and medications.

Work With a Dietitian if You Have Prediabetes 

Because many people with prediabetes may have other health conditions, such as high cholesterol or high blood pressure, it’s important to individualize nutrition recommendations. 

A registered dietitian can help develop a personalized nutrition plan that fits your lifestyle, improves blood sugar control, and reduces your risk of developing type 2 diabetes. Ask your primary care provider for a referral to a registered dietitian or check with your health insurance plan to see if nutrition counseling for prediabetes is covered.

Reversing Prediabetes — Is it possible?

A diagnosis of prediabetes does not mean that developing type 2 diabetes is inevitable. Healthy lifestyle changes—including eating a balanced diet, being physically active, maintaining a healthy weight, getting adequate sleep and managing stress—can help improve blood sugar levels and may prevent or delay the progression to type 2 diabetes. In many cases, these changes can even help return blood sugar levels to the normal range.

“Every healthy choice you make is an investment in your future health. Lasting changes doesn’t come from perfection; it comes with small, consistent changes.”

Medically reviewed by Evangelina DiSpirito, RDN, LDN, E-RYT 500.