If you’re considered pre-diabetic (upwards of 30% of Americans meet the criteria, and many of them may not even know it), revamping your diet and lifestyle choices can make a tangible difference in changing your health status. Indeed, according to the CDC, it is possible to reverse prediabetes with the right lifestyle interventions.
“Prediabetes can be a scary thing to get diagnosed with, but the good news is it’s reversible. Incorporating lifestyle changes like healthy eating habits, better sleep, and physical activity can help. Take it slow and start with small, actionable steps,” says Mackenzie Burgess, RDN, registered dietitian nutritionist and recipe developer at Cheerful Choices. “If you need help setting goals or staying accountable with your diet, seek the advice of a registered dietitian nutritionist.”
Echoing Burgess, Eleana Kaidanian, RD, CDN, CPT-WFS, registered dietitian and owner of Long Island Nutritionist, a private virtual practice based in New York comments: “Reversing prediabetes or even a full-blown diabetes diagnosis is not a myth; in fact, I help my patients achieve this regularly, so I know it’s doable, you can do it too! My clients can tell you and I will too, it does take work, it does take change, however, if you set yourself up for success, I have seen A1Cs in the 8s (diagnostic of diabetes) go down to the mid 5s (healthy/normal range) achieved in 90 days with diet and exercise,” she says. “Being consistent with your efforts will not only make your efforts more habitual and easier over time but will also help you achieve the results you are looking for.”
Beyond meeting with a health professional such as a trusted doctor and/or nutritionist to come up with the best personalized approach for you, here are six simple guidelines that may help you reverse prediabetes. And for more on how to eat healthy, don’t miss Drinking Habits to Avoid If You’re Pre-Diabetic, Says Dietitian.
Burgess recommends starting meals with a simple side salad or colorful roasted vegetables of choice. That doesn’t sound too bad, now, does it? “Eating vegetables as the first part of a meal is a simple eating habit that can help control blood sugar levels. Research shows that those who ate vegetables before the main carbohydrate portion of their meal had lower levels of blood glucose following the meal compared to those who ate carbohydrates first,” says Burgess.
We’re not talking Skittles, friends. “Eating a variety of colorful fruits and vegetables is an attainable and fun eating habit that may help reverse prediabetes. This is because the different colors in foods represent different antioxidants, phytochemicals, and nutrients that are related to a lower prevalence of prediabetes,” says Burgess. “While it probably isn’t realistic to eat every color in one meal, try to incorporate different colored foods throughout the week, with the goal of eating as many as possible,” she continues, recommending people try topping yogurt with various berries, stirring colorful bell peppers into pasta dishes, or whipping up this rainbow quinoa salad.
More guacamole? Sign us up. “Eating more healthy fats, such as monounsaturated fats, can improve how well your body uses insulin which may help reverse prediabetes,” says Burgess. “One study found that eating more monounsaturated fats, especially olive oil, improved insulin sensitivity in people with prediabetes. Other good sources of monounsaturated fats include avocado, nuts, and seeds. Try roasting vegetables in olive oil, topping toast with avocado instead of butter, or making nut-crusted salmon.”
Intermittent fasting may be trendy, but listen up to learn more about meal timing to reverse prediabetes: “Fad diets such as intermittent fasting will not help you reverse your prediabetes. In fact, you should implement the opposite. Aim to eat frequently, ideally every two-to-three hours, as a schedule to keep your blood sugar from dropping low between snacks and meals and to prevent very large meals due to gaps in the diet that can cause spikes in your blood sugar,” shares Kaidanian.
“Your body wants to keep your blood sugar steady. Encouraging spikes and dives in your blood sugar levels by skipping snacks/meals, by going long periods of time without eating, then overeating is not diabetes-friendly. Rather, eating a small, balanced, portion of food every couple of hours will keep you satisfied and within your carb limits due to portion size. You will feel more satisfied and your blood sugar will be in a healthier and happier place with these changes in your eating schedule,” she elaborates, also pointing to this research.
RELATED: Surefire Ways to Lower Your Blood Sugar, Say Dietitians
Hear ye, hear ye: “Not all carbs are created equally or affect your blood sugar the same way,” proclaims Kaidanian. “When selecting snacks and meals, aim for high fiber carbohydrates in the form of fruits/vegetables (especially with the skin intact), beans, nuts, seeds, and whole grains. Fiber is rough and tough—think wheat bread vs. soft fluffy white bread—and adding fiber to your diet is more work for your body to break down into energy. That work and time factor results in the slow release of sugar into the bloodstream over a longer period of time, therefore preventing a spike that could arise from a no fiber carb such as juice,” she explains. As Kaidanian breaks it down, choosing a high-fiber food such as an apple with the peel is more complex than a simple carbohydrate, in this example, apple juice.
“However, you don’t have to stop there. By choosing not to eat a stand-alone carb even if it is a high-fiber one, and adding a protein or a fat to it, you can make the snack or meal choice even more complex,” she adds. For instance, try a small apple with the peel and a spoon of natural unsweetened nut butter, recommends Kaidanian. “By doing so, your body will respond with better glycemic control of the foods you just put into your body to break down into energy,” she concludes, highlighting this research. She had us at apple with almond butter.
RELATED: 15 Best Snack Combos That Double Weight Loss
“There are three macronutrients that make up all the energy we receive from our diet, specifically, proteins, fats, and carbs,” explains Kaidanian, noting that out of the three, carbs have the most impact on blood sugar. “It’s not that you should eat no carbs, rather, you must be aware of the amount of carbs you eat in a given moment. Unfortunately, our Westernized diet is very carb-heavy. You likely don’t need to go on a low-carb diet, it’s just that most people are eating a supercharged carb-laden diet. In comparison, it, therefore, may seem that you need to make a big shift, but in reality, you should just keep track and stay within range of your carb requirements,” she says, citing this research and these CDC carb-counting guidelines.
“Carb counting is a method I use with my clients to understand ballpark numbers for carbohydrate sources and how many grams to aim for in a given sitting.”
For snacks, Kaidanian recommends 15 grams of total carbohydrates (this is equivalent to 1 carb count) and for meals a range of 15-30 grams.
“Remember, you can and should add proteins and fats for more volume and satiating food combos. An example of a snack within this range could be one or two hard-boiled eggs (0-1 gram of carb) plus a cup of fresh bell peppers (9 grams of carbs).” To learn more about carbs, check out How to Calculate Net Carbs for Weight Loss.
What Happens To Your Body When You're Hangry
One minute you’re out for a walk, happily engaged in conversation—and the next, you’ve turned into a crazy monster with a grumbling stomach who snaps when your friend accidentally brushes against you. Or you’re at the deli, finally next in line, and that woman’s indecisiveness makes you want to scream in a fit of rage “JUST PICK SOMETHING!”
Sound familiar? If it does, you’re not alone. You’ve likely experienced hanger—anger fueled by hunger—a phenomenon where people become grumpy and short-tempered (Read: turn into ravenous, crazy people) when they’re overdue for a snack and their blood sugar is running low. It feels like your stomach is about to eat itself, your brain feels like it’s in a fog, and your body feels drained. Not only is hanger extremely uncomfortable (for you and whomever the poor soul is who happens to be near you at the time), but it can also lead to heightened food cravings, putting you at risk of reaching for an unhealthy snack and making less-than-optimal food choices.
So, what is it that makes us like this and what’s really going on when we’re hangry—let’s find out!
When we eat food, the region of our brain that processes pleasure and reward lights up as the fats and sugars of the meal release chemicals known as opioids that bind with receptors in the brain. You read that right. These are the same type of signaling chemicals as drugs. In turn, this triggers the release of dopamine, one of the feel-good hormones that regulate things like emotion, behavior, alertness, and impulsivity. It’s the same hormone that is released when we fall in love, gamble, have sex, and partake in drugs and alcohol (and what ultimately plays a part in addiction). So, because consuming food is related to making you happy, your brain wants you to continuously repeat that pleasurable feeling. And you’re keeping it from doing that. (Psst! When you do finally eat, check out these 23 Foods That Happy People Eat!)
What happens when you don’t get food? It all starts with ghrelin. When the stomach is empty, it releases ghrelin, the hunger hormone. Ghrelin is produced in the gut in response to your standard meal schedule—as well as at the mere sight or smell of food—and is designed to signal your brain that your body needs more energy or food. When ghrelin hits the brain, it hits areas that control your body’s automatic processes, metabolism, and the reward center we just mentioned. When ghrelin causes all that stimulation, your brain has to listen. And it usually does so by making you eat food. So when you’re depriving that sensation, you’re really ticking off your brain.
Ghrelin’s role in controlling the reward center of your brain is pretty powerful, and, as it turns out, might be one of the contributing factors to your hangriness. According to a study in the journal Neuropharmacology, when researchers stimulated mice with systemic ghrelin (which should tell their brains to eat) but did not actually provide any food for them to nosh on, the dopamine levels in their brain didn’t just stay the same, they actually decreased.
Because dopamine is a neurotransmitter that aids in improving mental function and concentration, just that slight change in dopamine levels that you might experience by depriving yourself of food can affect your ability to concentrate and focus on daily work. Furthermore, this neurotransmitter is also in charge of keeping emotions in check, so low dopamine can mean you have less control over your anger.
Other people who have decreased levels of dopamine? People who are going through alcohol or drug withdrawals. And they commonly experience irritability, mental confusion, anxiety, agitation, and slowness in thought. So when you try to ignore your body’s messages that you need to eat, your hanger may be coming from a place of addition and withdrawal.
Another reason you get hangry is also tied to the hunger hormone. After ghrelin is produced in the gut and travels to the brain, the brain then commands the release of a second hormone called neuropeptide Y, which stimulates appetite. This natural brain chemical has several functions, including increasing food intake as well as regulating anger and aggression, and it seems like the two are linked. According to a study in the journal Biological Psychiatry, people with high levels of neuropeptide Y in their cerebrospinal fluid had more measures of aggression and impulsivity as well as impulsive aggression. So it certainly makes sense that high levels of nY caused by hunger can lead people to become a bit hangry.
While many hormonal changes contribute to hanger, basic body functions do as well. After we eat, our bodies digest food into its basic parts: protein to amino acids, fats to fatty acids, and carbs to glucose. Glucose is our body’s primary unit of energy (followed by fatty acids or lipids). As our body digests glucose, it enters into the bloodstream to help feed our organs and tissues. After around 6 hours, your blood glucose levels become too low to provide adequate energy. While other organs can use different nutrients to continue to function, your brain critically depends on glucose. In fact, 25 percent of the energy you get from food is used for your brain alone. So when the sugar in your bloodstream goes down, so does your brainpower. Feel like you’re lacking in mental acuity? Don’t miss out on these 10 Best Brainpower-Boosting Secrets.
Low blood sugar can have a particularly large effect on high-level tasks and emotions that require the most amount of energy, like self-control and anger. When your brain lacks adequate fuel, the part of the brain responsible for curtailing angry impulses doesn’t have enough resources to exert self-control. For example: In a study published in Proceedings of the National Academy of Sciences, researchers found that married couples get increasingly angry and mean towards one another—via pin pricking a spousal voodoo doll and blasting opponents with loud noises—when their blood sugar was low.
It’s not just married couples either. Researchers at Florida State University who reviewed studies on the subject were able to link glucose with being the primary source of self-control. They found depressed glucose levels were associated with increased irritability around others, over-the-top anger, and general anxiety, while restoring glucose levels through either giving participants a sugary snack or upping their levels of insulin—the hormone which helps your body store glucose—were able to sufficiently improve self-control.
If your blood-glucose levels fall far enough, your brain will perceive it as a life-threatening situation. In turn, your brain instructs several organs in your body to synthesize and release hormones that increase the amount of glucose in your bloodstream. This effect, called the glucose counter-regulatory response, causes your body to increase production of hormones that can directly signal the conversion of stored glycogen into glucose, like the hormone glucagon, but also the stress hormones adrenaline (aka epinephrine aka the fight-or-flight hormone) and cortisol—known as “the belly fat hormone” for its ability to trigger hunger and pull lipids from the bloodstream and store them in our fat cells.
These stress hormones are released in all sorts of stressful situations, not just during the stress of low blood glucose levels. And just as you might instinctively shout out in anger at someone when your stress hormones are heightened during a dangerous situation, the flood of adrenaline you get when you become hangry can promote a similar response. Feeling stressed in general? Don’t miss these Teas for Weight Loss That Combat Stress!
Even though your brain is attempting to use all of these hormones to alleviate your hunger, your body might not even have the proper building blocks to make these hormones. Dietary nutrients such as tyrosine, tryptophan, and choline provide the building blocks for certain mood-regulating neurotransmitters. The catch? Your body can only get these nutrients from food. You’re probably familiar with choline, a nutrient found in egg yolks which is required to synthesize acetylcholine, the neurotransmitter that plays important roles in arousal, attention, motivation, and muscle-activation. High tyrosine levels allow neurons to manufacture dopamine, which we’ve already covered, and tryptophan is the precursor for serotonin, a calming neurotransmitter whose low levels are associated with aggressive behavior.
Our bodies, like cars, need the proper fuel to survive and run efficiently. In this analogy, you probably guessed correctly that fuel is food, and in particular, the unit of energy is glucose. When we put the wrong types of fuels into our bodies, like highly processed foods such as refined sugars and carbs, we’re not giving our body the proper nutrients it needs to function properly. If you rely on pro-inflammatory foods like fast food and processed junk, your body is most likely depleted in antioxidants and phytonutrients from fruits and veggies that help our bodies rid themselves of toxic metabolites.
The moment our digestion stops, our body goes through a period of “cleaning” where our tissues release toxic substances into circulation for removal. Without free-radical-fighting antioxidants to clear them out, your cells have to store these toxic products that build up in the body. A study in Nutrition Journal found that people who were on a low nutrient diet were more likely to feel hungry after a meal and were also more irritable when hungry, as opposed to those on a high-nutrient diet. The researchers speculated that our bodies can become addicted to these toxic metabolites, so when some people feel weak, headachy, tired, or mentally dull after a meal they might confuse it with hunger, but what they really could be experiencing is withdrawal symptoms.
As you can see, there are several different pathways and mechanisms at play that might be contributing to your anger when you’re hungry. But lucky for you, the only thing you need to focus on is stuffing your face! While you may have a hankering for the fastest, easiest kind of fuel—like soda or chips—know that grabbing a smoothie or handful of nuts is just as easy. Junky, processed foods may satisfy you right away, but they’ll unavoidably lead to spikes in blood glucose levels that come crashing down—fast. Leaving you even hangrier. Be sure to reach for nutrient-rich, satiating foods high in healthy fats, protein, and fiber.
What Happens to Your Gut When You Eat Oatmeal
If you were to picture what happens when you dig into a bowl of oatmeal in the morning, you might imagine the benefits of each bite dispersing out to various parts of your body. After all, oats are well known for protecting your heart, strengthening your blood vessels, and slimming your waistline. But they also have a lot to offer the body part where they spend the most time: your gut!
As a whole grain food full of fiber, antioxidants, and other nutrients, oatmeal flexes some heavy-duty force for good in your belly. Here’s a look at what this versatile, down-to-earth breakfast food can do as it makes its way through your GI tract. And don’t miss the healthiest way to cook oatmeal!
If we’re talking gut health, we might as well start with the function that affects us everyday: our bathroom habits. Abundant research has examined how your morning oatmeal bowl could help you while, well, on the bowl. One large systematic review in the British Journal of Nutrition found that, in people with no history of bowel disease, oats and oat bran could significantly increase stool weight and decrease constipation.
It’s likely that the bran portion of the oat grain is responsible for oatmeal’s ability to get things moving. In a 2008 study on nursing home residents, those who received an oat bran supplement were more likely to be able to stop using laxative medications. And it’s not just older people who can benefit from oatmeal’s evacuating effects. A 2020 study on children concluded that oatmeal might reduce constipation symptoms like gas, straining, and a feeling of incomplete evacuation.
You may have noticed oatmeal packaging boasting of its soluble fiber content. And it’s true: oatmeal is among the best sources of this nutrient. So what’s the big deal about soluble fiber?
Among its many benefits (like lowering cholesterol and improving blood glucose control), this form of fiber has some pretty special effects on your gut. Because it creates a viscous, gel-like substance in the GI tract, it can actually slow down digestion, keeping you fuller longer.
In fact, research shows that a form of soluble fiber called beta-glucan, especially plentiful in oats, increases the perception of satiety. Besides preventing the annoyance of mid-morning snack cravings, staying full can help you reach your weight loss goals.
Just don’t fall prey to the worst oatmeal habits for weight loss!
We’re not done with you yet, fiber! These days, we all hear a lot about the importance of maintaining a healthy microbiome—AKA the trillions of bacteria inhabiting our gut. One excellent way to boost the health of the all-important microbiome is to feed it the right kind of fiber, known as prebiotic fiber.
Here’s where beta-glucan shines again. As a prebiotic fiber, it’s been shown to help improve the growth and colonization of certain helpful strains of gut bacteria. A microbiome rich in healthy bacteria has been linked to all sorts of health benefits, like reduced risk of type two diabetes, depression, and obesity.
If you live with celiac disease or inflammatory bowel disease (IBD), don’t be surprised if your doctor or dietitian recommends oatmeal for your morning meal. Some research has found that eating more oat bran could result in small improvements in symptoms of ulcerative colitis.
Meanwhile, since oats are gluten-free, they’re an ideal grain for folks with celiac disease. (Just be sure to purchase oatmeal that’s certified gluten-free—otherwise, you may end up with cross-contamination if they’re processed alongside wheat.) It’s even possible that oats’ microbiome-boosting prebiotic fiber could help reduce symptoms of celiac disease—though more research is needed to draw firm conclusions.
On the other hand, if you’re experiencing diarrhea during a celiac or IBD flare, you may prefer to avoid oats for a while. Some people find its soluble fiber to be too much for their GI tract to handle when suffering from loose bowels.
Sarah Garone, NDTR