Receiving news that your A1C levels are in the pre-diabetic range can be both unsettling and empowering. It’s a wake-up call—but not a sentence. Pre-diabetes means your blood sugar is higher than normal but not yet high enough to be diagnosed as type 2 diabetes. That is good – for now. Diabetes 2 carries a great many risks we’d all like to avoid!
The good news? You have time to take action, and eating properly is one of the most effective and accessible tools at your disposal.
Let’s dive into what A1C means, how food affects it, and practical strategies for eating in a way that supports blood sugar balance, promotes health, and helps prevent or delay diabetes.
Understanding A1C and Pre-Diabetes
Your A1C (also called hemoglobin A1C) is a blood test that reflects your average blood sugar levels over the past 2–3 months. Hemoglobin is a protein in red blood cells that binds to glucose (sugar) in your bloodstream. The higher your blood sugar, the more glucose attaches to hemoglobin.
A1C Ranges:
- Normal: Below 5.7%
- Pre-diabetic: 5.7% to 6.4%
- Diabetic: 6.5% or higher
If your A1C falls between 5.7% and 6.4%, you’re pre-diabetic, which puts you at increased risk for developing type 2 diabetes, heart disease, and stroke.
Why Food Matters: The A1C-Food Connection
Food directly affects your blood glucose levels. Carbohydrates (carbs), in particular, are broken down into glucose, which enters your bloodstream and influences your A1C over time. Managing when, what, and how much you eat can help maintain steadier blood sugar levels, lowering your A1C and reducing your diabetes risk.
Eating Goals for Pre-Diabetes
When eating to manage or reduce A1C, the key goals are to:
- Stabilize blood sugar by avoiding large spikes and crashes.
- Improve insulin sensitivity to help your body use sugar more efficiently.
- Support weight management, if needed, as even modest weight loss (5–7% of body weight) can reduce your risk of developing diabetes.
- Fuel your body with nutrient-rich, whole foods for overall health.
Core Principles for Pre-Diabetic Eating
1. Balance Your Plate: The 50/25/25 Rule
A balanced plate is both healthier and helps control blood sugar without feeling deprived.
- 50% non-starchy vegetables: Leafy greens, broccoli, peppers, zucchini, cauliflower
- 25% lean protein: Chicken, turkey, tofu, fish, eggs, legumes
- 25% healthy carbs: Whole grains, sweet potatoes, beans, fruits
2. Choose High-Fiber Carbohydrates
Fiber slows down the absorption of sugar, preventing sharp spikes in blood glucose. Aim for 25–30 grams of fiber per day.
Examples:
- Whole grains: Quinoa, oats, barley, whole wheat
- Legumes: Lentils, black beans, chickpeas
- Fruits: Berries, apples (with skin), pears
- Vegetables: Broccoli, carrots, Brussels sprouts
Avoid refined carbs like white bread, white rice, pastries, and sugary cereals—they lack fiber and cause quick blood sugar spikes.
[NOTE: see the link between diabetes and the risks involved in food borne illness]
3. Be Mindful of Portions
Even healthy carbs can raise blood sugar if consumed in large quantities. Keep portions moderate.
Examples of appropriate carb servings:
- ½ cup cooked oatmeal
- ½ cup cooked brown rice or quinoa
- 1 small apple or banana
- 1 slice whole grain bread
Use measuring cups or a food scale to learn portion sizes, especially early on.
Best Foods for Lowering A1C
1. Leafy Greens
Spinach, kale, Swiss chard, and arugula are low in carbs and calories but rich in fiber, vitamins, and minerals.
2. Fatty Fish
Salmon, sardines, and mackerel provide omega-3 fatty acids that reduce inflammation and support heart health—a concern for pre-diabetics.
3. Nuts and Seeds
Almonds, walnuts, chia seeds, and flaxseeds offer healthy fats, fiber, and protein, all of which help stabilize blood sugar.
4. Berries
Blueberries, strawberries, and raspberries are low-glycemic fruits rich in antioxidants and fiber.
5. Legumes
Lentils, black beans, and chickpeas are high in fiber and protein and have a low glycemic index.
6. Whole Grains
Choose oats, quinoa, barley, and bulgur over white rice or pasta for slow-digesting carbs.
7. Greek Yogurt
Plain, unsweetened Greek yogurt is high in protein and probiotics, which may improve insulin sensitivity.
Foods to Limit or Avoid
- Sugary Beverages: Soda, fruit juices, sports drinks spike blood sugar rapidly.
- Refined Grains: White bread, pasta, and rice cause quick glucose absorption.
- Fried Foods: Often high in trans fats, which worsen insulin resistance.
- Sweets and Desserts: Cakes, cookies, candy, and ice cream are high in sugar and refined carbs.
- Processed Snacks: Chips, crackers, and granola bars often have hidden sugars and low fiber.
Timing and Frequency: When You Eat Matters
1. Don’t Skip Meals
Skipping meals can cause blood sugar swings and lead to overeating later, spiking glucose levels.
2. Consider Smaller, Balanced Meals
Eating smaller, frequent meals (every 3–4 hours) can help some people maintain steady blood sugar, though others do well with three well-balanced meals. Monitor your body’s response.
3. Evening Eating
Avoid heavy, carb-rich meals late at night, as insulin sensitivity is lower in the evening. Try to finish eating at least 2–3 hours before bedtime.
Drinks: Choose Wisely
- Water: Your best choice; aim for 8–10 cups/day.
- Unsweetened tea or coffee: Fine in moderation; avoid sugary additives.
- Sparkling water with lemon: A good soda substitute.
- Avoid alcohol or limit: Alcohol can affect blood sugar and interact with medications.
Sample Day of Eating for Pre-Diabetes
Breakfast:
- Scrambled eggs with spinach and tomatoes
- ½ avocado
- 1 slice whole grain toast
- Black coffee or herbal tea
Snack (if needed):
- 10 almonds
- 1 small apple
Lunch:
- Grilled chicken breast
- Mixed green salad with olive oil and vinegar
- ½ cup quinoa or lentils
Snack:
- Greek yogurt (plain, unsweetened) with cinnamon and a few berries
Dinner:
- Baked salmon
- Steamed broccoli and cauliflower
- ½ sweet potato
Evening (if hungry):
- Herbal tea and 1 tbsp peanut butter on celery
- [NOTE: se the link between diabetes and food insecurity]
Lifestyle Tips Beyond Food
- Exercise Regularly
Aim for 150 minutes/week of moderate activity (e.g., walking, cycling). Exercise improves insulin sensitivity and helps lower A1C. - Sleep Well
Poor sleep affects hormones that regulate hunger and blood sugar. Aim for 7–9 hours/night. - Manage Stress
Chronic stress raises cortisol, which increases blood sugar. Practice deep breathing, meditation, or yoga. - Track Your Progress
Use a food journal or app to track meals, glucose levels, and how different foods affect you. - Work with a Dietitian or Diabetes Educator
Personalized guidance can help you develop a sustainable eating plan.
Debunking Common Myths
Myth 1: I Have to Avoid All Carbs.
Reality: You don’t need to cut out carbs entirely—just choose the right ones (high fiber, low glycemic index) and watch portions.
Myth 2: Sugar Is the Only Problem.
Reality: All refined carbs (white bread, pasta) can spike blood sugar, not just table sugar.
Myth 3: I Need Special ‘Diabetic’ Foods.
Reality: Many labeled products are expensive and unnecessary. Focus on whole, unprocessed foods.
Small Steps, Big Impact
Being told you are pre-diabetic is an opportunity to reclaim your health. The way you eat can either push you toward diabetes or steer you back toward balance. It’s not about deprivation or rigid dieting—it’s about consistent, mindful choices that serve your body’s needs.
Start small. Swap sugary drinks for water. Add more vegetables to your meals. Choose whole grains over white flour. Every positive choice compounds, helping lower your A1C and empowering you to take control of your health journey.
You don’t need to be perfect—just persistent. And every meal is a new chance to nourish yourself in the direction of healing and prevention.
