Ask the experts: Low-carb diet and pre-diabetes

Question: “I am pre-diabetic and my doctor has suggested a very low-carb diet to lose some weight. Is this a good idea? I’m worried it won’t be sustainable because it’s very restrictive and I would have to think about what I can and can’t eat all the time. Is there a better way?”

-Jan, NSW

Expert advice: Low-carb diets may be beneficial for individuals with pre-diabetes, as they may help improve blood sugar control and reduce the risk of developing type 2 diabetes. However, not all carbohydrates are created equal and, like you mentioned, keeping up dietary changes long term is an issue. With traditional low-carb diets being so restrictive, this can be hard! I suggest seeking advice from an accredited practising dietitian to determine the level of carbohydrate for your needs and to ensure that you are getting all the necessary nutrients.

The best-practice treatment for pre-diabetes involves the same lifestyle changes that are recommended for people diagnosed with diabetes. For most, this will include regular physical activity (to help lower blood glucose levels), eating a healthy and balanced diet, and achieving and maintaining a healthy weight (to make your insulin work better).

A healthy eating plan for losing weight and reducing the risk of type 2 diabetes needs to include a reduction in total energy (kilojoules), particularly from saturated fat foods such as butter, full-fat dairy products, fatty meats, takeaway foods, biscuits, cakes and pastries. Instead choose a wide range of high-fibre, low-glycaemic index (GI) carbohydrate foods such as wholegrain breads and cereals, legumes and fruit. People with pre-diabetes, need to consume added sugars in moderation — no more than 10 per cent of total energy (less than 55g) a day for the average adult.

Aim to do at least 30 minutes of moderate intensity physical activity (like swimming or brisk walking) on most, if not all, days of the week.

Choose an eating pattern you enjoy that helps you manage your blood sugar levels well. That way it will be healthy and sustainable.