Nutritional Strategies in Prediabetes: A Scoping Review of Recent Evidence

Abstract

Nutritional therapy has been conventionally recommended for people with prediabetes as a method to delay or halt progression to type 2 diabetes. However, recommended nutritional strategies evolve over time. Hence, we performed a scoping review on recently reported nutritional interventions for individuals with prediabetes. Ovid MEDLINE, PubMed, Embase, Scopus, CINAHL and PsycINFO databases were searched to identify relevant research articles published within the past 10 years. Ninety-five articles involving a total of 11,211 participants were included in this review. Nutritional strategies were broadly classified into four groups: low calorie diet, low glycemic index diet, specific foods, and a combination of diet and exercise. The most frequently assessed outcomes were plasma glucose, serum insulin, serum lipid profile, body mass index and body weight. More than 50% of reported interventions resulted in significant improvements in these parameters. Nutritional interventions have demonstrated feasibility and practicality as an effective option for prediabetes management. However, the intervention variability demonstrates the challenges of a ‘one-size-fits-all’ approach. Investigations in genetically diverse populations and objective assessment of progression rate to diabetes are necessary to better comprehend the impact of these nutritional strategies in prediabetes.

Role of Fluid Milk in Attenuating Postprandial Hyperglycemia and Hypertriglyceridemia

“…In general, intervention studies examining the effects of dairy intake suggest favorable effects on vascular function. A recent scoping review reported that proteins derived from milk are common interventions for prediabetes and that significant improvements in brachial artery flow-mediated dilation and oxidative stress markers are observed without any evidence to support the benefit of milk proteins on insulin or lipid profiles [ 104 ]. In the early stages of atherosclerosis, damage to vessel walls can be protected by milk-derived bioactive peptides, which have anti-inflammatory effects on endothelial cells [ 105 ].…”

“…The available studies investigating dairy-derived proteins suggest a cardioprotective effect in preclinical populations. For instance, proteins derived from milk are common interventions for prediabetes since significant improvements have been observed in oxidative stress markers and glucose metabolism, especially postprandial glucose and glycated hemoglobin A1c (HbA1c), without any improvements of insulin profiles [ 104 ]. A proprietary whey protein hydrolysate that contained bioactive peptides with α-glucosidase-inhibiting properties reduces postprandial hyperglycemia in prediabetes adults [ 124 ].…”

“…Whey protein isolate lowers triglyceride response more than casein in postmenopausal women [ 138 ] while whey protein isolate consumed with a high-fat meal lowers triglyceride response more than casein in individuals with type 2 diabetes [ 101 ]. However, while proteins derived from milk are common interventions for prediabetes and exhibit positive outcomes on glucose metabolism, a recent review found no evidence to support the benefit of milk proteins to lipid profiles [ 104 ]. For additional reading substantiating the differences between whey and casein, the review by BjØrnshave and Hermansen is recommended [ 139 ].…”

Quality and Quantity of Protein Intake Influence Incidence of Type 2 Diabetes Mellitus in Coronary Heart Disease Patients: From the CORDIOPREV Study

“…In this sense, a large number of studies suggest that lifestyle changes (increased physical activity, adherence to a healthy diet, avoidance of smoking, and maintenance of an adequate body weight) might help to prevent the onset of both conditions [ 4 ]. Concerning dietary interventions, there is compelling evidence that food ingredients might have an impact on glucose regulation, as some food components improve β-cell function, insulin sensitivity, glycaemic control, or oxidative stress [ 5 ]. In this regard, frequent intake of red meat and processed meat has been associated with an increased risk of developing T2DM, whereas whole-grain and fibre intake has showed an inverse association with T2DM incidence [ 6 ].…”

Normal Versus Slowly Processed Pasta and Post-Prandial Glucose Homeostasis in Healthy Subjects: A Pilot Study

“…A healthy diet and regular physical activity are both powerful tools in terms of primary prevention, becoming first-line treatments when a metabolic disease occurs [ 1 ]. Thus, nutritional health is nowadays a major issue for the general population and, even more, for high-risk subsets of individuals [ 2 ].…”