Prediabetes Diet | Johns Hopkins Medicine

If your doctor says your bloodwork reveals prediabetes, you’re bound to have questions about what’s best to eat. Tara Seymour, an advanced practice clinical dietitian and diabetes educator at Johns Hopkins, provides guidance on how a healthy diet and lifestyle can control — and even help reverse — prediabetes.

Diet for Prediabetes — What foods should I 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.

The key to warding off progression of prediabetes is a balanced approach to diet, says Seymour.

“People with prediabetes do not have to eliminate entire food groups,” she explains. “All foods can fit in the meal plan, and patients should steer clear of fad diets and other strategies that promise quick fixes, since their claims are not supported. We encourage making gradual behavior changes. Small changes can lead to big results. ”

With that in mind, she regards the Mediterranean diet as the gold standard for people with prediabetes, with its emphasis on whole grains, lean protein and healthy fats.

She also refers patients to 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).

“Though these resources are not specifically for prediabetes, they can serve as a guide to incorporating healthy choices, especially when you’re eating away from home,” Seymour says.

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, not fried

Water or another zero-calorie beverage is preferred.

Seymour also recommends:

• Avoiding excessive intake of added sugars by limiting sugary beverages, cakes, cookies, candy and snacks
• Limiting portion sizes of refined carbohydrate foods such as white bread, white rice and white pasta
• Incorporating fiber to reach a goal of 25 to 30 grams per day by eating a variety of fruits, vegetables and whole grains
• Limiting saturated and trans fats by choosing lean protein and low-fat dairy

Foods to Avoid If You Have Prediabetes

“Grapefruit and pomegranate juice can interact with some medications, since they are processed by the same liver enzyme that metabolizes medication. That enzyme is cytochrome P450, which accounts for about 75% of the total drug metabolism performed by the body.”

In addition, Seymour advises care with some nutritional supplements. Ginseng, gingko and garlic are OK in moderation, but high doses of these, as you get in over-the-counter supplements, can cause low blood sugar. “When it comes to supplements,” she says, “it is always important to know your risks and follow the proper dietary protocol by consulting your doctor or dietitian.”

“What should I eat for breakfast if I have prediabetes?”

“Opt for balanced meals that incorporate lean protein, low fat dairy and plenty of fiber,” Seymour advises. “Try cereals with at least five grams of fiber per serving, whole fruits, vegetables and whole grains.

“If you’re tempted to skip breakfast, try a low carbohydrate meal replacement bar or shake to start your day off right.”

“What fruits should I avoid with prediabetes?”

Seymour stresses that all types of fruit are OK and unlikely to be a problem for people who have prediabetes (with the exception of pomegranate juice and grapefruit for people taking certain medications).

“Fruit is a carbohydrate that provides both sugar and fiber,” she says. “You will get more fiber eating whole, fresh fruit than you will by drinking fruit juice. ”

“All foods can fit,” she adds. “The key is to watch your portion sizes and read labels of prepared items. Fruit juice and canned fruit may have more sugar.”

A professional can help customize a prediabetic meal plan

Because everyone is different and many people with prediabetes have other health issues, Seymour says it is important to tailor prediabetes food plans to the individual. For instance, patients with high cholesterol may do better with a lower-fat approach, while those with high A1C may benefit from a meal plan that’s lower in carbohydrates.

Working with a doctor or dietitian can be helpful. “People diagnosed with prediabetes can ask their primary care practitioner for a referral to a local registered dietitian,” Seymour says. “That way, they can get individual counseling to achieve their health goals.”

Prediabetes and sugar — How much is too much?

Blood sugar levels are important indications of prediabetes, and it’s no secret that most Americans eat more sugar than they should. Sugar can hide in less obvious places, including processed foods such as breakfast cereals, frozen meals, snacks, sauces and dressings.

Though some sugar is necessary for your body to function, too much can worsen prediabetes. Seymour explains: “Carbohydrates are an important source of energy since glucose [blood sugar] is the preferred molecule to fuel the brain. However, excessive intake of refined carbohydrates from added sugar can cause adverse health effects.

Recommendations for Limiting Sugar

“The World Health Organization advises limiting added sugars to less than 10% of your total energy intake. For added health benefits, you would limit sugar calories to 5% or less of your total.

“For example, for someone on a 2,000-calorie daily diet, if they are following the 10% guideline, they would limit sugar calories to about 50 grams, which is about 12 teaspoons. For the 5%, they would stick to 25 grams, or about six teaspoons.

“The American Heart Association is a little more stringent, and for people at risk for heart disease, including those with prediabetes, it recommends less than six teaspoons of sugar a day for women (about 25 grams) and less than nine teaspoons (about 36 grams) a day for men. ”

That’s not a lot. Seymour points out that one can of soda contains about 32 grams of sugar, which is about eight teaspoons.

“We urge our patients to watch what they drink,” Seymour says, noting that sweetened beverages such as sodas, sports drinks, juices and gourmet coffee shop creations account for some of the biggest concentrated sources of added sugar. “Just one of these beverages can take up your entire recommended allotment of sugar for the day ― or even several days.”

The 5-20 Rule

Another way to assess whether a product is overly high in sugar is to read the nutrition label. “The general rule for sugar content is choose products with a sugar content of 5% or less of the daily requirement and avoid items in which the amount of sugar is 20% or more of the daily requirement,” Seymour says.

How to Reverse Prediabetes — Lifestyle

Seymour says switching to well-balanced meals high in healthy, fiber-rich foods, along with incorporating more physical activity, can help people with prediabetes take charge of their health.

“It has been well cited in research studies such as the National Institutes of Health’s Diabetes Prevention Program Outcome Study that incorporating healthy eating habits, weight reduction and increased physical activity can lower your risk of developing type 2 diabetes.

“Additionally, lifestyle changes resulting in modest weight loss have shown to delay the onset of 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. Seymour recommends that people with prediabetes 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.

Lose some weight

To steer away from type 2 diabetes, Seymour says men and women should try to achieve and maintain a body mass index of 25 or lower. Waist circumference should be under 35 inches for women and under 40 inches for men.

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,” says Seymour. “So, for instance, for a person weighing 200 pounds, a weight loss of 10 to 20 pounds could make a difference.”

Get enough sleep

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

Avoid excessive alcohol and all tobacco

“These are modifiable lifestyle factors that can significantly lower your risk of several chronic diseases, including type 2 diabetes, heart disease, vascular problems and metabolic syndrome,” Seymour explains.

Stay on top of your numbers

Seymour says people with prediabetes should be vigilant about their laboratory test results. “Know your ABCs,” she advises. “That’s A1C, blood pressure and cholesterol. And if you’re at risk or have prediabetes, make sure you follow up with your A1C level with a blood test at least yearly.”

Reversing Prediabetes — Is it possible?

Yes! “If you’ve been diagnosed with prediabetes, progressing to diabetes is not a given,” Seymour emphasizes.

In addition to taking medications, she says there are other ways to take control.

“Adopting a well-balanced diet, staying active, controlling your weight can put you in control, enabling you to arrest or even reverse the process,” she says.

“I like this quote from the CDC: ‘Life doesn’t always give you the time to change the outcome. Prediabetes does.’”

Diabetes-Friendly Recipes | Johns Hopkins Medicine

Diabetes-Friendly Recipes | Johns Hopkins Medicine

People living with diabetes face many questions when it comes to diet and meal planning. The goals of healthy eating for those with diabetes are to support a healthy weight and maintain blood glucose levels. With a little instruction and inspiration, it is easy to accomplish these objectives – deliciously.

Like anyone following a healthy lifestyle, people with diabetes should opt for plenty of vegetables, fruits and lean protein. Sugary foods, starchy vegetables and refined carbohydrates should stay on the shelf. But dark leafy greens, protein-packed beans and other legumes, fish (those rich in omega-3 fatty acids like salmon and trout) and fiber-rich whole grains like barley, provide a wide variety of tastes and nutrients to combine creatively.

The right recipes ensure that people living with diabetes can say “yes” to dessert. Delicious berries and other fruits (fresh or dried) combined with yogurt, ginger, nuts and even a touch of whipped cream can tempt everyone at the table while ensuring optimal health.

Wellness and Prevention

• 
  Broiled Trout with Almonds
• 
  Cream of Broccoli Soup
• 
  Healthy Recipes – Mandarin Stir-Fry Beef
• 
  Do-It-Yourself Trail Mix
• 
  New World Salmon Florentine
• 
  Fresh Lemon Broccoli Pesto-Style Sauce
• 
  Southeastern Seasoned Catfish
• 
  Herb Roasted Potatoes
• 
  Oriental Greens
• 
  Grilled Lemon-Sage Chicken
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  Roasted Asparagus
• 
  Red Rosemary Vinegar
• 
  Roasted Vegetables
• 
  Summer Vegetable Curry
• 
  Stuffed Peppers
• 
  Vegetable Dip Mix
• 
  Cantaloupe Soup
• 
  Picnic Potato Salad
• 
  Crunchy Chicken Salad
• 
  Carrot-Oatmeal Muffins
• 
  Lime Shrimp Kebabs
• 
  Homemade Chicken Parmigiana
• 
  Fruity Nutty Spinach


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Diabetes Diet – Useful and Unhealthy Foods

Diabetes does not mean that you urgently need to give up everything tasty and eat only broccoli until the end of your days. Healthy does not mean tasteless: we analyze what you can eat with diabetes, what you should not, and how to build a menu so that the contents of the plate please you every time without raising your sugar level.

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Diabetes is not a death sentence, it can be controlled if you control your sugar levels and eat right. We have collected recommendations for you on a diet for diabetics: eat and be healthier!

Contents of the article

Do not self-medicate! In our articles, we collect the latest scientific data and the opinions of authoritative health experts. But remember: only a doctor can diagnose and prescribe treatment.

Diabetes mellitus is a hormone-related disease in which the body either does not produce enough insulin, or insulin does not cope with its main task – the processing of glucose. There are two types of diabetes, type 1 is insulin dependent and type 2 is non-insulin dependent. The difference between them is that in the first case, less insulin is physically produced in the body than necessary, and in the second case, it may be enough, but there are problems with its “functionality”, that is, it does not work as it should. As a result, not all the glucose that enters the body is broken down, the cells do not receive enough nutrition, and excess sugar remains in the blood and goes into the urine.

Both types of diabetes involve dietary control. Proper nutrition in diabetes is critical because with type 1 diabetes, you need to limit the amount of sugar that enters the body, and with type 2, you need to abstain from carbohydrates that are digested too quickly. In general, diet therapy for any type of this disease is “what the doctor ordered.”

Diabetes: diet and nutrition

The good news is that rigid diets are long gone. It is enough to follow the general recommendations: eat regularly, moderately and choose a healthy diet. Your diet should be rich in nutrients and should not contain too much fat and calories. In fact, the diabetic diet is suitable for any person who would like to eat right, and it does not matter at all whether he has a disease or not. It’s just that if it is, then the priority of the diet increases, and if not, adhering to the diet described below will be useful in any case.

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Nutrition in diabetes: what to avoid?

Let’s start with what is not worth eating. You most likely know that diabetes increases your susceptibility to cardiovascular disease, and this is no joke, because heart and vascular disease is the leading cause of death in the world. So, to reduce the risks, do not eat the following foods:

• Saturated fats. Do not buy fatty dairy products and do not eat fatty meat. This means that butter, red meat (beef, pork, especially bacon), and various processed foods (for example, sausages) should be removed from the diet. Choose products without palm oil in the composition, and still do not eat coconuts (it is unlikely that you do this every day, but suddenly). Here we will mention fast food, that is, we will say a hard “no” to it.
• Trans fats. They can be in ready-made food or baked goods – be careful with this!
• “Bad” cholesterol. Try not to have more than 200 mg of cholesterol per day in your diet. There is a lot of it in fatty dairy products, meat, egg yolks, liver and other offal, respectively, all this should be limited.
• Salt. There is also a daily dose – preferably no more than 2.3 g per day (that’s about a third of a teaspoon without a slide) or even less if you have high blood pressure.
• High sugar foods. Everything is clear here, all sorts of sweets, instant cereals (it’s hard to keep track of how much sugar is added), desserts… By the way, low-fat yogurts often contain a ton of sugar, so read the ingredients carefully. In industrial juices, not to mention soda, there is even more sugar.

If you are on or planning to follow a diabetes diet, try replacing some of the ingredients in your diet with the following:

• Ordinary rice – for brown or wild rice, can be added to ordinary cauliflower rice.
• Mashed potatoes – for vegetable puree from the same cauliflower or other vegetables rich in fiber.
• Pasta – for whole grain or vegetable pasta.
• White bread – for whole grain bread.
• Instant porridge – high-fiber flakes without sugar.
• Instant oatmeal – bran oatmeal.
• Corn flakes – for unsweetened bran flakes.
• Corn – for peas or salad greens.

Diabetes diet: what about sweets?

Also, just because you need to follow a diabetic diet doesn’t mean you have to cut out sweets completely. But most of us, let’s be honest, eat a lot more sweets than are considered harmless. Even with diabetes, you can eat your favorite desserts – but only a little. Moderation is everything. Here are some tips to reduce your sugar intake.

1. Reduce the amount gradually, a little at a time.
2. If you plan to have dessert after your main meal, remove some of the rice, pasta, or bread from that meal, otherwise you end up with too many carbohydrates.
3. Add some “healthy fat”. Fat slows down the processing of food a little, which means that blood sugar will not skyrocket as quickly. This does not mean that you need to eat Pavlova with a burger, but you can eat some ricotta, yogurt or nuts.
4. Eat dessert with your meal, not as a snack, so it doesn’t cause a spike in sugar levels.
5. Eat your sweets slowly, enjoying every bite. So you will eat less and get more pleasure.
6. Add sugar to your meals, don’t rely on manufacturers. By the way, in almost any recipe, the amount of sugar can be reduced by a quarter or even a third without losing taste. If it seems too bland, you can add cinnamon, vanilla, nutmeg.

We have already talked about this, but it’s better to repeat: always check the ingredients of the products you buy or dishes in a cafe, if you have a choice, eat at home or not at home, then self-cooked food will be healthier. The amount of sugar in the composition is not always indicated explicitly – it can be “syrup”, “lactose”, “agave juice”… Nutrition control for diabetes in women and men implies the acquisition of new skills – and not only cooking, but also reading labels.

Diabetes diet: keeping track of fats

As for fats, accounting and control are also needed here. The most harmful are artificial trans fats. Try not to eat anything fried, store-bought pastries, packaged snacks, or anything labeled “partially hydrogenated,” even if it says before that the product labeled as trans fat does not contain.
The “right” fats are found in fish and vegetable sources. Olive oil, nuts, avocados, salmon, tuna, and flaxseed are excellent sources of fat. Saturated fats, which are found in dairy products and red meat, may not be completely eliminated from the diet, but they should be no more than 10% of the daily calorie intake.

How to reduce the amount of unhealthy fats?

• Snack on nuts instead of chips or cookies.
• Boil, bake or stew instead of frying.
• Replace most red meat with poultry, eggs, fish, and plant-based protein sources.
• Do not dress salads with industrial dressings – it is better to use linseed, olive or sesame oil.

Diabetes: diet and nutrition “the right way”

And now our favorite part is about how to eat right with diabetes and what you can still eat. So:

• “Healthy” carbohydrates. These include fruits (the brighter the better) and vegetables, whole grains, legumes, and low-fat dairy products.
• Foods rich in fiber. The same as in the previous paragraph, minus milk, plus nuts.
• Food rich in omega-3 acids. These acids prevent the development of heart and vascular diseases. An example of such food is fish. Salmon, mackerel, tuna, sardines – bake and enjoy.
• The “correct” fats. Avocado, nuts, vegetable oils.

If you’re still wondering which diabetes diet is right for you, try the “plate method” which is very common in the US. It is elementary: you take a plate, fill half of it with non-starchy vegetables, for example, carrots, tomatoes, broccoli. A quarter – protein (white meat, fish). The remaining quarter – starchy vegetables (peas) or whole grains (brown rice). Separately, you add a few nuts or avocado slices, plus fruit, plus a glass of water or unsweetened tea/coffee. Ready!

In general, it is customary to divide food into several large groups and eat something from each group a day.

Group 1 : fruits and vegetables. Try to add a little bit from this group to each dish (except desserts, of course). Carrots and broccoli will liven up the side dish, raspberries, strawberries, plums, peaches or watermelon will be a great snack. Foods from this group should be eaten at least 5 servings a day (one serving is equal to your handful, that is, it is a whole peach or five plums).

Group 2 : starchy products. Potatoes, pasta, rice. At least a little. If you need to remove some of the carbohydrates, start with white bread and pasta.

Group 3 : proteins. You can not eat meat every day, but some portion of the protein in the diet should be in any case. A couple of times a week – fatty fish, a source of the necessary acids.

Group 4 : dairy products. We all need some calcium. Unsweetened and low-fat yogurt, skimmed milk in porridge or plain, whole grain bread sandwich with cheese.

Group 5 : oils. Also at least a little every day, for example, dress salad with olive oil or stew chicken on it.

Diet for diabetes: menu

Everything is clear with the products, but what exactly can be prepared from them to make it tasty and healthy? We have collected several options for breakfast, lunch and dinner for you. We tried to choose the most delicious, who said that diabetes food should be insipid and dull? Definitely not us!

Breakfast:

Natural unsweetened yogurt with berries and fruits whole grain flour

Whole grain tortilla with vegetables and lean meat (may be wrapped, can be eaten as a snack)

Zucchini pancakes

Omelette with spinach and mushrooms

Lunch:

Lasagna (with sheets of whole grain dough)

Lentil soup

Baked chicken with vegetables

Brown rice pilaf with turkey

Grilled bell pepper stuffed with tomatoes and shallots

Quinoa with celery and zucchini (you can add any vegetables) + baked fish

Vegetable soup

Dinner:

Caesar salad

Vegetable stew

Smoothie (any fruit and berries)

Cauliflower risotto

Chicken and broccoli casserole (again, you can add any vegetables )

Oat pancakes

Miso soup

How to eat with diabetes: video guide

more than 420 million people in the world suffer from diabetes mellitus (DM). One of the important methods of treatment of this disease is diet. Its goal is to prevent or delay the occurrence of complications and prolong a person’s life. Diet for diabetes is the topic of our article today.

Classification of the disease and the role of nutrition

Since 1965, the WHO has periodically updated and revised the classification of diabetes mellitus. In Russia, today the version proposed in 1999 with additions is used.

The type of nutrition in diabetes is selected individually in such a way as to optimize the level of sugar in the blood to the maximum acceptable value. It depends on the mechanism of development of pathology.

Disease grades

Diabetes is distinguished:

Type 1. Previously, it was called insulin-dependent, youthful or children’s. Today under SD 1 Art. imply immune-mediated, idiopathic. With this pathology, an insufficient amount of insulin is produced in the human body, the deficiency of which is replenished through daily injections. Today, medicine does not know exactly what provokes type 1 diabetes, so it is not possible to develop preventive measures.

Clinically, the pathology is manifested by excessive urination (polyuria), thirst (polydipsia), overwhelming hunger, weight loss, visual disturbances and fatigue. Possible sudden onset of these symptoms

Type 2. Previously, it was called non-insulin dependent or adult diabetes. In this case, the production of insulin is not disturbed, but a failure occurs in its effective use. According to WHO, 95% of people with diabetes are diagnosed with type 2. The most common cause of pathology is overweight and lack of physical activity. The clinical presentation is similar to type 1 diabetes, but usually not as pronounced. Because of this, as a rule, there are some difficulties in the early diagnosis of the disease. In many people, pathology is detected only when complications are already developing. And this process can take more than one year. A few years ago, type 2 diabetes was diagnosed only in the adult population, today it has become increasingly common in children.

Gestational. It is manifested by an increase in the level of glucose in the blood, but the indicators do not exceed the normal values ​​so that diabetes can be diagnosed. The gestational form develops in pregnant women, which increases the risk of complications during gestation and the birth itself. In the future, both the woman and the child can develop type 2 diabetes.

In most cases, this pathology is detected not during the collection of anamnesis and conversation with the patient, but during prenatal screening.

Other specific types. They are diagnosed with genetic defects in the function of β-cells and insulin action, diseases of the exocrine part of the pancreas, endocrinopathy, infectious processes, and a number of other pathological conditions.

Types of diets for diabetes

There are quite a lot of them: carbohydrate-free, protein, low-carb and others. At the same time, a physiological, in all respects, balanced diet is considered the most preferable. Experts also note that it should be individualized, taking into account the patient’s eating habits and nutrition stereotype.

To account for carbohydrate-containing products, it is recommended to use a simple system of bread units (XE) that is perfectly suitable for real life. It helps a person with type 1 and type 2 diabetes maintain a varied diet: replace some carbohydrate-containing meals with others, but at the same time avoid serious fluctuations in blood sugar. One bread unit of the product contains 10-12 g of carbohydrates. The XE system is convenient in that a person does not need to use the scale every time to find out the carbohydrate content to the nearest 1 g. He can make a visual assessment using simple units of measurement: a piece, a glass, a piece, an st. l. etc.

Basic nutrition rules for type 1 diabetes mellitus

The main method of treatment for people with this diagnosis is insulin replacement therapy. Here, the diet for diabetes is used adjunctively. Since the injected insulin “cannot know” at what time and how much a person will eat, the diabetic himself must ensure that the effect of the drug is consistent with his diet. To do this, you need to know which foods can increase blood sugar levels.

Proteins and fats do not have a sugar-increasing effect. Therefore, people with type 1 diabetes can consume them in the same amount as without this diagnosis, provided that their body weight is normal and there are no other medical contraindications.

Carbohydrates, on the other hand, have a real sugar-increasing effect. But this does not mean that they should be limited. If the patient does not have problems with being overweight, carbohydrates should only be taken into account in order to correctly calculate the dose of the drug with insulin.

Conventional diet therapy for type 1 diabetes recommends eating 6-7 small meals a day (including lunch). This regimen aims to adjust nutrition to the action of long-acting insulin. This is necessary because if a person skips a meal, hypoglycemia is possible, and if a person consumes a large amount of carbohydrates, a peak increase in blood sugar, which cannot be covered by the action of prolonged insulin. Medicine recommends adapting insulin therapy to your diet, and not vice versa.

Basic nutritional guidelines for type 2 diabetes

Clinical recommendations of the Russian Federation, approved in 2022, suggest that dietary restrictions, including for weight loss, should be used with caution. Their use is justified if they lead to a marked improvement in carbohydrate or lipid metabolism, blood pressure levels, or other important indicators of health status. It should be noted that hypocaloric nutrition can adversely affect bone tissue, the intake of vitamins, and the development of sarcopenia.

Older people with type 2 diabetes who are not overweight and not on insulin should not be given a fixed amount of carbohydrates. If the patient is taking short-acting (ultra-short-acting) insulin, a practice-oriented assessment of the amount of carbohydrates in a meal is allowed.

What can I eat if I have type 2 diabetes?

What is recommended to be limited, if possible completely eliminated?

More precise recommendations about which foods for type 2 diabetes are suitable for you and which are not, always give a doctor. As a rule, this is preceded by a series of laboratory tests.

Healthy foods for diabetes

Prohibited foods for diabetes

Avoid or limit as much as possible:

It is recommended not to cook food that involves frying. Use utensils that allow you to cook food without adding fat. Vegetable oil is an important component of the daily diet, and it should be consumed in very small quantities.

Fatty fish are a key source of Omega-3 and many other substances that are extremely beneficial for the human body. Because of this, this product is not as strictly limited as fatty meat.

Other dietary strategies in diabetes mellitus

As already noted, any dietary restriction must be individualized. Today, there are several options for dietary strategies for diabetes in overweight patients. Good results can be obtained by the Mediterranean diet, which also involves daily physical activity.