A 47 year-old white man of Italian descent with a strong family history of type 2 diabetes and cardiovascular disease was recently diagnosed with prediabetes. He has always been proud that he does not have any chronic disease and has never needed to take any medications, despite having a weight problem. He does not follow any specific diet plan, but is very active. He is currently doing 150 minutes of moderate intensity physical activity every week. He cooks most of his meals and rarely dines out. His meals, in general, are high in carbohydrates as he loves pasta, pizza, and bread. He also adds olive oil to most of his meals and eats fatty fish two times per week. He does not eat much red meat, but eats a lot of processed meat and cheese. During his last visit to his primary care physician, his fasting plasma glucose was 110 mg/dL (normal, 70-100 mg/dL), and his glycated hemoglobin (HbA1c) was 6.1% (normal, <5.7%). He was shocked by the results. Except for obesity, he does not have any other health problems. When your dietitian reviewed his 3-day food log, she found that he consumes approximately 2800 calories per day with total carbohydrates comprising 60% of his diet.
- Weight: 206 lbs (93.6 kg)
- Height: 67 inches (170 cm)
- Body mass index (BMI): 32 kg/m2 (normal, 18.5 to 24.9 kg/m2)
- Waist circumference: 40 inches
- Blood pressure: 130/80 mm Hg
- Low density lipoprotein cholesterol (LDL-C): 98 mg/dL (desirable, <100 mg/dL)
- High density lipoprotein cholesterol (HDL-C): 42 mg/dL (desirable, ≥60 mg/dL)
- Triglycerides (TG): 186 mg/dL (desirable, <150 mg/dL)
His internet search led him to read the results of the diabetes prevention program, which showed that weight loss reduces type 2 diabetes risk by 58%. He stated that he was in the best shape, and he would like to reach that goal over the next 8 weeks by reducing total caloric intake to 1000-1200 calories/day and increasing his activity to 50 minutes on 5 days of the week to a total of 250 minutes/week. He came to you for advice regarding healthy eating patterns and physical activity that will help him to prevent type 2 diabetes.