A nutritious, balanced diet is important for those with prediabetes and high cholesterol. Although individual recommendations vary, dietitians frequently recommend Mediterranean and DASH diets.

The Dietary Approaches to Stop Hypertension (DASH) diet can improve insulin resistance and may help with weight management. It focuses on a varied diet including whole grains, low fat dairy products, fruits and vegetables, and lean meats and fish. The Mediterranean diet focuses on similar foods.

People with prediabetes have an increased risk of high cholesterol, which means they may develop cardiovascular disease, so diet is very important. Additional lifestyle strategies, such as exercising for at least 30 minutes per day, can minimize the risk of developing type 2 diabetes and heart disease.

Read on to learn more about what foods to eat and avoid when living with prediabetes and high cholesterol.

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People with prediabetes have high blood sugar levels when fasting. However, their blood sugar is not high enough to be considered type 2 diabetes.

To prevent the progression from prediabetes to type 2 diabetes, doctors suggest following a nutritious, balanced diet. However, because everyone has different health requirements, individual meal plans and advice can vary.

Many experts suggest that people with prediabetes and high cholesterol would likely benefit from following a combination of the DASH and Mediterranean diets. Both these approaches focus on a whole foods diet that is low in highly processed foods and saturated fat.

To reduce high blood sugar and cholesterol levels, a person can incorporate more healthy fats, fruits, vegetables, and lean proteins.

However, it is important to note that these are general guidelines. They are not a replacement for individualized advice. Each person’s nutritional needs vary. When possible, speaking with a registered dietitian is recommended.

Healthy fats

Suggesting a person with prediabetes eats some foods that are high in fat may seem counterintuitive if they have high cholesterol.

However, unsaturated fats can reduce the amount of low-density lipoprotein (LDL), or “bad” cholesterol, and increase the amount of high-density lipoprotein (HDL), or “good” cholesterol.

A person should still consume saturated fats in moderation. They can focus on polyunsaturated and monounsaturated fats. Foods that contain healthy fats include:

  • avocados
  • olive oil
  • nuts
  • seeds
  • olives
  • fatty fish, such as salmon and sardines

Vegetables

People living with prediabetes and high cholesterol should aim to eat more non-starchy vegetables than starchy ones. Examples of starchy and non-starchy vegetables include:

StarchyNon-starchy
potatoescarrots
sweet potatoescauliflower
cornleafy greens
winter squashbell peppers
pumpkineggplant
peaszucchini
parsnipstomatoes

A good rule of thumb is to eat 3–5 servings of non-starchy vegetables per day. One serving of vegetables is roughly 1/2 cup of cooked vegetables or 1 cup of raw vegetables.

Protein

Diets that include healthy sources of protein have the potential to return prediabetes blood sugar levels to a healthy range. However, foods within this group do vary in the amount of fat they contain, which is something people with high cholesterol need to monitor.

Sources of protein include:

Plant-based options

  • beans and legumes
  • whole grains
  • soybeans
  • lentils and pulses
  • tofu
  • tempeh

Animal-based options

  • chicken
  • turkey
  • fish
  • Greek yogurt
  • low fat cheese
  • eggs

When a person has prediabetes with high cholesterol, they should limit their intake of red meats because of the density of saturated fats and salt. If they do choose to eat them, they can consider lean instead of fatty cuts.

Fruits

Carbohydrates are an important part of a balanced diet. Fruit is a great source of carbohydrates containing fiber and micronutrients.

While most fresh fruits do have a low glycemic index (GI), pineapple and melon have slightly her GI values. Many dried fruits contain a lot of carbohydrates for their relatively small size, so fresh is preferable when possible.

Suitable fruits can include:

  • berries
  • apricots
  • plums
  • peaches
  • apples
  • kiwis

People with prediabetes and high cholesterol should avoid or limit heavily processed foods and beverages that are high in sugar, saturated fat, and salt.

Sugary drinks

Sugary sweetened drinks can contribute to a higher risk of cardiovascular problems in some people living with type 2 diabetes.

Sugary drinks to avoid or limit include:

  • processed fruit juice
  • sodas
  • energy and sports drinks
  • sugary coffees and teas

Processed foods

In a 2022 review, researchers linked ultra-processed foods to increasing obesity levels and a higher likelihood of LDL cholesterol and type 2 diabetes.

Examples of ultra-processed foods include:

  • crackers
  • chips
  • sweets
  • processed bakery goods, such as pastries
  • processed meats, including bacon, sausages, and deli meats

Other foods and drinks to consider

Additional foods and drinks people with prediabetes can avoid or limit include:

  • foods high in saturated fats, such as fried foods, butter, and margarine
  • refined carbs, such as white bread and pasta
  • alcohol

If a person has prediabetes and high cholesterol, they may find the DASH diet beneficial. This eating plan can potentially reduce cholesterol and insulin resistance.

However, the Mediterranean diet is also a popular choice, so a person may want to combine both dietary approaches.

Below are two 1-day meal plan examples that combine foods from both the Mediterranean and DASH diets. One example is for a person who eats meat, and the other example is for a person who follows a vegetarian or vegan diet.

Animal-based option

The following sample meal plan includes breakfast, lunch, dinner, and two snacks.

Breakfast

  • 2–3 ounces (oz) smoked salmon with 1 tablespoon (tbsp) cream cheese
  • tomato slices
  • coffee or tea (milk optional)

Snack

  • 4 oz low fat yogurt
  • a handful of almonds

Lunch

  • cooked skinless chicken breast with a mixed salad and vinaigrette
  • additional raw vegetables
  • water with lime slices

Snack

  • 1 oz low fat cheese
  • a handful of grape or cherry tomatoes

Dinner

  • hamburger with no bun
  • grilled onions
  • mixed salad
  • 1 cup broccoli
  • water with lime

Plant-based option

The following sample meal plan includes breakfast, lunch, dinner, and two snacks.

Breakfast

  • 1/4 cup granola with 6 fluid ounces (fl oz) of Greek yogurt or vegan yogurt
  • 1/2 banana
  • 10 almonds
  • coffee or tea

Snack

  • carrot sticks
  • 2 oz hummus

Lunch

  • lentil soup
  • 1/2 sandwich with whole wheat bread and nut butter
  • small mixed green salad with vinaigrette
  • 1 cup fruit
  • water with lemon slices

Snack

  • roasted chickpeas with herbs and spices
  • small plum

Dinner

  • roasted cauliflower steak with spices
  • watermelon burrata salad
  • water with watermelon chunks

The Centers for Disease Control and Prevention (CDC) emphasizes that small lifestyle changes and strategies can have a big impact on the prevention of type 2 diabetes. To reduce the risk of diabetes, a person can:

  • eat enjoyable foods in moderation
  • increase physical activity to at least 30 minutes per day, several days per week
  • manage stress levels in healthy ways

Below are some common questions about diet for people with prediabetes and high cholesterol.

What should someone with prediabetes and high cholesterol eat?

People with prediabetes and high cholesterol levels should eat a balanced, nutritious diet. Healthcare professionals may recommend diets such as the Mediterranean diet.

How can someone fix high cholesterol and prediabetes?

A healthful, balanced diet can help someone to reduce insulin resistance and cholesterol to improve high cholesterol and prediabetes. Doctors may also recommend maintaining or achieving a moderate weight and getting regular exercise.

What foods should someone stay away from if they are borderline diabetic?

Healthcare professionals may recommend that people with prediabetes avoid or limit alcohol, trans fats, and processed foods.

What is the fastest way to fix prediabetes?

Achieving or maintaining a moderate weight and certain lifestyle changes, such as getting regular exercise and eating a healthful diet, can help to reduce the risk of a person with prediabetes developing type 2 diabetes.

Foods that are beneficial to people living with prediabetes and high cholesterol tend to include whole foods, such as fresh fruits, vegetables, and lean cuts of meat.

The DASH and Mediterranean diets can be effective at reducing both insulin resistance and cholesterol. This makes them highly suitable for people who are trying to manage both their blood sugar and cholesterol levels.

In addition to eating more whole foods, people with prediabetes and high cholesterol can try to limit their alcohol consumption and foods high in saturated fat and sugar.