I have pre-diabetes, high cholesterol and high blood pressure. Now what?

If you’ve recently been diagnosed with pre-diabetes, high blood pressure (hypertension), or high cholesterol, it’s normal to feel concerned. The good news is that there are steps you can take to improve your health and manage these conditions. In addition to any recommendations your doctor may provide—including medications or further testing— please continue reading to understand the two major lifestyle changes that can have a significant, positive impact on your health: the Mediterranean diet and regular cardiovascular exercise.

1. The Mediterranean Diet

The Mediterranean diet is a heart-healthy eating pattern inspired by traditional foods from countries bordering the Mediterranean Sea, such as Greece, Italy, and Spain. Research shows it can improve cholesterol levels, lower blood pressure, improve blood sugar control, and reduce risk for heart disease and diabetes.

Focus on Whole, Unprocessed Foods:

- Vegetables: Aim to fill half your plate with a variety of colorful, non-starchy vegetables (e.g., spinach, broccoli, bell peppers, zucchini).

- Fruits: Choose fresh fruits like berries, apples, oranges, or pears—limit fruit juices.

- Whole Grains: Opt for whole-grain bread, brown rice, oats, barley, or quinoa instead of refined grains like white rice or white bread.

- Legumes: Include beans, lentils, or chickpeas several times weekly.

Prioritize Healthy Fats:

- Use extra-virgin olive oil as your primary cooking fat. Avoid butter or margarine.

- Include nuts (e.g., almonds, walnuts) and seeds (e.g., chia, flaxseeds), but watch portion sizes (a small handful).

- Eat fatty fish (e.g., salmon, mackerel, sardines) twice a week for healthy omega-3 fats.

Limit Unhealthy Fats and Refined Carbohydrates:

- Cut back on saturated fats (e.g., fatty cuts of meat, butter, full-fat dairy).

- Avoid trans fats found in processed or fried foods.

- Reduce intake of refined sugars and white flour products (e.g., pastries, donuts, sugary drinks).

Incorporate Lean Protein:

- Choose lean proteins like fish, skinless poultry, or plant-based proteins (e.g., tofu, tempeh).

- Limit red meat (e.g., beef, lamb, pork) to a few times per month, and focus on lean cuts.

Stay Hydrated:

- Drink plenty of water throughout the day.

- Keep sugary drinks, including sodas, to a minimum. If you drink alcohol, do so in moderation (e.g., one to two glasses of wine per week —but discuss this with your doctor).

Flavor with Herbs and Spices:

- Use herbs (e.g., basil, oregano, dill) and spices (e.g., turmeric, cinnamon) to season foods instead of using salt.

2. Regular Cardiovascular Exercise

Exercise is another essential component of managing pre-diabetes, hypertension, and cholesterol. It can help lower blood pressure, improve cholesterol levels, and improve how your body processes sugar. The goal is to get at least 150 minutes of cardiovascular exercise per week.

What is Cardiovascular Exercise?

Cardiovascular (or aerobic) exercise includes activities that increase your heart rate and breathing. Examples include:

- Walking briskly: A great option that’s easy to start—aim for at least 30 minutes, 5 days a week.

- Cycling: Whether stationary or on the road, cycling is gentle on joints.

- Swimming: Perfect for those who prefer low-impact exercise.

- Dancing: A fun way to incorporate physical activity.

- Jogging or running: If your joints allow, increase the intensity.

- Group classes: Such as aerobics, Zumba, or spin classes.

Tips for Incorporating Exercise:

1. Start Slow: If you’re new to exercise, begin with shorter sessions (e.g., 10-15 minutes) and gradually increase over time to avoid injury.

2. Break It Up: It doesn’t have to be done all at once—three 10-minute sessions throughout the day still count.

3. Make It a Habit: Schedule exercise at the same time each day to build a routine.

4. Buddy Up: Exercising with a friend or family member can make it more enjoyable.

5. Monitor Intensity: Use the “talk test”—you should be able to talk but not sing during moderate exercise.

6. Wear Proper Footwear: Invest in comfortable, supportive shoes to protect your joints.

Don’t Forget to Check with Your Doctor

Before beginning an exercise program, speak to your doctor, especially if you have other health conditions or concerns. They can help tailor your exercise plan if necessary.

By adopting the Mediterranean diet and regular cardiovascular exercise, you may experience the following benefits over time:

- Decreased blood sugar levels and improved insulin sensitivity, reducing the risk of progressing to type 2 diabetes.

- Lower bad cholesterol (LDL) and increased good cholesterol (HDL), which help protect against heart disease.

- Decreased blood pressure, which lowers the risk of stroke, heart attack, and kidney problems.

- Weight loss and improved body composition.

- Reduced risk of chronic diseases, including cancer and Alzheimer's disease.

- Improved energy levels, mood, and sleep quality.

Don’t forget, everyone is different!

Your doctor may recommend additional interventions, such as medications, specialist referrals, or further tests, depending on your individual health needs. This page is not intended to replace those medical recommendations but rather to support your journey to better health. Always follow your doctor’s advice and bring up any questions or concerns you may have about your condition or treatment plan.

If you ever feel unsure of how to implement these changes, consider asking for additional support, such as a referral to a registered dietitian for personalized dietary advice for exercise guidance.