Role of Nutrition Therapy in Prediabetes: A Systematic Review
7 affiliations
- 1Faculty of Public Health, Can Tho University of Medicine and Pharmacy, Can Tho 94000, Vietnam
- 2Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho 94000, Vietnam
- 3School of Preventive Medicine and Public Health, Hanoi Medical University, Ha Noi 100000, Vietnam
- 4AMV Group Medical Joint Stock Company, Ho Chi Minh City 70000, Vietnam
- 5Jio Health Vietnam General Clinic, Ho Chi Minh City 70000, Vietnam
- 6Institute of Theoretical and Applied Research, Duy Tan University, Ha Noi 100000, Vietnam
- 7School of Business and Economics, Duy Tan University, Da Nang 550000, Vietnam
Abstract
Prediabetes represents a critical window for diabetes intervention, but the comparative effectiveness of dietary strategies remains uncertain. This systematic narrative review evaluated structured dietary interventions (SDIs) on metabolic outcomes in adults with prediabetes and identified approaches that may support glycemic improvement and diabetes prevention. PubMed, Embase, the Cochrane Library, and Web of Science were searched for randomized controlled trials (RCTs) published through August 23, 2025. Eligible studies compared SDIs with comparators in adults with prediabetes; observational and nonrandomized trials were excluded. Risk-of-bias (RoB) was assessed using the Cochrane RoB 2 tool. Because of substantial heterogeneity in interventions, comparators, follow-up, and outcomes, findings were synthesized narratively. Finally, ten RCTs, involving 1,098 participants, were included. At 12－52 weeks, calorie-restricted and low-carbohydrate diets were associated with reductions in body weight and glycemic indices, with some trials reporting normoglycemia. Diets for low-glycemic-index appeared to improve insulin sensitivity, whereas Mediterranean diets improved fasting glucose and ectopic fat. High-protein, low-glycemic-index diets may sustain longer-term metabolic enhancements. Intermittent fasting, particularly alternate-day fasting, appeared beneficial for selected outcomes, including weight loss, with glycemic advancements in a few studies. However, interpretation is limited by the small number of trials, heterogeneity, and RoB concerns. Overall, SDIs may offer metabolic benefits for adults with prediabetes, but no single strategy emerged as universally optimal. These findings provide evidence-informed dietary considerations, and further high-quality trials are needed to strengthen sustainable diabetes prevention strategies.
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BibTeX
@article{nguyen2026role,
title = {{Role of Nutrition Therapy in Prediabetes: A Systematic Review}},
author = {Hien Thi Nguyen and Thang Nguyen and Phuc Duong Phan and Hai Thanh Phan and Huu Minh Le and Dat Tan Nguyen and Dinh Kim Luong and Nam Ba Nguyen and Giang Hai Ha},
journal = {Preventive Nutrition and Food Science},
year = {2026},
month = oct,
doi = {10.3746/pnf.2026.104},
url = {https://doi.org/10.3746/pnf.2026.104},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Role of Nutrition Therapy in Prediabetes: A Systematic Review
AU - Hien Thi Nguyen
AU - Thang Nguyen
AU - Phuc Duong Phan
AU - Hai Thanh Phan
AU - Huu Minh Le
AU - Dat Tan Nguyen
AU - Dinh Kim Luong
AU - Nam Ba Nguyen
AU - Giang Hai Ha
PY - 2026
DA - 2026/10/21
JO - Preventive Nutrition and Food Science
DO - 10.3746/pnf.2026.104
UR - https://doi.org/10.3746/pnf.2026.104
AB - Prediabetes represents a critical window for diabetes intervention, but the comparative effectiveness of dietary strategies remains uncertain. This systematic narrative review evaluated structured dietary interventions (SDIs) on metabolic outcomes in adults with prediabetes and identified approaches that may support glycemic improvement and diabetes prevention. PubMed, Embase, the Cochrane Library, and Web of Science were searched for randomized controlled trials (RCTs) published through August 23, 2025. Eligible studies compared SDIs with comparators in adults with prediabetes; observational and nonrandomized trials were excluded. Risk-of-bias (RoB) was assessed using the Cochrane RoB 2 tool. Because of substantial heterogeneity in interventions, comparators, follow-up, and outcomes, findings were synthesized narratively. Finally, ten RCTs, involving 1,098 participants, were included. At 12－52 weeks, calorie-restricted and low-carbohydrate diets were associated with reductions in body weight and glycemic indices, with some trials reporting normoglycemia. Diets for low-glycemic-index appeared to improve insulin sensitivity, whereas Mediterranean diets improved fasting glucose and ectopic fat. High-protein, low-glycemic-index diets may sustain longer-term metabolic enhancements. Intermittent fasting, particularly alternate-day fasting, appeared beneficial for selected outcomes, including weight loss, with glycemic advancements in a few studies. However, interpretation is limited by the small number of trials, heterogeneity, and RoB concerns. Overall, SDIs may offer metabolic benefits for adults with prediabetes, but no single strategy emerged as universally optimal. These findings provide evidence-informed dietary considerations, and further high-quality trials are needed to strengthen sustainable diabetes prevention strategies.
SN - 2287-1098
SN - 2287-8602
ER -