How to Prevent Prediabetes in Children

Image Credit: DAVID Swift / Flickr. This image has been modified.

How to Prevent Childhood Obesity & Diabetes

Thirty years ago, virtually all diabetes in young individuals was thought to be autoimmune Type 1 diabetes, but since the mid-90s, we started to see an increase in Type 2 diabetes among youth, particularly in the United States. Indeed, “the term adult onset diabetes has now been scrapped and replaced with ‘Type 2’ because children as young as eight are now developing the disease.” And the effects can be just as devastating. A 15-year follow-up of children diagnosed with Type 2 diabetes found an alarming rate in young adults of blindness, amputation, kidney failure and death in young adulthood.

Why the dramatic rise in childhood diabetes? The dramatic rise in childhood diabetes is due to the dramatic rise in childhood obesity. During the past 30 years, the number of children diagnosed as being overweight has increased by more than 100 percent. Once an obese child reaches age six, it’s likely they’ll stay that way. And even if they don’t, being overweight in our youth predicts adult disease and death regardless of adult body weight.

Being an overweight teen may predict disease risk 55 years later, including twice the risk of dying from heart attack, more cancer, gout, and arthritis. In fact being overweight as a teen “was a more powerful predictor of these risks then being overweight in adulthood.” This underscores the importance of focusing on preventing childhood obesity.

How do we do it? From the official American Academy of Pediatrics clinical practice guidelines: the problem appears to be kids eating too much fat and added sugar, and not eating enough fruits and vegetables.

Doctors, at every occasion beginning soon after a child’s birth, should endeavor to give sound advice regarding nutrition and growth so that obesity and its complications may be curtailed. What might sound advice sound like?

The chair of the nutrition department at Loma Linda published a review suggesting not eating meat at all might be an effective strategy. Population studies have consistently shown that vegetarians are thinner than comparable non-vegetarians.

In the largest such study to date (highlighted in my video How to Prevent Prediabetes in Children), a body mass index over 30 is considered obese, 25 to 30 overweight, and under 25 an ideal weight. The non-vegetarians were up at 28.8, showing the average meat-eater in the U.S. is significantly overweight. As one gets more and more plant-based, the average BMI drops. But even the average vegetarian in the U.S. is overweight. The only dietary group that was, on average, ideal weight were those eating strictly plant-based. It comes out to be about a 30-pound difference between average vegans and meat-eaters.

In school-aged children, the consumption of animal foods (meats, dairy, or eggs) is associated with an increased risk of being overweight, whereas plant-based equivalents like veggie burgers, veggie dogs, and veggie cold cuts were not. The whole plant foods like grains, beans, and nuts were found to be protective.

This may be because plant-based diets are low in energy density and high in starch, fiber, and water, which may increase feelings of fullness and resting energy expenditure, meaning resting metabolic rate. Eating plant-based appears to boost metabolism, such that you just burn more calories at rest. However, we’re not sure how much of the benefits are due to increased consumption of plant foods versus decreased consumption of meat.

“Plant-based diets should be encouraged and promoted for optimal health. Local, national and international food policies are warranted to support social marketing messages and to reduce the social, cultural, economic and political forces that make it difficult to promote such diets.” For example, although the advice to consume a plant-based diet is sound, questions arise concerning the relatively high price of produce.

We could reduce the burden of childhood obesity and prevent further spread of the disease, but we need to ensure that plant foods are affordable and accessible to children of all income levels. Getting diabetes in childhood cuts about 20 years of their life. What parent wouldn’t go to the ends of the Earth to add decades to their children’s lives? Fruits and vegetables may not fit on the Dollar Menu, but our kids are worth it.

We make life and death decisions at the grocery store buying food for our family. It’s never too early to start our kids off on the right foot. See my video Heart Disease Starts in Childhood.

And healthy doesn’t have to mean more expensive. Check out Eating Healthy on a Budget.

For some tips on getting our kids to eat their vegetables, see my videos Tricks to Get Kids to Eat Healthier at School and Tricks to Get Kids to Eat Healthier at Home.

Once one has prediabetes, there’s a way to prevent it from progressing further. See my video How to Prevent Prediabetes from Turning into Diabetes.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

13 responses to “How to Prevent Childhood Obesity & Diabetes

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  1. If a person will eat a starch based Whole foods diet, as Dr John McDougall recommends it is NOT expensive to eat WFPB. Maybe if you by organic food. It may be the best, but not necessary. I grow a fair amount of my wife and I’s produce and starches organically, but when purchasing them i buy conventional almost every time. I am almost 61 and have not been sick for several years. I also have plenty of energy and work hard most of the time. To think it is expensive to eat healthy is a myth.

  2. Until recently I’d been overweight, most of that time on the brink of obesity, for all my life or as long as I could remember. In the past year I finally lost about 30% of my former bodyweight through calorie restriction and have been eating what the good doc Greger orders. Needless to say I feel like a different person now and I don’t mean worse (except for my Raynaud’s that got worse, probably because I’m more sensitive to cold now and/or the greatly lowered blood pressure).

    I have to say this article was a downer for me, what I’d feared seems likely to be true: I probably did a bunch of damage to my body during my most sensitive period in life. But I guess if any diet has a chance of mitigating or reversing some of it, it’s the way I’m eating right now. And I’m reaping the massive shorter-term benefits either way.

    1. Good for you, Merlin. I’m sure you worked super hard to lose the weight and get yourself on the WFPB path. The community helps keep us all on our respective healthy eating paths.

    2. Hi Merlin,

      Greetings from Wisconsin, America’s Diaryland!

      I certainly know what it is like to grow up eating a less-than-ideal diet. You are never too young to start eating well, but you are never too old either! Congratulations on making such a healthy choice. As Dr. Greger points out in his book and numerous videos ( ) a plant based diet gives your body a chance to heal.

      Keep us posted on how your plant-based journey is going!

  3. As a parent of a child with Type 1 diabetes, I do wish you would put “Type 2 diabetes” in the title and not just “diabetes”. My 3 yr old didn’t develop his diabetes from diet and lifestyle and it’s a horrible stigma to have to deal with daily from ignorant people. One of the first comments I got when telling relatives of his autoimmune disease is “so can you fix it by changing his diet”- NO, my three year old (who’s already thin from his body starving prior to diagnosis) doesn’t need to go on a diet!

    1. To be fair, the very first sentence in the article begins:
      “Thirty years ago, virtually all diabetes in young individuals was thought to be autoimmune Type 1 diabetes, but since the mid-90s, we started to see an increase in Type 2 diabetes among youth, ”

      Yes, you are right, he does not need a weight loss diet. However, a healthy eating diet can help. Te leaflet below from PCRM may be helpful.

  4. We eat a plant based diet and have been for a year now. Prior to this we were vegetarian. My daughter is 12 and is 90% plant based (rest of time vegetarian). Are there any risks to a child following a plant based diet? She takes a b12 supplement. Any other deficiencies we should be concerned about?

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