Most Americans know that they can reduce the risk of diabetes by cutting back on sugar and carbohydrates. But how many realize that a tablespoon of vinegar can make the blood sugar go down?

“Quite a few studies show that vinegar can help lower blood glucose levels,” says registered dietician Carol Johnston. “It works best when it is ingested at the beginning of the meal.”

Johnston, a professor and associate director of the Nutrition Program at Arizona State University’s College of Health Solutions, has conducted several trials measuring vinegar’s impact on blood sugar.

“A meal that contains a lot of starch will make blood glucose levels spike,” Johnston tells Newsmax Health. “Vinegar seems helpful in moderating that spike.”

That’s pivotal for people with prediabetes, because those types of spikes encourage insulin resistance, which can snowball into Type 2 diabetes.

But vinegar can help to stop that progression. In some of Johnston’s studies, it worked better on people with prediabetes than diabetics and healthy people. And any kind of vinegar – apple cider, wine, white distilled – works because they all have the active ingredient, acidic acid.

It’s thought to work because acidic acid blocks enzymes that digest the starch found in carbohydrates. So the starch, which is normally converted into sugar, goes undigested.

Johnston notes that vinegar won’t help much with sugary soft drinks because it only seems to work on starches. She also warns that the vinegar needs to be diluted and suggests mixing just one or two tablespoons of it with a cup of water.

“Vinegar is very acidic, so this isn’t one of those things where a little is good and more is better,” warns Johnston. “A little does the trick. You don’t need to do more.”

Vinegar is just one surprising way to cut diabetes risk. Here are a few other things you can do:

Take a walk: In another study, Johnston found that reducing blood sugar spikes was as easy as taking a walk. “We simply had people get up after their meals and walk for 15 minutes,” she notes. “And we’re not talking about speed-walking. They can walk at their own pace, and it has the same effect on blood sugar as vinegar.”

Go nuts: Several studies have associated almonds, walnuts, and other tree nuts with a reduced risk of diabetes, even though no one really knows why. “We saw beneficial effects of almond consumption in Type 2 diabetics, but we don’t know which of the many substances in the nut may be working,” says Johnston. “In any case, daily nut consumption is probably a good plan.” Shoot to eat between one and three ounces of nuts a day.

Take coffee breaks: Many studies have associated coffee consumption with a reduced risk of diabetes – including one that found people who drank four or more cups of coffee a day had a 50 percent reduced risk. Researchers say that caffeine and a couple of other compounds are responsible. But don’t worry about missing out by drinking decaffeinated coffee – it’s just as effective as regular.

Pump iron: A Harvard School of Public Health study found that men who do resistance training for at least one hour a week reduced their risk of developing Type 2 diabetes by 12 percent. And the more time they spent training, the bigger the payoff. Men who trained 150 minutes a week saw a 34 percent reduced risk. Pumping iron improves insulin sensitivity, and the added muscle mass increases metabolism.

Eat breakfast: Skipping the day’s first meal can encourage insulin resistance. But whether breakfast is healthy for you depends on what you eat. Experts say to trade the pancakes, muffins, and bagels for fresh fruit, yogurt, and whole grain cereal.

“There are a lot of things out there that are said to have anti-glycemic effects, but they’re not all scientifically based,” says Johnston. “Vinegar and walking do have the science behind them. And if you want something simple, you can’t get any simpler than drinking water-diluted vinegar before eating and taking a walk afterwards.”