Obesity and its association with metabolic syndrome are implicated in many disease states. Research has focused on the role of diet and lifestyle modifications in the evolution of prediabetes to diabetes seeking ways to intervene and improve outcomes. Proven nutritional include leaner proteins, an abundance of vegetables, extra-virgin olive oil, and controlled portioning of carbs and starches. The transition from a sedentary state to an exercise routine of moderate intensity has shown efficacy in lowering metabolic risks. The synergy of dietary and physical activity modifications are the building blocks for lifestyle modifications examined in this review as a means of preventing obesity-related diabetes.