Our objective was to evaluate the effects of a moderate calorie and carbohydrate-restricted diet on cardiovascular risk indicators in overweight or obese patients with prediabetes. A clinical trial was conducted in which 86 subjects presenting with overweight or obesity and prediabetes received a personalized diet of 1,200 to 1,700 calories with a distribution of 50 % carbohydrates, 20 % proteins, and 30 % fat. Body weight, fat mass, and lean mass were measured through bioimpedance. Glucose, total cholesterol, high density lipoprotein cholesterol and low density cholesterol, and triglycerides were measured. The measurements were taken at the beginning of, and at, 6 and 12 months during the intervention, and the differences were compared by paired Student's t and χ(2) tests. At 12 months, a significant reduction was noticed in body weight in patients with overweight and obesity (72.4 ± 7.8-69.6 ± 7.5 kg) (85.7 ± 14.8-80.2 ± 12.7 kg) with body mass index (28.2 ± 0.8-27.2 ± 2.1 kg/m(2)) (34.3 ± 3.5-32.1 ± 3.2 kg/m(2)), systolic (120.9 ± 14.2-112.4 ± 11.5 mmHg) (124.1 ± 11.9-115.7 ± 14.0 mmHg), diastolic blood pressures (79.0 ± 9.3-71.8 ± 8.3 mmHg) (80.4 ± 9.0-73.7 ± 13.1 mmHg), glucose (106.0 ± 8.9-95.9 ± 7.5 mg/dL) (107.3 ± 7.0-97.0 ± 8.2 mg/dL), and significant improvement on lipid profile (p < 0.05). The restrictions in the calorie and carbohydrate diet decrease the cardiovascular risk indicators in overweight or obese adults with prediabetes.