Loe raamatut: «Low Blood Sugar: The Nutritional Plan to Overcome Hypoglycaemia, with 60 Recipes»
Eat to Beat Low Blood Sugar
The Nutritional Plan to Overcome Hypoglycaemia, with 60 recipes
Martin Budd and Maggie Budd
Contents
Cover
Title Page
Introduction
Part One Low Blood Sugar - Facts and Figures
Chapter 1 – So what exactly is low blood sugar?
Chapter 2 – The causes of low blood sugar
Chapter 3 – The symptoms of low blood sugar
Chapter 4 – The diagnosis of low blood sugar
Part Two Treating Low Blood Sugar
Chapter 5 – The low blood sugar diet
Chapter 6 – The Glycaemic Index
Chapter 7 – Case histories
Part Three The Recipes
Chapter 8 – Introduction
Chapter 9 – Breakfasts
Chapter 10 – Lunchtime snacks and sandwiches
Chapter 11 – Salads
Chapter 12 – Soups
Chapter 13 – Main meals
Chapter 14 – Desserts
Chapter 15 – Between-meal snacks and drinks
Chapter 16 – Baking
Part Four Taking it Further
Chapter 17 – Supplement use
Glossary
Resources
Index
Copyright
About the Publisher
Introduction
Since the publication of my first book, Low Blood Sugar, in 1981, the established medical attitude to the diagnosis and treatment of low blood sugar has radically changed. For many years doctors viewed sudden falls in the blood sugar as a relatively harmless cause of the sort of transient symptoms that we can all at times experience. The recommended treatment at the time was usually sugar cubes or a bar of chocolate.
These days, low blood sugar, or hypoglycaemia to give it its proper name, is seen by many doctors, naturopaths and researchers as an important clue that indicates a general inefficiency in our sugar regulation system. This faulty control has been termed dysglycaemia.
A host of symptoms and health problems are now known to develop as a result of poor blood sugar regulation. These include obesity, high blood pressure, anxiety, depression, fatigue, late onset diabetes, gout, heart disease, thyroid and adrenal deficiency and a recently defined group of abnormalities known as Syndrome X, or the metabolic syndrome.
While some of the technical aspects of the diagnosis and treatment of low blood sugar will be briefly discussed, this book essentially offers dietary advice to readers with low blood sugar to enable them to help themselves. Correct eating to minimize the adverse effects of dysglycaemia can reduce the distressing symptoms of low blood sugar, and lessen the risk of the many health problems associated with a high sugar diet that can develop in later life.
Part One looks at what low blood sugar means, its causes and symptoms. Part Two concerns itself with diet, providing guidance on what you should and should not be eating and the importance of timing meals well, as well as an easy-to-follow low blood sugar diet. Low blood sugar can cause a wide range of problems and the solution is not always the same. For this reason, a range of case histories is provided to illustrate some of the problems and solutions involved.
Part Three is where we get practical with the Eat to Beat Low Blood Sugar recipes. Here you will find a selection of recipes appropriate for a low blood sugar diet - both in terms of their content and when they are designed to be eaten. Part Four, entitled Taking it Further, outlines the value of specific nutritional supplements used to treat low blood sugar.
Towards the end of the book you will also find a glossary that explains the terminology currently in use in the field of blood sugar imbalances - for instance, Syndrome X, insulin resistance, glycaemic index and dysglycaemia. Please note, low blood sugar, low blood glucose and hypoglycaemia are one and the same, so in order to avoid confusion I describe the condition as low blood sugar throughout this book.
PART ONE Low Blood Sugar – Facts and Figures
CHAPTER 1 So what exactly is low blood sugar?
Low blood ‘sugar’ refers to a low level of glucose in the blood. There are no rigid criteria for diagnosing low blood sugar, as considerable individual variations can exist. However, a blood glucose level of below 3.5mmol/litre will usually cause the typical symptoms of low blood sugar. This is not a rare condition – everyone reading this book will have experienced the symptoms of low blood sugar at some time in their lives.
However, for such a widespread problem, it is surprisingly misunderstood. Indeed for many people almost every aspect of the low blood sugar condition is either contradictory or confusing. This is well demonstrated by the questions that I am frequently asked, examples being:
‘If diabetics with high blood sugar need to avoid sugar, why do those with low blood sugar also need to avoid sugar?’
‘Why are the symptoms and causes of low blood sugar on the increase, yet most of us eat too much sugar?’
‘Why do many people with low blood sugar develop high blood sugar [type II diabetes] in later life?’
‘My doctor has advised me to suck a sugar cube whenever I feel shaky or dizzy between meals [low blood sugar symptoms]. You advise me to avoid sugar, who is correct and why?’
‘We are told that all the carbohydrates in our diet end up as glucose in the blood. Do I therefore need to avoid all forms of carbohydrate for the remainder of my life?’
The answers to these and other questions will become apparent as you read this book.
The beginning – the discovery of low blood sugar
Perhaps low blood sugar should be termed ‘Seale Harris Syndrome’ after the American GP who first defined its symptoms in 1924. Dr Harris – a contemporary of Banting and Best, the co-discoverers of the role of insulin in diabetes – noticed that many diabetic patients attending the new insulin clinics developed symptoms of low blood sugar. Given that diabetes is characterized by a high blood sugar level, caused by the lack of insulin (a hormone that controls the level of glucose in the blood), this observation was surprising. The reason, however, was simple – many diabetics have difficulty in accurately judging their insulin requirements and often overdose themselves, producing a condition known as hyperinsulinism, which consequently causes low blood sugar (or hypo).
Crucially, Dr Harris noted that he also had several patients in his regular practice who exhibited symptoms of the ‘hypo’ reaction on a regular basis, but who were not diabetic and were therefore not taking insulin. He accurately concluded that these patients probably experienced the unpleasant symptoms of hypoglycaemia as a result of an inefficiency or imbalance in their sugar-regulating apparatus. This complex mechanism involves the islet glands of the pancreas that release insulin, the liver, to some extent the pituitary, thyroid and adrenal glands and other functions that play a part in sugar metabolism.
Dr Harris discussed his ideas with Dr Banting, who agreed that the role of insulin in non-diabetic low blood sugar offered a new aspect to the study of blood sugar balance. No papers on the topic had appeared in medical literature prior to Seale Harris’s work, but his discoveries led to numerous similar papers appearing in journals all over the world.
CHAPTER 2 The causes of low blood sugar
You may ask why many people who eat and drink excessive amounts of sugar-rich foods do not suffer from low blood sugar, while others who follow a near-perfect low sugar diet experience low blood sugar symptoms. The answer appears to lie in the many background health influences that can predispose an individual to dysglycaemia and low blood sugar.
This is a very complex subject but a brief list will serve to highlight the chief causative factors:
Excessive sugar intake, leading to pancreatic overstimulation, hyperinsulinism and insulin resistance.
Adrenal under-production, leading to adrenal deficiency or hypoadrenalism.
Imbalance and subsequent deficiency of the thyroid.
Excessive use of tobacco (each cigarette smoked raises the blood sugar equivalent to 2½ teaspoons of sugar).
Excessive use of alcohol and caffeine – both serve to stress the adrenal mechanism.
Inability to handle prolonged or excessive stress, leading to adrenal debility and inefficiency (known in the US as adrenal exhaustion or adrenal fatigue).
Food allergies or intolerances, which can be caused by, but also aggravated by, low blood sugar.
Mineral deficiencies. These include chromium, which is now deficient in the soil of Western nations. The minerals zinc, vanadium, magnesium, manganese and potassium are also essential for optimum blood sugar control.
Hereditary factors, in particular a family history of diabetes, hypothyroidism, asthma, epilepsy, clinical depression or chronic fatigue.
When attempting to treat blood sugar disorders one key question that must always be considered is whether the patient’s low blood sugar is only a symptom, or is itself a cause of symptoms.
Fasting hypoglycaemia
When low blood sugar is simply a symptom, it is generally the result of fasting, or transient, hypoglycaemia – low blood sugar that is caused by a delayed or missed meal. This is something we have all experienced; the symptoms include shakiness or dizziness and fatigue, perhaps a mild headache or a feeling of ill temper. Usually the symptoms are coupled with a strong urge for chocolate or something sweet.
Those who experience such symptoms on waking each morning usually have a background health problem. However, there are very few health problems that can cause us to feel worse on rising than we feel upon retiring. The list includes adrenal exhaustion, hypothyroidism, drug addiction and alcoholism. Those with severe food intolerances can also feel tired, thickheaded and irritable on waking – the reason for this is thought to be the early onset of withdrawal symptoms resulting from the night fast.
Reactive, or functional, hypoglycaemia
This problem is the main subject of this book. It defines a type of chronic low blood sugar that usually requires an appropriate dietary strategy and supplement use. The symptoms can occur at any time and, for many unfortunate sufferers, can be virtually continuous.
WHAT HAPPENS TO THE BLOOD?
The symptoms of low blood sugar can develop as a result of two principle changes in the blood sugar. These changes can involve either the actual low level of the blood sugar or the speed of fall in the blood sugar. Unfortunately the human brain cannot store glucose, so even a five per cent fall in the available glucose supply to the brain and nervous system can produce an adrenal response with subsequent symptoms.
WHAT ARE THE IDEAL GLUCOSE LEVELS?
The normal level of our fasting blood sugar (fasting refers to food avoidance for 12 hours) is 4–7mmol/L. Many diabetic clinics define a patient’s symptoms as ‘hypo’ if a patient’s blood falls below 4mmol/L. However, I have frequently seen great symptom variations in a patient’s response to low blood sugar levels, although generally I have found that a blood sugar level below 3.5mmol/L can predictably cause symptoms to surface.
The American doctor and nutritionist Carlton Fredericks, a renowned authority on low blood sugar, stated “when blood sugar drops as little as 0.25mmol/L below the normal for the patient, a profound glandular compensation may start’. However, as mentioned above, a low level of blood sugar is not the only cause of low blood sugar symptoms – an inappropriately rapid fall in the blood glucose can also give rise to symptoms.
SPEED OF FALL IN BLOOD SUGAR
A rapid fall in the blood sugar level (for whatever reason) in excess of 1.5mmol/L in one hour can produce symptoms of low blood sugar. These changes occur irrespective of the actual level of blood sugar, for example a fall from 7mmol/L to 5mmol/L in 30–45 minutes can often cause low blood sugar symptoms to develop.
Both of the trigger factors that cause low blood sugar symptoms – i.e. speed of fall and a general low level – are subject to individual variations. I have seen patients who appeared to be symptom-free with a blood sugar level of 2.5mmol/L and others with levels around 3.5mmol/L who could barely walk or talk.
Insulin-dependent diabetics can ‘hypo’ when they overdose on their insulin requirements in relation to food and/or activity. Glucometers are used to check their blood glucose levels. Early models were designed to measure high blood sugar levels, however the more recent glucometers can measure blood sugar levels as low as 1.5mmol/L with a finger-prick blood sample. Accurate results can be achieved within 6–60 seconds, depending on the model used.
The problems caused by too much sugar
The high-carbohydrate Western diet provides sugar far in excess of our energy needs. Consumption of sugar alone in Great Britain amounts to 27kg (60–65lb) per person per year. If you include the sugar-rich refined carbohydrates we eat (for example, sweets, chocolates, cookies, cakes, cereals, soda and cola drinks) then our total sugar ‘load’ can be as high as 90kg (200lbs) per person (the figures in the US follow close behind). In terms of calories, one teaspoon of sugar per day equals 100 calories per week, so the amount of calories consumed by someone at the top end of the sugar-intake scale is vast.
When we eat sugar, we either use it for energy needs, or it is stored as glycogen or fat. Marathon runners know that they need to consume extra carbohydrates three to four days before a race to provide stored fuel for gradual release during the race. Likewise, those who do heavy manual work can often avoid weight and health problems as a result of converting all their food (fuel) directly to energy.
The experience of the explorer Sir Ranulph Fiennes clearly demonstrates how important it is that we match our energy intake to our output. On an Arctic trek, Fiennes lost weight despite consuming 5000 calories a day. In spite of his high calorie diet, his energy requirements meant he utilized a total of 11,000 calories each day. His subsequent weight loss was therefore inevitable. Perhaps we could justify our high sugar diets with marathon running or polar exploration – not popular choices. Fortunately there are other solutions (these are discussed in Part Two).
Insulin
Central to the problem of low blood sugar is the hormone insulin. Any rise in our blood sugar requires an insulin response. Insulin is a hormone secreted by the pancreas to lower blood glucose levels; it does this by transporting the glucose to the muscle cells and other tissues. Insulin is uniquely the only hormone to promote food (fuel) storage for future use. For this reason it is often termed the storage or fattening hormone.
This storage facility was essential for human survival several thousand years ago, for the early hunter-gatherers were very similar to the present day big cat carnivores in Africa and India. Their eating habits consisted of large meals perhaps every three to four days. The ability to store food was therefore a vital survival strategy. Unfortunately 21st-century men and women follow a largely sedentary lifestyle yet they often eat carbohydrate-rich meals and snacks three to six times daily. Our metabolism can only convert a small amount of excessive sugar to glycogen, which is stored in the liver and muscle cells. The remainder is stored as fat. Our food is our fuel and if the fuel is not required it is stored and excess weight is the result.
However, a sugar-laden diet does not only lead to the storage of fat. Because the insulin response is constantly being overworked, it can become less efficient as the cells become less sensitive and resistant to the effect of the insulin.
INSULIN RESISTANCE
This gradual loss of sensitivity to the blood insulin results in an increase in the level of insulin as the pancreas secretes more and more in an attempt to normalize the blood sugar balance. The end result is an on-going high level of blood insulin (hyperinsulinaemia). This excess insulin promotes more fat storage at the expense of available energy. High-sugar and high-carbohydrate eating can eventually lead to obesity, high blood fats, high blood pressure and fatigue (this group of disorders is known as Syndrome X, or metabolic syndrome). Such inappropriately high levels of blood insulin can cause chronic irritable bowel syndrome, adrenal exhaustion and disturbances to the female hormonal balance (as in Polycystic Ovary Syndrome).
The adrenal response
Although the brain and nervous system rely on blood sugar as the chief nutrient, excessively high levels of blood sugar can cause damage to nerve cells.
The temporary fall in the blood sugar caused by the insulin response to food triggers adrenal compensation, where adrenaline is released to counter the effect of the low blood sugar. This yo-yoing of the blood sugar levels can lead to a chronic imbalance in the blood sugar control (dysglycaemia), causing adrenal deficiency and a reduced thyroid hormone output. The thyroid gland reflects our metabolic rate and mild hypothyroidism can result from adrenal exhaustion.
The role of the adrenal hormone adrenaline in the blood sugar narrative highlights a design fault in our body chemistry. This vital hormone has two major functions. These are stress-handling (the so-called fight or flight response) and raising our blood sugar when the level falls too low.
As any athlete knows, adrenaline increases the metabolic rate, the heart rate, the blood flow to muscles and the oxygen intake. In a primitive society this would prepare us to either run or attack. However, for those of us who suffer from low blood sugar (which causes our brain and nervous system efficiency to be compromised), the adrenaline response that occurs is identical to our reaction to any type of stress. This explains why so many sufferers of long-term low blood sugar experience episodes of aggression and mood changes – examples being women with pre-menstrual syndrome and diabetics or non-diabetics who ‘hypo’. Our metabolism cannot identify the reason for the adrenal surge, hence the stress response that occurs with low blood sugar.
Summary
The modern high carbohydrate/sugar diet, coupled with our sedentary lifestyle, has lead to an increase in many low blood sugar symptoms, including obesity, fatigue and poor stress handling. The subsequent adrenal compensation and exhaustion can result in mild hypothyroidism, high blood pressure and subsequently Syndrome X. Anxiety, depression, elevated blood fats and metabolic depression can be the consequence.
In the next chapter we look at the many symptoms that can result from low blood sugar.
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