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Low Blood Sugar (Hypoglycemia) The 20th Century Epidemic?

by MARTIN BUDD N. D., D. O., Lic.Ac.

Frequency of Meals

An important characteristic of the hypoglycemic diet is the need for frequent meals. As we know, the hypoglycemic patient produces too much insulin in response to certain foods, and the blood sugar falls. The only way to avoid a severe drop in the blood sugar is to eat small meals at frequent intervals. Frequent snack meals of starch (e.g. sandwiches, cereal, etc.) would serve only to aggravate the problem, as all forms of carbohydrate are absorbed very quickly. Protein and fats are, however, slowly absorbed and the sensitive insulin apparatus is not triggered. Small regular meals consisting of protein or fats serve to stabilize the blood sugar, and sudden rises and falls in the glucose level are avoided.

This leveling off of the blood sugar throughout the day is extremely important, as it is the speed of elevation that triggers off the insulin response and not the amount of rise (e.g. an increase of 70mg to 110mg of sugar in the blood will produce as much pancreatic response as a rise from 170mg to 210mg). The drinks between meals prevent overeating as they serve to reduce the almost unbearable craving for food so characteristic of hypoglycemia The milk drinks have the job of `topping up' between meals, for without them the blood sugar would drop and symptoms would develop.

Proteins

I find the concept of a high protein diet unacceptable and unnecessary, and prefer to talk in terms of a 'protein- spread diet'. This means simply, normal protein consumption with plenty of variety in choice of protein sources, but to have the protein at least four times daily. As I have already said, proteins and fats are absorbed slowly and do not upset the insulin-glucose ratio.

Fat is recommended in the diet as it depresses pancreatic activity. It should be remembered, however, that this diet is a short-term corrective programme, and it may be unwise to consume the amount of fat recommended in the diet for long periods. This particularly applies to patients with a history of heart or circulation problems, or with a high level of fat in the blood. (It is usual, if a high cholesterol or triglyceride factor is suspected, to measure these with blood tests before placing the patient on the high fat diet.)

Night-time `Fast'

The diet requires that the patient has an early breakfast and a late supper. Both these meals should include either fat or protein. This recommendation is made to reduce the hours one spends `fasting' throughout the night As has been discussed many times in preceding chapters, the blood sugar normally falls to a low level between the hours of 3 a.m. and 5 a.m. The early morning asthma attack, the onset of migraine, panic feelings and anxiety, night-time raids on the pantry, etc. are all expressions of this phenomenon. By reducing the hours between dinner and breakfast, there is a good chance that the early morning crisis can be averted. The majority of people eat their last meal around 7 p.m. and have breakfast at 7 a.m. This twelve-hour fast is too long, and careful, regular eating throughout the day is pointless if a patient develops a hypoglycemic episode every night.
I advise patients to eat a small protein supper prior to going to bed (10.30 p.m. to midnight) and to have a glass of milk on waking (6.30 a.m.-7.30 a.m.). If, in spite of this, the early morning symptoms persist, I have at times recommended that patients set their alarm to wake around 3 a.m. and have a small meal. This may be tedious, but, if the early morning symptoms can be suppressed for two to three weeks, it can be considered to be well worthwhile. After such a time the diet and other measures have usually normalized the insulin-glucose balance sufficiently to allow the patient to sleep through the night.

Fruit; Apples, apricots, strawberries, raspberries, blackberries, grapefruit, melons, oranges, peaches, pears, pineapple, tangerines. May be cooked or raw with or without cream, but without sugar. Never have more than one piece of fruit at a time (e.g. one apple, one orange, etc.).

Juice; Any unsweetened fruit or vegetable juice, except grape juice or prune juice. Avoid tinned fruit juice unless pure.

Beverages; Decaffeinated coffee or herb teas.

Desserts; Fruit- fresh, stewed or baked.

Salt; Use sea salt in moderation.

Avoid Absolutely
Any foods not mentioned on the diet and, in particular: sugar; chocolate and other sweets etc., such as cake, pie, pastries, sweet custards, puddings, ice cream; salted nuts; and all cereal products; tinned foods; diabetic foods; syrup; molasses; and honey. Avoid ordinary coffee; tea, alcohol; soft drinks; beverages containing caffeine; tobacco; potatoes; rice; grapes; raisins; plums; figs; dates; bananas; avocados; spaghetti, macaroni and noodles. THESE DIETS SHOULD ONLY BE USED UNDER THE DIRECT AND REGULAR SUPERVISION OF A PRACTITIONER.

Why the Hypoglycemic Diet?

When the majority of patients first encounter the diet prescribed for hypoglycemia, they are understandably baffled by the ban on sugar. They have been given a diagnosis of low blood sugar and yet they must avoid sugar. Hypoglycemia is the opposite of diabetes, and diabetics cannot have sugar, therefore, surely the hypoglycemic sufferer must eat lots of sugar?

Another area of misunderstanding is the question of sugar falling when we miss meals. It has been acknowledged for many years that controlled fasting can be eliminative and rejuvenating. `Why', the low blood sugar patient asks, `do I feel so ill with an overnight fast, when prolonged fasts are frequently recommended at health clinics?'

Throughout our lives we are instructed and persuaded that sugar gives us energy. Sugar, honey, glucose and molasses are names synonymous with vitality. The hypoglycemic patient is exhausted and depressed. It can, therefore, be very confusing to be told that he will feel better if he avoids all foods and drinks that are traditionally thought to provide energy.

There are sound physiological reasons why sugar and refined carbohydrates must be avoided. White sugar is absorbed too quickly and the body reacts by discharging insulin into the blood. We know that hyperinsulinism is the central problem in reactive hypoglycemia, and sugar aggravates and perpetuates this problem. Our digestive system needs a small amount of carbohydrate in order to efficiently break down and absorb proteins and fats. This, however, can be supplied by taking non-refined carbohydrates (e. g. whole-wheat bread, whole-meal cereal and the starch content in fruit). In the context of blood sugar balance, the color of the sugar is irrelevant. Both brown and white sugar have the same disturbing effects. Honey's sweetness is derived chiefly from sucrose (white sugar) and molasses has similar effects. For this reason both items are barred from the diet.

Synthetic Sugar

This may be a useful point at which to mention synthetic sugars. Although, from the purely chemical viewpoint, they should not influence the insulin-glucose balance, there are two facts worth noting.

1. If one needs to follow a low blood sugar diet for several months, and possibly always avoid sweet foods, it makes dieting considerably easier if all forms of sweetness are avoided, including synthetic sweeteners (e. g. saccharine).

2. Carlton Frederick maintains that synthetic sweeteners trigger the pancreas into activity rather like a conditioned reflex. He points out that even the smell of food can stimulate the gall bladder into activity and many physical changes (e.g. allergies, migraine, etc.) can be triggered off by the smell and taste of food.

Diets work only if the patient is prepared to follow them for a prescribed period of time. With the hypoglycemic diet it is essential to maintain the diet for an initial period of eight to twelve weeks. It follows that any diet must fulfill these requirements:

1. It should not contain expensive or exotic food (e.g. fillet steak daily).

2. Many patients work full time and cannot prepare elaborate dishes; the meals must be simple, particularly as there are four to six meals per day.

3. The diet should not be too unsociable and too different from the average diet. Otherwise, I have found that patients are too easily tempted to `stray' off the recommended foods.

4. The meals should be tasty and enjoyable.

5. Since many hypoglycemic are overweight (especially the ladies), and very conscious of extra pounds, the diet should not cause one to put on weight.

6. Finally, and perhaps most obvious, the diet must work. Only by feeling better will a patient continue to follow a strict diet, week after week.

It is quite impossible to draw up an individual diet for each patient. I use, therefore, a standard diet for hypoglycemia and encourage patients to talk over any problems or uncertainties.

Recommended Diet

The standard diet that I use is as follows:

On rising: Medium orange, 1/2 grapefruit or 100ml (4 fl oz) fruit juice or cup of beverage or milk.

Breakfast: Fruit or 100m1(4 fl oz) fruit juice. 1 egg, with or without 2 slices of ham or bacon. 1 slice of whole-wheat bread or toast, with plenty of butter. Milk or beverage.

2 hours after 100ml (4 fl oz) fruit juice. breakfast:

Allowable Food and Drink Vegetables
Asparagus, beets, broccoli, brussels, lettuce, mushrooms, nuts, cabbage, cauliflower, carrots, celery, sweetcorn, cucumber, beans, onions, peas, radishes, sauerkraut, tomatoes, turnips, swede, parsnips and any other vegetables not on the `avoid' list.

Lunch: Meat, fish, cheese or eggs with salad- large serving of lettuce or tomato with mayonnaise or french dressing.

Vegetables if desired.
1 slice of whole-wheat bread, toast or crispbread with plenty of butter.

3 hours after lunch: ( 4 fl oz) milk.

1 hour before dinner: 100ml (4 fl oz) fruit juice.

Dinner: Soup, if desired (not thickened with flour). Vegetables. Meat, fish or poultry. 1 slice of whole-wheat bread, if desired. Dessert (fruit- fresh, stewed or baked) and beverage.

Every 2 hours until bed-time: Small handful of nuts (unsalted).

Notes
Live fresh yogurt or goat's milk is preferred to cow's milk. Where butter is mentioned, vegetable margarine may be substituted. If the dairy products are unacceptable, owing to catarrh or migraine or asthma, substitute soya milk, plant milk or other non-animal products. IT IS ADVISABLE TO AVOID THE USE OF SYNTHETIC SUGAR SUBSTITUTES.

Allowable Vegetables
Asparagus, beets, broccoli, brussels, lettuce, mushrooms, nuts, cabbage, cauliflower, carrots, celery, sweetcorn, cucumber, beans, onions, peas, radishes, sauerkraut, tomatoes, turnips, swede, parsnips and any other vegetables not on the `avoid' list.


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