Preventing Reactive Hypoglycemia - Ask a Nutritionist

Transcript:

Hello and welcome to Dishing Up Nutrition's “Ask a Nutritionist” podcast, brought to you by Nutritional Weight and Wellness. My name is Leah Kleinschrodt. I'm a Registered and Licensed Dietitian. We are thrilled to be celebrating 20 years on air, discussing the connection between what you eat and how you feel while sharing practical real life solutions for healthier living through balanced nutrition.

Thank you all so much for your support and listenership over the years. And if you're enjoying the show, please let us know by leaving a rating or review on your favorite podcast platform. Providing feedback helps others find these important real food messages. So on today's show, I will be answering a question that we received from one of our Dishing Up Nutrition listeners.

This listener says, “How do you avoid reactive hypoglycemia?” So I want to thank this listener for their question. It's a really good one. I've worked with several clients over the years who know they struggle with reactive hypoglycemia. And the good news is that we can usually get them smoothed out and feeling better pretty quickly.

What is reactive hypoglycemia?

So I first want to dive into what reactive hypoglycemia is, just give a brief overview, what those symptoms are, and then we'll talk about how to prevent it from happening in the first place. So reactive hypoglycemia is low blood sugar that happens after eating in someone who is not diabetic. Reactive hypoglycemia usually happens within two to four hours or so after eating a meal.

So I think of it oftentimes as the low, this low blood sugar is reacting to a higher blood sugar in that previous meal. So we get a big spike in glucose first from a big load of carbohydrates in that meal. And these are usually the more processed and refined carbohydrates.

And so when we get this big spike in blood sugar and big spike in glucose, our pancreas has to send out a lot of insulin to do the cleanup work because too much sugar in our bloodstream is toxic to our cells. But if the pancreas and insulin overcorrect, they can send the blood sugar crashing in the opposite direction.

Now you have too little blood sugar in the system, which is also a danger to the body and you will feel a low blood sugar. You might feel tired or you might feel like suddenly you've hit a wall or you're dizzy or lightheaded. You have trouble concentrating. You might get sweaty or shaky, feel hungry, blurry vision, kind of get anxious or feel on edge, nauseated.

You might even have a fast heart rate. So there's a lot of symptoms that can go on with that low blood sugar feeling, none of which are usually any fun. I actually have a good friend who I've seen suffer from these kind of episodes on occasion. He'll be completely fine one minute. And then five minutes later, it will hit him like a ton of bricks.

You can just see it on his face. He looks drained. He looks like he's had the wind taken out of his sails. He's out of it. He usually has to like sit or lay down for a few minutes. And he's often usually pounding some gummy bears and some Gatorade to get through it; not the avenue I'd recommend necessarily, but it just shows that the body has an intense need to rescue those glucose levels as quickly as possible. Because low blood sugar, too lower blood sugar is an emergency situation.

How do we avoid hypoglycemia?

So how do we avoid reactive hypoglycemia? I'd say the most helpful thing I found is to eliminate the high blood sugars in the first place. And we do that through a balanced eating approach. Ideally, we are choosing slower digesting carbohydrates. We'll get a little deeper into the carbs in just a minute.

Then we want to pair those carbohydrates with a good whack of protein and healthy fats. This helps the blood sugar stay in more of a rolling hills course with gentle ups and downs in your blood sugar. And it'll help avoid the roller coaster effect of the big dramatic swings up and down.

So first we have to look at the quality of the carbohydrates we're eating. Slower digesting carbohydrates will typically be less processed and typically will have more fiber to them. This means our digestive tract has to work harder to break these carbohydrate foods down, but that also means they enter the bloodstream at a slower rate.

Our pancreas is then able to keep better pace and just squirt out smaller amounts of insulin to take care of the job. So one way you can think about it is like this. If you light a match, it's pretty easy to just turn on the faucet in your kitchen, even at a trickle, and we can put that match out pretty easily.

But if your house is on fire, you need to turn on the big powerful fire hose to put that fire out. And in the meantime, you're flooding your house in order to get back in control of the situation. That's what it's like if you are flooding your digestive tract and your bloodstream with large amounts of processed and refined carbohydrates.

Then the pancreas needs to turn on that fire hose in order to put out that glucose fire. And then in the meantime, we've got a blood sugar crash or the flooding of the house. That's the collateral damage that happens. But if we eat carbohydrates that are slower to digest and get into the bloodstream slower, that's more like the match situation where actually we only need a little bit of water to put out that match or just a little bit of insulin to deal with those carbohydrates.

Which carbohydrates serve our blood sugar well?

So which carbohydrates are going to act more like matches and serve our blood sugar better? These would be the real food, whole food carbohydrates that we talk a lot about on Dishing Up Nutrition. Think any kind of vegetable. Most fruits, potatoes and sweet potatoes, squash, like butternut squash or spaghetti squash, things like beans and lentils, brown and wild rice and quinoa. And this is not an all-inclusive list, but it covers the majority of the foods in the groups that people eat routinely.

Which carbohydrates do we recommend avoiding for optimal blood sugar balance?

The carbohydrates that may act more like that house fire situation would be more of the refined carbohydrates like the breads, the pastas, the cookies, muffins, crackers, chips, cereals, candies, pastries, even alcohol, soda, or other sweetened drinks. The list goes on and on.

These carbohydrates are often made of flour, usually wheat flour, and they have a lot of their fiber removed during their processing. So these carbohydrates will hit the bloodstream quicker and harder. And so for example, eating a bagel for breakfast will result in a bigger blood sugar spike and then that greater potential for a lower blood sugar a few hours later.

Eating a bagel for breakfast: bigger blood sugar spike versus eating an apple for breakfast. So really the quality of the carbohydrates that we are eating matters in this situation. And before I move on, we do need to take a quick break. When we get to the other side of break, I'll talk a little bit more specifics about carbohydrates and how we smooth out those blood sugars. We'll be right back.

​-----

Pair quality carbohydrates with healthy protein & fat for blood sugar balance

All right. And we're back with our “Ask a Nutritionist” episode. We're talking about how to prevent reactive hypoglycemia. And we just finished talking about the quality of the carbohydrates that we're eating. That makes a big difference in how our blood sugars respond. But we also can't forget the other piece of this equation, which is pairing those carbohydrate foods, even fruits and vegetables with some protein and some healthy fats.

I always describe the proteins and healthy fats as the anchors for our blood sugar. They keep us from drifting too high and they keep us from drifting too low. So back to our breakfast example, you wouldn't want to eat a bagel alone, but you also probably still wouldn't want to eat an apple all by itself alone for breakfast either.

We would say let's pair that apple with two hard boiled eggs or a turkey sausage patty for your protein, and then top it off with some peanut butter or maybe a quarter of a cup of nuts on the side. That would be your healthy fat. And sometimes I work with clients and it sometimes is a challenge to get off or get away from some of those more processed carbohydrates.

So if I have a client who still prefers to do a bagel or toast at breakfast for their carbohydrate, I might ask them if they'd be willing to eat only half of the bagel or stick with one slice of toast at that meal, and then we still round out that meal with some eggs, or maybe some smoked salmon or a cup of whole milk cottage cheese.

And then we slather that toast or the bagel with some full fat cream cheese or butter, or we put some avocado slices on there for the healthy fats. So again, that even seems to make a difference in and of itself. Again, if we compare those carbohydrates with the proteins and the fats, they help to buffer that blood sugar response and prevent that dip a couple hours later.

Other factors to consider outside of food choices for hypoglycemia

Now, before I sign off, I do just want to mention really quick that there are other factors outside of our food choices that can also impact our blood sugar. And our insulin response, I would still say food and our food choices are the biggest ones. But so if you are someone who is prone to low blood sugars or you just have really sensitive blood sugars, like I fall into this category. I know this about myself.

These would just be a couple other factors to think about and to work on if possible. Some of these are sleep deprivation, chronic high stress, and if we think about it, oftentimes the stress and the sleep troubles go hand in hand, and digestive troubles. Think like IBS or reflux can also make us more prone to having some wonky blood sugars.

So some groups of people that I think about that fall into these camps: caregivers often check a lot of these boxes. So whether you're a parent or you have a child with special needs or you're caring for a spouse or an aging parent, you know, anybody who has those intense caregiver roles can fall into these situations where we might have that chronic high stress or we're not sleeping really well.

I often think about shift workers, especially in the medical field. There are other fields that have those round the clock schedules as well. If you're someone who's had a lot of antibiotics over the years for various ailments, again, like that can lead to some gut troubles and can lead to other disturbances metabolically that can just make your blood sugars a little more sensitive.

So if you're in a season of life where some of these things are coming to a head, this would be a time I would encourage you to think about doubling down on the dietary strategies that I just mentioned earlier, thinking about the quality of those carbohydrates, thinking about pairing any carbohydrates that you eat with some protein and healthy fat to smooth out those blood sugars.

And what you also might notice is you might see a correlation with more low blood sugar episodes during these more stressful times or during these sleep deprived times, even if at other times in your life when things are a little more smoothly, you might see some more low blood sugar episodes when they're usually a little bit more well controlled under normal circumstances. So I just wanted to put a few of those things out there as well.

Nutrition obviously makes a huge impact in your blood sugar regulation, but there are some other areas that we can look at that can make us more or less sensitive to those blood sugar swings. So I hope that was helpful and hopefully gave you some strategies to think about if you know you are someone who has sensitive blood sugars or kind of falls into that camp of reactive hypoglycemia.

And again, just wanted to thank everyone so much for listening to our “Ask a Nutritionist” episode and remind you if you found this episode helpful, be sure to leave us a rating and review on your favorite podcast app. And if you have a nutrition question you would like us to answer, we have two options for you. You can join our private Dishing Up Nutrition Facebook community by searching Dishing Up Nutrition on Facebook.

Join Our Dishing Up Nutrition Facebook Group

Or you can call 952-641-5233 to leave your question in our Dishing Up Nutrition voicemail box. So please don't be shy. If you have a question, let us know and we look forward to hearing from you.