Dietary and Lifestyle Considerations
Life Extension® suggests that most healthy people strive to maintain fasting glucose levels between 70 and 85 mg/dL and 2-hour post-meal glucose levels no more than 40 mg/dL above fasting levels, or a maximum of 125 mg/dL. Adjustment of dietary habits can help stabilize glucose levels and achieve these goals for many people. In addition to the strategies outlined in this protocol, readers are encouraged to review the protocol on Diabetes.
One dietary strategy for avoiding a rapid spike in blood sugar levels after a meal is increasing intake of dietary fiber, which slows the rate of carbohydrate absorption. For example, a study on 63 patients with type 1 diabetes assessed the effect of 24 weeks of a high- or low-fiber diet. Compared to 15 g of fiber daily, those who ate 39.1 g on average exhibited half as many episodes of hypoglycemia (Giaco 2000). The increased fiber intake in this study was accomplished by eating more fruits and vegetables.
A more direct way to reduce the glycemic impact of the diet is to consume fewer carbohydrates. This was tested in a group of subjects with severe reactive hypoglycemia who had recently undergone Roux-en-Y gastric bypass surgery for weight loss (Kellogg 2008). In this study, the high-carbohydrate meal contained 79% carbohydrates, 11% fat, and 10% protein, and the low-carbohydrate meal contained 2% carbohydrates, 74% fat, and 24% protein. Of 12 participants, 10 (83%) showed improvement in their symptoms, and of these, 3 (25%) had complete resolution of their symptoms (Kellogg 2008). These findings suggest that a low-carbohydrate diet attenuates pathological glycemic excursions in this population (Cui 2011).
Typical dietary suggestions for reactive hypoglycemia include (Gaby 2011; Hamdy 2013; Nippoldt 2013):
- Avoid refined carbohydrates (eg, white rice, white flour).
- Eat several small meals and snacks throughout the day (6 small meals or in-between meal snacks).
- Avoid excess alcohol while fasting (or at least consume food while drinking alcohol).
- Eat foods with a lower glycemic index. These are foods that raise blood sugar levels more slowly (eg, lean protein, high-fiber foods).