Handling hypoglycemia (low blood sugar)

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If you have prolonged and/or recurrent symptoms, you need to visit your doctor in order to find and treat the underlying cause of this condition. Changing to a healthier way of eating may well help ease the symptoms while you undergo tests, and will certainly do no harm. Keeping a food/symptoms journal for a week to ten days will help highlight any recurring pattern of symptoms. Be sure to track stress levels, too.

Hypoglycemia can be caused or exacerbated by; diseases of the pancreas, liver or kidneys; PCOS (polycystic ovary syndrome); diabetes; pregnancy; a weakened immune system; chronic mental or physical stress; alcoholism; allergies or prolonged drug use (including antibiotics). Three types of drug having a known blood glucose lowering effect are monoamine oxidase inhibitors (used to treat depression), quinine sulphate (anti-malarials) and aspirin. However, do NOT stop taking drugs that have been prescribed for you without first checking with your doctor. See what I mean about looking for the root cause of the problem?

One thing about the symptoms of hypoglycemia is that they can very simply be eased by eating something. The symptoms will generally dissipate within ten to fifteen minutes once food is ingested (if they don't, then perhaps hypoglycemia is not the problem). So you will find symptoms easier to manage if you have more, smaller-than-usual, meals throughout the day.

If you have chronic, prolonged or recurrent symptoms of hypoglycemia, here are some suggestions:

DO plan on having something to eat every two-and-a-half to three hours, for example: breakfast at 7:00am, a snack at about 10:00am, lunch at 1:00pm, a snack at 3:30 or 4:00pm, dinner at 6:30pm and a last snack at about 9:00pm (I'm using these times as a rough guideline. Your own preferences and needs will dictate when you eat.)

DO include a little fat, a little protein and, of course, carbohydrates at each meal and snack. You cannot afford to skip or even delay a meal or snack.

DO keep your portions small - you don't want to increase the number of calories/kilojoules you consume in a day.

DO aim at reducing, or (better still) eliminating, simple and refined carbohydrates like white flour, sugar, honey, all syrups - replace these with natural whole foods. Stick with low- and moderate GI foods.

DO increase your protein intake slightly, by using eggs, nuts, seeds, fish, beans and pulses.

DO avoid caffeine, alcohol and anything with high levels of potassium e.g. bananas (potassium lowers chromium and manganese). Avoid the sweetener 'stevia', too, because it has the potential to lower blood sugar and blood pressure.

DO (and I never thought I would say this!) increase your salt intake slightly. Salt slows insulin response so helps to diminish the rapid rise and fall of blood sugar levels. It also helps to raise blood pressure.

DO come back on Wednesday for some meal and snack suggestions.

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A portable lunch and home in time for dinner

Remember on Monday I said that hypoglycemia (low blood sugar) and hypotension (low blood pressure) have very similar presenting symptoms? So it makes sense to treat those symptoms in the same way - at least as far as eating goes. The suggestions I made on Tuesday are applicable treatments for both conditions. But then, those suggestions are good for anyone interested in healthy eating (apart from increasing salt and protein, of course. Most of us eat way too much of those.)

Yesterday I looked at on-the-run breakfasts, and today I'm going to dream up some no-fuss take-to-the-office lunches. A healthy, balanced dinner at home shouldn't ever present a problem - there are new recipes on this blog every week day, and past and current recipes are collected and categorised on my other blogs, listed on the right of this page.

I am a great fan of the soup-salad-sandwich lunch, whether I am at home or at the office. I'll start with soup.

You can make a rich, creamy tasting soup out of butternut or carrots (or both), which is delicious hot or cold.
Start with: 1 onion, peeled and quartered.
Add to this 1 medium butternut, peeled, deseeded and cut in chunks (or 5-6 large carrots, scrubbed and sliced).
Put the prepared veg in a saucepan and pour in about 750ml of chicken or veg stock .
Bring to the boil, then reduce the heat and simmer for about 30 mins.
Once the veg are soft, blitz the whole lot with a hand-blender, or in a liquidizer, until it is smooth.
Now you can add more water if you want a thinner soup.
Then add in whatever you like in the way of flavouring - 2 Tblsp curry paste, 2 Tblsp chopped coriander (cilantro) or 2 Tblsp of grated ginger root - and blitz again to disperse the herbs.
Pack into plastic containers (this freezes well, though you may want to blitz it again on thawing).
Serve with a dollop of fat free yoghurt, creme- or fromage fraiche.
I usually get 4-5 servings of about 350ml each out of one pot of soup.

Salads are a fabulous way of packing in all those vitamins and minerals. And 'salad' is very versatile - you can put in pretty much whatever you have. To most people a salad is rabbit food, but it doesn't have to be. I always start off with mixed lettuce leaves because I like lettuce, but you can add rocket; baby spinach; chopped fresh mint; chopped fresh basil; watercress; mustard cress; asparagus and alfalfa sprouts; and I'm still only on the green stuff. For colour and crunch there are: red, yellow and green bell peppers, red onion, radishes, olives, beetroot. For substance add: chickpeas, cannellini beans, broad beans. For extra protein add; hardboiled egg, feta cheese, nuts, pine nuts, seeds, smoked trout. For a sweet surprise add chopped apple, mango, pineapple, pear, grapes, cherry tomatoes, orange segments. No dressing required.
Or you could start with cooked rice or pasta and add any or all the above.
Lucky rabbits!

Sandwiches are versatile, too. You could pack the salad above between two slices of whole wheat bread, or in a bagel, or in a hollowed out whole wheat seed roll. Then there are the usual sandwich fillings; egg- chicken- or tuna mayonaise (use a low oil light mayo, and you don't need to butter the bread). Or choose a filling of cold meat, chicken or cheese.

Full yet? Don't get bogged down with eating the same lunch every day. Ring the changes with left-overs (which don't sound very appetizing after the soup-salad-sandwich combo above!) or look back at the breakfasts I suggested yesterday - many of those make a suitable lunch.

If you suffer with hypoglycemia or hypotension remember to split your meal between lunch and a snack.
And please, watch your portion sizes.

Breakfast and snack suggestions

 I have been talking specifically about alleviating hypoglycemic symptoms so far this week, but the meal and snack suggestions I'm making today are applicable to anyone wanting to improve their eating habits. If you suffer with hypoglycemia then save some of your breakfast for a snack later; but don't eat a piece of fruit on its own, the sugars are too quickly and easily digested so you need to have a couple of provitas or 1/2 slice of whole wheat bread and half a glass of skim mik as well.

A healthy breakfast
Breakfast really is the most important meal of the day, but we pay scant attention to it and just grab whatever comes to hand - a slice of toast, a bowl of cereal. Or nothing at all! You have been fasting all night, your blood sugar is low and you need a kick start before you can expect your body and brain to perform optimally. Many of us make the excuse that we 'don't have time' for breakfast. Make time. It's vital for your health. Ideally, breakfast should contain a little protein, a little fat and carbohydrates. Some ideas:

No time available?
A small carton of low-fat or fat-free yoghurt (fat and protein - even fat free has a trace of fat). Add to this one tablespoon of seeds - sunflower, pumpkin, linseed, sesame, flax, linseed, whatever (fat and protein) - and one tablespoon of bran (carbohydrate).

4 pro-vita biscuits (carbs) spread with one tablespoon low-fat or fat-free cottage cheese (fat and protein). Top with slices of cucumber or tomato (more carbs).

A smoothie: 1/2 cup of each of the following: frozen (or fresh) berries, yoghurt, milk, water. Whoosh together with a hand blender. Accompany with an English muffin or crumpet (whole wheat, of course).

A piece of fruit, a small piece of cheese and a slice of whole wheat bread or toast.

A little time available?
A piece of fruit, 1 egg (fat and protein), 1 slice wholewheat bread or toast.

40 - 50gm high bulk, high fibre cereal with 1/2 cup milk and 1/2 cup yoghurt. (I particularly like the Weigh Less Hi-Bulk Meusli. 50gms gives a respectable bowl-full).

2-3 Tablespoons baked beans on toast. Sprinkle with some grated cheese. Eat a piece of fruit or drink 1/2 glass pure unsweetened fruit juice.

No rush?
Cooked oats with 1/2 cup of chopped fruit (or 1 tablespoon raisins or cranberries) and 1 tablespoon cottage cheese, creme fraiche or yoghurt.

One egg omelette with a filling of 1 thin slice ham chopped or 1 tablespoon grated cheese, tomato, chopped mushrooms (quickly dry fry mushrooms and tomato before adding to the omelette). Serve with one slice of whole wheat toast.

A home-made pancake (use 1/2 nutty wheat flour, 1/2 cake flour, no sugar) filled with 1 cup chopped fruit of your choice, sprinkled with cinnamon, topped with a dollop of fromage frais.

Poached haddock or kipper with one slice whole wheat bread

See? It's not so difficult to come up with no-fuss, nutritious breakfasts, is it? Any of the No time breakfasts make easily portable, eat any time snacks, too.

Let's do lunch tomorrow.