What is the best diet for hypoglycemia?

Various diets have been proposed for hypoglycemia over the years. The earliest treatment was a high-protein, high-fat diet with a minimum of carbohydrates, in the belief that all carbohydrates stimulated the pancreas to produce insulin. Such diets had mixed results and are certainly not healthy in the long run. They have largely been abandoned but variations still exist, such as the Atkins diet and more recently Barry Sears’ “zone” diet which involves a 30/30/40 ratio between protein, fat and carbohydrate.

The prominent American nutritionist Paavo Aerola started a change in thinking about hypoglycemia treatment in the 1970s when he advocated a largely vegetarian diet with an emphasis on complex carbohydrates. Aerola’s diet was popular for many years and very successful. However, it relies heavily on dairy products for protein – which doesn’t suit everyone.

More recently, a concept known as the “glycemic index” of foods has been developed. The glycemic index represents the amount by which a food raises the blood sugar level, with glucose having an index of 100. It is interesting that foods such as white bread can raise the blood sugar almost as much as ordinary white sugar, whereas as whole-grain breads cause a much slower rise in blood sugar.

I have proved this myself – before I knew anything about glycemic indexes. When I was experimenting with the high-carbohydrate, low-fat diets I often had a white bread roll with a small amount of low-fat cheese (no butter) and salad for lunch. I would always get a headache during the afternoon following such lunches but I persisted because I thought it was a “healthy” low-fat meal and it had no-sugar.

Occasionally, I would have a thick cheese sandwich on wholemeal bread (with butter) and a glass of milk – supposedly a very bad meal from the low-fat viewpoint. But I felt great during the afternoon after such a lunch. Fats such as butter and cheese can be useful in controlling low blood sugar because they slow down the absorption of carbohydrate. Of course, that is not a licence to eat a lot of fat – nor a lot of anything, for that matter.

A huge meal, even if it contains no sugar, can raise the blood sugar more than a candy bar. Getting back to the glycemic index, it can be confusing sometimes because different studies give different indexes for the same foods. For example, some studies have found potatoes to have a high glycemic index (making them unadvisable for people with hypoglycemia) while others recommended potatoes as one of the best foods for keeping blood sugar stable!

Fruit is another controversial food in relation to hypoglycemia. Some experts advocate eating fruit because its sugars (mainly fructose) are “natural” and thus don’t affect the hypoglycemic like refined sugar does. Others find better results by avoiding fruit, at least in the initial stages of treatment. I found fruit often affected me adversely, particularly sweet fruit likes bananas, grapes or water melon.


To sell diet book today, you need to come up with something even more outrageous than the previous best-selling diet book. That’s why we have such extreme views on diet being promoted by best-selling authors. If you wrote a book advocating a good old-fashioned balanced diet, with three meals a day of protein, fats and carbohydrates, hardly anyone would buy the book. People are always looking for some new, cutting edge theory on diet.

This is because most of us eat unbalanced diets. We just don’t want to admit it. So we look for any theory to help us get well, lose weight or whatever else we want from our diet – while ignoring the obvious truth that is staring us in the face.

So I’m going to advocate a good old-fashioned balanced diet. This is so rare in a diet book today, that it almost does qualify as being something new!

You do need to avoid sugar initially

Okay, now down to the nitty gritty. In addition to a balanced diet, you do need to avoid sugar in all its forms, for the first few weeks of your recovery from hypoglycemia.

And if you’re like most hypoglycemics, this will prove very difficult. Because you’re addicted to sugar. Yes, it’s an addiction that very difficult to break. You need to make a decision. Do you want to keep on over-eating of sugary foods – or do you want to get well?

Assuming you really do want to get well, then you need to start looking at your diet for everything that contains sugar – in all its forms. This means not just sugar, but everything that contains sugar. I’m not going to go into a tedious list of everything that contains sugar, just to fill up more space in this book. Just use your common sense. And read labels. You know what contains sugar without me having to tell you!

Fruit contains simple sugars and can adversely affect many hypoglycemics

If you find you’re not getting better after eliminating all other sugars, try cutting out fruit for a while – especially sweet fruit like bananas. You may find if you eat fruit on its own, between meals, you get hypoglycaemic symptoms afterwards. But if you eat fruit as part of a balanced meal, you are fine. (I’ll explain this later.)

I have experimented with different diets to see which has the most beneficial effects on my blood sugar levels. I have found the best results with a diet based on complex carbohydrates and adequate protein, with a certain amount of fat to slow down the impact of the carbohydrates on my blood sugar. Fat is usually regarded as the main villain by modern diet writers but a certain amount of fat is essential, particularly if you suffer from low blood sugar.

In fact, many people develop low blood sugar by following the popular high-carbohydrate, low-fat diet theories to extreme. They think fruit is a “good” food and eat lots of it while avoiding foods like eggs, cheese and whole milk. But they could be better off avoiding fruit if they are hypgolycemic and eating eggs for breakfast.

Eggs are a particularly valuable food. They help build up the adrenal glands – a vital factor in recovery from hypoglycemia. Of course, they contain cholesterol and should be eaten in moderation. But one or two eggs a day will not harm most people’s cholesterol levels and, in fact, there is growing evidence that sugar is much more harmful in raising cholesterol than foods such as eggs, dairy products or meat.

Many experts on hypoglycemia advocate six small meals a day rather than three meals. It used to be almost universally accepted that frequent, small meals was best. But some writers on the subject have recently challenged this belief. The problem with eating six or more meals a day is that it can easily lead to over-eating – something that can adversely affect hypoglycemics because the body is flooded with extra sugar which it doesn’t need.

In the early stages, you might find you need a snack between meals to alleviate extreme symptoms of low blood sugar. However, I believe it is best to establish the habit of eating three balanced meals a day and perhaps one regular snack. Having said that, you shouldn’t allow more than five or six hours between meals or you will start to experience hypoglycemic symptoms. Eating breakfast at about 7.30am, lunch about 12.30pm and dinner about 6pm should be fine for most people, without the need for too many snacks. But if a meal is late, for some reason, then it’s best to have a snack (but not a sweet snack!).

I always have a snack about 4pm in the afternoon – usually a cup of tea and piece of toast with butter. It keeps me going until dinner time.

Eating snacks can also be detrimental if you have a problem with addictive eating or a tendency to binge on sweet foods which many people with hypoglycemia do, in a desperate attempt to make themselves feel better. By eating three balanced meals a day, you have the best chance to keep your blood sugar stable and avoid destructive sweet snacks.

So what is a ‘balanced diet?

A balanced meal should contain some protein and complex carbohydrate plus a moderate amount of fat. A good breakfast is one or two eggs on one or two slices of buttered wholegrain toast; or unsweetened porridge or cereal plus one or two pieces of buttered toast.

Lunch could be sandwiches with wholegrain bread and butter plus a filling of salad vegetables and a small amount of cheese, meat, chicken or fish; or it could be a more substantial meal of meat or fish with cooked vegetables, potatoes, pasta or rice. Forget dessert and, until you feel better, avoid even fruit at the end of the meal initially.

If dinner is the main meal of the day, there is an endless variety of suitable foods, according to your taste. The main principle is to eat protein, complex carbohydrates and vegetables, and avoid refined sugar in any form.

If you really need to finish with something sweet, try a small home-made muffin, biscuit or piece of cake, made with just a small amount of sugar and have only a small helping! You’ll need to experiment to see how much sugar you can tolerate.

Eating sugar as part of a meal has less effect on blood sugar levels than eating a sweet snack on its own. That’s another good reason for eating just three meals a day. It is important not to over-eat because that overworks the liver, which plays a vital role in keeping blood sugar stable. An overworked liver is the cause of much hypoglycemia and it takes time for a damaged liver to restore itself.

So don’t set back your progress by over-eating. Listen to your body and stop when you feel comfortably full. If you are not eating sugar, you are less likely to overeat because most over-eating tends to be of sugary, fatty foods.

It usually takes at least a month to recover from hypoglycemia by following a balanced diet. Some people start feeling better after a week or two, while others who have been sick a long time might find they need three months or more to really start feeling the benefits. Initially, you will almost certainly feel intense cravings for something sweet and may be tempted to lapse.

If you are hypoglycemic, you are essentially addicted to sugar and you are fighting something which can be as difficult as an addiction to cigarettes or alcohol. If you do slip, pick yourself up and start again. The first week or two is the hardest in starting a low-sugar diet that’s when the cravings will be at their most intense. Eating even a small amount of something sweet can actually trigger a full-blown binge because of the way your body reacts to sugar.

Don’t despair. You may have to pick yourself up many times before you can stick to a balanced diet. It just proves that you have been over-dependent on sugar for too long and that you must break the addiction before you can ever expect to enjoy good health again.

Keep that as your motivation when the sugar cravings come. Tell yourself: “I might feel bad now but I’ll be ten times worse if I binge”.

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