Hi, I read with interest the recent post about possible hypoglycemia and it has prompted me to ask you all for some input on a recent problem I experienced. I have been a ‘vegetarian’ for 20 years. I eat fish, dairy, and eggs, but no other animal products. I am also hypoglycemic- have been for at least 15 years. Usually I control the hypoglycemia pretty well and I eat protein/carbs every 2-3 hours throughout the day. 2 days ago I had a frightening sugar crash. Dumb on my part, I did my morning workout, didn’t eat, took my son to the bus, then used a snow blower to plow out 2 driveways- when I finished I was very weak, got inside, blacked out, had very low pulse (under 30), no doubt low blood pressure, and even with food intake it took awhile to recover. Yes I saw my Doc asap, actually called her during the episode, and she confirmed that my low blood sugar triggered this. I am training for IM Wisconsin (my second IM) and will be training to race it which is going to require me to be much stronger than in '03 when my goal was to finish the IM. Is it possible for me to take care of all my nutritional needs required for this type of training by following a vegetarian diet? I have heard and read that you cannot get all the iron/protein needed for this level of competition without meat. I would like to learn more about this and have my own nutrition assessed to ensure that I am taking in what my body needs. I live in a small town in SW MI so resources aren’t too readily available so I am looking for any information/referrals to guide me toward help.
Chronic or acute low blood sugar is a complex situation caused by many different things and affected by countless others. I am not an expert here, and it sounds like you need one.
I can only dispute one thing. Your wrote : “I have heard and read that you cannot get all the iron/protein needed for this level of competition without meat.”. But earlier you wrote: “I eat fish, dairy, and eggs, but no other animal products.” You can get TONS of protein and iron from these sources and all the plant-based food products out there. Matter of fact, you can even overdose on protein from those sources alone, even for the level of training you are aiming for.
I was diagnosed with Hypoglycemia when I was 19, nearly 20 years ago and have dealt with it since with no drama. I was diagnosed after suffering bouts of dizziness and blackout during excersize, at first they gave me iron supplements then they found out I had Thalassemia which hit the nail on the head, waste of time for the iron. Apparently this is one of the major causes of low hemoglobin and low blood sugar disorder misdiagnosis around. People get prescribed iron supplements that do zip and cause side effects, one such problem is low blood sugar, ie: below 4 on the glycometer.
Anyway…
I am not what you call a “vegetarian” as I do eat small amounts of red meet however my diet is mainly fish and poultry mixed with lots of rice and vegetables. I will deliberately eat red meet before hard training weeks and before rest days. I am not a big dairy fan and dont eat many eggs, I love olive oils and fresh produce of any type and just about any mix as long as it is tasty. My diet would mostly be Mediterranean and Thai/Indian even when I’m in Malaysia.
Daily:
If I feel even slightly tired I test my blood sugar with my glycometer! Then vary my diet accordingly.
Vitamin C - helps with iron absorbtion from foods.
Vegetables or fruits with higher zinc and potassium, also plenty of greens and legumes.
Avoid: Drinks with Tanin but believe it or not alcohol does not seem to effect me, well from the low blood sugar provided I eat well.
During training: I eat banana bread and lots of breads with spreads like peanut butter and jam and drink plenty of fluids with them. Isotonic drinks can cause lows and make you feel worse, then I hit the coke.
Monthly:
Vitamin B supplimental injection, it is a mixed B group vitamin with something else. If I can find the full details I will post it. Iron injection, not sure dose or type just that it is to avoid cronic fatigue like symptoms and it seems to work.
May I suggest to eat a burger and a chocolate milk shake?
I didn’t think so!
Really, by eating fish and eggs, etc., I don’t see why you can’t get “enough” of the right kinds of protein to do an Ironman. If you eat enough fish, you might even swim faster. (I’m in quite a mood today, aren’t I?) Seriously, find those that have similar eating habits and requirements and that have successfully trained for this distance. I’m sure there are many. Good luck in your quest, Alison, I hope succeed beyond your wildest expectations!
Be sure not to skip your between meal snacks. Cheese and crakers, smoked salmon on a slice of rye bread, something like that. That will keep your blood sugar more constant. As for doing an Ironman–get yourself a blood sugar monitor. (They are relatively inexpensive to buy. The test strips are what runs into $. Ask your doc for a scrip for the test strips so you can charge them to your health plan if you’re covered.) Check your blood before, after and during your workouts. Log it and find out how much you need to take in per hour of exercise to stay between 80-120 MgDl. When you race, stick to your plan–don’t skip any food. Remeber, if you slow down to eat, you may lose some time, but if you bonk, you’ll definitely take yourself and maybe some others out.
I can’t figure out how hypoglycemia and vegearianism are related. I wouldn’t think that your level of protein consumption has anything to do with your blood sugar levels. Even if it did, you still eat fish and eggs so I would imagine that you get enough protein (assuming you eat these regularly).
How are your electrolyte levels? I just figured out, after 6 months of ALWAYS getting dizzy when I stood up, that if I take one electrolyte tablet in the morning (and of course drink lots of water) that I don’t get dizzy anymore. I tried everything before I thought of this, and nothing worked. I even passed out once and spent a few hours in the ER hooked up to an EKG. I never eat fast food and I think my healthy diet was just far too low in electrolytes.
The hypoglycemia and vegetarianism are related more or less by the fact that in order to keep the blood sugar level stable I need to eat protein with every meal snack, etc… which makes me wonder if I am getting the quality of protein I need in order to keep everything in balance. I’m not sure about my electrolyte levels, and have been thinking I should get them checked, so you raise a good point for me to further explore-- I wonder if I had consumed Gatorade that morning instead of water if the whole event might have been prevented? Of course, same could be said if I had taken the time to eat also!
How does protein intake affect blood sugar levels? I wouldn’t think it would be related. Just curious.
For what it’s worth, I stopped drinking all Gatorade-type drinks and only drinking water and diet soda. This probably had something to do with my low electrolyte levels.
My understanding of it is that protein is processed more slowly than carbs so when my insulin finally kicks in there isn’t such a dramatic drop in the overall blood sugar. What happens with hypoglycemia is that there is a delay in the insulin being relased into the system-- by the time it kicks in the blood sugar levels are already lowering so instead of returning the level back to normal the insulin drops it too low. The goal is to prevent the blood sugar levels from dropping too far so staying away from sugary stuff and eating protein can help with that. I suppose the low carb diet would be good for someone with this condition but not for triathletes who need thier carbs!
Usually I control the hypoglycemia pretty well and I eat protein/carbs every 2-3 hours throughout the day.
Hey Alison, even if you weren’t hypoglycemic, it’s a good idea to eat often & in a balanced way. I’m no expert and I’m not HG to my knowledge, but I need to munch much more often than that to stay alert & energetic. Every 30min - hour sounds more reasonable. But that takes a lot of planning of course - or really well stocked cupboards, drawers & pockets!
Is it possible for me to take care of all my nutritional needs required for this type of training by following a vegetarian diet? I have heard and read that you cannot get all the iron/protein needed for this level of competition without meat.
That’s a bunch of hogwash. Even for strict vegans and especially for a pesco-vegetarian like you. The only issue for IM competition & training IMO will be to maintain a diet that’s dense enough in calories. (I am assuming you have you micronutrient needs addressed by eating lots of fruits, veges, legumes, nuts & whole grains). It’s just about how much food you choose from each food group.
Wow, every 30-60 minutes? Now that would be a challenge for me-- I have a hard time eating every 3 hours, beleive it or not I don’t have that great of an appetite. A typical day for me?? Something like this:
5am Carnatation Instant breakfast (as of Friday I have done this) pre- workout
8am breakfast Kashi cereal, yogurt, fruit
10am nuts/cottage cheese
12noon sandwich whole grain, hummus, lettuce, tomato, cheese, a fruit
3pm crackers/ PB
6pm dinner fish, rice, vegie, fruit
9pm snack yogurt
I am in the process of locating a RD- have 2 that I sent e-mails to this am, hopefully they can help me fine tune this
In my post the other day, I said as a joke that I need a book like this. But then I found out that there really is such a book. I’m going to buy it from Amazon and maybe in a couple of weeks let you all know how it it.
By the way, my doc told me that protein smoothes out the body’s absorbtion of carbs. That prevents the peaking and crashing of blood sugar levels caused by carbs. These crashes are what defines hypoglycemia.
BTW, do you notice that caffene and alcohol mess you up at all? I end up with headaches from both. Is this hypoglycemia related?
That’s a tough one if appetite is a problem for you… Hmmm how to stimulate appetite? A start may be to split some of your snacks into two and eat them slightly spaced apart. At least that way it’s no extra food prep.
Your diet looks good from what I can tell. It may not help with the HG but, I’d try substituting something like Finn Crisp, Ryvita or some whole grain, transfat free crisp bread for that cracker. Avoid the white rice even though the protein smooths out the sugar spike. Throw some nut in that Kashi to supplement the protein in the yogurt. And spinach for lettuce, even if it’s romaine, but especially if it’s iceberg.
Despite what all the others are telling you, it does make a difference that you don’t eat meat or chicken. While you can get lots of protein from other sources, like beans for example, the protein that controls glucose for the longest period is red meat.
In terms of how well and how long they control blood sugar levels, the best protein is red meat. Next is chicken/turkey. Next is fish. Next is dairy. And the weakest is vegetable protein.
The strange thing is that I knew all of this from experience before I ever heard it from a nutritionist. If I had a peanut butter sandwich for lunch, I’d have a headache in the afternoon. If I had a tuna sandwich, I wouldn’t. I just had no clue as to why this was.
My understanding of it is that protein is processed more slowly than carbs so when my insulin finally kicks in there isn’t such a dramatic drop in the overall blood sugar. What happens with hypoglycemia is that there is a delay in the insulin being relased into the system-- by the time it kicks in the blood sugar levels are already lowering so instead of returning the level back to normal the insulin drops it too low. The goal is to prevent the blood sugar levels from dropping too far so staying away from sugary stuff and eating protein can help with that. I suppose the low carb diet would be good for someone with this condition but not for triathletes who need thier carbs!
Ok, I’ll bite:
gatstric emptying is higly affected by the composition and caloric density of your meal. Carbs empty fastest, fat and protein more slowly.
When carbs ONLY (think Gatorade, white rice, …) enter your bloodstream, your insulin will rise dramatically. One reason is to remove glucose from your bloodstream as quickly as possible because a) there’s probably a need for it somewhere, b) elevated glucose levels have corrosive effect in your cardiovascular system (which is why diabetics have problems in body parts w/ small blood vessels - fingers, toes, eyes, kidneys).
The problems is that sometimes, the spike of glucose isn’t perfectly matched to the ingested glucose, likely b/c the human body wasn’t made to eat high-fructose corn syrup, or pure sucrose/maltodextrin. So more insulin than necessary is released, and you end up w/ lower glucose levels than you originally had - and crash. Eating a mixed meal has two effects on that:
gastric emptying is slowed, hence not all glucose enters the bloodstream at the same time.
a ‘diluted’ meal (not 100% carbs) blunts the insulin response somewhat.
So if anything, your insulin is working too hard for the amount of carbs you have enter your bloodstream. Staying away from ‘sugary stuff’ is certainly not a bad idea since different all-carb foods will raist your insulin levels to different heights (google ‘glycemic index’ for this).
But what your dietician is likely going to do first is to see whether your caloric expenditure matches your intake. More likely than not, you just need to eat more. From what I know, being a vegetarian (fish or no fish is not much of a problem.
let me know if you have more questions, but looks like people have just about covered it.
is not much of a problem.