Keeping the weakness, shaking, and headaches a bay requires eating more often than you might normally, which can make losing weight an uphill battle.
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"That must suck!" one of my college classmates exclaimed when I explained to her why I had to bring my dinner to the gym and eat it right afterward on the subway. The hour-long subway ride would mean my blood sugar would crash. And by then, I'd learned the hard way that low blood sugar was to be avoided at all costs. Otherwise, I'd be stuck with a shattering migraine and intense nausea that would put me out of commission for the rest of the night.
It did suck. And it still does. Back then, my classmate also caught on to one thing no one ever tells you about having low blood sugar. "It must be impossible to lose weight," she said sympathetically. Not that I needed to at the time, but I couldn't help but agree.
Every time I try to tone up or lose a couple of post-holiday pounds, hypoglycemia (low blood sugar) makes it even more difficult. Whether I make an effort to eat a little less or exercise more, I end up getting shaky, clammy, and cold, with an intense fogginess that makes my head feel like it's going to explode. The remedy is to eat something that will bring my blood sugar back up, even if I'm not hungry.
If you want to lose weight or be healthier, but have experienced the low-blood-sugar roadblocks, here are some tips on how I've made it work. (It's important to note that if you have diabetes, or haven't consulted with your doctor about these kinds of symptoms, do that first and foremost, as suggestions for dietary changes will be different for everyone.)
Eat every three to four hours.
Having something to eat every three to four hours keeps your blood sugar level on an even keel. Just make sure you keep those meals well balanced. If you just have carbohydrates, like a bowl of cereal or pasta with tomato sauce, your blood sugar will go up and trigger a release of more insulin. While insulin is responsible for helping to break down glucose (blood sugar) to be used or stored as energy, too much can trigger a steep drop post-spike. Avoid this by balancing whole-grain carbs with protein and fat, which are digested and absorbed by the body more slowly.
And surprisingly enough, eating frequently can also be helpful for weight loss. Knowing that you're never too far away from your next meal or snack prevents you from getting to that hangry place where you'll eat the first thing you see.
Include protein, fat, and fiber every time.
Whether it's a meal or a snack, the components matter. Protein, fat, and fiber all slow down the rise in your blood sugar after you eat. This is important because while having hypoglycemia can mean you are at dangerously low blood sugar levels between meals, reactive hypoglycemia (that spike and dip) is what happens directly after you eat something. Including foods that have protein, fat, and fiber (what I call the "magic 3") can prevent this from happening.
Not only do "the magic 3" stabilize blood sugar levels, these nutrients keep you feeling full longer than if you were to just load up on carbs. Protein-rich foods take more energy to burn than other foods, and fat and fiber slow down the rate that food empties out of your stomach. The result? You burn more calories and feel satisfied with less, both of which are important if weight loss is your goal.
For protein, you could have foods such as chicken, fish, meat, eggs, tofu, beans, lentils, cheese, Greek yogurt, or cottage cheese. Fiber-rich foods include whole grains, vegetables, fruits, beans, lentils, and nuts and seeds. For your fat, choose a healthy fat such as olive oil, avocado, or nuts and seeds. (Notice a reoccurrence? Yep, nuts and seeds have all three—protein, fat, and fiber—so they make the perfect snack.)
Choose slow-digesting carbs.
Keeping some carbohydrates in your diet is important for maintaining healthy blood sugar levels, but choosing the right carbs is crucial. Not all carbs are created equal. Those carbs with a high glycemic index (a measurement of how quickly and how high a food raises your blood sugar) will digest much faster than slow carbs, or those with lower GI level. In this case, slow and low are best. Eating foods low on the glycemic index has been shown to help control blood sugar levels, while foods on the higher end of the GI spectrum will cause that spike and drop immediately after eating. Avoiding blood sugar crashes will also help you manage your weight because you'll be less hungry and will, therefore, be able to deal with cravings more effectively. Bonus: Many lower-GI foods also tend to be high in fiber.
If you're thinking about following a low-carb diet to avoid a blood sugar roller coaster, keep in mind that this hasn't been proven as an effective treatment for reactive hypoglycemia. A certain percentage of fat and protein can be turned into glucose (sugar), but that process isn't very efficient. So if you experience a hypoglycemic episode, carbohydrates are what's going to make you feel better.
Limit carbs to ~30 grams per meal.
While following a low-carb diet isn't recommended for people with hypoglycemia, keeping carbs consistent and moderate may be beneficial. One study found that eating six small meals per day, each with about 30 grams of carbohydrates, was effective for reducing hypoglycemic symptoms. Eating a consistent amount of carbohydrates every few hours keeps your blood sugar steady, especially when you focus on foods rich in fiber and low on the glycemic index.
When you cut back slightly on carbohydrates to stay at about 30 grams per meal, replacing those calories with sources of protein can help maintain the calories you need to fuel your body and recover from workouts. Protein and fat have much less of an effect on blood sugar and insulin levels than carbohydrates, so remembering that balanced plate of macros will keep blood sugar levels normal and help you lose weight. (However, you don't need to count calories to see success.)
This moderate-carb approach can help with portion control, which can get out of hand when grains are involved. Getting fewer calories from carbs and more from filling protein and heart-healthy fats can help you drop some extra weight and maintain that weight loss without ever feeling deprived. (This way of eating is the foundation of diets such as Whole30 and Paleo.)
Never leave home without a snack.
I always have a bag of raw almonds in every purse, my glove compartment, and gym bag so I'm never stuck being starving with low blood sugar if say, restaurant reservations get pushed back or I have to run some errands after the gym. Carrying snacks is not just a great way to prevent low blood sugar when your day doesn't go as planned or you need a boost before a fitness class, but it's also key to helping you lose weight. Hunger is your enemy when it comes to weight loss, so having healthy snack options on hand can help you avoid having to grab something less than ideal when you're starving. Experiment with having a snack with slow carbs, protein, fat, and fiber two hours or so before your workout. (Related: The Best Pre- and Post-Workout Snacks for Every Workout)
Eat as soon as possible after a workout.
As I learned in college, you need to eat pretty much right after you exercise to avoid blood sugar drops. This is the time it's okay—even beneficial—to have fast-burning carbs like white rice or potatoes. These faster-burning carbs will bring your blood sugar back up quickly, but they should always be paired with some protein to help rebuild your muscles. Liquids are absorbed faster than solids, so having a protein shake with a banana is a great choice. You can follow up with a proper meal in an hour or two.
Many of my clients who are trying to lose weight think they can avoid eating back the calories they burned after exercise by skipping a meal post-workout. But ultimately, they end up eating more later on because they let themselves get too hungry (not to mention the trouble they cause by not refueling their muscles for recovery). That's why having a healthy high-protein snack post-workout is a good idea—it can help keep your eating on track so you don't end up overdoing it at the next meal.