Positive Health Online

Blood sugar

Fluctuations in blood sugar can cause:

• cravings
• water retention
• excess thirst
• mood swings

Moods can swing from euphoric to unhappy; angry to couldn't care less; irritable and anxious to bored and tired. The positive moods can be as dangerous as the negative, because you are likely to swing rapidly from one extreme of mood to the other. You must take control of those highs and lows because the associated food cravings can undermine your efforts to change your eating patterns.

Perhaps you know that you are only overcome by cravings for sweet things at pre-menstrual times. If so, this chapter will later explain how blood sugar levels are connected with our hormones.

Nutrition and blood sugar

Nutrition is the key to stabilising the levels of blood sugar. After a meal, glucose from the breakdown of food (digestion) is absorbed through the wall of the intestine into the bloodstream. At this point, there is, quite naturally, a high level of glucose in the blood. The body takes what it immediately needs for energy and then produces insulin from the pancreas in an attempt to lower the level of excess glucose. Any glucose that is not used immediately for energy is changed into glycogen and stored in the liver and muscles to be used later. The glucose level in the blood then reduces to normal.

How do we maintain glucose levels?

To maintain this balance in our blood sugar the body works in a similar way to the thermostat on a central heating system. Our natural 'thermostat' clicks into action as glucose levels rise and fall.

The body takes action in the following ways:

When the glucose levels fall too low
The hormone adrenaline is released from the adrenal glands and glucagon is produced from the pancreas. Glucagon works in the opposite way to insulin and increases blood glucose by encouraging the liver to turn some of its glycogen stores into glucose to give us quick energy. If the blood glucose level stays low for a period of time hypoglycaemia – low blood sugar level – can occur.

Symptoms include: irritability, aggressive outbursts, palpitations, forgetfulness, lack of sex drive, crying spells, dizziness, anxiety, confusion, forgetfulness, inability to concentrate, fatigue, insomnia, headaches, muscle cramps, excess sweating and excessive thirst.

Sounds familiar? Chances are that if you have a history of dieting then some or many of those symptoms are known to you. In themselves they can be burdensome, but more importantly they are the outward manifestations that your body is having trouble maintaining a good blood sugar level. They can certainly undermine the efforts of many dieters by triggering unhealthy eating which contributes to weight gain.

When the glucose level rises too high
Insulin is produced by the pancreas to lower it. If the blood sugar level remains too high, this causes the symptoms of hyperglycaemia – high blood sugar level. The extreme form of this is diabetes which is a medical condition needing expert attention often entailing regular insulin injections. Weight cycling – weight gain, loss then gain – may make you more prone to diabetes. Obese people have a 77 times higher chance of developing diabetes than a person at their correct weight – the greater your weight the higher the risk of developing diabetes.

During a normal day, the amount by which your blood sugar level rises and falls depends on what and when we eat:

What we eat or drink

When we eat any food in refined form its digestion is very fast. Refined foods have been stripped of their natural goodness by various manufacturing processes. Two of the most widely used refined foods are sugar and white flour. When digestion is too fast glucose enters the bloodstream too rapidly. This also happens when you eat any food or drink that causes a stimulant effect, like tea, coffee, sugar and chocolate. This sharp, fast rise in blood glucose makes you feel momentarily good but the 'high' quickly passes plummeting you to a low point, making you feel tired and drained. So what do you need? Another stimulant like a bar of chocolate or cup of coffee (or both!) to give you another boost.

The second boost will cause the blood sugar level to go up rapidly again and the vicious cycle is repeated. As blood sugar levels go up and down so too do our eating patterns with cravings for sweet foods and drinks.

Over time, this constant over-stimulation exhausts the pancreas. Then, instead of too much insulin, it produces too little. Too much glucose stays in the blood, causing the symptoms of high blood sugar levels.

You are advised to eat natural wholefoods which are unrefined and full of goodness. Their merits in terms of helping to maintain balanced blood sugar levels are discussed later in this chapter.

When we eat or drink

If there is a long gap between eating the blood glucose will drop to quite a low level and you will feel the need for a quick boost, say a cup of tea and a biscuit. At the same time, the adrenal glands will make the liver produce more glucose. The combination of these two acts causes high levels of glucose in the blood which again calls on the pancreas to over-produce insulin in order to reduce the glucose levels. The vicious cycle starts all over again and the adrenal glands become ever more exhausted.

To solve this problem try
• Grazing – develop a 'grazing' mentality to your eating patterns thus eating little but often. Leave behind the dieting philosophy of no food between meals.
• Avoid skipped meals – maybe you thought that if you ate less by missing meals you would lose weight but the resultant swings in blood sugar are setting you up to fail. They create a biological urge that must be satisfied and you shouldn't ignore your body's demands even if you were strong enough.

Make it easy for yourself. If you stop what is causing the biological urge then you won't be constantly at war with your own body.

Effects of adrenaline

If blood sugar levels are frequently low and our system is regularly being asked to pump out adrenaline then our health will suffer. Adrenaline is the hormone most of us associate with stress – it is released for 'fight or flight' and its effect is very powerful. If you were threatened in the street, for example, or face any kind of physical danger your survival mechanisms would instantly step into action with the adrenal glands immediately producing large amounts of adrenaline.

The effects of adrenaline are
* heart speeds up
* arteries tighten to raise blood pressure – hence a 'beating' heart
* liver immediately releases emergency stores of glucose to give energy
* digestion stops because it is not necessary for immediate survival
* clotting ability of the blood is increased in case of injury.

This all means that you have been made ready to run faster, fight back and generally react more quickly than normal. Unfortunately, when your blood sugar level drops during the day or night, adrenaline is released automatically and the body experiences all the above sensations except that there is no outside stress to respond to. When this happens repeatedly, you can experience all the health problems outlined under the hypoglycaemia section earlier in this chapter. It can also contribute to heart disease by increasing the risk of blood clotting and higher blood pressure and the sudden release of glucose for energy can cause extreme fluctuations of sugar levels in the blood.

These fluctuations in blood sugar create an internal stress which the body then has to deal with. It causes an increase in sodium retention causing a bloated feeling from excess water. The digestive system will not function efficiently and less stomach acid will be produced which means that more food will actually be stored because it has not been digested sufficiently. The longer food stays in the intestines and remains undigested, the more calories are likely to be absorbed. It is therefore important that food is moved quickly out of the intestines.

Cravings and Binges – What's the difference?

Cravings
Most dieters experience cravings to a lesser or greater degree. With some it is for chocolate, with others it is for biscuits and cakes. Certainly it is for sweet foods that most people crave although some dieters crave fats – especially cream and hard cheese. Others, who don't usually have a drink problem, can find themselves craving a glass of alcohol. The sugar cravings are caused by the fluctuating blood sugar levels that we've just looked at. The other cravings could be caused by a food allergy or perhaps a yeast problem.

By and large you can control your own cravings, even those linked to the hormonal ups and downs of the menstrual cycle. It might be hard at first but by following the rules in this chapter you will find that with the passing of each successful day it will get easier and eventually the cravings will cease.

Binges
Binges can signal a more serious problem. Giving in to a craving and eating a bar of chocolate or several biscuits is not bingeing. A binge is eating for eating's sake, almost uncontrollably and even when you aren't hungry. Binge-ers have been known to grab at food with their hands rather than waste time with a knife and fork. There is a desperation about binge-ers who often binge in response to an emotional upset. Eating non-stop until you've finished a family-sized tub of ice cream, or a complete gateau, for example, is bingeing. So too is eating to the point of being sick. This is a long way from the normal cravings that most dieters experience.

Binge-ers will often feel physically and mentally ill after they've binged and it can be associated with psychological illnesses, like bulimia.

If you know that you binge, it is advisable to see your GP.

How can highs and lows be prevented?

There are three good ways:

1. Eat complex carbohydrates regularly
2. Avoid refined foods, especially sugar
3. Reduce foods and drinks that are stimulants

1. Eat complex carbohydrates regularly

To maintain well-balanced blood sugar levels eat foods such as complex carbohydrates that give a slow rise in blood sugar and keep a constant level for about three hours. Then eat again and prevent the level from dropping. Spacing food at three-hourly intervals in this way is a proven solution to the battle with cravings.

Dr Katharina Dalton, a pioneer in the recognition and treatment of pre-menstrual syndrome (PMS), has found that the symptoms of PMS can be relieved by eating regularly. This stops the blood sugar level from dropping and adrenaline from being released. While Dr. Dalton's findings have proved invaluable for PMS sufferers it serves to confirm the general theory that actually applies to all of us, including men.

Complex carbohydrates give a slow release of energy because it takes time for the digestive tract to break them down into simpler substances that the body can use. Carbohydrates are a large group of foods that includes sugars and starches. They are an important source of energy and the body breaks them down into the simple sugar, glucose. It is the slow speed with which this happens that is important to keeping blood sugar constant.

There are two types of carbohydrates:

Complex

• Grains (wheat, rye, oats, rice, barley, maize)
• Beans (lentils, kidney, chickpeas, aduki etc)
• Vegetables, including potatoes
• Fibre in grains, beans and vegetables

Simple

• Fruit
• Honey
• White and brown sugar
• Glucose in high-energy drinks

To help maintain a steady blood sugar level, aim to eat complex carbohydrates as part of your main meals and also as snacks during the day.

You do not necessarily need to eat great amounts – sometimes just an oat cake can be enough between meals to keep eating urges at bay.

If you find the symptoms associated with low blood sugar levels are greatest first thing in the morning or, you wake during the night, heart pounding and cannot get back to sleep, then it is very likely that your blood sugar level has dropped overnight and adrenaline has kicked into play. Eating a small, starchy snack, like an oat cake, one hour before going to bed and if possible, one hour after getting up, will help to alleviate these symptoms.

Make sure your complex carbohydrates are unrefined, which in general means choosing brown instead of white. For example, wholewheat bread, brown rice and wholemeal flour as opposed to the white versions which have been refined and therefore stripped of essential vitamins, minerals, trace elements and valuable fibre content. In order to digest these refined foods your body has to use its own vitamins and minerals, so depleting your own stores.

Fibre
It was originally thought that fibre's role was only to speed up the passage of food residues to prevent constipation. It is now known that some forms of fibre can actually slow down the absorption of sugars and help to maintain our blood sugar balance. Without fibre, food will affect the blood sugar level more quickly and it is harder to eliminate the food residues. The food stays in the body longer, which means that it absorbs more calories so preventing you from shedding those pounds.

Cravings and food allergies
If you experience cravings it's likely to be an indication that you suffer from blood sugar imbalance. They may also be symptoms of a food allergy, so this is worth checking. Ironically, if we are allergic to a particular food, we tend to crave it and eat it more. Ask yourself the question: "Which foods or drinks would I find it hard to give up?" The answer will give you a clue as to what to look out for.

Shirley had been experiencing bad PMT symptoms and throughout the month would feel extremely hungry by about 5pm even though dinner was not until 6pm. We talked about her pattern of eating and she said that she was drinking up to eight mugs of tea a day. I explained the effects of drinks like tea and coffee on blood sugar balance and their link to PMT symptoms and advised her to gradually wean herself off drinks containing caffeine. Unfortunately, Shirley decided to cut out the eight mugs of tea straight away and rang me a couple of days later complaining of a bad headache and flu-like symptoms. Cutting caffeine out of your regime really must be done over a few days and it is best to begin by having half your drinks caffeinated and half de-caffeinated. Then over the next few days reduce the amount of caffeinated cups even further. Eventually you should cut out the de-caffeinated coffee because it still contains stimulants despite the absence of caffeine.

Gradually introduce herb, fruit or grain tea so that you are still drinking the same amount of liquid. Once Shirley had taken the advised course of action it took her just a few days to feel a lot better. By the time I saw her two cycles later she was eating little and often and this pattern of eating had really helped with the PMT symptoms.

2. Avoid refined foods, especially sugar

The simple carbohydrates (with the exception of fruit) are all refined foods and should be avoided. Although fruit contains fructose (fruit sugar) which is a simple sugar, the fibre content of the fruit is a complex carbohydrate which slows the digestion rate. So fructose is acceptable when taken in the whole fruit, like an apple, but not when used in the refined form of powered white fructose, which is bought in boxes.

Pure fruit juice can also cause a rapid change in blood sugar levels because it is not buffered by the fibre that is normally present. It is better to dilute fruit juice in water to make it less concentrated.

Sugar sneaks unexpectedly into many foods. By the way, the brown-is-best theory doesn't apply to sugar, all colours do the same damage to your blood sugar balance! A can of cola may contain up to eight teaspoons of sugar as may a pot of fruit yogurt. Most of the convenience foods and drinks we buy are laden with sugar including savoury foods such as baked beans and mayonnaise. Did you know that tomato ketchup has just 8% less sugar, weight for weight, than ice cream and that the cream substitute for coffee is 65% sugar compared to 51% for a chocolate bar?

Sugar is an inexpensive bulking agent. Even some toothpastes contain sugar but as toothpaste is not a food, sugar does have to be included on the ingredients list.

When sugar is in its natural form – the whole sugar cane – it is fine to eat. It has all the right amounts of fibre and is a wholefood. When it is refined sugar is just 'empty' calories – it contains no nutritional value so you can stop eating it and lose nothing but weight.

You may be tempted to substitute sugar with artificial sweetners – DON'T! You are simply introducing an alien chemical which the body then has to deal with. Nobody really knows what havoc these chemicals can cause when introduced to the body's own delicately balanced biochemistry.

If a food or drink is described as 'low sugar' or 'diet' it will usually contain a chemical sweetner. These are also found in some non-diet crisps, ice lollies, sauces, pot noodles and some over-the-counter medicines. It's worth checking labels carefully.

3. Reduce foods and drinks that are stimulants

Sugar, smoking, caffeine in tea, coffee, chocolate and caffeinated soft drinks are all stimulants and cause a fast rise in blood sugar level followed by a quick drop which contributes to the roller-coaster ride of blood sugar swings. Avoid them whenever possible, even better, cut them out of your diet completely. Substitute them for example with herbal teas, grain coffee, spring water and diluted fruit juices.

• Extracted with permission from Natural Alternatives to Dieting by Marilyn Glenville, Ph.D. Kyle Cathie Ltd, 1999. £9.99. Tel: 0171-840 8789.