Budd Maggie - Eat to beat low blood sugar: the nutritional plan to overcome hypoglycaemia, with 60 recipes

I AM VERY pleased to have the opportunity of introducing this book which I know will be a source of help to a great many people. I have had the privilege of working in close collaboration with Martin Budd at the Basingstoke Clinic over the past twenty years and we have shared in the often demanding task of treating and supporting perhaps a thousand victims of what Mr Budd appropriately called the 20th century epidemic. His experience in the field of Functional hypoglycaemia makes this latest book, written jointly with Maggie Budd, clinically authoritative. The many recipes, which have been formulated to provide the increased protein/ carbohydrate ratio fundamental to successful treatment, will give real practical help.

We have never been fully aware just why hypoglycaemia became such a neglected clinical backwater. Be that as it may, the publication of Mr Budds first book in 1981 brought a steady flow of letters from patients throughout the UK complaining of a wide range of symptoms which the author had described as low blood sugar syndrome. Regrettably, the majority of these patients had been unable to obtain the help they sought. Although seminars were organised by The Basingstoke Clinic, there are still not enough practitioners experienced in the diagnosis and treatment of functional hypoglycaemia.

This book will therefore fill a need, both in providing self-help to patients in suitable cases, and in drawing attention to a neglected area of clinical practice.

Keith Lamont
Basingstoke, Hants

Note: In December 1984 The Basingstoke Clinic came under new management and the original team became dispersed.

Low Blood Sugar

M OST OF US have experienced symptoms of hypoglycaemia or low blood sugar. These may include weakness, tremors, dizziness, palpitations, anxiety and hunger. The commonest triggers for these unpleasant symptoms are stress or sudden shock, unaccustomed exercise, a missed or delayed meal, excessive coffee or alcohol intake, and in women, the 4-5 day premenstrual effect. Frequently there exists a combination of 2 or more of these factors.

Although a sudden fall in the blood sugar can be responsible for some of the above symptoms, the more unpleasant acute symptoms associated with low blood sugar are in fact caused partly by the release into the blood of the hormone adrenalin. This hormone, which is released by the paired adrenal glands situated over each kidney, serves to convert into glucose the carbohydrate reserves held in the liver, and known as glycogen. In this way undesirably low levels of glucose in the blood are quickly corrected. Although this adrenal compensation is triggered when the blood glucose is too low, the same response can occur when the blood glucose level falls too quickly.

Adrenalin is also released to help the body combat stress. In addition to the blood sugar surge, this hormone increases the heart rate and raises the blood pressure. The rate of respiration is also increased; in fact the whole metabolism is revved-up. This has been termed the flight or fight response, and can be compared to pulling out the choke on a car, causing an increase in available fuel and accelerating the engine.

The hunger experienced with low blood sugar is usually expressed as a sugar craving (particularly pre-menstrually), and all the symptoms rapidly improve after taking sugar in food or drink. If the various components of the sugar-regulation system are working efficiently our body chemistry is rapidly normalised. This phenomenon is known as transient hypoglycaemia, and such infrequent and temporary slumps in the blood sugar level do not normally require special diets or treatment.

Unfortunately there are those who suffer a more chronic, severe and reoccuring form of low blood sugar, known as functional hypoglycaemia. This condition was first described in the late 1920s by an American doctor named Seale Harris. His contemporaries Banting and Best had recently discovered and refined the hormone insulin for the treatment of diabetes. Insulin-dependent diabetics can occasionally overdose on insulin, causing a sudden undesirable fall in the blood sugar. This was termed a hypo effect, and caused symptoms including faintness, dizziness, anxiety and if severe, a temporary collapse and unconsciousness.

Dr Harris observed that several of his non-diabetic patients were experiencing very similar symptoms to patients attending the new diabetic clinics. This led him to conclude that if non-diabetics were suffering hypos (or insulin shock), then perhaps there existed a medical condition that was opposite in character to high blood sugar in diabetes. He called this new condition hyperinsulinism, (excess insulin in the blood), and assumed that just as diabetics suffer an insulin deficiency resulting in high blood sugar, there are those who suffer an excess causing low blood sugar. Although high and low blood sugar appear to be opposite conditions, they are both caused by defective or inefficient blood sugar regulation.

Dr Harris stated that an overworked pancreas could be the cause of hyperinsulinism and this condition could in many cases precede diabetes. Overactivity of the bodys systems and organs with subsequent exhaustion and inefficiency is a common pattern in disease. As this type of low blood sugar is caused by faulty function and not by damage or disease, it is now known as functional hypoglycaemia. The term hyperinsulinism has been reserved to describe the more serious organic problems that cause excessive insulin production.

Apart from functional hypoglycaemia and hypoglycaemia of diabetes, there are other types of hypoglycaemia, termed Organic. These are caused by a variety of diseases including pancreatic tumours, liver disease and other fairly obscure glandular disorders. This more serious side of low blood sugar highlights the need for accurate diagnosis and effective treatment. Surgery may be essential for the relief of these non-functional types of hypoglycaemia.

Together with starches and fibre, sugar is one of the three main carbohydrates in food. It is the bodys chief fuel and an important source of energy.

Chemically speaking, carbohydrates are made up of units called monosaccharides. These units can exist by themselves, in pairs (disaccharides), or in long chains (polysaccharides). Monosaccharides and disaccharides are called simple sugars, while polysaccharides, which include starches and cellulose (fibre), are called complex carbohydrates. The commonest simple sugars are glucose (blood sugar, and also found in fruit and honey), fructose (fruit sugar), galactose (found in milk), sucrose (table sugar), lactose (found in milk), and maltose (found in malted barley).

All sugars and starches are broken down during digestion to form the monosaccharide glucose, used for energy. Any spare sugar is converted into glycogen, a polysaccharide stored in the liver and muscle tissues. Glycogen in the liver is stored ready for conversion back to glucose as needed. However the muscle glycogen cannot be sent to the blood to be turned into glucose. It is only available as a fuel for the muscle tissue. When the liver and muscle tissues reach saturation, any surplus carbohydrate not required for immediate energy needs is converted into fat and stored in the fatty tissue. When the livers glycogen stores are depleted, the body uses protein from food or muscle tissue as a secondary source of energy and converts it into glucose.

If we eat unrefined complex carbohydrates such as brown rice, pulses, wholemeal bread and pasta the conversion of these large long chain polysaccharides to glucose in the blood is gradual, and our tissues and blood contain only enough sugar for normal functional requirements.