Diets that perpetuate hypoglycemia (and accidents)

Beware of fluid imbalances from fasting, ketogenisis, and reactive hypoglycemia. I was commenting on it here, initially (but more than one diet is involved in the matter). Simply sipping a sports drink can prevent it, if you want to do an extreme diet otherwise (unless that involved a stack of pancakes).

Something to be aware of is that a ketogenic diet tends to cause hypoglycemia, and hypoglycemia tends to cause accidents.

"A high-fat, low-carbohydrate diet, often referred to as a ketogenic diet (KD), has been suggested to reduce frequency and severity of chronic pediatric and adult seizures. A hypoglycemic state, perpetuated by administration of a KD . . ." In other words, ketogenesis perpetuates hypoglycemia.

Low normal fasting glucose and risk of accidental death . . . hypoglycemia may contribute to automobile and motorcycle accidents, by ≥10%.

Sleep related collisions were strongly over-represented during the month of Ramadan (42%) . . . Ramadan involves fasting ("We now know that fasting results in ketogenesis") . . . There is an increase in accidents . . ., and accidental deaths associated with fasting . . .

"Hypoglycemia is a condition known to disrupt many everyday activities and is associated with increased risks of hospitalization, falls, motor vehicle accidents and mortality . . ."

"Cognitive impairment unattended by subjective symptoms or objective signs is an uncommon but important consequence of hypoglycaemia. It can lead to a condition in which a patient behaves as an automaton in a manner totally alien to their usual personality and of which they have no recollection when their blood glucose level is restored to normal. It can cause a wide range of criminal behaviour, although the commonest offences relate to a loss of control, for example driving offences . . . "

Cognitive cost as dynamic allocation of energetic resources . . . "Moderate hypoglycemia, such as that arising from fasting, can impair cognitive performance short-term verbal and spatial memory, and the speed of mental computation."

Sugar for the brain: the role of glucose in physiological and pathological brain function . . .
"Glucose metabolism is closely integrated with brain physiology and function."

Taking a vitamin or dietary supplement may be necessary, as well, to prevent the adverse effects of fasting or its mimickry: "The diet is directly connected not only with the physical status but also with the functioning of the brain and the mental status. The potentially beneficial nutrients with a protective effect on the nervous system function include amino acids (tryptophan, phenylalanine, tyrosine, taurine), glucose and vitamins C, E, D and beta-carotene, B group vitamins (vitamin B12, vitamin B6, vitamin B4, vitamin B1) and minerals (selenium, zinc, magnesium, sodium, iron, copper, manganese, iodine) . . ."

"Hypoglycemia can happen suddenly. It is usually mild and can be treated quickly and easily by eating or drinking a small amount of glucose-rich food. If left untreated, hypoglycemia can get worse and cause confusion, clumsiness, or fainting. Severe hypoglycemia can lead to seizures, coma, and even death... Signs include hunger, nervousness, shakiness, perspiration, dizziness or light-headedness, sleepiness, and confusion."

The reason that diets are especially dangerous (if they perpetuate hypoglycemia) is that when you become hypoglycemic too often, the warning signs may go away, but the risks will not. "Glycemic thresholds for symptoms of hypoglycemia shift to lower plasma glucose concentrations following recent episodes of hypoglycemia, leading to the syndrome of hypoglycemia unawareness--loss of the warning symptoms of developing hypoglycemia . . ."

"Whereas starvation hypoglycemia is frequently seen, so called reactive hypoglycemia is very rare . . ."

Too many carbohydrates at once can cause reactive hypoglycemia (sugar crash) . . .

By the way, foods such as oats and barley have a lower glycemic index than wheat, rice, and corn (muffins, pancakes, etc), unless you add a bunch of sugar (so you are less likely to encounter reactive hypoglycemia with those when moderately sweetened).

Anyway, I haven't reasearched every diet, so feel free to mention the hypoglycemic effects of others, etc. I'm not saying that these diets are necessarily harmful, if done in moderation (without inducing hypoglycemia, for instance). I think it is an underestimated problem, and hope this helps.

 

This isn't about one article, there are several medical studies correlating hypoglycemia with accidents. That was the point (it's another risk factor to be aware of, especially with imblanced diets, which these are by definition).

"One interpretation of these data is that children with ketotic hypoglycaemia have abbreviated fasting tolerance due to accelerated starvation. The declines in glucose production and amino acid concentrations and the activation of fatty acid oxidation and ketogenesis observed in these children may be perfectly normal, simply occurring earlier than they do in the majority of children. Similar accelerated starvation occurs in lean compared to obese individuals, in adult women compared to adult men, in children compared to adults, and in pregnant and lactating women compared to non‐pregnant women." Parsing ketotic hypoglycaemia...

Obese individuals are less likely to have that problem, but this isn't a certainty. People may respond differently to dietary imbalances on different days (with greater fluid loss due to sweating, etc), which is why fasting is traditionally a medically supervised diet. It doesn't have to be all or nothing though. A fluid fast can include sugar and salts (electrolytes), instead of just water, for example. Marathon runners have dropped dead over this kind of fluid imbalance (when drinking only water).

"There is clinical evidence to support the use of the ketogenic diet (KD) in diabetes, obesity, and endocrine disorders. KD is gaining interest but is to be performed under strict medical supervision of dieticians and physicians to be effective and may, therefore, require hospital settings for its initiation . . ."

 

The fact is that refined sugar is cleaner than unrefined sugar, or most foods otherwise (as far as foodborne pathogens or contaminants go—other plant foods like peanut butter, melons, and lettuce kill people with outbreaks of salmonella, listeria, etc., while sugar inhibits bacterial growth), and sugar is known to enhance sports performance, before, during, and after exercise. Sweetness and saltiness are basic tastes for a reason. Our fluid balance depends on getting sugar and salt on a regular basis (that's why sports drinks contain those; they work together to enhance hydration too, and are based on oral rehydration therapy, which was developed by doctors to prevent severe dehydration, or overhydration in sports).

Overeating anything can be bad, so you can't say it's all good. Too much water throws off the fluid balance (and too much salt at once is worse than sugar or water by far, but we still need it too). Hummingbirds, for example, are fed refined sugar nectar, and they use it more efficiently than people, but also drink more of it (several times their body weight) when they need to gain fat, in order to migrate thousands of miles. Nectar is a natural source of energy (and table sugar is the closest match to that, off the shelf). Our brains depend on sugar entirely to function, and our bodies obviously store its energy easily (so to say it is inherently harmful is like shooting the messenger, when the message is about people not exercising enough). Animals can get fat easily with things like sugar, because most can't stockpile enough to eat it every day. Then their weight balances out later, so it's feast and famine for them, and all feast for the fat people (no mystery there).

The anti-sugar news typically pertains to overeating (diabetic alternatives, etc). Similarly to how some foods are hyped over relatively rare allergies (like the gluten free craze). The world health organization mainly recommends limiting sugar in the diet to prevent tooth decay (yeah, well hummingbirds don't need teeth). I don't know why people go so far off the deep end with the other information, when medical studies speak for themselves (if you don't have a specific medical condition, it's better not to eliminate essential nutrients). If sugar were anything close to being as bad as a narcotic, it wouldn't be a staple food, which it pretty much is (because it is practically harmless as a nutrient, and actually necessary in one form or another). The body utilizes refined sugar easiest, so it can be easier on the body digestively, unless you eat a ton of the stuff! Well, obviously people did, and then they had to blame it on what they ate, but it was them (or gurus trying to sell everything as snake oil, including obscure diets, like the "snake diet", so of course they may try to villainize established dietary practices).

My point was that this shouldn't be an all or nothing discussion, though, because the body doesn't work that way... saying that sugar is bad, period, simply isn't true. I think it tastes good (which is a natural tendency, for survival), so it's beyond me why people want to hear the opposite. Well, I'd rather not become hypoglycemic and have a seizure over misinformation either. Maybe that's just me. However, I'd like anyone else to know, so they don't get in an accident. Even if you usually feel fine on an extreme diet, it couldn't hurt to take some sugar packets or a sports drink with you, in case you feel faint or something.

Personally, I was looking into this while trying out intermittent fasting (on my own time), and that's about the biggest thing there—maintaining a fluid balance, in order to avoid hypoglycemia, hyponatremia, hypokalemia, etc. (which could become a severe condition, like kidney failure, in the summer, especially, and refeeding syndrome with longer fasts). The increased potential for accidents while driving is an important risk to be aware of (I try to learn from the mistakes of others). Safety first... yeah, well that sounds like a good excuse for having sugar!

 

Reactive hypoglycemia is more of the truck stop dietary risk there. I once had a team driver passing out on me just after he ate. I no longer drive as a team.