How to maintain a balance
The ketogenic diet is popular among weight-watchers. The diet requires cutting back on all kinds of carbohydrates to divert the body’s energy fuel source from carbs to fats. This results in fat metabolism and ketone bodies’ production, which are used for carrying out different metabolic processes in the body.
Since the keto diet utilizes the stored fats as energy fuel, it effectively helps shed pounds on the weighing scale. The short-term benefits of the ketogenic diet are well recognized and appreciated. That is why the keto diet is often recommended for patients with type II diabetes, as it helps lower blood sugar and maintains the body’s insulin levels. The diet also helps such patients lose weight, which caters to better cardiovascular and general health overall.
But is a ketogenic diet safe for people who experience hypoglycemia?
The link between hypoglycemia and keto diet
The long-term effects of the keto diet are still under research. One of the side effects of the keto diet is hypoglycemia, that low blood sugar levels.
Since the body shifts its gear from consuming carbs to fats as an energy source, it is natural to expect a shift in blood sugar levels. The Keto diet brings the blood sugar levels down, leading to symptoms known as keto flu.
Keto flu occurs during the early days of starting the keto diet when the body is experiencing the transition from utilizing carbs to fats. It includes symptoms like
- Headache
- Sugar cravings
- Nausea
- Vomiting
- Constipation
- Diarrhea
- Irritability
- Weakness
- Muscle cramps
- Dizziness
- Poor concentration
- Stomach pain
- Muscle soreness
- Difficulty sleeping
Keto flu does not affect everyone on a keto diet. Some are fortunate enough to duck away these symptoms. It depends on how much carbohydrates you were taking before starting the diet. It is more of a withdrawal effect; the more refined and straightforward carbs you were taking before starting keto, the more severe the symptoms and vice versa.
However, keto flu should not deter you from reaping the benefits of a keto diet. The condition is usually over within a week. Other factors attributed to keto flu development include dehydration, loss of electrolytes, withdrawal of carbs, etc.
Low blood sugar or hypoglycemia is particularly of concern in patients with diabetes who take oral anti-diabetic drugs or are insulin therapy. If the medications are not adjusted, it can lead to a severe hypoglycemia. A study involving 11 adults with type 1 diabetes who followed a ketogenic diet for over two years reported that the median number of low blood sugar events was close to 1 per day. If persons suffering from type I diabetes cut back their carb intake without adjusting their insulin dose, they are at high risk of hypoglycemia.
The same goes for persons with type II diabetes.
Any effort on adopting a keto diet should be made in collaboration with their physician and dietitian.
If done correctly, the keto diet helps diabetic patients lose weight, reduce their drug doses and maintain healthy blood sugar and insulin levels.
Who else is more prone to hypoglycemia?
Hypoglycemia is not specific to diabetes. Some conditions make one prone to developing low blood sugar levels. These include:
Reactive hypoglycemia – It usually occurs after meal consumption owing to overproduction of insulin in individuals who:
- Have pre-diabetes or have a family history of diabetes
- Have undergone stomach surgery
- Have certain enzyme deficiencies that disturb their digestion
Non-reactive/fasting hypoglycemia – The underlying cause is usually another disease. For example;
- Disorders affecting liver, heart, or kidneys
- Medications like those used for kidney failure, aspirin, sulfa antibiotics, anti-malarial drugs like quinine
- Excessive alcohol consumption
- Eating disorders like anorexia
- Pregnancy
- Pancreatic tumor
- Hormonal deficiencies like those of cortisol, growth hormone, glucagon, or epinephrine
- Obesity
Precaution is advised in all such cases while adopting the keto diet because the transition from carbohydrates to fats may instigate low blood sugar levels. The importance of consulting a dietitian in all such cases cannot be emphasized enough if selecting a keto diet because you never know; a keto diet may not be for you!!
How to create a balanced blood sugar level in a ketogenic diet?
Hypoglycemia treatment usually involves consuming a well-balanced diet that includes low or no sugar, high protein, moderate fat, and complex carbohydrates.
Since the keto diet aims at removing carbs from your diet, it cannot be categorized as a balanced diet. So what you can do to create a balanced sugar level while keeping a keto diet. Here are some tips to follow:
Go from low carb to no carb
Make your transition from high carbohydrate intake to low, followed by no-carbs.
The most followed ketogenic protocol recommends an average of 70-80% fat, 5-10% carbohydrate, and 10-20% protein from total calories.
For a 2000-calorie diet, this transforms to about 165 grams fat, 40 grams carbohydrate, and 75 grams protein.
You see, a typical ketogenic diet reduces total carbohydrate intake to less than 50 grams a day up to 20 grams a day.
So if you have been consuming a typical high-carb diet, this transition would be a huge tax on your total calorie input and your blood sugar levels. This will make you more prone to falling prey to hypoglycemia. In fact, it is the contributing reason for keto flu and the number of people exiting the ketogenic schedule.
Experts suggest taking baby steps at a time. Cut back on your carbohydrate intake in small amounts days before you start the keto protocol. This would help your body adjust to transit from carbohydrates to fats in an effective manner. You will most likely face subtle or no keto flu symptoms when you embark on your keto drive. Why? Because your blood sugars will maintain themselves.
Do not restrict calories early
Another expert suggestion is not to restrict your total caloric intake. If you plan to do so, do it when you are well-adjusted to the diet protocol.
Taking total calories early and reducing them later on, would help you get over the weight plateau that often troubles the weight-watchers. It would also help your body adjust the sugar levels in the long run.
Personalize your carbohydrate intake
It is always advisable to personalize your carbohydrate intake by consulting with your health provider and dietitian. A low-carb diet may allow for 20% of carbs, while a keto diet may restrict it to 10% or even lower. Having a session with the experts would help you identify the best number of carbohydrates that work for you.
This is particularly important if you have diabetes or are taking prescription drugs for any other condition. It would also make room for the holiday season, traveling, or weekend outings with friends and family. You will be saved from the hassle of counting calories and keeping a check on your macromolecules. Personalizing your keto meals would give you peace of mind and ensure your safety by removing any risk of ow blood sugar levels at any time.
Go for high fiber carbohydrates
Refined and processed carbohydrate sources deliver empty calories, which do no good to your blood sugar levels. Replacing these items with nutrient-dense carbs will help fill your satiety levels and maintain the blood sugar levels as well. High fiber carbs will also help cut back your triglyceride levels, which often tend to go high with a keto diet.
Select high fiber carbs even if you are consuming as little as 10 grams of them. Plant-based foods usually contain more fiber. For example, there is a difference between eating an orange and drinking orange juice. The juice is devoid of much-required fibrous content.
Select high-quality proteins and fats
Not all fats and proteins are made equal. Go for nutrient-dense food items while selecting proteins and fats. Innovative cooking goes a long way while preserving the nutrient content of a food item. For example, grilled meat has more nutrients than fried ones.
Similarly, opting for mono-unsaturated and poly-unsaturated fats instead of saturated ones would keep a check on triglyceride levels and prevent sugar from hitting a low.
Avoid processed foods. Having an avocado or a bunch of whole nuts are far better choices than butter, nut butter, and nut milk, though you can take the latter if required.
Go easy on sweeteners
If you can, avoid sweeteners at all costs. They are known to increase your cravings for sugary foods. Low-calorie or zero-calorie sweeteners are available, but they are not preferred because they disturb your taste buds for the sweet sense.
Make use of glycemic index
Glycemic index is a measure of how much a food item will raise your body’s blood sugar level. Search the list of foods with their glycemic index. It is important to note that eating low glycemic index foods can raise your blood sugar levels if eaten in excessive amounts. So keep foods with a low glycemic index handy and consume them in fixed portions recommended by your dietitian. This should keep your blood sugars from plummeting too low or high.
Foods to maintain healthy blood sugar levels
Here are some food items recommended by registered dietitians and certified diabetes mentors:
- Quinoa
- 100% whole wheat bread
- Beans
- Lentils
- Oats
- Salmon
- Tuna
- Sardines
- Asparagus
- Berries
- Greek yogurt
- Spinach
- Broccoli
- Ground flax seeds
- Chia seeds
- Almonds
- Avocado
- Extra virgin olive oil
- Home-made peanut/almond butter
- Kale
- Cinnamon
- Green tea
- Zucchini
- Cauliflower
- Edamame
- Carrots
- Eggs
- Tomatoes
- Bell peppers
- Humus
- Tofu and Tempeh
- Sweet potatoes
- Pumpkin
- Bok choy
- Celery
- Dark chocolate (without added sugar)
- Bitter gourd
- Chickpeas
- Walnuts
- Home-made bone broth
- Wild rice, and so on
I hope this list will give you a jumpstart to your keto journey and prevent your blood sugar levels hit their low.
