Question:

Hi, I’d like to know some good ways to cut calories for people with low blood sugar issues (hypoglycemia). It can be hard to cut caloric intake with approaches like intermittent fasting and meal replacement shakes because that causes blood sugar levels to drop. So, I’d like to know the best way to obtain a calorie deficit when there are limitations like hypoglycemia in play. Thank you for your help!

– Michael B.

Answer:

When people experience hypoglycemia it’s usually as a drop after elevated blood sugar following a meal (called reactive hypoglycemia), rather than waking up with low blood sugar (fasting hypoglycemia). The best approach to restricting intake while avoiding a hypoglycemic event would be to modestly reduce intake throughout the day, particularly of refined carbohydrate. 

Retaining protein, fiber and fat at an eating session will help slow carbohydrate absorption and blunt the initial spike in blood sugar. The analogy I like to provide is to consider a roller coaster – the greater the incline/peak, the greater the fall. Fun for a ride, but disaster for blood sugar stability. Keeping blood sugar steady is the goal, so consuming foods that minimize a spike to begin with is part of the approach. Stick to complex carbohydrates from starches along with your protein foods, vegetables, fruit, dairy and nuts/seeds. 

Consider cutting down portions slightly at each meal and snack. You’ll hardly notice a difference in satiety from eating three-quarters of your normal volume. And leave the side of bread/rolls/tortillas, only eating those that are the main part of the entrée. For example, no garlic bread necessary if you’re eating pasta and skip the side of toast with your omelet and home fries.  

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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