Elite Fitness, Whole Foods, Low Blood Sugars and Crashes

Hi tudiabetes Community,

It's been awhile since I've had any questions but I'm having some troubles managing my blood sugars these days.

I'm very active in bicycle racing and recently we moved to a more wholesome diet of 6 ingredients or less within reason. If things are natural or organic but have more ingredients that's fine. You just have to be able to recognize the things you are eating are not genetically modified.

I'm now having trouble going all out for longer than 45 min. without my BG dropping like a rock. I can't figure out what to eat to help sustain the maximum effort required. Eating during some races is not an option as the race is only 30-45min long in the case of a criterium at maximum effort. Taking my hands of the bike to open a gel pack can have disastrous consequences. Any ideas on what food can maintain the steady burn without being too "engineered"???

It's painful falling to the back because of a low and I'm trying to find new ways to sustain my BG momentum.

I'm willing to try anything.


What if you set up a helmet as a modified drinking hat? (Sorry, I don't know what they're called, but they have a place to put soda cans and straws attached so you can drink without touching anything.) You can fill it with watered down organic juice and sip it so you can keep yourself steady.

Alternatively, you can get a Camelbak backpack and do the same, but I don't know how easy those are to wash after use and you might not want to use juice in there for that reason.

Hi Mike, maybe a little more information on the macro content of your meals and meal plan as well as your insulin regime prerace??

You basically have two polar extremes to consider. You can go with more of a traditional approach to athletic nutrition and keep your carb and protein content relatively high compared to your fat intake. This should keep your muscle glycogen content high enough to get you through the typical criterion race and the associated training necessary to go at that pace for up to 2 hours. Sounds like you're bonking due to low BG though. That may have more to do with your BG levels prior to race time and your basal and bolus doses leading up to the race.

You could also go low enough carb and high enough protein and fat to go with a ketogenic diet which a lot of endurance athletes seem to be having a lot of success with these days. It will cost you some top end/max heart rate performance but the low to upper midrange performance seems to be unaffected.

Either way, we could use a little mroe info.

FHS Summarizes it well. In fact, ketogenic might be the more viable approach. In a ketogenic state, you have much more sustainable energy and a better chance of minimizing BG swings compared to trying to ingest the right amount of fast acting carbs at the right time. I just read a great book on this topic: The Art and Science of Low Carbohydrate Performance Paperback by Jeff S. Volek, Stephen D. Phinney. You can find it on Amazon here: http://www.amazon.com/The-Art-Science-Carbohydrate-Performance/dp/0983490716/ref=sr_1_1?ie=UTF8&qid=1401221782&sr=8-1&keywords=the+art+of+low+carbohydrate+performance

He will have to be careful in his choice though. Sounds like he's training for both short distance criterions and, maybe, some longer distance road races?

I'm not sure of his training regime, but if he goes low-carb and ketogenic, he may, or may not, be able to avoid the BG drops, but chances are his short distance max effort criterion performance will suffer. His BG may not drop as dramatically, but if he's ketogenic, his power output will most likely experience a drop-off.

His issue may just require a basal/bolus adjustment. Just need more info.

Thanks everyone! If you have any more ideas, please send my way! I'll do some investigating here.

Steve Phinney argues that once you adapt to low card (over a couple weeks) you actually get back to the same performance you had with a high carb diet except you totally eliminate the bonk from depleted glycogen. Here is a good interview discussion on the topic.

I have no problem being the lab rat, I think I'll have to give this a shot!

Like I've said a few times now, Phinney's latest studies simply do not address the difference between aerobic and anaerobic performance adequately enough for him to make any substantiated claims regarding purported benefits to maximum effort athletics.

He's claiming that a ketogenic diet gives you better access to a larger pool of fat reserves to fuel aerobic performance, which is true. He does not deny that a ketogenic diet sacrifices your store of gycogen. He does not deny that maximum performance can only be fueled by this smaller store of glycogen.

He tries to claim that, instead, a ketogenic diet results in a more "efficient" use of these limited stores of glycogen. However, he has no evidence for this beyond anectdotal. Which is too bad, because he has literally no experimental evidence to justify the 180 degree turn from his earlier paper that pretty much kills any notion that a ketogenic diet can do anything for aerobic performance.


Therapeutic use of ketogenic diets should not require constraint of most forms of physical labor or recreational activity, with the one caveat that anaerobic (ie, weight lifting or sprint) performance is limited by the low muscle glycogen levels induced by a ketogenic diet, and this would strongly discourage its use under most conditions of competitive athletics.

I've posted this link a couple of times now as well.


Here's the summary...

Take away?

1-It takes several weeks at the minimum to adapt to a ketogenic diet.

2-Aerobic capacity is the same on a ketogenic or mixed diet (no better, no worse).

3-Anaeroblic power output from the glycolytic pathway is crushed by a ketogenic protocol.

I think it's worth taking a look at, but just be aware of the limitations. You'll have to decide for yourself if it's working for you or not based on your own performance requirements.

Again, just for completeness, I'd love to see your pre-race insulin regime. If it's just your tendency to go hypo that's holding you back on your shorter races, you may not have to adjust your diet at all.

There are three main ways to manage blood sugar levels:

1) Diet, limiting your carb intake to no more than 4 15 g portions per meal,

2) Exercise, doing some sort of activity (walking, biking, aerobics, etc...) for 15 minutes within two hours after eating. If the patient is insulin dependent and their blood sugar is above 200 mg/dl they should check for ketones before exercising.

3) Medication and insulin, the patient should make sure they are using the proper dosage to keep blood sugars under 180 and above 70 mg/dl.

I recently read a fascinating book on ketogenic diets for endurance athletes and how a high-fat, low carb diet can provide you with long-term energy without crashing.

It's called "The Art and Science of Low Carbohydrate Performance" by Jeff Volek and Stephen Phinney. Available on Amazon Kindle.

You have to monitor your blood glucose level in your blood, and see that the glucose level is within the normal range. Normally, people with Diabetes are advised to eat 6 small portions of meal a day, so that the Glucose level in the blood does not fluctuate too much.

I'm intrigued by your focus on "natural" and "organic" and "not genetically modified." I hope you're injecting animal insulin, because you know modern insulins like Lantus, Humalog, and Novolog are all recombinant DNA genetically modified, so if you think eating this sort of stuff is bad for you, imagine the consequences of injecting it!

Sorry to be a bit flip, but the whole organic thing drives me crazy--the same substance can often be produced via organic and synthetic laboratory methods. People seem to have this image of organic farming as just involving water and sunlight and manure, but "organic" pesticides are widely used and sometimes have more significant environmental and health implications, because the synthetic ones were developed to reduce those impacts. The GMO thing is potentially more complicated, but I for one am thankful for the GMO insulins that help me stay healthier!