41：赛季中期能量补给：反应性低血糖详解

本期节目由我的一对一营养指导项目赞助播出。

This episode is brought to you by my one on one nutrition coaching program.

如果你训练很努力，但仍在为营养问题而纠结，如果你总是感到饥饿、精力不足，或者想知道为什么训练没有带来你想要的结果，你并不孤单。

If you're training hard but still second guessing your nutrition, if you're hungry all the time, running low on energy, or wondering why your training isn't translating into the results you want, you're not alone.

这正是我创建一对一营养指导项目的原因。

And that's exactly why I created my one on one nutrition coaching program.

我们与耐力运动员合作，他们渴望清晰，厌倦了凭感觉或靠搜索来安排饮食。

We work with endurance athletes who are looking for clarity, who are tired of winging it or googling their way through fueling.

你想要变得更精瘦，但又不想牺牲能量或表现。

You want to get leaner without tanking your energy or performance.

你想要保持力量，训练顺利，身体感觉良好。

You want to keep your strength, train well, and feel good in your body.

通过我们的个性化营养计划和直接的一对一支持，我们帮助你更明智地饮食，控制食欲，全天精力充沛，并让你的营养计划可持续。

Through our personalized nutrition plan with direct one on one support, we help you feel smarter, get that appetite under control, feel more energized throughout the day, and make your nutrition sustainable.

这不是关于限制性节食。

This isn't about restrictive dieting.

这是关于建立一套适合你和你独特生活及目标的方法。

It's about building something that works for you and your unique life and goals.

我们与各个级别的耐力运动员合作。

We work with all levels of endurance athletes.

这个项目是为真实运动员和真实生活设计的。

This program is designed for real athletes with real lives.

请访问alexlarsonnutrition.com或查看节目说明中的链接获取更多信息。

Head to alexlarsonnutrition.com or grab the link in the show notes for more information.

我是亚历克斯·拉尔森，注册营养师，铁人三项完赛者，也是《耐力饮食》的主持人。

I'm Alex Larson, dietitian, Ironman finisher, and host of Endurance Eats.

这个播客会分解耐力营养的科学，并将其转化为实用的营养建议，彻底改变你对身体供能的看法。

The podcast where we break down the science of endurance nutrition and turn it into practical nutrition advice to revolutionize how you think about fueling your body.

所以，找个座位坐下，或者如果你在外面训练就继续动起来，让我们开始吧。

So grab a seat or keep moving if you're out training and let's get started.

欢迎回到《耐力饮食》的季中燃料特别集。

Welcome back to another mid season fuel episode of Endurance Eats.

前几天我在一个铁人三项的Facebook群里看到一位运动员提了个问题。

I saw an athlete post a question the other day in a triathlon Facebook group.

他们没让我做这个，但我觉得这个话题很适合在像这样的节目里聊一聊。

They didn't ask me to do this, but I thought this is a really good topic to cover in an episode like this.

他们问的是反应性低血糖。

They asked about reactive hypoglycemia.

这种情况比较少见。

This is fairly rare.

大约有8%的运动员会经历，但作为一个营养迷，我觉得这超级有趣，我想多聊聊这个话题，以及运动员如何预防它发生。

It's about eight percent of athletes who experience it but as a nutrition nerd, I think it's super interesting and I want to talk about it more and how athletes can prevent it from happening.

什么是反应性低血糖？

What's reactive hypoglycemia?

嗯，就是吃完东西后血糖突然下降。

Well, it's a sudden drop in blood sugar after eating.

通常是在吃完饭后四小时内，但对运动员来说，通常发生在运动开始后的十到三十分钟内，而且会有症状。

Usually within like four hours of eating, but for athletes, it typically happens in the first ten to thirty minutes of exercise and it's symptomatic.

运动员会感到极度虚弱，可能还会恶心和头晕。

Athletes will feel intense weakness, maybe some nausea and dizziness.

不好受吧？

Not fun, right?

但为什么会这样呢？

But why is this happening?

运动员在锻炼前通常会摄入大量碳水化合物，我们身体的自然反应是血糖升高，这样身体就能利用这些糖分作为能量。

So an athlete eats before the workout usually a good amount of carbs and our body's natural response in an increase in blood sugar is we'll see a rise so that our body can use that sugar as energy.

然而，当我们开始运动时，血液中的胰岛素仍然很高，不仅胰岛素帮助降低血糖水平，肌肉也会开始吸收葡萄糖来利用这些能量。

However, when we start exercising and that insulin is still high in the bloodstream, not only do we have insulin helping lower blood sugar levels, but our muscles are also going to start pulling in glucose to use this energy.

这两者结合起来，会迅速使血糖水平降得太低，导致低血糖发作。

And the combination of both of those together can quickly drop those blood sugar levels too low and causing that hypoglycemia episode.

一旦发生这种情况，身体会自我调节，但需要一些时间才能感觉好转。

Once this happens, the body will regulate itself, but it takes some time until you feel better.

所以你最终还得再难受个十分钟左右，那感觉可不好。

So you end up kind of suffering for, you know, another ten minutes and it's not pleasant.

所以我想聊聊一些具体的方法，如果你是运动员，有这种反应性低血糖的情况，可以试试这些方法，来预防这种情况发生。

So I want to talk through some tangible things to test out if you are an athlete that experiences this reactive hypoglycemia so that we can prevent this from happening.

我不会同时尝试所有这些不同的策略。

I wouldn't do all of these different strategies all at the same time.

我会在单独的情况下有策略地测试它们。

I would test them out strategically in an individual situation.

等你都试过之后，如果对你有用，就可以考虑同时采用多种方法。

Once you've tested them all out, then you could move to incorporating multiple at a time if it makes sense for you.

第一个策略主要是关于训练前补充能量的时机。

The first strategies involved are gonna be more about timing of your pre workout fueling.

如果你在训练前20到60分钟吃了东西，然后在训练早期就感到能量骤降，

So if you're consuming your pre workout fuel in that like twenty to sixty minutes before, and you're noticing that energy crash earlier on in the workout.

我会建议你试试在训练开始前更近的时间吃点零食，最多提前5到10分钟。

I would experiment with a snack closer to the start of the workout, like five to ten minutes at most.

这些零食最好是容易消化的碳水化合物，以免在训练中出现肠胃问题。

You're going want them to be fairly easy to digest carbs just to prevent any like GI issues during the workout.

你甚至可以在热身的时候摄入碳水化合物。

You could even take carbs in during your warmup.

这样做的原理是，你在胰岛素还没起作用之前就摄入了碳水并开始运动，这样你的肌肉就会开始吸收那些葡萄糖。

And the rationale here is that you're consuming the carbs and starting your exercise before insulin has kicked in and your muscles will start soaking up that glucose.

因为在运动时，我们的身体会做一件非常酷的事情。

Because during exercise, our body does this really cool thing.

这叫做胰岛素非依赖性葡萄糖摄取。

It's called insulin independent glucose uptake.

听起来很专业，但简单来说，就是我们的肌肉和脂肪细胞可以在不需要胰岛素的情况下从血液中吸收葡萄糖。

Fancy word, but basically it's where our muscles and fat cells can take in glucose from the blood without needing insulin.

当我听到有些运动员担心摄入太多糖分，担心运动时会产生很大的胰岛素反应时，实际上胰岛素反应非常小，这真的很酷。

When I hear about athletes that are worried about taking in all the sugar and having this big insulin response during their workout, there's actually a very minimal insulin response, which is really cool.

这种补充策略实际上得到了多项研究试验的支持，对运动员来说是一个非常实用的解决方案。

This top off strategy is actually supported in like multiple research trials, it's a very practical fix for athletes.

我想尝试的第二个实验是，在运动前大约60到90分钟或更早摄入你的运动前补给。

The second experiment I would try would be to consume your pre workout fuel more like sixty to ninety plus minutes before the workout.

这样，当你开始运动时，你的胰岛素和血糖已经回落到基线水平了。

That way, your insulin and glucose has already gone back down to baseline when you start exercise.

这更适合那些在上午晚些时候或一天中较晚时间锻炼的人，他们会有那种运动前的餐食。

This would be more for people that work out later in the morning later on in the day that would have kind of that pre workout meal.

而且以后，你可能会尝试这两种策略的组合：在运动前90分钟到2小时吃一顿运动前的餐，然后在开始前5到10分钟用一些容易消化的碳水化合物来补充能量。

And also later on, would probably experiment with both of these tactics where you could do a pre workout meal, you know, ninety minutes to two hours before the workout, and then you'd top yourself off with some easy to digest carbs like that five to ten minutes before you start.

第三个实验是，在开始运动时就摄入运动补给。

Experiment number three would be to start consuming your sports fuel right as you're starting the workout.

就像我提到的热身，但你的补给从第一分钟就开始了。

Like I mentioned that warm up, but like your fueling routine starts at minute one.

我自己实际上就是这么做的，不是为了预防反应性低血糖，而是为了提前补充能量。

And I do that actually myself not to prevent reactive hypoglycemia, but just to get ahead of my fueling.

对于那些受反应性低血糖困扰的人，这可以保持血糖稳定，防止它在运动开始后的10到30分钟内下降。

People who struggle with that reactive hypoglycemia, this would be a way to just keep that blood sugar steady and prevent it from dropping in that kind of ten to thirty minutes right away in that exercise.

接下来的一系列策略，我们更关注你实际吃的东西。

The next set of tactics, we're looking more at what you're actually eating.

我们可以做的是更有策略地调整一些碳水化合物的摄入，换成升糖指数更低一些的食物。

What we could do is seem a little bit more strategic with swapping out some of your carbs to something that's a little bit more of a lower glycemic index.

升糖指数是一个从1到100的评分标准。

Now glycemic index, it's a scale of one to 100.

它给食物打分。

It rates foods.

数值越高，食物让血糖升得越快。

The higher the number, the faster the food will raise your blood sugar.

比如运动补给，它们的升糖指数就很高，因为目的是让能量快速进入血液，为运动供能。

Sports fuels, for example, would have a very high number because the objective of them is to get that energy to your bloodstream quickly and fuel that workout.

不过运动前，我们可以考虑选择像燕麦加香蕉，或者吐司配果酱和花生酱这样的食物。

Before workouts though, we could look at choosing something like oatmeal with a banana, a toast with some jam and peanut butter.

虽然花生酱含有一些糖，但它主要成分是脂肪和蛋白质，显然不会让血糖升太多，但把高升糖指数的食物和含蛋白质、脂肪的食物搭配在一起，会减缓血糖上升的速度。

Even though peanut butter, while it has some sugar in it, it's mainly like a fat and some protein as of I mean, obviously, it's not gonna raise your blood sugar much, but pairing some foods that have a higher glycemic index with things that have protein and fat will lower how quickly your blood sugar is raised.

这样消化就会慢一些。

So they get digested slower.

血糖生成指数不是我最喜欢看的指标，因为当你混合不同食物时，它会变得非常复杂。

Glycemic index isn't my favorite thing to look at because it gets really complicated when you're mixing in different foods.

我当然会尽量避免在运动前那三十分钟里吃那些高糖食物。

I certainly would try to avoid some of those sugar bombs in that thirty minute pre workout window.

如果你想吃那些高糖食物，我会建议搭配一些蛋白质。

If you're going to include some of those sugar bombs, I would pair it with some protein.

我自己确实发现，尤其是早上刚醒来，如果我要和朋友去跑个三十分钟的步，我会在出门前吃一包苹果酱之类的东西。

I certainly find for myself, especially right away in the morning, if I wake up and go for, let's say, a thirty minute run with a friend, I will have an applesauce pouch or something like that before I head out the door.

我有时会搭配半根奶酪棒，这样能摄入一点蛋白质和脂肪，避免早上只吃碳水导致血糖迅速飙升。

I sometimes will pair it with like half of cheese stick just to get a little bit of protein and fat in with that so I don't get that like rush of a blood sugar spike right away in the morning if I were just to have carbs.

我确实看到很多有反应性低血糖的运动员在谈论增加蛋白质摄入。

I do see a lot of athletes who have reactive hypoglycemia talk about really increasing their protein intake.

他们总是说蛋白质、蛋白质、蛋白质，他们害怕碳水化合物。

They're like protein, protein, protein, they're afraid of carbs.

我觉得你不需要害怕碳水化合物。

I don't think you need to be afraid of carbs.

我觉得你只需要在时间安排上讲究策略，确保自己不是能量不足的运动员。

I think you just need to be strategic with timing and making sure that you're not an under fueled athlete.

当然，我认为我们可以实现血糖缓慢上升，但我也要非常小心，以免在运动过程中增加肠胃问题的风险。

Certainly, I think that we can achieve that slower rise in blood sugars, but I would just be really careful also so that we don't increase your risk for GI issues during that exercise.

如果有一位运动员因为反应性低血糖来找我，我也会看看他们的整体营养摄入。

If I were to have an athlete start working with me who has reactive hypoglycemia episodes, I would also just look at their general nutrition intake.

如果他们长期能量摄入不足，这肯定是问题的一部分。

If they are someone that is chronically under fueled, this is certainly something that can be part of the puzzle.

而且可能会发展到这样的地步：我们可以考虑使用连续血糖监测仪，或者做一些指尖采血来测试血糖，以便获得一些客观数据，因为可能不一定是他们的血糖在下降，而只是他们经历了那种血糖快速波动的症状。

And it may get to be a situation where we could look at using a continuous glucose monitor or just getting some finger sticks done to test blood sugars just to provide us some objective data because it might necessarily not be that their blood sugar is dropping, but they might just be experiencing those symptoms of that kind of rapid swing of their blood sugar.

这就是我倾向于的。

That's what I tend.

如果我感觉到任何这类症状，通常就是那样，不一定是低血糖，但如果这也是一个非常慢性的问题，并且有一些非常严重的发作，我会强烈建议那位运动员去他们的初级保健医生那里进行医学评估，以排除一些与营养时机和他们吃的食物无关的其他问题。

If I feel any of those kinds of symptoms, it's usually that, it's not necessarily a low, but if it's also a very chronic issue and there are some very severe episodes, I would highly recommend that that athlete get a medical evaluation with their primary care provider just to rule out some things outside of like the nutrient timing and the foods that they're eating.

这就结束了本期赛季中期的燃料节目，我们稍微深入探讨了反应性低血糖。

That wraps up this mid season fuel episode, taking just a little dive into that reactive hypoglycemia.

如果你在锻炼初期会遇到这种崩溃感，我希望这能让你明白，你并没有问题，也没有做错什么。

If you're someone who deals with these early workout crashes, I hope this gives you a sense of clarity and relief that you're not broken, you're not doing anything wrong.

你的身体只是在应对时机、胰岛素和碳水选择，这些都是完全可以调整的。

Your body is just responding to timing, insulin, and carb choices in a way that you can absolutely troubleshoot.

试试我今天提到的几个补给实验吧。

Try a few of these fueling experiments that I talked about today.

给自己一些时间来调整。

Give yourself some time to dial it in.

这些小小的改变，能让你在锻炼的前二十分钟到半小时里，感觉更稳定、更强壮、更有能力。

These small changes can make a massive difference in how steady, strong, and capable that you feel in those first twenty to thirty minutes of your workout.

如果你需要更多支持，随时可以联系我。

And if you want more support, feel free to reach out.

节目说明里会有链接，告诉你如何与我的营养师教练团队合作。

There's gonna be a link in the show notes in how you can work with my dietitian coaching team.

记得关注这个节目，这样你就不会错过任何一集了。

And make sure you're following the show so that you don't miss an episode.

好好补充能量，训练要强劲，我们下集再见。

Fuel well, train strong, and I will see you in the next episode.