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Large Meals, High Blood Sugar and The Chinese Restaurant Effect

Doris' Blog
By: dorisjdickson

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Posted: Dec 28, 2008 14:42
  • Large Meals, High Blood Sugar and The Chinese Restaurant Effect

    Fortunately, the end of large holiday meals is upon us.  Frequently, people eat very large meals on Thanksgiving and Christmas and though their blood sugar seems “OK” several hours after eating they notice high, erratic, stubborn blood sugar after the fact – often even the next day.  What causes this?


    Dr. Richard Bernstein, author of the Diabetes Solution, refers to the phenomenon we notice following large meals as the “Chinese Restaurant Effect.”  Dr. Bernstein noticed the phenomenon in a patient who ate large amounts of supposedly “free” lettuce before swimming.  However, as Dr. Bernstein mentions, it can happen to a diabetic if they eat sawdust!  It seems the effect is caused by volume not calorie or carbohydrate content.


    What exactly happens?  Dr. Bernstein explains that the upper part of the small intestine contains cells that release hormones into the bloodstream when they are stretched, as after a large meal that we eat at Thanksgiving, Christmas, etc.  In a non-diabetic, these hormones signal the pancreas to produce insulin to prevent the blood sugar rise.  Insulin dependent diabetics, likely, take a fairly large dose of insulin to accomplish the same task.


    After noting this fairly large dose or natural release of insulin, the pancreas simultaneously produces glucagon to offset the potential excess effect of the insulin.  This happens in both a non-diabetic as well as in a diabetic.  He continues, the glucagon release causes “gluconeogenesis and glycogenolysis and thereby raise your blood sugar.”  Thus, if you eat a large amount your blood sugar can go up by a large amount – an unpredictable large amount that has you scratching your head about the math the insulin to carb ratio that normally works well.


    So, in Dr. Bernstein’s words 1) do not “stuff” yourself and 2) there is no such thing as a “freebie” regardless of what we were taught or whether we eat something entirely indigestible.


    My personal experience confirms Dr. Bernstein’s findings.  This is especially true when I eat a large meal that is higher in carbs than my usual fare.  I used to think I was losing my marbles so I was relieved to read there is actually a physiological reason for what seems like absurd behavior of my blood sugar. 


    In my case, the glucose increase tends to happen overnight or the next day.  It does not happen immediately following the meal.  It also tends to be mimic insulin resistance – I assume since my liver is spitting out tons excess glucose.   After all, it can only store 10-12 hours of glucose.  What is a body to do with the rest?


    This again, is where I would love to have a “liver-ometer or a digestion-ometer.  It is so frustrating to be unable to “see” what is going on in my liver, pancreas and digestive tract.  After all, it is difficult to troubleshoot, diagnose and treat a problem if you cannot measure or see it. 


    So, in my opinion, now that I understand the mechanics, I have a choice.  I can overeat and pay the price for 12-24 hours after the fact.  On the other hand, I can eat less food, miss out on a few goodies, and feel a whole lot better for the duration.  As I always say, we can choose the watermelon or the kidneys.  It is all up to us.


    Doris J. Dickson

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