Weekend Headaches and Glycemic link

Alex.C.Punnen 2012 Personal Observations- A laymans treatise.

I was more or less regularly getting headaches on weekends or holidays. I am on more predisposed to headaches than the average person; and my headaches are mostly caused by too much strain or too much sun. But other than this I have or used to have the weekend headache syndrome.This begins as a dull headache that would increase to above my comfort threshold by night and would make me just want to sleep off. I tried to think out the possible causes , or the difference in my routine on weekends that could cause this. The main difference was food and sleep. On weekends the food I ate in the afternoon was higher than on normal weekdays. The seconds was the afternoon siesta on weekends. I tried out many combinations for many months, sleeping before food, Not sleeping in the afternoon etc, but not to any effect. I dont know how I came to the link, or how i stumbled on the link, but I came across a old paper by Benjamin P. Sandler, M.D. in which he observed that the lowering of blood glucose was linked to the incidence of polio. In that paper he also wrote about other side effects of low blood glucose like headache. An excerpt below from his paper http://www.whale.to/a/sandler_b.html
“Many healthy people have symptoms of low blood sugar without realizing that the symptoms are due to low blood sugar. For example, many individuals experience a physical let-down in their daily activities around 11 A.M. and 4 P.M. At those hours they get a little tired, may have a slight headache or a sensation of lightheadedness, become a little moody or depressed or irritable, and usually are hungry, especially for something sweet to serve as a "pick-up." And so they will usually partake of the following: a cup of coffee or tea or chocolate, pie, cake, pastry, cookies, candy bars, ice cream, soft drinks, or the like. These sweet foods and beverages afford a rapid relief from their symptoms because they cause a rapid rise in blood sugar level. I regard as artificial the rapid rise in blood sugar produced by eating sugar. The sugar is an artificial stimulant; and in some people the desire for sweets amounts to a craving, and the demand for something sweet during this craving amounts to an addiction. I regard this craving for sweets as abnormal. In the first place the low blood sugar is abnormal and could have been prevented. However slight, it is abnormal and is caused by a dietary error, namely, the ingestion of sugar and starch. The low blood sugar that comes on around 11 A.M. is due to eating sugar and starch at breakfast, and the low blood sugar at 4 P.M. is due to eating sugar and starch at the noon meal. On a high protein low carbohydrate diet the fall in blood sugar at 11 A.M, and 4 P.M. does not occur and so there is no physical let-down and no need for a pick-up. Cigarette smoking can also serve as a pick-up because nicotine can cause an immediate rise in blood sugar level by stimulating the adrenal-sympathetic system, the rise occurring at the expense of liver glycogen.

The physical and mental pick-up which follows eating something sweet is accompanied by a rise in blood sugar which lasts for about 30 to 60 minutes and which is soon followed by another fall in blood sugar. A vicious cycle is thus set up.

The last paragraph is where he is referring to the glycemic index of food. I live in South India where rice constitutes the major portion of lunch. Now rice is a carbohydrate and has generally high glycemic index. This means that after having a meal of rice the blood sugar goes up fast as it is easily broken down to glucose. But this sudden glucose level triggers a insulin rush by the body to keep the blood glucose low. This causes a sudden drop in the blood glucose, triggering headache. This is how I understand it and my understanding may not be fully correct. But thats about it in laymans terms. Reading this article was a revelation to me.Suddenly I became aware of the missing link. in my search between headache and diet. So then I started out my experiment. First I forgo lunch completely. Doing so is exhausting and also could trigger other headache. But thought I was tired that afternoon I did not have any headache luckily. But then after about 5 PM headache set in; after some weeks I understood the cause of it to be related to the sugar in the evening tea; I reduced that too and headaches became less frequent during weekends. Since going without lunch is tiring I came upon the full protein and fat diet of the Intuits, since in the polar regions other than protein and fat of animals they have no ready fruit and vegetables. Here is an excerpt
“One example of such people are the Intuit or Eskimo people. Since such carb staples are fruit and vegetables aren't readily available in the Arctic tundra, the Intuits subsist on diets containing mainly protein and fat. A famous Arctic explorer, Vilhjalmur Stefansson, tried the Intuit diet of meat and fish, finding he felt ill only when he cooked the fish to make it more palatable. Later, he and a colleague traveled North again, and dined with the Intuits and their limited and "dangerous" diet for nearly 5 years, with neither man suffering any ill effects at all. In an effort to convince the medical community of the lack of problems associated with Intuit cuisine, in 1928 Stefansson had himself admitted to Bellevue Hospital in New York for a year of observation. This observation didn't involve any mental problems, as Bellevue is usually associated with, but rather involved an extended metabolic study to access the long-term effects of low-carb eating. Despite deriving 80% of his daily calories from fat, at the end of the study, Steffansson was not only healthy, but showed a decline in blood cholesterol levels. - http://www.ppcchicago.com/articles/unjustlyaccused.php”

More of this diet can be read from the 2004 article in DISCOVER magazine -The Inuit Paradox http://discovermagazine.com/2004/oct/inuit-paradox There are two primary ways that the body can generate energy, one by breakdown of carbohydrates to glucose and then by breakdown of glucose, the second by breakdown/metabolism of fat (called ketosis).

The body can derive energy from metabolisms of protein too called as gluconeogenesis. This is a stress to the liver and beyond a certain point it causes too much damage and even death. Here is the relevant excerpt from the DISCOVER magazine article.
“The simplest, fastest way to make energy is to convert carbohydrates into glucose, our body’s primary fuel. But if the body is out of carbs, it can burn fat, or if necessary, break down protein. The name given to the convoluted business of making glucose from protein is gluconeogenesis. It takes place in the liver, uses a dizzying slew of enzymes, and creates nitrogen waste that has to be converted into urea and disposed of through the kidneys. On a truly traditional diet, says Draper, recalling his studies in the 1970s, Arctic people had plenty of protein but little carbohydrate, so they often relied on gluconeogenesis. Not only did they have bigger livers to handle the additional work but their urine volumes were also typically larger to get rid of the extra urea. Nonetheless, there appears to be a limit on how much protein the human liver can safely cope with: Too much overwhelms the liver’s waste-disposal system, leading to protein poisoning—nausea, diarrhea, wasting, and death.”

This full fat and protein diet is a bit too much as usually it mean that I have to rely on pork and bread (or chapathi). Last July during the mango season, one afternoon I had just mangoes instead for lunch and I felt refreshed. Mangoes had the sugar in it and surprisingly I found that eating it does not lead to the classic headache after like for rice. So I am more or less sold on fruits for lunch and since mangoes are seasonal I have come to rely on plantains after a brainwave from my wife.This is different from banana is that it is filling and I have read long ago in some pioneer doctors accounts in Africa that they would come to the clinic with a bunch of plantains which was their staple diet. Also in Kerala which is my native place, plantains are common part of breakfast where they are prepared boiled. Excerpt from Wikipedia
Plantains are a major food staple in equatorial Africa and Andean regions. Their attractiveness as food is that they fruit all year round, making them more reliable all-season staple food. This is particularly important for communities living in mountains or forests with inadequate food storage, preservation and transportation technologiesPlantain tends to be firmer and lower in sugar content than "dessert" bananas. Bananas are almost always eaten raw, while plantains tend to be cooked or otherwise processed, and are used either when green or unripe (and therefore starchy) or overripe (and therefore sweet). An average plantain has about 220 calories and is a good source of potassium and dietary fiber.

http://en.wikipedia.org/wiki/Plantain

So this is my current diet, a heavy breakfast with eggs chapathi, fatty meat (pork or mutton), oats and tea with no or very less sugar; lunch one plantain, afternoon tea with very less or no sugar, dinner - lots of rice, vegetables , fish and curd and sometimes meat. Side effect of the diet is that I have lost some weight, ( 179 cm, 70 kg now 64 to 65 kg - not ideal weight), I guess my cholesterol should be climbing, need to check this after six months. Weekend headaches have become rare though sometimes still it is there, especially if I break the weekday routine of sleep (lack of sleep being a major trigger). Overall I have come to the conclusion from my experience that sugar is the link, but I may be wrong, and also I don't really know the long term effect of my current diet. Footnote 1. I am putting this because I feel that this could help others.I am not a doctor or a dietician and all my information is got from the internet articles; please don't follow blindly , follow a middle path and don't take things to an extreme. To end - did you know that sugar that is now common all over the world, is a rather modern discovery; how I shudder at the sight of this commodity in the department stores now :).
Sugar remained relatively unimportant until the Indians discovered methods of turning sugarcane juice into granulated crystals that were easier to store and to transport. [6] Crystallized sugar was discovered by the time of the Imperial Guptas, around 5th century AD.[6] Indian sailors, who carriedclarified butter and sugar as supplies, introduced knowledge of sugar on the various trade routes they travelled.[6] Buddhist monks, as they travelled around, brought sugar crystallization methods to China. -

http://en.wikipedia.org/wiki/Sugar