My lunch yesterday reminded me why I do this work

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One of the reasons I first became interested in nutrition was to deal with some health issues I had of my own. Throughout my time at medical school and once I was practising as a doctor I was, generally speaking, quite lethargic compared to how I feel now. I had, like a lot of people, particular problems with fatigue in the mid- to late-afternoon. That’s not so much of a problem if you’re sitting at the back of a lecture theatre or stretched out in the common room, but it’s not so good once you’re consulting in an outpatient clinic or performing surgery in an operating theatre.

In retrospect, I realise that a lot of my fatigue issues were down to two main things:

  1. blood sugar imbalance
  2. wheat sensitivity

No wonder eating sandwiches for lunch was not working so well for me.

All of this came back to me in stark fashion yesterday. My girlfriend and I got up early to fly to Malta (an small island in the Mediterranean Sea and my parents’ homeland). Once in Malta, we were given lunch by some relatives (and good friends) of mine. The dish of the day was timpana. If you’re reading this and are Maltese, you’ll know instantly what this is. But the likelihood is you’ll never have heard of this dish. It is, penne pasta, baked in a tomato-based mince sauce. And if there were not enough wheat and carbohydrate in this dish already, it comes with a pastry top (image below).

On one level, there’s nothing nicer than eating timpana with my family (I was certainly not going to refuse). However, the effects of this lunch on my wellbeing were not so good. A short while after eating I found myself suddenly needing sleep. I don’t think the sleep deprivation helped, but usually I have no desire to sleep in the afternoon even when I’ve missed some sleep. I went to bed, and woke up two and half hours later feeling like I’d been roused from a coma. I was also ravenously hungry.

The cause of the hunger (just two and a half hours after a substantial lunch) was almost hypoglycaemia (low blood sugar). Most likely, the glut of insulin secreted after a sugar surge as a result of the timpana had induced this state of affairs. The low blood sugar would also account for me feeling less than spritely, though perhaps some wheat sensitivity did not help here either.

I do have experiences like this from time to time because, however keen I am to eat well, I’m not obsessive about it and sometimes life just gets in the way. Plus, I have the comfort of knowing why I end up feeling awful when I do. Just like someone who drinks half a dozen pints of beer or a bottle and a half of wine knows why they have a hangover in the morning, I knew my mid afternoon crash and ravenous appetite yesterday was down, for the most part, to the wheat and carb-fest I had for lunch (delicious though it was).

It struck me that this insight is in contrast to how I was for many years, hauling my way through the day sometimes, and often affected by intense pangs of hunger for sweet and/or starchy foods, but not knowing why. Actually, I thought that’s just how I was – I just considered feeling this way as normal.

Yesterday’s experience reminded me that many people are currently in a similar situation: experiencing significantly compromised energy and wellbeing, and perhaps driven to eat quite rubbishy foods, but at the same time having no idea that relatively simple modifications to the diet could make the world of difference. It’s a real privilege, I believe, to do a job that allows me the opportunity to raise awareness regarding these issues, and suggest things that may help.

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