{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T09:52:43Z","timestamp":1773827563945,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T00:00:00Z","timestamp":1642982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: A well-balanced nutritional diet pattern has a significant role in the management of diet-related disorders. Currently, there are no specific dietary guidelines to refer to when advising non-diabetic patients with symptoms attributed to hypoglycemia in the postprandial period or patients with confirmed reactive hypoglycemia (RH). The aim of this study was to investigate the impact of the dietary interventions, and their sustained outcome, on the severity of hypoglycemic-like symptoms occurring in non-diabetic patients. Methods: The study group included forty non-diabetic individuals with symptoms consistent with RH. At the baseline, each patient underwent RH diagnosis and complex dietary evaluation. Over a period of six months, each patient had four appointments with a dietitian. Two sessions were focused on a dietary education about low glycemic index diet (LGID) and Mediterranean diet (MD). The said diets were to be followed for a period of three months, with two additional dietary check-ups. Once dietary supervision was completed, patients had no imposed dietary patterns. The final follow-up appointment took place twelve months later and that is when each patient underwent a detailed assessment of their current dietary habits and evaluation of the frequency of symptoms consistent with hypoglycemia. Results: There was a statistically significant reduction in the severity in eight out of the ten analyzed hypoglycemic-like symptoms after the dietary interventions. The most significant change was observed in the following symptoms: hunger (\u03b72 = 0.66), impaired concentration (\u03b72 = 0.61), hand tremor (\u03b72 = 0.55), and fatigue (\u03b72 = 0.51). The outcomes were comparable for both recommended diets, the LGID and the MD. The reduction in hypoglycemic-like symptoms continued after the twelve-month period. The individualized dietary counselling significantly improved the patients\u2019 eating habits in comparison to those present prior to intervention in terms of healthy diet index (F(2,78) = 27.30, p &lt; 0.001, \u03b72 = 0.41, 90%CI [0.26; 0.51]) and unhealthy diet index (F(2,78) = 433.39, p &lt; 0.001, \u03b72 = 0.91, 90%CI [0.89; 0.93]). Conclusions: Healthy modifications in dietary habits may improve patient\u2019s well-being and reduce the severity of their postprandial symptoms attributed to hypoglycemia. Therefore, dietary intervention focused on appropriate nutritional management combined with follow-up consultations may be a beneficial step towards comprehensive treatment of non-diabetic patients who present with hypoglycemic-like symptoms in the postprandial period.<\/jats:p>","DOI":"10.3390\/nu14030497","type":"journal-article","created":{"date-parts":[[2022,1,25]],"date-time":"2022-01-25T21:07:11Z","timestamp":1643144831000},"page":"497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Assessing Long-Term Impact of Dietary Interventions on Occurrence of Symptoms Consistent with Hypoglycemia in Patients without Diabetes: A One-Year Follow-Up Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4127-7332","authenticated-orcid":false,"given":"Marianna","family":"Hall","sequence":"first","affiliation":[{"name":"Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, 01-445 Warsaw, Poland"},{"name":"Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration in Warsaw, 02-507 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Walicka","sequence":"additional","affiliation":[{"name":"Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration in Warsaw, 02-507 Warsaw, Poland"},{"name":"Department of Human Epigenetics, Mossakowski Medical Research Institute Polish Academy of Sciences, 02-106 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1830-2114","authenticated-orcid":false,"given":"Mariusz","family":"Panczyk","sequence":"additional","affiliation":[{"name":"Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7413-1212","authenticated-orcid":false,"given":"Iwona","family":"Traczyk","sequence":"additional","affiliation":[{"name":"Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, 01-445 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2018). 6. Glycemic Targets: Standards of Medical Care in Diabetes-2018. Diabetes Care, 41, S55\u2013S64.","DOI":"10.2337\/dc18-S006"},{"key":"ref_2","first-page":"57","article-title":"Current perspective on the role of insulin and glucagon in the pathogenesis and treatment of type 2 diabetes mellitus","volume":"11","author":"Ojha","year":"2019","journal-title":"Clin. Pharmacol. Adv. Appl."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s11892-018-1018-0","article-title":"Hypoglycemia Among Patients with Type 2 Diabetes: Epidemiology, Risk Factors, and Prevention Strategies","volume":"18","author":"Silbert","year":"2018","journal-title":"Curr. Diabetes Rep."},{"key":"ref_4","first-page":"337","article-title":"Postprandial reactive hypoglycemia","volume":"26","author":"Brun","year":"2000","journal-title":"Diabetes Metab."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"384","DOI":"10.36740\/WLek202002134","article-title":"Reactive hypoglycemia-an interdisciplinary approach of the disease of XXI Century","volume":"73","author":"Hall","year":"2020","journal-title":"Wiad. Lek."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Hall, M., Walicka, M., Panczyk, M., and Traczyk, I. (2021). Metabolic Parameters in Patients with Suspected Reactive Hypoglycemia. J. Pers. Med., 11.","DOI":"10.3390\/jpm11040276"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.jada.2004.12.012","article-title":"Should hypoglycemia patients be prescribed a high-protein diet?","volume":"105","author":"Blumberg","year":"2005","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.2337\/dc15-0100","article-title":"Impact of fat, protein, and glycemic index on postprandial glucose control in type 1 diabetes: Implications for intensive diabetes management in the continuous glucose monitoring era","volume":"38","author":"Bell","year":"2015","journal-title":"Diabetes Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3821","DOI":"10.2337\/dc13-2042","article-title":"Nutrition therapy recommendations for the management of adults with diabetes","volume":"36","author":"Evert","year":"2013","journal-title":"Diabetes Care"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"505","DOI":"10.3945\/ajcn.112.042457","article-title":"Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes","volume":"97","author":"Ajala","year":"2013","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Ojo, O. (2019). Nutrition and Chronic Conditions. Nutrients, 11.","DOI":"10.3390\/nu11020459"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"11","DOI":"10.2147\/ciia.2006.1.1.11","article-title":"Dietary approaches that delay age-related diseases","volume":"1","author":"Everitt","year":"2006","journal-title":"Clin. Interv. Aging"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"k2396","DOI":"10.1136\/bmj.k2396","article-title":"Food based dietary patterns and chronic disease prevention","volume":"361","author":"Schulze","year":"2018","journal-title":"BMJ"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1089\/jmf.2018.0063","article-title":"A Low-Glycemic, Mediterranean Diet and Lifestyle Modification Program with Targeted Nutraceuticals Reduces Body Weight, Improves Cardiometabolic Variables and Longevity Biomarkers in Overweight Subjects: A 13-Week Observational Trial","volume":"22","author":"Tripp","year":"2019","journal-title":"J. Med. Food"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.jacl.2011.03.002","article-title":"A Mediterranean-style low-glycemic-load diet improves variables of metabolic syndrome in women, and addition of a phytochemical-rich medical food enhances benefits on lipoprotein metabolism","volume":"5","author":"Jones","year":"2011","journal-title":"J. Clin. Lipidol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1093\/ajcn\/nqz149","article-title":"Low-glycemic index diets as an intervention for diabetes: A systematic review and meta-analysis","volume":"110","author":"Zafar","year":"2019","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"468","DOI":"10.4314\/ahs.v16i2.15","article-title":"The concept of low glycemic index and glycemic load foods as panacea for type 2 diabetes mellitus; prospects, challenges and solutions","volume":"16","author":"Eleazu","year":"2016","journal-title":"Afr. Health Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1080\/10408690390826554","article-title":"Low-glycemic-load diets: Impact on obesity and chronic diseases","volume":"43","author":"Bell","year":"2003","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.numecd.2013.04.008","article-title":"Long-term effects of low glycemic index\/load vs. high glycemic index\/load diets on parameters of obesity and obesity-associated risks: A systematic review and meta-analysis","volume":"23","author":"Schwingshackl","year":"2013","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1038\/ejcn.2013.27","article-title":"Is glycaemic index (GI) a valid measure of carbohydrate quality?","volume":"67","author":"Wolever","year":"2013","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s12020-016-1018-2","article-title":"Mediterranean diet for type 2 diabetes: Cardiometabolic benefits","volume":"56","author":"Esposito","year":"2017","journal-title":"Endocrine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"8947","DOI":"10.18632\/oncotarget.13553","article-title":"Impact of Mediterranean diet on metabolic syndrome, cancer and longevity","volume":"8","author":"Noce","year":"2017","journal-title":"Oncotarget"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"9139","DOI":"10.3390\/nu7115459","article-title":"Definition of the Mediterranean Diet; A Literature Review","volume":"7","author":"Davis","year":"2015","journal-title":"Nutrients"},{"key":"ref_24","unstructured":"Gawecki, J. (2014). Dietary habits and nutrition beliefs questionnaire for people 15\u201365 years old, version 1.1\u2014Interviewer administered questionnaire. Dietary Habits and Nutrition Beliefs Questionnaire and the Manual for Developing of Nutritional Data, Polish Academy of Sciences."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Si\u0144ska, B., Jaworski, M., Panczyk, M., Traczyk, I., and Kucharska, A. (2021). The Role of Resilience and Basic Hope in the Adherence to Dietary Recommendations in the Polish Population during the COVID-19 Pandemic. Nutrients, 13.","DOI":"10.3390\/nu13062108"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Serra-Majem, L., Tomaino, L., Dernini, S., Berry, E.M., Lairon, D., Ngo de la Cruz, J., Bach-Faig, A., Donini, L.M., Medina, F.X., and Belahsen, R. (2020). Updating the Mediterranean Diet Pyramid towards Sustainability: Focus on Environmental Concerns. Int. J. Env. Res. Public Health, 17.","DOI":"10.3390\/ijerph17238758"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1016\/j.euroneuro.2019.10.011","article-title":"Nutritional psychiatry: Towards improving mental health by what you eat","volume":"29","author":"Adan","year":"2019","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_28","first-page":"1","article-title":"How diet modification challenges are magnified in vulnerable or marginalized people with diabetes and heart disease: A systematic review and qualitative meta-synthesis","volume":"13","author":"Vanstone","year":"2013","journal-title":"Ont. Health Technol. Assess. Ser."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Augimeri, G., and Bonofiglio, D. (2021). The Mediterranean Diet as a Source of Natural Compounds: Does It Represent a Protective Choice against Cancer?. Pharmaceuticals, 14.","DOI":"10.3390\/ph14090920"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"100640","DOI":"10.1016\/j.conctc.2020.100640","article-title":"The MEDGICarb-Study: Design of a multi-center randomized controlled trial to determine the differential health-promoting effects of low- and high-glycemic index Mediterranean-style eating patterns","volume":"19","author":"Bergia","year":"2020","journal-title":"Contemp. Clin. Trials Commun."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Gibson, A., and Sainsbury, A. (2017). Strategies to Improve Adherence to Dietary Weight Loss Interventions in Research and Real-World Settings. Behav. Sci., 7.","DOI":"10.3390\/bs7030044"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1080\/17437199.2014.941722","article-title":"Theories of behaviour and behaviour change across the social and behavioural sciences: A scoping review","volume":"9","author":"Davis","year":"2015","journal-title":"Health Psychol. Rev."},{"key":"ref_33","first-page":"284","article-title":"Engaging Patients in Decision-Making and Behavior Change to Promote Prevention","volume":"240","author":"Krist","year":"2017","journal-title":"Stud. Health Technol. Inform."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/j.jand.2014.11.017","article-title":"The impact of eating frequency and time of intake on nutrient quality and Body Mass Index: The INTERMAP Study, a Population-Based Study","volume":"115","author":"Aljuraiban","year":"2015","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Paoli, A., Tinsley, G., Bianco, A., and Moro, T. (2019). The Influence of Meal Frequency and Timing on Health in Humans: The Role of Fasting. Nutrients, 11.","DOI":"10.3390\/nu11040719"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"206s","DOI":"10.1016\/S0197-2456(00)00080-5","article-title":"Dietary adherence: Characteristics and interventions","volume":"21","author":"Sherman","year":"2000","journal-title":"Control. Clin. Trials"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"107586","DOI":"10.1016\/j.jdiacomp.2020.107586","article-title":"Small changes in glucose variability induced by low and high glycemic index diets are not associated with changes in \u03b2-cell function in adults with pre-diabetes","volume":"34","author":"Utzschneider","year":"2020","journal-title":"J. Diabetes Complicat."},{"key":"ref_38","first-page":"163","article-title":"Mediterranean diet and emotion regulation","volume":"7","author":"Holt","year":"2014","journal-title":"Med. J. Nutr. Metab."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Echeverr\u00eda, G., Tiboni, O., Berkowitz, L., Pinto, V., Samith, B., Von Schultzendorff, A., Pedrals, N., Bitran, M., Ruini, C., and Ryff, C.D. (2020). Mediterranean Lifestyle to Promote Physical, Mental, and Environmental Health: The Case of Chile. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17228482"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Andrade, V., Jorge, R., Garc\u00eda-Conesa, M.T., Philippou, E., Massaro, M., Chervenkov, M., Ivanova, T., Maksimova, V., Smilkov, K., and Ackova, D.G. (2020). Mediterranean Diet Adherence and Subjective Well-Being in a Sample of Portuguese Adults. Nutrients, 12.","DOI":"10.3390\/nu12123837"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"234","DOI":"10.3390\/nu5010234","article-title":"Diet-microbiota interactions and their implications for healthy living","volume":"5","author":"Jeffery","year":"2013","journal-title":"Nutrients"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e2927","DOI":"10.1002\/dmrr.2927","article-title":"Gut microbiome response to short-term dietary interventions in reactive hypoglycemia subjects","volume":"33","author":"Quercia","year":"2017","journal-title":"Diabetes Metab. Res. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Merra, G., Noce, A., Marrone, G., Cintoni, M., Tarsitano, M.G., Capacci, A., and De Lorenzo, A. (2020). Influence of Mediterranean Diet on Human Gut Microbiota. Nutrients, 13.","DOI":"10.3390\/nu13010007"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/3\/497\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:06:34Z","timestamp":1760133994000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/3\/497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,24]]},"references-count":43,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["nu14030497"],"URL":"https:\/\/doi.org\/10.3390\/nu14030497","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,24]]}}}