What percent of calories from carbs do you recommend for a patient with hypoglycemic episodes? I know you said lower percentages for people tending toward higher blood sugars. Also you commented in the case of how increasing patient’s carbohydrate you think could help hypoglycemic episodes to decrease, so I wondered about the amount you would typically recommend? The patient in the case study you put at 25 percent to 30 percent, but said it was because of a family history of heart disease.

Chris Kresser:  So we’re going to have a whole unit on hypoglycemia and the blood chemistry section so I’ll keep this short, but the answer is you kind of have to experiment because it depends whether the patient is frankly hypoglycemic and has no hyperglycemia or insulin resistance or leptin resistance. As I’m sure you know, hypoglycemia can occur in the context of hyperglycemia, so they can have reactive hypoglycemic episodes after meals or hypoglycemia that’s induced by taking too much insulin or just that kind of early stage pre-diabetes where they’re vacillating back and forth between high and low blood sugar, or you can have hypoglycemia that is unrelated to high blood sugar. So in the former case, I found that a higher-protein, lower-carb diet tends to help more. In the latter case, I found a moderate carbohydrate diet of like 25 percent to 30 percent with high protein intake tends to help more. So those are starting points for experimentation, but you really have to experiment to find out what works best.