I mentioned a while back that I had used diet to control reactive hypoglycaemia and I just received a PM asking me what my daily diet was. I thought I'd start a thread on it in case others found it helpful. I got advice on my diet from Alexandra Barton, a nutritionist (among other things) who considers herself pretty much recovered from ME/CFS. She asked me to keep a food diary for a week and having seen it, thought I was eating far too little protein and too much carbohydrate, which would be sending my blood sugar all over the place. She recommended changes to my diet which actually led to some good short-term improvement in my overall condition as well as getting rid of the hypoglycaemia but which sadly didn't last; however, I've maintained the diet because it controls my hypoglycaemia and has stopped the associated weight gain (I was eating more when I was getting hungry and shakey, and putting on weight). Here are the rules she gave me, from my notes at the time: 1. Eat within an hour of waking. If necessary, eat and then go back to sleep (I was having big trouble getting out of bed in the morning - I started keeping some cheese and oatcakes by the bedside to eat as soon as I woke and started feeling better in the morning and able to get up sooner. This improvement has lasted). 2. Never leave as much as four or five hours between eating - it's too long. 3. The ideal is three meals plus one snack. You will find it hard to begin with because your body has a "memory" of what chemicals it should be providing when to digest what and you will have to reprogramme it. You may feel awful for a few days (five or so days; and I did indeed feel not too good). Be rigid about eating at the same time every day and having your snack at the same time. She likes people to see dramatic change, which is why she recommends changing so suddenly but if you are particularly frail and want to avoid any kind of bodily shock you could transition gradually (in my opinion!). 4. A meal should be a portion of high-quality protein (not pulses or nuts because they don't have all the amino acids and pulses are high in carbs, but rather meat/fish/cheese) as big as your fist and a slightly smaller sized portion of carbohydrate (which includes fruit) plus vegetables of any kind (their carbohydrate content doesn't count). You can have as much protein as you want. You can have fruit at mealtimes (as your carb portion) but never on its own as a snack, only with protein. 5. A snack is a smaller portion of protein than for a meal, plus a portion of carb that is smaller than the protein portion. I started the diet two and half years ago. I found it really difficult at first; the meals were much bigger than I was used to and it was hard to get used to eating so much for breakfast. Each meal took me about an hour to eat at first, with each mouthful seeming like really hard work after a certain point. My body certainly did have some readjusting to do but after a few days it did indeed get the hang of it. My hypoglycaemia came under control quite quickly (I did have the first few days of feeling hungry between meals and having to tough it out) and I felt much improved overall after three weeks; that lasted for about four weeks and then declined, which was disappointing. Perhaps I'm a bit better than I was. I think mornings are easier, though whether that's to do with the diet or better sleep meds for my insomnia, I don't know. I didn't keep records of when I tried various things. Alex is very nice and consulting with her (which I did by phone) was only 35 at the time. Her advice may have been specific to me in some ways so I'd suggest caution if applying it to yourself. Here's her nutrition page for PWC; if you are not in the UK, maybe she might consider a consultation by email. I hope this helps - actually, checking my notes from all that time ago has reminded me that I have drifted from the plan a bit and might benefit from following it more closely again!