Research paper
Kishimoto I. Subclinical reactive hypoglycemia with low glucose effectiveness — why we cannot stop snacking despite gaining weight. Metabolites. 2023;13(6):754. doi:10.3390/metabo13060754. PMID: 37367911. PMCID: PMC10304473.
Why we cite it
Review paper proposing a physiological mechanism for why some overweight people cannot stop snacking despite gaining weight — subclinical reactive hypoglycemia (SRH). Using continuous glucose monitoring in **obese/overweight men without diabetes — men only**, Kishimoto reports that **half** — the paper's word, twice — exhibit glucose below 70 mg/dL after a 75-g oral glucose load *"without notable hypoglycemic symptoms except hunger"*, and that people with SRH **snack more frequently** than those without it. **The causal loop is the author's proposal and is hedged in his own abstract**: a vicious cycle *"**can be formed**"*, the data *"**suggest**"* the Sg association, and prevention *"**might be** key"*. This section previously said the dips *"trigger"* eating, *"creating"* a vicious cycle: snacking → blood sugar spike → insulin surge → blood sugar crash → hunger → more snacking. The paper introduces glucose effectiveness (Sg) as the connecting mechanism — low Sg links SRH to snacking habits and obesity, while high Sg may break the cycle: *"Exercise training improves Sg"*, and Sg *"is high in those with low-fat diets"*, an association for diet (corrected 2026-09-10 from *"high Sg (from exercise and lower-fat diets)"*, the causal reading of the diet association that the Extracted-knowledge bullet had already corrected). **For the project, the library reads this as support for environmental and metabolic approaches to snacking. The paper itself says only that snacking *"in certain conditions may not be self-controllable"*.** (Corrected 2026-09-10. This section read *"47% — 'half' in the abstract's own rounding"*, but the paper's only 47% is the share whose sensor glucose reached **≥200** mg/dL, the opposite condition, so the reconciliation was the record's own invention. It also said the paper *"provides the physiological explanation for why breaking snacking patterns requires environmental and metabolic interventions, not just willpower"*.)