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Swedes struggle to make sense of a new diet trend

Swedes struggle to make sense of a new diet trend

Published: 24 Sep 2009 16:20 GMT+02:00
Updated: 24 Sep 2009 16:20 GMT+02:00

Some see LCHF as cutting-edge and a wake-up call about the state of our knowledge on dieting. Others see it as a fad and wonder about the effects it may have on people’s overall health.

The LCHF diet debate began in earnest in Sweden after Dr. Annika Dahlqvist first prescribed the way of eating to help some of her diabetic patients lose weight. Dieticians then brought her decision to the attention of the Swedish National Board of Health and Welfare (Socialstyrelsen), claiming the diet didn’t fit standard weight loss guidelines.

While the Board ruled in January 2008 that the diet was acceptable, it cautioned that the randomized controlled trials on which it was based constituted slim scientific justification and that there were no long-term studies available to back of claims about its benefits.

So, what exactly is LCHF anyway?

The theory behind the diet is eat few carbohydrates and replacing those calories with fat. It is similar to the popular Atkins diet, for example, which calls for replacing carbohydrates with proteins.

While Sweden’s National Food Administration (Livsmedelsverket) recommends healthy adults eat a diet composed of 50 to 60 percent carbohydrates, 10 to 20 percent protein, and 25 to 35 percent fat, a person on the LCHF diet would reduce that percentage of carbohydrates significantly, while at the same time increasing fat intake.

“The need for carbohydrate restriction is individually based. Lowering the percentage of carbohydrates to 20 percent of calories may be sufficient in many cases, while others need a maximum of 5 percent to induce weight loss,” explains Ralf Sundberg, a transplant surgeon with the Slottsstaden Medical Group in Malmö in southern Sweden, and advocate of the LCHF diet

While it may seem counterintuitive that consuming more fat can aid weight loss, a look at the mechanisms involved sheds some light on this apparent paradox.

As it turns out, eating more fat doesn’t necessarily cause more fat to be stored – as long as one’s caloric intake is balanced with energy expenditure.

Moreover, by replacing carbohydrates with fat, dieters have less glucose in their blood. Lower glucose levels mean less insulin is released. And since insulin plays a role in storing fat in the body and in blocking its use as an energy source, reduced insulin levels make it easier for the body to burn fat as energy.

In terms of weight loss, therefore, the LCHF diet works by making the body use more fat as an energy source, helping one lose weight.

In addition, eating more fat gives one the feeling of being full over longer periods of time, thus inducing a decrease in overall caloric intake.

Following the preliminary debate sparked by Dr. Dahlqvist, more Swedes began to take a look at the literature supporting various dietary standards, prompting an increase in the diet’s popularity, as well as continued discussion about its merits.

According to Ingrid Larsson, a nutritionist at Sahlgrenska University Hospital in Gothenberg, part of the fascination with LCHF stems from what some see as a lack of convincing information about how people ought to best to their diets in order to avoid certain diseases.

“There is a group of people in Sweden, some of them health professionals, some of them not working in the medical or nutritional area at all, who are very disappointed with the modest level of our knowledge about the dietary management of obesity, diabetes, and cardiovascular risk factors,” she explains.

“If you do not have that knowledge, then it is easy to search for a simple solution. ‘Eat more fat and less carbohydrates: that will solve your problems!’”

Sundberg, on the other hand, thinks the popularity of LCHF comes from people who have concluded that current dietary recommendations are based on “selective and misleading citations of the scientific literature” written by people with financial ties to the food industry.

In addition, more studies have come out supporting the benefits of LCHF.

“Many regular people dared to change their eating habits and found that their health improved – especially those suffering from diabetes and obesity,” says Sundberg.

He thinks Sweden is ahead of the curve in recognizing that diets like LCHF have a number of advantages for people’s health.

“But Sweden is not the only country. The interest of low-carb diets in the United States is increasing, although there has not been the same kind of media response yet,” he says.

While Sundberg believes that LCHF is “safe for everyone” he admits some segments of the population may want to refrain from changing their diets.

“It’s not recommended during pregnancy because carbs are necessary for weight gain, and growing children should not be denied carbs for the same reason,” he says.

He adds, however, that most but not all overweight individuals can lose weight with LCHF.

But there are others who remain skeptical about the diet – including Larsson, who says she still won’t recommend LCHF.

She explains that the Swedish Association of Clinical Dietitians (Dietisternas Riksförbund – DRF) has yet to find proof that the diet is better than any other diet.

“LCHF has not been proven to be superior to the recommended energy-reduced diets that obese patients are advised to follow,” she says.

“We have no data on the long-term safety of these diets, including diabetes and cardiovascular risk factors.”

Furthermore, she cites research findings about the adverse effects of increased saturated fat intake.

“Many studies over several decades have come to the conclusion that high consumption [of saturated fat] does lead to an increased risk of arteriosclerosis (hardening of the arteries),” says Larsson.

She adds, however, that the findings don’t necessarily mean someone who consumes a lot of saturated fat will suffer from arteriosclerosis, “a high intake of saturated fat does lead to an increased risk” for the disease.

But Sundberg has a different opinion.

“Saturated fats do not clog arteries,” he says.

He cites a study from Harvard University which found that where “arteriosclerotic narrowing of coronary arteries progresses more rapidly from a carbohydrate-rich diet, while the opposite was found with a diet rich in saturated fats.”

In other words, a high-carb diet may actually be worse for your arteries than a high-fat diet.

Another bone of contention among dietary experts is whether or not eating a lot of fat and few carbohydrates could lead to deficiencies in certain essential nutrients.

Larsson cautions that, over time, an LCHF diet may also lead to a decreased intake of vitamins A, C, E, B1, folate, potassium and magnesium – which come mainly from plant and cereal sources, the common base for many carbohydrate-rich foods.

Sundberg, however, counters that “the risk of nutritional deficiencies is greater with the low-fat high-carb diets recommended by authorities today.”

Thus, in the absence of a clear consensus on LCHF, food-lovers concerned about their weight or their health are left to examine and compare literature for and against the diet.

And in the mean time, they will be left to satisfy their hunger at their own risk.

The Local (news@thelocal.se)

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Your comments about this article

13:30 September 26, 2009 by foxpur
Having watched my "Sambo" utilize the LCHF diet, she has been very happy and successful with the outcome and continues on it. It is not a 'fast' diet, but a steady loss.. it can be measured by-weekly and is very apparent on a monthly rate.
15:10 September 26, 2009 by DamnImmigrant
A Rose by any other name - Atkins = Low Carbohydrate, High Fat !?!?

While avoiding the carbohydrates, you DO NOT worry about fat intake. It is NOT the idea that you EAT fat! It is the idea that you avoid the carbohydrates! The protein that you eat will contain fat and you do NOT worry about consuming it!

Yes! This diet really does work and the studies are showing that the LCHF diet is really the only one that works long term and that it has positive long term health benifits!
17:11 September 26, 2009 by boothssi
Actually, I believe that current nutritional guidelines are based upon original scientific fraud that toll place several decades ago. However, if the "many studies over several decades" have proven that a high saturated fat diet leads to an increased risk of cardiovascular disease" as stated by Ingrid Larsson, I would be most happy to get access to the references and data. But as Lenin once said, "if you tell a lie enough times it becomes the truth" so I suspect the data does not exist, only the assurances that it does.
19:27 September 26, 2009 by Adele Hite
This is a direct quote from the 2005 Dietary Reference Intakes (Macronutrients) report published by an independent US government agency, the Institute of Medicine Food and Nutrition Board (whose members are not beholden to the USDA Farm Bill): "Compared to higher fat diets, low fat, high carbohydrate diets may modify the metabolic profile in ways that are considered to be unfavorable with respect to chronic diseases such as coronary heart disease (CHD) and diabetes" (DRI, Ch. 8, 437). Another quote from the same document: "Low-fat, high-carbohydrate diets, compared to higher fat intakes, can induce a lipoprotein pattern called atherogenic dyslipidemia . . . a pattern that is associated with increased risk for CHD" (DRI, Ch. 11, 777). And yet another: "Other potential abnormalities accompanying changes in distribution of fat and carbohydrate intakes include increased postprandial responses in plasma glucose and insulin concentrations. These abnormalities are more likely to occur with low fat, high carbohydrate diets. They potentially could be related to the development of both type 2 diabetes and CHD" (DRI, Ch. 11, 784). And finally: "The lower limit of dietary carbohydrate compatible with life is apparently zero" (DRI, Ch. 6, 275).

In short, the known human physiology and biochemistry support a LCHF diet for a healthy metabolic profile, and clinic trials from 1 to 4 years demonstrate its benefits for improving cardiovascular disease risk markers, insulin levels, and blood sugar control (Gardner, Shai, Westman, Esposito). For the record, no comparable clinical trials have demonstrated similar effectiveness with regard to a low-fat, high-carbohydrate diet. Longer studies of observational data not only confirm the benefits of low-carb diet patterns with regard to heart disease risk factors, but also fail to demonstrate similar benefits from low-fat diet patterns (Halton and Willett).

For the politics of why some scientists, public health figures, and politicians refuse to accept these facts, see Gary Taubes' work.

Don't expect paradigms to shift without resistance from those upholding the status quo. Educate yourself, and understand that many times experts who have made a living promoting current conventional thinking may be very last ones to be willing to accept a change that may cause them to lose face, or worse, financial support.
01:34 September 28, 2009 by jag2009
Do

GI

Diet

!
15:28 September 28, 2009 by Aussie_Downunder
Um... That diet's not new. Well maybe in Sweden it is :)
16:54 September 28, 2009 by Xxsarahxx
OMG!!! I am sick and tired of this crap!!!!

I am here to tell you and living proof, 80 kg and now I am 57kg that all these fatties need to do is to stop eating so much, period!!!!!!!!!!!!!

Stop babying the fatties by coming up with these ridiculous diets. Here's the cold hard truth...stuffing your face with anything over and above what your body needs for a day(which is a different amount for everyone) will make you fat. Eating less than your body needs will make you thin.

Crikey if you eat one small Banana over and above your normal daily intake for a year you will put on around 5kg!! Too much anything makes you a chunky monkey!!

1kg is in or around 7500cal. You need to subtract that from what is normal for your body for a week so say 2000 per day, 14000 (for the week) and you will lose about a kilo. Of course you can do it slower if you want to and add exercise.

Bottom line, western people are piggys and we eat to much. THE TRUTH HURTS!!
16:56 September 28, 2009 by Roger O. Thornhill
Oh the diet does work. But be forwarned it low carb intake is a lifelong change.

Go back to eating alot of carbs and you are going to blowup and gain to more than you were when you started.

Be VERY CAREFUL to follow exactly the procedures.

Once you are in ketosis the pounds just fall off. How you reintroduce carbs and source is extremely incremental and important!!!!!!

Once you are out of ketosis, it is difficult to get back in.

This website: http://www.lowcarb.ca/ is very helpful and dedicated to lowcarbers whether Atkins, Miami Beach etc.

Read the forums.

Best advice - don't get fat in the first place.
18:54 September 28, 2009 by phishery
Another useful site dedicated to managing diabetes using a restricted carbohydrate diet with increased fat intake is D-solve http://www.dsolve.com (www.dsolve.com).

It is a real shame that diabetics are not pointed in this direction by most medical professionals since carbs require much more drastic insulin therapy which is more difficult to manage.

D-solve is dedicated to helping diabetics achieve normal blood sugars by lowering insulin requirements and thus simplifying their entire management approach.
09:50 September 29, 2009 by Irishmanabroad
Whatever happened to a balanced diet and regular exercise?!?
19:50 September 30, 2009 by Geno44
Uhhhh....has anyone ever heard of Dr. Atkins' Diet Revolution?
01:05 October 3, 2009 by Lillmassa
It's quite amusing to read some of the comments on this article. There are so many still believing in the totally absurd idea of calories in vs calories out. It's NOT that simple. I'm a diabetic type 2, and as a result of eating LCHF for about one year I no longer eat my Metformin Meda medicin (diabetic pills). Actually, I was able to stop right away when starting with LCHF. My bloodsugarlevel is at a normal level! Weightloss is also a result of LCHF since I've managed to lose a total of about 20 kilograms during this time. I have two questions for those in dubt:

1. Why do you think breastmilk contains so much fat if it's so totally dangerous for our survival?

2. What is the reason for LCHF being presented, already in an copyrighted book from 1917 (about 4-5years BEFORE the dicovery and manufacturing of insulin for diabetics)? For what purpose, might you think?

Not true? Well, how about this link:

www.archive.org/details/diabeticcookeryr00oppeiala

People like Andreas Eenfeldt, Annika Dahlqvist, Lars-Erik Litsfeldt, Sten Sture Skaldeman and many other swedish persons are truly lifesaving pioneers within the LCHF area.
14:31 October 23, 2009 by vijayakumar
I would like to know more about this LCHF can somebody throw more light on this
23:11 March 22, 2010 by RedYeti
"LCHF" is the cornerstone of a growing realisation that we are better off eating food that we have evolved to eat.

I've been eating this way for years and am very, very healthy on it (I eat this way to be healthy!).

But don't just take my word for it (or even that heart surgeon quoted above!) - try it. Here's a great starter from a very interesting Dr in the USA:

http://www.paleonu.com/get-started/
18:53 August 9, 2010 by msaliassweden
I say, "Do what works for you"... LCHF was introduced to America in mainstream by Dr. Atkins, many years ago. I am sure before that there was someone else with the diet. If your health determines it is good for you, then do it.

I personally find it harder to do the LCHF diet in Sweden because there are not as many options I have in the states as far as easy to buy & quick snacks like beef jerky high protien/low carb bars etc... Just my opinion.

I also think that if you feel comfortable eating a stick everyday and it provides nutritional value for you personally, then do it...

There is no right or wrong answer here, it's all about YOU!

What works for me, might not work for you... we are all different and individuals.

Eat for your health!
13:17 September 5, 2011 by costaricaeric
I am a 55 y/o US ex-pat living in Thailand. I have been on the LCHF diet for 5 months. I found this site while researching the LCHF trend in Sweden.

So far I have lost 11 kgs., my energy and libido are higher and my thinking is clearer. I did the research, implemented the diet and am monitoring the results. Blood tests here are very inexpensive. My current test showed HDL of 81, LDL 89 and Triglycerides of 81. Because of this diet, I now have the blood chemistry of a very young man.

My friends are also following this diet and are experiencing similar results. One man, a 68 y/o ex-Pat has the lowest weight and blood pressure he has seen in 30 years.

Do the research, but only listen to the results of clinical studies and not observational studies.
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