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DIET

Swedes struggle to make sense of a new diet trend

A new diet has surfaced in Sweden recently, the Low-Carb High Fat diet (LCHF), but experts remain divided over the new method for trimming one’s waistline, The Local’s Caroline Gravel discovered.

Swedes struggle to make sense of a new diet trend

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.

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DISCOVER SWEDEN

The three tasty treats that make spring in Sweden a forager’s dream

Although parts of Sweden are still under snow at this time of year, spring is in full swing here in Skåne in the south of Sweden. Here are The Local's top tips for what you can forage in the great outdoors this season.

The three tasty treats that make spring in Sweden a forager's dream

You might already have your go-to svampställe where you forage mushrooms in autumn, but mushrooms aren’t the only thing you can forage in Sweden. The season for fruits and berries hasn’t quite started yet, but there is a wide range of produce on offer if you know where to look.

Obviously, all of these plants grow in the wild, meaning it’s a good idea to wash them thoroughly before you use them. You should also be respectful of nature and of other would-be foragers when you’re out foraging, and make sure not to take more than your fair share to ensure there’s enough for everyone.

As with all foraged foods, only pick and eat what you know. The plants in this guide do not look similar to any poisonous plants, but it’s always better to be safe than sorry – or ask someone who knows for help.

Additionally, avoid foraging plants close to the roadside or in other areas which could be more polluted. If you haven’t tried any of these plants before, start in small doses to make sure you don’t react negatively to them.

Wild garlic plants in a park in Alnarpsparken, Skåne. Photo: Johan Nilsson/TT

Wild garlic

These pungent green leaves are just starting to pop up in shady wooded areas, and may even hang around as late as June in some areas. Wild garlic or ramsons, known as ramslök in Swedish, smell strongly of garlic and have wide, flat, pointed leaves which grow low to the ground.

The whole plant is edible: leaves, flowers and the bulbs underground – although try not to harvest too many bulbs or the plants won’t grow back next year.

The leaves have a very strong garlic taste which gets weaker once cooked. Common recipes for wild garlic include pesto and herb butter or herbed oil, but it can generally be used instead of traditional garlic in most recipes. If you’re cooking wild garlic, add it to the dish at the last possible moment so it still retains some flavour.

You can also preserve the flower buds and seed capsules as wild garlic capers, known as ramslökskapris in Swedish, which will then keep for up to a year.

Stinging nettles. Wear gloves when harvesting these to protect yourself from their needles. Photo: Johan Nilsson/TT

Stinging nettles

Brännässlor or stinging nettles need to be cooked before eating to remove their sting, although blanching them for a couple of seconds in boiling water should do the trick. For the same reason, make sure you wear good gardening gloves when you pick them so you don’t get stung.

Nettles often grow in the same conditions as wild garlic – shady woodlands, and are often regarded as weeds.

The younger leaves are best – they can get stringy and tough as they get older.

A very traditional use for brännässlor in Sweden is nässelsoppa, a bright green soup made from blanched nettles, often topped with a boiled or poached egg.

Some Swedes may also remember eating stuvade nässlor with salmon around Easter, where the nettles are cooked with cream, butter and milk. If you can’t get hold of nettles, they can be replaced with spinach for a similar result.

You can also dry nettles and use them to make tea, or use blanched nettles to make nettle pesto.

Kirskål or ground elder, another popular foraged green for this time of year.
Photo: Jessica Gow/TT

Ground elder

Ground elder is known as kirskål in Swedish, and can be used much in the same way as spinach. It also grows in shady areas, and is an invasive species, meaning that you shouldn’t be too worried about foraging too much of it (you might even find some in your garden!).

It is quite common in parks and old gardens, but can also be found in wooded areas. The stems and older leaves can be bitter, so try to focus on foraging the tender, younger leaves.

Ground elder has been cultivated in Sweden since at least 500BC, and has been historically used as a medicinal herb and as a vegetable. This is one of the reasons it can be found in old gardens near Swedish castles or country homes, as it was grown for use in cooking.

Kirskål is available from March to September, although it is best eaten earlier in the season.

As mentioned, ground elder can replace spinach in many recipes – you could also use it for pesto, in a quiche or salad, or to make ground elder soup.

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