Dr Aidin Rawshani

Low-carbohydrate diet for beginners

Contents

Lose weight with LCHF (low carb high fat) and low carbohydrate diet

LCHF (Low Carb High Fat) is a type of low-carbohydrate diet, which involves the fact that the food contains a small amount of carbohydrates. You who previously read our article on nutrients, know that we humans receive energy from carbohydrates, fats and protein in food. If you reduce the proportion of carbohydrates, you need to increase the percentage of fat and/or protein in the food. If you choose a low-carbohydrate diet that is of the type LCHF, you choose to mainly increase the percentage of fat in the food. In other words, LCHF means reducing carbohydrates and increasing the amount of fat.

Eating a little carbohydrate and a lot of fat goes against the traditional Swedish diet circle and the nutritional recommendations established by Swedish, American and European authorities over the last 50 years. Traditional dietary advice recommends that we minimize the intake of fat and instead try to saturate ourselves with carbohydrates and protein. The Food Administration’s dietary advice says that fat should account for 25 -40% of the energy intake, carbohydrates should account for 45 -60% of the energy intake and protein should account for 10 -20% of the energy intake. 20 Thus, according to the Swedish Food Administration, the energy of the food should be dominated by carbohydrates. LCHF means the exact opposite of this, namely that fat should dominate energy intake.

It is easy to understand why LCHF is often criticized by scientists, because it (scientists and authorities) has long been believed that the fat content of food affects blood fats, and hence the risk of heart attack and cardiovascular disease. Nowadays, we know that the fat content of the food does not have a major impact on the individual’s blood lipids and therefore the theory that LCHF increases the risk of a heart attack falls. In addition, it has been proven that LCHF is most likely the most effective diet for losing weight. In this article we will go through LCHF very carefully. We will discuss the science behind LCHF, expected effects of LCHF (including side effects), practical advice, tips, recipes and materials You can download.

1

Nutritional content of the diet according to various diets. LCHF (low carb high fat), Atkins and South Beach are the diets with the lowest carbohydrate content. The Swedish diet circle is similar to the American Unified diet, which is a diet developed by the American Heart Association, the American Cancer Society and others.

Why is LCHF (Low Carb High Fat) so popular today?

Low-carbohydrate diet is generally very popular today and in Sweden LCHF is the most popular variant. There are thousands of websites and blogs dedicated to LCHF. In general, low-carbohydrate diet occurs in the following two variants:

  1. Moderate reduction of carbohydrates and a higher percentage of protein in food.
  2. Sharply reduction of carbohydrates and a higher percentage of fat in food. This variant is what is called LCHF (Low Carb High Fat).

Of course, these two variants can be modified; for example, you can reduce carbohydrates sharply and eat a higher percentage of protein (which is what you do if you follow the Atkins diet). Thus, in Sweden, LCHF is the most popular variant of low-carbohydrate diet. It should already be mentioned that the scientific studies carried out on low-carbohydrate diets have varied in terms of the amount of protein and fat contained in the diet. This makes it somewhat more difficult to assess which effects are explained by the reduced amount of carbohydrates, as well as the effects of changes in fat or protein proportions. We will discuss all the important studies in detail below.

The main reasons why LCHF is popular today are because the diet leads to losing weight, weight loss comes fairly fast and the diet seems easy to maintain. Difficulties with losing weight and maintaining a lower weight have been discussed in our article How to lose weight. LCHF does not appear to pose any health risks; on the contrary, studies suggest that LCHF has advantages over the traditional Swedish diet. This is discussed in detail below.

Is LCHF safe or does it involve risks?

There are no convincing studies to suggest that LCHF is harmful. The National Board of Health and Welfare wrote in a statement (2008) that:

“The recommendation of a “low-carbohydrate diet” to patients with overweight and patients with type 2 diabetes today can be considered in accordance with science and proven experience.”

Today there is even more science and proven experience that suggests that low-carbohydrate diet is a safe method for losing weight. Professor Christian Berne, who has been an investigator of the Swedish National Board of Health and Welfare, concludes that:

“evidence [evidence] of danger not emerged in so far made systematic literature reviews”.

In 2011, the Swedish National Board of Health and Welfare began to recommend low-carbohydrate diets to people with type 2 diabetes. You write the following:

In recent years, moderate low-carbohydrate diet has been scientifically studied to an increasing extent. Several studies have investigated the effect of moderate carbohydrate reduction even in diabetic patients. […] Several international guidelines for the dietary treatment of people with diabetes today recommend a diet that is largely similar to moderate low-carbohydrate diet, especially in case of overweight and reduced sensitivity to insulin.It is still unclear whether extreme low-carbohydrate diet can be good in diabetes, as there is no scientific basis for assessing long-term effects and long-term risks. If a person nevertheless chooses to try an extreme low-carbohydrate diet, it is important that healthcare services can provide information on the composition of this type of diet and monitor their state of health and the effect of their diet.

The American Diabetes Association (ADA) has over the years chosen not to recommend or discourage any specific diet for people with diabetes. In the latest opinion, ADA writes:

Carbohydrate intake from whole grains, vegetables, legyms and dairy products, focusing on foods with a high content of fiber and low total content of carbohydrates, should be preferred, especially over foods with a high content of sugars.

In 2013, the State Preparation for Medical Excursion (SBU) writes the following in its report on Food in Obesity, that low-carbohydrate diet such as LCHF is more effective than traditional dietary advice to lose weight. You write:

Several different advice on changing diet and drinking habits can reduce weight or waist circumference in people with obesity. In the short term (six months) advice on strict or moderate low-carbohydrate diets is more effective for weight loss than advice on low-fat diets. In the long term, there are no differences in effect on weight loss between advice on strict and moderate low-carbohydrate diet, low-fat diet, high-protein diet, Mediterranean diet, diet focused on low glycemic load or diet with a high percentage of monounsaturated fats.After people with obesity have lost weight, they can maintain their weight better with advice on low-fat diets with a low glycemic index and/or high protein content than with low-fat foods with a high glycemic index and/or low protein content. There is no basis for assessing whether advice on low-carbohydrate and Mediterranean foods, for example, are effective in preventing weight gain after weight loss.Cessation or death from cardiovascular disease: For people with obesity, intensive advice on Mediterranean foods (with extra olive oil or nuts) and almonds) to lower risk of getting sick or death from cardiovascular disease compared to advice on low-fat diet.Cowing sickness in diabetes. People with obesity have greatly increased risk of diabetes. […] However, advice on low-fat diets does not reduce the risk of diabetes compared to advice on a diet with standard fat content, among women with obesity who have passed menopause. [/quote]

Since the reports of the Swedish Social Board and SBus have been published, we will discuss these later and try to come to a conclusion about how effective LCHF is in losing weight, whether weight loss is sustainable in the long run and whether the diet is safe.

What is the difference between LCHF (Low Carb High Fat) and ketogenic diet (diet that provides ketosis)?

Ketogenic diet is a strict variant of LCHF. This means that the amount of carbohydrates is very gracely limited if you eat ketogenic diet. This, as a rule, means that one should not eat more than 50 grams of carbohydrates per day. The reason for calling the diet “ketogenic” is because the sharp decrease in carbohydrates causes the body to break down a lot of fat to get energy; when fat breaks down, ketones are formed (also called ketone bodies). Ketones can be used as energy (fuel) in the body, especially in the brain. You can read all the details about how the body handles carbohydrates, fats, ketones (ketone bodies) in our article Nutrients and Nutrition: Fat, Carbs and Protein.

LCHF and causes of the causes?

Man has evolved over millions of years and during this time the human body has adapted to its environment. Access to food, climate, nature and environment are some of the factors that shaped man. Man has been shaped according to his environment to maximize his chance of survival; this is called evolution. This means that our genes (and factors that govern how our genes are expressed) have been shaped by our environment. Our body — the brain, the gastrointestinal tract, the liver, the metabolism, the muscles, the heart and so on — has been optimized to the conditions that have taken place over the last thousands of years.

During most of this time, man has been a hunter and a collector and all food were natural, which means that it came directly from nature without being “processed” first (read more about the Paleo diet here). More than 8000 years ago, humans started farming, as a result of which the intake of carbohydrates increased. Over the past 200 years, dietary habits have changed dramatically. Carbohydrates found in bread, pasta, rice, potatoes, starch, etc., have come to dominate the food. In addition, life changed through automation, modernization and industrialization. Man, once a physically active being eating natural food, suddenly became sedentary and consumed tremendous amounts of processed food and carbohydrates.

This development is largely the result of industrialization, development in technology, chemistry and mechanics. During the 20th century, food production developed at a raging pace; food production became very efficient, more food was produced, more energy-dense food and more food was processed every year. 21 Carbohydrates became an increasing part of the content on the plate. At the same time, automation took off; instead of walking and running, we started driving a car, bus, train, plane; instead of working physically with hands, the machines took over and the man became increasingly passive. So we spent less and less energy while eating more calories.

World-renowned researcher Salim Yusuf has coined the term “causes of the causes”, which refers to the factors that lead to high blood lipids, high blood pressure, obesity, overweight, diabetes etc. Dr. Yusuf’s research team believes that the reason is simply the lifestyle changes that have taken place over the last 100 years. 22

In conclusion, man is most likely not built to eat the food that many of us eat today. LCHF is likely closer to “natural food” because LCHF means reducing the intake of processed carbohydrates.

Fat Hysteria, Cholesterol, Cardiovascular Disease and Heart Attack

In the 1960s and 1970s, the relationship between blood lipids and cardiovascular disease (coronary heart disease leading to a heart attack) was revealed. Since then, thousands of well-made studies have shown that high blood lipids (especially high LDL cholesterol, which is also called “bad cholesterol”) increase the risk of heart attack and cardiovascular disease. Lowering LDL cholesterol causes a reduced risk of a heart attack. This is not questionable, no matter how much you like LCHF and hate the pharmaceutical industry.

Unfortunately, there was a misunderstanding: it was assumed that fatty foods caused high lipids in the blood and therefore increased risk of a heart attack. This theory succeeded in etching itself among scientists, authorities and therefore the public. For the past 60 years, we have taken it for granted that fatty foods produce high blood lipids and that’s bad because it increases the risk of a heart attack. It was no longer before it was found out that fatty foods probably also lead to overweight and subsequently develop diabetes. Against this background, the Dietary Guidelines for Americans (DGA) have recommended eating low fat foods to prevent overweight and/or heart attack. There are two problems with this theory:

  • Fatty foods have little impact on blood fats.
  • Fatty foods have no significant impact on body weight. Because low-fat does not lead to losing weight (at least not convincing).

So the cornerstone of our diet advice in the Senate 50 years has been wrong. Nevertheless, dietary advice gained stringency and the population of Sweden, like the rest of the Western world, reduced their intake of fat. To compensate, they started eating more carbohydrates instead. In fact, this may be one of the reasons why the population has not succeeded in becoming slim, but on the contrary, we are just getting thicker.

New (and robust) science shows that you do not get better blood lipids by eating less saturated fat. In fact, if you eat less saturated fat and instead eat more carbohydrates, you get worse blood lipids. The old Swedish practice of replacing saturated fat (e.g. butter) with unsaturated fat (e.g. olive oil) is also not very scientific; studies show that this certainly lowers LDL cholesterol (“bad cholesterol”) and blood pressure, but it also leads to HDL cholesterol, i.e. “the good cholesterol”). cholesterol,” drops and this is unfavorable. Last but not least, triglycerides rise in the blood (this is a type of blood fat that is not desirable to have high levels of). In conclusion, the current Swedish dietary recommendation, which says that we should reduce the total intake of fat and saturated fat and increase the amount of carbohydrates, is not very scientific. 23

Carbohydrates, sugar, sugars, starch: dear child has many names

Carbohydrates are a collective name for several different substances. Carbohydrates often consist of chains of smaller molecules. Starch is an example of such a carbohydrate; starch consists of long chains of glucose (glucose). When we eat starch (found in potatoes, rice, pasta etc), the chains break down to glucose in the intestines, and then glucose is absorbed. The body uses glucose (glucose) as a source of energy in the first place. However, the body can also use fat and protein, but it prefers sugar because it is easiest to extract the energy contained in glucose. The fact is that all carbohydrates, except fiber, are converted into glucose in the body. So it does not matter if you eat fruit sugar, milk sugar, cane sugar or potatoes — all carbohydrates are converted to glucose (glucose) in your body. Thus, the exception to this rule is fibers, which are found among other things in plants. Fibers are carbohydrates that man can not break down and take up in the intestine and therefore fibers pass our small intestine (for man there are no calories/energy in fiber).

When we eat foods that contain carbohydrates, the carbohydrates (glucose) end up in the blood. Eventually, they reach the pancreas that reacts to glucose by releasing insulin to the body. (It should be mentioned that when eating food, incretins are also released from the intestine. GLP-1 is an important incretin and it also stimulates the pancreas to release insulin). In other words, when you eat food, you get carbohydrates and then insulin is released into the blood. Insulin signals to all cells in the body that glucose is coming and the cells can then prepare to absorb and use glucose as a fuel. In our fat (fat under the skin, fat in the abdomen, etc.), the cells react to insulin by stopping all fat degradation. In between meals, there is some fat breakdown because the body is able to extract the energy stored in fat. In fact, fat is extremely energy-rich; more energy-rich than glucose! The following picture illustrates this.

The process of eating food and carbohydrates (glucose) and incretins end up in the blood so that the pancreas (pancreas) releases the hormone insulin. Insulin leads to the fact that the cells of the body prepare to take in and use glucose, and at the same time the breakdown of fat is interrupted.

If you eat less carbohydrates, the level of insulin in your blood drops. Then the breakdown of fat increases and the body extracts more and more energy that is stored in the fat. Despite this, the body can maintain stable blood sugar and this is due to the fact that the liver has stored glucose in the form of glycogen, and it can break down the glycogen into glucose which is then sent out into the body. In addition, the liver (and kidney) can produce new glucose that is sent into the body. The latter (the production of glucose) is called gluconeogenesis, and the liver uses fat, protein and lactic acid as the building blocks for making glucose!

Prolonged reduction of carbohydrates in food leads to weight loss. This is the principle of LCHF!

Why do a low-carbohydrate diet and LCHF work?

First of all, we must note that diet with less carbohydrates works for those who want to lose weight. LCHF is today the most popular variant of this diet and there is good scientific support for losing weight with LCHF.

A study shows that low-carbohydrate diet provides the fastest and greatest weight loss, compared to low-fat diets and Mediterranean foods. Note, however, that you lose weight with all diets, which can certainly be explained by the fact that a diet change (trying to lose weight) often entails other lifestyle changes that cause you to lose weight (e.g. increased physical activity). It is the case that low-fat diets alone do not lead to significant weight loss (see below). Low carbohydrate diet had the best effect on blood lipids, while Mediterranean food had the best effect on blood sugar.

The question is: why and how does LCHF work? It can immediately be concluded that no one knows with certainty why LCHF works. However, there are several theories that may seem reasonable explanations and these are presented below. It should also be added that although you are not completely sure how and why LCHF works (to lose weight), it is nothing new under the sun; it is often in medical science. Thus, we can conclude that one factor (in this case LCHF) affects another factor (in this case body weight), without being able to account for the very mechanism behind.

1. More fat, more protein: increased satiety

Of fat, protein and carbohydrates, in fact, carbohydrates are the least satiating. This means that one gram of carbohydrates gives less satiety than one gram of protein, or one gram of fat. Protein is the most saturating nutrient. LCHF often means eating more protein and the high protein content in the food makes you more saturated. 24 Protein is about as energy-rich as carbohydrates but unlike carbohydrates, the body does not store protein. So there is no “protein layer” in the body and that means that excess protein is sent out again (we pee out the excess). LCHF means that you (as a rule) eat more protein and then you get more saturated without gaining weight. However, it should be noted that protein can be converted into both glucose (glucose) and fat but this is a costly process (many chemical reactions are required) that require energy.

2. Simple instructions

LCHF and other low-carbohydrate diets are easy to follow. One should simply reduce the intake of carbohydrates and the rest should be eaten (basically as one pleases). In other words, LCHF is an uncomplicated diet, because you only need to identify how much carbohydrates different foods contain. Doing it is an easy match. In the table below you can search 2000 Swedish foods and see how much carbohydrates the food contains (the table shows how many grams of carbohydrates are in 100 g of food).

Because you are not allowed to eat carbohydrates, the supply of food also decreases, which is likely to lead to reduced intake of food and thus weight loss.

Fibers do not contain calories and do not count

Note that fiber is actually a type of carbohydrate. Most fibers actually consist of glucose (glucose) but humans cannot break the bonds that hold the glucose units together and thus we cannot absorb fiber in the intestine. This means that fibers do not contain any energy for man (there are no calories in fiber!). Fibers pass our small intestine (where absorption of nutrients occurs) without being affected. In the colon, however, there are bacteria that can break these bonds and utilize the energy contained in the fibers (but we humans do not take up the nutrients contained in fibers). This means that you should not count fibers as energy.

3. Most people think LCHF is good food

4. Less carbohydrates give lower insulin and thus increased breakdown of fats

When we eat carbohydrates, glucose (glucose) comes out into the blood. Of course, there are other types of carbohydrates, but all forms are converted to glucose in the liver. In other words: when we eat food, the blood sugar rises (the level of glucose in the blood). Glucose signals to the pancreas to release insulin. This increases the level of insulin in the blood and makes the body’s cells prepare to absorb and use glucose (glucose) as a fuel. Insulin is, therefore, a hormone that sets the body to use glucose (glucose) as a fuel. Between meals, the insulin level in the blood drops. Then the fat tissue reacts by starting to break down fat. When fat breaks down, fatty acids and monoglycerides (also known as glycerol) are formed. Several organs can use fatty acids as an energy source directly. In the liver, fatty acids are also converted into ketones (also called ketone bodies) and these are also used as energy (especially by the brain). Last but not least, the liver can convert glycerol into glucose! Overall, this means that we break down fat when the insulin level in the blood is low. By eating less carbohydrates we also get lower insulin levels and then the breakdown of fat can start!

5. Ketones (ketone bodies) are satiating and reduces appetite

The less carbohydrates you eat, the more fat you break down (explained under item 3). Fat breaks down into fatty acids and glycerol. As mentioned above, some cells (for example, the heart) can use fatty acids directly as fuel. In the liver, fatty acids are also converted into ketones (ketone bodies) and these can also be used as fuel in the body, especially in the brain. The less carbohydrates you eat, the more ketones (ketone bodies) you make. Manufacture of ketones (ketogenesis) becomes especially pronounced if you eat less than 50 grams of carbohydrates per day. This type of diet, where the goal is to eat so little carbohydrates that ketogenesis becomes pronounced, is called a ketogenic diet. A strict LCHF diet is a ketogenic diet because you are betting on eating very little carbohydrates. Apart from the fact that a ketogenic diet (i.e. strict LCHF) leads to losing weight because you break down fat, it also leads to a decrease in appetite. Studies show that ketones (ketone bodies) and ketogenic diet lead to a decrease in appetite. The food intake can actually reduce 10% on the ketogenic diet! 25

6. Calorie for calorie: do carbohydrates contain more energy per calorie?

By now, you may know that fat, protein and carbohydrates contain different amounts of energy. Fat contains the most energy; each gram of fat contains 9.3 kilocalories (kcal). Carbohydrates contain 4.2 kcal of energy per gram, and protein contains 4.1 kcal per gram. The big question is whether 1 kcal of carbohydrates, 1 kcal of fat and 1 kcal of protein result in as much energy. In other words: is 1 calorie always 1 calorie? Do you lose as much weight on a low-calorie diet? What does the ratio of fat, protein and carbohydrates look like?

This is a rather difficult subject, but we are trying to make it understandable. The food we eat contains energy in the form of carbohydrates, fats and proteins. The aim is to convert these substances into a form of energy that the body can use. This energy form is called “ATP” and it is simply a substance found in all cells and it is used to drive chemical reactions. The body thus converts fat, protein and carbohydrates into ATP, which is then used as fuel. In fact, the chemical processes that convert fat, protein and carbohydrates into ATP are actually operated using ATP! So making energy costs energy!

It is various chemical processes that are required to convert fat, protein, and carbohydrates, respectively, into energy. These processes are not as effective. A number of studies suggest that converting carbohydrates is more effective than converting fat and protein. That is, it costs less to handle carbohydrates. The less it costs to produce energy, the more energy is created. This means that diets that contain a lot of carbohydrates are easier to extract energy from and then there is more energy per calorie. A diet that is rich in fat and protein is more costly for the body to handle and therefore the body cannot extract as much energy per calorie. In other words, low-carbohydrate diet (including LCHF) is more costly for the body and therefore the body consumes more energy and loses more weight! It is especially costly to eat protein because it costs the most to handle proteins.26

Studies thus suggest that 1 calorie is not always 1 calorie, which means that some calories affect weight more than others. Those who advocate LCHF and other low-carbohydrate diets have often pointed out just that. This means that if two people eat as many calories a day, but one eats less carbohydrates, that person will lose more weight. Of course, this has been investigated in clinical studies where two diets with the same amount of calories but different amounts of carbohydrates were compared. In a total of 9 out of 10 studies, reduced carbohydrate weight loss was found to be greater. 27

Even studies in animals show that limiting carbohydrates, without limiting total calories, gives a greater weight loss.28

Thus, there are studies that suggest that carbohydrates ultimately contain more calories than fat and protein. But the fact is that there are many studies that speak against this, and those studies are also well done. These studies allowed participants to be closely monitored at a research facility and examined what happens if they go from eating ‘regular food’ to eating low-carbohydrate food without changing the number of calories. These studies did not see that low carbohydrate diet yielded any benefits and the benefit of eating less fat was equal to the benefit of eating less carbohydrates. 29 Researchers advocating LCHF and low-carbohydrate diet have criticized these studies for (1) allowing participants to eat for a lot of carbohydrates, or (2) been too short (it is said that the studies have not followed individuals long enough to observe the benefits of a low-carbohydrate diet.

In conclusion, there is evidence both for and against that carbohydrates would have caloric benefits for calorie. The body definitely prefers carbohydrates and possibly it can extract more energy from carbohydrates, compared to protein and fat. If the body is worse at extracting energy from fat and protein then more energy is “spilled” when these substances are handled. Fat and protein are thus “less efficient” as an energy source and that means losing more weight by eating these substances.30

7. Loss of water

It should also be mentioned that a reduced intake of carbohydrates leads to us getting rid of water in the body. 31. As mentioned earlier, LCHF and other low-carbohydrate diets lead to the liver being forced to break down its glycogen into glucose. Glycogen is bound to water and glycogen degradation releases the water, with excess water peeing out. Each gram of glycogen is bound to 2 grams of water. When all the glycogen is broken down, a total of 1 kg of water is lost. About the same amount of glycogen is found in the muscles and this means that after 10 days of LCHF (low carbohydrate diet) you lose about 2 kg due to loss of water. 32 This can explain the rapid weight loss you see at the start of low carbohydrate diets. In addition, ketone bodies are made which also lead to us peeing more. 33

Summary

LCHF and low-carbohydrate diet are easy to follow and the food is considered good because fatty and protein foods include many popular dishes and foods. The high percentage of fat and protein makes you measured by fewer calories. The instructions are simple, you only need to get rid of food and foods rich in carbohydrates. Food should contain about 5% carbohydrates (normal LCHF). By eating less carbohydrates, blood sugar and insulin levels decrease, which leads to a breakdown of fat and thereby lose weight. The body can provide its energy needs on fatty acids, ketones and proteins. You do not risk getting low blood sugar because there is little sugar (carbohydrates) in your food and in addition the liver makes sugar (glucose) from glycerol which is formed during the breakdown of fat. You also do not have to count calories because you are likely to still eat calories when you decrease in carbohydrates. If you count calories (to reduce the number of calories) you are likely to lose even more weight but in the long run it is not recommended.

If You have Type 2 Diabetes

Reduced intake of carbohydrates leads to the fact that blood socket becomes lower. Then the need for medicines and insulin (which lower blood sugar) may decrease. It is important that you measure your blood sugar frequently if you start with LCHF. However, Metformin does not involve an increased risk of low blood sugar. It is advisable to contact your doctor/nurse to inform you that you are adjusting your diet to LCHF. Although LCHF often results in better blood pressure and better blood lipids, it may be useful to check these parameters after conversion to LCHF.

The science behind LCHF: lose weight, blood sugar, blood lipids, blood pressure

In 2006, Nordmann published a meta-analysis of 5 clinical trials comparing low-carbohydrate diets with low-fat and low-calorie diets. After 6 months, the largest weight loss was seen in the low-carbohydrate diet group (they had lost 3.3 kg more than the other groups) but after 12 months there was no difference between the groups (Nordmann AJ et al. (2006) Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk Factors: a meta-analysis of randomized controlled trials. Arch Internal med 166:285—293).

Nordmann also examined how low-carbohydrate diet affected risk factors for cardiovascular disease. It was found that low-carbohydrate diets had a better effect on HDL cholesterol and triglycerides; but low-fat diets had a better effect on total cholesterol and LDL cholesterol (Nordmann AJ et al. (2006) Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta analysis of randomized controlled trials. Arch Internal med 166:285—293).

People with diabetes lose more weight by limiting carbohydrates, compared to limiting other nutrients, according to a Danish study (Due A et al. (2004) Effect of normal-fat diets, either medium or high in protein, on body weight in overweight subjects: a randomised 1-year trial . Int Jobes Relat Metab Disord 28:1283—1290).

Several studies comparing low-carbohydrate diets with other diets have shown that low-carbohydrate diets in principle always produce faster and more pronounced weight loss at the beginning, but that differences between groups are blurred after some time. However, there are qualitative studies that have long-term follow-up where it is seen that low-carbohydrate diets are better also in the long term. Shai and colleagues have done several important studies that had excellent adherence to the study and showed that low carbohydrate diet was superior to other diets for losing weight. Shai’s study shows that low-carbohydrate diet is as good as the Mediterranean diet for losing weight. After 2 years, the low-carbohydrate group lost 4.7 kg, the Mediterranean diet 4.4 kg and low-fat diet 2.9 kg. The blood fats (which are of importance for cardiovascular disease) changed similarly in all three groups!

Side effects and undesirable effects of low carb high fat (LCHF)

Rapid decrease in carbohydrates (sugar, starch) can lead to a change in the first few days. It can be compared to a common dependence that needs a couple of days detoxification. You can then feel increased anxiety and sugar cravings. This is rapidly transient (usually within 1 to 2 days). Headache, fatigue, constipation, dizziness, palpitations and irritability may also occur in the first few days. Constipation can become protracted and requires increasing the amount of fiber in the food.

As the days go by, the body adapts to burn less carbohydrates and more fat, which reduces the symptoms of change. It is important to drink extra water the first week and feel free to salt the food a little extra. Half a teaspoon of salt in a large glass of water once a day for 7 days do the trick.

If you experience severe changes (unusual), you can gradually reduce carbohydrates over a week instead of a cross decrease. However, we recommend that you start your LCHF diet by making a dramatic reduction in carbohydrates.

LCHF and risk of cancer

Theoretically, a strict low-carbohydrate diet can lead to nutritional deficiency and osteoporosis, as well as kidney damage. It can, theoretically, also impair the body’s defenses against cancer by weakening the immune system (because fruit, vegetables and fiber are associated with the ability of the immune system). However, these concerns have not been confirmed and therefore today it cannot be argued that LCHF, other than theoretically, increases the risk of cancer. [ootnote] Bray GA et al: Low-carbohydrate diets and realities of weight loss. JAMA 289:1853-1855. Crowe TC et al: Safety of low-carbohydrate diets.Obes Rev. 6:235-245 [/footnote]

High consumption of red meat (beef, lamb, pork) also appears to increase the risk of cancer. In particular, the risk of colon cancer (colon cancer) increases with increased intake of these foods. Thus, there is reason to consume only moderate amounts of red meat. Fish and poultry have not been shown to increase the risk of cancer. It should also be added that the risk of cancer, including colon cancer, decreases when losing weight.34

LCHF, osteoporosis and muscle mass

Krieger and colleagues have investigated 87 studies (which, however, had a short follow-up) on the effects of LCHF/low-carbohydrate diet. In these studies, it was noted that low carbohydrate diet resulted in rapid weight loss but also a greater loss of skeletal and muscle tissue (0.7 kg more loss). After 12 weeks, low carbohydrate diet had given 1.7 kg greater loss of bone and muscle tissue compared to diet rich in protein. 35 We, therefore, recommend that you who have risk factors for osteoporosis, or who have a muscle disease, discuss with your doctor before starting LCHF. However, it should be added that other diets also cause loss of skeleton and muscles.36

LCHF and effects on kidneys

If you eat a lot of protein as part of a low-carbohydrate diet, there is a risk of kidney damage. There are studies that indicate that high protein intake among people with impaired renal function can be harmful. However, subjects with normal renal function had no renal impact on a diet with a high protein content. 37

LCHF/ketogenic diet and risk of kidney stones

Ketogenic diet has been reported to increase the risk of kidney stones among children, but not among adults. 38

Atkins diet: a type of low-carbohydrate diet

The Atkins diet claims that it provides weight loss without the need to take into account calories. The Atkins diet advocates a sharp decrease in carbohydrates in food. Atkins diet involves eating a maximum of 20 g of carbohydrates per day initially, and then gradually escalate it to 100 g/day. That is, with the Atkins diet, losing weight fast at the initial stage (because carbohydrate intake is low). Thus, the Atkins diet provides ketosis (it is a ketogenic diet). With the Atkins diet you eat a lot of protein foods (meat, fish, chicken, eggs) instead. Fatty foods (cheese, oil) are allowed in almost any quantities. Vegetables should have a low carbohydrate content. Sugar is strictly prohibited.

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  1. Man använder  termen “Energiprocent, E%” för att ange hur mycket energi som kommer från kolhydrater, fett och protein.