Lower Carbohydrate, Higher Fat and Ketogenic Diet? What's It All About

In 2018, the experts, health ‘gurus’, and social media ‘influencers’ we subscribe continue to battle it out over the Lower Carbohydrate Higher Fat (LCHF) Diet and Ketogenic Diet (KD). Such noise has increased confusion on the merits and appropriateness of this diet. Maybe you’ve been so conditioned to avoiding fat that it’s become increasingly difficult to wrap your head around eating more fat and lowering your carbohydrates, for the benefits seen in research and promoted by this way of eating. No doubt all the hype about this dietary approach has caught your attention and now you’re wanting to learn more and see if this new diet is for you. So, let’s get into it.

Let’s start by defining.

There are many variations of the ‘Lower Carbohydrate Diet’, however the overall purpose of these type of diets (regardless the ‘style’ you choose) is to change your eating patterns and food choices by limiting foods rich in carbohydrates, especially refined and highly processed foods. These diets promote an increased dietary intake of foods rich in protein and/or fat; from plants and animals. In other words, it changes the ratio of carbohydrates to protein to fat macronutrients. They both promote maximising the quality of the foods you eat, especially gut health promoting high fibre carbohydrates when eaten.

There are distinguishable differences between the LCHF Diet and KD and these are:

Typical KD macronutrient profile is well defined and comprises of 75% fat, 20% protein and 5% (<50g per day) carbohydrates. To highlight, 50g of carbohydrates per day is equivalent to 1 apple, 1 slice of bread and 1 small potato. These are based on a person’s intake of 8,400kJ/day.
Typical LCHF macronutrient profile is poorly defined but usually comprises of 25% carbohydrates (<130g per day), 20-30% protein and 45-55% fat. These are based on a person’s intake of 8,400kJ/day.
The KD drives the metabolic process in your body called Ketosis. During a state of Ketosis your body creates ketones, which are produced from the breakdown and metabolism of fats and uses them for energy as an alternative to glucose/sugar (from carbohydrate/protein rich foods). Achieving ketosis is the primary goal here, stimulated by the significant dietary restriction of foods rich in carbohydrates (as too many carbohydrates reduces the likelihood of achieving a state of ketosis). This includes fruit, some vegetables (mostly starchy), all grains, cereals and legumes and some dairy.
The LCHF diet has fewer dietary restrictions due to the macronutrient profile however in my practice most clients who follow any form of a Lower Carbohydrate Diet restrict at least one food group. It’s important to note that research has shown that eating wholegrains, fruits and vegetables/legumes can lower the risk to chronic disease and are an excellent source of vitamins, minerals, fibre and phytonutrients. [vi – vii]
Research supports the use for a KD as a medical intervention in some cases of epilepsy and may play a role in some cancers, particularly brain cancer. [i-iv]

What are the average Australians eating for carbohydrates

On average, Australians consume about 220g of carbohydrates per person per day, making up 40-45% of total energy intake which is considered a moderate intake of carbohydrates. The current Australian Dietary Guidelines which is designed for a healthy Australian population suggest 45%-65% of the diet should be made up of foods rich in carbohydrates. [v]

What does the food look like on these diets?

The following is a list of foods that are commonly eaten more often and less often on LCHF and KD.

Eat more of:

Animal foods – eggs, fish (all types, preferably oily fish such as salmon, mackerel sardines and tuna), meat (all types), poultry (all types) and seafood (all types)
Dairy – no added sugar full-fat cheese (all types), cottage cheese, cream, sour cream and dairy alternatives such as coconut yoghurt and almond milk.
Fruit – avocado, blackberry, blueberry, elderberry, olive (all types), raspberry and strawberry.
Nuts – almond, brazil, macadamia, peanut, pecan and walnut
Seeds – chia, flax, hemp, pine, pumpkin, sesame, sunflower and tahini.
Vegetables – artichoke, asparagus, bamboo shoots, beans (green, wax, Italian), bean sprouts, beets, brussels sprouts, broccoli, cabbage (green, bok choy, Chinese), carrots, cauliflower, celery, Chinese greens such as bok choy, choy sum, Chinese broccoli), coleslaw (packaged, no dressing), collard greens, cucumber, eggplant, fennell, garlic, greens (collard, kale, mustard, turnip), kognac, mushrooms, okra, onions, peppers, radishes, salad greens (chicory, endive, escarole, lettuce, romaine, spinach, arugula, radicchio, watercress), sprouts, squash, sugar snap peas, swiss chard, tomato, turnip, watercress, and zucchini.
Cooking fats – grass-fed butter, coconut oil/cream, mayonnaise and olive oil.
Flour – almond, coconut, flax and LSA.

Eat less of:

All grains and cereals – bread, breakfast cereals, buckwheat, noodles, pasta and rice quinoa.
Dairy – milk, yoghurts (of any kind)
Fruit – apple, apricot, banana, cantaloupe, cherries, clementine, date, dried fruit (all types), fig, grapefruit, grapes, guava, honeydew melon, kiwi, mandarin, melon, nectarine, orange, passionfruit, peach, pineapple, plum and watermelon.
Nuts – cashew and pistachios.
Vegetables – butternut squash, corn (all types), peas, potato, pumpkin (all types), sweet potato, taro and yam.
Legumes/Pulses – baked beans, black eye beans, broad beans, cannellini beans, chickpeas, haricot beans, lentils (all types), pea pods and 4 bean mix.
Flour – all wheat/grain based.
Drinks – coconut water, juice (all types) and sugar containing beverages.

Taking the next step

You may have noticed that I haven’t reinvented the wheel and placed myself in the middle of the war-zone with facts or debates for or against these types of diets or provided general non-specific advice.

Just like all dietary approaches, there is no one size fits all. If you are considering these types of diets, you need advice from an Accredited Practising Dietitian (APD) with an interest and expertise in this area of nutrition. Why? Looking at the foods listed that are commonly eaten more often and less often, it’s going to require meticulous planning to adjust your diet to achieve this style of eating. Not to mention that the most successful nutritional strategy is one that is individualised, that takes into consideration culture, food availability and personal preferences. And of course, follows recommendations that encourage a variety of foods from the five main food groups each day.

Key to any nutritional strategy or Diet is ensuring that it is able to be maintained over the long term, whilst providing adequate amounts of nutrients and kilojoules to achieve optimal health and wellbeing. Working with an ADP ensures the approach is right for you, long term habits are developed to prevent a yo-yo effect, and not blindly following what the latest celebrity trend is.

Written by Absolutes Accredited Clinical & Sports Dietitian Andrew Ho-Peng

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Lower Carbohydrate, Higher Fat and Ketogenic Diet? What’s It All About

Lower Carbohydrate, Higher Fat and Ketogenic Diet? What’s It All About

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