Questions and answers about LCHF

Frågor och svar om LCHFHere are common questions and answers about low carb high fat (LCHF) nutrition and health:

Is saturated fat dangerous?

No. That is an old and disproven theory. It’s been a mistake from the beginning. More.

I started eating LCHF / very low carb and I feel dizzy / a headache / tired?

Dizziness / headaches and similar symtoms are common during the first week as your body adapt to a very low carb diet. These symptoms usually go away in a few days.

Adding a bit more carbs to the meals reduces the symptoms but can slow the adaptation (and weight loss).

Another possibility is that you are dehydrated / low on salt. When starting a very low carb there is extra loss of salt and fluids through the kidneys in the first weeks, until the body adapts. Drinking some extra fluid and putting some extra salt on your food during the first week can avoid this problem and often cures the symptoms. Alternatively you can drink some buillon a few times a day.

Do you use blood pressure medication? A very low carb diet can lower high blood pressure, and medication may need to be reduced in that case. Low blood pressure may result in dizziness.

Why are Asian rice eaters thin?

Probably because they do not eat a lot of sugar or refined starch. More.

What about gallstones and LCHF?

High fat food can give you short term trouble if you already have gallstones. Low fat food gives you gallstones in the long term. More.

Can you eat LCHF if you’ve had your gallbladder removed? Yes.

Can you eat low carb cookies / bread / pasta and lose weight?

That is probably not a good idea:

Do you get cancer from eating red meat?

Highly unlikely, although favoring unprocessed meat is the healthiest choice. Replacing meat with processed carbs may be one of the worst things you can do for your health and weight. More. 

Do you get hypothyroidism on a very low carb diet?

No, hardly on a well-formulated low carb diet, meaning you replace the energy from carbs by eating more fat. In scientific studies on LCHF there are no problems with the thyroid and I see no new thyroid issues in my patients going strictly low carb.

However, starvation can lead to hypothyroidism, and if you remove carbs AND fat from your diet you will be starving. So you do need to eat carbs or fat to fuel your body.

Bottom line: A LCHF diet is fine for your thyroid. More.

Is there scientific proof that LCHF is good for weight / blood sugar / cholesterol / blood pressure?

Yes.

Are studies showing better weight loss on low carb diets sponsored by the meat industry or the Atkins foundation?

Yes, a few of them are. But repeated independent studies show the same results.

Does insulin play a role in weight gain / loss?

Yes, it’s absolutely crucial in most cases. Some bloggers have objections but they do not change biochemical facts. More.

Can you drink alcohol on LCHF?

Sure, in moderate amounts. But beer and sweet drinks need to be avoided. Choose wine or non-sweetened liquor. More.

Is salt dangerous?

No. At least not in moderate amounts. More.

What’s a good LCHF breakfast except for eggs?

Perhaps this.

Can you eat fruit on LCHF?

Only occasionally, as an exception, if you want to be strict and get the maximum effect. Fruit contains a lot of sugar. Fruit is candy from nature.

Why are Americans obese?

This is why.

More knowledge

This talk by me from the Ancestral Health Symposium 2011 summarizes the history and science behind the ongoing revolution in diet and health.

More theory and practice

Here four of the world’s biggest experts on the subject explain the theory and practice of various kinds of carb restriction:

Do you have more questions?

Here’s more Q & A from my mailbox.

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381 Comments

  1. Zepp
    You are insulin resistent.. and that doesnt revert that fast.. thats what happens in your body now.

    And insulin resistens is a way for your cells to protect against high blood sugar.. excersise is one way to make more GLUT4!

    GLUT 4 is your insulin dependent glucose transport chanels in to your cells.. and you never have more then you need.

    If one have high glucose levels and high insulin levels.. one need less.

    And to make more complicated.. then when you start eating a high fat diet/ketogeic diet.. fat strugle for entry in to you cells.. you get partly "fat induced insulin resistent"!

    Starving and excersice is a way to coop whit both.. but not that pleasant at same time.

  2. Zepp
    im not Doc.. but that is normal glucose levels.. 3-6 is normal in fasting state.. and up to 8 after a meal.

    It seems to me as classical transitation side effects.

    And yes is about glucose shortage.. but if one is healty.. it never goes low.. but you can feel effects of hormones trying to get it up.

    Thats mostly becuse your body still use glucose and they are in short suply.

    http://www.ketotic.org/2012/05/keto-adaptation-what-it-is-and-how-to....

  3. Jo
    Thanks Zepp.

    Tried the tuna with water, tastes yuck. So i can't have that.

    How about double cream milk, chicken spread or mayo 3tsp daily?

    Reply: #354
  4. Zepp
    Yes.. my opinion too!

    Soo Im stuck to coock and eat real food!

    And mayby thats the good outcome of it.. there are no shortcuts!

    How about to buy, coock and eat real food frome the best you can find?

    Cream milk, chicken spread and mayo you can use in your coocking!

  5. Dorothy
    I had Yellow Jaundice when I was 13, and have since then had to be really careful with eating fatty and rich foods. It seems as though this LCHF diet is just that...fatty and rich foods. Is this true or is it all in my head? I am 33 years old now.
    Thanks.
  6. Anne Rosbottom
    Hello,
    It would seem like I would end up eating more protein on this diet, is this not bad for you? Also, I read a post by "a proper doctor" who said it's all about energy in and energy out and saturated fat is bad for you. I just find this a bit worrying. Can you help?
    Thanks,
    Anne

    u

    Reply: #359
  7. Sue
    I had part of my thyroid removed and are on Eltroxin 0.1mg. My iron levels drop if i don't eat the right foods. Can I go on the LCHF Diet without side affects
    Reply: #360
  8. Jenise LeMay
    Hi. I'm trying to figure how milk fits into the picture. Is it to be avoided totally? Also, how do we get the vitamins that fruit provides if we don't eat them. I've always felt that fruit has special nutrients, but am supposing most of that would be made up in the vegetables.
    Reply: #361
  9. Zepp
    Well its not a high protein diet.. its a high fat diet!

    Protein is not that good as fuel.. and when on cut out a lot of carbs one need to eat some other energy rich macro nutrient.. otherwise one starv.

    There are no evidens that saturated or total fat is dangerus.. except mayby a lot of Omega-6 oils.

    And ofcourse its about calories.. if one need to lose weight.. one should eat such food that make one burn fat.. and if one eats a lot of carbs the body burns glucose, cuts of fatoxidation and store the excesses.. and when your blood sugar drops.. you get hungry again.

    Heres an cardioligist that wrights about healt, cardivascular diseases, food and others.

    http://www.docsopinion.com/

    And here some beginners advice!

    http://lowcarbdiets.about.com/od/lowcarb101/a/gettingstarted.htm

    http://authoritynutrition.com/low-carb-diet-meal-plan-and-menu/

    http://www.ketotic.org/2012/05/keto-adaptation-what-it-is-and-how-to....

  10. Zepp
    Eltroxin is the same as Levaxin a replacement for those T4 your thyroid gland not producing.

    Its not affected of food as long one dont eat poison.

    The best source for iron is hem iron its easyest for humans to take up in the blood.

    Hem iron is in meat and blood.. becuse other animals have the same iron then we need and use.

  11. Zepp
    Use milk and other dairys to your meals and to your cooking.. dont live on dairys if you need to lose weight.. eat proper meals.

    As you did understand.. there are more nutrients in veggies.. but fruits are real food.. but provide mostly water and sugar.

    Take fruit as dessert after a proper meal or some berries.. and its like dairys.. dont live on fruits!

  12. Helen
    Will LCHF cause gout? I thought that wheat and sugar would cause it but everything I have been reading says meat does. My father in law suffers from it and I was going to tell him to avoid starches but it looks like it is meat that causes it and I am ketogenic so now I am concerned that I will develop gout.
    Reply: #363
  13. Zepp
    Its wrong that you read!

    Gout is moste often about metabolic syndrome.. and fructose and alcohol is a major concern!

    No its not about meat.. its about purines.. and then they extrapolite frome that.. and think its about meat!

    Its about uric acid and the kidneys ability to excret urea.. its often about genetic predisposition and other factors that make the uric acid to fall out as crystals!

    Drinking lot of water and high intake of c-vitamine says to make one pee out more uric acid.

    "Lifestyle
    Dietary causes account for about 12% of gout,[2] and include a strong association with the consumption of alcohol, fructose-sweetened drinks, meat, and seafood.[4][8] Other triggers include physical trauma and surgery.[6] Recent studies have found that other dietary factors once believed associated are, in fact, not, including the intake of purine-rich vegetables (e.g., beans, peas, lentils, and spinach) and total protein.[9][10] With respect to risks related to alcohol, beer and spirits appear to have a greater risk than wine.[11]
    The consumption of coffee, vitamin C and dairy products, as well as physical fitness, appear to decrease the risk.[12][13][14] This is believed partly due to their effect in reducing insulin resistance.[14]
    Genetics
    The occurrence of gout is partly genetic, contributing to about 60% of variability in uric acid level.[6] Three genes called SLC2A9, SLC22A12 and ABCG2 have been found commonly to be associated with gout, and variations in them can approximately double the risk.[15][16] Loss-of-function mutations in SLC2A9 and SLC22A12 cause hereditary hypouricaemia by reducing urate absorption and unopposed urate secretion.[16] A few rare genetic disorders, including familial juvenile hyperuricemic nephropathy, medullary cystic kidney disease, phosphoribosylpyrophosphate synthetase superactivity, and hypoxanthine-guanine phosphoribosyltransferase deficiency as seen in Lesch-Nyhan syndrome, are complicated by gout.[6]
    Medical conditions
    Gout frequently occurs in combination with other medical problems. Metabolic syndrome, a combination of abdominal obesity, hypertension, insulin resistance and abnormal lipid levels, occurs in nearly 75% of cases.[3] Other conditions commonly complicated by gout include: polycythemia, lead poisoning, renal failure, hemolytic anemia, psoriasis, and solid organ transplants.[6][17] A body mass index greater than or equal to 35 increases a male's risk of gout threefold.[10] Chronic lead exposure and lead-contaminated alcohol are risk factors for gout due to the harmful effect of lead on kidney function.[18] Lesch-Nyhan syndrome is often associated with gouty arthritis."

    http://en.wikipedia.org/wiki/Gout

    One have to try it out.. and ofcourse.. there are no need to overdo the meatconsumtion.. if one have gout problems!

    You know.. those how solv the Gout mysterie.. is Nobell prise candidates!

    You know one can get gout with low levels of uric acid and many with high levels dont get it!

    Its probably multi factoral.

  14. Susanne
    Hello
    I have a question about some blood test result that I have just received after being on the LCHF diet for half a year.
    My "bad" cholesterol has gone from 3.8 to 4.7
    My "good" cholesterol has improved - 1.98
    My Diabetes has gone from 40 to 41.

    I find this really upsetting and wonder what on earth I have done wrong. I do eat butter and the occasional cream but avoid as much Carbohydrates as I can.
    Can you help lease?
    Susanne

    Reply: #365
  15. Zepp
    Your LDL is still low.. and your HDL is super!

    The normal thing on a high fat diet is that Total cholesterol rises a bit, and HDL rises a lot.. thats good!

    The higher LDL is often becuse of the formula they use.. becuse they dont measure LDL.. but counts it mostly from triglycerides.. and that altso supose get lower.

    Then the counting does that LDL seems to have rised.

    http://www.docsopinion.com/2013/12/15/10-pitfalls-of-using-ldl-choles...

    But if its HBA1c its normal?

    "In general, the reference range (that found in healthy persons), is about 20–40 mmol/mol (4–5.9 DCCT %)"

    http://en.wikipedia.org/wiki/Glycated_hemoglobin

  16. Susanne Khouri
    Hej och tack för svar.
    Jag får nog studera det där lite mer. (Min doktor rådde mej att sluta med dieten.)
    Jag är 67 år och frisk och kry så det var därför som jag blev orolig för min höga diabetesvärde. Som jag förstår så är 40 i högsta kanten av normal och så att ha gått UPP en till 41, fastän jag varit så försiktig med sockret är förbryllande. Men jag ska titta på de där länkarna som du skrivit.
    Susanne
  17. Kathryn Mary
    Where does coconut milk and coconut cream come into the lchf way of eating. Is it ok to eat?
    Reply: #368
  18. Zepp
    If its whithout sugar its okey!

    But it often got the same amount of carbs as milk.. take cream!

  19. Mark
    I have a question for you and I really hope you can answer it for me.. How do I stay on carb free diet for the long run?
    I have been on a LCHF diet before and I go back to my old habits after 2 months. I know it works, but it's hard for me to sustain my eating habits on carb free diet!
    Here is why:
    I get tired of eating the same food over and over again, I am usually just eating meats, like steak, but after a while, I start to want variety in my foods and start eating bad again. I don't know how to cook and I don't want to read thousands of complicating recipes. Is there a simple carb free recipes for meals i can use to start cooking? Please help
  20. Zjb
    Hi,

    I read about this diet and i really want to give it a try.

    However i have my doubts, since i have problems with high cholesterol.
    Most doctors i met, advised me to avoid fat meat and high fat dairy products, and only eat beef/chicken, but no pork since it has too much cholesterol.

    How does the LCHF diet decrease cholesterol, if it does?

    Reply: #372
  21. Sophie
    Hello LCHFers,

    Does anyone have any advice on how to eat LCHF on the cheap? I am trying to watch my budget and for the most part of my LCHF life money was no object and I bought whatever food I wanted... Now I am trying to be smart.

    What are good things to buy? any tips on how to eat high fat? What foods are the cheapest and most filling?

    I intend to buy chicken to make broth, and marrow. I like a lot of cream and butter... Any tips would be welcome!

    Reply: #373
  22. Zepp
    Moste of your cholesterole is made in your body.. and if you eat more, then your body not making that much itself.

    Its bogus.. this fat/cholesterole hypotesis.. its extrapolited frome those witth Familiar Hyperlipedmia!

    High blood lipids is mostly part of the metabolic syndrome.. how mostly is about Hyperinsulinemia.

    And you know whats to moste comon cause of chronical high insulin?

    Its high blood sugar.

    Some of us do have higher then normal lipids anyhow.. but a ketogenic diet reduce internal cholesterole production by Glukagon.

    Cholesterole is regulated by a lot of mechanismes.. for instans Insulin promotes it and Glukagon reduce it.

    " HMG-CoA reductase is also hormonally regulated. The enzyme exists in phosphorylated (inactive) and dephosphorylated (active) forms. Glucagon stimulates phosphorylation (inactivation), and insulin promotes dephosphorylation, activating the enzyme and favoring cholesterol synthesis."

    http://www.bioinfo.org.cn/book/biochemistry/chapt20/bio8.htm

  23. Zepp
    You should go for that cheap fatty long cooking meat.

    Make stews and soup/broth.

  24. brett
    What are your thoughts on LCHF for a marathoner. I run 120-130km per week, I have been on strict LCHF (aprrox 20-30g carbs per day) for 2 weeks and I have been on low carbs for 2 1/2 months (100g per day) but I am really struggling for energy on very long runs (over 25km). I have also been a lot more thirsty than normal on some runs as well. Do you have any advice or suggestions?
    Reply: #376
  25. Ross Korbell
    Hi all, I have read extensively on the lchf diet and I have one important question which I can find no answers. That is,
    What happens to the high fat that I eat if I am not in ketosis?

    Any insight on this will be greatly appreciated from the bottom of my heart. Thanks everyone for sharing so much info and experiences, it really helped tremendously. I already lost 14 pounds in lchf one month although I am probably not in ketosis because I eat bananas for the potassium and it prevents the "weird" feeling. I also eat things like fried chicken where there is carbs and sugars in the batter. However I am hesitant to purposely ingest fats although that is suppose to give better results. Perhaps I will feel more reassured if I know what happens to fats if I am not in ketosis..? Help!

    Replies: #377, #378
  26. Zepp
    It seems that more and more long distance runner take an LCHF approche.. and its a very good reson for that!

    Those in the elit can use as much as 10,000 Kcal in such race.. its a menace to indulge such amount of energy and still runing!

    But one have several 100 tusends of energy stored as fat.. better to use that.. and replace it afterward!

    But on a high strenius excercis one use more then normal amounts of glucose.. then its enough to ad that glucose.. mayby not more then 2000 Kcal in that race!

    Heres an Ultra Marathon sucessfull runner!

    http://www.timothyallenolson.com/2013/04/10/nutrition/

    And if you got the hand on Superstarch.. use that in your race!

    http://www.generationucan.com/super.html

  27. Zepp
    To sort something out for you!

    One burn what one eats!

    And the high fat part is high as your energy demand.. it often regulates by it self.. IE, one dont eat more then nesecery of Calories.. becuse one have plenty of fat stored!

    I can asure you that a major part of your meals get stored.. and then used betwen meals.. often a high fat approche make one eat more seldome!

    Dont bother about ketosis.. its altso regulates by it self.

    If one eats less carbs then your bodys emediate need for glucose.. the body make ketone bodies.. to replace some of that glucose.

    Dont eat pure fat by spoon.. its disgusting.. and some sort of eating disorder.. on the other hand.. dont be afraid for fatty food..or using fat in your coocking.. its as simple as that!

    You know.. following advices to get in to ketosis.. for example 20 grams a day your body do upregulate your betaoxidation and your capacity to burn fat instead of using glucose.. without going thru ketosis.

    The major fat burning in your body is still and even more frome now fat burning/betaoxidation without going thru ketosis!

    Ketosis is about replacing glucose for tissuies that not can use fatoxidation directly.. like your brain, small parts of other internal organs.. and your heart prefer ketone bodies.. sparing glucose.. for other organs!

    http://www.ketotic.org/2012/05/keto-adaptation-what-it-is-and-how-to....

  28. A
    Ross,

    Regarding your potassium, have you tried coconut water? I can highly recommend it as it contains loads of potassium without getting the extra sugar that bananas have. The amount of carbs depends on what brand of coconut water you buy but I believe that the highest amount is still lower than what a banana contains (23 g carbs/100 g). Someone told me that coconut water contains as much potassium as four bananas so you might have to look it up for medical reasons.

  29. Geri
    I have lactose intolerance and will not be able to eat , heavy cream, cheese, etc. Any
    suggestions or recommendations?
    Reply: #380
  30. Zepp
    Me too.. so I use lactose free dairys!

    But.. in reality.. I dont use that much dairys.. I eat real food instead!

    Well if you got problems frome chese and butter.. its rather exceptional.. becuse they only have trace amounts of laktose!

    And on top of that.. one is on a LCHF diet for weightloss adviced to avoid dairys anyhow!

    Eat pork and other fatty meat.. fatty fisch and fatty veggies.. eat the meat with the fatty rind on it!

    http://www.fitintegrity.com/uploads/9/5/1/6/9516119/no_sugar_no_starc...

  31. Vanessa
    Hi, absolutely LOVE your blog. Thank you!! I have always been interested in nutrition and have been doing a significant amount of research into Paleo/ Low carb high fat. I was a carb addict (literallly lived off carbs!) but have been carb free for 17 days now.

    I feel like crap :( Literally, I could cry. I just spent 2 hours in bed and I am usually an annoyingly active and busy person. I am exhausted every day, I even struggle to lift my legs to walk. I eat enough calories, enough protein and a lot of fat.

    I do go to gym most mornings and I do high intensity work outs. I come back and have raspberries within 30 mins of my workout for glycogen depletion.

    I am trying to do everything by the book. Can it be that LCHF isnt perfect for everyone???? Am I potentially doing something wrong??

    I am not overweight and relatively healthy. I am doing this because I want to be at my optimum health and I have a long family history of cardiovascular disease. My husband is doing it to. He has a lot of weight to lose but I am seeing little change :( I would apprecaite any responses!

    Thank you!! :)

    Reply: #382
  32. Zepp
    You are in transitation period.. and it take some time still to adapt.. and that goes for your husband too!

    What you fell is mostly glucose shortige.

    And many do lose salts in the begining, ad more salt to your meals.. or take plain salt in a glas of water.. drink it.. if you feel better after an hour, then it was salt defiency.

    http://www.ketotic.org/2012/05/keto-adaptation-what-it-is-and-how-to....

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