Pumpkin and Pinenut Spinach Salad


Roasted pumpkin is a delicious base for a salad (and lower in carbohydrate than most people think!). If you need a higher carbohydrate option, you could use sweet potato instead of the pumpkin. Combined with feta and crunchy pinenuts, you can have a gourmet vegetarian dinner any night of the week, or a great salad addition to a summer BBQ.

Recipe from Super Food for Performance in Work, Sport and Life.

Serves 4-8

750g butternut pumpkin, peeled
2tbsp olive oil
40g pine nuts
150g baby spinach leaves
80g feta cheese
Additional 2tbsp olive oil
1 tbsp. lemon juice
1 tsp Dijon mustard

Preheat oven to 200 degrees C.  Chop pumpkin into small cubes and place on a baking tray lined with baking paper.  Drizzle with the olive oil and turn to coat.  Roast for 30 minutes or until tender and leave to cool.
Towards the end of cooking, place the pine nuts on a baking tray in the over for a couple of minutes to lightly toast, or this could alternatively be done in a small non-stick frying pan on the stove.  Allow to cool also.
Place spinach in a serving bowl, top with pumpkin, pinenuts and crumbled feta.  Whisk additional 2tbsp olive oil, lemon juice and Dijon mustard and season with salt and pepper.  Serve salad with dressing.

Fibre-rich, Low-Fructose, Vegetarian, Gluten-free

10 of the best restaurant meal choices for athletes


Sleep, train, recover, eat, work/study, eat, train, recover…..the life of an athlete can be super-structured and this repetition can also apply to meals and snacks. Some athletes feel it is too difficult to eat out at restaurants when they are trying to meet their performance nutrition needs, so end up avoiding eating out, or find it quite difficult and stressful to make choices when they do venture away from home.    

But looking after yourself doesn't mean you have to lock yourself in an altitude tent for a month and live on steamed chicken, broccoli and rice! There are a feast of nutritious eating out options around that contribute to athlete health, nutrition and performance goals. Here are 10 of the best choices to help you enjoy eating out with friends and family, while keeping your training goals on track:

  • Eye fillet steak with vegetables

Dinner at the pub should never be a problem - you can always find a grilled steak on the menu. Order with steamed vegetables and baked/roast/sweet potato instead of chips for a meal rich in lean protein, iron, zinc and vitamins. You may need to add some extra carbohydrate to help meet your training needs.

  • Thai beef or chicken salad

With plenty of fresh herbs, garlic, chilli and fresh vegetables for vitamins and antioxidants, a Thai salad is terrific choice. Vermicelli noodles will provide some fuel, while the meat or chicken provides high quality protein and minerals.

  • Prawn and vegetable stir-fry

Seafood is a great eating out option, but it’s often served deep fried. Prawns in a stir-fry give you extra vegetables, and by ordering the rice or noodles separately you can vary the amount of carbs to your needs.

  • Poke bowl

You can get just about anything in a bowl these days, even smoothies (which I still don’t quite understand!). Poke bowls originate from Hawaii but are now widely available and traditionally contain plenty of fresh vegetables, rice, pickled vegetables, seaweed, edamame, rice and raw fish.

  • Steamed fish and greens

Most menus these days will offer a grilled or steamed fish options, and it will often be served with green vegetables and soy/ginger/garlic/chilli style sauce. Check out my Instagram for some examples of these, it’s one of my favourite choices when I go out for dinner!  If you don't eat much fish at home, choosing it when you are out will help to boost your omega-3 intake.

  • Grilled haloumi and vegetable stack

For a vegetarian option, grilled vegetable stacks can be a great choice, just make sure there is a decent source of protein like haloumi or ricotta cheese or tofu.

  • Fajitas

Fajitas are the perfect Mexican dish to share with friends. Everyone can pick their own favourite fillings - lean meat or chicken, plenty of vegetables and soft tortillas make for a well-balanced and filling meal.

  • Lamb Greek salad

Protein, minerals, healthy fats, vitamins – lamb and Greek salad are the perfect match.  Like many salad meals, you may need to serve with some bread, rice, quinoa or sweet potato for extra energy, depending on your goals and needs.

  • Vietnamese Pho

Asian-style vegetable/noodle soups are a great eating out option, containing lean protein like beef or chicken, plus fresh herbs, vegetables and noodles.  Soup is hydrating and assists with recovery and fuelling. 

* You may have noticed some common elements to all of these meals - vegetables, herbs, good quality protein, healthy fats and adjustable carbohydrate according to individual needs.  Go for nutrient-density and quality for health and performance benefits                 

* Of course, if you don't eat out too often and are heading out for a celebratory dinner you can throw all this advice out the window and just choose what you really feel like! You never know though, it could still be one of the options above.....

If you are interested in more sports nutrition info, recipes and tips, please add your details for my free newsletter, at the bottom of any page on my website.  You can also follow me on FacebookTwitter and Instagram and look out for my new book Super Food for Performance available for pre-order now, due to arrive in December 2017!

Effect of LCHF on blood test results PLUS ketogenic diets PLUS coconut oil


I have been thinking about this whole LCHF movement and some of the passionate advocates of this style of eating, and I continue to be bewildered as to why they are SO passionate about spreading the LCHF word?  Perhaps their own personal experience has been so overwhelmingly powerful that they feel no option but to help others to experience the same?  Or is it to challenge the exisiting dietary guidelines and advocate for change (not that too many people actually follow the current dietary guidelines anyway)?  Or is it to promote the next diet book they have at the publishers, just about ready to hit the shelves.  You know what, I am really not sure, and there are probably different incentives depending on the individual.  The wide range of characters promoting LCHF makes things even more confusing – some scientists, doctors and dietitians are gunning for it, and so too celebrities, chefs, and everyday Australians.  Interestingly, Australia is the number one country at present where the LCHF message seems to be getting air time.  Apparently in the US and other countries, there is no such interest, and LCHF may just be viewed as another fad diet.  Jimmy Moore, a speaker at LC Downunder seminars is from the US and he was congratulating Australia on their interest and uptake of LCHF (and for supporting his livelihood via purchasing his books and other resources).  So are we just all being sucked in, when other countries don’t seem to give two hoots about LCHF, or are followers on the crest of the next wave of nutrition truth……..

My curiosity about why LCHF supporters are so passionate extends to Associate Professor Ken Sikaris. His name may sound familiar to you if you live in Victoria and received a blood test report in the last ten years or so - his name may have been printed at the top of each page.  Ken Sikaris is a pathologist, specialty biochemistry, with a particular interest in cholesterol.  A/Prof Sikaris has an impressive resume in the world of pathology.  I hope I am not being naïve, but his apparent neutrality in the commercial world (unless he has plans to release his own brand of coconut oil/fat/paste/milk/cream*see end of post), along with his vast professional experience in pathology, makes it difficult to predict any reason why he would want to be talking about LCHF at the Low Carb Downunder seminar, other than because the research is indicating something.  A/Prof Sikaris has also tried LCHF himself and he credits this for his personal weight loss and improvements in blood lipid profile, which he presented as one of a number of case studies.  He also showed some real research, a pleasant change from the heavily weighted anecdotal and case study format of most of the seminar sessions.  Admittedly, I have not critiqued every study that was presented, but the trends that were observed in the large number of studies he discussed shone quite a positive light on LCHF for cholesterol, triglyceride and blood glucose levels.

I don’t want to simplify the complexities of blood testing and interpretation, but to summarise the content and research within the presentation, the trends observed in blood parameter changes with LCHF from the studies presented are something along the lines of this:

- Increase in Total Cholesterol

- Increase in LDL cholesterol (‘bad’ cholesterol)

- Increase in HDL cholesterol (‘good’ cholesterol)

- Decrease in small dense LDL (‘bad’ cholesterol)

- Decrease in triglycerides

- Decrease in HbA1C

  • Please note, these are observed trends that were presented based on studies during one session of the Low Carb Downunder conference and are not indicative of expected changes in ALL individuals.  For some people, a LCHF diet may produce unfavourable results which may be of significant risk to health.

Reading through the list above, the first impression is that eating more fat through LCHF will increase total and LDL cholesterol. Higher fat intake is likely to increase total, LDL and HDL cholesterol, but reducing carbohydrate helps to reduce triglycerides, which A/Prof indicated may be the key element in reducing cardiovascular risk.  He indicated that as triglyceride levels increase >1.5mmol/L, more LDL will be in small dense (modified) form, that hangs around in the blood, rejected by the liver and may end up in blood vessels.  On the other hand, if triglycerides are <1.5mmol/L, LDL are likely to be in the larger form that may be taken up by the liver.  It may be that small dense LDL could potentially be the new marker of CVD risk, and that even if total and LDL cholesterol are higher, CVD risk could be reduced if small dense LDL% is lower.  And this could all link back to carbohydrate and their impact on TG's.  On a low-fat, higher carbohydrate intake, it was observed that more small dense LDL is formed. It was suggested that a short period time of only 3 weeks could potentially show blood changes of decreased triglycerides and small dense LDL.

With regard to HDL, observed increases have been quite large in magnitude, and it was suggested that there is no drug that can increase HDL to that extent. 

HOWEVER, it was acknowledged that not ALL individuals experience positive changes to blood cholesterol profile with LCHF.  For some people, LCHF increases total cholesterol excessively, and this is likely related to genetics.  This is often due to an increase in Lp(a), a modified LDL particle that the liver does not particularly like and so, like the small dense LDL, it can end up in the blood vessels, which can be dangerous for cardiovascular health.

So to summarise the presentation by Ken Sikaris, LCHF can have a positive effect on blood lipid profile, but can have a negative effect in some people.  The dilemma for me is how do you know who will have the favourable outcome and which individuals should be wary. 

During the Q&A panel session, the question was asked if LCHF would be suitable for someone after a stroke or heart attack.  The overwhelming response from the panel was yes, it would be a better dietary strategy for future health, but how do they know how that person will respond to LCHF.  Can a favourable outcome be guaranteed??

The other question is whether the change in blood results is due more to the actual change in macronutrient intake, or related to the associated loss of weight?

During the panel discussion it was also suggested that individuals may be better to go very low carbohydrate to start with, rather than easing into it, to achiever results sooner and allow the body to fat adapt.  Many of the blood parameter changes in the studies presented were based on very low carbohydrate intakes of <40g/day, or what would be considered a ketogenic diet.  The word 'ketogenic' sounds very clinical and a little bit daunting, but is basically the lowest carbohydrate form of LCHF, where ketones and fat replace carbohydrate as fuel.

Jimmy Moore calls ketones 'super fuel', but indicates that you need to keto adapt to become a ketone burner.  I am sure there are a variety of approaches, but his recommendation is to start eating unlimited fat to become fat adapted, then decrease intake over time so it allows stored fat to be broken down for energy.  So it is not a matter of eating as much fat as you like, effectively there calorie control.  With regard to carbohydrate, 30-80g seems to be deemed acceptable for 'keto', and protein is recommended not to be overdone, in case it is converted to glucose (there was lots of talk about gluconeogenesis), which may impair ketogenesis.  Of course, you need to buy a ketone monitor to carefully track ketone levels.  After about 1-4 months you become keto-adapted, and on your way to health and happiness by all accounts.

Many dietitians have scoffed at LCHF as just another fad.  But how many dietitians recommended VLCD programs like Optifast?  I know I do, not routinely but for individuals where it is deemed appropriate.  These programs create ketosis, and can be very successful for weight loss, but they are not for everyone and are not representative of longer term healthy eating patterns.  Is there a difference between VLCD programs and LCHF diet??  There are many, the most obvious being that Optifast for example is designed for a short period of time, not forever.  There are a lot of things to consider when making decisions about the best approach to food and nutrition for any one individual.

It seems that nutrition is becoming more and more complex when really in a practical sense when it comes to food choices we should be getting back to the basics of simple, fresh, delicious food.  The foods you choose are up to you, and based on a range of factors that are unique to you.  If you are finding your nutrition a challenge, speak with a dietitian who can help you work through it.  (although some dietitians may not recommend eating coconut oil by the spoonful as an afternoon snack, see below....)

* Just as a side note from earlier in this post, I really don’t get the coconut oil thing, nor do I understand the current interest and obsession with all things coconut.  Why is coconut oil considered so much better than any other fat?  It’s basically just saturated fat, although it does contain significant amounts of medium chain triglycerides (MCT's) with about 50% of the MCT's being lauric acid, which has been reported to have health benefits.  Coconut oil is great to cook with and adds flavour to foods, but the evidence that it does a lot more is currently lacking.  I heard Professor Andrew Sinclair, Chair in Nutrition Science from the School of Medicine at Deakin University, speak at a recent nutrition seminar in Melbourne, the topic being his area of expertise – fats.  He didn’t have anything particularly groundbreaking to say about coconut fat, but did mention that researchers at Deakin are looking into reviewing the literature on coconut oil and health…..perhaps they will find something exciting, until then.....

This Thoughts post provides informational content only, and is not for individual nutrition prescription purposes.  For more specific nutrition guidance and recommendations tailored to your individual needs you should speak to an Accredited Practising Dietitian.



Saturated fat is back and ketones are the new carbs…if you follow LCHF

Yes, a LCHF meal can look like this.....&nbsp;

Yes, a LCHF meal can look like this..... 

I felt as though the Low Carb High Fat (LCHF) movement was taking over my life last week.  Along with everyone else in the country who has an interest in nutrition, I watched ABC’s Catalyst last Thursday night.  I then backed this up with the Low-Carb Downunder seminar in Melbourne on Saturday, so I was up-to-my ears in ketones and carbohydrate talk. My brain actually feels a bit overloaded and is experiencing a slight tug-of-war between my entrenched knowledge that has been accumulating over many years and this ‘new’ input that is being promoted by everyone from doctors, to scientists, to athletes and celebrity chefs. 

I am writing this post to provide an insight to some of the information presented at the Low Carb Downunder seminar for those who did not attend and may be interested.  There will also be the unavoidable mentions of Catalyst and associates, as well as a few interpretations of my own relating to all things LCHF.  Apolgies in advance about the length of this post, and there will be Part 2 to come, just so much to think about!

I arrived at the seminar and was greeted at St Kilda Town Hall by an unusual crowd, some sporty types, some middle-aged overweight men and women, mostly older vs younger people and I think more potential ‘users’ than health professionals.  There were also not as many people as I expected, from reports of the last Low Carb Downunder seminar that sounded like standing room only.  I was the only dietitian there (I will get to my concerns about that later….)

So I managed to find a comfortable seat amongst the believers, without being blown away by any ketone-related bad breath.  First line of the introduction by Dr Rod Tayler, anaethetist, was ‘How good was Catalyst?’ to which there was an almighty cheer.  Oh no, I was starting to think that maybe I really shouldn’t be there, but once the cheering had subsided I got out from under my chair and composed myself because I really wanted to hear what all the fuss over LCHF is about.  Well, the introduction was like nothing I had seen before – slide after slide of recommended reading. Actually not recommended reading, recommended purchasing!  It was a book sale….right up front, no warming us into it.  Not just books – there were DVD’s (including Cereal Killers of course), sponsors products, even ketone measurers!  All very strange for a so-called professional conference.  But I stuck it out, and I am glad I did, because things did get more interesting.

First presenter was Jimmy Moore, who also started off with visuals of his programs and books for sale, but then did get into more substantial content.  Throughout the entire day I found myself intrigued and amazed one minute, then finding it very hard to take things seriously the next.  The thing that seemed to get me off-side was that most of the information presented was based on anecdotes, case studies or articles written by journalists who had interviewed someone who has tried LCHF.  There was not a lot of original research or content (except for A/Prof Ken Sikaris, whose great presentation I will discuss in a future post).

One thing that quite surprised me, that was also very obvious during the Catalyst program, was the non-extreme approach.  Of course there was thorough discussion of the ketogenic diet, where carbohydrate intakes approaching less than 20g/day are all the rage, but there was also recognition that carbohydrates (albeit vegetable-based) can still make a valuable contribution as part of a LCHF approach.  From my perspective, it seems that the LCHF approach is not as anti-carbohydrate as Paleo, and there could be the potential to sneak in some fruit or grains here or there without feeling like you have betrayed the low-car fellowship.  There were no ‘carbs are poison’ or ‘sugar is toxic’ signs anywhere, and carbohydrates were in fact spoken of, at times, in a favourable light, particularly for active people.  I repeatedly heard the phrases ‘there is no one-size fits all’ and ‘what works for you’.  There was also an emphasis on the types of people that LCHF could work for and there was not necessarily a directive that everyone should be eating this way.  For example, it was highlighted both on Catalyst and at the conference that LCHF works best for individuals whose bodies have trouble 'managing or tolerating' carbohydrate and a major focus was people who are overweight and/or have diabetes.

In fact, when Dr Zeeshan Arain, a Melbourne based doctor who works in both general practice and sports, spoke about his experiences with LCHF and athletes, he openly discussed the potential detriment of inadequate carbohydrate for an athlete who is highly metabolically active. Young male athletes with a decent amount of muscle mass perhaps?  There is currently a lot of focus on athletes and LCHF, but again much of the ‘evidence’ is anecdotal.  Dr Trent Stellingwerf, regarded sports nutrition researcher from Canada https://twitter.com/TStellingwerff has recently been active on Twitter summarizing the published data on fat adaptation and ketogenic diets and performance and showed the majority of studies indicate no change or reduced performance with LCHF (see my Facebook page Lisa Middleton – Advanced Sports Dieititian for the shared post, thanks to Thinking Nutrition for sharing this also).  John Hawley and his team at RMIT, along with Louise Burke and other researchers have led the way in this area of sports nutrition, and it would have been great to get their perspective on Catalyst.  It was a shame that line-up of interviewees on Catalyst was basically the presenter list from the Low-Carb Downunder seminar earlier this year, no bias there at all.  How about a novel idea, get the world's best researchers together in the same room to present the evidence and sort it out and come to some type of consensus so we can all move on with our lives?

One thing that has frustrated me are the headlines about athletes who are using LCHF, without any description about when and how they are using it.  I think if we asked for more detail, it may become obvious that LCHF is often being used as a weight loss strategy in the off-season, when peak performance is not required.  In-season carbohydrate intake may be a different story.  I think the potential role of LCHF for weight loss is quite obvious…..if you cut out most of the carbohydrates and sugar from your weekly intake, you automatically reduce your total calorie intake, and how much fat can you really physically eat?  You eat less so you lose weight.  No problem with doing this in the short-term, with appropriate guidance from a dietitian to ensure you are doing it properly.  Another key message from the conference is that LCHF is not high protein, with the recommendation that protein intakes should be kept relatively low.

It was great to hear real athlete perspectives at the Low Carb Downunder seminar.  Tom McDonald, a player from Melbourne Football Club, spoke of his experience with LCHF, and one of his incentives to initially reduce carbohydrates was for his digestive system. He was not trying to lose weight, in fact he reported that he has always been underweight.  So he reduced his gluten and grain intake, but still maintains an estimated 100-200g carbohydrate per day, with much of this coming from sweet potato and bananas. Tom indicated his normal breakfast on training days would be bacon/sausage/eggs, occasionally with sweet potato and the night before games he would go for something like bolognaise sauce with cheese, vegetables and sweet potato.  So effectively he has reduced his wheat/gluten/processed carbohydrates but does not follow extremely low carbohydrate patterns.

Other anecdotal examples followed. Brian Rabinowitz, an experienced and successful triathlete and coach, who has been doing LCHF of late and says he has never trained better and can vouch for a number of the athletes he trains who are also flying with their training and performance, having changed from a gel-fuelled race to virtually water and oil.  Vicky Kuriel is a ‘LCHF dietitian’ who presented on the day (so there were in fact 2 dietitians at the conference!) and reported that her husband competes in ironman events with nothing more than water and nut butter, a significant change from his previous high-carb fuelling.  Apparently he is feeling and performing better than ever (he does eat carbs usually, ~150g/day although it varies day-to-day).

I know these personal accounts are not evidence-based science, but I find them quite powerful, especially when they come from credible sources.  That is another point, some of the outspoken experts on LCHF are very smart people….they are not just salespeople trying to boost their commission (although they may have a book or product on the side?).  I have spoken with many professional people who I know and trust who have great faith in the LCHF approach.

Saying that, I am certainly not sold on the concept of athletes becoming fat adapted by eating more fat, allowing fat to be more readily available as the main fuel to power elite performance.  Examples were presented of ultra-endurance athletes who train their bodies to burn fat as fuel and use ketones instead of carbs, but the thing with ultra-endurance is that it can be done at a steady-state pace.  If you need to put on a burst of speed to pass a competitor or at the finish line, carbohydrate will provide the rapid fuel to do this.  The question remains, that even though the bulk of science does not support the role of LCHF for performance, are there specific types of athletes, or individuals with a specific genetic make-up, who may benefit from the LCHF approach?

A great quote that I came across on Twitter from Professor Stuart Phillips, well-regarded sports nutrition researcher from Canada:

‘When it comes to LCHF and sport performance, I think it's important to remember that "Science is “the process of understanding the world through experimentation and observation,” whereas beliefs are “feelings that something is true.” Thus, the former represents an ideal of discovering truth that exists separate from the knower, whereas beliefs are internally held understandings filtered through one’s world view. By “unscientific belief,” something is held as generalizable fact without substantial scientific supporting evidence…" Brown et al. Adv. Nutr. 5: 563–565, 2014. So evidence trumps anecdotal experience and cognitive dissonance!’

Stuart Phillips PhD Twitter - @mackinprof

I can certainly understand why scientists and health professionals, including dietitians, are having a hard time accepting this LCHF theory, and perhaps why I was the only dietitian at the seminar.  If your entire academic and working life has revolved around evidence-based practice, LCHF doesn’t quite fit as the bulk of evidence just is not there.  Health professionals are trained not to base their practice on case studies or something that worked for your neighbor down the road.  But I don’t think you can ignore emerging trends or turn a blind eye to what people are out there doing, even if it doesn’t fit the evidence-based practice model.    

Vicky Kuriel is a dietitian who was disillusioned about dietetics, and stopped working in nutrition for a period of time due to her frustration about the lack of results for her clients with traditional methods.  She is proud to be a LCHF dietitian and provided compelling reports of client success in the areas of weight loss and reduction of gastrointestinal symptoms.  Vicky also emphasized that the key is to find the right mix of nutrition for your individual needs and to listen to your body, so again it is not all about the lowest carbohydrate intake possible for everybody.  Vicky’s final slide said this, ‘The truth is transient in nutrition’ and her message was that we need to be open to new ideas and science.

Of course during the seminar there were a number of digs at ‘those nosy’ dietitians, although the speaker, knowing that I was the only dietitian in attendance, did kindly indicate that I was not one of those he was speaking negatively about!

I had been prepared for dietitians to be criticised at this conference, and to be honest, some of the comments were spot on.  As a young dietitian working at my first professional sporting club I was known as the carbohydrate queen.  My studies had taught me that carbohydrate and athletic performance, in the majority of sports, go hand-in-hand and that was my message for athletes…..carbs, carbs and more carbs.  Of course I still recommend carbohydrate to athletes, but my approach these days is somewhat more balanced with greater emphasis on overall nutrient balance and individualized nutrition strategies.  Another example where dietitians have a lot of work to do is in the hospital food service.  Admittedly I have never worked in a hospital, other than my placement at uni nearly 20 years ago, and I don’t have full comprehension of budgetary and other contstraints that may exist, but surely something can be done to improve on the rubbish food that is currently provided in many hospital settings.  During a short stay at hospital with my young son a couple of weeks ago, I was absolutely appalled at the breakfast tray that he was presented with.  A sachet of puffed rice cereal, a piece of white bread with margarine and jam and a tub of apple juice.  Absolutely terrible, and this is what hospitals are dishing up to our sickest members of the community whose bodies are crying out for nutrients (I am happy to be challenged on this one, as I am sure dietitians have made efforts to improve food service, with likely limitations.....please say this is the case?????). 

There has been outcry from dietitians around the world about the potential risks of LCHF.  Not enough fibre, not enough calcium, too much fat, not enough wholegrains….the list goes on.  With plenty of vegetables, fruit, nuts and seeds, a well balanced LCHF diet provides great potential to eat lots of fibre.  Especially for those following LCHF who are not following a super-low carbohydrate ketogenic plan, there is scope to eat many high fibre foods.

I can see the potential issues with calcium and this would need to be addressed for any person choosing a LCHF way of eating.  For someone who does choose to eat in a LCHF style, it is important to know what you are doing and it would be advisable to seek professional advice from a dietitian who can help to ensure you are getting all of the nutrients you need. 

In terms of fat intake, concerns about too much or the wrong type have mostly been driven by the impact on health and cholesterol levels, but the evidence is mounting that LCHF eating does not have a negative impact on blood cholesterol profile for everybody, and I will go into more detail about this in my next Thoughts post.

Most dietitians are anti-diet of any type, and there are warranted concerns about LCHF's restrictive nature and the potential impact on psychological well-being and a person's relationship with food.  I was very pleased to hear Dr Arain mention this issue in his presentation and address body image and societal pressures to be a certain shape/size.  He also mentioned body dysmorphia and disordered eating, and this highlights the fact that many people who recommend LCHF are also aware of the sensitivities associated with food, and the potential psychological impact of restriction and 'diets'. Although some LCHF advocates are not as aware....

Dr Arain also mentioned another potential negative associated with LCHF eating - the development of commercial 'low-carb' products.  Similar to the proliferation of highly processed 'low-fat' products, these 'low-carb' products would not fit the 'real food' approach of LCHF but many people may use these frequently for convenience.

This leads on to probably the biggest problem that I see as a result of generalised LCHF guidelines - people don't do it properly.  The message that 'high-fat' is good could be interpreted as 'well, make that double bacon with my triple-decker cheeseburger then thanks'.  I can visualize this at take-away stores around the country, with this new message that saturated fat is a good guy.  Not that I think this is or was the intention of the low-carb, high-fat supporters, but this is the message that is coming across to the general public loud and clear.  And it creates the problem that people skip the low carb bit and just add in the fat, because fat is ‘good’.

The danger is that people choose selectively to include or omit the foods they wish.  A friend of mine who is a great GP put it perfectly ‘people just take the bits and pieces from different diets that they like’, which from my perspective creates a potential risk of even greater negative effects on their health.  Bacon is good, so must be good with everything, right??  Maybe on an extra piece of white toast, but is butter or margarine better with that?? 

Nutrition right now is confusing, but one thing that everyone does seem to agree on is that you need to find the best way of eating that works for you, based on real foods, that allows you to live and perform at your best.

In the next post I will give a summary of Associate Professor Ken Sikaris' presentation on the effect of LCHF on blood cholesterol profile, plus Ketogenic diets and Banting…. To make sure you keep up to date as new articles go up, 'Like' my Facebook page Lisa Middleton - Advanced Sports Dietitian and subscribe to my newsletter via the website home page.


This Thoughts post provides informational content only, and should not be substituted for individual nutrition prescription from a health professional.  For more specific nutrition guidance and recommendations tailored to your individual needs you should speak to an Accredited Practising Dietitian. 




What I love about eating like a cavemen


Perhaps like you, I have been quite fascinated at the to-and-fro in the media between various individuals about the merits, or otherwise, of following a Paleo style of eating.  I love a bit of healthy debate, and I think everyone has a right to their opinion, but the thing that disappoints me most is the tone of recent discussions and the use of blatant or insinuated negativity directed towards individuals and their opinions.  Present your arguments, based on science and fact, but please don't ridicule others to promote your own opinions.  Credibility is built on honesty, transparency and results, not by personal attacks to try and make your opinions appear superior.  At least the fiery debate has put nutrition into the spotlight and inspired many of us to think about, and discuss, how, what and why we eat.

So what is 'Paleo' anyway?  I think there is plenty of confusion about Paleo, low-carb, gluten-free, clean eating, etc.  The Paleo approach promotes gluten-free, but is not completely carbohydrate free, and is based on the eating patterns of our caveman ancestors from Paleolithic times.

The brief in a nutshell:

Include - fresh meat, poultry, fish/seafood, eggs, nuts, seeds, vegetables, herbs, occasional fruit

Avoid - everything else, including dairy, grains (especially wheat apparently), legumes and all processed foods.

Things I love about Paleo:

- food in as close to natural state as possible

- high quality protein from meats, poultry, fish/seafood, eggs, nuts and seeds

- plenty of fresh seasonal vegetables 

- use of herbs and spices

- not much sugar

- no additives

- sustainability

Things I don't love about Paleo:

- avoiding dairy and grains completely, even minimally processed varieties

- not  much fruit 

- unlimited type and amount of fat

- potential expense

- preparation time

- not family friendly, inappropriate for children with regard to nutrient inadequacy and restrictive nature 

I seem to have  more positives on my list than negatives BUT the negatives are deal-breakers.  A positive relationship with food involves flexibility with choices, and the option to incorporate any type of food (obviously some more regularly than others).  It also is important to enjoy food without guilt, and I think this could be challenging with any style of eating that prescribes long-term rules and restrictions.  

How about 'partial-Paleo' or even 'lacto-graino-Paleo' as an alternative to full-on Paleo?  Just like there are various options for vegetarians (eg. lacto-ovo-vegetarian follow a vegetarian style of eating, and don't eat meat but include dairy and eggs), there could be different options for Paleo, which allow for our modern lifestyles, preferences, cooking options and nutrition needs?  Lacto-graino-Paleo could include some nutritious options within the dairy, grain and legume families.  Perhaps some A2 milk, some natural/Greek style yoghurt, a delicious tasty cheese, and some nutrient-packed oats or rye products.  Or even sometimes, shockingly, enjoying delicious fresh-baked white bread or a crunchy and gooey chocolate brownie! 

I am certainly not endorsing a Paleo style of eating, or any other specific style of eating,  across the board, because everyone is different and different things work for different people.  I do believe that it is everyone's individual choice as to what, how and why you eat and how you live your life in general.  Food serves a purpose in keeping your body energised and healthy, but is also a big part of our lives to be shared, appreciated and enjoyed.  Many of our most wonderful food memories involve foods that would not be considered to be 'healthy'.  I can still smell the home-made sausage rolls, an infrequent but much loved and anticipated lunch order from the local general store next to my old primary school.  Or Mum giving my brothers and I a few coins (no doubt silver ones, that we often pooled together for maximum value) to spend at the supermarket on snacks to take into the movies.  We weren't in the fresh produce section that is for sure.  Who would want to deny children these experiences and memories?  Being a dietitian I am obviously interested in health and eating well, but I also love to enjoy special food occasions.

If you like the idea of Paleo, or any other particular style of eating, make sure it is right for YOU.  Think about how it fits your lifestyle, the demands, pressures and costs involved, whether there is good nutrient balance for your particular health needs, potential for nutrient inadequacies and if it really makes you feel good.....you may have to make some modifications to come up with something that suits your unique needs.  Above all, work towards eating choices that you can live with long-term and that allow you to eat well, widely and without ongoing deprivation or guilt.