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DIET

Swedes struggle to make sense of a new diet trend

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

Published: 24 September 2009 16:20 CEST

Swedes struggle to make sense of a new diet trend

Some see LCHF as cutting-edge and a wake-up call about the state of our knowledge on dieting. Others see it as a fad and wonder about the effects it may have on people’s overall health.

The LCHF diet debate began in earnest in Sweden after Dr. Annika Dahlqvist first prescribed the way of eating to help some of her diabetic patients lose weight. Dieticians then brought her decision to the attention of the Swedish National Board of Health and Welfare (Socialstyrelsen), claiming the diet didn’t fit standard weight loss guidelines.

While the Board ruled in January 2008 that the diet was acceptable, it cautioned that the randomized controlled trials on which it was based constituted slim scientific justification and that there were no long-term studies available to back of claims about its benefits.

So, what exactly is LCHF anyway?

The theory behind the diet is eat few carbohydrates and replacing those calories with fat. It is similar to the popular Atkins diet, for example, which calls for replacing carbohydrates with proteins.

While Sweden’s National Food Administration (Livsmedelsverket) recommends healthy adults eat a diet composed of 50 to 60 percent carbohydrates, 10 to 20 percent protein, and 25 to 35 percent fat, a person on the LCHF diet would reduce that percentage of carbohydrates significantly, while at the same time increasing fat intake.

“The need for carbohydrate restriction is individually based. Lowering the percentage of carbohydrates to 20 percent of calories may be sufficient in many cases, while others need a maximum of 5 percent to induce weight loss,” explains Ralf Sundberg, a transplant surgeon with the Slottsstaden Medical Group in Malmö in southern Sweden, and advocate of the LCHF diet

While it may seem counterintuitive that consuming more fat can aid weight loss, a look at the mechanisms involved sheds some light on this apparent paradox.

As it turns out, eating more fat doesn’t necessarily cause more fat to be stored – as long as one’s caloric intake is balanced with energy expenditure.

Moreover, by replacing carbohydrates with fat, dieters have less glucose in their blood. Lower glucose levels mean less insulin is released. And since insulin plays a role in storing fat in the body and in blocking its use as an energy source, reduced insulin levels make it easier for the body to burn fat as energy.

In terms of weight loss, therefore, the LCHF diet works by making the body use more fat as an energy source, helping one lose weight.

In addition, eating more fat gives one the feeling of being full over longer periods of time, thus inducing a decrease in overall caloric intake.

Following the preliminary debate sparked by Dr. Dahlqvist, more Swedes began to take a look at the literature supporting various dietary standards, prompting an increase in the diet’s popularity, as well as continued discussion about its merits.

According to Ingrid Larsson, a nutritionist at Sahlgrenska University Hospital in Gothenberg, part of the fascination with LCHF stems from what some see as a lack of convincing information about how people ought to best to their diets in order to avoid certain diseases.

“There is a group of people in Sweden, some of them health professionals, some of them not working in the medical or nutritional area at all, who are very disappointed with the modest level of our knowledge about the dietary management of obesity, diabetes, and cardiovascular risk factors,” she explains.

“If you do not have that knowledge, then it is easy to search for a simple solution. ‘Eat more fat and less carbohydrates: that will solve your problems!’”

Sundberg, on the other hand, thinks the popularity of LCHF comes from people who have concluded that current dietary recommendations are based on “selective and misleading citations of the scientific literature” written by people with financial ties to the food industry.

In addition, more studies have come out supporting the benefits of LCHF.

“Many regular people dared to change their eating habits and found that their health improved – especially those suffering from diabetes and obesity,” says Sundberg.

He thinks Sweden is ahead of the curve in recognizing that diets like LCHF have a number of advantages for people’s health.

“But Sweden is not the only country. The interest of low-carb diets in the United States is increasing, although there has not been the same kind of media response yet,” he says.

While Sundberg believes that LCHF is “safe for everyone” he admits some segments of the population may want to refrain from changing their diets.

“It’s not recommended during pregnancy because carbs are necessary for weight gain, and growing children should not be denied carbs for the same reason,” he says.

He adds, however, that most but not all overweight individuals can lose weight with LCHF.

But there are others who remain skeptical about the diet – including Larsson, who says she still won’t recommend LCHF.

She explains that the Swedish Association of Clinical Dietitians (Dietisternas Riksförbund – DRF) has yet to find proof that the diet is better than any other diet.

“LCHF has not been proven to be superior to the recommended energy-reduced diets that obese patients are advised to follow,” she says.

“We have no data on the long-term safety of these diets, including diabetes and cardiovascular risk factors.”

Furthermore, she cites research findings about the adverse effects of increased saturated fat intake.

“Many studies over several decades have come to the conclusion that high consumption [of saturated fat] does lead to an increased risk of arteriosclerosis (hardening of the arteries),” says Larsson.

She adds, however, that the findings don’t necessarily mean someone who consumes a lot of saturated fat will suffer from arteriosclerosis, “a high intake of saturated fat does lead to an increased risk” for the disease.

But Sundberg has a different opinion.

“Saturated fats do not clog arteries,” he says.

He cites a study from Harvard University which found that where “arteriosclerotic narrowing of coronary arteries progresses more rapidly from a carbohydrate-rich diet, while the opposite was found with a diet rich in saturated fats.”

In other words, a high-carb diet may actually be worse for your arteries than a high-fat diet.

Another bone of contention among dietary experts is whether or not eating a lot of fat and few carbohydrates could lead to deficiencies in certain essential nutrients.

Larsson cautions that, over time, an LCHF diet may also lead to a decreased intake of vitamins A, C, E, B1, folate, potassium and magnesium – which come mainly from plant and cereal sources, the common base for many carbohydrate-rich foods.

Sundberg, however, counters that “the risk of nutritional deficiencies is greater with the low-fat high-carb diets recommended by authorities today.”

Thus, in the absence of a clear consensus on LCHF, food-lovers concerned about their weight or their health are left to examine and compare literature for and against the diet.

And in the mean time, they will be left to satisfy their hunger at their own risk.

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How to grow your own fruits and vegetables in Sweden

Know your growing zone

Sweden is split into eight different growing zones, known as växtzoner in Swedish, with one being the mildest zone in the far south of the country and eight being the harshest, in the far north.

The easiest way to figure out which zone you live in is to search your address on a digital growing zone chart like this one from the Swedish Garden Association.

There are two “bonus” zones too, which you’re unlikely to see on plant labels: zone zero, which refers to extra mild conditions in zone one, like a sheltered south-facing garden or the climate inside an unheated greenhouse, and the fjällzon or zone nine, which is found in mountain regions.

Lots of fruit trees can handle snow, for example, but not all of them will survive the winters in harsher, colder zones.

“Apple trees or fruit trees will survive snow,” British gardener and cider maker John Taylor, known for presenting Swedish gardening show Trädgårdstider (Garden Times), told The Local.

“You can grow all kinds of apples, pears, plums, cherries, we can grow edible quince in southern Sweden, so there’s a bunch of fruit trees which will survive, but it depends what rootstock they’re on – that’s called grundstam in Swedish,” he explained.

“There’s one rootstock called B9 that survives down to minus 40, because it’s from Russia, then there’s another called M106, and that probably doesn’t want to live in the depths of Norrland.”

Buy plants local to you

An easy way to make sure the plant you’re planning on buying is going to survive in your zone is by sourcing it from a local plant nursery or garden centre, as they won’t sell plants that can’t handle the local climate.

“There’s a nursery in the north of Sweden and Finland called Blomkvists, they sell lots of fruit varieties which will survive up there,” Taylor said. “You can grow pretty much anything you want up there, just as we can [in Skåne, southern Sweden], but it will be different varieties that taste different and will survive the frost.”

You won’t be able to grow Mediterranean fruits like lemons or oranges in Sweden unless you bring them inside during the winter, although you should be able to grow peaches or nectarines in most of the country.

“The further up in the country you go, the further north you are or the further away from the coast, the harsher the climate becomes, so you might need to have them on a south-facing wall or in a greenhouse,” Taylor said.

Think outside the box

Although the growing season in Sweden may be shorter than it is further south, there are still a number of crops from warmer climates that do surprisingly well.

“People don’t really grow cucumbers outside here, I don’t think they realise that you can actually grow them outside,” Taylor said. “Tomatoes, too. You don’t need a greenhouse, you just stick them in the ground, they’re basically a weed – you’ll get so many you won’t know what to do with them.”

Sweetcorn, for example, performs well in a Swedish climate, Taylor said, although Swedes more often grow it as a feed crop for pigs.

You can also test things by trying to build a microclimate so you can grow things that are one or even two growing zones away from yours. Usually this is done by providing shelter from the wind and the weather using fences, hedges or by planting near buildings, as well as providing protection during the winter.

And if you’re pushed for space, look into companion planting, where you can grow multiple plants which complement each other in the same space.

One example of this is the “three sisters”: corn, climbing beans (or peas), and squash. The corn provides a support for the beans or peas, which anchor the corn in high winds while fixing nitrogen in the soil, while the squash’s large leaves provide shade for the soil, preventing it from drying out.

Don’t be put off just because you don’t have any outside space

Thinking outside the box applies to balconies too.

“If you’re in a built-up area, you will get reflected light from other buildings, so even if you’re on an east-facing balcony, you should be able to grow a lot of stuff. North is a bit more tricky, but east and west are probably better than south as you’re not getting hammered by the sun all day,” Taylor said.

You should be able to grow things like tomatoes, cucumbers and flowers, but it’s important to get hold of good soil and replenish it each year, so your plants have enough nutrients.

“Anybody with a balcony can grow pretty much the same that you can in a garden, you just have to get the soil up there and you always have to fertilise, the soil becomes nutrient deficient after one season.”

“But if you’re prepared to get the soil up on your balcony you can grow anything, even fruit trees. They will be smaller and stunted, and won’t give as much fruit – I’ve done it myself – so don’t see it as an obstacle, see it as a possibility.”

Kale and tomatoes growing on a balcony. Photo: Johan Nilsson/TT

Take inspiration from Swedish growers

Thinking outside the box doesn’t mean that you should completely ignore what all your Swedish neighbours are doing. If you’re not sure what to plant in your garden or what fruit and veg you should try to grow, take a look at what other people who live near you are growing.

You might also come across some crops you’ve never tried before which work well in a Swedish climate, like Alpine strawberries (smultron), honeyberries (blåbärstry), wild garlic (ramslök) or sea buckthorn (havtorn).

This doesn’t just apply to varieties, but also where you plant them in your garden. Some crops need full sun, some work best in shade, and others, like asparagus, can grow tall and cast a shadow over your garden.

“You want a south-facing location for all fruit, and berries – check out what your neighbours are doing,” Taylor said.

If you don’t want tall plants to cast a shadow over other crops, see if you can plant them at the northernmost edge of your garden, while making sure that sun and soil conditions are still optimal. Blueberries, for example, need acidic soil to thrive, meaning you will probably need to amend your soil if planting in the ground, or even plant them in containers.

Think about what you want to do with your harvest

This may seem obvious, but it’s important to plant what you like to eat, too. If you hate the aniseedy, licorice-y taste of fennel, why bother growing it?

You should also choose the variety of crop based on what you’re going to use it for. Do you want to make pickles with your cucumbers, or are you going to eat them on salads? Do you want cherry tomatoes for snacking on, or big beef tomatoes for making sauces?

“Think ‘what am I going to do with my harvest’,” Taylor said. “Am I going to juice it? Am I going to preserve it? Am I going to make cider with it, for example?”

Apples, for example, can range from sweet eating apples to tart cooking apples, so make sure you do your research before you commit to buying an apple tree. Most varieties exist in English-speaking countries, so you should be able to search the name of the variety online and find some information in a language you understand, if you don’t speak Swedish.

“Patience is a virtue,” he added. “A lot of fruit trees are going to take two or three years, or even more, to give a harvest. So you have to have patience.”

Learn to deal with the Swedish weather

Many areas of Sweden along the coast or in the south of the country can get windy, which you’ll have to learn to deal with.

“How to deal with the wind? You can’t,” Taylor said. “We cannot affect this, we are powerless.”

“What you have to do is plant them in areas where there’s less wind, usually behind large buildings.”

Some plants simply won’t survive the wind, so either you plant them close to buildings, protect them, or accept that you’re restricted in what you can grow.

Make sure to provide supports for crops which will grow tall, like sunflowers, peas, beans and sweetcorn, and tie these down well or bury them deep in the ground, so summer storms can’t blow them away.

Listen to the full interview with John Taylor in The Local’s Sweden in Focus Extra podcast for Membership+ subscribers. Out on Wednesday, May 8th.

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