1)
How come Sweden recommend a high fat, low car diet if research suggests they cause osteoporosis etc? (I'm just wondering, and am not trying to be antagonistic!)
'No we didn't say LCHF diets are always the best ' This was written by the authors of the report after some of the reports on the internet and newspapers.
ie a lot of misquoting going on
'For other food types , such as low carbohydrate diets (like Atkins or LCHF ) or diet with a low GI , no scientific evidence to determine whether they affect morbidity or mortality in people with obesity'
see
http://www.aftonbladet.se/debatt/article17631151.ab You'll have to put it through a translation site unless you speak Swedish
2) my concerns are about individuals we are all different, backgrounds, problems etc etc.
(several potential concerns but I'll just mention one)
As was shown earlier Keto diets in epilepsy have lead to bone loss (and the mechanism ie why is described in many papers)
Osteoporosis is not a nice condition. It is implicated in fractures, often caused by simple falls. Hip and femoral fractures frequently don't mend in these cases and may lead to death . Worse though, in my opinion is the on going pain and loss of mobility caused by osteoporosis. This is just as bad as any of the complications of diabetes mentioned earlier
Two scenarios to show people at opposite ends of the spectrum .
a) A man in his 60s. He was overweight got diabetes He went on a very low carb, ketogenic diet. He lost the weight and glucose levels fell. Unfortunately, he weight loss didn't save him from needing a couple of stents in the narrow arteries that he developed pre diabetes . Nevertheless, he is doing well and thinks he can maintain the status quo.
He's male, he may have developed a good bone density earlier in life and doing weight bearing exercise which increases bone density ( that includes walking with an excess weight) . As a man his bone loss is slower than in women.
Research evidence is inconsistent, some say that bone density is slightly increased in T2, some say about normal, however there appears to be an increased risk of falls in old age.
b) An adolescent girl with T1, worrying about her weight and increasing glucose levels. She's of normal weight.
she's scared about increasing insulin so thinks about changing diet .
Insulin needs increase greatly in puberty. Bone is laid down in the years up to about 30. After that it slowly demineralises. After the menopause the speed of bone loss increases greatly. One in three women develop osteoporosis in old age. Low bone mineral density is consistently observed in T1 women so the risk is greatly increased . Hypoglycaemia adds to the risk of falls.
Ok stereotypes but is a ketogenic diet applicable for both? for ever?