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• The terms 'low carb' and 'keto' are laymen's terms and help people to identify this way of eating when seeking dietary management. Educating the patient then involves explaining the difference between 'low carbohydrate' - LCHF and 'very low carbohydrate' - VLCHF approaches. LCHF was previously referred to as 'low carb high fat' and PhD Dietitian Caryn Zinn from Auckland University initiated an important change years ago to 'low carb healthy fat'. Researchers also use the terms LCHF and VLCHF. There is nothing to stop people who are currently applying the term 'low carb' to a 45% carb ratio to do the same with TCR. This is not an appropriate reason to change the language. There is nothing wrong with the language. Low carb or very low carb healthy fats describes this dietary approach perfectly. I believe 'therapeutic carbohydrate restriction' is a step down from that. It is less descriptive and completely ignores the fact that focusing on healthy fats is of equal importance. It should remain part of our message, and part of the dialogue. Those of us who use these dietary approaches consider low carb intake to be over 50 g and under 130 g of carbohydrate. This isn't technically correct as there are people who can tolerate higher carb and remain in ketosis, particularly with longer term use and optimal metabolic health. Very low carbohydrate approaches are not as easy to define, as the amount of carbohydrate it takes to enter ketosis is an individual approach and differs according to metabolic health and other factors. VLCHF should be described as 'the amount of carbohydrate reduction required to induce ketone production and nutritional ketosis, as measured by urine, breath or blood' (many studies fail to test for ketosis which is a fundamental flaw). In case I haven't made myself clear - I am apposed to this proposed change.
  February 24, 2022