What is Therapeutic Carbohydrate Restriction?
TCR involves swapping out foods high in carbohydrates and replacing them with proteins and healthy fats, which provide an alternative energy source. Examples of high carbohydrate-containing foods incude bread, pasta, rice, cereal, cakes, pastry, couscous, oats, quinoa, farro, barley, potatoes, and most fruits. Food that have higher protein and fat content include meats and poultry, fish and seafood, full fat dairy products, eggs, nuts and seeds, tofu, tempeh, and cold pressed olive oil. All diets can be modified to suit a low-carbohydrate diet, including vegan diets. Try to buy “whole foods” which are minimally processed. Processed foods contain chemical additives, emulsifiers, manufactured seed and vegetable oils etc, which are endocrine disruptors, contribute to oxidate stress, impact cravings and mood to name a few effects. If foods are packaged, try to select options with ingredients that are recognised as “real foods” such as almonds or coconut. It may be wise to choose packaged foods that have <5 ingredients. Check the macronutrients and pay attention to the carbohydrate content. Aim for <6g carbohydrates/100g.
The Real-Life Medicine is a fantastic website with a podcast, courses and other resources including 3 simple documents that utilise a traffic light system to categories foods where:
GREEN = metabolically safe, low carbohydrate foods.
RED = high carbohydrate containing foods, or foods that contain harmful components that cause additional metabolic damage
ORANGE = these are sometimes foods.
Professor Peter Brukner has a similar method of categorising safe vs unsafe foods and summaries this information into one handy page. This can be found on the Defeat Diabetes website, he also offers an app based program.
The Defeat Diabetes website and Real-Life Medicine websites both contain helpful information and delicious recipes using low carb real foods.
A typical Australian diet contains > 220-280g carbohydrates per day.
Low carbohydrate diets contain of 50-100g carbohydrates per day.
A liberal low carbohydrate diet contains up to 130g carbohydrates per day.
Ketogenic diets contain up to 50g of carbohydrates per day
How does therapeutic carbohydrate restriction work for weight loss?
When we switch our energy source from glucose to proteins and fats, the following events occur.
It is more difficult for our bodies to break down the energy stored in proteins and fats vs carbohydrates, resulting in a slower release of energy. This means that we feel full for longer.
Fat’s make us feel full; carbs make us hungry. When we consume dietary fat, this triggers the release of satiety-promoting hormones such cholecystokinin, peptide YY, leptin, GLP1 and GIP (see “weight regulation” tab). Note the popular weight loss injectable medications such as Liraglutide (Saxenda), Semaglutide (Ozempic and Wegovy) and Tirzepatide (Monjaro) mimic the effects of GLP1 and GIP. In other words, we make “free” weight loss injectable medications when we consume dietary fats. In contrast to this, when we consume carbohydrates, this triggers the release of endorphins (reward messages) that promote eating more, and hunger-promoting hormones such as ghrelin.
A reduction in insulin release secondary to reduced carbohydrate intake means that we have access to our stored fats via lipolysis (remember that insulin inhibits hormone sensitive lipase). This means that we can avoid the protective metabolic processes associated with calorie restriction that would usually prevent weight loss (see weight regulation tab). This is particularly important when introducing intermittent fasting
When we break down stored fats, we produce ketone which have further hunger suppression effects.
But wait. There’s more.
It’s not just about weight loss and diabetes:we can reverse disease with LCWFs. Other advantages of LCWF changes include:
Improvements in mental clarity, anxiety/depression and sense of well-being
Improvements in quality of sleep and energy levels
Improvement and prevention of neurodegenerative diseases such as Alzheimer’s Disease, Parkinson’s Disease, cognitive decline/dementia (which is now being referred to as the new “Type 3 diabetes) and multiple sclerosis
Improvements in pain perception
Improved wound healing
Improved migraine control
Improvements in endurance and recovery
Improvements in autoimmune/inflammatory diseases
Improvements in blood pressure control
Prevention and improvements in gout
Improved endocrine function with improvements in fertility, reversal of polycystic ovarian syndrome, testosterone levels, thyroid function and cortisol levels
Improvement in lipoedema
Reversal of metabolic-associated liver disease
Improvement in abdominal symptoms such as bloating, constipation, and cramping
Reduced risk of certain cancers as well as the improvement in treatment response in some cancers
