We attended a Low Carb Down Under event in Sydney on the 5th of May 2018. One of the highlights of the day was when the speakers participated in a question and answer session, with questions submitted by the audience members. A range of topics were covered and we have collated the information below.

Check out our full review of all the speakers, the topics covered and our takeaways from the event here.

The presenters who participated in the question and answer sessions are detailed below. This information can be found on the Low Carb Down Under website.

Dr Paul Mason is a sports medicine and exercise physician who developed an interest in low carbohydrate diets in 2011. He then spent thousands of hours reading and analysing the scientific literature. For the last three years, he has been applying this knowledge in treating metabolic and arthritis patients who have achieved dramatic and sustained weight loss and reductions in joint pain, improved metabolic well being, diabetic control and reductions in arthritis.

Dr Doron Sher is a specialist knee and shoulder surgeon. He holds a Masters degree in Biomedical Engineering and surgical fellowships in Australia, Canada and America. His passion for helping patients avoid unnecessary surgery has led to his involvement in two successful metabolic, arthritis, weight loss and sports performance clinics.

Dr Peter Brukner is a specialist sports and exercise physician and a world renowned sports medicine clinician and researcher. He has recently held positions as Head of Sports Medicine and Sports Science at Liverpool Football Club and Team Doctor for the Australian cricket team.

Dr Gary Fettke is an Orthopaedic Surgeon from Tasmania who treats patients suffering the effects of obesity and diabetes every day. He described a nutritional model of inflammation which combined fructose, refined carbohydrates and polyunsaturated oils in 2013. He speaks nationally and internationally on the benefits of restricting carbohydrates in treating modern diseases.

Dr Rod Tayler is a Melbourne anaesthetist with an interest in low carb nutrition. He is the founder of the lowcarbdownunder.com.au website which hosts a range of resources.

Dr Maryanne Demasi is an investigative journalist and former presenter and producer on ABC television’s Catalyst program.

Taryn Polovin is an exercise physiologist with a postgraduate certificate in nutrition. She is an international instructor trainer and lecturer at the Australian Filex fitness conference and was a host and presenter on Aerobics Oz Style on channel 10. She has been low carb for 12 years and regularly treats clients with low carb nutrition strategies.

Jessica Turton is an Accredited Practising Dietitian (APD) and Nutritionist. Her Masters in Nutrition and Dietetics was a systematic review investigating the effect of low-carbohydrate diets in the management of type 1 diabetes mellitus. This year she is undertaking her Research Doctorate (Ph.D.) which involves a primary intervention study investigating a very low-carbohydrate diet for the management of type 1 Diabetes.

Q&A

When is the best time to test ketones?

Dr Rod Tayler – From a convenience perspective first thing in the morning is the best as you can also test your fasting blood glucose. However, potentially you will have a higher reading later afternoon before eating dinner. Dr Taylor said if seeing a higher reading motivated you to continue on, then late afternoon in a fasted state would probably give you the highest reading.

Dr Paul Mason – measuring later in the day will give higher and more consistent readings.

Is it safe for health professionals to recommend LCHF to their patients?

Dr Gary Fettke – Yes! AHPRA (Australian Health Practitioner Regulation Agency) has communicated that all medical professionals can give specific individualised dietary advice to their patients. He also mentioned that a low carb diet is much more mainstream now, due to the CSIRO (Commonwealth Scientific and Industrial Research Organisation) in Australia releasing low carb diet plans and cookbooks, so there is much less controversy around it.

How to help with muscle cramps?

Dr Paul Mason – Muscle cramps can be relieved by supplementing with magnesium and sodium. Dr Mason recommended min 3g up to 6g per day in regards to sodium.

Dr Doron Sher – Hydration is important, so make sure you drink water.

If cholesterol doesn’t cause heart disease what does?

Dr Gary Fettke – Consuming a diet high in inflammatory foods like sugar, carbs & polyunsaturated fat causes inflammation in every cell in the body. Dr Fettke recommends an anti inflammatory diet which is low carb and with no vegetable oils to avoid inflammation and the resulting health concerns.

Your thoughts on carb ups and carb cycling

Dr Rod Tayler – I can’t see a benefit of consuming excess carbohydrates as it will kick you out of ketosis and you will lose the health benefits of using ketones.

Dr Gary Fettke – From an evolutionary perspective, in nature you may might come across a glut of fruit occasionally, so you would be cycling in and out of ketosis.It is not something he practises and he thinks that you need strong will power to get back on the bandwagon afterwards.

Dr Rod Tayler (in response to Dr Fettke) – Evolutionary applications don’t apply to modern times as we don’t need to store fat for the winter from eating high amounts of fruit at the end of summer.

Dr Peter Brukner – From his experience it can be hard for people to restrict a cheat meal or day to just once a week and he does not believe it is necessary. From a performance point of view, the mentality has always been to carb load prior to an event. The new theory is to train low and compete high, by consuming a moderate amount of carbs prior to the event. However, it is best to experiment, as approaches vary based on the individual.

Dr Paul Mason – Sees no benefit.

Dr Doron Sher – Ask the patient what are their goals and how is their metabolic condition. If they are type 2 diabetic, insulin resistant or trying to lose weight, it is not suited to them. Actually scheduling so called cheat meals or carb ups it is a mistake.

Is LCHF suitable for someone with gall stones or who has had their gall bladder removed?

Dr Paul Mason – For patients with gall stones there is a small risk of an attack with a change to a higher fat diet, but most patients improve and the stones dissolve overtime. Dr Mason used a great analogy to describe how gall stones are formed. The bile contained within the gall bladder is like a detergent that helps your body break down fat. When you eat a low fat meal, only a small amount of bile is excreted. The remaining bile that is not used solidifies in the gall bladder over time and eventually turns to stones. Conversely, when you eat a fatty meal the gall bladder is completely emptied into the stomach, with no excess remaining to turn to stone. If you eat a low fat diet normally and then eat one high fat meal, if the gall stones are present you may have an attack as the gall bladder tries to completely empty itself. Hence, the high fat meal is blamed as the cause of gall stones, when it fact it is the low fat diet.

Dr Gary Fettke – When starting a low carb high fat diet after you have had your gall bladder has been removed you will need to increase fat slowly overtime, but you still will be able to eat LCHF.

LCHF with kidney disease in regards to a higher protein consumption?

Dr Paul Mason – There is zero evidence that protein consumption impacts the kidneys. a major cause of kidney disease is diabetes. Insulin levels in the blood impact blood pressure and how the kidneys effectively excrete salt. On a low carb diet, when your insulin is low the kidneys are able to excrete excess salt efficiently and this is the best conditions for them.

Thoughts on exogenous ketones

Dr Peter Brukner – The science hasn’t been done properly yet so the jury is still out. Natural ketosis is better for performance than exogenous ketones. There may be situations were it is appropriate, but we don’t know yet.

Dr Paul Mason – Exogenous ketones may inhibit fat metabolism and he does not recommend them for people trying to lose weight. For performance purposes there may be suitable applications.

High carb & high fat – Family members who add carbs to your high fat meal, is this dangerous?

Dr Rod Taylor – The consensus is that a high carb high fat diet doesn’t work and studies have shown that it can result in bad outcomes.

Dr Paul Mason – Basically you are describing a donut!

Thoughts on Metformin as a weight loss tool

Dr Paul Mason – Metformin is the only diabetic drug to be proven to increase lifespan. Dr Mason recommends Metformin for his insulin resistance and diabetic patients as it can be easier for them to get into ketosis and also promotes weight loss.

Dr Gary Fettke – I am into ‘describing’ for my patients rather than prescribing. Concurs that Metformin is being advocated as a longevity drug, but he would rather use dietary intervention in the first instance.

Dr Peter Brukner – Be careful not to use Metformin as a substitute for a change to a low carb diet. It should not be used as a first option for treatment, only as the second option if the patient is not seeing an improvement with a change in diet, but they should still be used in conjunction.

Dr Maryanne Demasi – Be aware that research has shown that Metformin may Deplete vitamin B12 levels, so this should be monitored by your GP.

How to quit sugar from a psychological perspective

Dr Maryanne Demasi – Practice, practice, practice! Educating yourself to help with motivation. You might need to give quitting a few goes until it sticks.

Dr Rod Taylor – Low Carb Down Under has a new low carb course, which would be useful for beginners.

Dr Gary Fettke – In Latin, doctor translates to teacher. So Dr Fettke is about educating his patients. An approach that Dr Fettke uses is discussing how most of us are interested in our financial retirement, but what about investing in our health retirement. Dr Fettke also made the point that when a patient is visiting a surgeon it is usually at a stressful and critical time in their life. Given this, it can be a good time for an intervention to be successful.

Dr Peter Brukner – I like to tell it like it is. It is going to be hard, you might feel like crap for a few weeks and potentially have the ‘keto flu’. It can be hard to get your head around fat being okay to eat, but this just takes time.

Dr Paul Mason – He used to have 5 sugars in his coffee and acknowledges that sugar is definitely an addiction. You need to learn to distinguish between true hunger and cravings. Dr Mason discussed the cheese test to try and distinguish between hunger and cravings. When you want something to eat, ask yourself if you would like some cheese. If you are truly hungry cheese will be a good option. If it is a craving then you probably won’t want cheese, you will want something else and you just need to fight it. Another point is that sleep is very important in regards to hunger signals. Both Ghrelin and Leptin are affected by lack of sleep. Also when you are sleep deprived your control and motivation is lessened .

Does eating LCHF cost more?

The general consensus from the panel was to do the best you can within your budget. Yes, it can be expensive if you choose organic specialised products and grass fed meats, but some things are less expensive like eggs, mince, and butter.

Another point was that generally on a low carb, high fat diet over time you eat less food overall, so can be cheaper from the point of view that you are buying less food. Also, a lot of packaged processed snack foods can be expensive too, and you will no longer be buying these.

Final Thoughts

The Q&A was one of our favourite parts of the day. The presenters bounced off each other well and were very good at answering the questions in an easy to understand manner.

We really liked the way they ran the Q&A. By getting the audience to write their questions out, they were able to curate them and avoid the same question being asked 2-3 times. It also meant that you could ask a question, even if you were too nervous to speak on the microphone.

Sometimes, the Q&A at conferences can be a bit of a shambles, but not this one. It was run really well and was one of the highlights of the day.

Did you also attend a Low Carb Down Under event? We would love to hear your thoughts in the comments.

Check out some of our other low carb event reviews here

Comments

leonard marder says

October 02, 2018 at 9:44 pm

Hi,
Could you please provide a name of magnesium supplement that Dr Paul Mason mentioned in his answer regarding muscle cramps?

How to help with muscle cramps?
Dr Paul Mason – Muscle cramps can be relieved by supplementing with magnesium and sodium. Dr Mason recommended min 3g up to 6g per day in regards to sodium.

- havebutterwilltravel says
  
  October 03, 2018 at 9:01 pm
  
  We don’t have the name of the actual supplement he was recommending. All of the recordings for that day are now up on the low carb down under you tube channel. Best bet, would be to watch his talks from that day.

Experts answer low carb diet Q&A – LCDU Sydney 2018