FAQ

FREQUENTLY ASKED QUESTIONS

Do dietary plans embrace any specific nutritional fundamentals?

Generally, all nutrition interventions prescribed will encompass the principles of Therapeutic Carbohydrate Restriction (TCR) using real, nutrient-dense, human appropriate foods, however dietary adaptions and implementation will be tailored to the unique needs of the person. Ketogenic and low carbohydrate dietary plans are formulated to ensure nutritional sufficiency using a ‘food first’ approach and supplementation when indicated.

Foundational knowledge of human nutrition and metabolism will be taught to empower you to create your own unique dietary plan overtime and embrace a holistic health focus. In the context that TCR is a therapeutic treatment, specific pre-treatment and during-treatment assessment, monitoring and supervision will be essential for those with medical problems or on certain medications. Some people will require fewer intensive assessments and interventions then others.

What is Therapeutic Carbohydrate Restriction (TCR)?

Therapeutic Carbohydrate Restriction refers to a variety of dietary interventions in which carbohydrate intake is reduced to less than 130 grams per day (or <26% daily energy intake). If sufficiently low enough to cause an increase in blood, urine and/or breath ketones, typically less than 50 grams carbohydrates per day, the nutritional intervention is termed a ketogenic diet or very-low carbohydrate diet. The measurable elevation in ketones is an indication the body is mainly burning fat and ketones for fuel and referred to as ‘nutritional ketosis’.

The level at which ketosis is achieved is highly individual, but most people will have an elevation in ketones when carbohydrate intake is below 20 grams per day. TCR can be an intervention with or without nutritional ketosis, however certain approaches may more effective treatment for certain conditions to achieve therapeutic goals. TCR should be tailored to the individual’s specific needs and health goals and when implemented as a therapeutic intervention, also under the provision of close monitoring and support for safety and to aid adherence and success.

How many consultations will I need to achieve my goals?

The exact number of sessions you will need to address your top nutritional and lifestyle priorities and achieve optimal health outcomes will be unique to you. Successful learning and behaviour change are processes that depend on a number of different components. It cannot be expected you reach your health goals without sufficient support. Your individual needs vary depending on: your current health status, nutritional status, medical history, biochemical profile, medication profile, genetics, stage of life, physical activity level, severity of stress, mental and emotional state, sleeping habits, ability to implement and manage change, and many other factors.

Generally, 5-10 consultations will be recommended over a course of 6-12 months from your initial consultation to enable the development and refinement of personalised care that will be extended on as you progress, modified if ineffective or adapted if your health priorities or circumstances change. Improving your health takes more than following a prescribed dietary plan - it’s about implementing self-care practices and sustainable behaviour change that become your way of life.

Do you offer services to children and adolescents?

Services are generally only offered to people 18 years or older. Under certain circumstances an agreement may be made to support someone in a younger stage of adolescence (15-17 years old) requiring ketogenic or low carbohydrate nutritional therapy that has been referred by a specialist, or under a supportive healthcare team. Alternatively, parents and/or carers may agree to services to improve their own nutritional knowledge, dietary choices and confidence in managing their child(ren) or family’s dietary habits and health.

Can I claim a rebate from Medicare or my Private Health Fund?

Accredited Practising Dietitians (APDs) are recognised by both Medicare and Private Health Insurers in Australia and these entitlements can claim a rebate for dietetic services. Please read more about the rebated entitlements under the Appointment section.

Why are the fees more expensive than standard dietitian services?

Generally, dietitians based in medical centres offer short consultations and more generalised dietary advice. Amanda is dedicated to working in the specialised area of Therapeutic Carbohydrate Restriction and Holistic Addiction Medicine Counselling to treat metabolic and mental disorders, as well as improve general health and performance. She strives to effectively communicate and provide high quality patient-centred care and personalised care planning that focuses on root-cause healing, shared decision-making and zest for patient empowerment.

The fee schedule is regularly reviewed and reflects the additional qualifications, research, skill set, experience, standard of care and value provided to new and existing patients. All services are based on the latest scientific evidence known at the time and regularly updated to reflect the ever-growing field of nutritional science and research in human health.

When is a Ketogenic nutritional therapies contraindicated?

Low carbohydrate nutritional therapy in the form of a Ketogenic diet should not be used in any of the following conditions:

  • Kidney failure
  • Porphyria
  • Acute illness or injury (e.g. Covid-19, influenza, pneumonia, burns, appendicitis, acute pancreatitis, head injury)
  • Mental health crisis (i.e worsening psychosis, suicidal thoughts, mania, agitation, aggressive or violent thoughts, confusion, recent traumatic experience)
  • Taking medicines in the SLGT2 inhibitor class
  • Inborn errors of metabolism and rare genetic disorders impacting fat/ketone metabolisms, often diagnosed in infancy such as glycogen storage disease type 1, primary carnitine deficiency, carnitine translocate deficiency, pyruvate carboxylase deficiency, carnitine palmitoyltransferase deficiency types I and II, succinylcholine-CoA acetoacetate transferase deficiency 2, methylmalonyl CoA epimerise deficiency, 3-hydroxyacyl-CoA deficiency, beta-ketothiolase (T2) deficiency, acyl-CoA dehydrogenase deficiencies.

What health conditions require medical support if planning to implement Therapeutic Carbohydrate Restriction?

It is advised you consult with your primary medical doctor/specialist and have a supportive healthcare team involved if you have any of the following conditions:

  • Diabetes (type 1 or type 2)
  • Hypertension
  • Heart disease
  • Kidney disease
  • Gout
  • Liver disease
  • Gallbladder disease
  • Pancreatic disease
  • Undergone bariatric surgery
  • Cancer
  • Substance use disorder(s)
  • Anorexia Nervosa
  • Epilepsy
  • Traumatic brain injury
  • Prone to kidney stones
  • Underweight (body mass index - BMI <20)
  • High performance/elite athlete
  • Pregnant or breastfeeding
  • Under the age of 18 years old
  • Taking medications for diabetes, high blood pressure, heart disease or for psychiatric conditions.
If your medical practitioner is not supportive, ask them to share their concerns with you. If you disagree with their assessment, you can seek a second opinion. Consider searching the online Low Carbohydrate Clinician Directories listed in the ‘Medical Support’ section under Appointments.