Nutrition care is individualised according to each person’s medical and nutritional needs, eating history, preferences and treatment goals. Where clinically appropriate, nutrition interventions may incorporate Therapeutic Carbohydrate Restriction (TCR), including low-carbohydrate or ketogenic approaches. Nutritional adequacy, appropriate assessment and ongoing monitoring are considered as part of individualised dietetic care. Medical involvement may be recommended where nutrition therapy requires medical monitoring or medication adjustment.
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.
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.
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.
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.
Low carbohydrate nutritional therapy in the form of a Ketogenic diet should not be used in any of the following conditions:
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: