Registered Dietitian Franziska Spritzler: a Strong Believer of a Whole Food Low-Carb Lifestyle
Through Diet Doctor, we got to know Registered Dietitian Franziska Spritzler. Besides being a certified Dietitian, Franziska is also a certified Diabetes Educator who strongly believes in a well-balanced, low-carbohydrate lifestyle. You may know her as the Low Carb Dietitian.
Since there aren’t many Dietitians in The Netherlands yet who advocate a low-carb / keto lifestyle, we really wanted to learn more from Dietitians who have been in the keto ‘field’ for a longer time already. Therefore, we asked Franziska if she would be interested in an interview, and she luckily was!
We asked her about how she got into keto, how she implements the low-carb / keto lifestyle in her own life but also in the lives of her clients, and about her perspective on new developments within the keto world.
We feel very grateful that she took the time to answer our questions, and are very excited to be sharing them in this blog.
Hi Franziska, thank you so much for taking the time to answer our questions. Could you share a bit more about yourself, about lowcarbdietitian.com and what you currently do?
I'm a registered dietitian and certified diabetes educator with expertise in low-carb and ketogenic diets. Although I worked with patients and clients individually for several years, I am currently working full time as an expert writer and reviewer at Diet Doctor (www.dietdoctor.com).
So how, and when did you come into contact with implementing a low-carb / keto diet as a Registered Dietitian and how does it differ from your previous approach?
I began following a low-carb approach in early 2011, after learning that my own post-meal blood sugar was increasing to potentially dangerous levels despite having normal fasting blood sugar, being lean, and following what I assumed was an ideal diet (low fat, moderate in complex carbs, no sugar or refined grains) – and the one I'd been recommending to my patients with diabetes for years. Once I significantly cut back on carbs and increased my fat intake, my post-meal blood sugars normalized, and I realized that a low-carb lifestyle would work as well (or better) for people with diabetes, metabolic syndrome, etc.
At the moment, I no longer monitor my diet, as I have been eating this way for more than eight years and know how many carbs I can eat to maintain normal post-meal blood sugar levels (less than 10 grams net carb per meal). However, in the beginning, I tracked my carb intake and blood sugar intake and adjusted my diet accordingly based on my results.
You are specialized in implementing a low-carb approach in clients with Diabetes. Unfortunately, there are still some misconceptions about ketosis and ketoacidosis among healthcare professionals. Could you describe in a few sentences why people with Diabetes (Type 2 and Type 1) can actually successfully manage their condition with this approach?
Diabetic ketoacidosis is a pathologic, potentially fatal condition that typically occurs in people with diabetes who don't produce any insulin (type 1's and a much smaller portion of type 2's). Blood ketone levels are 10+ mmol/L in ketoacidosis, blood sugar is usually elevated, acid-base and electrolyte imbalances occur, and the patient feels profoundly ill. By contrast, in nutritional ketosis, blood ketone levels are 3.0 mmol/L or less, blood sugar remains in the normal range, no metabolic disturbances are present and the person feels well. People with type 2 diabetes who produce insulin can follow a ketogenic diet safely (unless they take certain medications known as SGLT-2 inhibitors, which greatly increase the risk of ketoacidosis), and people with Type 1 Diabetes can follow a ketogenic diet as long as they strictly monitor ketones, blood sugar, and how they feel overall. They should also be closely monitored by a medical professional, especially in the early stages of starting a very-low-carb diet.
Thanks for your clarification on that topic! For what kind of other health conditions can a low-carb / keto approach be beneficial from your own experience with clients?
Health conditions such as diabetes, obesity, PCOS, fatty liver disease, acne, menopausal symptoms, and anxiety could be well-managed with a low-carb / keto lifestyle.
Has following a low-carb/keto lifestyle changed your own health behaviour and you as a person, and how?
Absolutely! I eat much more whole food now then I did in the past, and I actually eat more vegetables as well; in fact, I generally eat vegetables at every meal unless I'm traveling and there aren't any available. I feel so much more energetic, less hungry, and fitter than I did before – and being 52 years and well into menopause, that's saying something! I recommend the low-carb lifestyle not just for its many health benefits but also because of how delicious and easy it is.
It is indeed delicious! What are your all-time favourite foods and recipes?
My 10 favorite foods are salmon, avocados, nuts, eggs, broccoli, beef, 100% dark chocolate, Brussels sprouts, greek yogurt, and butter. Honestly, I have too many favorite recipes!
But here are a few you can find online:
Keto baked salmon with lemon and butter
Keto Brussels sprouts and hamburger gratin
Low-carb chipotle prawn and broccoli salad
What would you like to tell people who are interested in starting a keto diet but feel overwhelmed yet want to prevent nutritional deficiencies and avoid mistakes?
In addition to reviewing the many guides available online at Diet Doctor and KetoDiet (including some I wrote or contributed to), I would read at least one book prior to starting the diet, and the reading material I'd recommend would depend on why someone is following the diet:
Diabetes:
Dr. Bernstein's Diabetes Solution by Richard K. Bernstein, MD
Conquer Diabetes and Prediabetes: The Low-Carb Mediterranean Diett by Steve Parker, MD
The Ketogenic Diet for Type 1 Diabetes by Keith Runyan, MD
Conquer Type 2 Diabetes with a Ketogenic Diet by Keith Runyan, MD
Weight loss and general health:
The Art and Science of Low Carbohydrate Living by Steve Phinney, MD, and Jeff Volek, PhD, RD
The Art and Science of Low Carbohydrate Performance by Steve Phinney, MD, and Jeff Volek, PhD, RD
Low-Carb, High-Fat Food Revolution by Andreas Eenfeldt, MD
Great recommendations! We are curious what you think of the current product developments in the world of keto such as MCT? Do we need them? (Supplements, snacks, etcetera)
I don't really have a strong opinion, other than my personal feeling that sticking with whole food is better and prevents preoccupation with food in general and the “next big thing” in keto. We definitely don't need these supplements, snacks, and treats, but if people want to use them for convenience or because it helps their initial transition to low carb, I think they're ok.
Talking about a whole food approach: how does a well-formulated low-carb day (in terms of macros / food products / supplements) look like according to your expertise?
This is difficult to answer, because it will vary quite a bit from person to person, truly. I also don't recommend getting too caught up in macros other than monitoring carb intake at first while eating enough protein and fat to stay satisfied.
Getting too caught up in macros won’t benefit to your overall health indeed … What is your opinion on the following approaches: OMAD, lazy keto and intermittent fasting?
I've never done any of them personally and don't find them appealing, but for some OMAD or IF may work better than eating three meals a day. To be honest, I actually didn't even know what lazy keto was until I looked it up. If the 20 grams of carbs are net rather than total carbs, it sounds like a reasonable approach, although I still think that eating mindfully is important for people who want to lose weight, especially those who report feeling as though they don't have an “off” switch when it comes to knowing when they're full.
Thank you so much for your contribution, Franziska! It is great to have had the opportunity to learn more about the perspective from another Registered Low-Carb Dietitian. Hopefully more and more Dietitians will get inspired to give the low-carb approach with it’s amazing health benefits a serious thought!