Food choices, perceptions of healthiness, and eating motives of self-identified followers of a low-carbohydrate diet

Background: Low-carbohydrate (LC) diets have gained substantial media coverage in many Western countries. Little is, however, known about the characteristics of their followers.

Objective: The article analyses how those who report following an LC diet differ from the rest of the population in their background, food choices, weight reduction status, as well as food-related perceptions and motives. The data are a part of the Health Behaviour and Health among the Finnish Adult Population survey collected in spring 2012 (n=2,601), covering 15- to 64-year-old Finns.

Results: Seven per cent of the respondents identified themselves as followers of the LC diet. Gender and education were not associated with following an LC diet. The youngest respondents were the least likely to follow such a diet. The LC diet group preferred butter but also vegetables more commonly than the other respondents and were less likely to use vegetable bread spreads. The followers of the LC diet and the other respondents agreed about the healthiness of whole grain, vegetable oils, vegetables, and fruits and berries, and of the harmfulness of white wheat. Compared to the other respondents, the LC diet group was less likely to regard eating vegetable/low-fat products as important, more likely to regard eating healthy carbohydrates, and the health and weight-managing aspects of foods, as important and placed less value on sociability and pleasures connected to food. The results showed varying food choices among the followers of the LC diet: some even reported that they were not avoiding carbohydrates, sugars, and white wheat in their diet.

Conclusions: Planners of nutrition policies should follow-up on new diets as they emerge and explore the food choices and motives of their followers and how these diets affect the food choices of the whole population.

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Alex’s Notes: After last week’s article on the patterns of supplement use among college students, I was pleased to see another study published that attempted to explore the mindset of certain dieters. This time around, the focus was on a low-carbohydrate (LC) diet in Finland. According to the researchers, during 2010 and 2011, LC diets became widely discussed in the media – to the point of forming a social movement. The diets were typically accompanied with images of butter, cheese, bacon, and other fatty animal products that acted as symbols of the diet.

A similar thing happened in Sweden, where the LC diet actually challenged the national nutrition guidelines and claimed them to be based on fraudulent science. But this isn’t a paper on LC diet efficiency. Rather, it is a paper that aims to explore how LC diet followers differ from other persons with regard to their food choices, socioeconomic background, and perceptions of health risks from food, and eating motives.

Over the spring of 2012, the researchers designed a series of questions to be sent out in the annual Health Behavior and Health among the Finnish Adult Population (AVTK) monitoring survey after piloting them among the consumer panel of the National Consumer Research Center. The survey has been in effect since 1978, and each year 5,000 Finnish citizens aged 15-64 years are randomly selected to receive the 12-page questionnaire. Consumption of foods and beverages containing carbohydrates was measured with a food frequency questionnaire (FFQ) that was included with the AVTK survey.


Male / Female


(15-30 / 30-49 / 50-64 years)


(<10 / 10-12 / >12 years)

N = 2601

43 / 57 %

24 / 35 / 41 %

12 / 30 / 58 %

Overall, 7% of the respondents reported that they were following the LC diet in 2012, and only 3% reported that they had not heard of the diet. The average BMI in the LC diet group was significantly greater (27.21 kg/m2) than the BMI of other responders (25.59 kg/m2), and significantly more (57%) of the LC dieters reported they were currently trying to lose weight compared to the others (21%).

Food Choices

Among the major food categories, there were no significant differences in frequency of consumption of fruits and berries or meat among the respondents. Of the data not shown by the researchers, it is mentioned that French fry, candy, chocolate, and fish consumption were also not different. Unfortunately we cannot see how frequently these were eaten, although it is mentioned that 74% the LC dieters ate candies or chocolate at least once per week. The rest is summarized below.


LC Diet

Everyone Else

I Eat More

Fresh Vegetables



Cooked Potatoes

Rice and Pasta


Sugar-sweetened Soft Drinks

Interestingly, only 83% of the LC dieters reported avoiding all carbohydrates with 87% avoiding sugars and refined wheat products in their diet. Additionally, 44% of LC dieters ate cooked potatoes at least once per week, 54% ate rice and pasta at least once per week, 12% drank juice 6-7 days per week and 42% drank juice 1-5 days per week, and 20% drank sugar-sweetened soft-drinks at least once per week. Clearly there is a disconnect here, and the authors propose two explanations:

  1. Some respondents wanted to identify themselves with the phenomenon even though from the nutritional perspective they were not actually following a LC diet, and
  2. Some of the respondents may have lacked knowledge of nutritional contents of foods and assumed that they were following the LC diet even though they may have been eating banned foods.

I personally think the second reason is more likely given personal experience. Especially with the juice drinking frequency, many people aren’t aware (in my experience) that juice is basically sugar water.

Regarding fat choices, butter was a significantly more prevalent fat used for both cooking and as bread spread compared to the other participants, and margarine/vegetable spreads less often. Even so, vegetable oils were still by far the most common fat used in cooking in both groups, at over 50%.

The Why and Who

Why do the groups differ in their food choices? Vegetables, root vegetables, fruits, and berries were considered good for health by virtually everyone who responded (>95%). Both LC respondents and other persons considered refined wheat products as harmful to health, although this belief was significantly more prevalent among LC dieters (87 vs 69%). However, the majority of LC dieters (80%) and other respondents (90%) regarded whole grain products as good for health. So why then are the LC dieters avoiding grains and starchy tubers?

Only 26% of LC dieters considered animal fats good for health, and 44% said they were bad for health. This may explain why vegetable oil was still the predominant cooking oil. Yet, 26% LC dieters also considered vegetable bread spreads as harmful to health. Regardless, 84% of the respondents in both groups regarded vegetable oils as good for health, and 10% as having no effect on health.

The associations made indicate that LC diets were over three-fold more likely to be over 35 years of age, and the chance of being a LC dieter increased by about 4% for every 1 BMI point over 13 kg/m2. Perhaps this was due in part from the fact that those respondents who considered health and weight management as an important aspect in their food choices were more likely to follow an LC diet, whereas placing value on the pleasure and social aspects of food choices had the opposite effect. Gender and education had no significant associations, and neither did perceptions of the health effects of animal fats, vegetable bread spreads, and refined wheat products. However, preference for vegetable and low-fat products reduced the probability of choosing a LC diet, whereas preferencefor healthy carbohydrates and meat and animal fat products were positively associated with an LC diet.

Bottom line

Diets are interesting. We would be wise to monitor them as they emerge and explore the motives of the dieters. Perhaps even try to look inward and find out why we do what we do.


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