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Aims: Low Carbohydrate High Fat (LCHF) diets are popular for weight loss or glucose control. The main source of energy in such diets is fat but the composition of nutrients varies. This study aims to investigate dietary variations in a real-world LCHF population and its associations with cardiovascular risk factors.

Methods: We recruited 100 volunteers who considered themselves adherent to a LCHF diet. Their last 14 days of dietary intake was assessed using diet history interviews. Validation of energy intake against expenditure was made using activity monitors. Predictive variables for the linear regression models were selected using stepwise bidirectional assessment of Akaike information criterion (AIC).

Results: Energy intake (E%) from carbohydrates was low, 8.7 E%, and fat was the main replacement. Dietary cholesterol was associated with higher total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Dietary sodium intake was associated with higher blood pressure. Protein intake was associated with lower diastolic blood pressure but also with lower HDL. The intake of dietary fibre was associated with lower LDL and total cholesterol but with higher hemoglobin A1c (HbA1c). The intake of carbohydrates and saturated fatty acids (SFA) was not associated with any of the outcome variables.

Conclusion: In this LCHF population, variations in intake of carbohydrates and saturated fatty acids could not predict any aspects of the cardiovascular risk profile. Lower fibre intake and higher cholesterol and sodium intake predicted a less favorable cardiovascular risk profile.