Category Archives: nutrient density

the Nutrient Optimiser Score

It’s natural to want to see how we compare with others to learn how we can keep improving.  We want to be better than yesterday.

This article gives an overview of the Nutrient Optimiser Score and what it takes to get to the top of the Nutrient Optimiser Leaderboard.

Fancy a little “healthy competition”?   Then read on.

My daily nutrient intake

The chart below shows my nutrient profile for three weeks of food logging.

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The vertical axis shows the various essential micronutrient (i.e. vitamins, minerals, amino acids and essential fatty acids).

The horizontal axis is my proportion of the recommended daily intake per day that I achieved for each of these nutrients.

The nutrients are then sorted to show the nutrients that I am getting less of at the top.  The ones that I am getting plenty of are at the bottom.

We don’t really need to worry about getting too much of the nutrients at the bottom of the list as long as they’re coming from whole foods.

By continuing to focus on the nutrients towards the top of the chart we de-emphasise the nutrients we are getting plenty of.

Comparing apples to oranges?

The problem with comparing my profile with someone else’s is that being bigger, I could just eat more food to get more nutrients and this.  This would penalise someone who is smaller or who is trying to restrict their energy intake to lose body fat.  We would be comparing apples and oranges!

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We want to encourage people to consume higher levels of nutrients per calorie.

We hope that the Nutrient Optimiser help people get the nutrients we need without excess energy.  This tends to lead to improved satiety, weight loss and overall metabolic health.

Normalising to RDI / 2000 calories

In order to usefully compare my nutrient density with someone else’s, we need to bring my nutrient intake back to an equivalent amount of nutrients per unit of energy.

To do this we normalise to nutrients per 2000 calories.

During the three weeks that these foods were logged, I was consuming an average of 1567 calories per day.  So to remove the influence of food quantity we normalise intake to RDI / 2000 calories.

The chart below shows my nutrients from the chart above factored up by 2000 / 1567 = 1.28.

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Now we have normalised my nutrients to 2000 calories per day, the Nutrient Score calculated by simply taking the area to the left of the line at 300% line that is filled, which in my case is 90%.

This 300% value is arbitrary.  We initially used 200%, but people were starting to get better at creating nutrient-dense meals.  Setting the line at 300% leaves plenty of room for improvement.

Which nutrients do I need more of?

The table below shows the nutrients that I am getting less of sorted by % DRI.

nutrient % DRI prioritise
Potassium 114% yes
Copper 133% yes
Magnesium 140% yes
Calcium 150% no
Manganese 164% yes
Pantothenic Acid (B5) 178% yes
Vitamin E 181% yes
Folate 196% yes
Omega 3 221% yes
Vitamin C 223% yes

Calcium doesn’t get prioritised due to my lower calcium:magnesium ratio as shown in the bottom left from my Nutrient Optimiser Full Report.

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The Nutrient Optimiser algorithm goes off looking for the foods and meals that will provide me with more of the nine nutrients that I’m not getting as much of.

Rather than worrying about avoiding the nutrients that I’m getting plenty of, the algorithm allows me to focus on getting more of the nutrients that I’m not getting as much of.

Why is this important?

It’s fairly well established that eating too much is not good.  We end up with diabetes, obesity and a whole range of undesirable outcomes.

Maximising nutrient density enables you to get away with fewer calories without missing out on the nutrients you need, which is useful if you are trying to lose body fat.  Focusing on foods with a higher nutrient density tends to lead to increased satiety which enables us to manage our appetite.

If I was a lean endurance athlete I would be looking for more energy dense foods that could provide me with the nutrients I need while still getting plenty of nutrition.

The leaderboard

The image below shows the current Nutrient Optimiser Leaderboard showing the current rankings based on the last four weeks of food logged by these people.

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You can click on the names of the people to view their full report to see what they are eating to make it to the top or the bottom of the leaderboard.

We hope that this public leaderboard will drive some “healthy competition” as well as sharing of information on the different ways we can optimise our nutrition.

How to make it to the top

There is no specific dietary approach that will get you to the top of the leaderboard.  We don’t believe in the magic of any specific approach such as paleo, keto, low carb or vegan.

However, the common thing all the people towards the top of the leaderboard are eating plenty of is minimally processed whole foods.

  • Paul Burgess is a dietician and strength athlete who is using the Nutrient Optimiser to refine his diet in a cutting phase.
  • Carrie Burns Diulus, who comes in at #4 is an orthopedic surgeon who has Type 1 diabetes and follows a plant-based diet.
  • Dr Rhonda Patrick is a nutrition and research guru who runs Found My Fitness.
  • Brianna Theroux is a nutrition and fitness consultant who is very particular about what she puts into her body.

Follow the guidance of the Nutrient Optimiser

The Nutrient Optimiser will give you a list of foods and recipes that will help you boost the nutrients that you are not getting as much of.

The idea is that you just eat more of the meals and foods towards the top of the list.

Over time this will change and adapt as you continue to rebalance your nutrition from the ground up.

If you’re interested, you can get a free Nutrient Optimiser that will give you food and meal suggestions along with recommended macro ranges for your situation.  Once you bit more serious you can start logging your meals in Cronometer and get a more detailed analysis based on your micronutrient profile.

We’re really excited about what this could achieve in the world of nutrition.  We’d love to hear your thoughts, questions and suggestions on how we can make this even better to help more people.

how to optimise your protein, fat and carbohydrates to minimise hunger

In the How much protein do you need to optimise satiety article we looked at the critical role of protein in managing hunger.

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The analysis of half a million days of MyFitnessPal data showed that your body is satisfied with less energy when you give it adequate protein.  Hunger increases if we don’t get enough protein.

So, with protein locked in, this article looks at how fat, carbohydrates and fibre affect our appetite.

Fat

The chart below shows the scatter plot of fat versus % goal calories consumed for about half a million days of food logs from 9,900 MyFitnessPal users.[1]

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On the vertical axis, an intake of less than 100% line means that an individual logged less than their goal for the day.  A typical goal calorie intake is set at about 15% below a person’s Basal Metabolic Rate or the amount of energy needed to maintain weight.

To make sense of all this data, we divided it up into 25 “bins’.  Each of the dots in the middle of the chart below represents the average of 22,000 days of data, while the ones at the extremes where there is less data available represent around 11,000 days of data.

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This analysis suggests that the lowest spontaneous energy intake occurs with a lower fat intake.

Satiety seems to improve a little when we have around 60 to 70% fat, presumably because we can still accommodate a reasonable amount of protein.

Satiety is the worst at the highest levels of fat, likely because refined fat is energy dense and there is no room for protein.

Many people report that they find fat satiating.  However, this is likely because they are able to consume a lot of calories quickly, so they feel full.

However, on a calorie for calorie basis, the data indicates that fat is the least satiating macronutrient.  While you feel full sooner, you had to consume more energy to achieve satiety.

Carbohydrates

The chart below shows the scatter plot for carbohydrate vs % goal intake achieved.

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The simplified chart for carbs is shown below.

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This data suggests that:

  1. We get the lowest satiety when carbohydrates make up about 47% of the energy in our diet.
  2. We see some improvement in satiety with around 25% carbs.
  3. A very low carbohydrate intake provides less satiety, presumably because it corresponds with a higher fat intake.
  4. Satiety improves dramatically when carbohydrates exceed 60%.

Dietary battle lines tend to be drawn around extremes of low or high carbohydrate (e.g. low carb and keto vs plant-based, vegan and fruitarians).  This data suggests that both camps may be correct to some extent.

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We just need to avoid the middle ground of moderate levels of carbohydrate combined with moderate fat levels of fat, particularly with low protein (a.k.a. hyper-palatable junk food).

On the high carb extreme, it’s going to be hard to ingest enough energy to overeat.  But when we add generous amounts of fat, we are able to consume enough energy to exceed our daily requirement.

Then due to oxidative priority, carbohydrates must be burned off first.  So any excess fat that is not burned at the end.

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The moderate carb moderate fat grey zone

So it seems we can do OK with either extreme of high or low carb.  It’s the ‘grey zone’ of moderate fat with moderate carbs that seems to really mess us up.

There are plenty of examples of people who seem to do well on either high or low carb extremes in nature.  However, we very rarely find a combination of both fat and carbs together with low protein.  The closest we come to this in nature is milk, which is ironically a pretty good growth formula!

In order to understand how the ratio of fat to carbs affects our satiety, I plotted the fat versus carb ratio for days where people logged less than 25% protein.

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  • On the left-hand end of the chart, a very high carb low-fat diet can be hard to overeat. It’s just a lot of effort and takes a lot of time to get too much food in your stomach.
  • On the right-hand end of the chart, a very high fat low carb approach is easier to over consume compared to the high carb low fat.
  • But in the middle, we have the ultimate miracle grow formula of fat mixed with carbs.

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In food the food industry, food scientists spend a lot of time trying to optimise for this bliss point of the optimum mix of fat, carbs and salt that will enable us to eat more of their food.

If you want to avoid obesity, diabetes and the most common western diseases your mission is to avoid this grey zone.

Putting it all together

The chart below shows the plots for protein, fat, carbs, sugar and fibre together.

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The key takeaways are that:

  1. Increasing protein improves satiety.
  2. Decreasing fat is likely to help you eat less.
  3. Unprocessed contain more fibre are beneficial.
  4. Varying carbohydrates has a smaller impact on satiety compared to manipulating fat or protein.

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Example foods

So, to understand how to apply this, let’s look at some examples of each of the foods that fit these categories.

High protein to maximise satiety

Once you push protein above 50% there isn’t much room for fat or carbohydrates.   You will struggle to over-consume these foods!

food % protein % fat % carb
cod 92% 8% 0%
haddock 92% 8% 0%
white fish 92% 8% 0%
crab 91% 9% 0%
lobster 91% 9% 0%
egg white 91% 3% 6%
pollock 90% 10% 0%
protein powder 88% 5% 7%
kangaroo 88% 12% 0%
turkey breast 88% 7% 6%
crayfish 86% 14% 0%
whiting 86% 14% 0%
chicken breast 81% 19% 0%
shrimp 81% 14% 5%
ground beef (lean) 76% 24% 0%
molluscs 74% 7% 19%
scallop 74% 7% 19%
sirloin steak (lean) 73% 27% 0%

Worst case macronutrient profile (the grey zone)

These foods have low protein and a mix of carbs and fat.

food % protein % fat % carb
Nutella 4% 50% 46%
choc chip cookie 4% 44% 52%
pie crust 4% 45% 51%
doughnuts 4% 42% 54%
Kit Kat 5% 45% 50%
Danish pastry 6% 44% 50%
M&Ms 6% 48% 46%
Snickers 6% 44% 50%
ice cream 6% 48% 45%
croissant 8% 47% 45%

High satiety, low carb

On the low carb end, we get improved satiety when carbs are below 30%, protein is greater than 20% and we have less than 60% fat.

This is the sort of macronutrient profile that we would have experienced before agriculture away from the equator and/or during winter.

These foods are not as satiating as the ultra-high protein foods, but they will be a vast improvement on low protein junk food diet.

food % protein % fat % carb
caviar 36% 58% 6%
oysters 46% 31% 22%
sardine 49% 51% 0%
herring 47% 53% 0%
turkey 48% 24% 28%
natto 34% 44% 22%
sirloin steak 46% 54% 0%
roast beef 49% 51% 0%
lamb 41% 59% 0%
milk (full fat) 20% 51% 29%
Greek yogurt 37% 46% 16%
chicken 47% 53% 0%
beef ribs 43% 57% 0%
mozzarella 31% 58% 11%
cottage cheese 45% 36% 19%

High satiety, high carb

We also seem to get improved satiety when carbs go above 60% with more than 20% protein.   Most people who lived close to the equator (or in other places during summer) would have had access to higher carb foods that contain less fat.  These foods have a lower energy density and hence are very hard to overeat!

food % protein % fat % carb
mung beans 35% 3% 62%
lentils 30% 3% 67%
chard 30% 8% 62%
lettuce 30% 7% 63%
mushroom 29% 7% 64%
Brussel sprouts 28% 7% 65%
broad beans 27% 3% 70%
peas 26% 3% 71%
turnips 26% 9% 64%
kidney beans 26% 3% 71%
cowpeas 26% 4% 70%
peas 26% 4% 70%
black beans 25% 4% 72%
zucchini 24% 14% 62%
lima beans 24% 7% 70%
artichokes 23% 2% 74%
navy beans 23% 4% 73%
broccoli 23% 9% 68%
kale 23% 11% 67%
seaweed 22% 11% 67%

If you are going to use a high carb low fat approach you may need to go out of your way to ensure you get adequate protein, particularly as proteins from plant-based sources tend to be less bioavailable.

Summary

So, in summary:

  • We seem to get improved satiety with either lower carbohydrates (between 20 and 30%) or high (greater than 60%) carbohydrate.
  • Lowering fat reduces energy density and helps us reduce our overall energy intake.
  • If your goal is to spontaneously reduce calorie intake and lose weight with minimal hunger you should consider:
    • prioritising protein,
    • minimise added or refined fats,
    • avoid foods that are high in both carbs and fat and have minimal protein (aka junk food).

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Alternatively, if you want to ignore macronutrients altogether, you can focus on nutrient density using the Nutrient Optimiser and get pretty much the same outcome.

how to maximise nutrient density

We surveyed the Nutrient Optimiser Facebook Group to see what they wanted to learn more about.

Overwhelmingly, the most requested topic was nutrient density.

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Given that nutrient density is the central component of the Nutrient Optimiser algorithm, it’s the perfect place to start this educational series.

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Managing nutrient density ensures you get all the micronutrients you need without too much energy.

This short article will give you an understanding of what “nutrient density” means, why it is important and how you can use the Nutrient Optimiser to improve your diet.

Macronutrients

Most of the time people think in terms of the macronutrients:

  • protein,
  • carbohydrates,
  • fat, and
  • fibre).

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While consideration of macronutrients can be useful, it doesn’t do much to ensure we are obtaining the micronutrients that we need.

Many get enthusiastic about specific macronutrient ratios (e.g. high fat, low carb, low protein, low fat etc.).  Unfortunately, poorly defined macronutrient extremes can be detrimental to your micronutrient profile.  But when you focus on micronutrients,, macronutrients largely look after themselves.

Essential Micronutrients

There is a wide range of compounds in our food that we are adapted to thrive on.  But it’s the essential nutrients that we can’t make from other sources that we need to get from our food.

These essential micronutrients are listed below, divided into their categories of vitamins, minerals, amino acids and essential fatty acids.

vitamins

  • choline
  • thiamine
  • riboflavin
  • niacin
  • pantothenic acid
  • vitamin A
  • vitamin B12
  • vitamin B6
  • vitamin C
  • vitamin D
  • vitamin E
  • vitamin K

minerals

  • calcium
  • copper
  • iron
  • magnesium
  • manganese
  • phosphorus
  • potassium
  • selenium
  • sodium
  • zinc

amino acids

  • cysteine
  • isoleucine
  • leucine
  • lysine
  • phenylalanine
  • threonine
  • tryptophan
  • tyrosine
  • valine
  • methionine
  • histidine

essential fatty acids

  • eicosapentaenoic acid (EPA)
  • docosahexaenoic acid (DHA)

There are conditionally essential nutrients, beneficial nutrients and other compounds that we are aware of but don’t measure.  There’s no need to worry too much about these other substances.

If you are eating minimally processed whole foods with plenty of the essential micronutrients, you’ll likely be getting more than enough of all the other beneficial nutrients.

Recommended daily intake levels

Recommended daily intake levels of the essential nutrients have been established for both sexes at various life stages (i.e. pregnant, young or old).

These recommended intake levels are typically based on the amount that is required to prevent nutrient deficiencies.  It’s usually better to get more than the minimum amount of the essential nutrients where possible.

While supplements can be a useful stop-gap measure, we strongly recommend obtaining more of your nutrients from whole foods which contain all the other beneficial nutrients.

The Nutrient Optimiser will help you determine which nutrients you are currently not getting enough of and which foods and meals will help you fill your micronutrient gaps.

Emphasising the harder-to-find nutrients

Building on the previous work of the likes of Bruce Ames, Joel Fuhrman and Mat Lalonde, the Nutrient Optimiser algorithm focuses on boosting only the nutrients that you are not getting as much of.

If a particular group of nutrients is easy to find or you are already getting heaps of them, there’s no need to focus on trying to get more of them.

The Nutrient Optimiser helps you to rebalance your diet by focusing on the foods that contain the nutrients you are not getting enough of.

The purple bars in the chart below show the nutrients in all the foods in the USDA food database.

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As you can see, some micronutrients are easier to find than others.  Nutrients such as vitamin C, vitamin K and vitamin B12 are generally easy to get enough of while nutrients such as choline, calcium, magnesium and potassium are harder to find.

The light blue bars show the nutrients in the highest ranking 10% of foods in the USDA database when we focus on boosting the nutrients that are harder to find.

We get a massive boost in the nutrients that are harder to find while still getting plenty of the other nutrients.

Nutrient ratios

The Nutrient Optimiser algorithm also looks at the balance between nutrients that operate synergistically.

While the quantity of nutrients is important, the ratio between key nutrients also needs to be considered.  If the nutrient ratios fall outside the target range, they don’t get prioritised.

ratios

target

Zinc : Copper

8 – 12

Potassium : Sodium

> 2

Calcium : Magnesium

 < 2

Iron : Copper

10 – 15

Calcium : Phosphorus

> 1.3

By doing this, the Nutrient Optimiser guides you to eat more of the foods that will help to improve your nutrient balance as well as getting more nutrients per calorie.

Your appetite is the original and ultimate Nutrient Optimiser

The human taste buds have evolved to be the ultimate Nutrient Optimiser, telling you which foods and nutrients you need at a particular point in time.

Wild animals seek out the foods they need at a particular point in time.  Similarly, in the absence of processed hyper-palatable flavoured foods, our cravings guide us to the foods we need.

However, these days, in our modern food environment we have lost the ability to determine what we need.  Our appetite has been tricked into eating foods that look and taste amazing. However, these manufactured foods often contain negligible nutrients.

The Nutrient Optimiser will help you to shortlist foods and meals that contain the nutrients.  Once you’re eating real food that contains nutrients, you can learn to trust your appetite again.

Personalised for you

We have put a lot of effort into developing optimal food lists for different contexts.

  • We can prioritise the nutrients that are harder to find in the USDA foods database.
  • We can prioritise the nutrients that are associated with various health conditions.
  • We can prioritise nutrients that are harder to find in conventional dietary patterns (e.g. ketogenic, low carb, paleo, plant-based, standard western diet, vegan etc.).
  • We can even prioritise the nutrients that most people are missing out on.

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But none of these approaches considers what YOU are eating now and what nutrients you personally need more of.

That’s why we created the Nutrient Optimiser.

The Nutrient Optimiser can use your food log (exported from Cronometer) to identify the nutrients that you are not getting enough of.

The Nutrient Optimiser algorithm then creates your personalised nutritional solution to identify the foods and meals that will fill your current nutritional gaps.

This is truly personalised nutrition, optimised for YOU.

What YOU should eat

Rather than stressing about what NOT to eat, the Nutrient Optimiser helps you focus on what you SHOULD be eating to optimise your diet from first principles.

Once you are getting your fill of the foods that you should be eating, our cravings for the other foods tend to dissipate.  Worrying about what not to eat becomes a non-issue.

One common observation from people who have used the Nutrient Optimiser to refine their food choices is how little food they need to be satisfied.

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Once you solve satiety, optimal weight and body fat levels often look after themselves.

Nutrient density is central

Nutrient density is central to the Nutrient Optimiser algorithm.  However, it is not the only parameter.

The Nutrient Optimiser algorithm also considers:

  • insulin load (to help tweak your diet if you are insulin resistant or have diabetes), and
  • energy density (which can be useful to make your diet even more satiating, so more fat can come from your body).

We’ll cover these other parameters in the following articles.

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redesigning nutrition from first principles

In a sea of nutritional gurus, theories and conflicting opinions, have you ever wondered,

“What should I eat to optimise my blood sugars, weight and health to feel great and thrive?”

If your answer is “yes,” you’re in luck!

This article sets out a bold proposal and methodology to redesign nutrition from the ground up using first principles.

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It also gives you a peek under the hood of the Nutrient Optimiser, an exciting new tool to help you identify optimal foods to incorporate into your diet to achieve your goals.

Overview

But before you dive in, let me give you an overview of where we’re going.

  • Humans require food that contains:
    • adequate nutrients,
    • energy (but not too much), and
    • the ability to maintain healthy hormone levels.
  • The Nutrient Optimiser algorithm considers insulin load, nutrient density and energy density to identify optimal foods to suit different people with different goals.
  • People with diabetes or some degree of metabolic syndrome are on a blood sugar/insulin rollercoaster which drives appetite and fat storage.
  • Stabilising blood sugars and insulin levels using a lower insulin load dietary approach can help to normalise appetite and improve energy levels and often leads to a degree of spontaneous weight loss.
  • Being able to accurately quantify the insulin load of our food enables us to ensure we invest it wisely on protein and other nutrient-dense foods while still maintaining excellent blood sugar levels.
  • The foods that require the least insulin are typically high-fat foods which may not contain adequate amounts of vitamins and minerals.  We need to find the balance between a lower insulin load and adequate nutrient density.
  • Some nutrients are easier to obtain than others. The nutrient density index embedded in the Nutrient Optimiser algorithm prioritises foods that contain more of the harder to find nutrients.
  • People on a low carb or ketogenic diet often miss out on a number of nutrients, particularly electrolytes (e.g. potassium, magnesium, calcium and sodium) and our pancreas will increase insulin levels to enable our kidneys to hold on to these nutrients if we are not getting enough of them from our diet, and thus drive insulin resistance.
  • We can use energy density to manage how filling our food is to suit our goals.  For example, someone wanting to lose weight by eating less by decreasing their energy density or someone wanting to eat more by increasing energy density.
  • The Nutrient Optimiser considers what you are currently eating and identifies nutrient-dense whole foods that will provide the nutrients that you are not getting enough of while also managing your blood sugars and weight goals.
  • The Nutrient Optimiser can help retrain people to make progressively better food choices and reduce nutrient-poor processed foods using a quantitative algorithm that eliminates the emotion, belief and conflicts of interest that often derail our best nutritional ntentions.

My why

My name is Marty Kendall, and my journey into nutrition started fifteen years ago when this happened…

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…and we started thinking about having these.

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My wife Monica has Type 1 Diabetes.  Not too long after we got married we started researching how we could optimise her blood glucose control to minimise the risks associated with a diabetic pregnancy.

And personally, I have a family history and my own struggles with prediabetes and obesity (as you can see from the “before and after” below).

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By day I’m an engineer.  I like to use data to optimise things quantitatively.

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I even spent a period of time developing trading systems.  In this environment, it is critical to eliminate emotion, belief and confirmation bias.

As they say, necessity is the mother of invention.  I got frustrated with the lack of useful information for people with diabetes and decided to take matters into my own hands to create the optimal nutritional solution for my family.

The key components of optimal nutrition

You may have noticed that there is a lot of argument and conjecture about what is the best diet.  Unfortunately, decades of expensive epidemiological studies don’t seem to have provided any clarity.

Paleo, vegan, low carb, fruitarian, pescetarian, Mediterranean, vegetarian, plant-based, ketogenic, the list of nutritional camps goes on and on.

But when you peel away the dogmatic belief and conflicts of interest I think what we really need from our food is:

  • adequate nutrients,
  • enough energy (but not too much), and
  • the ability to maintain healthy hormone levels (e.g. insulin, ghrelin, leptin, mTOR etc.).

After experimenting with a range of parameters to optimise nutrition, the three that I have found to be most useful are:

While not as useful by themselves, we can combine these parameters using a multi-criteria analysis and apply different weightings to each parameter to optimise food choices to suit different people with different goals.

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Given that the diabetes epidemic is exploding, let me start by discussing how we can quantify the insulin load of the food we eat to optimise our blood sugar control.

The blood sugar rollercoaster

Someone with diabetes is on a constant rollercoaster of treating blood sugars with insulin.

You eat, and your blood sugars go up.  You dose with insulin, and eventually, your blood sugars start to come down.  Then you find your blood sugars have dropped too low so you feel compelled to eat again.  Maybe something sweet or a glucose tablet that you wouldn’t have otherwise eaten.  This cycle continues night and day.

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The blood sugar – insulin roller coaster leaves you feeling fatigued and hangry, often gaining weight due to fat storage effects of excess insulin.

When the inputs of food and insulin are both large, it’s impossible to match the right amount of insulin to the food you eat.  There is always a massive error!  And the blood sugar swings are like a bad theme park ride.

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So logically, the goal for someone wanting to manage their blood sugars is to reduce the dietary inputs that need insulin.[1]   But then, the next question is:

“What exactly is it in our food that raises blood glucose and requires insulin, and then how can we accurately quantify it so we can more effectively manage it?” 

The food insulin index data

A couple of years back, I stumbled across a motherload of Food Insulin Index data in a University of Sydney thesis[2] that I thought might hold some clues about how we could more accurately manage insulin.

So I exported the data into a spreadsheet and started tinkering with it to better understand the relationship between the food we eat, our glucose response and the insulin we need.

Our blood sugar response to glucose

It’s not a great surprise for most people to see that our blood glucose response is correlated with the carbohydrate we eat.

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However, things get more interesting when we look at the insulin response to the food we eat.

Measuring our insulin response to food relative to glucose

The Food Insulin Index quantifies the area ‘under the curve’ insulin response to a range of foods.  Pure glucose is assigned a score of 100%, and everything else is measured relative to that.

The food insulin index is a little bit like the Glycemic Index.  However, rather than just measuring the maximum rise in blood glucose, the food insulin index measures the insulin response to the food we eat over time.

Understanding our insulin response to the food we eat is much more useful for someone who cannot keep their blood sugars at normal levels due to insulin resistance (type 2 diabetes) or not being able to produce enough insulin (type 1 diabetes).

Carbohydrates versus insulin response

When we plot carbohydrates against the Food Insulin Index, we find that, while high-fat foods such as bacon and avocado have a small insulin response, high protein foods (e.g. steak and fish) have a significant insulin response even though they don’t contain any carbs.

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People with Type 1 diabetes find that they need insulin to cover the protein they eat.  However, the details of why and how much are often not well understood which leads to poor blood sugar control.

Fats versus insulin response

Higher fat foods have a smaller insulin response, while low-fat foods (which are typically processed grain products) have a high insulin response.

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[Note: There are a couple of situations where fat will require insulin.  The glycerol backbone that holds fat molecules together can be converted to glucose via gluconeogenesis which will need insulin to metabolise.  Also, when we consume more energy than we require over the long term, regardless of macronutrient source, the pancreas secretes insulin to keep energy stored in the liver while the energy coming in from our diet is used up.   However, the changes in insulin levels due to dietary fat are negligible in the short term compared to the carbohydrates and protein.]

The insulin response to dietary protein

Although protein needs some insulin to help us build and repair our muscles and organs, higher protein foods tend to have a lower insulin response because they force out refined carbohydrates from our diet.

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Does protein turn into chocolate cake?

When I first started looking into this issue, I thought the reason that protein requires insulin was because the glucogenic amino acids in protein were being converted to glucose which needs insulin.[3]

But I have since come to understand that it’s not quite that simple.  Protein does not turn to chocolate cake in our bloodstream.

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I feel partially responsible for propagating that misunderstanding with my early posts on the food insulin index.[4] [5]  Many people are avoiding protein to minimise insulin, and I’ve been trying to set the record straight.[6]

Insulin has many critical roles in our body.

  • Most people are aware that insulin helps the body take glucose into the cells to be used for energy.[7]
  • Bodybuilders are well aware that insulin is an anabolic hormone that helps us use the protein we eat to build and repair muscle and organs.[8] [9] [10]
  • The third, lesser-known function of insulin, is that it works to hold glucose in the liver (i.e. glycogen) for later use when we’re not eating.[11]

Type 2 diabetes occurs when we become resistant to the effects of insulin, and stored glucose leaches out into our bloodstream.  Similarly, Type 1 diabetes occurs when the pancreas can’t produce enough insulin to keep glycogen stored in the liver, and we see our blood sugars rise.  Effective and efficient use of insulin in our body is critical to our metabolic health.

Most of the amino acids that make up protein can be converted to glucose via gluconeogenesis, but converting protein to ATP it’s really difficult compared to just using fat and/or carbs. for energy[12]  It takes a lot of energy to convert protein to glucose (we use 6 ATP to yield only 2 ATP of energy!).  So the body tends to look for other energy sources once you’ve consumed enough protein.

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That’s why you can quickly become full-on lean protein, but we always have a “dessert stomach” with enough room for carbs and fat which are much easier for the body to use for energy.

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Let me clarify this with a real-life example that is close to home.

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Pictured above is my wife Monica’s blood glucose response measured with a continuous glucose meter) to this meal of steak and veggies shown below.

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Over the first few hours after finishing the meal the carbohydrates in the veggies digest and raise her blood sugars.  Then the insulin that she injected with the meal kicks in and brings the blood sugars down.

But then over a period of about ten hours, we can see that she is slowly metabolising the steak which requires insulin for the anabolic process of muscle repair.  While the insulin is going to work on the protein, Monica doesn’t have enough insulin to stop the glucose being released into the bloodstream.

You could be forgiven for thinking that protein is being converted to sugar.  But it’s actually the glycogen in the liver leaching into the blood due to a lack of insulin.  Monica actually needs more insulin here to enable her to build and repair her muscles as well as keep glucose in storage in the liver at the same time!

Most people see their blood sugar decrease after a high protein meal due to the effect of insulin (the insulin released to metabolise the protein also brings the blood sugars down and keeps the glycogen shut in the liver).  If you find that your blood sugars rise significantly after a high protein meal, it might be a sign that you actually need more insulin to ensure you are effectively using the protein you are eating.

According to the Protein Leverage Hypothesis, (Simpson, 2005) rather than minimising protein, someone with diabetes eating less carbohydrate may actually require more protein.

“One source of protein loss is hepatic gluconeogenesis, whereby amino acids are used to produce glucose. This is inhibited by insulin, as is the breakdown of muscle proteins to release amino acids, and therefore occurs mainly during periods of fasting.

“However, inhibition of gluconeogenesis and protein catabolism is impaired when insulin release is abnormal, insulin resistance occurs, or when circulating levels of free fatty acids in the blood are high.

“These are interdependent conditions that are associated with overweight and obesity and are especially pronounced in type 2 diabetes. It might be predicted that the result of higher rates of hepatic gluconeogenesis will be an increased requirement for protein in the diet.”  [13] 

Type 1 Diabetes guru Richard Bernstein says he found it hard to build and maintain muscle before he understood the importance of matching insulin with protein.

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However, after matching adequate protein with the right amount of insulin this is no longer a problem, even after more than seven decades of living with Type 1 Diabetes.

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At the same time though, there’s no point choking down more protein beyond what you have an appetite for.   Regardless of the macronutrient source, there’s no use consuming more energy than you need, particularly as the errors in matching food with insulin can exacerbate the glucose/insulin rollercoaster.

Anyone who is somewhere on the spectrum of metabolic disease needs to invest their limited supply of insulin wisely (e.g. to metabolise protein to build and maintain muscle and metabolise limited glucose from nutrient dense green leafy veggies) rather than squander it (on refined grains and sugars).

I hope this interlude into protein metabolism gives you an insight into why a good understanding of our insulin response to protein is important.   While there are a wide range of other hormones that drive our metabolism (e.g. mTOR, leptin, ghrelin and PPK) most of these fall in line if we optimise insulin and blood glucose levels.

Fibre

As a general rule, indigestible fibre does not require insulin and does not raise blood sugar levels.  High fibre foods such as All Bran and navy beans tend to have a lower insulin response due to their high indigestible fibre content.  Hence, it appears that a ‘net carbs’ approach makes sense, at least for whole foods.[14]

[Note:  Many people with Type 1 find that they do require insulin or have a blood sugar response to sugar alcohols and other fibres used in manufactured foods so it may be prudent to adopt a total carbs approach when dealing with foods that come in a packet and claims to have low ‘net carbs’.]

Fructose

Fructose (a.k.a. fruit sugar) is processed in the liver without requiring insulin.  However, some of it is converted to glucose via gluconeogenesis.[15]   Analysis of the food insulin index data suggests that 25% of the fructose we eat requires insulin.   However, this is typically such a small component and difficult to calculate, so it’s generally not worth worrying about.

The solution

After playing around with the Food Insulin Index data for a while, I found we can more accurately predict our insulin response to the food we eat when, in addition to carbohydrate, we also consider the effect of indigestible fibre and protein.

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[If you want to dig into this data a little more you can check out these charts in an interactive Tableau format here.]

With this improved understanding, we can then develop these formulas to calculate the insulin load and the percentage of insulinogenic calories.

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Understanding the insulin load of our food helps us to more accurately calculate the insulin people with diabetes would need to inject, including for protein.   Or conversely, it can help them make better food choices so their pancreas can keep up and maintain healthy blood sugar levels.

Being able to calculate the proportion of insulinogenic calories allows us to identify the most ketogenic foods that will elicit the smallest insulin response in our pancreas.  Understanding the percentage of insulinogenic calories can be beneficial for people who require therapeutic ketosis to help with the management of cancer, epilepsy, Alzheimer’s or dementia.

With better food choices that require smaller inputs of insulin, we are able to smooth out the blood sugar-insulin roller coaster.

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This is a big deal for someone with Type 1 diabetes.  However, the same principles apply to anyone on the spectrum of metabolic disease (which is a growing portion of the population).

I believe our first priority should be to normalise blood sugar and insulin swings.  Often satiety and weight loss will naturally follow as we are able to access our own body fat more efficiently and are not driven to eat by fluctuations in blood glucose and insulin.

Lack of nutrients in fattiest foods

However, after looking at the foods that elicit the smallest insulin response, I realised we may have another problem.  The least insulinogenic foods tend to be mainly fat!

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While an unnecessary fear of fat has driven the unfortunate low-fat processed food saga that has been in place for most of my lifetime, I think we also need to acknowledge that the highest fat foods typically do not contain a lot of the essential vitamins and minerals.

This chart shows the nutrients contained in the fattiest foods as a percentage of the recommended daily intake for each of the essential nutrients.  The nutrients are then sorted to identify which nutrients these foods fail to provide in adequate quantities.

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So if you ate a little bit of the eight hundred fattiest foods of the eight thousand foods in the USDA database you would not be getting the DRI for the following micronutrients:

  1. Vitamin D
  2. Folate
  3. Potassium
  4. Choline
  5. Manganese
  6. Vitamin C
  7. Magnesium
  8. Calcium
  9. Pantothenic acid
  10. Vitamin K
  11. Riboflavin
  12. Vitamin B6
  13. Vitamin A
  14. Vitamin E

Nutrients lacking in the most ketogenic foods

Rather than sorting by percentage fat, this chart shows the nutrients contained in the most ketogenic foods using the percentage insulinogenic calories formula shown above.

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While these foods (refer summary below) are an improvement on the nutritional profile of the fattiest foods, they still do not provide the recommended daily intake for about a third of the essential nutrients.

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So the next question is, what can we do to maintain low insulin levels and while still getting the micronutrients we need?

Enter nutrient density.

Nutrient density

Building on the work of the likes of Dr Mat Lalonde and Dr Joel Fuhrman I developed a nutrient density index to identify foods that contain more of the nutrients that are harder to find.

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Dr Lalonde’s nutrient density system considered all the essential nutrients in terms of nutrients per weight of foods and ended up with a very protein heavy (e.g. 60 to 70% of energy) array of foods.

Dr Fuhrman’s Aggregate Nutrient Density Index considered vitamins and minerals (but not amino acids or essential fatty acids) along with a range of other factors as noted below.

The following nutrients were included in the evaluation: fiber, calcium, iron, magnesium, phosphorus, potassium, zinc, copper, manganese, selenium, vitamin A, beta carotene, alpha carotene, lycopene, lutein and zeaxanthin, vitamin E, vitamin C, thiamin, riboflavin, niacin, pantothenic acid, vitamin B6, folate, vitamin B12, choline, vitamin K, phytosterols, glucosinolates, angiogenesis inhibitors, organosulfides, aromatase inhibitors, resistant starch, resveratrol plus ORAC score.[16]

Rather than prioritising all nutrients, I think we only need to worry about boosting the nutrients that we are currently not getting enough of.   To reduce any percieved bias or conflict of interest, my version of the nutrient density index only considers the essential nutrients that have established targets.

While there are many other nutritional parameters that are nice to have (e.g. phytonutrients, lycopene, lutein, zeaxanthin, phytosterols, glucosinolates, organosulfides, resistant starch etc.), they tend to come along for the ride if we focus on getting the essential nutrients from whole foods.

Unfortunately, we currently only have data for the nutrients that are actually in a food.  Hopefully one day we will also be able to account for your digestion, the effect of anti-nutrients and the bioavailability of nutrients from different food sources.

Most of the time these are not a problem as focusing on nutrient-dense foods eliminates most anti-nutrients.  Most people get plenty of amino acids, iron, zinc and vitamin A which are less bioavailability in plant-based sources.  However, if you are consuming a 100% plant-based diet, you may need to pay extra attention to getting adequate of these nutrients.

A well-formulated ketogenic diet

So, going back to the ketogenic foods, once we emphasise the harder-to-find nutrients, we get a massive boost in the micronutrient content of our diet, while still maintaining a ketogenic macronutrient ratio.

The image below shows the ketogenic foods with and without consideration of nutrient density.  When we boost the harder to find nutrients all of the nutrients get a significant boost.

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The nutrient score that you see on each of these charts enables us to compare the nutrient density of each these dietary approaches quantitatively.  While the recommended daily intake levels are not set in stone, and your body doesn’t flip an on/off switch once the minimum levels are achieved, I think we ideally want to meet the recommended intake levels for as many nutrients as we can.  However, there’s probably not much use chasing more than twice the recommended daily intake levels.   So, if we filled the whole red rectangle, we would get a perfect score of 100%.

As you’ll see below, we can create a theoretical list of foods that get us pretty close to a perfect nutrient density score of 100%.  However, in real-life, it’s hard to achieve such a high nutrient density score.  Dr Rhonda Patrick currently holds the top position on the Nutrient Optimiser Leaderboard with a score of 82%.

Low carb is more nutritious than keto

If we tweak the weightings in the multi-criteria analysis and put less emphasis on insulin load and more on nutrient density we get a more nutritious group of low carbohydrate foods and the nutrient score increases from 64% to 97%.

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A summary of these foods is shown below.

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While I could go on about the importance of the various vitamins, minerals and fatty acids, the thing I see most regularly with low carb diets is a lack of alkalising minerals such as potassium, magnesium and calcium.

The chart below shows a typical nutrient profile for someone following a ketogenic diet.  Notice the cluster of lower levels of potassium, magnesium and calcium at the top of the chart.  There has been a lot of talk about sodium lately.  However, it seems that these other minerals are actually harder to get in sufficient quantities.

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Dr James Dinicolantonio references this study in his recent book, The Salt Fix, that shows that low sodium diets tend to lead to insulin resistance.

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The kidneys call on the pancreas to secrete more insulin to help them hold onto sodium when there isn’t much coming in from our diet.[17]

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Volek and Phinney point out that the fundamental problem with low salt diets is that they cause a loss of potassium which is critical for building and maintaining muscle.

“Salt depletion causes a compensatory loss of potassium, which has a negative impact on muscle mass since potassium is a necessary cofactor for building muscle.”

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Managing sodium and potassium is a massive deal for our body, with 40% of the body’s energy and 70% of the brain’s energy used just to manage the sodium-potassium pump that is fundamental to our energy production.

As well as for sodium, the body upregulates our basal insulin to hold on to other electrolytes such as potassium and calcium.[18]

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Ironically, a low carb or ketogenic diet that minimises total carbohydrates in an effort to reduce the bolus insulin required for our food, may actually lead to a reduction in electrolytes that drives insulin resistance through an upregulation of basal insulin to enable our kidneys to hold onto precious electrolytes if we’re not getting sufficient quantities from our diet!

Paul Jaminet points out that Palaeolithic diets were naturally high in potassium and low in sodium.  Salt was rare and highly valued, so we evolved mechanisms for protecting against the threat of low sodium levels.  However, because potassium was plentiful back then, we have not developed similar evolutionary mechanisms to protect us against low potassium levels, even though they are every bit as devastating to our health.[19]

Today, potassium tends to be hard to obtain from our diet or even from supplements (which are limited to 99mg when the RDI is 4800mg or nearly 50 capsules), so we need to pay particular attention to make sure we get enough of it.

While I don’t think it’s ideal to focus on just one nutrient, we get a respectable amount of nutrients if we just chase high potassium foods.

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And while there are a number of fruits (like bananas) in the high potassium foods list, there are still a ton of non-starchy veggies if you need to manage your blood sugar levels.

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Energy density

Once you have normalised your insulin and blood sugar levels to that of a metabolically healthy person, there may not be any use in doubling down on more dietary fat if your goal is to lose body fat.

If your goal is further weight loss, I believe the ideal approach is to maximise the nutritional content of your diet so you can minimise energy intake without risking nutrient cravings.  The image below shows how the weight loss phase of a ketogenic diet includes a substantial amount of fat coming from the body with a more modest dietary intake of fat and lower overall calories.[20]

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Foods with a lower energy density (in terms of calories per weight of food) tend to be more filling and allow you to reduce energy intake naturally which will, in turn, allow your body fat to be used for fuel.

Optimal foods for weight loss if you’re still insulin resistant

These weight loss foods prioritise low energy density while also prioritising nutrient density and a low insulin load to help you lose weight if your blood sugars are still a little elevated.

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And they contain a very respectable amount of nutrients.

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Maximum nutrients with minimum energy

Meanwhile, the foods in this list just prioritise a low energy density and high nutrient density and hence provide a lot of nutrition without too much energy.

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And the nutrient profile is spectacular!

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A Protein Sparing Modified Fast is often used in weight loss clinics to maximise the rate of fat loss while ensuring you get adequate protein to maintain your lean muscle mass.

Adding nutrient density to this protocol will further improve your chances of success by avoiding cravings and nutrient deficiencies while maintaining an aggressive energy deficit.

What I find really interesting here is that, even though we are not prioritising any of the amino acids, we are getting tons of protein!  It seems that when we focus on the harder-to-find nutrients, protein becomes a non-issue.

It’s also interesting to note that the macronutrient split of these the most nutrient dense foods is similar to the macronutrients that generate the lowest ad lib energy intake.[21]

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Conversely, actively avoiding protein tends to have a diabolical impact on the essential vitamin and mineral content of our diet as shown in the chart of the lowest protein foods below.

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As you can see from the food list below, it’s hard to minimise protein without going very high carb or relying on a lot of refined fats.

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Optimal foods for bodybuilders

If you’re a bodybuilder trying to build muscle you can focus on boosting the more anabolic branched chain amino acids (i.e. valine, leucine and isoleucine).

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The foods listed below will help you recover and build muscle if you are working out.

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Optimal foods for endurance athletes

If you are an endurance athlete who doesn’t want to rely on pasta and energy gels to get enough energy you can focus on high energy density foods while still keeping nutrient density high.

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Foods with a higher energy density are not as nutrient dense.  However, these foods are still pretty good.

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Micros > macros?

You may have noticed that the macronutrient splits of the various dietary approaches vary significantly.  However, what is consistently missing from these optimal food lists are sugars and processed grains which contain a pitiful amount of nutrition.  The contrast between the cereals, baked goods, snacks and fast foods…

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… and the most nutrient dense foods is dramatic!

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A low carb diet will ensure that you avoid the majority of these dangerous Franken foods along with the sugars, seed oils, anti-nutrients and chemicals that are often associated with processed grains.

However, what I’ve found, after playing around with all these food lists for a few years, is that everything seems to work out pretty well when we start by prioritising the harder-to-find micronutrients and tweak from there to suit our goals.

Personalised nutrition

A further problem that I identified with these lists is that they do not consider what YOU are currently eating.

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Each person’s interpretation of a low carb, ketogenic or paleo diet will vary depending on preferences, finances, culture, appetite and activity levels.

I think what you really want to know is:

which foods will provide you with more of the nutrients you are not getting from your diet right now?

So this year I’ve developed the Nutrient Optimiser algorithm, a tool that will tell you:

  • what foods you should be eating more of,
  • which foods you should be eating less of, and
  • which new foods you should look for next time you go shopping.

Rather than adopting the Pete Evans diet or the Tom Brady diet for a period and then falling off the wagon once the meal plans run out, the Nutrient Optimiser will help you help you make continual incremental improvements in your journey towards optimal nutrition.

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The algorithm takes your food log, entered in Cronometer, and analyses it to see which nutrients you are currently not getting enough of.

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Nutrient imbalances

We also look at the critical ratios to make sure we’re not prioritising nutrients that are going to exacerbate any current imbalances.  The chart below shows an example of how we can use these ratios to refine the nutrients we want to prioritise.

ratios ratio target recommendation
Omega 6 : Omega 3 0.3 < 4 omega 6 : Omega 3 ratio is good.
Zinc : Copper 7 8 – 12 zinc : copper ratio is outside limits.
Potassium : Sodium 1.5 > 2 potassium : sodium ratio is low.
Calcium : Magnesium 2.3  < 2 calcium : magnesium ratio is high.
Iron : Copper 11 10 – 15 iron : copper ratio is within range.
Calcium : Phosphorus 0.6 > 1.3 calcium : phosphorus ratio is low.

Tailoring nutrition to suit blood sugar and weight loss goals

The Nutrient Optimiser algorithm also helps you choose your ideal dietary approach based on your blood sugars as well as our performance and weight loss goals.

approach average glucose (mg/dL) average glucose (mmol/L)
well formulated ketogenic diet > 140 > 7.8
diabetes and nutritional ketosis 108 to 140 6.0 to 7.8
weight loss (insulin resistant) 100 to 108 5.4 to 6.0
weight loss (insulin sensitive) < 97 < 5.4
most nutrient dense < 97 < 5.4
nutrient dense maintenance < 97 < 5.4
bodybuilder < 97 < 5.4
endurance athlete < 97 < 5.4

Targeted nutrients to suit your symptoms

We can also factor in additional nutrients that relate to your current symptoms such as diabetes, low testosterone, fertility or a wide range of other conditions associated with nutrient deficiencies.

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Optimal food to suit your goals

The algorithm then generates a suite of personalised food sorted in descending order lists tailored and prioritised to suit your goals.  And coming soon, optimal meals and meal plans that will align with your goals.

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Best and worst days

The algorithm also gives a nutrient score for each day of your food log.  You can learn a lot by reflecting on what you are consuming on your best and worst days.

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Leaderboard

To date, I’ve run the Nutrient Optimiser analysis for about seventy different people.

It’s exciting to see the competitive types try to work their way up the leaderboard.

And if you’re a nutrition nerd like me you may find it interesting to head over to the leaderboard and drill down to see what each of these people is actually eating to achieve these high and low nutrient scores.

Sitting in first place at the top of the leaderboard is Dr Rhonda Patrick who, as you can imagine, does look like she eats pretty healthy.

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But the best competition is against yourself, with incremental improvements by implementing the recommendations of each iteration of the Nutrient Optimiser analysis.  For example, we can see Andy Mant has made leaps and bounds in his diet in preparation for his recent Paris wedding.

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Andy had some great success with plenty of seafood and oysters (check out his report here).  Meanwhile, people like Amy boost their nutrients with organ meats on a zero carb approach.  Others achieve a high level of nutrient density with plenty of green veggies.

The Nutrient Optimiser still doesn’t force you to eat specific foods but allows you the latitude to find the best selection of foods that align with your preferences.

Want to learn more?

If you’re interested, all the food lists (and a whole lot more) are available for free here.

If you want to learn more about the Nutrient Optimiser you can check out the FAQ over at NutrientOptimiser.com.

There are also a number of Facebook groups where you can participate in the discussion about Optimising Nutrition and share the journey.

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My hopes for the future

I presented the guts of this article as a presentation at Low Carb Down Under Gold Coast in October 2017.  A frequent comment was that it was apparent that I had spent a LOT of time developing the food lists and the Nutrient Optimiser.  Yes indeed, this has been a labour of love.  A challenging problem to solve with personal ramifications.

I would love to see the Nutrient Optimiser take off and help a lot of people and perhaps pay for a little of the time that I have invested into it.  Getting some income will enable it to be developed into a quality system that will help a lot more people.

But I really do hope that the system that I have developed will educate people to start an underground revolution by enabling them to confidently make food choices that provide them with the nutrients they need with enough energy while also optimising their hormones.

Decades of epidemiological studies have been fruitless in providing a clear direction as to the optimal human diet.  Nutrition research and education are so fraught with entrenched belief systems, confirmation bias and with conflicts of interest.

It’s impossible for the everyday person to know what they should eat to feel OK and thrive at life.  It seems Big Food is just winning and Big Pharma (also owned by the same companies) is making a killing cleaning up the mess.  The current system is broken and needs to change!

The Nutrient Optimiser algorithm gives us the chance to redesign and rebuild nutrition from the ground up.  My dream is that it will empower educated enthusiasts, then dieticians and personal trainers, then doctors, then insurance companies and then medical systems.  At that point, big food will catch on and realise they need to provide nutritious foods that enable people to thrive and win at life.

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references

[1] http://www.diabetes-book.com/laws-small-numbers/

[2] https://ses.library.usyd.edu.au/handle/2123/11945

[3] https://optimisingnutrition.com/2015/07/06/insulin-index-v2/

[4] https://optimisingnutrition.com/2015/03/30/food_insulin_index/

[5] https://optimisingnutrition.com/2015/03/23/most-ketogenic-diet-foods/

[6] https://optimisingnutrition.com/2017/06/03/why-do-my-blood-sugars-rise-after-a-high-protein-meal/

[7] http://www.medscape.org/viewarticle/438374

[8] https://www.ncbi.nlm.nih.gov/pubmed/16705065

[9] https://www.bodybuilding.com/fun/max_insulin_response.htm

[10] https://www.t-nation.com/diet-fat-loss/anabolic-power-of-insulin

[11] https://www.youtube.com/watch?v=VjQkqFSdDOc

[12] https://chrismasterjohnphd.com/2017/08/19/29-gluconeogenesis-expensive-essential-mwm-2-29/

[13] https://www.ncbi.nlm.nih.gov/pubmed/15836464

[14] https://optimisingnutrition.com/2015/03/30/what-about-fibre-net-carbs-or-total-carbs/

[15] https://optimisingnutrition.com/2016/01/25/fructose-victim-or-villain/

[16] https://www.drfuhrman.com/learn/library/articles/95/andi-food-scores-rating-the-nutrient-density-of-foods

[17] https://www.ncbi.nlm.nih.gov/pubmed/21036373

[18] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC301822/

[19] http://perfecthealthdiet.com/

[20] https://www.youtube.com/watch?v=2KYYnEAYCGk

[21] https://www.ncbi.nlm.nih.gov/pubmed/24588967

The nutrient-dense Protein Sparing Modified Fast (PSMF)

The Protein Sparing Modified Fast (PSMF) is regarded by many to be the most effective way to lose body fat while preserving muscle and avoiding rebound binge eating due to nutrient deficiencies.

First developed in the 1970s, the PSMF has seen various permutations in weight loss clinics and the bodybuilding community.

While the specifics vary depending on context, a PSMF generally defined as a diet with adequate protein, while simultaneously limiting energy from carbohydrates and fat.

While the protein intake is high in terms of the food on the plate, it could also be seen as a ketogenic diet due to the high contribution of body fat to your energy expenditure which will generate ketones.

Despite the peculiar name, there’s nothing really magical about a PSMF.  It just means that you pay particular attention to protein in an energy deficit.

If you want to lose weight quickly and body fat fast you need a more substantial deficit, and therefore more attention needs to be paid to ensuring you are getting adequate protein.

This article outlines the key principles of the PSMF that can be applied to weight loss or maintenance over the long-term.

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If you just want a PSMF calculator to determine your optimal protein, fat and carbohydrate range along with nutrient-dense foods and meals, then we recommend you get your Nutrient Optimiser free report.

Medical applications of the PSMF

In the medical version of the PSMF, patients obtain the majority of their energy from protein while keeping energy from carbohydrates and fat low.[1]

Protein levels are set at 1.2 to 1.5 g/kg of ideal body weight per day.  Note: For someone with 30% body fat wanting to get to 10% body fat this would be equivalent to 1.5 to 1.9g protein per kilogram of lean body mass or LBM.

  • Carbohydrate intake is typically restricted to less than 20 to 50 g/day.
  • Additional dietary fat beyond what comes with lean protein sources is minimised.
  • Patients in the weight loss clinic setting (e.g. for morbidly obese people in the lead up to bariatric surgery) are restricted to less than 800 kcal/day.

The Cleveland Clinic has carried out extensive research into the use of adequate protein low-calorie diets for aggressive weight loss and found that:[2][3][4]

  • patients are encouraged by the initial period of rapid weight loss which leads to a lower dropout rate;[5]
  • meal replacements in the form of commercial shakes or bars can be used, however learning to make meals from whole foods critical to developing habits that lay the foundation for long-term success;
  • the PSMF is effective for people with normal glycemic control as well as pre-diabetes or type 2 diabetes;[6]people on a whole food-based PSMF are significantly less hungry and preoccupied with eating compared to those on a liquid-formula based version of the PSMF; and
  • most of the weight lost during a PSMF is from fat tissue rather than muscle.[7]Adherence to a very-low-calorie, ketogenic PSMF program results in major short-term health benefits for obese patients with type 2 diabetes. These benefits include significant weight loss, often more than 18kg, within 6 months. 

In addition, significant improvements in fasting glucose and haemoglobin A1c levels are linked to the caloric and carbohydrate restriction of the PSMF.  Insulin resistance was also attenuated, with possible partial restoration of pancreatic beta-cell capacity.[8]

Bodybuilding applications

Lyle McDonald popularised the PSMF for the bodybuilding community in 2005 with his 2005 Rapid Fat Loss Handbook.

McDonald details how someone can individualise the PSMF based on their goals and context.

  • Someone who is already very lean and undertaking heavy weight training will need higher levels of protein, while someone who isn’t yet lean may do better with a less aggressive approach over a more extended period.
  • McDonald’s recommended protein intake ranges from 2.2 g/kg LBM to 4.4 g/kg LBM
  • Unlimited green leafy fibrous veggies are strongly encouraged as they are filling and provide the vitamins and minerals with minimal calories.
  • McDonald also recommends supplementing with a multivitamin, sodium potassium, magnesium, taurine, calcium and fish oil.
  • A severely energy restricted PSMF is typically not a long-term proposition due to the risk of nutrient deficiencies with a severe energy deficit.

If you are active and/or doing resistance training, then your requirement for protein is even higher.  As shown in the chart below from a recent review paper by Stuart Phillips, lean muscle mass is best preserved when we have at least 2.6g/kg total body weight where there is an aggressive deficit (e.g. 35%).  A lower protein intake of 1.5 g/kg body weight seems to be adequate where we have a more moderate deficit.

Protein drives satiety

The body fiercely defends loss of muscle mass by increasing appetite after periods of fasting or low protein consumption to ensure that muscle mass is retained.[10]

Conversely, as per the Protein Leverage Hypothesis (Simpson, 2005), it appears that we continue to eat until we get enough protein, and thus prioritising protein typically leads to a lower spontaneous calorie intake.[11][12]

“Protein generally increases satiety to a greater extent than carbohydrate or fat and may facilitate a reduction in energy consumption under ad libitum dietary conditions.”[13][14]

If we eat foods with a lower % of energy from protein we may end up consuming more energy to obtain our adequate protein.   Conversely, we can ‘hack’ our appetite by prioritising adequate protein while minimising energy from carbohydrate and fat.

The chart below shows the relationship between protein intake and energy intake based on half a million days of MyFitnessPal data, with the lowest spontaneous intake occurring with the highest protein intake (i.e. 2.4 g/kg LBM).

Similarly, the chart below shows that diets with a higher percentage of their energy from protein tend to increase satiety and lead to less energy intake while dietary approaches with less protein tend to increase spontaneous energy intake.

Protein is prioritised, with carbohydrates and fat viewed more as lower priority fuel sources:

  • Minimum carbohydrate requirement: While there is a need for the vitamins and minerals that are often packaged with carbohydrate-containing foods such as non-starchy vegetables, there is really no minimum level of carbohydrates.  While it takes a little bit more work, we can get the glucose we need for our brain function from protein via gluconeogenesis.
  • Minimum fat requirement: Most people have plenty of body fat stores that they can draw on and hence do not have an immediate need for dietary fat other than the essential Omega 3 fatty acids.  You can still get a robust micronutrient profile with 10% dietary fat (or 0.4 g/kg LBM).  This allows the fat from your body to be used for energy.

The secret to a sustainable and successful PSMF is to get adequate protein, along with vitamins, minerals, the essential fatty acids with energy.  This will improve satiety while also getting adequate nutrients which is really the holy grail of weight loss and long-term maintenance.

Thermic effect of food

The other advantage of consuming a higher protein diet is increased thermogenesis (i.e. the energy lost in the process of converting food into energy).  The thermic effect (or specific dynamic action) is 5 to 15% for carbohydrates and fat and 20 to 35% for protein.[15]The thermic effect of food is illustrated nicely by these images from Physioqonomics.[16]  We lose a lot more calories metabolising protein compared to fat or carbohydrates.

While there is much debate over the “metabolic advantage” of fat vs. carbohydrates with claims that we can eat more calories of fat than carbs, there is actually an advantage’ when it comes to how many calories of protein we eat versus how much we can convert to energy.

While we can convert protein to glucose (i.e. gluconeogenesis), it is harder to do, and our body doesn’t like to do unless it has to.[17] Satiety typically kicks in quickly once we have had adequate protein and we go in search of fat or carbs which are easier to convert to energy.

Just think, you can only eat so much steak, but you always have a ‘dessert stomach’, even after a big meal.  Humans are programmed to overeat foods with fat and carbs with minimal protein to ensure that they survive the coming winter.

Should you just eat the highest protein foods?

So, the obvious question is:

What should I eat on a PSMF?

The table below lists the foods with the highest protein content as a percentage of energy.  These foods may be useful if you are looking to boost your protein intake.

food % protein
cod 92%
haddock 92%
white fish 92%
crab 91%
lobster 91%
egg white 91%

For a  longer list of nutrient dense, high protein foods and meals tailored for your current situation and goals we recommend you get to obtain your Nutrient Optimiser free report.  Just select “fat loss (insulin sensitive)” as your goal.

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The problem with a very high protein diet

While you may be getting plenty of essential amino acids if you focus purely on high protein foods, you may not be getting all the vitamins and minerals you need.

As shown in the chart below, there is a strong relationship between protein and nutrient density.  However, if we only focus on high protein foods, we may still end up missing out on the harder to find vitamins and minerals.[18]

The chart below shows the micronutrients provided by the top 10% of the foods in the USDA database when sorted for maximum protein content.

Now imagine, that rather than getting 2000 calories, we are getting only 800 or 400 calories during long-term fasting or extreme dieting.  We have a higher chance of becoming deficient in many key nutrients which may in turn increase appetite and drive us to eat more than we would like to.

Ensuring you are getting adequate micronutrients is a key component to long-term success in weight loss and maintenance.  

In his Rapid Fat Loss Handbook McDonald mentions ‘The Last Chance Diet’ which was popular in the 1970s and 80s.  It was essentially a PSMF centred around liquid nutrition which led to the death of a number of devotees due to some fatal flaws.[19][20]First, they picked the cheapest protein source available, collagen; a protein that provides essentially zero nutrition to the body.  Second, they provided zero supplemental vitamins and minerals (some of which would have been obtained if the dieters had been eating whole foods in the first place). This caused a couple of problems including cardiac heart loss (from the total lack of protein) and arrhythmias from the lack of minerals.

Basically, the problem wasn’t with the approach so much as with the food choices.  PSMF’s based around whole foods (which provide high-quality proteins as well as vitamins and minerals) and with adequate mineral supplementation have shown no such problems.[21]

Bruce Ames’ Triage Theory

Nutrient density becomes even more critial when we consciously try to limit our energy intake.

Attaining adequate micronutrients can help to mitigate metabolic/mitochondrial slowdown and adaption to the severe calorie deficit.  If we are getting the range of micronutrients we need, the body is more likely to keep on feasting on our own fat stores without reacting like there is a famine.

Similar to the protein leverage hypothesis, it seems if we provide the body with low nutrient density food it is driven to consume more energy to ensure that it gets the nutrients it needs.

While we can argue that the some of the DRIs for various nutrients are overly conservative, you also don’t have to look too far to find people that argue that we need multiple times the DRI for another particular nutrient to optimise our health and longevity.

You don’t need to worry about precisely meeting the daily recommended intake for every single micronutrient every single day.  A healthy well-balanced diet will achieve the DRI for the majority of the essential micronutrients most of the time.

More research is required to understand whether our requirements for different nutrients change depending on our diet (e.g. how much less vitamin C do we need if we are not consuming as much glucose) and how much more bioavailable nutrients are from plants versus animals.

However, if you are an order of magnitude below the recommended values for a handful of nutrients, then you should consider focussing on foods that contain that contain higher levels of that cluster of nutrients.  If you are an order of magnitude over the recommended values for a particular group of nutrients you don’t need to prioritise foods that contain those nutrients.

Bruce Ames’ Triage Theory suggests that if we are low in critical nutrients, the body will prioritise those nutrients for functions essential to short-term survival rather than longevity and preventing the diseases of ageing (e.g. cancer, heart disease, Parkinson’s, Alzheimer’s, etc.).

“The triage theory posits that some functions of micronutrients (the approximately 40 essential vitamins, minerals, fatty acids, and amino acids) are restricted during shortage and that functions required for short-term survival take precedence over those that are less essential.  Insidious changes accumulate as a consequence of restriction, which increases the risk of diseases of ageing.”[22][23]

So, while we might do OK with poor nutrition for a period of time, we will probably do better if we obtain a substantial amount of all the essential nutrients.  Ideally, we would get these nutrients from whole foods which are more likely to contain all the non-essential but also beneficial vitamins and minerals that we don’t track.

The nutrient-dense adequate protein diet

So, to recap:

  1. getting adequate protein is essential, especially if we are fasting or restricting energy intake, and
  2. not getting sufficient nutrients is potentially dangerous and possibly the fatal flaw of the PSMF.

We can use the Nutrient Optimiser to prioritise foods with the nutrients we want to obtain more of.   Prioritising amino acids is usually unnecessary because maximising vitamins and minerals generally leads to more than adequate protein.   However, in a PSMF where we are severely limiting energy, we want to increase protein as well.

The chart below shows the resultant micronutrient profile achieved if we ate 2000 calories per day of the foods recommended by the Nutrient Optimiser.  When we focus on nutrient density, we get adequate quantities of all nutrients other than the Omega 3 fatty acid alpha-linolenic acid.

The chart below shows the same foods if we only ate 600 calories per day rather than 2000.  Even with these highly nutrient dense foods, we miss the DRI for eight of the essential nutrients.  Hence, we may still benefit from supplementing with Omega 3, vitamin D, calcium, magnesium and potassium if we are intentionally limiting energy on a PSMF.

It’s not hard to imagine that our ability to maintain a low energy intake and achieve sustained weight loss is likely related to getting adequate levels of the various essential micronutrients without having to over-consume energy.  Conversely, a nutrient-poor diet will likely drive us to consume excess energy which will lead to obesity.

Calorie math

To make this a little more practical let’s look at some calorie math using a hypothetical scenario.  If you want to skip the numbers and are looking for a PSMF calculator, then we recommend you check out the Nutrient Optimiser free report and select fat loss (insulin sensitive).

Let’s say Super Ted is looking to get shredded for the Ketogains conference in two weeks but also wants to stay strong and to win the arm wrestle and beat the reigning champion, Mighty Mouse.

Super Ted currently weighs 160 lbs or 73kg and has 10% body fat.  His maintenance energy intake is 2336 cal/per day.

While getting the majority of your dietary energy from protein might seem excessive…

… it’s not so dramatic when you also take into account the body fat being burned.

Between the 8% dietary fat (8%) his body fat stores (60%) Super Ted will be getting a ketogenic level of 68% of his energy from fat while also adequate protein to maintain his muscles and enough carb containing vegetables to get the vitamins and minerals that are also critical to his long-term success.

The details of the calorie math are shown below.  Once you take the energy deficit into account Super Ted is consuming 2.2g/kg LBM.

body weight (kg) 73
body weight (lbs) 160
body fat (%) 10%
lean body mass (kg) 62
maintenance (cal) 2336
deficit 60%
diet (calories) 934
protein (% diet) 59%
fat (% diet) 20%
net carbs (% diet) 13%
diet protein (g) 138
dietary fat (g) 21
body fat (g) 156
body fat (kg/week) 1.1
net carbs (g) 30
fibre (g) 19
protein (% energy burned) 24%
dietary fat (% energy burned) 8%
carbohydrate (% energy burned) 5%
protein (g/kg LBM) 2.2

When you look at his Nutrient Optimiser analysis, you see that Ted Naiman (aka Super Ted) is actually consuming 2.4g/kg LBM.

Meanwhile, Luis Villasenor (aka Mighty Mouse) is also consuming protein at 2.4g/kg LBM during his PSMF.  Luis says his regular protein intake is around 140g increases this up to 180g during a strict PSMF.

Insulin resistant long-term fat loss scenario

For most of us, such an aggressive fat loss approach might be hard to maintain long-term.  So, let’s consider another scenario with another hypothetical character.

Introducing…  Big Ted.

Big Ted doesn’t post shirtless for photos on the internet.

At 110kg and 30% body fat Big Ted is far from shredded.

Big Ted is also pre-diabetic.

His doctor has warned him that if he doesn’t lose a significant amount of weight he will need to take Metformin and then insulin before too long.

Big Ted is motivated to drop a significant amount of weight with perhaps a calorie deficit of 30% which will take him about 30 weeks to get to his goal weight of 90kg.

We can refine Big Ted’s PSMF approach given that his circumstances and goals are different from Super Ted’s.  Rather than just prioritising nutrient density and energy density, this scenario also prioritises a lower insulin load given Big Ted’s looming pre-diabetes situation.

The chart below shows the nutrient profile of these foods once we take a 30% energy deficit into account.  Big Ted will be meeting the DRI for all his nutrient other than Omega 3s which he may need to supplement.

This is basically a hybrid between a PSMF and a low carb diet.  If you want to try this approach in the Nutrient Optimiser select ‘fat loss (insulin resistant)’ for a not so aggressive version of the PSMF for a lower long-term approach.

Calorie math

The charts below show the energy consumed and energy burned.  There is a significant amount of fibre which will not be metabolised for energy, but rather feed his gut bacteria.  There is still a substantial amount of net carbs from veggies. However, there are no sugars or processed grains to be seen, so they’re not about to boost his insulin or send him on a blood sugar roller coaster.

Once his body fat loss is accounted for, half of Big Ted’s energy expenditure is still coming from fat.

Although we didn’t prioritise amino acids, we still get a solid 2.2g/kg LBM protein.

body weight (kg) 110
body weight (lbs) 242
body fat (%) 30%
lean body mass (kg) 77
maintenance (cal) 3000
deficit 30%
diet (cals) 1875
protein (% diet) 36%
fat (% diet) 30%
net carbs (% diet) 20%
fibre (%) 14%
diet protein (g) 169
dietary fat (g) 63
body fat (g) 100
body fat (kg/week) 0.7
net carbs (g) 94
fibre (g) 66
protein 23%
dietary fat 19%
carbohydrate 13%
protein (g/kg LBM) 2.2

As shown below, the nutrient profile of these foods is also excellent.  These foods will help Big Ted to minimise his chance of developing nutrient deficiencies which may lead to rebound binge eating and derail his long-term weight loss efforts.

How often should I eat on a PSMF?

Big Ted is fond of intermittent fasting.  He finds it easier to not eat for a day or two and then eat to satiety rather than trying to count calories or restrict energy.  Meanwhile, Super Ted likes to eat two meals per day which save him time and helps him not overeat.  But which one is ideal?

It’s not so important when you eat as long as you stick to the foods that align best with your goals.  Recent research suggests that in the fasted state we can use up to 3.5 g/kg/day and digest up to 4.3 g/kg/day of protein.[25]  This makes sense in an evolutionary context when there wouldn’t have been a regular supply of food, but we would have needed to be able to use the food when we came across a big hunt after a long famine.

Practically though, it can be hard to consume your minimum protein allocation in one sitting.  Eating two meals a day seems to be ideal to help you maintain a consistent deficit while maximising satiety and minimise your opportunities to continue to eat.

image4

Eating earlier in the day also appears to be better as it aligns better with your circadian rhythm and insulin sensitivity as well as eliminating opportunities to overeat which seems to be easier at night when you have time to kill rather than when you are trying to get on with your day.

Screenshot 2018-05-30 03.16.21.png

How low can you go?

A PSMF is never a zero calorie fast as it will have enough calories to get the protein you need and ideally some essential fats and adequate vitamins and minerals.  People with more fat to loss will be able to maintain a more significant deficit for longer without losing muscle than lean bodybuilders.  Your Nutrient Optimiser free report will give you an estimate of this lower calorie intake based on your current body fat levels, and your minimum recommended protein intake.

Screenshot 2018-06-28 06.00.54.png

Each person needs to find the ideal approach that they can sustain until they achieve their goal.

Ideally, if you’re going to the effort of tracking your food and dieting, then you want to be losing at least 0.5% body weight per week.   If you’re not achieving at least 0.5% per week, you should ratchet down your maximum calorie intake until you do.

Weight loss of 1.0% per week should be treated as an upper limit over a shorter period.  If you’re losing more than 1.0% per week over the long term you may risk losing excessive amounts of lean muscle mass.

What about rabbit starvation

Rabbit starvation happens to very lean people if they only have lean protein foods with minimum fat available.  They just can’t get enough energy to sustain high levels of body fat.  However, for most of us who have plenty of body fat, this is an advantage.

IMG_9148

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How to do a nutrient dense PSMF

  • Eat more of the foods and meals recommended your Nutrient Optimiser free report.  
    • The fat loss (insulin sensitive) option is designed for aggressive short-term weight loss (i.e. leading up to a bodybuilding comp).
    • The fat loss (insulin resistant) option may be more appropriate if you have more weight to lose over a more extended period.
    • Minimum protein intake in a weight loss clinic setting is 1.2g/kg total body weight.  Your appetite will likely drive you to eat more protein if you are working out.   2.2 to 2.4 g/kg lean body mass is typical for someone lifting heavy.
    • Focusing on nutrient-dense foods will ensure you still get adequate protein as well as vitamins and minerals while minimising energy consumption.
    • Eat only carbs that come with non-starchy veggies (i.e. no processed grains or foods with added sugars).  Eat only the fat that comes with lean protein foods.
  • Don’t eat too much
    • It will be hard to overeat these high nutrient density low energy density foods.
    • It may be beneficial to track or plan your energy intake to ensure you are achieving your goals.
    • Ratchet down your maximum energy intake until you achieve your desired rate of weight loss (e.g. greater than 0.5% per week).
  • Lift heavy / exercise (optional)
    • If you are dieting and not active the body will see your muscle as unnecessary and expensive.  Resistance training will help you to use the protein to build lean muscle and keep your metabolic rate up.
  • Pay attention to your micronutrients
    • To improve your chance of long-term success, it’s essential to pay attention to both your protein and your micronutrient intake.    If you want to maximise your chance of success you can track your food in Cronometer and feed it back into your Nutrient Optimiser report to determine the optimal foods and meals to help you continue to fill your nutrient gaps.

Summary

  • The protein sparing modified fast (PSMF) provides adequate levels of protein to support lean muscle mass while restricting energy from carbohydrates and fat.
  • Protein intakes vary widely depending on the goals and the level of energy restriction between.
  • Providing adequate nutrients, ideally from whole foods, is critical to long-term weight loss and maintenance.
  • It is crucial to prioritise nutrient-dense foods to improve your chances of long-term success.
  • While the PSMF is commonly used in weight loss clinics and the bodybuilding community, the principle can also be applied in other situations to maximise fat loss while maintaining lean muscle mass.

 

References

[1]http://www.mdedge.com/ccjm/article/96116/diabetes/protein-sparing-modified-fast-obese-patients-type-2-diabetes-what-expect

[2]https://www.ncbi.nlm.nih.gov/pubmed/9149474

[3]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4784653/ama

[4]https://www.ncbi.nlm.nih.gov/pubmed/4037162

[5]http://www.mdedge.com/ccjm/article/96116/diabetes/protein-sparing-modified-fast-obese-patients-type-2-diabetes-what-expect

[6]https://www.ncbi.nlm.nih.gov/pubmed/24513578

[7]http://www.mdedge.com/ccjm/article/96116/diabetes/protein-sparing-modified-fast-obese-patients-type-2-diabetes-what-expect

[8]https://www.dropbox.com/s/rjfyvfsovbg9fri/The%20protein-sparing%20modified%20fast%20for%20obese%20patients%20with%20type%202%20diabetes%20What%20to%20expect.pdf?dl=0

[9]http://www.mdedge.com/ccjm/article/96116/diabetes/protein-sparing-modified-fast-obese-patients-type-2-diabetes-what-expect

[10]http://www.nature.com/ejcn/journal/v71/n3/full/ejcn2016256a.html

[11]http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2005.00178.x/abstract

[12]https://www.dropbox.com/s/zej4razn4dn993y/protein%20leverage%20hypothesis%20-%20simpson2005.pdf?dl=0

[13]http://ajcn.nutrition.org/content/87/5/1558S.long

[14]https://www.ncbi.nlm.nih.gov/pubmed/15466943

[15]https://en.wikipedia.org/wiki/Specific_dynamic_action

[16]http://physiqonomics.com/calories-child-friendly-version/

[17]http://www.biologydiscussion.com/biochemistry/energy-production/specific-dynamic-action-factors-and-example-energy-production/43998

[18]https://optimisingnutrition.com/2017/05/27/is-there-a-relationship-between-macronutrients-and-diet-quality/

[19]http://www.dietsinreview.com/diets/last-chance-diet/

[20]https://www.amazon.com/Last-Chance-Diet-When-Everything-Failed/dp/0818402393

[21]http://www.bodyrecomposition.com/the-rapid-fat-loss-handbook/

[22]https://www.ncbi.nlm.nih.gov/pubmed/19692494

[23]http://ajcn.nutrition.org/content/90/4/889.full.pdf+html

[24]https://optimisingnutrition.com/2017/05/27/is-there-a-relationship-between-macronutrients-and-diet-quality/

[25]http://www.sciencedirect.com/science/article/pii/S0261561417302030

post updated August 2017

how much protein is too much?

Now that fat is out of the spotlight, the focus for many in low carb and vegan circles has turned to protein as the macronutrient that needs to be avoided for health, good blood sugar control and longevity.

At the same time there are still are plenty of ‘meat heads’ who say that their ‘brotein’ can do no wrong and you can’t get enough of it.

In the sea of conflicting opinions and advice, how do we determine the optimal amount of protein that will suit our situation, goals and needs?

How much protein do we need?

How much is too little protein?

How much protein is too much?

This is an intriguing, controversial and multifaceted discussion.

So hold on as I try to unpack the various perspectives!

Typical guidance

First, let’s look at the general recommendations for protein intake.

Lean body mass

Protein recommendations are often given in terms of grams per kilogram of lean body (LBM) where “LBM” is your current weight minus your fat mass.

Protein is required to support your muscles, not your fat.

You can use a DEXA scan, bioimpedance scale or pictures (like the ones below) to estimate your level of body fat (% BF) and then calculate your LBM using the following formula:

lean body mass (LBM) = body weight weight x (100% – %BF) / 100%. 

None of these methods are particularly accurate.  However, calculating your body fat levels or protein intake to a high degree of accuracy is not necessary for most people.

Absolute minimum protein requirement

According to Cahill’s starvation studies[1] we burn around 0.4g/kg LBM per day of protein via gluconeogenesis during long term starvation.

After we burn through the food in our stomach and then the glycogen stored in our liver and muscle, the body will turn to its own internal protein stores (i.e. muscles, organs etc) and, to a lesser extent, fat (glycerol backbone) to obtain glucose via gluconeogenesis.

The figure below shows that we use less protein the longer we go without food.  After a couple of days of no food, fat and ketones kick in to supply the energy deficit.

People with better insulin sensitivity may burn through less protein as they are able to access their body fat stores for energy more easily when they go without food.  However, people who are lean and insulin sensitive may have less body fat to burn before the body will turn to protein during fasting.  Hence, extended fasting is not typically recommended if you are super lean.

Gluconeogenesis peaks at around two days and decreases thereafter as insulin levels decrease  and ketones rise further.  While chronic muscle loss is bad news (sarcopenia), particularly in old age, short term gluconeogenesis and autophagy is not necessarily a bad thing as the body will ‘self eat’ and clean out the old and sick and superfluous parts of the body for fuel.

After a fast the body is primed and highly insulin sensitive and ready to build new muscle.   Fasting can actually be beneficial for gaining muscle provided that the refeed has adequate amounts of amino acids to support muscle growth.

Daily recommended protein intake

The Daily Recommended Intake (DRI) for protein is 0.84g/kg of body weight (BW) while the Estimated Average Requirement (EAR) is 0.68 g/kg BW.[2]

This minimum protein level is based on nitrogen balance studies that indicate that if healthy test subjects eat less than around 0.6 g/kg BW you will be losing muscle and be at risk of the various diseases of malnutrition and then factored up to 0.8 g/kg BW as a factor of safety.[3] [4] [5] [6] [7]

Keep in mind though that the DRI is a recommended minimum per day to prevent diseases related to protein deficiency.  This is not necessarily optimal.

More recent studies have indicated that higher quantities of protein may be necessary, particularly for older people.[8] [9] [10] [11] [12] [13]

Older people appear to require 1.0 to 1.3 g per kilogram of total body mass per day protein to optimize physical function, particularly whilst undertaking resistance exercise recommendations.[14]

As discussed in the article Is there any relationship between macronutrients and diet quality (micronutrients) it’s actually quite hard to achieve adequate levels of vitamins and minerals while also hitting these minimum DRI levels.

According to Simpson and Raubenheimer in Obesity: the protein leverage hypothesis (2005) people with diabetes may actually need to eat more protein to ensure that they have adequate levels to build lean muscle mass given that gluconeogenesis can be higher due to insulin resistance.

Keep in mind too that minimum protein recommendations are given in terms of total bodyweight, not lean body mass.  For someone with 30% body fat 0.8g/kg BW will convert to 1.1 g/kg LBM.

If you fast for a day or two you should consider compensating with more protein on your feasting days.  If you are fasting for fat loss there is no need to replace additional fat when you feast.

DRI for individual amino acids

If we dig a little deeper we see that there are also requirements for individual amino acids as shown in the table below.[15] [16]  Depending on what you’re eating you can be deficient in some amino acids while getting enough other amino acids.

 

Amino acid(s) mg per kg body weight mg per 70 kg mg per 100 kg
Histidine 10 700 1000
Isoleucine 20 1400 2000
Leucine 39 2730 3900
Lysine 30 2100 3000
Methionine Cysteine 10.4 + 4.1 (15 total) 1050 1500
Phenylalanine + Tyrosine 25 (total) 1750 2500
Threonine 15 1050 1500
Tryptophan 4 280 400
Valine 26 1820 2600

The Nutrient Optimiser reviews the individual amino acids to make sure they are all adequate.     People who are running close to the minimum DRI for protein overall are typically deficient in a handful of individual aminos.

cropped-2017-04-22-2

Typical protein intake

The average protein intake for the general western population is about 1.2 g/kg LBM or around 16% of calories.[17]  This is greater than the minimum required to maintain nitrogen balance in the figure above and the DRI values.

It seems that most people get enough protein without trying too hard.   However, what constitutes as “enough” protein will vary depending on whether you are going through puberty, weight lifting,a middle aged sedentary office worker or an elderly person in a nursing home.

Appetite is a strong drive that ensures that you don’t stop eating until you get enough protein.  Average protein intake seems to be consistent across cultures and time.[18]

Practical maximum protein intake

Recent research indicates that, when fasted, we can use up to 3.5g/kg/day and breakdown and metabolise up to 4.3g/kg/day.[19]  This makes sense in an evolutionary context where would be primed to use a lot of protein after going without and then making up for lost time after a successful hunt.

Rabbit starvation’ is said to occur when people only have lean protein available and just can’t get enough calories in because they are eating only lean protein.  However, I have seen people eat higher levels of protein in an energy excess situation when they are trying to gain weight (e.g. Andy Mant who is trying to gain size eating and muscle 4.4g/kg LBM or Bailan Jones who is a growing young man with type 1 diabetes at 5.0g/kg LBM).

From a pure calorie standpoint we could theoretically eat up to around 7g/kg LBM using very protein foods.   However, most people will struggle to eat more than 3.5g/kg LBM because protein is very satiating and it is hard to find protein containing foods that don’t come with substantial amounts of fat.

The chart below shows the nutrient score for the highest protein 10% of the foods in the USDA database.  What we can see is that high protein foods provide a ton of amino acids while lacking key vitamins and minerals.  This is not an optimally balanced diet at a micronutrient level.  Rather than worrying specifically about ‘too much protein’ I think it’s more useful to think in terms of getting the range of micronutrients you need without having to consume excess energy.

I think the real problem eating ‘too much protein’ is that once our protein goes too high we end up reducing the amount of vitamins, minerals and essential fatty acids that our food contains.  While it is important to get adequate amino acids, it is also important to get adequate vitamins, minerals and essential fatty acids.

It’s also worth keeping in mind that protein has a net acidic load that the body needs to balance to maintain acid/base homeostasis.  If we eat a lot of protein without adequate amount of alkalising minerals (e.g. potassium, magnesium, phosphorus and calcium) our kidney may struggle to maintain an optimal pH balance which can lead to low level metabolic acidosis in the long term.[20] [21]

How will you spend your “discretionary calories”?

I think it’s important to keep in mind that the DRIs for protein are a minimum to prevent disease and should not be treated as optimal targets or maximum values.  Finding the right balance of all the essential nutrients is quite a balancing act.

In this video Dr Donald Layman points out that if we targeted the minimum DRI for protein, carbs and fat we would end up with only eight hundred calories per day whereas, on average, we eat around 2300 calories per day.  Hence, there is a window of “discretionary calories” that we can chose how we fill to make up our daily energy requirements.

People in low carb circles are fond of saying ‘there is no such thing as an essential carbohydrate’.  So, once we cut the carbs out we are left with only 314 calories to meet our essential macronutrient requirements as shown in the table below.

macro DRI (g) DRI (calories) % energy
minimum protein 56 224 71%
Essential fats 10 90 29%
total 66 314 100%

Now this might be reasonable if we were minimising calories for weight loss (e.g. we could try to live on protein powder and Omega 3 capsules).  However, this this would be impossible to achieve with whole food.

Discretionary calories from body fat

The chart below shows the break up of energy sources if we were living on the minimum DRI for protein and essential fatty acids.  85% of our energy would be coming from our body fat stores.  This would be the ultimate protein sparing modified fast (PSMF) however there is a pretty good chance we would struggle to obtain adequate levels of vitamins and minerals from 300 calories.

Then once we reached our goal weight we would need to work out what we are going to fill the rest of our intake with to prevent drastic weight loss (and literally starving to death)?

From carbs

Another option is to fill the window of ‘discretionary calories’ with carbohydrates which would look like this.

macro DRI (g) DRI (cals) % energy
protein 56 224 10%
carbs 497 1986 86%
fats 10 90 4%
total 563 2300 100%

From protein

Filling your energy deficit with protein would be impossible in terms of available foods (even with protein powders which are only 80% protein) as well as the strong satiety that would kick in well before then.

macro DRI (g) DRI (cals) % energy
protein 545 2181 91%
carbs 7 29 5%
fats 10 90 4%
total 250 2300 100%

From fat

The other option is to fill the remaining energy deficit with dietary fat.  This looks like a therapeutic ketogenic macro ratios.  This will be difficult without consuming the majority of your energy intake from butter, cream and MCT oil.

macro DRI (g) DRI (cals) % energy
protein 56 224 10%
carbs 7 29 5%
fats 227 2047 85%
total 291 2300 100%

Optimising for micronutrients and insulin load

My suggestion is to look to fill your remaining energy requirements with foods that provide the micronutrients you need while keeping an eye on the insulin load of your diet.

Keeping your blood sugar and insulin levels down will help normalise appetite and access your own fat stores for fuel.

However, ensuring that you are getting the micronutrients you need will help you prevent nutrient cravings with less energy which will be ideal for optimising longevity, insulin resistance and blood sugar levels.

How much protein are real people actually eating?

Protein in real life varies significantly, as evidenced by the fifty or so people on whom I have run the Nutrient Optimiser analysis.   As you can see in the table below, protein intake in real life is highly variable.  The average protein intake amongst these people who are generally following a low carb diet is 2.1g/kg LBM.

Name score protein (g/kg LBM) protein (%) fat (%) fibre (%) net carbs (%)
Rhonda Patrick 82% 2.5 17% 57% 10% 15%
Briana Theroux-Hulsey 79% 3.5 29% 21% 15% 35%
David Houghton 77% 0.6 17% 2% 21% 60%
Andy Mant v3 77% 4.4 27% 53% 5% 15%
Alber Van Zyl 75% 1 15% 77% 2% 6%
Alma Fuente 75% 5.3 27% 60% 7% 6%
Mike Berta 74% 2.1 31% 58% 4% 7%
Alex Leaf 74% 3.3 33% 26% 10% 32%
Alex Ferrari 74% 2 17% 54% 6% 24%
Deb Pinsky Lambert v2 72% 1.2 31% 61% 3% 6%
Luis Villasenor 72% 2.4 43% 48% 3% 5%
Gayle Louise 71% 2.4 40% 49% 4% 7%
Ted Naiman 70% 2.4 24% 64% 5% 7%
Andy Mant v2 70% 3 26% 54% 6% 15%
Robin Reyes v3 69% 1.6 18% 67% 6% 8%
Ruth Jamieson v2 66% 1.6 18% 67% 6% 8%
Amy 65% 3.3 41% 57% 0 1%
Paul Burgess 64% 1.9 28% 46% 6% 19%
Chris Hobson 63% 2.3 27% 63% 3% 8%
Ingunn Lovik 62% 1.5 21% 70% 1% 8%
Sophia Thom 62% 1.1 24% 65% 4% 7%
James DiNicolantonio 62% 3.3 26% 53% 5% 16%
Franziska Spritzler 61% 2.3 27% 55% 10% 8%
Sarah Koenck 58% 2.2 14% 77% 4% 6%
Ruth Jamieson v1 57% 1.4 19% 65% 7% 9%
Maria Fornarciari 52% 1.6 30% 61% 3% 6%
Matija Mlakar 50% 2.1 23% 49% 11% 17%
Nicole Jacobi 48% 2.8 32% 60% 3% 6%
Graeme Monteith 48% 2.6 18% 67% 5% 10%
Dave Knowles 46% 2.4 31% 63% 2% 3%
John Robertson 46% 1.4 16% 59% 4% 21%
Leah Williamson 44% 1.8 19% 75% 2% 3%
Nicole Ricine 43% 2.1 18% 79% 1% 2%
Balin Jones 43% 5 26% 66% 3% 5%
Kevin Tunis 37% 1.2 17% 76%% 1%% 7%%
Andy Mant v1 34% 3.7 35% 54% 2% 9%
George 34% 0.8 9% 69% 9% 12%
Robin Reyes v2 32% 1.6 21% 59% 4% 15%
Lorraine Ayre 30% 1.3 19% 64% 5% 12%
Terry Palmer 29% 1.5 25% 62% 5% 8%
Paul Stansel 28% 1.5 18% 77% 2% 3%
Gigi Giodani 26% 1.6 15% 81% 1% 2%
John Kerr 25% 0.7 11% 84% 2% 3%
Robin Reyes v1 23% 1.1 13% 50% 2% 35%
Bacon Man 22% 2.6 30% 69% 0% 1%
Patrick Butts v1 21% 0.8 18% 73% 4% 5%
Patrick Butts v2 20% 1.4 26% 66% 3% 6%
Harry Nguyen 20% 2.3 20% 72% 4% 4%
average 53% 2.1 24% 60% 5% 11%
25th percentile 34% 1.4 18% 54% 3% 6%
75th percentile 70% 2.5 28% 68% 6% 15%

I have also included the 25th and 75th percentiles, which indicate that half of these people were eating between:

  • 1.4 and 2.5g/kg LBM protein per day,
  • 18 and 29% energy from protein,
  • 54 and 67% energy from fat, and
  • 6 and 15% energy from net carbs.

Very few of these people are consuming anywhere near the minimum DRI levels for protein.  And the people who are the closest have some of the poorest nutrient scores.

Protein scales with activity levels

Unfortunately, simply eating protein doesn’t build muscles.  You also need to exercise to use the protein to build lean body mass (i.e. muscles).  If you’re active, you’ll need more protein for growth and repair of muscles.  If you’re sedentary you’ll need less.

There appears to be an upper limit to how much protein can be used for muscle protein synthesis (i.e. to grow and repair your muscles).  If you’re active, then it’s likely that your appetite for protein will increase to make sure you get these higher levels of protein to prevent muscle loss.

As shown in the figure below from Effects of Exercise on Dietary Protein Requirements (Lemon, 1999):[22] [23]

  • a strength athlete won’t stimulate more muscle protein synthesis by eating more than about 1.8 g/kg LBM;
  • an endurance athlete won’t trigger more muscle protein synthesis with more than around 1.4 g/kg LBM; and
  • someone who is sedentary won’t trigger more muscle protein synthesis with more than around 0.9 g/kg LBM.

So, if you are wanting to minimise energy intake while still building muscle you could use these values as a minimum protein intake.

is protein really a good source of energy?

We typically think in terms of the macronutrients, carbs, fat and protein as if they are all sources of energy.  However, there are some that argue that protein should not be considered be an energy source equivalent to carbs and fat.

Protein is critical for growth and repair of our muscles and organs and our neurotransmitters.[24]  While it is true that protein can be converted to glucose and ketones if required, the reality is that it is not easy for the body to do this![25]

The amount of energy lost in processing each macronutrient (i.e. the thermic effect of food or specific dynamic action) is shown in the table below.[26]  Compared to carbohydrate and fat, it takes a lot of energy to convert protein to glucose.  The body just doesn’t want to do it unless there is absolutely is no glucose available from any other sources.

macronutrient min max
carbohydrate 5% 15%
Protein 20% 35%
fat 5% 15%

Personally, I find that if I eat a lot of protein and not much else my appetite for carbs or fat will increase.  It seems that my body wants to use anything other than protein to replenish liver glycogen.  To quote Jason Fung:[27]

Why would your body store excess energy as fat, if it meant to burn protein as soon as the chips were down? Protein is functional tissue and has many purposes other than energy storage, whereas fat is specialised for energy storage.

Would it not make sense that you would use fat for energy instead of protein?  Why would we think Mother Nature is some kind of crazy? 

That is kind of like storing firewood for heat. But as soon as you need heat, you chop up your sofa and throw it into the fire. That is completely idiotic and that is not the way our bodies are designed to work.

oxidative priority

There is only a small capacity for protein storage in our blood stream and we waste around 25% of the energy from the protein as heat in processing it.  Hence, the body typically doesn’t drive us to overeat protein, but it can be used for fuel if there is nothing else to burn.   It makes sense that protein sends a strong satiety signal back to our brain once we have eaten as much as we can use.

It’s also useful to look at protein in terms of oxidative priority.  Craig Emmerich from mariamindbodyhealth.com has prepared the below refinement of Ray Cronise’s oxidative priority chart[28] (see Oxidative Priority, Meal Frequency, and the Energy Economy of Food and Activity: Implications for Longevity, Obesity, and Cardiometabolic Disease) by adding in ketones.

What this means is:

  1. The body will prioritise clearance of alcohol because there is no storage system for it.
  2. Similarly, the body will look to clear ketones from the system because there is minimal storage capacity for them in the blood.
  3. The body will look to clear protein that hasn’t been used for muscle repair and neurotransmitters for brain function.
  4. We will turn to glucose, for which we have a greater storage capacity in our liver, muscles and bloodstream.
  5. Lastly, once we have burned through all these other substrates, will we look to burn our fat, either dietary or the fat stored on our body.

So, if you want to burn body fat you need to limit alcohol, exogenous ketones, protein, carbohydrate and dietary fat.

Oxidative priority versus insulin load

I think Cronise’s oxidative priority concept is another way to look at the insulin load of our diet.

insulin load = carbohydrates – fibre + 0.56 * protein

Our body uses insulin to keep glycogen stored in our liver and fat in our adipose cells until the other fuels are used up.  There is no point in going out of our way to consume excessive protein because it takes more effort to burn through before we can get to the fat on our plate or our belly.   However, it is logical that our appetite switches off once we get enough protein because there is no room to store excess protein and it’s hard work to burn it.

but what about mTOR?

mTOR (mammalian target of rapamycin) controls our fuel flow and our appetite.  Similar to insulin and insulin-like growth factor (IGF-1), mTOR promotes growth.  Growth is good if we are a baby or a teenager.  But some people grow too much.

There is a limited number of times we can turn over our cells in our lifetime.  Constant periods of plenty without periods of restriction leads to continued growth of unwanted things like cancer.

Dr Ron Rosedale is a proponent of limiting protein in an effort to extend lifespan.

There have been a number of other proponents of limitation of animal protein in the vegan circle for some time. Dr Greger’s Plant Based NutritionFacts.org recommends limitation of methionine, leucine and isoleucine.

Dr Steven Gundry recommends a grain free high fat version of the protein restricted approach.

One option in response to this theory is to consistently restrict protein to achieve long term health.  Some people try to keep their protein low to ensure that they are always in a state of autophagy or muscle breakdown and self eating.

However, I don’t think chronic intentional protein restriction is necessarily optimal.  What we are aiming for is adequate, but not excessive, energy intake (including protein) without malnutrition (i.e. vitamins, minerals, aminos and essential fatty acids).

On top of this, balanced periods of feasting and fasting will allow autophagy and growth.

Before we had refrigerators

In the days before agriculture, fertilisers from fossil fuels, and even refrigerators in our homes (less than 100 years ago) our environment would enforce periods of growth and period of famine.

These days, we can source cheap food to keep on growing 24/7, 365 days a year.   We have no externally enforced periods of autophagy when we can clear the old and dying proteins in our body.

If we have growth interspersed with fasting, then we give the body a chance to build muscle and use protein for repair while also giving the body a chance to clean house and purge the dying white blood cells and burgeoning cancer cells before it gets ugly.

Your body will naturally crave more protein in periods of activity and repair and less in periods of inactivity.  If your appetite isn’t working as well as you’d like it to (i.e. you have more body fat than you would like), you can force a feast / fast cycle based on managing your weight or your blood glucose levels.

Like many things in life, optimal protein intake is a balance between extremes.  More is not necessarily better.  But less is not better either.  We want our body to thrive on enough, but not too much energy while still getting the micronutrients it needs.

Too much mTOR and IGF-1 can stimulate excessive growth and cancer while too little can lead to muscle loss, which does not support health in old age.[29]   The EAR and DRI for protein actually increase for people over 70 to prevent sarcopenia.  If you are lacking lean muscle mass then there is a greater chance you will not have great insulin sensitivity in old age.

If you are suffering from sarcopenia you may fall and break your hip and never get up again.  As shown in the figure below, too much or too little IGF-1 is not good.  As with most things, it’s a balance.

protein leverage hypothesis

Protein is critical to life so our appetite typically makes sure we get enough.  “Obesity: The protein leverage hypothesis[30] suggests that we keep eating until we get enough protein.  If we are getting plenty of protein then we will stop eating when we get enough energy and protein.

In the wild, animals have an innate sense of the nutrients they need and which foods will provide those requirements, whether they be protein, energy or other micronutrients.

While it’s easy to track macronutrients and calories, I think it’s often the body’s micronutrient needs that derail our calorie restriction efforts and aspirations.

Most of the food that is available to us these days is much more deficient in micronutrients than it once was, but at the same time it is flavoured and coloured to make it appear that it has heaps more nutrition than it actually does; so we keep on eating the food that is manufactured to look and taste good, all the while not getting the micronutrients we really need from the food, so we just keep eating.

We need a range of nutrients from our food to fuel our mitochondria so that it can efficiently burn through the food we eat, and not have it sit around in the blood.[31] [32]

For instance, the figure below from Spectracell shows the nutrients that are often missing in people with diabetes.[33]  We need all these nutrients from our food to support our mitochondria to effectively produce energy from our food and stop excess glucose and fatty, fatty acids and ketones building up in our blood stream.

action steps

It’s important to meet your minimum protein intake which may be higher if you are growing, older or active.

Once you’ve met the minimum intake of protein and essential fatty acids (about 314 calories per day) you need to decide what you are going to fill the rest of your “discretionary calories” with to prevent starvation.

If you are looking for therapeutic ketosis (i.e. for cancer, epilepsy, dementia, Alzheimer’s etc) then you may want to get the majority of your energy from fat while maintaining minimum protein levels and also staying in an energy deficit (see optimal foods for therapeutic ketosis).[34] [35]

If you’re managing diabetes and not looking to lose weight you will likely want to keep your carbohydrates low and get more of your energy from fat (see optimal foods for diabetes and nutritional ketosis).

If you’re wanting to lose body fat then perhaps you can count the energy from your body as part of your daily intake and try to maximise the nutrient density of the remaining intake.  That is, maximise nutrients with the minimum amount of energy intake (see optimal foods for fat loss).

summary

  • You can get too much protein but at the same time you can get too little protein.
  • Periods of feasting and fasting are beneficial rather than targeting chronic high or low protein.
  • It’s very hard to get a good balance of micronutrients with low protein. Protein tends to come packaged with other nutrients.
  • If you focus on micronutrients (vitamins, minerals, amino acids, fatty acids) then the macronutrients (carbs, fat and protein) largely look after themselves. We will get enough, but not excessive, amounts of protein.

 

references

[1] http://www.nejm.org/doi/full/10.1056/NEJM197003192821209

[2] https://www.nrv.gov.au/nutrients/protein

[3] http://ajcn.nutrition.org/content/77/1/109.full

[4] https://www.ketogenicforums.com/t/hobbit-vs-2-keto-dudes/10641/12

[5] http://www.ketogenic-diet-resource.com/daily-protein-requirement.html

[6] https://intensivedietarymanagement.com/how-much-protein-is-excessive/

[7] http://perfecthealthdiet.com/category/nutrients/protein/

[8] https://www.ncbi.nlm.nih.gov/pubmed/11382798

[9] https://www.ncbi.nlm.nih.gov/pubmed/23867520

[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4623318/

[11] https://www.ncbi.nlm.nih.gov/pubmed/12626690

[12] http://ajcn.nutrition.org/content/99/4/891.long

[13] http://ajcn.nutrition.org/content/86/4/995.long

[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555150/

[15] http://apps.who.int/iris/bitstream/10665/43411/1/WHO_TRS_935_eng.pdf

[16] https://en.wikipedia.org/wiki/Essential_amino_acid

[17] http://ajcn.nutrition.org/content/87/5/1554S.full

[18] https://www.ncbi.nlm.nih.gov/pubmed/15836464

[19] http://www.sciencedirect.com/science/article/pii/S0261561417302030

[20] https://optimisingnutrition.com/2016/11/19/the-alkaline-diet-vs-acidic-ketones/

[21] https://www.youtube.com/watch?v=E44yCNpP8bs

[22] https://www.researchgate.net/publication/13445647_Effects_of_Exercise_on_Dietary_Protein_Requirements

[23] http://bayesianbodybuilding.com/the-myth-of-1glb-optimal-protein-intake-for-bodybuilders/

[24] https://www.ncbi.nlm.nih.gov/pubmed/7903674

[25] https://www.ncbi.nlm.nih.gov/m/pubmed/22215165/

[26] https://en.wikipedia.org/wiki/Specific_dynamic_action

[27] https://intensivedietarymanagement.com/fasting-and-muscle-mass-fasting-part-14/

[28] http://online.liebertpub.com/doi/pdf/10.1089/met.2016.0108

[29] https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2011-1377

[30] http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2005.00178.x/full

[31] http://www.simonandschuster.com.au/books/The-Dorito-Effect/Mark-Schatzker/9781476724232

[32] https://www.researchgate.net/profile/Fred_Provenza

[33] https://naturallynourishedrd.com/wp-content/uploads/2013/09/Interactive-Library-Nutrient_Correlation_Wheels-2.pdf

[34] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263749/

[35] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4215472/

is there a relationship between macronutrients and diet quality?

Q:  To achieve optimal health, diabetes control and longevity you should:

  • Eat more fat to burn your body fat.
  • Follow a Protein Sparing Modified Fast (PSMF).
  • Eat more protein and lift heavy.
  • Drink Bulletproof Coffee.
  • Fast more.
  • Decrease protein and eat more fat bombs.
  • Take exogenous ketones, butter and MCT oil to boost your blood ketones.
  • Eat only plants.
  • Eat no plants.
  • All of the above.
  • None of the above.
  • I give up! All you ‘diet gurus’ can’t agree.  I’m going back to Maccas where things are simple!

Although many of these answers are contradictory, all are ‘correct’ depending on which low carb / keto group(s) you belong to.  It can be confusing out there on the interwebs!

Image result for confusing

For the last two years I’ve been working to refine our ability to quantitatively define and optimise our food quality (a.k.a. nutrient density).

At the start of 2017, I developed the Nutrient Optimiser and have since run detailed macronutrient and micronutrients analyses for more than forty people, all with different starting points and with different goals.

2017-05-23

With all the conflicting advice out there and my personal quest to manage diabetes while maximising nutrient density, I wondered what my nutrient analysis tools might be able to tell us about the relationship between macronutrients and micronutrients to provide some clarity to the circular debates that I see so often online.

I’m never sure where these articles will end up when I start the analysis.  And this one is certainly interesting!

The analysis suggests that a nutrient dense diet is typically not low in protein.  However just focusing on increasing protein won’t necessarily lead to a nutrient dense outcome.

We get a much better outcome when we focus on the harder-to-find micronutrients (i.e. vitamins, minerals and essential fatty acids).  From there we can tweak the nutrient dense template to suit our goals (e.g. weight loss, diabetes control, muscle gain, athletic performance or therapeutic ketosis).

Nutrient density

Let’s quickly look at what we mean by ‘nutrient density’ and how we can quantify it.

All foods

The chart below shows the nutrients provided by the 8,000 foods in the USDA database in terms of the percentage of the Daily Recommended Intake (DRI) if you ate just a little bit of all of them.

It’s easy to meet the recommended minimum intake of the micronutrients shown at the bottom of the chart (e.g. vitamin B12 and most of the amino acids) (at least if you are eating animal products).

However, you really have to go out of your way to get adequate amounts of the nutrients at the top of the chart (e.g. omega 3, vitamin D, choline, vitamin E, calcium, manganese and magnesium).

The most nutrient dense foods

The chart below shows the micronutrients provided by the most nutrient dense foods.  When we focus on foods that contain more of the harder-to-find nutrients we can get a massive boost in all the micronutrients.

Why should we pursue a nutrient dense diet?

With adequate amounts of nutrients being provided by the food we eat there is a good chance we will be able to satisfy our cravings with less energy.

Obtaining adequate levels of all the micronutrients will ensure that we have what we need to drive our mitochondria at full power rather than limping along.  We will feel energised and may find that our appetite turns off sooner and we will be less likely to overeat and get fat.[1] [2]  [3] [4] [5] [6] [7] [8] [9] [10] [11]

The chart below shows a comparison of the most nutrient dense 10% of the foods available compared to all the foods in the USDA database.  We get a significant improvement in our food quality by prioritising more nutrient dense foods.

Which nutrients do we need to worry about?

After a ton of trial and error and systems refinement (and some robust debates with Ray Cronise) I finally figured out that maximising nutrient density works best when we only focus on boosting the nutrients that are harder to obtain.

The nutrients listed below tend to be generally harder to get in adequate quantities:

  • Alpha-linolenic acid
  • EPA + DHA
  • Choline
  • Vitamin D
  • Vitamin E
  • Calcium
  • Magnesium
  • Potassium
  • Phosphorus
  • Zinc
  • Thiamine
  • Pantothenic acid
  • Niacin
  • Manganese
  • Folate
  • Selenium

Which nutrients are easier to find?

Listed below are the micronutrients that we don’t need to prioritise because they are fairly easy to get enough of:

  • Leucine
  • Valine
  • Sodium
  • Methionine
  • Isoleucine
  • Tyrosine
  • Riboflavin
  • Lysine
  • Vitamin B-6
  • Histidine
  • Threonine
  • Phenylalanine
  • Tryptophan
  • Iron
  • Vitamin C
  • Copper
  • Vitamin A
  • Vitamin B-12
  • Vitamin K

I have intentionally left out all the amino acids (i.e. protein) from the prioritisation because, as you will see below, it’s easy to get enough protein when we focus on the vitamins, minerals and essential fatty acids.

Can you get too much of a good thing?

As a general rule it’s hard to get excess micronutrients from real food, but it is possible.

  • While we can get more than thirty times the DRI for vitamin K from a nutrient dense diet there is no upper toxicity level of toxicity for vitamin K[12] [13] from natural sources.  However you can get too much menadione which is used as a vitamin K supplement.[14] [15]
  • We can get eighteen times the DRI for vitamin B12 from a nutrient dense diet, however again, there is no upper limit established for B12.[16] [17]
  • We can get seventeen times the DRI for Vitamin A from a nutrient dense diet. It is possible to get vitamin A toxicity, though again this typically occurs from supplementation.[18] [19]  There are some reports of Hypervitaminosis A from explorers gorging on polar bear liver, but this is not likely to be a common occurance.[20] [21]
  • We can get around twelve times the DRI for copper from a nutrient dense diet which is around the upper limit.  Though these high levels are unlikely to occur without high liver consumption which is not common.
  • A nutrient dense diet can provide around fifteen times the DRI for vitamin C however the upper limit is more than 20 times the DRI.[22] [23] Excessive vitamin C supplementation usually causes diarrhea, so it’s largely a self limiting situation.
  • A nutrient dense diet will provide around ten times the DRI for iron while the upper limit is set at around six times the DRI. Many women are iron deficient while many men have hemochromatosis which is excess iron storage.  Liver, mushroom, seaweed and spices are the highest sources of iron.  It’s useful to understand your current iron status to know whether you need more or less iron or should even be considering donating blood.
  • It is quite easy to get more than the DRI for amino acids. While high protein diets do not cause kidney disease in healthy people there is no need to chase excess super high levels of protein.[24]   And just like liver, most people will struggle to eat excessive amounts.

So yes, it is possible to get excessive levels of some micronutrients, though generally not a concern unless you are eating a LOT of liver or supplementing with synthetic nutrients.

The chart below shows the nutrient profile of Amy who is following a zero carb diet with a lot of organ meats.  While she is generally getting high levels of most nutrients, she is still not meeting the DRI for a number of vitamins and minerals that are typically found in plant foods (e.g. vitamin K1, calcium, manganese, vitamin E, magnesium and potassium).

At the other extreme we have David who is eating a plant based diet that has plenty of vitamins and minerals but less amino acids.  He knows he needs to supplement with vitamin B12 and vitamin D which are hard to get from a purely plant based diet.

When it comes to nutrient density I often see arguments around whether or not the daily recommended intake levels are correct and whether they might vary for different people with different dietary approaches and whether or not nutrients from plant or animal based food are more bioavailable.

While I think these are definitely under researched areas I think these discussions are not so relevant when we’re orders of magnitude above or below the DRI values.  We need to identify the full range of foods, from whatever source, that will provide the nutrients that we’re not getting enough.  We can then choose from within those to suit our tastes and preferences.  Our appetite can be a pretty good guide once we eliminate the processed hyper palatable nutrient poor foods that our willpower is no match for.

There is plenty of discussion about excess protein or excess calories.  While it’s true that excess is typically not good, I think it’s more valuable to focus on eating foods that contain more of the nutrients that we are currently not getting enough of.   When we’re eating nutrient dense whole foods we’re less likely to need to consciously worry about calories, protein, fat, carbs, sugar, fibre or whatever.

Is there any relationship between macronutrients and nutrient density?

While I don’t see a lot of discussion about nutrient density or food quality, there is seemingly endless debate in social media in low carb and keto circles around macronutrients.  People are often very passionate about eating more or less protein, carbs, fat and fibre.

Perhaps this is because macronutrients are reasonably easy to track and understand.  Or maybe it is because the previous approach hasn’t worked, so they swing to the other extreme.

We’ve been told for so long that fat is bad and now people are realising that it’s not as bad as they were told, so they swing to the other extreme.  Now fat can do no wrong.

Meanwhile, there are plenty of people who stick to fat being bad and wanting to avoid it.

Different people have different perspectives on the multifaceted topic of nutrition.

But is there really any value gained by focusing on primarily on macronutrients?  Will it improve our food quality or the adequacy of the various essential micronutrients?

To understand whether there is any useful relationship between the various macros and micronutrient adequacy I have plotted the various macronutrients versus the nutrient density score for the 8,000 foods in the USDA foods database.

Note: In this analysis a high nutrient density score means that a particular food has a relatively large amount of the harder-to-find nutrients listed above.  

Protein versus nutrients density

There is a lot of debate about protein and whether we should be getting more or less of it.

The chart below shows the nutrient density score for the harder-to-find vitamins, minerals and essential fatty acids vs protein (%).

2017-05-28 (9).png

Although amino acids have not included in the nutrient density score it appears that the more nutrient dense foods have more protein.  Conversely, foods with less protein have less of the nutrients that are harder to find.

It seems that if we avoid protein we will end up with less nutrients overall.  While if we focus on getting the nutrients that are harder to find we will get enough protein.

However, as they say, correlation does not equal causation.  There is a lot of scatter in this chart.  In this case the correlation (R2) of this relationship is 0.31.

This analysis makes me wonder if the studies that the benefits from increased protein are not at least in part from, not just getting adequate amino acids, but the increased levels of the other micronutrients that often come along with protein.

It’s hard to separate good nutrition and protein.

Fat versus nutrient density

The chart below shows the nutrient density score versus the percentage of calories from fat.

2017-05-28

The first thing to point out here is that there is a massive amount of scatter and a low degree of correlation between fat and micronutrients (R2 = 0.06).

However, it does seem that very high fat foods contain less of the harder-to-find nutrients.

Meanwhile at the other extreme very low fat foods can either be nutrient poor (e.g. sugar and processed grains which would be at the bottom left of this chart) or very nutrient dense (e.g. non-starchy vegetables which would be at the top right of this chart).

If we run a trend line through all these foods we see that the highest nutrient density occurs at around 30% calories from fat.

The reality is that not many people live primarily on high nutrient density low fat foods at the top left corner of this chart. People avoiding fat will often slip into the bottom left of this chart and resort to the low fat processed grains and sugars to get enough energy to get through the day.

Sugar versus nutrient density

There is currently a lot of focus on sugar as the primary culprit for our poor health.  Gary Taubes and Damon Gameau are down on sugar while Robert Lustig is leading the charge against fructose or fruit sugar.

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This analysis suggests that foods with more sugar have a poorer nutrient density, though it’s hard to make sense of this unless we differentiate between added refined sugar and naturally occurring sugar in plant based foods that come with a ton of other nutrients.  However, low sugar content does not necessarily guarantee excellent nutrient density.

Energy density versus nutrient density

Energy density is the amount of energy we get per gram of food.

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Minimally processed foods contain more water and fibre and thus have a lower energy density but also tend to have a higher nutrient density.

Meanwhile, processed foods that are shelf stable and easy to transport typically have less water and fibre and more preservatives.

While lower energy density foods have a higher nutrient density, most people won’t survive long on a diet of only lettuce, broccoli and celery.  They will need some more energy dense foods to survive.

However, if you are looking to lose weight in a hurry while still getting the nutrients you need, focusing on lower energy density foods might not be a bad place to start.

Most people agree that eating more veggies will be better for their health, but the unfortunate reality is that it takes some time and money to prepare the food yourself rather than reaching for a quick and cheap energy hit with minimal effort.

Net carbs versus nutrient density

Foods with more digestible carbohydrates typically have a lower nutrient density.

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However, simply going low carb doesn’t guarantee that we maximise nutrient density  There is a range of high and low nutrient density foods at the low carb end.

Whether or not you carbs are nutrient dense will likely depend more on whether they are highly processed or in their natural form, and will likely make a bigger contribution to their nutrient density than the quantity of carbs.

Fibre

Higher fibre foods contain more nutrients.  However, we can’t just add fibre supplements to maximise nutrient density.  Plant based whole foods that also happen to have heaps of fibre that provide us with more higher levels of nutrition.

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Insulinogenic calories

The proportion of insulinogenic calories is the proportion of the food we eat that requires insulin to metabolise.

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On the right hand side of the chart, highly processed foods with minimal protein and fat typically don’t provide a lot of the harder-to-find nutrients.

Meanwhile on the left hand side of the chart, foods with minimal fibre, carbs and protein are also less nutritious.

If we plot a trendline it appears that the maximum nutrient density occurs at around 50% insulinogenic calories.

If you are already insulin resistant you may want to steer your dietary ship to the left with a lower insulin load diet to the point that your pancreas can keep up and maintain normal blood sugars.  Meanwhile if you’re fit and insulin sensitive you will be able to have more leeway when it comes to macros and insulin load.

Summary

So what to make of all this?  Which of these parameters has the best correlation with food quality or nutrient density?  The table below shows the various parameters sorted by their correlation (R2) with their nutrient density score.

parameter correlation comment
protein 0.32 Nutrient dense foods tend to have more protein.
energy density 0.15 Lower energy density foods are typically more nutrient dense.
net carbs 0.12 Foods with more net carbs are typically less nutritious.
insulinogenic 0.11 Nutrient density peaks at around 50% insulinogenic calories.  Extremes are not optimal.
fibre 0.08 High fibre foods are often more nutritious.
fat 0.07 Nutrient density peaks at around 30% fat.
sugar 0.04 High sugar content correlates with low nutrient density

It seems that if we want to optimise the quality of our diet we should:

  1. Focus on the foods that contain the harder-to-find nutrients.
  2. Not actively avoid protein.
  3. Chose lower energy density foods when we can.
  4. Avoid foods that are largely digestible carbs with minimal fibre (e.g. processed grains and sugars).
  5. Chose moderately insulinogenic foods without swinging to either extreme (though we should err on the less insulinogenic side if we already have diabetes).

Meanwhile, sugar, fat and fibre, aren’t spectacular predictors of nutrition.

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chasing nutrients vs chasing macros

So, if protein is good, more is better, right?   Bring me the bulk tub of protein powder!

Not so fast.  It is important to understand the difference between emphasising:

  • all nutrients,
  • protein,
  • less insulinogenic foods, and
  • harder-to-find nutrients.

Maximise all nutrients

The chart below shows what happens to the micronutrient profile when we simply maximise all nutrients.

The amino acids are through the roof (69% protein) because aminos are easy to find in our food system, but we’re still lacking in many of the harder to get nutrients.

Maximise protein

If nutrient density correlates with protein then it makes some sense to prioritise protein.    Doesn’t it?

The chart below shows what happens to the nutrient profile if we sort the USDA foods database by % protein.  It seems that if we simply focus on protein we get a poor vitamin and mineral profile.

Minimising protein and maximising fat

Minimising protein and carbs while maximising fat is all the rage in the keto scene.  Unfortunately, a very low insulin load diet is not a high nutrient density approach as we can see from the chart below.  While we get adequate protein (15%), the vitamin and mineral profile is poor.   With 80% of our energy coming from fat we are deficient in about half the micronutrients.

Perhaps a very high fat therapeutic ketogenic approach should be reserved for special circumstances and extra attention given to the nutrients you won’t be able to get from your food?

Prioritising the harder to find nutrients

The chart below shows the outcome when we focus the harder to find nutrients (excluding amino acids).  We get adequate quantities of all the micronutrients and still plenty of protein.

Learnings from the Nutrient Optimiser analysis

It’s one thing to look theoretically in a database of individual foods.  But it’s another to look at what people are eating in real life.  Next, I’m going to share what I’ve learned from analysing a lot of different people’s food logs in the Nutrient Optimiser.

The nutrient density score

But first, I need to introduce you to the Nutrient Density Score.

The chart below shows Rhonda Patrick’s nutrient analysis.  Rhonda’s diet is not particularly extreme in anything other than nutrients.

Rhonda would score 100% if she could achieve 200% of the DRI for the hardest to hardest to find lower half of the nutrients.  However, because she doesn’t achieve 200% with all of the lesser scoring half of the nutrients she only gets a Nutrient Density Score of 81.3%.

For reference, if we add a little bit of all the foods in in the USDA database we would get a nutrient density score of 63% .  The most nutrient dense 10% of the foods in the USDA database will give us a nutrient density score of 93%.  Even Rhonda has some room for improvement.

By contrast, the chart below shows Patrick’s nutrient density score which comes in at only 21%. Patrick is following a very high fat keto approach even though his blood sugars are great and he doesn’t appear to be insulin resistant, just obese.

With so many of his micronutrients being nowhere near the DRI vales Patrick will need to eat a lot more of his current diet to meet the daily recommended intake for most of the nutrients.

There is a good chance that that Patrick will be craving more food to obtain the nutrients that he needs to get through the day.  Even though he is trying to lose weight, he might end up overeating more calories using his current diet than if he spent a week eating with Rhonda.

The table below shows the nutrient density score for more than forty Nutrient Optimiser analyses that I’ve run to date along with:

  • protein (g/kg LBM),
  • protein (%)
  • fat (%)
  • fibre (%)
  • net carbs (%).

I encourage you to click on each of the names below to review their nutrient analysis to see what they are and aren’t eating to get these scores.

Name score protein (g/kg LBM) protein fat fibre (%) net carbs (%)
Rhonda Patrick 82% 2.5 17% 57% 10% 15%
Briana Theroux-Hulsey 79% 3.5 29% 21% 15% 35%
David Houghton 77% 0.6 17% 2% 21% 60%
Andy Mant v3 77% 4.4 27% 53% 5% 15%
Alber Van Zyl 75% 1.0 15% 77% 2% 6%
Alma Fuente 75% 5.3 27% 60% 7% 6%
Mike Berta 74% 2.1 31% 58% 4% 7%
Alex Leaf 74% 3.3 33% 26% 10% 32%
Alex Ferrari 74% 2.0 17% 54% 6% 24%
Deb Pinsky Lambert v2 72% 1.2 31% 61% 3% 6%
Luis Villasenor 72% 2.4 43% 48% 3% 5%
Gayle Louise 71% 2.4 40% 49% 4% 7%
Andy Mant v2 70% 3.0 26% 54% 6% 15%
Robin Reyes v3 69% 1.6 18% 67% 6% 8%
Ruth Jamieson v2 66% 1.6 18% 67% 6% 8%
Amy 65% 3.3 41% 57% 0 1%
Ingunn Lovik 62% 1.5 21% 70% 1% 8%
Sophia Thom 62% 1.1 24% 65% 4% 7%
Franziska Spritzler 61% 2.3 27% 55% 10% 8%
Sarah Koenck 58% 2.2 14% 77% 4% 6%
Ruth Jamieson v1 57% 1.4 19% 65% 7% 9%
Maria Fornaciari 52% 1.6 30% 61% 3% 6%
Matija Mlakar 50% 2.1 23% 49% 11% 17%
Nicole Jacobi 48% 2.8 32% 60% 3% 6%
Graeme Monteith 48% 2.6 18% 67% 5% 10%
Dave Knowles 46% 2.4 31% 63% 2% 3%
John Robertson 46% 1.4 16% 59% 4% 21%
Leah Williamson 44% 1.8 19% 75% 2% 3%
Balin Jones 43% 5.0 26% 66% 3% 5%
Andy Mant v1 34% 3.7 35% 54% 2% 9%
George 34% 0.8 9% 69% 9% 12%
Robin Reyes v2 32% 1.6 21% 59% 4% 15%
Lorraine Ayre 30% 1.3 19% 64% 5% 12%
Terry Palmer 29% 1.5 25% 62% 5% 8%
Paul Stansel 28% 1.5 18% 77% 2% 3%
Gigi Giodani 26% 1.6 15% 81% 1% 2%
John Kerr 25% 0.7 11% 84% 2% 3%
Robin Reyes v1 23% 1.1 13% 50% 2% 35%
Patrick Butts v1 21% 0.8 18% 73% 4% 5%
Patrick Butts v2 20% 1.4 26% 66% 3% 6%
Harry Nguyen 20% 2.3 20% 72% 4% 4%

In the charts below we’ll quickly look at the relationship between the macros and their nutrient score.

Protein

This chart shows the relationship between protein intake and each person’s nutrient density score.  The average protein intake for this range of people following a low carb or keto diet is 2.1g/kg LBM or 23% of energy.

On the top left corner of the chart we have David who is following a plant based diet and intentionally getting lower levels of protein but also maximising vitamins and minerals from plant based foods.

On the bottom left we have a number of people following a therapeutic ketogenic diet targeting low protein and high fat.

As long as you are not trying to target low protein and high fat to generate higher blood ketones then it doesn’t seem to matter what your protein intake is.  Most people get enough protein to support their activity levels.

The chart below shows the nutrient density score versus protein (%).  Again, it seems that it’s hard to get high levels of nutrients if you are targeting minimal protein levels.

% insulinogenic

The story is similar with insulin load.  Reducing the insulin load of your diet to the point that your blood sugars normalise is a great idea, but less is not necessarily better.  We want to avoid really high insulin levels but not drive it so low that we don’t have enough nutrients to repair our muscles and organs.

Fat

High levels of fat do not guarantee high levels of nutrition.

Net carbs

It’s good to reduce the carbohydrate load of your diet to normalise your blood glucose levels, but again minimising is not necessarily the best idea and may be unnecessary if you are not managing diabetes.

Higher levels of isn’t necessarily bad either when it comes to nutrient density.  On the top right of the chart we have David who is striving for a nutrient dense plant based diet with about 35% net carbs while for contrast we have Robin’s baseline junk food diet which also has about 35% net carbs which has about the same nutrient density score as the very high fat therapeutic keto dietary approaches on the bottom left of the chart.

Fibre

Higher levels of fibre typically correlate with more nutrition (although you can get heaps of nutrients from shellfish and organ meats with minimal fibre intake).

Summary

  • A nutrient dense diet is not low in protein; however focusing on protein won’t necessarily guarantee great nutrition.
  • Foods with a lower energy density are often more nutrient dense. To maintain our body weight and growth we will need to add more energy dense foods (i.e. more non-fibre carb and / or fat).  Meanwhile, dialling back the energy density and forcing your body to use your stored body fat can be a good strategy for weight loss.
  • Reducing your carb intake or the insulin load of your diet can be useful if you are managing diabetes. However less is not necessarily better.
  • For the most part ensuring you are getting the harder-to-find micronutrients will maximising your diet quality without going to macronutrient extremes.

references

[1] https://www.youtube.com/watch?v=rYXF0l18ciI

[2] https://www.youtube.com/watch?v=ncVJfZZ7bTM

[3] https://www.youtube.com/watch?v=ZjUgX91VZpk

[4] http://perfecthealthdiet.com/2011/02/perfect-health-diet-weight-loss-version/

[5] https://www.ncbi.nlm.nih.gov/pubmed/18469287

[6] https://www.ncbi.nlm.nih.gov/pubmed/19785688

[7] http://www.tandfonline.com/doi/abs/10.1080/13590840220143062?journalCode=ijne20&

[8] https://www.ncbi.nlm.nih.gov/pubmed/19263591

[9] http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2007.00465.x/abstract

[10] https://www.ncbi.nlm.nih.gov/pubmed/20142823

[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988700/

[12] http://www.consumerlab.com/RDAs/#VitaminK

[13] http://www.consumerlab.com/RDAs/#VitaminK

[14] https://en.wikipedia.org/wiki/Menadione

[15] https://www.amazon.com/Nutrient-Bible-Henry-Osiecki/dp/1875239545

[16] http://www.consumerlab.com/RDAs/#B12

[17] https://www.amazon.com/Nutrient-Bible-Henry-Osiecki/dp/1875239545

[18] http://www.mayoclinic.org/drugs-supplements/vitamin-a/safety/hrb-20060201

[19] http://www.consumerlab.com/RDAs/

[20] https://www.121dietitian.com/never-eat-a-polar-bears-liver/

[21] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1257872/

[22] http://www.consumerlab.com/RDAs/#VitaminC

[23] https://www.amazon.com/Nutrient-Bible-Henry-Osiecki/dp/1875239545

[24] https://chriskresser.com/do-high-protein-diets-cause-kidney-disease-and-cancer/

personalised nutrition… how to tweak the moving parts

There are a number of moving parts when it comes to optimising nutrition to suit your personal situation and goals.

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General nutritional recommendations are standardised for simplicity.    However simple and standard doesn’t always work for everyone, particularly if you aren’t average, or don’t want to be average.

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Just like people come in different shapes and sizes, their nutritional requirements vary widely depending on our situation and goals.

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The Nutrient Optimiser is a moderately sophisticated tool to optimise food choices to suit different people with different goals.  However, I don’t want it to be a black box. Ideally I would like people to understand the inputs and how best to refine their nutrition to suit their goals.

The problem is black boxes is you get what you put in.  If you understand the inputs you’ll have a better chance of getting the output you’re after.

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This article discusses the various parameters that the Nutrient Optimiser manages.    Even if you’re not a user, it may be of interest to see how you can truly personalise your nutrition.  If you are already using the Nutrient Optimiser this article will help you understand how the algorithm uses various parameters to determine the optimal foods for you.

Multicriteria analysis

The first thing to understanding is the parameters used in the multi criteria analysis which is at the heart of the Nutrient Optimiser algorithm.  The image below illustrates the three main dials that you can adjust in the algorithm:

  • insulin load,
  • nutrient density, and
  • energy density.

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A multi criteria analysis is a way to combine a number of priorities.

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You do it all the time.  You want to have money in the bank but you also want to wear clothes and live under a roof.  So you balance these priorities depending on your goals.  You like to look and feel good but you also like to eat treats “occasionally”.  So you balance these priorities.

You want to have the proverbial cake and eat it too.  We make compromises all the time in life.  Living at the extremes is not always healthy or optimal.

I have written at length on the blog about the three key parameters of the system.  The pros and cons of having the various parameters at either extreme are highlighted in the table below.

Parameter Too high Too low
Insulin load Very high insulinogenic processed junk food that drives a blood glucose roller coaster. Super high fat therapeutic ketogenic foods do not provide high levels of the broad range of various essential vitamins and minerals.
Nutrient density Very high nutrient per calorie foods are also very low energy density.  For someone who is active and not looking to lose weight the most nutrient dense foods may not contain enough energy to provide satiety and prevent excessive fat loss. Low nutrient density processed junk food leads to a lack of satiety (nutrient hunger), overeating and a whole host of other health issues.
Energy density Energy dense foods are ideal for someone who is very active and looking to replenish energy, though not necessarily for someone who is less active or looking to lose weight. Low energy density foods are very bulky and hard to get enough energy  to maintain weight if you’re very active.

 

As you can see, these three parameters are important to different people to different degrees for different people.  The table below shows the ‘pre-set values’ in the system that have been found to work well for different goals.  More experienced users of the Nutrient Optimiser may want to tweak these values to refine the results to further suit their preferences.

approach insulin load nutrient density energy density total (absolute)
bulking -20% 60% -20% 100%
nutrient dense maintenance 20% 70% 10% 100%
weight loss (insulin resistant) 5% 70% 25% 100%
weight loss (insulin sensitive) 0 85% 15% 100%
therapeutic ketosis 15% 85% 0% 100%
diabetes and nutritional ketosis 10% 90% 0% 100%

You may have noticed that some of the parameters are negative (e.g. insulin load and energy density for the bulking approach).

While many people are eating too much, some athletes want to bulk up and / or get more energy “down the pie hole” to support their amazing feats of endurance.

Someone who is insulin resistant will want to minimise the insulin load of their diet, bodybuilders often want food to spike insulin around workouts to promote growth.  If you turn the nutrient density parameter negative you’ll get a list of processed junk food that you see in the supermarket aisles.

Adapting the system as you progress

People would ideally use these value as a starting point and refine them to suit your goals as you see fit and as you get fit.

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Someone who starts out with  diabetes, is on three medications and hundreds of units of insulin may need to start on the high fat therapeutic keto approach to reduce the insulin load of their diet.

Someone like this who is looking to progressively refine their diet would come back and re-run the Nutrient Optimiser every two to four weeks to see their new dietary recommendations and refinements.  Through continual, gentle, non-judgemental and anonymous guidance (with the support of the Nutrient Optimiser Facebook group community as required) they would be able to progressively refine their diet.

In time, their blood glucose would come down with lower insulin load foods.  But then they still might want to lose weight so they would start to prioritise lower energy density foods rather than low insulin foods so much.  Then as their weight came closer to optimal and they were more active they might swing back to some focus on insulin load to enable them to have a more nutrient dense suit of foods.

Where do I start?

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While there are a lot of parameters you can use, your average glucose levels and waist : height ratio is a pretty good starting place as shown in the table below.

A higher fat / ketogenic / low carb approach typically works really well for people who have elevated blood glucose and elevated insulin levels.  However, as blood glucose control and improved insulin sensitivity kicks in but you still need to lose weight energy density and nutrient density become more important.

The table below will give you a guide on which approach might be most appropriate based on your current weight blood glucose levels and body fat levels.

approach average glucose waist : height
(mg/dL) (mmol/L)
therapeutic ketosis > 140 > 7.8  
diabetes and nutritional ketosis 108 to 140 6.0 to 7.8  
weight loss (insulin resistant) 100 to 108 5.4 to 6.0 > 0.5
weight loss (insulin sensitive) < 97 < 5.4 > 0.5
bulking < 97 < 5.4 < 0.5
nutrient dense maintenance < 97 < 5.4 < 0.5

 

Food preferences

There are a plethora of different approaches to choosing foods.  Some of these are based around avoiding allergens (autoimmune, lactose intolerant, nut allergy etc) or digestive issues (zero carb, low fodmap).  Some are based on religious belief systems (e.g. vegetarian).

Although the ideal approach is going to be to prioritise the most nutrient dense foods available, we have also created options to suit your preferences.

The recommended foods list will be based on the remaining top 10% foods.   Noting your preferences up front will save you sifting through a long list of foods that you may not want to eat.

option details
most nutrient dense No limitations
zero carb Eliminates vegetables, fruit, grains and any non-animal based sources of carbohydrate.
vegan / plant based No animal products or animal derived products such as dairy or eggs.
vegetarian No animal products but includes eggs and
paleo No grains, dairy or processed foods.
pescatarian Vegetarian plus seafood
gluten intolerant No grain products
nut allergy Excludes nuts
no salicylates  
no organ meats Excludes organ meats.
no offall  

Should I log my supplements?

No!

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But why not?

The goal of the Nutrient Optimiser is to identify nutrient deficiencies and whole foods to fill them.  If you don’t manage to fill the gaps, then you will know which nutrient you might need to supplement.

There is a credible line of thinking that the reason that many processed foods are fortified with B vitamins and the like is that we would find these foods unpalatable and lose our appetite without the fortification.[1] [2] [3] [4] [5]  With fortification, we associate these otherwise nutrient devoid processed foods with essential vitamins and hence we are happy to keep eating them.  Unfortunately, they don’t also contain the full range range of beneficial nutrients that whole foods possess (i.e. essential, non-essential and the ones that we haven’t discovered yet) so fortified foods are unlikely to lead to optimal health.

If you are taking a ton of supplements then you may be able to continue to happily eat large quantities of nutrient poor processed food that you would otherwise lose your taste for.  If you cut back to foods that don’t need to be fortified or flavoured to make up for their nutritional deficiencies you will be able to hear your appetite again and let it guide you to whole foods that contain the nutrients you need at a particular point in time.

Regardless of whether this narrative is correct I think it’s safer to get your nutrients from real food.  Supplements supplement.  They shouldn’t be the foundation.

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If you still can’t quite cover off on the nutrients you need from real food, you can supplement in a targeted manner once you’ve got the foundation of whole foods in place.

Micronutrients

The Nutrient Optimiser compares the nutrients you are getting to the recommended daily allowance (RDA) or daily recommended intake (DRI).  Different RDA / DRIs are commonly given for different situations including  whether you are male or female and if you are pregnant or breastfeeding.

Recommended micronutrient levels for men are typically greater than those for women (other than iron, which is greater for women).  Levels of micronutrients during pregnancy and breastfeeding are greater for obvious reasons.  These values (for adults) are included in the Nutrient Optimiser.

You may have blood tests that indicate you are deficient or sufficient in particular nutrients.  You may also be able to use tools like the Organic Acids Test or the NutrEval test to identify any nutrient deficiencies that you need to prioritise.

If you have this data you can override the recommendations from your food log to focus the nutrients you know you are low in.  For example you may have blood tests that you are getting a lot of vitamin D from the sun so you could decrease your dietary targets or you may have blood tests that suggest you are low in iron due to poor absorption so you can increase your dietary targets.

The daily recommended intake levels for vitamins, minerals and essential fatty acids are shown in the table below.  Keep in mind that these are the recommended minimum levels to prevent the diseases of malnutrition.  There is generally no harm in being above these levels in a particular nutrient if you are getting it from real food.  However if a certain nutrient is super high there is a chance that you are neglecting other nutrients.

Vitamin men women pregnant breastfeeding
B1 (Thiamine) (mg) 1.2 1.1 1.4 1.4
B12 (Cobalamin) (µg) 2.4 2.4 2.6 2.8
B2 (Riboflavin) (mg) 1.3 1 1.4 1.6
B3 (Niacin) (mg) 16 14 18 17
B5 (Pantothenic Acid) (mg) 5 5 6 6
B6 (Pyridoxine) (mg) 1.3 1.2 1.9 2
Folate (µg) 400 400 600 500
Vitamin A (IU) 3000 3000 3000 3000
Vitamin C (mg) 90 75 85 120
Vitamin D (IU) 600 600 600 600
Vitamin E (mg) 15 15 15 19
Vitamin K (µg) 120 90 90 90
Calcium (mg) 1000 1300 1000 1000
Copper (mg) 0.8 0.8 1 1
Iron (mg) 8 18 27 10
Magnesium (mg) 400 310 350 310
Manganese (mg) 5.5 5 5 5
Phosphorus (mg) 1000 1000 1000 1000
Potassium (mg) 3800 2800 2800 3200
Selenium (µg) 55 55 60 70
Sodium (mg) 460 460 460 460
Zinc (mg) 11 9 11 12
Omega-3 (g) 1.6 1.1 1.4 1.3

Amino acids

There is a lot of passion around the topic of optimal protein levels.

I think the long and short of it is that if you focus on getting the harder to find nutrients you won’t need to worry too much protein.  However if you focus on getting particularly high or low levels of protein you will risk missing out on getting adequate vitamins and minerals.

However, unless you’re actively trying to avoid protein you will likely be getting enough.  Conversely, unless you’re trying to hammer down to get extra protein with powders, you will find it hard to get too much protein whole foods.

As long as you’re not living exclusively off hyperpalatable processed foods I think you can generally trust your appetite to make sure you’re getting enough protein.  People who are active and working out will need more protein to support muscle growth and recover.  People who are sedentary will need less protein (as well as fat and carbs).

The Nutrient Optimiser takes your weight and LBM into account to tell you how you’re positioned against normal healthy protein intake levels which are noted in the table below.

Scenario % calories g/kg LBM
minimum (starvation) 6% 0.4
RDI/sedentary 11% 0.8
typical 16% 1.2
strength athlete 24% 1.8
maximum 35% 2.7

To take things another step further, the Nutrient Optimiser also looks at the adequacy of the individual amino acids.  If you’re following a lower carb or paleo approach these are likely to be adequate.  If you’re vegan, fasting or aiming for therapeutic ketosis, the Nutrient Optimiser may encourage you to seek our more of specific amino acids if you’re not getting enough.  Although typically most people get enough of the amino acids unless they are actively trying to avoid protein.

The table below shows the minimum daily requirement of the various essential amino acids in terms of milligrams per kilogram of body weight as well as for someone who is 70kg and 100kg.  These target levels have been included in the Nutrient Optimiser based on your total body weight.  If you are deficient in any of these individual amino acids the Nutrient Optimiser will highlight foods that will fill the gaps.  The Nutrient Optimiser also checks to make sure you’re getting enough protein overall based on your lean body mass.

Amino acid(s) mg per kg body weight mg per 70 kg mg per 100 kg
Histidine 10 700 1000
Isoleucine 20 1400 2000
Leucine 39 2730 3900
Lysine 30 2100 3000
Methionine

Cysteine

10.4 + 4.1 (15 total) 1050 1500
Phenylalanine

+ Tyrosine

25 (total) 1750 2500
Threonine 15 1050 1500
Tryptophan 4 280 400
Valine 26 1820 2600

Common micronutrient deficiencies

Managing micronutrients is a bit of a moving feast.  You could run a reasonable argument that the various daily recommended intakes (DRI) are based on limited knowledge and understanding.  Realistically in the early stages of understanding nutrients and how they work in our body.

For this reason, the Nutrient Optimiser doesn’t try to hit the DRI for every single nutrient.  That would be unrealistic with real food (chemical concoctions like Soylent or other meal replacement products, might get closer, but who knows what you’ll be missing out on if you only get what we currently understand to be the essential nutrients).  Instead we want to highlight the nutrients that you are currently getting in smaller quantities and help you focus on the foods that contain more of those harder to find nutrients.

The chart below shows common micronutrient deficiencies.  The majority of people are not getting adequate amounts of vitamin D, vitamin E, magnesium, calcium, vitamin A and zinc.  However your situation will be unique.

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The Nutrient Optimiser will progressively train you to incorporate new foods and rebalance your diet to fill your nutritional gaps.  When you get to the point that most of your nutrient requirements meet the minimum from real food you might just find your appetite and cravings for particular nutrients start to diminish.

If you’re interested in checking out how the Nutrient Optimiser has worked for a number of other people check out the Nutrient Optimiser Facebook Page or the Nutrient Optimiser site for more details on the tool and how to be involved.

2017-05-23

 

references

[1] http://freetheanimal.com/2015/10/fortification-obesity-refinements.html

[2] http://freetheanimal.com/2015/06/enrichment-theory-everything.html

[3] http://freetheanimal.com/2016/05/enrichment-promotes-everything.html

[4] http://www.audible.com.au/pd/Health-Personal-Development/The-Dorito-Effect-Audiobook/B00WVLVT0Q

[5] https://www.amazon.com/Dorito-Effect-Surprising-Truth-Flavor/dp/1476724237

nutritious high energy density foods for athletes

If you’re an athlete, the “problem” with nutrient-dense foods like non-starchy vegetables and organ meats is that it can be hard to get enough fuel to support your activity.

Foods designed for athletes are energy dense but are not nutrient dense but rather are fast burning foods that don’t contain a lot of essential nutrients.  These foods may provide fuel for the short term, but they can lead to gut distress in the short term and as well as inflammation and insulin resistance in the long term.

To overcome these problems, this list of foods has been designed to be both nutrient dense and energy dense to ensure someone who is very active can get enough fuel while maximising nutrient density as much as possible.

Energy density

The energy density of the foods listed below comes out at 367 calories per 100g compared to 231 calories per 100g for all foods in the USDA foods database.  They will contain enough energy to fuel an active life without spending all day chewing or overfilling your stomach.

Macronutrients

From a macronutrient perspective these foods will provide you with:

  • more protein for muscle recovery,
  • more fat to produce energy,
  • more fibre due to the lower level of processing, and
  • less non-fibre carbohydrates which will normalise blood glucose levels while still providing some glucose for explosive power.

Micronutrients

The chart below shows that these foods are quite nutrient dense, with all of the nutrients achieving greater than the daily recommended intake.

Nutrient dense, energy-dense foods for athletes

Listed below are the top 10% of the foods using this ranking including:

  • nutrient density score (ND)
  • energy density (calories/100g) and
  • their multi-criteria analysis score (MCA).

Vegetables

While the vegetables and spices in this list aren’t particularly energy dense, they will ensure that you get the vitamins and minerals you need to perform at your best.  The lower energy density vegetables have been removed because they won’t be that helpful fueling for race day.

food ND calories/100g MCA
spinach 17 23 1.6
yeast extract spread 11 185 1.4
seaweed (wakame) 13 45 1.3
portabella mushrooms 13 29 1.2
shiitake mushrooms 7 296 1.1
broccoli (sulforaphane) 11 35 1.0
shiitake mushroom 11 39 1.0
seaweed (kelp) 10 43 0.8
cauliflower 9 25 0.7

seafood

Seafood packs some nutrient density and energy density at the same time.

food ND calories/100g MCA
cod 13 290 1.9
crab 14 83 1.4
anchovy 10 210 1.3
salmon 11 156 1.3
lobster 13 89 1.3
fish roe 11 143 1.3
caviar 8 264 1.2
halibut 11 111 1.2
trout 10 168 1.2
sturgeon 10 135 1.1
crayfish 11 82 1.1
pollock 10 111 1.0
oyster 10 102 1.0
shrimp 10 119 1.0
haddock 9 116 0.9
rockfish 9 109 0.9
sardine 7 208 0.9
octopus 8 164 0.9
flounder 9 86 0.8
white fish 9 108 0.8
perch 8 96 0.8
mackerel 4 305 0.7
whiting 7 116 0.7
herring 5 217 0.7
tuna 6 184 0.7
clam 6 142 0.6
scallop 7 111 0.6

eggs and dairy

Eggs are nutritionally excellent.  Butter has plenty of energy.

food ND calories/100g MCA
egg yolk 6 275 0.9
butter -5 718 0.7
whole egg 5 143 0.5

fats and oils

Fats and oils don’t contain a broad range of micronutrients, but they’re a great way to fuel without excessively raising your blood glucose or insulin too.  From an inflammatory perspective, they’re going to be better than process grains and glucose for fueling as well as keeping insulin levels low to enable you to access your fat stores during endurance activities.

food ND calories/100g MCA
grapeseed oil -4 884 1.3
peanut oil -5 884 1.1
olive oil -6 884 1.1
soybean oil -6 884 1.1
beef tallow -6 902 1.1
duck fat -6 882 1.1
soy oil -6 884 1.1
lard -6 902 1.1
coconut oil -7 892 1.0
walnut oil -7 884 1.0
palm kernel oil -6 862 1.0
mayonnaise -4 717 0.8

grains and cereals

The more nutrient dense bran component of wheat makes the cut. However, the more processed and more popular grains don’t make the list. Many people find the “train low, race high” approach to be useful to ensure you are fat adapted through fasted or low glycogen training but have some glucose in the system for explosive bursts on race day.

food ND calories/100g MCA
wheat bran 10 216 1.3
baker’s yeast 12 105 1.2
oat bran 5 246 0.8

legumes

Legumes are moderately nutrient dense and have a higher energy density than most vegetables.  Properly prepared legumes can be a cost-effective way of getting energy and nutrients, though not everyone’s gut handles them well.

food ND calories/100g MCA
peanut butter 1 593 1.1
soybeans 2 446 0.9
peanuts -1 599 0.9
cowpeas 2 336 0.6
black beans 1 341 0.5
broad beans 1 341 0.5

nuts and seeds

Nuts and seeds are a great way to get some energy in, though they’re not as high in the harder to find nutrients.

food ND calories/100g MCA
sunflower seeds 4 546 1.4
pumpkin seeds 1 559 1.1
almond butter 0 614 1.1
almonds 0 607 1.0
pine nuts -2 673 1.0
walnuts -1 619 1.0
brazil nuts -2 659 1.0
flax seed 1 534 1.0
sesame seeds -2 631 0.9
sesame butter -1 586 0.9
hazelnuts -2 629 0.9
macadamia nuts -4 718 0.8
pecans -4 691 0.8
cashews -2 580 0.7
pistachio nuts -2 569 0.7

animal products

Organ meats also do well in terms of nutrient density.  Fattier cuts of meat will pack some more energy.

food ND calories/100g MCA
lamb liver 12 168 1.4
veal liver 10 192 1.2
ham (lean only) 11 113 1.2
lamb kidney 11 112 1.2
beef liver 9 175 1.1
chicken liver 9 172 1.1
turkey liver 9 189 1.0
pork chop 8 172 0.9
chicken breast 8 148 0.9
pork liver 7 165 0.8
beef kidney 7 157 0.8
pork shoulder 7 162 0.7
veal 7 151 0.7
leg ham 6 165 0.7
ground pork 6 185 0.7
lean beef 7 149 0.7
sirloin steak 5 177 0.6

 

post updated October 2017

micronutrients at macronutrient extremes

In the previous article, Which Nutrients is YOUR Diet Missing?, we looked at the micronutrients that you might be lacking when following popular dietary strategies such as vegan, Paleo, keto, or zero carb.

As a follow-up, I thought it would be interesting to look at the effect on essential micronutrients if we define our dietary approach in terms of macronutrient extremes such as low carb, high fat, high protein, high carb, or low protein.

Humans tend to think in extreme terms.  It’s easy to follow a binary approach to nutrition, but which, if any, of these, are the most useful in terms of maximising the nutrition provided by our diet?

For most of my life, best practice nutrition has been defined by a fear of fat which spawned the low-fat processed food era.

And because protein is necessary for muscle growth, more must be better?

But protein is also insulinogenic, so less protein must be good.  Right?

And then of course, there is low carb, which has been popular since the appearance of the Atkins diet appeared in the early 1970s.

atkins.jpg

But then there are a good number of people who still define their diet as being high carb.

Banana-girl-.jpg

All of them seem to be similarly zealous about their all-or-nothing approach.

But are any of these macronutrient extreme approaches beneficial?  And if so, which one leads us to the optimal selection of nutritious foods that will lead to health, happiness, optimal weight, and longevity?

why bother with nutrient density?

The premise of nutrient density is that we want to maximise the quantity of essential micronutrients that we need to support our bodily functions while not overdoing energy intake.

Micronutrient dense foods allow us to obtain adequate nutrition with fewer calories.  Then, with our nutrients accounted for, higher micronutrient density might just lead to higher satiety levels, reduced appetite, reduced food intake and optimal body fat levels.

At the other extreme, if we consume fewer foods with a lower nutrient density, we will likely end up needing to consume more food to obtain the nutrients we need to survive and thrive.  If our appetite drives us to keep on eating until we obtain the nutrients we need, we may end up having to consume too much energy and and end up storing unwanted energy as fat.

macronutrient comparison

In this post, we’ll look at the micronutrients provided by the highest-ranking foods when we sort the eight thousand foods in the USDA database by the most and least fat, protein, and carbs.

Approach % protein % fat % net carbs % fibre
high fat 14% 82% 3% 1%
low net carbs 33% 67% 0% 0%
most nutrient dense 49% 19% 20% 12%
high protein 77% 22% 1% 0%
least nutrient dense 7% 32% 59% 2%
low protein 1% 27% 68% 3%
low fat 8% 1% 84% 7%
high net carbs 3% 2% 92% 2%

This chart shows the macronutrient split for these extreme approaches.

fat

While low carb is still in the lead in terms of internet searches (as shown in the Google Trends data below), the ketogenic diet is becoming pretty popular these days.

The chart below shows the nutrients provided by 2000 calories of the fattiest foods.  Nutrients are expressed in terms of the percentage of the daily recommended intake (DRI), for each nutrient, per 2000 calories (i.e. a typical daily intake).

While we achieve adequate amounts of about half of the essential micronutrients with a therapeutic ketogenic diet, we may need to consider supplementing some of the harder to obtain nutrients such as vitamin C[1], vitamin D, potassium, choline, vitamin K, and magnesium.

Looking at things from the other extreme, a low-fat diet will give you a ton of vitamin C, sodium, manganese, and iron.  However, it will be harder to obtain adequate quantities of the twenty-one essential nutrients, particularly essential fatty acids.

saturated fat

These days, the US Dietary Guidelines have lifted their limit on fat and cholesterol but retained their limitation on saturated fat.  Saturated fat and trans fats remain the two nutrients that we are advised to avoid.

The chart below shows the outcome when we avoid saturated fat.  The top 10% of foods with the lowest saturated fat are lacking (i.e. < 100% DRI) in nineteen essential nutrients.

At the other extreme, foods with the most saturated fat are slightly better with seventeen essential micronutrients lacking.

As discussed in the ‘What about Saturated Fat?’ article, I think saturated fat is neither a concern nor a priority.  Saturated fat a great clean-burning fuel, but there’s no need for us to make up for the last four decades of avoidance by suddenly binging on it.

The chart below shows a comparison of the nutrient density of the quartiles of saturated fat in terms of percentage of energy.  It seems that the foods with moderate levels of saturated fat that are the most nutrient dense.

protein

Once you move past the fear of fat, the next hot topic is optimal protein levels.

The ‘high protein bros’ recommend more protein for muscle growth and satiety, while many in the low carb/keto community target lower protein levels for longevity and ketosis through minimising insulin and mTOR signalling.[2]

As shown in the chart below, when rank foods to minimise protein, we end up with only four essential nutrients meeting the recommended daily guidelines to prevent malnutrition.

At the other extreme, if we prioritise protein we end up with ten nutrients that we fall short of.  The other twenty-six essential nutrients meet the minimum recommended levels.

Not only does protein contain essential amino acids, this analysis indicates that higher protein foods generally come bundled with high amounts of vitamins and minerals, such as vitamin B-12, selenium, vitamin B-6, riboflavin and copper.

It’s one thing to talk about targeting the minimum daily protein that you can get away with if you are looking to preserve muscle in fasting or extreme calorie deprivation during long-term weight loss.  It’s a whole different discussion if you’re looking to minimise protein while making up the rest of your daily energy intake with fats or carbs!

carbohydrates

The chart below shows the nutrients we obtain if we maximise energy from non-fibre digestible carbohydrates (i.e. net carbs).  This high carb approach provides adequate amounts of twelve of the essential nutrients, while still being inadequate in twenty-four essential nutrients.

The chart below shows that low carb performs better than high carb, only falling short in sixteen essential micronutrients.

One of the benefits of a low carb approach is that it often forces the elimination of many processed foods that fill the supermarket shelves to satisfy the demand for low-fat foods driven by the admonition by the for the last four decades by the ruling dietary establishment to minimise fat.

A nutrient dense diet contains less non-fibre carb than the typical diet, but some people will do better, at least for a while, on a carb restricted diet.  Another major benefit of low carb is for insulin resistant people when they can lower their blood glucose and insulin levels on a carb restricted diet.  Many people find it easier to lose excess body fat once they have restored their insulin sensitivity.

nutrient density

You’re probably wondering where all these analyses are headed.

With all of these extreme approaches being so deficient in many micronutrients, you must be thinking “I hope there is a happy ending to this story, and soon.”

The good news is that we can manipulate our food selection to maximise micronutrients.  But first, here’s something to scare you even more.

The chart below shows the outcome when we minimise the harder-to-find nutrients.  This low nutrient density approach ends up being adequate in only three essential nutrients: sodium, vitamin C and iron.

The good news is shown in the chart below, which quantifies the nutrients provided by the most nutrient dense foods when we prioritise for the harder to find nutrients.  Alpha-linolenic acid (found mainly in nuts and seeds) is hard to come by in adequate quantities, however, we can obtain the daily recommended intake of all the other nutrients when we prioritise the harder to find micronutrients.

comparison of nutrients adequate

It’s a little hard to present and digest this analysis clearly.  There is no agreed protocol to compare the nutrient density foods.  So I’ve tried to summarise it in a number of different ways to allow you to draw your own conclusions.

Firstly, the chart below shows the number of nutrients that each macronutrient extreme is adequate in, from the most nutrient dense at the top to the least nutrient dense at the bottom.

The chart below shows a stacked bar chart of the various nutrients in terms of % DRI.  It’s like we have added up all the above charts for each nutrient and stacked them on top of each other.  This chart demonstrates that there is a is a massive difference between the most nutrient dense and least nutrient-dense approaches.  If you’re foods that have a lower nutrient density you might just be hungrier compared to if you are eating the same number of calories of the most nutrient-dense foods which will much more effectively provide you with your essential micronutrients.