High-Fat Low-Protein vs High-Protein Low-Fat Diet Comparison

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In a recent Facebook thread Richard Morris of Two Keto Dudes fame said:  

The lipo-phobics and the amino-phobics are both talking past each other at strawmen.   The hysteria is not just humorous, it’s confusing and turning away novices. This phoney controversy causes people to recommend insane amounts of protein at BOTH ends of the spectrum.

In the macronutrient wars, protein tends to be a controversial topic.  So I thought it would be useful to clearly outline the arguments at both extremes of the “protein controversy” in an effort to bring some balance.  

The TL:DR summary is:

  • appetite is a reliable driver to make sure you get enough protein to suit your needs, 
  • our appetite decreases when we get enough protein, 
  • it’s hard to overeat protein because it’s hard to convert to energy, so the body doesn’t want more than it can use, 
  • most people get adequate protein without worrying about it too much, 
  • people who require a therapeutic ketogenic diet approach should pay attention to their diet to ensure that they don’t miss out on important micronutrients, and 
  • if you prioritise nutritious whole foods you’re likely getting enough protein.
Contents

High protein diet proponents

This section outlines the arguments from the high protein diet proponents’ end of the spectrum with some responses that hopefully bring some balance to the discussion.  

There is no such thing as too much protein

Refined protein supplements do not typically contain the same quantity of vitamins, minerals or essential fatty acids as whole foods.  

Supplements (e.g. protein powders) are intended to supplement rather than replace a whole food diet.  

Focusing on obtaining adequate vitamins, minerals and essential fatty acids typically lead to obtaining plenty of amino acids.  

Meanwhile, actively avoiding protein tends to dilute overall nutrient density in terms of vitamins and minerals.  

The body typically down-regulates appetite before it can consume ‘too much protein’.  It is physically difficult to eat “too much protein” from whole foods (although hyperpalatable whey protein shakes that are designed for bulking may be another matter). 

While protein is beneficial, we also need a balanced diet that provides other vitamins and minerals (e.g. electrolytes that will enable the kidneys to maintain acid/base balance in the body which are hard to obtain from protein supplements).  

Hence, it is possible to focus too much on protein to the point that you are missing other nutrients.  If you chase the micros you’re not getting enough from whole foods then you always get plenty of protein (e.g. the nutrient profile of the highest protein foods shown below is not as good as the most nutrient-dense foods above).  

Fasting will cause you to lose muscle due to a lack of protein intake    

Someone who is ‘fat adapted’ with lower insulin and blood glucose levels will be more easily able to access their stored body fat for fuel.  A high-fat diet reduces the need for glucose, and therefore the requirements for protein from gluconeogenesis decrease.  

The body defends lean muscle loss by upregulating appetite.  People with more body fat and/or lower insulin levels will likely find fasting easier than people who are lean and/or have high insulin.  

Fasting will drive autophagy which is beneficial to an extent.  Fasting and feasting is a cyclic process of building and cleaning out.  We need to balance both parts of the cycle. Humans generally do this fairly well in the absence of hyperpalatable processed foods.  

One of the benefits of fasting is that when you re-feed, your body will be more insulin sensitive, so you will build back new muscle more effectively with less protein and insulin required.  

People doing regular multi-day fasts should ensure their average protein intake is adequate over a number of days and not just on the days they eat.  

You should target more nutritious foods when you do eat to ensure you are getting adequate nutrients over the long term.  If your goal is to lose body fat then re-feeding to satiety on very high-fat foods may be counterproductive.  

Everyone needs to lift heavy weights and be jacked 

Not everyone wants to look good with their shirt off or is willing to invest the dedication that it takes to have a six-pack.  However, being active and having adequate lean muscle mass is important to maintaining insulin sensitivity and delaying the diseases of ageing. 

High fat low protein ketonians

The section below outlines a number of arguments against too much protein.  

Too much protein will turn to glucose like chocolate cake in your bloodstream

Protein can be converted to glucose via gluconeogenesis if no other fuel is available.  However, gluconeogenesis is hard to do, and the body only resorts to increased levels of gluconeogenesis above baseline in emergencies.  Gluconeogenesis yields only 2 ATP from 6 ATP.  

Too much protein is dangerous for your kidneys

High protein levels are only a concern if you have a pre-existing kidney issue.  

For all the talk about “excess protein”, protein intake is self-limiting.  People struggle to consume excessive amounts of protein for a significant length of time.  

Excess protein is quickly cleared from the bloodstream by the kidneys.  Consuming adequate levels of protein will actually help build and repair your organs, including your kidneys.  If you already have damaged kidneys and are on dialysis, it can be prudent to limit your protein so your kidneys don’t have to work as hard.  

Some people believe that protein can harm the kidneys due to misleading blood test results.  If you consume high levels of protein and/or supplement with creatine and have more muscle mass, you may see high levels of creatinine on your blood tests, with can lead to a misleading Estimated Glomerular Filtration Rate (eGFR) result. 

Keep in mind that this is estimated based on your creatinine levels and is not a direct measurement, and is typically not cause for concern.  To avoid a false reading, avoid creatine supplementation, high protein intake and protein supplements in the days leading up to your blood test.  

Bodybuilders who consume more protein are lean and have excellent insulin sensitivity and healthy kidneys.  It also appears hard to gain weight on a very high-protein diet. Participants in protein overfeeding studies with 3.4 and 4.4 g/kg BW of protein per day did not gain weight even though this required a significant caloric surplus to ingest so much protein!  

Protein is expensive and a waste to use for fuel

Using protein for fuel is metabolically expensive and can be beneficial if our goal is fat loss as it increases overall energy expenditure.   By contrast, fat and carbs are more efficient fuel sources.

High-protein foods are often financially expensive.  Processed high fat and high carb foods are cheaper to produce and hence can have a higher markup applied to them.  Thus food companies tend to promote cheaper foods with a higher carb and/or fat content.  

Too much protein is dangerous for people with diabetes

People with diabetes convert more protein to glucose through uncontrolled gluconeogenesis (i.e. due to insulin resistance in Type 2 and a lack of insulin in Type 1).  They also find it harder to build muscle due to a lack of insulin.  Hence, people with diabetes may benefit from consuming more protein to maintain or gain muscle.

Conversely, insulin-sensitive people may require less protein because they can use it more effectively to build and repair muscle.   

Older people tend to require more protein to prevent sarcopenia.  Losing lean muscle mass is a major risk factor for older people.   

The chart below shows that people with diabetes (yellow lines) produce more insulin in response to protein than metabolically healthy people (white line).  

Forcing in more protein beyond what you have an appetite for may make diabetes management more difficult.  However, most people get the results they need from reducing carbohydrates. The fact that protein turns to glucose can be a hack for people with diabetes who might want to get their glucose without the swings that carbohydrates can provide.  

Too much protein will make it hard to maintain healthy blood sugar levels because protein stimulates insulin and glucagon

Protein requires insulin to metabolise.  We also require adequate insulin to keep glycogen stored in the liver. 

As shown in the charts below, an increase in protein in the diet typically forces out processed and refined carbohydrates, decreasing your insulin and glucose response to food.

People with Type 1 diabetes don’t have enough insulin to metabolise protein and maintain normal blood sugars simultaneously and hence require exogenous insulin. 

People with Type 2 diabetes often have plenty of insulin but need to ‘invest’ their insulin well on metabolising protein to build muscles and repair their vital organs rather than ‘squandering it’ on refined carbohydrates.  

People with hyperinsulinemia often see their blood sugars decrease after a high protein meal as the insulin released to metabolise the protein also reduces their blood sugars.  

If you see your blood sugars rise after a high protein meal, you may have inadequate insulin.  If there is insulin insufficiency, you must learn to accurately dose insulin for protein rather than avoiding protein. 

High protein will shorten life due to excess mTOR stimulation

Humans need to balance growth (i.e. increased IGF-1, insulin and mTOR) with repair (i.e. autophagy, fasting and ketosis). 

The research into protein restriction and longevity is either theoretical or in worms in a petri dish, where they grew more slowly when protein and/or energy were restricted.  

Longevity research in monkeys suggests that energy restriction or a reduction in modern processed foods is beneficial.  However, no research in mammals demonstrates that protein restriction extends lifespan or health span.  

The low target protein values proposed by some for longevity (i.e. 0.6g/kg lean body mass or LBM) are practically impossible to achieve from whole foods without the addition of a significant amount of oils and refined fats and/or substantial calorie restriction to the point of rapid weight loss (e.g. check out the Nutrient Optimiser analysis of Dr Rosedale’s diet here).  

There is a difference between lifespan and health span. Humans in the wild who are frail risk fractures and other complications related to muscle wasting and lethargy.  As shown in the chart below, there is an optimal balance between growth and wasting.  Too much insulin and you grow to the point that you get metabolic disease complications.  Too little growth and you become frail, lose your muscle and bone strength, then you may fall, break your hip and never get up again.  

Just eating protein won’t give you gains!

Yes!  You need to force adaptive stress to cause muscle gains, not just eat protein.   If you work out, you will likely crave more protein. This is natural and healthy and ensures that we can recover and adapt.  

Eating too much protein will make you fat

Excess consumption of any macronutrient will make you fat.  However, eating more protein and fewer carbs and fat increases satiety. 

Research in resistance-trained athletes shows that overeating protein does not cause an increase in fat mass.   

Research in sedentary adults shows that overeating protein causes a more favourable change in body composition than overeating the same amount of calories from fat and/or carbohydrates.

Too much protein will lead to rabbit starvation

Healthy people can metabolise up to 3.5 g/kg protein daily and digest up to 4.3g/kg daily.  This makes sense in an evolutionary context (or even in more recent times before we had refrigerators) 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.

Theoretical research suggests there is no upper limit to protein intake to the point it is dangerous.   However, the practical upper limit seems to be around 50% of calories.  

If you force extreme protein levels, you get thirsty and pee out the excess protein.  

Growing children or active people tend to crave higher levels of protein to build and repair their muscles (i.e. 10-year-old Bailan Jones, who is a growing young man with Type 1 who consumes 4.4g/kg LBM).  

If you’re obese and eat only lean protein, you will use body fat for fuel.

If you are very lean and eat nothing but very lean protein, satiety will kick in, and you will not have enough body fat to burn.  This is dangerous. However, most people avoiding ‘excess protein’ tend to have plenty of body fat to use for fuel before rabbit starvation ensues.

If you’re not losing weight, you should cut your protein and your carbs and eat fat to satiety

Reducing processed carbs helps reduce insulin and stabilise blood sugars and helps many people reduce their appetite and lose body fat.   However, not everyone reaches their optimal weight with this method.  LCHF / keto works until it doesn’t. Many people find that they need to reduce dietary fat in addition to carbohydrates to ensure they burn body fat.  

Restricting protein and carbs while eating ‘fat to satiety’ may lead to an inadequate intake of vitamins and minerals, leading to cravings and a lack of satiety.

While reducing the insulin load of your diet to the point that you achieve normal blood glucose levels often helps improve satiety, effective weight loss diets typically involve some permutation of reduced fat and/or carbs to reduce energy intake. 

Medical weight loss clinics typically use a version of a protein-sparing modified fast, which provides adequate protein to prevent loss of lean muscle mass while restricting carbohydrates and fat.

People on a low carb or keto diet may have an increased requirement for protein due to the body’s increased reliance on protein for glucose compared to someone who is getting their glucose from carbohydrates.   

Protein is the most satiating macronutrient, and eating more fat when your appetite is craving protein, or other nutrients may lead to excess energy intake.  

Too much protein will kick you out of ketosis and halt fat burning

Contrary to popular belief, ketosis is only one of several pathways that helps us burn fat.  

Ketones (i.e. AcetoAcetate or AcAc) are produced when we don’t have enough oxaloacetate (OAA) to produce citrate in the Krebs cycle.  

If you are consuming enough protein and/or carbs to provide OAA, you will still burn fat, but through the Krebs cycle rather than ketones.  Thus, you may be “kicked out of ketosis” but still burning plenty of fat.

If you have high levels of NADH (associated with aging and diabetes), more of your AcAc will be converted to BHB in the liver.  

Most people will see ketones in their blood increase when fasting or dieting due to the lack of OAA as they burn body fat.  As shown in the chart below, blood glucose levels decrease while BHB increases.

Several beneficial processes (e.g. autophagy, increased NAD+, increase in sirtuins) that occur during fasting/energy restriction are associated with increased BHB.  Many of the benefits associated with BHB may be due to these other beneficial processes that occur in endogenous ketosis.  

We can force higher levels of BHB in the blood by eating more dietary fat and less protein and carbohydrates.  In this case, high BHB can be an indication that you are eating more fat than can be burned in the Krebs cycle, and it is building up in the blood.   Just because we see high levels of BHB in the blood, it should not be assumed that you are achieving the same benefits via exogenous ketosis as we do in endogenous ketosis.  

If your AcAc is not converted to BHB due to a higher NAD+:NADH ratio, you will see more breath acetone (BrAce).  If you do not have metabolic syndrome, you may see higher levels of BrAce (i.e. measured with the Ketonix) and lower levels of BHB in the blood.  BrAce reflects the recent history of AcAc concentration.

Someone who is metabolically healthy and easily able to access their body fat stores for fuel (i.e. low insulin levels) will have lower overall levels of energy floating around in their blood (i.e. from blood glucose, ketones or free fatty acids).  

Higher levels of energy in the bloodstream is a sign of poor metabolic health and reduced ability to access and burn fat.  

High levels of glucose lead to glycation.  High levels of free fatty acids lead to oxidised LDL.  High levels of glucose and free fatty acids tend to lead to glycated LDL.  High levels of ketones can lead to acidity if not balanced with adequate minerals.   

Learnings from the Nutrient Optimiser 

What is everyone else doing? 

The Nutrient Optimiser Leaderboard demonstrates that even low carbers have a wide range of protein intakes.  

  • Half of the people lie between about 1.4 and 2.5g/kg LBM, with an average of 2.1 g/kg LBM.  In terms of percentage, half of the people sit somewhere between 18 and 29% of energy from protein, with an average of 24% energy from protein.  
  • People near the top of the leaderboard (like Dr Rhonda Patrick) seem to be eating about 2.5 g/kg LBM of protein.  
  • Active people tend to eat more protein (e.g. Brianna, Andy Mant and Alex Leaf).  
  • “High” protein advocates Luis Villasenor of Ketogains and Dr Ted Naiman both seem to be consuming around 2.4g/kg LBM to support recovery from their exercise levels.
  • People following a zero-carb approach tend to eat more protein (e.g. Shawn Baker at 6.1g/kg LBM and Amy at 3.3 g/kg LBM) as more energy comes from animal food.  It could be that many of the satiety effects of a Zero Carb dietary approach are actually due to the high satiety effects of protein.   As noted above, they also need to consume more protein to offset the losses to glucose via gluconeogenesis.  
  • The people consuming 1.0 g/kg LBM tend to rely on a significant amount of added fats and do not achieve high nutrient scores (see examples here, here and here).  

What are the recommendations?

Some protein intake levels are outlined below for reference.

  • In long-term fasting, we use about 0.4g/kg LBM protein per day from our body via gluconeogenesis.  
  • The Estimated Average Requirement is 0.68g/kg body weight for men to prevent protein-related deficiencies and 0.6g/kg body weight for women.  A woman with 35% body fat equates to 0.92 g/kg LBM as a minimum protein intake.  These standard values are in the context of someone eating a standard diet where they would typically be getting plenty of glucose from carbohydrates and are not particularly active and protein requirements may be higher where someone is active and using some protein for glucose via gluconeogenesis.
  • The Recommended Daily Intake is 0.84g/kg body weight for men to prevent protein-related deficiencies and 0.75g/kg body weight for women (Note: For a woman with 35% body fat, this equates to 1.15g/kg LBM as a minimum for someone who is sedentary).
  • Steve Phinney recommends 1.5 to 2.0g/kg reference body weight which equates to around 1.7 to 2.2g/kg LBM for someone wanting to lose 10% of their body weight to achieve their ideal ‘reference weight’.  This increased level allows some glucose to come from protein via gluconeogenesis and adequate protein for people who are not eating carbs and active.  
  • Ketogains suggest 0.8 to 1.0g/lb LBM or 1.8 to 2.2g/kg LBM for people who are looking to maintain or build higher levels of muscle mass.  
  • From a sports nutrition standpoint, over 2.2 g/kg LBM is considered high protein.  
  • Mainstream bodybuilding recommends 1.7 to 2.5g/lb body weight or 3.7 to 5.5g/kg body weight.   For someone with 15% body fat, this would convert to 4.3 to 6.4g/kg LBM!!!

Emphasise all essential nutrients

When I first started tinkering with nutrient density, I assumed that we would simply want to boost all the essential nutrients (i.e. similar to Dr Mat Lalonde’s approach).  The chart below shows the nutrients provided when prioritising foods with higher amounts of all the essential micronutrients.  The amino acids are shown in maroon.  

The ‘problem’ with this array of foods is that, because protein is easy to obtain, this group of foods ends up being very high in protein!  Even the “high protein bros” won’t be able to consume seventy per cent of their energy from protein.   

As you can see from the figure below, we typically struggle to eat more than 50% of our energy from protein.  However, satiety levels tend to be highest and hence energy intake is the lowest at around 50% protein (dark blue area).   

There is generally no need to prioritise amino acids because it is easy to meet the Recommended Daily Intake levels of protein if we eat whole foods.   

Emphasise only harder-to-find nutrients 

Rather than prioritising all the micronutrients, the chart below shows the micronutrient profile we get if we prioritise the harder-to-find micronutrients (shown in yellow) without prioritising any of the amino acids (shown in maroon).    

As you can see, we still get heaps of protein. However, we get a much better micronutrient profile in the vitamins and minerals because we are only prioritising the harder-to-find micronutrients.  Maximising nutrient intake while minimising energy intake appears to be central to minimising natural energy intake and minimising nutrient-related cravings and bingeing.  

Highest protein foods 

The chart below shows the nutrient profile of the highest protein foods for comparison.   As noted above, when we prioritise foods based on their protein content, we end up missing out on several vitamins and minerals.  Thus, there appears to be a danger that we will miss out on micronutrients when we focus only on protein.  

Most ketogenic foods 

The chart below shows the nutrient profile of the most ketogenic foods (i.e. require the lowest insulin by limiting carbs and moderating protein).  It seems from this chart that if you require therapeutic ketosis, you will need to pay particular attention to getting adequate micronutrients (i.e. particularly, choline, folate, potassium, calcium and magnesium).  

Lowest protein foods 

And finally, to test the other end of this theory, the chart below shows the micronutrient profile if we actively avoid protein.  Many people in the vegan community aim to minimise protein while still consuming a high-carbohydrate diet. This analysis shows us that actively avoiding protein has a diabolical impact on the micronutrient profile of our food.  However, when we focus on balancing our diet at a micronutrient level, everything else seems to work out pretty well.

So what should I eat?

With all the conflicting opinions, it can be confusing to know what to eat.  In the end, it comes down to eating good food when hungry.  

If we remove hyperpalatable processed foods, I think we’ll have a much better chance of trusting our appetite to guide us to the foods that will be good for us.  

Once you’re eating fairly well and want to further refine your diet, you might want to check out your Nutrient Optimiser Free Report to help you continue your journey.

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