Tag Archives: nutrient density

how much protein do you need to optimise satiety? 

There is a lot of discussion, confusion and misinformation around the interwebs around the topic of protein.

  • Will ‘too much protein’ raise my blood sugars?
  • Will ‘too much protein” ‘kick me out of ketosis’?
  • Won’t ‘too much protein’ hurt my kidneys?
  • Won’t protein raise mTOR and give me cancer?
  • Isn’t protein is a poor energy source?
  • But I don’t want to be a bodybuilder!

While these are all interesting concerns, most people digging into nutrition are interested in losing some body fat and being healthy.  So, fundamentally, I think the most critical question is:

“How much protein do I need to and lose fat without excessive hunger?”

Show me the data!

We recently stumbled across a massive dataset on ResearchGate of more than half a million days or two million meals worth of anonymised MyFitnessPal Food Diary from nearly ten thousand people logging their food for more than two months.

I was intrigued to see what we can we learn about the protein intake of people who succeeded in eating less compared to the people who struggled to meet their goal.

The chart below shows % energy from protein vs how much they ate compared to their goal intake.

  • Greater than 100% means that they failed to meet their target.
  • Less than 100% means that they were able to consume even less than their goal.

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While there is a lot of scatter, we can see that people who consume higher % protein tend to spontaneously eat less, while those who consumed less protein tended to eat more and were less likely to achieve their goal.

We can remove some of the noise in this plot by breaking the data into 20 groups and looking at the average.   This next chart shows the % protein versus the % target intake on average for each of the 20 groups of people.  Each of these dots represents the average of 25,000 days of food logging.

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While there are some extremes, most people tend to get between 12% and 35% of their energy from protein.

What does this look like in terms of lean body mass?

Assuming most people are aiming for a calorie intake about 15% below their Basal Metabolic Rate (BMR), we can estimate their lean body mass using the Katch McArdle formula.  From this, we can then estimate their lean body mass (LBM) and convert the chart into protein in terms of g/kg LBM as shown below.

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A protein intake of around 0.7g/kg LBM (around the Daily Recommended Intake) appears to correspond with minimum satiety while a higher protein intake reduces hunger which will enable you to effortlessly consume less food and lose weight.

Increasing your protein intake from 0.7 to 2.4g/kg LBM appears to correspond to a spontaneous calorie reduction of approximately 15%.  When we consider the fact that protein does not yield as much energy due to the thermic effect of food, we end up with a spontaneous energy deficit of more than 20% simply by prioritising protein!

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Scenarios

Unfortunately, discussions on protein targets often get muddled in a mess of units.  So I thought it would be useful to demonstrate what the minimum and maximum protein amounts look like using different units.

0.7g/kg LBM protein

The table below shows what 0.7g/kg LBM (which provides minimum levels of satiety) looks like in terms of a number of different units for a lean and an obese man (consuming 2000 calories) and woman (consuming 1600 calories).

  • g/kg lean body mass (LBM)
  • g/kg ideal body weight (IBW)
  • g/lb LBM
  • g/lb body weight
  • g/lb ideal body weight.
sex body fat LBM (kg) body weight (kg) IBW (kg) protein (g) g/kg LBM g/kg BW g/kg IBW g/lb LBM g/lb BW g/lb IBW
F 20% 52 65 65 36 0.7 0.6 0.6 0.3 0.3 0.3
M 10% 68.4 76 76 48 0.7 0.6 0.6 0.3 0.3 0.3
F 40% 51.6 86 65 36 0.7 0.4 0.6 0.3 0.2 0.3
M 20% 68.8 86 76 48 0.7 0.6 0.6 0.3 0.3 0.3

2.4 g/kg LBM protein

Meanwhile, the table below shows the protein intake that corresponds to the highest satiety protein intake of 2.4 g/kg LBM.

sex body fat LBM (kg) body weight (kg) IBW (kg) protein (g) g/kg LBM g/kg BW g/kg IBW g/lb LBM g/lb BW g/lb IBW
F 20% 52 65 65 125 2.4 1.9 1.9 1.1 0.9 0.9
M 10% 68.4 76 76 164 2.4 2.2 2.2 1.1 1.0 1.0
F 40% 51.6 86 65 124 2.4 1.4 1.9 1.1 0.7 0.9
M 20% 68.8 86 76 165 2.4 1.9 2.2 1.1 0.9 1.0

My preference is to talk about protein in terms of g/kg LBM because it relates to the amount of metabolically active muscle mass.  However, body weight is simpler because you don’t need to think about how much body fat you have.  Meanwhile, ideal body weight suits some because they have an idea of what weight they would like to be.

If your goal is increased satiety, fat loss and decreased hunger then you will want to move towards the higher levels of protein.  In the first instance, you can just try to make sure you hit a minimum protein intake each day based on your weight and body fat.  This will help kerb the cravings and manage your overall intake.

As you become leaner you may need to dial in your overall energy intake by focusing on leaner protein sources to ensure you get the protein you need without excess energy.

Protein intake levels assumed in the Nutrient Optimiser

If you require therapeutic ketosis to manage epilepsy, Alzheimer’s or Parkinson’s then the Nutrient Optimiser algorithm will calculator your macros using a minimum of 0.8 g/kg LBM.

However, most people who are interested in nutrition are looking for fat loss and/or diabetes management (and not therapeutic ketosis), hence we set the minimum protein intake at 1.8 g/kg LBM.  Dietary approaches with lower protein than this ‘minimum effective dose’ tend to have a poor nutrient density.

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A protein intake of 1.8g/kg LBM corresponds to the level beyond which we don’t appear to get any further gains in muscle growth.[1][2]  However, we do appear to get additional benefit in satiety and nutrient density.

Many people get confused with the numbers and units, which is why we created the Nutrient Optimiser. to calculate your ideal macronutrient range as well as provide you with some suggested foods and meals that will help you reach your goals.

Responses to common concerns

If you are still concerned about ‘too much protein’ I have outlined some brief responses to the common concerns noted at the start of this article.

Too much protein will raise my blood sugars!

People that produce adequate insulin in their pancreas (i.e. not Type 1 diabetic) tend to see a fairly stable blood sugar response to protein.[3]  Some people even experience a drop in blood sugar, so start slowly and titrate up to a more ideal protein intake.[4][5]

While a low carb high-fat diet will mask the symptoms of diabetes by stabilising blood sugar and reducing your HbA1c, it is the reduction of fat stored around your organs that will ultimately reverse your diabetes![6][7]

Too much protein will ‘kick me out of ketosis’!

Ketosis occurs when there is less carbohydrates and proteins to provide oxaloacetate in the Krebs cycle, so we revert to ketosis to burn fat for energy.

If you need to lose weight then more protein will likely drive an energy deficit, which will cause higher ketone levels as you consume your body fat for fuel.  However, keep in mind that BHB ketones are mainly a transport or storage form of energy and do not correspond with effective use of fat for fuel.[8]

While ketones have experienced a surge in popularity thanks in part to people who would like to sell you some, ketones are far from the most important health marker.   

If you are more concerned about elevating your blood ketone levels than the fat that is being stored in your liver, pancreas, heart, eyes and brain and driving you towards the most common diseases of our western civilisation, then may I politely suggest that you should review your priorities?  

This video, while very graphic (you have been warned!), demonstrates why fat loss is not just for bodybuilders, but critical for health and longevity.

Too much protein will hurt my kidneys!

Unless you have late-stage kidney failure and are on dialysis ‘too much protein’ is not a concern.[9][10]  If you are concerned about your protein intake you should talk to your nephrologist (kidney specialist) about the optimal protein level for your situation.  (If you’re not already seeing a nephrologist there’s probably no need to be concerned about ‘too much protein’ hurting your kidneys.)

Will protein raise mTOR and give me cancer?

We need a balance between building up (mTOR and anabolism) and breaking down (fasting and autophagy).  What we do know for sure in all this is that excess energy (regardless of the source) seems to be one of the biggest contributors to diabetes, cancer and other metabolic diseases that accelerate ageing.[11]

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Optimising your diet with adequate protein to improve satiety and reduce body fat levels to ensure you are physically robust and independent for as long as possible sound like a much safer bet than crossing your fingers hoping that protein restriction (which only seems to work on worms in a Petri dish) will extend your life.

Protein is a poor source of energy!

Yes, fat is an efficient fuel source compared to protein. But if you have excessive stored body fat then getting more fuel is not your highest priority.  Your body is highly motivated to ensure you consume adequate protein to prevent loss of lean muscle.  Getting adequate fuel is secondary.

Eating lower protein foods means that, in the pursuit of adequate protein, you will need to consume more fuel (i.e. carbs and/or fat) than your body can use.  Conversely, eating higher protein foods reduces appetite.  With adequate protein locked in to build and repair muscle (and enable other vital functions), your body will be happy to get the fuel it needs from your excess stored body fat.

The spontaneous reduction in appetite that we see from the analysis of the half a million days of MyfitnessPal data demonstrates that your body is much more willing to burn your unwanted body fat if it is getting the protein it needs.

Forcing your body to convert some protein to glucose for energy (a.k.a. gluconeogenesis) is not such a bad thing.  If you always give your body some fat or carbs when you need energy it will never need to dip into your body fat stores.

But I don’t want to be a bodybuilder!

The ‘good news’ here is that it takes a lot of intentional effort (and often some extra chemical or hormonal assistance) to build massive muscles. Optimising your protein intake will only enable you to manage your hunger, lose body fat and reverse your diabetes.

Summary

So, in summary. the analysis of half a million days of MyFitnessPal data indicates that:

  • Our bodies seem to be happy with less energy when we provide it with adequate protein.
  • Low protein intakes correspond with the lowest levels of satiety and the highest energy intake.
  • Higher protein intakes tend to increase satiety and spontaneously reduce hunger.
  • Increasing protein from 0.7 g/kg LBM to 2.4 g/kg LBM corresponds to a to spontaneous calorie reduction of approximately 15%, even before we account for the higher thermic effect of protein.

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Thanks so much for reading!  In the next article in this series, we’ll look at what the data can tell us about the relative satiety provided by fat, carbs, sugar and fibre.  You might be surprised by the findings!  So make sure you subscribe to ensure you receive it!

 

References

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

[2]https://www.ncbi.nlm.nih.gov/pubmed/1400008

[3]https://optimisingnutrition.com/2015/06/15/the-blood-glucose-glucagon-and-insulin-response-to-protein/

[4]https://optimisingnutrition.com/2015/06/29/trends-outliers-insulin-and-protein/

[5]https://optimisingnutrition.com/2015/06/15/the-blood-glucose-glucagon-and-insulin-response-to-protein/

[6]https://optimisingnutrition.com/2018/05/03/ted-naimans-dam-fat-storage-insulinographic-explained/

[7]https://optimisingnutrition.com/2018/04/12/does-insulin-really-resistance-cause-obesity/

[8]https://optimisingnutrition.com/2018/02/24/is-the-acetoneglucose-ratio-the-holy-grail-of-tracking-optimal-ketosis/

[9]https://twitpl.us/f8Jb

[10]https://www.hindawi.com/journals/jnme/2016/9104792/

[11]https://optimisingnutrition.com/2016/03/21/wanna-live-forever/

how to optimise your energy and macro-nutrient targets

Most macronutrient and calorie calculators give you a specific target for calories, carbs, fat, protein and fibre.

This is simple, but unfortunately not optimal when it comes to ensuring optimal nutrition.

Nutrient-dense whole foods don’t come in prepackaged satchels of protein, carbs, fat, fibre and calories that you can mix together to meet specific macronutrient and calorie targets.

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In real life, nutritious whole foods have a range of macronutrients and micronutrient profiles.  Some days you might crave more energy or different nutrients based on your needs.

While calories and macros still play a role, chances are that you will do better if you initially focus on nutrient-dense whole foods rather than achieving specific macronutrient and calorie targets.  Once you remove nutrient poor highly processed foods from your diet you will be able to better trust your food cravings and appetite.

Where to focus

The personalised foods and meals in your free Nutrient Optimiser report will help you re-balance your micronutrient profile, stabilise your blood sugars and provide the energy you need from your food (but not too much, particularly if your goal is fat loss).

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To help you make the transition from just thinking in terms of macronutrients and calories, the Nutrient Optimiser provides you with personalised macro and calorie ranges.

The image below shows my macronutrient and energy ranges as someone who is currently 95kg with about 16% body fat and good blood sugars.  My current goal, after building some strength in the gym last year, is to lose some body fat while holding onto as much hard earned muscle mass as I can.

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Working within target ranges enables me to still listen to my appetite which may guide me to eat more on days that I am more active and when I tend to crave more protein and/or carbs.  Conversely, there may be other days when I am less active and less hungry and hence don’t need to eat more than my body is craving.

For me, as someone who has become fairly insulin sensitive with good blood sugars, these macronutrient ranges are fairly wide.  I could consume between 32 and 142 g of fat or up to 151g of non-fibre carbohydrates as long as I’m not overdoing my overall energy intake.

For contrast, I have shown below the macro and energy ranges that the Nutrient Optimiser would give for a woman who was also 95kg but had 50% body fat and type 2 diabetes and looking to lose weight.

Screenshot 2018-04-29 04.59.48.png

Her overall energy requirement is lower because she has less metabolically active lean mass.  Her target carbohydrate range is much lower to help her control her blood sugars.

At just over 500 calories per day, her lower limit of energy intake is also very low because she has a lot of body fat that can be mobilised.  However, she still needs a minimum level of protein, essential fat intake and other vitamins and minerals.

These macronutrient and calorie ranges can act as a starting point.  As you make progress with your weight loss or get your blood sugars under control, you can update your profile in the Nutrient Optimiser to update these numbers.

We’re also in the process of developing a Nutrient Optimiser Dashboard that will allow you to track your biometric data (e.g. blood sugars, waist, weight, blood ketones, breath ketones, body fat percentage etc.) help you fine-tune your macro and calorie targets to ensure you are moving towards your goal.

Lots of people are wannabe biohackers but end up getting caught up chasing markers that don’t help them reach their goals (e.g. chasing high ketones for weight loss).  Alternatively, they don’t adapt their approach as they progress (e.g. they don’t transition to a more nutrient-dense lower energy density approach once their blood sugars have stabilised on a lower carb diet).

If you have run your free Nutrient Optimiser report we’ll be sure to let you know once the dashboard is ready.

Calories

There is endless debate whether calories, hormones or nutrients matter more.

While most people agree that you need an energy deficit to lose weight and an energy surplus to gain weight, the way your body processes energy is complicated and hence impossible to calculate precisely.

Focusing on calories alone may be short-sighted.  Without attention to food quality and macros, it may be harder to manage your energy intake.

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If you are healthy, your metabolism will increase to burn off any excess energy.  You will fidget more and naturally move around more (i.e. non-exercise activity thermogenesis).

However, most people can’t do this forever, particularly if their food is nutrient poor and causes inflammation.  A chronic energy excess that drives body fat levels higher will most likely cause you to become overweight and insulin resistant once your fat stores cannot take in any more.

Conversely, if you restrict calories, your body will become more efficient.  You will adapt to cope with less energy.  Due to this ‘adaptive thermogenesis’ over time you will need to take in less energy if you want to keep losing weight.

This adaption is often seen as a bad thing.   But for most people, other than not getting to enjoy as much yummy food, training your body to do more with less is highly beneficial.

Metabolic efficiency

If your car is running well, it uses less fuel and gets the job done efficiently.

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But if your car is getting old and blowing heaps of fumes, it’s probably burning more fuel than it really needs.

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We want fuel-efficient cars to minimise cost and the impact on the environment.  But when it comes to choosing the fuel for our body, many of us want to know how much food we can get away with without looking too fat.

Energy is conserved

While our bodies are complex systems and we don’t understand everything that goes on inside them, energy is conserved.

We would love to be able to eat lots and lots of yummy stuff and stay lean, typically doesn’t work out in the long term.

If you are losing weight off your body, you are burning more than you are eating.

If you are gaining weight, you are taking in more energy than you are burning.

However, while energy intake still matters, your primary focus should ideally be on consuming nutrient-dense foods that don’t spike your blood sugars.   Once we have food quality dialled in quantity will fall into place.  Your appetite will start to work the way it is meant to.  Food that contains the micronutrients you need tend to help to prevent nutrient cravings, are more satiating and help you to consume less energy.

Is intermittent fasting better than calorie counting?

The unfortunate reality is that it’s not easy to maintain an energy deficit over a long period of time.

In the low carb or keto world, many people find some version of intermittent fasting helpful.

Others find calorie cycling or a targeted ketogenic diet (i.e. more carbs and/or calories on workout days) to be useful.

Still, others find that refeeds or diet breaks can be helpful to reset your hormones and appetite after a number of days or weeks of conscious and careful restriction.

Personally, I’ve done my share of intermittent fasting but found that I would always manage to compensate for my deprivation and congratulate myself with enough food at the end to maintain my weight over the long term.  And it was hard at the end of the fast to make sure I was eating the most nutrient-dense foods.  Once I started eating I would always find myself reaching for the energy-dense cream and peanut because I had earned it.

After a period of gaining strength in the gym last year and gaining a bit more fat than I would have liked, this year I have been more diligent in tracking my intake and making sure I’m eating nutritiously with adequate protein to support my recovery while maintaining enough of a deficit to ensure ongoing weight loss.

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This has also included a couple of “diet breaks” programmed around intense periods at work when I didn’t want to be thinking about food all the time.  After the period of mental and physical relaxation, once I dialled things back in the water weight dropped off and the weight loss continued.

However, you want to structure it, allowing some room to listen to your body’s signals can be useful.  In the long run, you will need to maintain a deficit if your goal is to lose weight or an overall surplus if your goal is to build muscle.

While not many people find tracking their food intake fun, many people find that they need to track to stay accountable and achieve their goals.  Even a short period of tracking can be helpful to help re-train your eating habits.

Your calorie range for weight loss

Rather than a fixed energy target, if you are trying to lose weight, the Nutrient Optimiser gives you a starting calorie range.

The lower limit calorie intake level is based on the maximum rate of weight loss you can achieve without excessive loss of muscle mass (i.e. 21 calories per pound of body fat)[1] [2] while also getting a minimum amount of protein.  The more fat you have to lose, the more aggressive your deficit can be without risking muscle loss.[3]

If you aim is weight loss, your upper limit calorie intake level is based on your basal metabolic rate (BMR) minus 15%.  This is a reasonably comfortable deficit for moderate fat loss that won’t generate excessive hunger for most people.

If you are feeling ambitious, you can aim for the lower calorie intake level.  But then one day you may feel more hungry or be more active so you can allow yourself to eat up to the upper limit without feeling guilty.

Most people under-report their food intake,[4] so targeting a lower intake will accommodate your optimism bias and crappy reporting.

Example calories and macronutrient ranges

The table below shows my recommended macro ranges from the Nutrient Optimiser in weight loss mode.  My target calorie intake for weight loss is 1,606 to 1,962 calories per day.  For me, this is a 15 to 30% deficit below my theoretical basal metabolic rate of 2,308 calories per day.

 

lower

upper

protein (g)

144

260

fat (g)

32

142

net carbs (g)

0

151

energy (cal)

1,606

1,962

deficit (calories)

702

344

deficit (%)

30%

15%

The image below shows how these lower limits look when entered into Cronometer.

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If you click on the energy bar in the web interface or the app, we get this popup where you enter this calorie range.

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While these values are calculated to four significant figures, they are only estimates of how much energy is in the food you are consuming.  Theoretical calculations should only be used as a starting point and refined based on actual progress.

If you find after a week or two that you are not achieving the weight loss you were hoping for you should reduce the maximum allowable calorie intake to ensure that you are losing weight.  A reasonable rate of weight loss is somewhere between 0.5 and 1.0% of your total body weight per week.  If you’re aggressive and very disciplined, you might be able to achieve a 1.5% loss per week for a short time.

Many people have found that they can sustain a more aggressive rate of weight loss over the long term if they have adequate protein and micronutrients.  You will also find it hard to overeat on the foods and meals recommended by the Nutrient Optimiser.

Similarly, if you find that your blood sugars are not trending down, you can reduce your carb target.  Once your blood sugars are dialled in you can loosen your carb target a little to allow more nutrient-dense foods.

If you’re not looking for weight loss

If you’re a lean athlete not aiming for weight loss, you will be able to ‘eat to satiety’ to ensure you recover.  If you’re looking to gain muscle without too much fat, you will want to target a slight energy excess.

Be careful eating back the calories from exercise if you are trying to lose weight.  Your Fitbit or Strava may tell you that you just burned a lot of calories, but if you enter that into Cronometer and then have the extra ice cream that it says you are allowed, you may find you are not getting the results you hoped for.

Protein

If you want to get more background about the charts and discussion below, the macro targets in the Nutrient Optimiser algorithm are based on the analysis detailed in the How to get the minimum dose of nutrition and Macros > micros? articles.   

Getting enough protein is important when losing weight to prevent loss of lean muscle mass.  The minimum protein intake in the Nutrient Optimiser is based on 1.8 g/kg lean body mass (LBM).

Nutrient density starts to drop off once protein drops too.   Getting adequate protein is as much about maintaining overall nutrient density as it is about getting protein for muscle growth and repair.

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It can be helpful to target higher levels of protein if you are in an aggressive energy deficit.  The upper limit provided by the Nutrient Optimiser is based on the optimum protein intake level or about 45% of your maintenance energy intake.   Beyond this point, any extra protein starts to have a negative impact on nutrient density.

Similar to your calorie ranges, you can click on the protein bar in Cronometer and enter your minimum and maximum protein intake as per the example below.

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If you find that you’re starting to lose too much muscle mass rather than body fat you can increase your minimum protein intake.   It’s hard to track muscle loss vs fat loss accurately, but the chart below is my attempt using my bioimpedance scales.  You can see during the first six weeks (during the Ketogains Bootcamp) I was losing twice as much fat compared to lean mass.  Later in my journey when I’m not working out as much you can see the ratio of lean mass loss vs fat-free mass loss is drifting up.

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Loss of hard-earned lean muscle mass in weight loss is real and you would be wise to do everything you can to avoid it.  Other than taking testosterone, steroids or choosing different parents, resistance training and a higher protein intake are the only things I’m aware of that will help you lose more fat and retain more muscle.

Fat

As shown in the chart below, a very low-fat diet (less than 10% energy from fat) may leave you struggling to achieve a good micronutrient profile.  Hence we recommend getting a minimum fat intake of 0.4 g/kg LBM.  While this is less fat than most people eat you will easily be able to achieve the daily recommended minimum requirements.

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My fat range is shown in the figure below.  If you’re in fat loss mode, you will likely be closer to the lower limit.  If you are trying to gain muscle or are very active, you will likely be eating more fat.

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Carbohydrates

You don’t need a lot of carbs to get a reasonable level of vitamins and minerals.   Non-starchy veggies like spinach and asparagus provide a range of vitamins and minerals that are typically harder to find in animal-based foods.

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The image below shows how this looks when entered into Cronometer.

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If you are managing diabetes?

If you are insulin resistant or have diabetes, the allowable upper limit of carbohydrates provided by the Nutrient Optimiser will be limited to help stabilise your blood sugars.  As you can see from the chart below, there is a balance between nutrient density and a lower dietary insulin load.

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Managing the insulin load of your diet will require a reduction in protein intake if you need a therapeutic ketogenic diet. Most people find that they get the outcome they need by reducing refined carbohydrates.

 

Summary

So, in summary:

  • You should use the Nutrient Optimiser to focus on nutrient-dense whole foods that align with your goals without worrying too much about macronutrients.
  • Logging your food in Cronometer enables the Nutrient Optimiser to fine tune your food and meal choices to rebalance your food choices and improve your micronutrient profile.
  • The calorie and macro ranges provided by the Nutrient Optimiser can be used to double check that you are on the right path.

In the next instalment, we’ll look at how the nutrient score is calculated and what it takes to get yourself to the top of the Nutrient Optimiser leaderboard.

 

References

[1] https://www.ncbi.nlm.nih.gov/pubmed/15615615

[2] http://www.burnthefatfeedthemuscle.com/how-to-lose-a-pound-of-fat-per-day

[3] https://optimisingnutrition.com/2017/10/30/nutrition-how-to-get-the-minimum-effective-dose/

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064631/

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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is ‘too much protein’ on keto really a thing?

  • There is a lot of confusion in keto land about ‘excess protein’.
  • Insulin and protein are used to build and repair your muscles, organs and the other important parts of your body.  This is an important and beneficial use of protein and insulin.
  • Foods that contain the harder to find nutrients (e.g. potassium, magnesium, choline, vitamin D) typically contain plenty of protein.
  • Actively avoiding protein and can lead to a less nutritious diet.
  • Unless you require therapeutic ketosis for the treatment of cancer, epilepsy, Alzheimers, Parkinson or dementia, you should be chasing vitality, health and nutrition along with stable blood sugar levels rather than some arbitrary ketone level.
  • There are a range of different ways to quantify protein intake.  Thinking in terms of percentages can be more confusing than helpful.
  • It’s hard to over-consume protein because it is highly satiating.  However, if you avoid protein your body may drive you to consume more calories until you get the protein it needs.
  • If you follow your appetite and focus on foods that contain the vitamins and minerals you need you will probably get enough protein.

Virta Facebook Live Q&A

I recently had the opportunity to pose some questions about protein intake to the Godfather of Keto, Dr Stephen Phinney in a recent Facebook live Q&A.

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Dr Phinney’s response to my question is shown below, including his recommended protein intake levels of 1.2 to 1.75 g per kg reference body weight of protein.

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While I largely agree with Dr Phinney’s response, I think it’s worth elaborating on some of the issues that are causing so much confusion at the moment.

Will too much protein kick me out of ketosis?

If you’ve read previous posts on Optimising Nutrition you’ve probably seen my analysis of the food insulin index data that shows that our carbohydrate intake alone doesn’t explain our insulin response to food.

The food insulin index data shows that our insulin response to food is more accurately predicted when we consider the fibre and protein content of our food, not just the carbohydrate.

However, I fear that many people have used the insulin load concept as a reason to avoid protein.  I now understand that this is far from optimal within the broader context of good nutrition for health, weight loss and vitality.

If you are interested in learning more the implications of the insulin index data I recommend you check out the following articles:

Effect on blood sugar and insulin

While trading your calories from butter for steak will increase your requirement for insulin, the food insulin index data suggests that as a general rule, getting more of your energy from protein will reduce your insulin requirements as it forces out processed carbohydrates as shown in the chart below.

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Getting more energy from protein tends to decrease our glucose response as it forces out nutrient-poor refined high carb foods.  Your body can convert protein to glucose (i.e. gluconeogenesis) if it really needs to but it’s a lot of work, so it would much rather get energy from carbs or fat.

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Protein is also very satiating.  Once we have enough protein, our body tends to crave more fatty and carby foods for energy.[10] 

While it is both financially and metabolically expensive, protein is the most important component of your diet.  Different people will need different amounts of protein depending on their life stage and activity levels.

While you probably don’t need to be going out of your way to binge on more protein than you can comfortably consume, actively avoiding protein containing foods is a recipe for nutritional disaster.  If you are exercising or lifting heavy then you will naturally crave more protein.

If you actually need higher levels of blood ketones for therapeutic ketosis, it may be a good strategy to consciously restrict protein.  However, I don’t’ think the vast majority of people chasing ketones are looking for therapeutic keto for the management of cancer, Alzheimer’s, epilepsy, dementia or Parkinson’s but rather fat loss or diabetes control.

Protein number crunching

The numbers around protein can be confusing due to the units used.

  • Dr Phinney uses ‘reference body weight’ (RW) (which he says is ‘the weight you were when you were in college’).
  • The mainstream nutrition world talks in terms of total body weight (BW).
  • Meanwhile, the sports nutrition community talk in terms of lean body mass (LBM).

In order to understand what this means in practice, let’s look at an example of a woman who is currently 40% body fat but was 25% in college (i.e. her reference weight).  For argument’s sake let’s say she was 70 kg in college but she is currently 87 kg or 193 lb.  The images below will give you an idea of what these level of body fat levels look like.

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In the table below I have calculated what Dr Phinney’s recommended protein intake looks like for this person in terms of:

  • reference body weight (RW),
  • lean body mass (LBM), and
  • body weight (BW).

Based on Dr Phinney’s guidance, this person should be eating between 84 and 123 g of protein per day.

  body fat weight (kg) weight (lbs) lower limit upper limit
reference weight 25% 70 154 1.2 g/kg RW 1.75 g/kg RW
lean body mass 0% 52.5 116 1.6 g/kg LBM 2.3 g/kg LBM
body weight 40% 87.5 193 1.0 g/kg BW 1.4 g/kg BW
protein (g/day)       84 123

On a practical note, there is nothing low about 2.3 g/kg LBM protein.  While I do track my intake I find it hard to get above 2.2 g/kg LBM even when trying to maximise protein.  At the same time, the lower limit is well above the official Recommended Daily Intake of 0.84 g/kg for men and 0.75 g/kg for women which are set to maintain nitrogen balance and prevent disease (i.e. not achieve optimal health and vitality).

What about percentages?

Talking about protein in terms of percentages of energy intake can be confusing as it depends on your activity levels or whether you are dieting.   Theoretical energy intake requirements are based on your lean body mass and activity levels.

The table below shows what Dr Phinney’s protein recommendation of 1.2 to 1.75 g/kg RW (or 1.6 to 2.3 g/kg LBM) look like for our hypothetical woman above in terms of percentage of energy intake for different energy intakes depending if she was trying to lose weight, maintain weight or was more active.

scenario calories lower upper
30% deficit 1158 29% 42%
sedentary 1654 20% 30%
lightly active 1852 18% 27%
moderately active 2084 16% 24%
vigorously active 2431 14% 20%
protein (g)   84 123

Protein intake in terms of percentage energy intake can vary widely to the point that it’s practically useless.  It’s generally much more useful to talk in terms of protein intake in grams per weight lean body mass rather than percentages.

Protein and nutrient density

Since stumbling across the insulin index, one thing I have found consistently is that nutrient-dense foods are not low in protein.

If you are focusing on the foods that contain the harder to find nutrients (e.g. magnesium, magnesium, choline, vitamin D etc) you will be getting plenty of protein.

Conversely, the only way to really get the ultra-low protein intakes being recommended by many people without an energy deficit is to avoid most solid foods and prioritise macadamia nuts, butter and oils.  It should not be a surprise that it will be hard to get a broad spectrum of essential nutrients with this sort of dietary approach.

As shown in the chart below, nutrient density tends to increase up to about 50% of energy intake.   If you’re eating more than 50% protein you’re likely relying on processed foods and supplements.[11]

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The chart below shows the nutrient profile of the most nutritious foods in the USDA database.  If you could stick to these foods you would easily be getting a lot of the essential nutrients without having to consume too much energy.

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The problem with these foods is that they can be very satiating which makes it hard to get enough energy in if you are active.  However, if you are trying to lose weight these foods may help to ensure that you are getting the nutrients you need with less energy without being hungry.

It’s interesting to see many people who have been experimenting with the Nutrient Optimiser have commented on how little food they can get away with while experiencing minimal levels of hunger.   Nutrient dense foods tend to be hard to overeat and also provide you with the nutrients to prevent cravings and hence reduce appetite.

For comparison, the chart below shows the nutrient profile of the ketogenic diet foods.  That is, the foods that have the lowest percentage insulinogenic calories.   These foods are 80% fat, 15% protein and 3% net carbs).  Ironically, an individual consuming these foods will be meeting the minimum levels of protein but they will be missing out on a large number of other vitamins and minerals.

I find that it’s often the people who are trying to actively avoid protein that find themselves at the bottom of the Nutrient Optimiser Leaderboard with a very poor nutrient profile.

The chart below shows the nutrient profile that we get when we actively avoid protein.  The only nturients that we get enough of in this scenarios is sodium and vitamin C!

Unless you are chasing therapeutic ketosis for the treatment of cancer, epilepsy, Alzheimers or dementia I think your focus should be on building health and maximising nutrition rather than higher ketone values.

If you are getting the micronutrients you need to thrive you will be getting plenty of protein and won’t need to worry too much about getting adequate protein intake.  Conversely, if you are actively avoiding protein you will be unnecessarily sacrificing your other micronutrients (especially if you are replacing your calories from protein and carbs with refined fat).

But will too much protein kick me out of ketosis?

As I write this I have been experimenting with adequate protein with less fat and carbs and maximal nutrients on the Ketogains Bootcamp.  A typical daily Cronometer summary is shown below.

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My protein is sitting at about 2.2g/kg LBM for me given that I’ve been spending a lot of time in the gym lifting heavy during this time.  I’ve also been able to hit many of the nutrients targets while maintaining a significant calorie deficit.

Leading up to this period my blood glucose levels were sitting in the mid 5s (approx 100 mg/dL).  However, once I introduced the energy deficit my glucose levels plummet to the mid 4s (approx 80 mg/dL).

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And although I don’t worry much about ketones, they seem to be sitting at around 0.7 mmol/L, which I’m pretty happy with.

I know if I keep my blood glucose around this level I will continue to lose weight and continue to improve my glucose control and HbA1c.

I also get plenty of breath acetone from endogenous ketones as shown on my Ketonix below.

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Don’t forget the basal insulin!

While there has been a lot of focus on what we can do to not have too much insulin, we need to remember that insulin has a number of important roles including:

  1. to help us get glucose into cells to be used by our mitochondria,
  2. to help build and repair our muscles, and
  3. to control the release of glucose from our liver while the energy in our bloodstream is used up.

People with type 1 diabetes demonstrate happens if we don’t have enough insulin.  Not only would we not be able to store the energy we eat as fat and muscle, the brake comes off the liver and all the stored energy in our body comes flowing out in the form of excess glucose and ketones (i.e. diabetic ketoacidosis).

The image below is the same child, “J.L.”, in the 1920s before and after receiving insulin therapy.  In a healthy person, insulin suppresses the fuel flow from the liver to healthy levels.

In someone on a standard western diet, basal insulin represents about 30% of the today daily dose.  Basal insulin drops to about 50% for someone on a low carb or keto diet.  But you can never drop your insulin requirements to zero.  You always need this basal to stop the uncontrolled flow of fuel from your liver into your bloodstream.

We focus so much on the effect of the food we eat but we forget that it’s also the excess fuel on your body and floating around in our bloodstream that also plays a massive role in the insulin demand on our pancreas.

Whenever there are high levels of energy sitting in our bloodstream (from glucose, ketones or fat) the pancreas has to ramp up basal insulin production until the fuel in our bloodstream is used up.  The more fat there is on our body the harder our pancreas has to work to hold back the pressure of excess fat on our body from being released into our bloodstream.

So, you may believe that your mug of Bulletproof coffee or the fat bomb may not be raising your insulin levels because it does not contain glucose or protein.  However, your pancreas is still working overtime to produce more insulin to hold the fat on your bum and until the energy coming in via your mouth is used up.

You may be able to ramp up your energy expenditure for a while by shivering and fidgeting, more but after a time of overdriving energy you’ll likely end up fat and insulin resistant.

If you really want to reduce your insulin levels you need to work on reducing the excess level of energy floating around in your bloodstream (from any source, including fat, carbs, protein or exogenous ketones) so your pancreas will decrease its production of insulin to allow body fat to be used.

Focusing on obtaining the nutrients you need without too much energy seems like common sense to me.

Therapeutic ketosis

Someone targeting therapeutic ketosis to assist with the management of chronic conditions such as cancer, epilepsy, dementia or Alzheimer’s may benefit from higher levels of ketosis and less reliance on glucose.  But I don’t think the vast majority of people who are Googling “keto” at the moment are looking for a therapeutic treatment.

therapeutic keto

Understanding how to quantify the insulin load of our food enables us to accurately tailor or food choices to suit our goals.  When it comes to insulin load we need to keep it low enough to get the results we need without compromising the nutritional value of the food we eat too much.

The chart below shows that nutrient density peaks at around 40% insulinogenic calories.

  • If you are insulin resistant it would be prudent to have less than 40% insulinogenic calories.
  • Someone on a low carb diet might have less than 25% insulinogenic calories.
  • Someone targeting therapeutic keto will likely need to have less than 15% insulinogenic calories to see therapeutic levels of ketones.

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Unless you really require therapeutic keto then I don’t think there is a need to worry too much about the impact of protein on your blood ketone levels.  Actively avoiding protein tends to lead to compromising nutrient density unnecessarily which may lead to nutrient cravings or deficiencies in the long term.

The glucose : ketone index

People who require therapeutic ketosis should also ensure that they are not driving the total energy in their system too high.  To do this they can track their glucose as well as ketones.  The glucose:ketone ratio (GKI) which was developed by Dr Thomas Seyfried to measure the degree of therapeutic ketosis.[12]

If you’re interested, your GKI can be calculated by dividing your glucose (in mmol/L) by your ketone values.  For example, if your blood glucose is 108 mg/dL and your blood ketones are 0.5mmol/L, GKI = blood glucose / ketone = (108 mg/dL / 18) / 0.5 mmol/L = 6 mmol/L / 0.5mmol/L = 12.

People who are chasing therapeutic ketosis typically do not need to worry about ingesting too much energy.   Driving a hypercaloric state with refined fats is not a major concern for someone trying to keep weight on (e.g. cancer cachexia).  However, ensuring that they are achieving lower glucose levels will ensure that they are not driving insulin resistance.

For reference, the table below shows the relationship between HbA1c, average glucose, ketones and GKI for different scenarios showing how your GKI and ketones correlate with HbA1c and blood glucose.

 metabolic health HbA1c average blood glucose blood ketones GKI
 (%)  (mmol/L)  (mg/dL)  (mmol/L)  
low  4.1 3.9 70 > 0.3 < 4
optimal 4.5 4.6 83 > 0.3 < 15
excellent < 5.0 < 5.4 < 97 > 0.3 < 20
good < 5.4 < 6 < 108 < 0.3 < 40
danger > 6.5 7.8 > 140 < 0.3 > 40

Really low GKI values (i.e. very high ketones and very low glucose) are typically seen in extended fasting when glucose levels to drop and ketones from body fat increase in a low insulin state.

The chart below shows my blood ketone and glucose levels during a seven day fast.  Amazingly, as my blood glucose levels dropped below 4.0 mmol/L my ketones drifted up to 8 mmol/L.  During more recent, however, I haven’t been able to achieve such high ketone levels.

While we can get these high ketone levels during fasting, we typically don’t see them in the fed state.  To give you an idea of what to expect, the chart below shows GKI values over time during fasting for RD Dikeman (from Type 1 Grit), Jimmy Moore, Simon Saunders (Keto Island) and myself.   As a rule of thumb, you might expect to see a GKI value less than 2 after two or three days of water fasting.

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Nutrient density analysis

Being a big fan of Dr Phinney and the Art and Science books, I couldn’t help running his recommended diet through the Nutrient Optimiser.  I entered all the meals in the Art and Science of Low Carb Living into Cronometer and ran it through the Nutrient Optimiser.

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If you’re interested, you can see the full report here and where these meals rank on the leaderboard here.

So what should you do with all this information?

So, to summarise:

  1. If you have great blood sugars and just want to lose weight then you should focus on maximising nutrient density while reducing the energy levels in your bloodstream.  There is no need to worry about “being in ketosis”.  You will produce ketones if you are successfully achieving an energy deficit and burning your own body fat stores.
  2. If you are insulin resistant then you will want to limit your insulin load to a maximum of 2.9 g/kg LBM.  This will restrict carbohydrates in your diet so your blood sugars stabilise.
  3. If you are trying to manage diabetes then you want to keep your insulin load under 1.8 g/kg LBM.  This will restrict carbohydrates and may reduce your protein intake a little.
  4. If you require therapeutic keto then you will want to keep your insulin load less than 1.1 g/kg LBM and may need to consider limiting protein.

The recommended values for protein and insulin load are shown in the table below.

approach

min protein

(g/kg LBM)

max insulin load

(g/kg LBM)

therapeutic ketosis 0.8 1.1
diabetes / nutritional ketosis 1.8 1.8
weight loss (insulin resistant) 1.8 2.9
weight loss (insulin sensitive) 1.8

Can run the numbers for me?

I realise all this data can be confusing if nutrition is not your hobby.

Over the last few months, I’ve been working with a very talented programmer, Alex Zotov, to develop some handy software to help people navigate all this information and put it into practice.

The first instalment of the Nutrient Optmiser is a free calculator that will help you identify the ideal macronutrient ranges to suit your goals as well as a shortlist of optimal foods and meals.  The table below shows how we can determine the optimal approach for you based on your metabolic health, waist to height ratio and goals.

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We’d love you to check it out the Nutrient Optimiser.  We’d love to hear what you think and how we can refine it to suit your goals.

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We hope it will be really helpful for a LOT of people on their journey towards health through optimal nutrition

 

references

[1]https://www.amazon.com.au/Keto-Clarity-Definitive-Benefits-Low-Carb/dp/1628600071

[2]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737348/

[3]http://assets.virtahealth.com/docs/Virta_Clinic_10-week_outcomes.pdf

[4]http://www.ncl.ac.uk/press/articles/archive/2017/09/type2diabetesisreversible/

[5]https://www.ncbi.nlm.nih.gov/pubmed/25515001

[6]https://cardiab.biomedcentral.com/articles/10.1186/1475-2840-12-164

[7]http://circoutcomes.ahajournals.org/content/3/6/661

[8]https://www.perfectketo.com/how-too-much-protein-is-bad-for-ketosis/

[9]https://nutritionfacts.org/video/the-great-protein-fiasco/

[10]https://digitalcommons.wku.edu/ijes/vol10/iss8/16/

[11]https://optimisingnutrition.com/2017/10/30/nutrition-how-to-get-the-minimum-effective-dose/

[12]https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/s12986-015-0009-2

micros > macros?

Most of the time, when it comes to nutrition, we like to think in terms of macronutrients.

  • Carbs.
  • Fat.
  • Protein.
  • Fibre.

Simple!

But maybe too simple?

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In the good old days, before your food was grown in nutrient depleted soil and the creation of nutrient-poor processed frankenfood, we just ate food.  We didn’t have to worry about micronutrients.  Pretty much everything we ate was full of them!

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These days micronutrients are harder to come by.  In a number of previous articles, I have suggested that maximising micronutrients as your first priority (before calories or macronutrients) will likely to be a more useful guide to help us genuinely optimise our nutrition.

Unfortunately, it’s hard to think in terms of micronutrients.  With thirty-four essential nutrients and many more conditionally-essential and beneficial nutrients and compounds in the food we eat, there are just too many moving parts to keep in our working memory.

Before the creation of hyper-palatable flavoured and coloured foods, our appetite was a useful to help us seek out the nutrients we need.  Over the years it had come to be the perfect nutrient optimiser, prioritising the foods we needed at any point in time.  Unfortunately, in our modern food environment, our paleolithic instincts are no match for modern food chemistry.

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Today, we need a little extra help to discern fake foods from the real foods that actually contain the nutrients we need to thrive.

This article outlines how we can utilise macronutrients to assist us, like training wheels, to help us get pretty close ot ideal nutrition.  We can then focus on eating nutrient-dense foods that will help us thrive and to enable us to look, feel and perform at our best.

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Macronutrient wars

Many diet communities built around a specific macronutrient profile that they believe is optimal.

Different people believe in a wide range of macronutrient philosophies as the cornerstone of their nutritional approach.  One of the many variations is IIFYM.

If It Fits Your Macros (IIFYM) or Flexible Dieting was a trend in the bodybuilding community based on the idea that you could eat pretty much anything you wanted as long as you hit your macro targets.[1] [2] [3]

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IIFYM blossomed as a response to the ‘clean eating’ trend that grew around the Paleo diet[4] trend which emphasised food quality and was largely ‘macro agnostic’.

With IIFYM:

  • protein is set based on your lean body mass (LBM) and activity levels (typically 1.8g/kg LBM),
  • energy intake is calculated and then tweaked based on your desired rate of loss/gain,
  • fat is generally set at 25%, and
  • the remainder of your energy requirement is filled with carbs.[5]

IIFYM… the good

There are some good things about IIFYM / flexible including:

  1. It’s simple.
  2. It avoids macronutrient extremes which often drive micronutrient deficiencies.[6]
  3. A consistent energy deficit will work for most people, particularly the young fitness enthusiast who does not have diabetes.

IIFYM… the bad

However, there are a number of downsides to the IIFYM / Flexible Dieting approach, such as:

  1. No consideration of micronutrients.  Food quality becomes critical when restricting quantity over the long term to avoid deficiencies and cravings.[7]
  2. Little emphasis is placed on food quality.  While they might fit your macros, low nutrient density foods can be hyper-palatable and lead to overeating.  Foods with a higher nutrient density are more likely to be satiating, have a lower energy density and be harder to overeat.   Someone can get all their food from processed packaged foods and still comply with the IIFYM approach.
  3. Doesn’t cater well to people who are insulin resistant/diabetic.
  4. Recent research does not support the minimisation of dietary fat.  While too much refined fat is not optimal, the fat that comes with nutritious whole food should not be a concern for most people.
  5. Tracking specific macros and calories replaces a neurosis about micromanaging food quality with an obsession with hitting particular macro targets.
  6. It may be hard to hit exact macronutrient targets with whole foods.

The minimum effective dose of macros

In reality, there is a range of macronutrient that will give you a substantial level of essential micronutrients.

The article Nutrition… How to Get the Minimum Effective Dose outlined the macronutrient ranges that give us the best chance of getting a reasonable micronutrient profile.

The vertical axis in the charts below shows the Nutrient Density Score which is a measure of the amount of micronutrients in a range of foods.

As shown in the example below, if we could get three times the recommended daily intake of all the thirty-four essential nutrients, we would get a perfect nutrient score of 100%.   There is probably limited benefit in getting more than three times the recommended daily intake of a particular nutrient.  At that point, you’ll likely benefit by focusing on foods that contain the nutrients you are not getting as much of.

I have calculated the nutrient density score for a range of dietary approaches to understand the relationship between micronutrient adequacy and macronutrients.  Check out the detail in this post if you’re interested.

Protein

Of all the nutrients, protein has the highest correlation with nutrient density.

If we assume a nutrient density score of 70% as our minimum effective dose of nutrition (as denoted by the red line on the chart below), we can get a reasonable nutritional outcome when our protein intake is at least 19% of our energy intake.

Nutrient density seems to peak when we get around 45% of our energy from protein.  .

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If you have ever tried to more protein and track your intake, you will appreciate how hard it actually is to hit 45% of your energy intake from protein!   As you increase protein intake to more than 45% of calories, you would need to depend more and more on processed foods, so the overall nutrient density decreases.

The minimum effective dose level of 19% of energy happens to align reasonably well with 1.8g/kg LBM protein which aligns IIFYM recommendation for protein.  This is also aligns with the point at which strength gains start to plateau for strength athletes as shown in the chart from Lemon below.

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Protein even more important when we are trying to lose weight.  Recent research suggests that our need for protein increases if we want to prevent loss of lean muscle mass in a significant energy deficit.

If we are active and/or doing resistance training, then our requirement for protein is even higher.  As shown in the chart below from a recent review paper by Stuart Phillips,[8] lean muscle mass is best preserved when we have at least 2.6g/kg total body weight (BW) protein if we are targeting an aggressive deficit (e.g. 35%).  If we are chasing a less aggressive energy deficit, then 1.5 g/kg BW protein seems to be adequate.image38.png

So, unless you require a therapeutic ketogenic diet (i.e. as an adjunct treatment for cancer, epilepsy, Alzheimer’s, Parkinson’s, etc.), it appears prudent to think of 1.8g/kg LBM as a minimum protein intake.  Higher intakes will likely be beneficial if your goal is to maximise nutrient density or lose fat without losing muscle.

As an aside, you needn’t worry about ‘too much protein kicking you out of ketosis’   The images below are from my recent Ketogains Bootcamp where I was eating plenty of protein, had low blood glucose levels and plenty of endogenous blood and breath ketones from my own body fat. 

As detailed in the Optimal ketone and blood sugar levels for ketosis article, if you are trying to lose weight or manage diabetes you really want to drive a low energy state in your bloodstream  If you are burning body fat and/or are decreasing your blood sugar levels then ketones will come along for the ride.  You don’t need to active chase them or track them.

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The chart below shows the nutrient profile we get when we minimise protein.

There is a concerning trend of people trying to minimise protein to minimise insulin and mTOR.  While these things are not good in excess, neither is missing out on essential nutrients of having consumed excessive amounts of energy to get the nutrients you need.

Given that not consuming an excessive amount of energy is the only thing that has been proved to extend lifespan in human it makes a lot more sense to me to increase your nutrient : energy ratio so you don’t have to eat as much to get the nutrients you need.

Carbohydrates

While the optimum intake of non-fibre carbohydrate is about 30%, it seems that the minimum effective dose of non-fibre carbohydrates is effectively zero.

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Although we can get lots of vitamins and minerals from non-starchy veggies, people who do not feel the need to consume plants in their diet can get a substantial amount of nutrition from organ meats, shellfish and the like with minimal carbs.

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The chart below shows the nutrient profile you could acheive if you focused on the most nutrient dense animal based foods.

If you are metabolically healthy, there’s nothing wrong with consuming up to 65% carbohydrates, particularly if they are from unprocessed sources.  However, nutrient density starts to fall off beyond 65% as processed grains and sugars begin to dominate your diet.

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The chart below shows the nutrient profile that you could achieve if you focused on the most nutrient dense plant-based foods.

Regardless of your dietary preferences, ethical position or religious beliefs, quantifying nutrient density is an exciting tool to help you optimise your food choices and find optimal nutrition within the wide range of reasonable carbohydrate intake levels.

Fat

Although fat doesn’t correlate well with nutrient density,[9] it seems we struggle to get a good nutritional profile with less than about 10% dietary fat (or about 0.4g/kg LBM dietary fat).

At the other extreme, we could consume up to around 65% of our energy from fat without having a detrimental impact on our nutritional profile.    Similar to carbohydrates, it starts to get harder to get a broad range of essential micronutrients if we are getting more than 65% of our energy intake from fat.

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The proportion of insulinogenic calories

The percentage of insulinogenic calories is a measure of the insulin we require to metabolise our food due to non-fibre carbohydrates and protein it contains.[10] [11] For someone who is metabolically healthy, insulin load does not need to be a major concern.

Optimal nutrient density seems to occur around 40% insulinogenic calories.   Diets with more than 65% insulinogenic calories tend to be very low fat, very low in protein or very high in processed carbohydrates.   Similarly, our nutritional profile with a very high fat very low insulin load diet is not so flash either.

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I have drawn three windows on the chart of % insulinogenic vs nutrient density score to show suggested target ranges for:

  1. someone who is insulin resistant has prediabetes or knows they have a family history of diabetes,
  2. someone with diabetes who needs to follow a low carb or nutritional ketogenic approach to manage their blood sugar, and
  3. therapeutic ketosis.

If you are insulin resistant or have a family history of diabetes, then keeping your insulin load below 50% is likely a good idea.

If you already have diabetes, then lowering your insulin load to less than 25% of your energy requirement will help stabilise blood sugar and insulin levels.  You also need to keep an eye on nutrient density so you can build health with the food you are eating.  The chart below shows the nutrient profile you can acheive with a nutrient dense low carb approach.  

Meanwhile, someone who requires therapeutic ketosis (for the treatment of cancer, epilepsy, Alzheimer’s, Parkinson’s etc.) typically requires an insulin load less than 15% of their energy requirement to see therapeutic benefits.  The chart below shows the nutrient profile that you can achieve with a high-fat ketogenic diet if you focus on maximising nutrient density.

However, keep in mind that driving your insulin load unnecessarily low can lead to a poor nutritional outcome.   The chart below shows the nutrinet profile of the most ketogenic foods without consdieration of nutrient density.

Personally, I think you need to find the balance between insulin load and nutrient density that works for you.  Ideally, a therapeutic ketogenic approach would only a short-term undertaking until the condition stabilises and you can transition to a nutrient dense low carb approach for maintenance.

Minimum effective dose + nutrient density for the win!

The table below shows the guidelines for the minimum effective dose of protein, fat and insulin load for different goals in terms of your lean body mass (LBM).

  • In all but the therapeutic ketosis scenario, we should aim to hit our 1.8g/kg LBM of protein.
  • We may need a lower protein intake to achieve therapeutic levels of ketosis.
  • In the therapeutic ketosis, diabetes and insulin resistant scenarios we limit insulin load to 1.1, 1.8 and 2.9g/kg LBM respectively to enable the pancreas to keep up and maintain healthy blood sugar levels. This will mean you need to reduce carbohydrates, and to a lesser extent protein.
approach min protein

(g/kg LBM)

min fat

(g/kg LBM)

max insulin load

(g/kg LBM)

therapeutic ketosis 0.8 0.4 1.1
diabetes / nutritional ketosis 1.8 0.4 1.8
weight loss (insulin resistant) 1.8 0.4 2.9
weight loss (insulin sensitive) 1.8 0.4
most nutrient dense 1.8 0.4
nutrient dense maintenance 1.8 0.4
bodybuilder (bulking) 1.8 0.4
endurance athlete 1.8 0.4

Once we have the protein, fat and insulin load ranges set, we are free, unencumbered by concerns about meeting theoretical macronutrient targets, to fill the rest of our diet with foods and meals that are most suited to our goals.

These macronutrient windows function a bit like bumper rails for a child at a bowling alley.  As long as you stick within those ranges, you have a good chance of getting a reasonable nutritional outcome.

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Once you learn to focus on nutrient dense foods, you will no longer need the bumper rails.

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The table below shows how the parameters of insulin load, energy density and nutrient density are used to optimise our food choices to suit our goals.  In some cases (i.e. weight gain or loss) we may intentionally focus on managing energy intake.  For most people, focusing on more nutrient-dense foods will get you most of the way.

approach insulin load energy density nutrient density target calories
therapeutic ketogenic very low lower
diabetes / nutritional ketosis low lower adequate
weight loss (insulin resistant) low low good lower
weight loss (insulin sensitive) lowest maximum very low
most nutrient dense maximum
nutrient dense maintenance high high
bodybuilder (bulking) high good higher
endurance athlete very high high

How to set your target energy intake

If you are trying to lose weight and going to the effort of tracking, it is useful to have an upper limit energy intake that you make sure you don’t exceed.

While there are many inaccuracies involved in our energy in and energy out calculations, tracking your food in an app like Cronometer can be a useful self-education tool to understand the quantity and quality of your diet.

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Most macro calculators calculate your Basal Metabolic Rate (BMR) based on your lean body mass (LBM) and activity levels.  From this, you can estimate the amount of energy you might need to gain weight or the amount you will need to limit to lose weight.

These formulas, while a useful starting point, are only indicative, and should be used as a starting point.  I’ve run the Nutrient Optimiser analysis for plenty of people who are lean but eating a lot more calories than you might expect.  Conversely, many people who are obese seem to be eating much less than you might think they would be.  This may be in part due to measurement error or optimism bias, but everybody’s metabolism seems to be unique due to a wide range of factors.

The best way to determine your actual energy requirement is to track your intake and reduce or increase from there to ensure you are gaining or losing as required.  This is an iterative process based on your long-term trend.

Maximum rate of fat loss

The maximum rate of fat loss you can sustain without significant muscle loss is influenced by your current body fat levels.  Someone with a lot more body fat might be able to maintain a larger energy deficit than someone who is already lean.

The paper A limit on the energy transfer rate from the human fat store in hypophagia (Alpert, 2005) proposed that this maximum rate of fat loss is 31 calories per pound of body fat.[12]  According to Alex Ritson, in a recent Sigma Nutrition podcasts, this was later revised down to a maximum rate of fat loss of 21 calories per pound of body fat without losing significant muscle mass.[13]

While you may not want to target this maximum rate deficit every day, it is useful to be aware of this number.  If you don’t feel hungry, there is no need to keep eating to hit some arbitrary energy intake above this.

The table below shows an example of what this might look like in practice.

  obese lean
weight (kg) 110 70
weight (lb) 242 154
LBM (lbs) 157 135
% BF 35% 12%
BF (lbs) 85 18
BMR 2106 1871
max deficit (cals) 1,785 378
max deficit (%) 85% 20%

The obese person can nearly meet their entire maintenance energy intake from body fat while the lean person could only mobilise enough body fat to provide about a fifth their energy requirements.

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While out might have enough body fat to survive an extended famine, I wouldn’t recommend fasting for extended periods without paying attention to periods of nutrient-dense refeeding.

Research into the Protein Sparing Modified Fast suggests that nitrogen balance is maintained with a minimum of 1.4g/kg of ideal body weight for men and 1.2g/kg of ideal body weight for women.[14] [15]

Once we account for body fat, 1.4 g/kg IBW ends up pretty close to the 1.8g/kg LBM minimum effective dose level discussed above).

So it seems reasonable to use 1.8g/kg LBM protein plus 0.4g/kg LBM fat as an absolute minimum energy intake to make sure you can get the nutrients you need.

Should I keep eating until I hit my calorie target if I’m not hungry?

Many people find their appetite stabilises once they take out refined carbohydrates from their diet and stabilise their blood sugar levels.  Others find that focusing on nutrient-dense foods decrease their appetite and lead to spontaneous satiety.[16]  Meanwhile, others just find it tough to keep within their calorie limits.[17]  The bottom line here is, if you have obtained your minimum protein intake to preserve your lean muscle mass, there is no real need to keep eating if you don’t feel hungry.

Rather than some specific target, I think it is much more useful to think in terms of a range of energy intake that will enable you to reach your goals.  If you’re hungry there is no harm eating up to your upper limit calorie intake.  However, if you are trying to lose weight, then there is no point eating more than you need to to get the nutrients you need.

The daily thought process for someone following this process would be…

  1. Have I met my minimum calorie target?  If not, keep eating nutrient-dense foods.
  2. Have I met my minimum protein intake?  If not, keep eating nutrient-dense foods.
  3. Do I feel hungry?  If no, don’t eat.  If yes, eat nutrient dense foods that align with your goals until you hit your absolute minimum energy target.
  4. Do you still feel hungry?  If yes, then eat nutrient dense foods until you hit your maximum calorie intake.
  5. Have I exceeded my maximum energy intake?  If yes, then stop eating.

Summary

So in summary:

  • Focusing on specific macronutrient targets takes the focus off food quality and micronutrients and can be counterproductive.
  • There is a range of macronutrients within which you can get a reasonable nutritional outcome that aligns with your goals. Within these limits, your focus should be on getting all the micronutrients you need.
  • If you are are insulin resistant or have diabetes then it’s prudent to focus on less insulinogenic foods.  However, there is no point driving your insulin load to the point that you compromise nutrient density unnecessarily.

How to calculate your target macronutrient range

I know all these numbers can be confusing!

To help make this process easier we have developed a free report at NutrientOptimiser.com.

Simply enter your goals, preferences, weight and estimated body fat % and the Nutrient Optimiser will spit out a free report with your recommended macronutrient ranges as well as a shortlist of suggested foods and meals that will help you optimise your nutrition that will align with your goals.

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To get your free report you go to NutrientOptimiser.com, tell us what you’re interested in and enter your email address.

As your situation changes (e.g. you lose weight or your blood sugars stabilise) you will be able to come back and update your details and get new macro targets as well as optimal meals and foods.

We think this is unique and exciting.  We hope it will help a lot of people cut through the dietary confusion.  We would love you to test it and give us some feedback.

 

I have included some worked examples of that the macronutrient ranges would look like in practice in the appendix below.  But the best way to understand how it works is just to go have a play and see what the Nutrient Optimiser would recommend for you!

 

Example macronutrient ranges

So let’s look at how this will look in practice with some worked examples.

Let’s take the example of Paul, who currently weighs 90 kg and has 19% body fat.  He’s done the Nutrient Optimiser analysis but wants to know what targets to put in Cronometer.

We will look at how he could use this approach to setting macronutrient ranges in the following scenarios:

  1. therapeutic ketosis,
  2. low carb / nutritional ketosis,
  3. insulin resistant weight loss, and
  4. weight gain / athletic performance.

Therapeutic ketosis

Paul is interested in the ketogenic diet and recommends it to many of his clients.

The table below shows the range of protein, fat, carbohydrates (in grams) if Paul was aiming for therapeutic ketosis along with the basis for the upper and lower limits.

  lower upper comment
protein (g) 58 80 Minimum protein based on 0.8g/kg LBM.

The upper limit is based on 15% insulinogenic calories assuming no carbs.

fat (g) 180 212 Minimum based on weight maintenance with minimum protein and carbs.

Maximum based on weight maintenance with minimum protein and carbs.

carbs (g) 0 48 The upper limit corresponds to minimum protein and 15% insulinogenic calories.
energy (calories) Calories are not limited on a therapeutic ketogenic diet.  Many people using chasing therapeutic ketosis are looking to keep weight on, so very high levels of dietary fat intake is not a concern.

The chart below shows the resultant macronutrient ranges for the therapeutic ketogenic dietary approach in terms of percentage of energy intake.    As you can see, regardless of the scenario, Paul’s energy would largely come from fat.

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The foods listed below would give Paul the best chance of achieving therapeutic levels of ketosis while maximising high micronutrients as much as possible.

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The chart below shows the nutrient profile of the foods listed above.  The nutrients coloured yellow typically harder to obtain on a therapeutic ketogenic diet and have been emphasised in the foods listed above.

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If you’re following a therapeutic ketogenic diet as an adjunct therapy for cancer, epilepsy, Alzheimer’s or dementia, then you’ll likely also be tracking glucose and ketone levels.

If you are following a disciplined high fat ketogenic diet, you should expect to see lower blood sugars and higher ketone levels.

If you want to get serious, you can track your Glucose Ketone Index (GKI) which was developed by ketogenic cancer researcher Dr Thomas Seyfried.[18]  Through fasting, higher fat and a lower insulin load many people who require therapeutic ketosis aim for a GKI value of less than 1.0 which means your ketone values are higher than your glucose levels.  If you are just looking to manage diabetes then having a GKI less than 10 is a healthy place to be on a day to day basis when not fasting.

Therapeutic ketosis takes a lot of dedication and discipline.  Many people find that their condition resolves after a period and they can transition to a low carb / nutritional ketosis approach without triggering adverse symptoms.

Diabetes / low carb / nutritional ketosis

A diet for management of diabetes is not as restrictive as a therapeutic ketogenic diet and provides a higher level of nutrition.  The table below shows the low carb style macronutrient range that would keep Paul in nutritional ketosis.

  lower upper comment
protein (g) 131 239 Minimum protein is based 1.8g/kg LBM.

Upper limit based on maximum insulin load of 1.8g/kg LBM with zero carbs.

fat (g) 131 178 Lower limit is based on weight maintenance with maximum protein and carbs.

The upper limit is based on weight maintenance with minimum protein and minimum carbs.

carbs (g) 0 60 The upper limit corresponds to minimum protein (1.8g/kg LBM) and a maximum 1.8g/kg LBM insulin load.
energy (cals) Calories are not necessarily controlled on a low carbohydrate diet.  The initial focus should be on stabilising blood sugars and appetite.  From there we can force an energy deficit if necessary.

The figure below shows the range of macronutrients that will fit within the guidelines of a low carbohydrate diet to stabilise blood sugar or achieve nutritional ketosis.

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This food list will enable you to maximise your micronutrients on a low carbohydrate diet.

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Compared to a therapeutic ketogenic diet, the low carbohydrate diet provides a significantly high level of nutrient density.  The nutrients shown in yellow that are harder to find on a low carbohydrate dietary approach that have been emphasised.

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If you are following a low carbohydrate dietary approach, you will likely be tracking your blood sugars on a regular basis.  Once you are able to stabilise your blood sugars to non-diabetic levels using a low carb diet, we can then start to focus on reducing energy to lose weight (i.e. if your waist : height ratio is greater than 0.5 or you have a higher than desirable level of body fat).  From there you can start to focus on an energy deficit if you do not find you are achieving your desired level of weight loss with a low carb diet alone.

average blood sugar  

hbA1c (%)

 

trig:HDL ratio

mg/dL mmol/L
diabetes > 140 > 7.8 > 6.5% > 3.0
pre-diabetes 108 – 140 6.0 – 7.8 5.4 – 6.5% 2.0 – 3.0
insulin resistant 100 – 108 5.4 – 6.0 5.0 – 5.4% 1.0 – 2.0
insulin sensitive < 97 < 5.4 < 5.0% < 1.0

Many people find that they actually need to drop their body fat levels further before they are able to achieve truly optimal blood glucose levels.

Aggressive weight loss

Paul actually wants to lose weight fairly aggressively, but without compromising his hard-earned lean muscle mass.

If we take 21 calories per pound of fat as the maximum rate of fat loss without significant loss of muscle, then Paul could theoretically cut up to 790 calories from his typical energy intake without significantly compromising his lean muscle mass.  This deficit would leave him with 1349 calories.  He will still be able to get his minimum protein and fat intake levels at this energy level.

Paul is eager to lose fat fast, so he wants to target an aggressive deficit of at least 20%.  However, if he’s not hungry, there’s no real point in consuming beyond 1349 calories per day (i.e. a 37% deficit).  Paul is also still mindful of his blood sugars and insulin resistance, so we will also ensure his insulin load remains under 2.9 g/kg LBM.

  lower upper comment
protein (g) 131 214 Minimum protein is based on 1.8g/kg LBM which is fine if he is only targeting a 20% deficit.

The upper limit is based on 2.9g/kg LBM insulin load.

fat (g) 29 132 Maximum fat is based on 20% energy deficit with min protein and carbs.
carbs (g) 0 231 Maximum carbs is based on target energy deficit with minimum protein and fat.
energy (cals) 1349 1711 Lower energy intake is based on BMR -21 cal/lb fat mass.  The maximum is based on 20% deficit against BMR.

The screenshot below from Paul’s Cronometer showing how he can enter his target protein range.  Simply click on the bar for energy, protein, carbs and fat to enter the target range.

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The figure below shows the macro split including the energy from body fat (shown in yellow).

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This figure shows the food proportion of protein, fat and carbs when we only look at the food intake.  When we consider the food intake alone, between 30 and 55% of energy is intake will be from.

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The foods below will maximise nutrition to align with this aggressive fat loss approach.

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The chart below shows the high level of nutrients provided by the foods listed above.  These foods also have a very low energy density meaning that they will be hard to overeat.

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If your goal is aggressive fat loss, then you will likely be tracking your energy intake and body weight and fat on a regular basis to make sure you are achieving your desired results.

There is little value in regularly tracking blood sugars or ketones with this style of approach as they will likely be excellent if you are maintaining a significant energy deficit.

Paul’s focus with should be on making sure he gets adequate protein and nutrient dense foods while keeping under his energy target.

As an aside, Paul is doing well and sitting at #2 on the Nutrient Optimiser Leaderboard.  You can see Paul’s detailed Nutrient Optimiser report here.

Maximum fat loss

The table below shows the macronutrient ranges if Paul was to target maximum energy restriction while minimising the risk of muscle loss.  This is based on the maximum energy deficit of 21 calories per pound of body fat.

  lower upper comment
protein (g) 234 241 Minimum protein is based on 2.6g/kg BW in view of the aggressive deficit.

The upper limit is based on maximum 2.9g/kg LBM insulin load.

fat (g) 29 150 Max fat is based on 37% energy deficit with min protein and carbs.
carbs (g) 0 108 Max carbs is based on target energy deficit with minimum protein and fat.

We also want to limit Paul’s insulin load to less than 40% of his maintenance energy intake

energy (als) 1348

 

A maximum deficit of 21 calories per pound of body fat (i.e. 37% deficit)

Even though the protein levels are very high and he has some history of insulin resistance, I do not think Paul is likely to see elevated blood sugar levels with such a massive deficit.

Some protein may be converted to glucose via GNG, however, there will already be such a dramatic energy deficit that he would likely be seeing very low blood sugar levels.

The chart below shows the macronutrient split, including body fat.

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This chart shows the macronutrient split of this approach when we consider the food only.  These foods contain between 56 and 72% protein which starts to make this style of approach difficult without significant reliance on protein powders.  Achieving a strict Protein Sparing Modified Fast is actually quite difficult in practice because attaining such a high level of protein intake with such an aggressive deficit is quite hard.

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The foods below will give you the best chance of minimising energy intake while getting adequate protein and nutrients.

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The chart below shows the nutrient profile of these foods with the harder to find nutrients emphasised.

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Weight gain

If Paul was wanting to gain weight, he could target a 20% energy surplus and choose nutrient dense and energy dense foods so he could achieve this.

  lower upper comment
protein (g) 131 289 Minimum protein is based on 1.8g/kg LBM.

The upper limit is based on 50% of energy from protein.

fat (g) 29 185 Maximum fat is based on 20% energy surplus with minimum protein and carbs.
carbs (g) 0 348 Maximum carbohydrates is based on target energy surplus with min protein and fat.
energy (als) 2567 The maximum is based on a 20% energy surplus against BMR.

The list of nutrient dense and energy dense foods below would help Paul to maximise nutrient density in an energy surplus.

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The chart below shows the nutrients provided by these energy-dense foods.

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You should make a calculator for that!

To get your optimal macronutrient ranges please check out the new calculator at NutrientOptimiser.com.

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We hope you love it!  Let us know how we can make it more useful to help you achieve your goals.

 

 

references

[1] https://www.iifym.com/

[2] https://www.bodybuilding.com/fun/your-complete-guide-to-iifym

[3] https://www.avatarnutrition.com/

[4] Incidentally, paleo has been in decline since January 2014 while IIFYM peaked in mid 2016.  Currently keto and vegan are the hot new diet trends.

[5] https://healthyeater.com/flexible-dieting-calculator

[6] https://optimisingnutrition.com/2017/03/19/micronutrients-at-macronutrient-extremes/

[7] https://optimisingnutrition.com/2017/06/17/psmf/

[8] https://www.ncbi.nlm.nih.gov/pubmed/29182451/

[9] https://optimisingnutrition.com/2017/10/30/nutrition-how-to-get-the-minimum-effective-dose/

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

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

[12] https://www.ncbi.nlm.nih.gov/pubmed/15615615

[13] https://sigmanutrition.com/episode207/

[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1646394/

[15] http://www.ketotic.org/2014/01/how-much-protein-is-enough.html

[16] https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-9-51

[17] https://ketogains.com/tag/tyler-cartwright/

[18] https://www.researchgate.net/publication/274011072_The_glucose_ketone_index_calculator_A_simple_tool_to_monitor_therapeutic_efficacy_for_metabolic_management_of_brain_cancer

optimal protein sparing modified fast foods & meals (PSMF)

The Protein Sparing Modified Fast (PSMF) is regarded by many to be the most effective way to lose body fat while preventing loss of lean muscle and 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 details vary depending on context, a PSMF generally defined as an energy-restricted diet with adequate protein while simultaneously limiting carbohydrates and fat.

Technically, the PSMF will be ketogenic because a significant amount of body fat will be burned due to a restricted energy intake.

Adequate protein is provided to prevent loss of lean muscle mass.  Supplements are often used to prevent nutrient deficiencies.

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

Optimal nutrient-dense foods are identified for someone looking for an aggressive weight cut (e.g. a bodybuilder leading up to a competition) as well as a hybrid low carb – PSMF approach for someone who is insulin resistant wanting to lose a significant amount of weight over a longer period.

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Medical applications of the PSMF

In the medical application 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.  (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 from lean protein sources is minimised.
  • Patients in the weight loss clinic setting are restricted to less than 800 kcal/day.

The Cleveland Clinic has done extensive research into the use of adequate protein low-calorie diets for aggressive weight loss with the following encouraging findings:[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] [9]

Bodybuilding applications

Lyle McDonald reinvented the PSMF in bodybuilding  community 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.
  • Someone who isn’t yet lean may do better with a less aggressive approach over a longer period.
  • McDonald’s recommended protein intake ranges from 2.2g/kg LBM to 4.4g/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 good multivitamin, sodium potassium, magnesium, taurine, calcium and fish oil.
  • A PSMF is typically not a long-term proposition due to nutrient deficiencies.

KetoGains’ Luis Villasenor added:

McDonald’s recommendations seem “massive” to most people due to the book being geared toward strength athletes who DO require more protein as they are effectively breaking it down when strength training. 

Bodybuilders who diet down to 4 – 5% bodyfat need an increased protein intake when preparing for a contest as their aim is to maintain as much as lean mass as possible; and for that, one needs protein and resistance exercise. 

With my clients, to avoid nutrient deficiencies, we use a “Ketogains PSMF” which adds 3-4 whole eggs a day, at least 150g spinach, plus other green veggies, and some avocado. The rest is lean sources of protein and more veggies, plus electrolytes.  This effectively puts the person in between 35 to 50g fats and 20g net carbs.  The rest of their energy comes from lean protein.

Protein drives satiety

The body actively 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, the Protein Leverage Hypothesis (Simpson, 2005) suggests that we continue to eat food until we get enough protein for critical bodily functions.[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 lower protein foods, 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.

  • Minimum carbohydrate requirement: While there is a need for the vitamins and minerals that are often packaged with carbohydrate containing foods (i.e. vegetables), there is indeed no such thing as an essential carbohydrate.
  • 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.

So, theoretically, if we get adequate protein as well as vitamins, minerals, the essential fatty acids can go a long way to providing everything that we need for long-term survival with less energy 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 we can convert protein to glucose (i.e. gluconeogenesis), it is really hard, 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.

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.

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%
orange roughy (fish) 92%
crab 91%
lobster 91%
egg white 91%
mozzarella cheese (non-fat) 90%
pollock 90%
protein powder (whey) 89%
turkey breast (fat-free) 88%
halibut 86%
crayfish 86%
whiting 86%
rockfish 86%
molluscs 86%
veal 84%
perch 81%
shrimp 81%
trout 81%
chicken breast 79%
lean beef 79%
whey protein concentrate (WPC) 78%
octopus 77%
ground beef 76%
pork chop 75%
flounder 74%
beef tripe 74%
pork shoulder 74%
scallop 74%
leg ham 74%
sirloin steak 73%
ham (lean only) 73%
beef heart 73%
turkey (skinless) 72%
clam 72%
turkey gizzard 72%
top round steak (fat trimmed) 72%
lamb kidney 71%
beef heart 70%
beef kidney 70%

I have summarised these in this image for easy reference.

The problem with a very high protein diet

But wait!

While you may be getting plenty of essential amino acids if you focus purely on high protein foods, there is a good chance that 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 just 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 the 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 important when we consciously try to limit our energy intake.

Attaining adequate micronutrients can help to mitigate metabolic/mitochondrial slow down 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 excess fat stores without reacting like there is a famine and holding onto our excess fat stores.

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.

I get some comments in response to the Nutrient Optimiser analysis suggesting that the Daily Recommended Intakes (DRI) for various micronutrients are excessive because an individual person has done fine on a diet per for a period of time with a less than optimal nutrient profile.

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.

I don’t think we need to worry about precisely meeting the daily recommended intake for every single micronutrient every single day.  There is no diet that meets the daily recommended intake for every nutrient without overdoing others.  I think 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 under the DRI for a handful of nutrients, perhaps 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 DRI for a particular group of nutrients you don’t need to prioritise foods that contain those nutrients.

Bruce Ames’ sobering 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 solid 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.

Low energy density

Another way to maximise nutrient density and prioritise protein at the same time is to reduce the energy density of the food we eat.

As shown in the chart below there is a relationship between the harder to find nutrients and energy density.[24]  While fat is a great fuel source and should not be feared or avoided, refined high-fat foods do not typically contain high levels of the harder to find vitamins and minerals that we need to thrive.  Foods with more fibre and water are also more filling and are more difficult to overeat and will lead to increased short term satiety.

If we prioritise adequate protein while minimising fat and carbohydrates we make up the deficit from our own body fat stores. Hence there is no need to prioritise dietary fat.

The nutrient dense adequate protein diet

So, to recap:

  1. getting adequate protein is important, especially if we are fasting or restricting energy intake, and
  2. not getting adequate 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.   Listed below are the 20 nutrients that have been prioritised in the following list of prioritised foods.

  1. Alpha-linolenic acid
  2. EPA + DHA
  3. Vitamin E
  4. Vitamin D
  5. Choline
  6. Calcium
  7. Magnesium
  8. Potassium
  9. Thiamine
  10. Phosphorus
  11. Pantothenic acid
  12. Manganese
  13. Folate
  14. Zinc
  15. Niacin
  16. Riboflavin
  17. Valine
  18. Selenium
  19. Leucine
  20. Tyrosine

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 (hence valine, leucine and tyrosine have been included).  As well as nutrient density, we have also prioritised low energy density foods in the multicriteria analysis.

The chart below shows the resultant micro nutrient profile achieved if we ate 2000 calories per day of these foods.  In the chart above we saw that if we just focus on protein, we will not be meeting the DRI for eleven nutrients.  However, 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.   The nutrients provided by an energy restricted diet without also prioritising nutrient density would be much worse.

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.

Best foods for a PSMF

The tables below summarise highest ranking 10% of foods in the USDA database when we prioritise for high nutrient density and low energy density.

Also included in the tables are:

  • the nutrient density score (based on the 20 nutrients listed above),
  • energy density, and
  • the MCA which is the overall ranking from the multi criteria analysis.

Compared to the highest protein food listed above which are 80% protein, these foods work out to be 59% protein, 20% fat, 13% net carbs and 8% fibre.  While this may seem high, as we will see in the ‘calorie math’ section below, it becomes more reasonable once we account for the energy from body fat.

Vegetables

It would be hard to imagine getting fat by overeating the vegetables listed below.

Maximising your intake of these vegetables will ensure you are getting adequate vitamins and minerals and hence maximise your chance of long-term success.

While these vegetables have a very high nutrient density score (ND) in terms of nutrients per calorie, they also have a low energy density which means you need to eat a lot of them to get the nutrients you need.

The downside of vegetables is that they can be expensive and take time to prepare fresh.

food % protein ND calories/100g MCA
watercress 60%  25  11  3.1
spinach 41%  23  23  2.9
seaweed (laver) 50%  22  35  2.7
asparagus 34%  21  22  2.7
basil 44%  20  23  2.5
endive 25%  19  17  2.5
white mushroom 43%  19  22  2.4
brown mushrooms 36%  18  22  2.4
portabella mushrooms 36%  18  29  2.4
Chinese cabbage 42%  17  12  2.3
lettuce 30%  16  15  2.2
coriander 31%  16  23  2.1
chicory greens 24%  16  23  2.1
alfalfa 52%  16  23  2.1
spirulina 64%  16  26  2.1
chard 30%  15  19  2.1
zucchini 24%  15  17  2.1
seaweed (wakame) 22%  15  45  2.0
parsley 27%  15  36  2.0
escarole 25%  15  19  2.0
okra 27%  15  22  2.0
beet greens 32%  14  22  2.0
shiitake mushroom 29%  15  39  2.0
turnip greens 36%  14  29  1.9
chives 35%  14  30  1.9
broccoli 23%  14  35  1.8
mung beans 35%  13  19  1.8
arugula 33%  12  25  1.7
dill 27%  12  43  1.7
cauliflower 26%  12  25  1.7
celery 16%  11  18  1.6
summer squash 18%  10  19  1.5
seaweed (kelp) 13%  11  43  1.5
yeast extract spread 52%  12  185  1.5
radicchio 22%  9  23  1.4
pickles 14%  9  12  1.4
cucumber 14%  9  12  1.4
mustard greens 34%  9  27  1.4
peas 26%  9  42  1.4
snap beans 18%  9  15  1.4
collards 27%  9  33  1.3
cabbage 18%  8  23  1.3
soybeans (sprouted) 34%  8  81  1.2
onions 19%  7  32  1.2
pumpkin 12%  7  20  1.2
kale 23%  7  28  1.2
radishes 16%  7  16  1.2
banana pepper 21%  7  27  1.2
bamboo shoots 43%  7  11  1.2
Brussel sprouts 28%  7  42  1.1
edamame 37%  8  121  1.1
artichokes 23%  6  47  1.1
sauerkraut 17%  5  19  1.0
red peppers 13%  6  31  1.0
eggplant 13%  5  25  1.0
chayote 9%  5  24  1.0

Animal products

These animal products are both nutrient dense and have a low energy density compared to fattier cuts of meat.  While the nutrient density scores are not as high as for the vegetables, the energy density is higher so you will be able to get more nutrients in using these foods.

food % protein ND calories/100g MCA
lamb kidney 71%  19  112  2.2
chicken liver 62%  19  172  2.2
beef liver 63%  18  175  2.1
veal liver 61%  18  192  2.0
lamb liver 61%  17  168  2.0
turkey liver 59%  17  189  2.0
ham (lean only) 73%  16  113  1.9
pork liver 66%  16  165  1.9
beef kidney 70%  15  157  1.7
chicken breast 79%  13  148  1.6
pork chop 75%  13  172  1.5
veal 84%  12  151  1.5
pork shoulder 74%  12  162  1.4
lean beef 79%  11  149  1.4
leg ham 74%  11  165  1.4
ground pork 69%  11  185  1.4
turkey heart 60%  11  174  1.3
lamb heart 65%  11  161  1.3
beef tripe 74%  9  103  1.3
ground beef 76%  10  144  1.2
sirloin steak 73%  10  177  1.2
beef heart 70%  10  179  1.2
turkey meat 66%  10  158  1.2
turkey drumstick 66%  10  158  1.2
bison 69%  9  171  1.1
chicken liver pate 27%  9  201  1.1
turkey gizzard 72%  8  155  1.1
lamb sweetbread 59%  8  144  1.0
chicken drumstick 62%  8  149  1.0
veal loin 63%  8  175  1.0
roast pork 53%  8  199  1.0

Seafood

Omega 3 fats (EPA, DHA and ALA) are essential and harder to get so you should prioritise fish in your nutrient dense PSMF.

food % protein ND calories/100g MCA
crab 91%  20  83  2.4
fish roe 58%  19  143  2.2
crayfish 86%  18  82  2.2
lobster 91%  18  89  2.2
halibut 86%  17  111  2.1
pollock 90%  16  111  1.9
salmon 68%  16  156  1.9
rockfish 86%  15  109  1.9
flounder 74%  14  86  1.8
oyster 46%  14  102  1.8
shrimp 81%  14  119  1.8
haddock 92%  14  116  1.8
perch 81%  14  96  1.7
cod 92%  16  290  1.7
sturgeon 64%  14  135  1.7
whiting 86%  13  116  1.6
trout 59%  13  168  1.6
octopus 77%  13  164  1.5
white fish 92%  12  108  1.5
anchovy 57%  13  210  1.5
clam 72%  12  142  1.5
tuna 68%  11  184  1.3
scallop 74%  9  111  1.3
caviar 36%  11  264  1.2
orange roughy 92%  8  105  1.2
sardine 49%  10  208  1.2
molluscs 86%  8  130  1.1

Egg and dairy

Eggs are nutritious.  Only a couple of low fat dairy products make the list.  Higher fat foods such as butter and cream need to be minimised on a PSMF to allow your body to use the fat from your butt and your belly.

food % protein ND calories/100g MCA
cream cheese (low fat) 61%  11  105  1.5
whole egg 36%  9  143  1.2
egg white 91%  7  52  1.1
cottage cheese (low fat) 51%  7  81  1.1

These nutrient dense PSMF foods are summarised in this image for easy reference.

Calorie math

To make this a little more practical let’s look at some calorie math using a hypothetical scenario.

Let’s say Super Ted is looking to get shredded for the Ketogains conference in two weeks where he wants to pose for shirtless 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 energy intake 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

These calculations assume that Super Ted’s insulin levels are going to be low enough to allow him to yield a significant amount of energy from his body fat stores.   Similar to fasting, it may take a few days before glycogen stores to be depleted enough for his insulin levels to drop which will allow his fat stores to more easily flow out of storage.  

These calculations also do not account for the metabolic slowdown that you will get during long term energy restriction.  This is the same with any way of eating that consciously restricts energy intake.  However, I think if we can minimise nutrient deficiencies we will have a better chance of avoiding an increase in which could drive our body to seek out the missing nutrients that it is not getting enough of.  

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.

As you can see, 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 large 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.

Nutrients to prioritise

Given Big Ted is not looking to be as dramatically calorie restricted we only need to prioritise the following nutrients.

  1. Alpha-linolenic acid
  2. EPA + DHA
  3. Choline
  4. Vitamin D
  5. Vitamin E
  6. Calcium
  7. Magnesium
  8. Potassium
  9. Phosphorus
  10. Zinc

Although amino acids are not prioritised the resultant list of foods is still 36% protein, 30% fat and 20% net carbs.

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.

This is basically a hybrid between a PSMF and a low carb diet.

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.

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 solid amount of net carbs from veggies. However, there is 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 protein per kilogram LBM.

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

Optimal foods for Big Ted are listed below.

Vegetables

food % protein ND calories/100g MCA
endive 25% 11 17 2.5
chicory greens 24% 11 23 2.4
coriander 31% 10 23 2.2
escarole 25% 9 19 2.1
spinach 41% 12 23 2.1
basil 44% 11 23 2.0
alfalfa 52% 7 23 2.0
zucchini 24% 9 17 1.9
chard 30% 11 19 1.9
arugula 33% 10 25 1.9
beet greens 32% 8 22 1.9
mustard greens 34% 8 27 1.8
watercress 60% 12 11 1.7
asparagus 34% 9 22 1.7
parsley 27% 9 36 1.7
Chinese cabbage 42% 9 12 1.6
curry powder 14% 6 325 1.6
collards 27% 7 33 1.6
summer squash 18% 8 19 1.6
lettuce 30% 8 15 1.6
paprika 15% 7 282 1.6
turnip greens 36% 7 29 1.5
broccoli 23% 8 35 1.5
cloves 6% 7 274 1.4
sauerkraut 17% 6 19 1.4
banana pepper 21% 5 27 1.4
okra 27% 7 22 1.4
pickles 14% 5 12 1.4
cucumber 14% 5 12 1.4
chives 35% 7 30 1.3
celery 16% 7 18 1.3
brown mushrooms 36% 10 22 1.3
sage 11% 5 315 1.3
artichokes 23% 6 47 1.3
marjoram 14% 5 271 1.3
thyme 10% 6 276 1.3
cauliflower 26% 6 25 1.3
edamame 37% 5 121 1.2
portabella mushrooms 36% 7 29 1.2
radishes 16% 5 16 1.2
eggplant 13% 4 25 1.2
cabbage 18% 6 23 1.2
blackberries 11% 3 43 1.2
shiitake mushroom 29% 6 39 1.1
radicchio 22% 8 23 1.1
jalapeno peppers 12% 3 27 1.1
caraway seed 19% 4 333 1.1
chayote 9% 4 24 1.1
rhubarb 15% 5 21 1.0
avocado 5% -0 160 1.0
snap beans 18% 6 15 1.0
red peppers 13% 3 31 1.0
olives 3% -1 145 1.0
turnips 26% 5 21 1.0
white mushroom 43% 7 22 1.0
dill 27% 6 43 1.0
poppy seeds 13% 3 525 1.0
kale 23% 5 28 0.9
seaweed (kelp) 13% 8 43 0.9
raspberries 8% 1 52 0.9
seaweed (laver) 50% 8 35 0.9
soybeans (sprouted) 34% 4 81 0.9
seaweed (wakame) 22% 8 45 0.9
Brussel sprouts 28% 4 42 0.9
celery flakes 14% 6 319 0.9
cumin 16% 4 375 0.8
bamboo shoots 43% 3 11 0.8
carrots 6% 3 37 0.8
onions 19% 5 32 0.8
carrots 9% 5 23 0.8
dill seed 15% 3 305 0.7
mustard seed 19% 2 508 0.7

Animal products

food % protein ND calories/100g MCA
beef brains 32% 5 151 1.5
turkey ham 63% 4 124 1.0
lamb brains 36% 2 154 1.0
lamb sweetbread 59% 4 144 0.9
turkey (skinless) 72% 3 170 0.8
turkey liver 59% 4 189 0.8
ground turkey 39% 2 258 0.8
lamb liver 61% 4 168 0.8
turkey drumstick (with skin) 50% 1 221 0.8
turkey bacon 29% 0 226 0.8
headcheese 36% –       0 157 0.8
lamb kidney 71% 4 112 0.8
turkey heart 60% 3 174 0.8
sweetbread 16% –       1 318 0.7

Seafood

food % protein ND calories/100g MCA
fish roe 58% 9 143 1.6
oyster 46% 10 102 1.5
mackerel 25% 4 305 1.4
caviar 36% 6 264 1.4
molluscs 86% 8 130 1.4
crab 91% 10 83 1.3
sardine 49% 6 208 1.2
flounder 74% 7 86 1.2
trout 59% 6 168 1.2
cisco 38% 4 177 1.2
sturgeon 64% 6 135 1.2
crayfish 86% 8 82 1.2
salmon 68% 7 156 1.2
lobster 91% 9 89 1.1
halibut 86% 8 111 1.1
anchovy 57% 5 210 1.0
perch 81% 7 96 1.0
herring 47% 4 217 1.0
rockfish 86% 7 109 1.0
pollock 90% 7 111 1.0
cod 92% 8 290 0.9
shrimp 81% 7 119 0.9
whiting 86% 6 116 0.8
white fish 92% 6 108 0.8
haddock 92% 6 116 0.7

Egg

food % protein ND calories/100g MCA
egg yolk 21% 4 275 1.4
whole egg 36% 4 143 1.3

Nut sand seeds

food % protein ND calories/100g MCA
tofu 43% 3 83 1.0
sunflower seeds 13% 2 546 0.9
pumpkin seeds 20% 3 559 0.8
flax seed 13% 1 534 0.8
almonds 13% 2 607 0.7

This image below summarises these foods for easy reference.

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.

Personally, I don’t think it matters exactly 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.[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.

Either Super Ted or Big Ted could still utilise their required protein intake if they followed an alternate day fasting or 5:2 plan or indeed any other permutation of fasting.  What is important though is that they ensure that they stick to their nutrient dense diet when they break their fast rather than reaching for the more energy dense foods when they eat again.

How low can you go?

Hopefully, this article has given you some actionable principles:

  • During weight loss, you should ensure that you get adequate protein while fat and carbs can be limited to achieve the energy deficit required to suit your target rate of loss.
  • As well as protein intake, we should aim to maximise all micro nutrients (vitamins, minerals, essential fatty acids and amino acids) ideally using whole foods.
  • You will find it hard to obtain adequate vitamins, minerals and essential fatty acids at one extreme or the other of protein intake.

As discussed in the ‘How Much Protein is Too Much’ article I noted that the minimum intake of protein and minimum essential fats tally up to around 314 calories as shown in the table below.

If we could stick to this approach, we would have a massive and highly ketogenic 85% of our energy coming from our body fat.  However, you would be at an increased risk of inadequate vitamins, mineral and fatty acids with such a low energy intake.

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

If you’re starving to death and only have lean protein available you might call it “rabbit starvation”.  However, if you still have plenty of body fat to burn it’s a PSMF.

#context matters


PSMFs for aggressive weight loss in a medical context generally aim for around 800 calories per day.

Lyle McDonald suggests that people following a PSMF for aggressive weight loss over a short period (e.g. cutting in the lead up to a bodybuilding show) might be eating between 400 and 800 calories per day.

Each person needs to find the ideal approach that they can live with for the long-term.

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How to do a nutrient dense PSMF

  • Eat mostly foods from the lists below.  
    • The nutrient dense PSMF diet foods are ideal for aggressive short term weight loss (i.e. leading up to a bodybuilding comp).
    • The nutrient dense weight loss foods for insulin resistance may be more appropriate if you have more weight to lose over a longer period.
    • Minimum protein intake in a weight loss clinic setting is 1.2g/kg total body weight.
    • Appetite will likely drive you to eat more protein if you are working out.   2.4g/kg lean body mass is typical for someone lifting heavy.
    • The highest protein foodcan be used to increase protein intake if required.
    • Focusing on these foods will ensure you still get adequate protein as well as vitamins and minerals while minimising energy consumption.
    • Limit carbs to what comes with non-starch veggies (i.e. no processed grains or sugars).
    • Limit fat to what comes with the lean protein foods.
  • Don’t eat too much
    • It will be hard to overeat these high nutrient density low energy density foods.
    • You may not have to consciously limit your food intake if you can focus only eat these foods.
    • It may be beneficial to track or plan your energy intake to achieve your goals.
    • Ratchet down your energy intake until you achieve your desired rate of weight loss.
  • Lift heavy / exercise (optional)
    • Working out will help you to use the protein to build lean muscle and keep your metabolic rate up.
  • Repeat 

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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.
  • Just maximising protein may not provide optimal levels of vitamins and minerals. Therefore, it’s important to prioritise nutrient dense foods to improve your chances of long-term success.
  • While the PSMF is commonly used in weight loss clinics and in the bodybuilding community, the principle can also be applied in other situations.

 

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

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.

But wee needn’t be too concerned about the micronutrients that are easy to obtain.  What we really care about is the nutrients that are harder to obtain.  The chart below shows the sum of the eighteen nutrients that are harder to obtain for each extreme approach.

application

It seems that thinking in terms of macronutrient extremes has some usefulness.  However, focusing on micronutrient density seems to provide an order of magnitude improvement in the level of actual nutrients provided by our food.

Maybe it’s time for a new trend?

The ‘problem’ with nutrient dense foods is that that they are so lean and contain so much fibre that it can be hard to consume enough calories to maintain weight.  You’ll just be too full!

If you are insulin sensitive and not looking to lose weight, then you could consider adding some more ‘Paleo friendly’ carbs such as beets, squash, yams, and sweet potatoes, and/or some fattier cuts of meat to fuel your activity.  If you are insulin resistant, you may need to add some fattier (but still relatively nutrient dense) foods to maintain your weight while also keeping your blood glucose and insulin levels in check.

Perhaps micronutrient density is the most important parameter to pursue in our diet.  Then with that cornerstone in place we can personalise our nutritional approach to suit our goals (e.g. weight loss, ketosis, athletic performance or healthy maintenance).

The various food lists in the table below are designed with micronutrient density as the main priority, but also consider insulin load and energy density to suit different goals.

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

personalisation

In the end, no one sticks to an optimal list of foods that perfectly balances their diet 100% of the time.

I’ve been working on a system that will give you feedback on YOUR current diet, identify which nutrients you are currently lacking, and which supplements or real whole foods you may need to add or subtract to optimise your nutrition.  Most people don’t eat perfectly all the time, but we could all use some help moving forward towards optimal.

Check out the Nutrient Optimiser page for more details.

 

notes

[1] There is a strong case for the idea that the DRI for vitamin C could be relaxed for a diet with lower glucose.  See http://breaknutrition.com/ketogenic-diet-vitamin-c-101/ and http://orthomolecular.org/library/jom/2005/pdf/2005-v20n03-p179.pdf

[2] Check out this video by Ron Rosedale for an overview of the topic of protein, mTOR signalling and longevity.  https://www.youtube.com/watch?v=xtZ0LqUBySQ

which nutrients is YOUR diet missing?  

I recently took a look at which nutrients might be missing from various popular dietary approaches in preparation for a recent on nutrient density.  At a population level, the chart below shows the proportion of the US population that are deficient in various micronutrients.  Many people are not getting enough vitamin D, vitamin E, magnesium, calcium, etc.

While your body hasn’t read the World Health Organisation’s reports on the Daily Recommended Intake of the various essential nutrients,[1] it’s likely that your appetite will drive you to seek out the nutrients that are lacking.  If we are deficient in something that is required the body kicks in “nutrient hunger” and cravings that will make sure it gets what it needs.[2] [3] [4]

If you work hard to restrict your food intake to a certain dietary approach, but the body doesn’t receive the nutrients it needs, it may slow down and not function at full capacity.   By contrast, adequate nutrition, without too much energy, slows many of the modern diseases of aging such as diabetes, Alzheimer’s and cancer and improves your chance of living healthfully to a ripe old age.[5]

USDA foods database

The chart below shows the nutrients that are both easiest and hardest to obtain from the eight thousand foods in the USDA foods database.  At the bottom of this plot we have iron, various amino acids, and vitamin C, all of which are easy to obtain in adequate quantities.

However, at the top of the chart, we can see that it is much harder to obtain adequate quantities of six essential nutrients (omega 3 fatty acids, vitamin D, choline, vitamin E, and potassium).  We would obtain sufficient quantities of all the other essential nutrients if we ate just a little of each of the foods in the USDA food database.

If we want to maximise nutrient density, it makes sense to prioritise foods that contain more of the harder-to-obtain nutrients.  The chart below shows the nutrients for the top 10% of the 8000 foods in the USDA database (blue bars) when we prioritise for those.  Not only do we get an increase in the more difficult to obtain nutrients, we also get a massive boost in all nutrients.  Rather than being inadequate in six nutrients, we are now lacking only one (alpha-Linolenic acid, an Omega 3 fatty acid).

Limiting our food selection to the most nutrient dense foods makes it easier for us to consume the required nutrients without excessive energy, which is ideal if we are trying to lose fat or reduce calorie intake to slow the diseases of ageing.[6] [7]  Nutrient density becomes even more important if you’re fasting or restricting calories to achieve long term weight loss.

Optimising nutrient density

If you’re reading this, then you’re likely aware that there is a wide variety of dietary approaches that people follow to optimise their health depending on their preferences and beliefs.

I’ve tried to turn many of these beliefs about nutrition into a quantitative algorithm that we can use to evaluate and compare these approaches, and make sure we’re getting the outcome we want (e.g. low insulin, blood glucose control, nutrient density, or low/high energy density).

After testing a number of options, the three quantitative parameters that I have found the three parameters that are most useful are:

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

My aim in this post is to show how considering nutrient density can improve various dietary approaches, from therapeutic ketogenic, vegan, paleo, and low fat.   This post highlights which nutrients you will most likely be lacking with each of the different nutritional approaches, which foods you can use to fill these nutritional gaps, and perhaps which supplements you may need if you are still looking for some added nutritional insurance.

There’s been a lot of talk lately by Taubes[8] and Lustig[9] about how bad sugar and fructose are, but I think these nutritive sweeteners are just extreme examples of nutrient poor foods that are highly insulinogenic and energy dense.  At the other end of the spectrum, we have foods like liver, broccoli, and spinach.  Everything else is somewhere in the middle and will support or work against your goals, whatever they may be, to different degrees.

My aim here is to help you see where each of these foods sits on that continuum and use this information to help you refine your food choices to reach your personal goals.

Therapeutic ketogenic diet

Let’s start with the therapeutic ketogenic dietary approach.   I have previously noted that a number of the issues and concerns with the ketogenic diet seem to relate to being able to obtain essential nutrients rather than consuming excessive levels of fat.[10] [11] [12]  On one hand, I’m excited that the concepts of insulin load and percentage of insulinogenic calories have been helpful for people with chronic conditions such as epilepsy, cancer, dementia, Alzheimer’s etc.  However, I think there is a risk their ultra-high fat diet will not contain the nutrients which are critically important for mitochondrial function and energy production.

The chart below shows the vitamins and minerals provided by a therapeutic ketogenic dietary approach if we simply prioritise for low insulin load (red bars)[13] in comparison to the average of all foods in the USDA database (orange bars).  If you don’t pay attention to nutrient density a therapeutic ketogenic diet can provide lower levels of nutrition.

As shown in the chart below if we ate a little of all the foods in the USDA database, we would be deficient in six essential nutrients, whereas if we follow a therapeutic ketogenic diet, we will likely be lacking in ten essential nutrients.

The chart below shows the effect of how thinking in terms of nutrient density can improve the therapeutic ketogenic dietary approach (blue bars) compared to prioritising for insulin load only (red bars).  All nutrients are boosted, particularly the harder to obtain ones.

While lots of people find that higher fat whole foods are hard to overeat, there are still some hyper palatable high fat foods that go down easily.  We talk about eating “fat to satiety”, but what happens when nutrient hunger kicks in and your body is craving more potassium, magnesium, calcium, or one of the other nutrients that are harder to obtain in a very high fat dietary approach?  If you keep on consuming large amounts of processed fats that don’t contain the nutrients you require, your appetite may not automatically turn off before you’ve consumed a lot of excess energy!

Low carb

The chart below shows the boost in nutrients when we consider nutrient density combined with a low carbohydrate approach.  It appears that, based on this analysis, that without a focus on nutrient density, a low carbohydrate diet is likely to be deficient in folate, vitamin D, choline, potassium, magnesium, pantothenic acid, calcium, vitamin E and manganese.  With a focus on nutrient dense foods, a low carb diet provides adequate amounts of the majority of nutrients.

Weight loss (insulin sensitive)

The weight loss approach is intended for people who are insulin sensitive but still have excess body fat to lose.  Foods with a lower energy density (e.g. spinach, broccoli cucumber, celery, lettuce etc) typically are harder to overeat because they are bulky.

This approach doesn’t pay any attention to insulin load because it is assumed that people using this approach are not insulin resistant and are able to maintain good blood glucose levels.  Practically, it’s also difficult to achieve a really high insulin load with these foods because they do not contain a large amount of processed carbs and are hard to overeat.

Without consideration of nutrient density, the essential fatty acids tend to be low along with vitamin B-12, choline, and tyrosine.  However, once we factor in nutrient density all these nutrients dramatically improve.

This approach may not be viable for long term maintenance due to the extremely low energy density which would make it hard to get in enough energy.  However, in the short term, it may be appropriate for a period of substantial energy restriction, and will provide maximum nutrition with a minimum amount of energy.

Zero carb

Getting adequate protein on a zero-carb approach is not a problem.  However, unless there is a major focus on organ meats, there are a large number of vitamins and minerals, such as   vitamin K, manganese, vitamin C, vitamin E, vitamin D, potassium, magnesium and calcium that may be worth supplementing.

Vegan

At the other extreme, the chart shows the nutritional analysis of the vegan diet.  The main deficiencies in a vegan approach are omega 3s and vitamin B-12, which are hard to obtain without animal products.  It may be prudent for vegans to consider fish oil supplementation and B-12 injections, or alternatively adding some seafood occasionally.

While it appears possible to obtain the recommended levels of protein, it’s hard to get very high levels of it.    If you are insulin resistant, the fat levels can be increased using added coconut products and nuts.

Higher insulin load foods for bulking

The bulking approach is designed for people who are looking to gain strength and size by combining nutrient density with more calories and insulin load.  Without consideration of nutrient density, a high insulin load means very low nutrient density foods.  However, once we factor in nutrient density, we get a range of highly nutritious foods that may be helpful if you want to gain size and strength, while still maximising health and nutrition.

Paleo

The chart below shows the nutrients provided by the Paleo approach (i.e. no processed foods, dairy or grains) both with and without consideration of nutrient density.  While ‘going Paleo’ eliminates many of the nutrient-poor processed food, it appears to be beneficial to also consider nutrient density as well in addition.

What does this all mean?

So, how do we decide which approach is best?  Unfortunately, it’s not straightforward so I’ll look at this a number of ways.

What we ideally want is to identify the foods that will provide us with high amounts of all of the nutrients.   The blue bars in the chart below represents the average of the % daily recommended intake of all the nutrients in the various approaches evaluated above, without considering nutrient density.  The orange bars represent the average minus 0.5 x the standard deviation which is a measure of reliability.  The higher the reliability the more consistent and high are the nutrients over all.

This chart shows that, in comparison to the other approaches, Paleo foods have a high and consistent level of nutrients; while the vegan and low energy density weight loss foods have high levels of some individual nutrients, but low levels of some others.  Without consideration of nutrient density, the high insulin, low carb and zero carb approaches are a bit lacking in nutrients.

Things become a little more interesting once we factor in nutrient density.  The vegan, therapeutic keto, low carb and zero carb approaches do poorly against the paleo, higher insulin load, most nutrient dense of all foods, and the lower energy density weight loss foods.

Many people will benefit on a high fat therapeutic ketogenic dietary approach, at least until their blood glucose and insulin levels normalise.  However, in time, it may be beneficial to transition to more nutrient dense foods to continue their journey towards optimal health.

As detailed in the ‘how to optimise your diet for insulin resistance’ article, I think you should eat the most nutrient dense foods your pancreas can keep up with while maintaining good blood glucose levels.  In time, someone who is highly insulin resistant may be able to progress to a more nutrient dense and more moderate fat approach if your ultimate goal is to normalise blood glucose levels and lose weight.

Food lists

If you identify with any of these goals, you may be interested in following these food lists.   If blood glucose levels are sky high or you are managing a chronic condition such as epilepsy, cancer, Alzheimer’s or dementia, you may benefit from a higher fat therapeutic keto dietary approach, for a period.  As your glucose levels come under control, you can transition to more nutrient dense foods that will also help you to achieve your weight goals.

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

Getting even more personal

As you can see, nutrients are provided at different levels depending on the approach.  However, most people don’t follow any dietary approach strictly, so the nutrients in your diet will be different depending on your personal habits and preferences.

Rather than trying to pick up someone else’s nutrition plan, or live by a strict list, I think it’s better to refine your current habits, emphasising the good foods, minimising the bad, and progressively trying new foods that may be beneficial.

To this end, I’ve been developing a Nutrient Optimizer algorithm that can help you refine your food choices to suit your goals.  By identifying the foods you are currently eating that align most with your current goals, which ones don’t, and which new foods perhaps you should consider.

Most current nutritional advice is driven by the avoidance of fat, particularly saturated fat, and therefore ends up being next to useless.  Calorie counting apps like MyFitnessPal does nothing but count calories, which is also of limited use.  Cron-o-meter tracks your micronutrients and can recommend foods to boost a single nutrient.  However, there doesn’t seem to be anything available that will tell you which foods will help you actually correct multiple deficiencies and  achieve a diet that is truly balanced in micronutrients.

The Nutrient Optimiser also allows you to tailor the approach to your goals, such as:  therapeutic ketosis, diabetes management, weight loss or just nutrient dense maintenance.  Food preferences like vegan, pescetarian, autoimmune, or paleo can be factored in to the recommended food lists.

At the moment, the process involves manually exporting food intake data from Cron-o-meter, then analysing it in a spreadsheet to manually generate a personalised report.  I am eager to do this as a proof-of-concept for a range of people with various goals (particularly therapeutic ketosis, vegetarian, zero carb, fruitarian) to demonstrate how it works.  So, if you’re happy to have your report shared publicly, and have a couple of weeks of Cron-o-meter data, feel free to send it to me and  have your data analysed.

In time, the plan is to automate the process via an online interface and then ideally an independent mobile app.    To keep up-to-date with progress, watch this space and check out the various analysed examples on the Marty Kendall’s Nutrient Optimiser Facebook page.

Epilogue…  limitations

For completeness, I thought it would be worth mentioning a few limitations relating to calculating nutrient density…

  1. Measuring foods in terms of calories has its own limitations as different macronutrients provide different amounts of energy (ATP) in different people. Some smart friends of mine are working on calculating ATP yield for different foods based on their macronutrient content.  I’ll happily update this analysis in terms of nutrients per ATP as soon as that data is available.  Initial indications are that people who are fat-adapted are able to use fat more efficiently (i.e. less entropy/losses in metabolism) and hence require less calories to yield the same amount of energy in the body (i.e. ATP).  Hence, it appears that it is even more important for someone following a low carb or ketogenic approach to maximise nutrient density in terms of nutrients per calorie.
  2. The official dietary reference values are based on limited research.[14] Typically, they relate to the minimum amount of a nutrient to avoid disease rather than the amount required for optimal function.  They may also vary by person (e.g. someone who is more active may need more protein) and by their diet type (e.g. someone who is on a low carb diet may need less vitamin C to process the limited amount of glucose).  Hence, I think the DRI values should be seen as a minimum.  Ideally, we want to get more than the minimum while not having to ingest too much energy.  I also don’t think nutrients are meant to come as individual vitamins and minerals in a bottle.  The nutrients required to metabolise a certain food typically come packaged in whole foods, and often work synergistically.  Taking supplements or fortifying foods will always be inferior to obtaining nutrients from whole foods.
  3. Species-specific bioavailability and anti-nutrients are contentious topics. Zero carbers will tell you that nutrients in animal based foods are more bioavailable than plant based foods, while the vegans will tell you the opposite.  To date, I haven’t been able to find useful data that would enable me to quantitatively refine the nutrient data in the USDA database regarding bioavailability.  All we currently have is a measure of the nutrients contained in the food– rather than the nutrients that make it into your body after digestion.  Again, if this data ever comes to hand, I’ll eagerly update the analysis.

Overall, I don’t think these limitations make a difference in the outcomes of the analysis.  This is not an exact science and the body doesn’t operate like a rigid machine.  Calculation of nutrient density is just a way to identify the foods that contain the most raw materials with the least amount of calories that your body can work with.

referecnes

[1] http://www.who.int/nutrition/publications/nutrient/en/

[2] https://books.google.com.au/books?id=gtQyAgAAQBAJ&pg=PA185&lpg=PA185&dq=%22nutrient+hunger%22&source=bl&ots=VMRQ8EbvHx&sig=l_xJEksBS538UX3QwQNxVJBXTLw&hl=en&sa=X&ved=0ahUKEwjRj6mSs5DSAhWKyLwKHXBQAjEQ6AEIKDAC#v=onepage&q=%22nutrient%20hunger%22&f=false

[3] https://www.amazon.com/Perfect-Health-Diet-Regain-Weight/dp/1451699158

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

[5] https://optimisingnutrition.com/2016/03/21/wanna-live-forever/

[6] http://ajcn.nutrition.org/content/78/3/361.full

[7] http://www.nature.com/articles/ncomms14063

[8] https://www.amazon.com/Case-Against-Sugar-Gary-Taubes/dp/0307701646

[9] https://www.youtube.com/watch?v=dBnniua6-oM

[10] https://www.thepaleomom.com/adverse-reactions-to-ketogenic-diets-caution-advised/

[11] http://ketotalk.com/2016/06/23-responding-to-the-paleo-mom-dr-sarah-ballantynes-claims-against-the-ketogenic-diet/

[12] http://www.thelivinlowcarbshow.com/shownotes/10888/868-dr-sarah-ballantyne-challenges-the-wisdom-of-low-carb-diets-for-women-2/

[13] In terms of macronutrients this high fat dietary approach comes out at 80% fat, 15% protein, 2% fibre and 3% net carbs.

[14] http://www.who.int/nutrition/publications/nutrient/en/