Tag Archives: protein

optimising macros for fat loss with less hunger

Many people like to define their diet based on macro ranges, such as:

  • low-carb,
  • ketogenic,
  • high-fat,
  • low-fat,
  • high-protein, or
  • high-carb.

However, if you want to control your appetite, reduce body fat, and improve your health, you probably want to know if your chosen dietary preference works.

Everyone agrees that consciously restricting calories can be difficult.  We want to understand how we can manipulate macronutrients and micronutrients to improve satiety and reduce hunger which will lead to a spontaneous reduction in appetite and sustained fat loss.

My Nutrient Optimiser partner Alex Zotov and I have been busy lately mining the database of half a million days of MyFitnessPal data for insights that can help us refine our algorithm to help people achieve their goal with more precision.  It’s fascinating to be able to quantitatively answer common questions and dispel many myths about nutrition with this massive data set!

Data cleaning

In order to focus on people trying to lose weight, we filtered for people with a calorie goal of between 1000 and 2500 calories and eliminated days where people consumed more than 300% or less than 50% of their target calorie intake.  This trimmed reduced out data set down from the original 587,187 days of data to 438,014 days of completed food diaries.

Definitions of diets by macronutrient range

The table below shows how we sliced up the data based on macronutrient ranges that align with different popular dietary approaches.

  • The “n” is the number of days in each ‘bucket’ of data.
  • The “%” column shows the percentage of days that meet that criteria.
  • The average row represents the average macronutrient breakdown of all 438,014 days of data. Each of the dietary approaches are subsets of this data.
Diet Protein Fat Carbs n %
Low-protein, high-fat < 15% > 70% 1,887 0.43%
High-fat > 70% 7,229 2%
Junk food < 20% > 30% > 35% 84,781 19%
Low-protein < 15% 87,985 20%
Standard Western 10 – 20% 30 – 40% 35-50% 43,504 10%
Low-carb, higher-fat > 60% < 30% 18,581 4%
Very low carb < 15% 21,644 5%
Low-fat < 25% 75,859 18%
Low-carb < 30% 64,960 15%
Low-carb, high-protein > 20% < 35% 34,870 8%
High-carb > 70% 4,966 1%
High-protein > 30% 72,473 17%
Very high protein > 40% 15,205 3%
Average  22% 36% 43% 438,014 100%

Average macros (%)

The chart below shows what each of the diet approaches looks like in terms of macronutrients for the days that met the criteria for each ‘bucket’.

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Average diet macros (grams)

Many people like to manage their diet by limiting or targeting a certain quantity of a particular macronutrient, so the table shows the average intake of each of the approaches in grams.  If you currently track your diet you might like to see how you compare to these averages.

Diet Protein (g) Fat (g) Carbs (g)
Very high protein 165 45 97
High protein 137 53 122
Low carb, high protein 116 86 54
Low carbohydrate 107 88 72
Low fat 93 33 201
Very low carb 101 107 31
Low carb, high fat 81 120 40
High fat 69 134 29
Standard Western 70 67 193
Junk food 62 76 185
Low protein 49 67 205
High carbohydrate 38 20 248
Low protein, high fat 47 158 47
average 86 62 168

Satiety of different macronutrient diet approaches

This table shows the average goal and actual calorie intake for each of the groups.  The right-hand column shows the average of the actual intake divided by their calorie goal and multiplied by 100%.

A calorie goal in MyFitnessPal is set by a person’s Basal Metabolic Rate minus an allowance to ensure that they achieve an energy deficit if they are trying to achieve weight loss.

  • A score of less than 100% means that someone was able to eat less than calorie goal for the day.
  • A score of greater than 100% indicates that someone was able to eat less than they planned.
Diet Goal (cals) Actual (cals) % Goal
Low protein, high fat 1,698 1,796 106%
High fat 1,698 1,597 94%
Junk food 1,779 1,673 94%
Low protein 1,730 1,615 93%
Standard Western 1,806 1,655 92%
Low carb, high fat 1,721 1,569 91%
average 1,795 1,575 88%
Very low carb 1,714 1,490 87%
Low fat 1,787 1,478 83%
Low carbohydrate 1,753 1,506 86%
Low carb, high protein 1,735 1,461 84%
High carbohydrate 1,592 1,325 83%
High protein 1,834 1,511 82%
Very high protein 1,804 1,453 81%

This chart shows the goal vs actual calorie intake for each approach graphically.

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The chart below shows the % goal achieved for each approach graphically.

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Discussion

Looking at the goal vs actual calories in the chart below we can see that:

  • The people following a low-protein, high-fat approach were the only ones to exceed their calorie target consistently.
  • The people using the high-protein diet had the highest target calorie intakes, suggesting that they were active and likely had more metabolically active muscle mass, and hence a higher BMR.
  • The high-carb approaches seemed to have a lower goal intake, indicating that these people may have already been typically smaller or had less muscle mass.

Both the high-fat and low-protein approaches have a negative impact on satiety.  Combining these two approaches (i.e. high-fat with low-protein) appears to lead to people to eat much more than planned.

Avoiding protein (i.e. in pursuit of ketones or due fear of gluconeogenesis) and consuming “fat to satiety” appears to significantly increase your chances of overeating.

Lowering carbohydrates provides slightly better than average satiety.  Focusing on reducing carbohydrates while also prioritising protein seems to provide a better outcome.

When we look at the correlation between macronutrient consumption and the ability to achieve your target calorie goal, we see that higher protein has the strongest alignment with followed by lower fat.  Restricting carbohydrate seems to have a much smaller impact on spontaneous calorie intake.

This observation from the data also aligns with this recent study that tested high protein low carb vs normal protein high fat and found that “Body-weight loss and weight-maintenance depends on the high-protein, but not on the ‘low-carb’ component of the diet, while it is unrelated to the concomitant fat-content of the diet.”

A higher protein approach with less fat may be more advantageous in terms of satiety if your goal is fat loss.

A high carb approach such as a Whole Food Plant Based approach may lead to weight loss.  However, it may not provide adequate protein to prevent loss of lean muscle which is a real concern during weight loss.

Also, keep in mind that plant-based amino acids and some micronutrients such as vitamin A and omega 3s are less bioavailable from plant-based sources compared to animal-based sources.

Someone following a high carb plant-based approach should monitor their body fat levels during weight loss and look to add additional protein if they are losing excessive amounts of lean muscle mass or their % body fat is increasing even though they are losing weight.

Personally, I used to follow more of a low carb high-fat approach in an effort to manage my insulin levels and blood sugars.  However, recently I have found much better results in terms of satiety and body composition by prioritising protein.

When you buy into the Carbohydrate-Insulin Hypothesis of Obesity, a lot of things get blamed on insulin resistance.  I was a victim, and my obesity was beyond my control (or so I thought).

I now realise that following a diet that enables you to eat less and control hunger is what will reverse insulin resistance (see this article for more discussion) and lead to increased satiety and fat loss.

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optimising fat and carbs for maximum satiety

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

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

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

Fat

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

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

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

image5.png

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

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

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

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

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

Carbohydrates

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

image8.png

The simplified chart for carbs is shown below.

image9.png

This data suggests that:

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

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

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

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

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

image6

The moderate carb moderate fat grey zone

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

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

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

image12.png

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

donut-522440_960_720[1].jpg

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

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

Putting it all together

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

image7.png

The key takeaways are that:

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

image1.jpg

Example foods

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

High protein to maximise satiety

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

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

Worst case macronutrient profile (the grey zone)

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

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

High satiety, low carb

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

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

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

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

High satiety, high carb

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

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

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

Summary

So, in summary:

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

image7.png

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

how 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.

image4.png

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.

Screenshot 2018-05-18 02.42.23.png

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.

image11

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]

image01

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/

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.

image21.png

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.

image11.png

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.

image10.png

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.

image22.png

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

image3.png

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

image23.png

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.

image27.png

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

image19.png

You should make a calculator for that!

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

image9.png

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

how to get the minimum effective dose of nutrition

The goal of Optimising Nutrition is to help you design the minimum effective dose of nutrition to support your goals (e.g. performance, weight loss, diabetes management, therapeutic ketosis, bodybuilding, etc.).

When we break it down, we require food that:

  • provides adequate micronutrients,
  • with enough energy (but not too much), that
  • enables you to maintain healthy hormone levels.

In nutrition, we talk about parameters such as:

  • macronutrients (protein, carbs, fat, and fibre),
  • carnivore vs plant-based,
  • energy density, and
  • insulin load.

Unfortunately, talking about “high”, “low” or “adequate” often leads to unproductive circular arguments due to a lack of definition.

Optimal typically lies somewhere between the extremes.

A ‘Goldilocks zone’ of not too little.  Not too much.

A ‘minimum effective dose’ if you will.

image32

If we want to design the minimum effective dose (MED), we need to understand which parameters have the most significant impact on the quality of our nutrition.

With all the discussion about ‘high,’ ‘low’ and ‘not too much’ we need to understand the acceptable range for each of the key parameters to ensure we don’t stray too far from optimum.

What is the ‘minimum effective dose’?

The ‘minimum effective dose’ (MED) is the smallest dose that will produce the desired effect.

In terms of medication, the MED is the minimum amount that will give the desired effect for most people.  Too much of a drug can be expensive and harmful.  Too little won’t have the enough of an effect.

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In fitness, the minimum effective dose is the point beyond which any additional stress would be redundant or even counterproductive to strength and fitness goals.

image7

In biohacking, the MED is about getting the desired outcome with the minimum investment of time, money or effort.

image19

What does MED mean regarding nutrition?

There are a handful of interacting factors that help us determine the minimum effective dose of nutrition.  Unfortunately, it’s not possible to optimise all parameters at once.  We need to decide which ones we want to prioritise and which ones we are prepared to sacrifice based on our context and goals.

image29

Before we get into the details of how we determine the MED of nutrition, let’s set the context with a review of some parameters.

Nutrients

The body needs a range of essential nutrients and benefits from an even more extensive range of non-essential nutrients.

Recommended Dietary Intake (RDIs) or are given as the minimum amount to prevent diseases of malnutrition for most people (i.e. not necessarily optimal health and longevity).

Nutritional requirements vary due to a wide range of factors.  Men need more than women (unless they are pregnant or breastfeeding).[1]

Many nutrients are easy to obtain, but we need to pay particular attention to getting adequate quantities of others.

If we are obtaining the recommended minimum levels for the majority of the essential nutrients, we are likely to significantly exceed the Recommended Daily Intake[2] for a number of these nutrients.

We tend to get a better nutritional outcome when we prioritise the foods that contain the harder-to-find nutrients, and the other nutrients tend to look after themselves.

The upper limit (UL) for most nutrients is difficult, if not impossible, to exceed without supplementations (except for those Arctic explorers that gorged on polar bear liver and felt ill due to hypervitaminosis[3]).

If you are an athlete, you will need more nutrients.  However, you will be able to consume a lot more energy, thus letting you achieve the minimum intake level for most nutrients rather easily.

At the other extreme, if you are restricting energy to lose weight, it may be hard to get enough nutrients from the food you eat.  Focusing on foods with a high nutrient : energy ratio will be critical.

In his Perfect Health Diet,[4] Paul Jaminet notes that:

a nourishing, balanced diet that provides all the required nutrients in the right proportions is the key to eliminating hunger and minimising appetite and eliminating hunger at minimal caloric intake.

Bruce Ames’s Triage Theory[5] warns that the body will prioritize available nutrients for short-term functions and at the expense of longevity where nutrients are limited.

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Francis Pottenger demonstrated that poor nutrition has generational impacts with his cats that progressively became more deranged to the point that they couldn’t procreate after three generations.[6]

image17.png

There is also a growing body of fascinating research suggesting that different nutrient deficiencies are related to specific conditions and boosting these nutrients (ideally with whole foods) will improve these chronic diseases.[7] [8]

image16

Maximising the nutrient content of our diet with the minimum amount of energy seems to be central to our short-term and our long-term health!

We crave nutrients like salt and protein and go out of our way to make sure we get them.[9] [10] [11]

The Protein Leverage Hypothesis shows that we keep eating until we get enough protein.[12]

A pregnant woman will crave weird foods and obscure flavours to ensure she’s getting the nutrients to grow a healthy baby.

image23

As you will see below, nutrition and protein are tightly interrelated.  Rather than the ‘Protein Leverage Hypothesis’, I think it’s reasonable to think that there is a ‘Nutrient Leverage’ effect such that we seek out more food until we get the nutrients we need.

It’s not unreasonable to think that getting adequate nutrients from the food we eat is a critical component of our satiety mechanism and managing our appetite.  If we don’t obtain sufficient nutrients from our food, we will be more likely to seek out more food in search of nutrients, and thus end up over-consuming energy and become obese and/or diabetic.

With our modern trend towards processed foods that are optimised for bliss point[13] and profit margin rather than nutrient content, it’s not surprising that we have an epidemic of malnourished obese people.[14] [15]

image24

Adequate energy

While we have developed our appetite to seek out foods that contain the nutrients we need, our drive for energy is even stronger.

Adapted biologically to scarcity, we tend to consume a little more energy than we need in preparation for leaner times.  However, today in our modern processed food environment with fossil fuels, chemical fertilisers, and artificial flavourings, winter never comes.[16]

Before the advent of processed foods, energy always came packaged with adequate nutrients.  However, this is no longer always the case.

image9

To thrive in our modern world with primal instincts, we need to find a way to reverse-engineer our food environment to ensure that we prioritise foods with the nutrients we require without too much energy.

Perhaps we need a shortlist of optimal foods and meals that will provide the minimum effective dose of nutrients that we require without having to consume excess energy.

Insulin load

Insulin is arguably the most important metabolic hormone that helps us build muscle, use glucose and keep stored energy locked away for a later day.

Adequate levels of insulin are critical to survival.  People with Type 1 diabetes die without insulin.  However, today’s processed foods tend to drive our insulin levels too high for too long, thus leading to insulin resistance and the majority of modern disease.[17]

Low carb and ketogenic diets help us bring insulin and blood sugar levels under control.  At the same time foods with an extremely low insulin load are tend to be mostly fat and do not contain the vitamins and minerals that we need.

We need to balance the reduction in insulin load that will help us stabilise blood sugars and insulin levels in our body without excessively and unnecessarily compromising nutrient density.

The official “Acceptable Macronutrient Distribution Range”

The table below shows the Acceptable Macronutrient Distribution Range for macronutrients to reduce chronic disease risk whilst still ensuring adequate micronutrient status along with the currently typical macronutrient” according to the Institutes of Medicine (IOM) [18][19].

macronutrient lower upper
protein 15% 35%
fat 20% 35%
carbohydrates 45% 65%

The Australian Ministry of Health notes that only 10% of energy is required from protein to cover physiological needs.  However, this level is insufficient to provide adequate micronutrients levels.  Active communities have much higher protein intake levels with no apparent adverse health effects.[20]

The chart below shows that our carbohydrate intake is trending up while fat has trended down as we have followed the official guidance to avoid fat to avoid heart disease over the past four decades.[21]

image13

The table below shows the typical macronutrient intake for the US, UK and eighteen non-Asian countries from the PURE study.

parameter protein fat carbs
United States (NHANES, 2000)[22] 15% 33% 52%
United Kingdom 16% 35% 50
non-Asia (PURE) 17% 28% 55%
Asia (PURE) 15% 21% 65%

A number of people such as Gary Taubes[23] and Nina Teicholz[24] have argued that the unnecessary fear of fat and retreat to processed carbohydrates has contributed to the obesity epidemic.

image27

One of the main goals of this article is to consider whether the ‘Acceptable Macronutrient Ranges’ set by the Institute of Medicine actually allows us to optimise nutrient density.

The data analysis

I’ve previously discussed the relationship between macronutrients and the nutrient density of individual foods (see Micronutrients at Macronutrient Extremes and Which Nutrients is YOUR Diet Missing?).  However, I thought it would be interesting to look at things in terms of the nutrient score for each nutritional approach.

To understand the relationship between nutrition and various food parameters I updated the analysis for a wide range of nutritional approaches as shown in the table below (sorted in descending order for nutrient density).  The table below shows the nutrients provided by 43 different nutritional approaches along with the shortlist of foods associated with each goal.  (This took me a LOT of time to re-run, so I’d love you to check it out).

approach score foods pdf nutrients
most nutrient dense 96% foods pdf nutrients
adrenal fatigue 96% foods pdf nutrients
weight loss (insulin resistant) 96% foods pdf nutrients
pregnancy 96% foods pdf nutrients
alkaline 96% foods pdf nutrients
asthma 96% foods pdf nutrients
testosterone 96% foods pdf nutrients
nutrient dense paleo 96% foods pdf nutrients
weight loss (insulin sensitive) 96% foods pdf nutrients
hypertension 96% foods pdf nutrients
excess estrogen 96% foods pdf nutrients
autism 96% foods pdf nutrients
hypothyroidism 95% foods pdf nutrients
pescetarian 95% foods pdf nutrients
breastfeeding 95% foods pdf nutrients
female fertility 95% foods pdf nutrients
sleep and insomnia 95% foods pdf nutrients
nutrient dense maintenance 94% foods pdf nutrients
depression 94% foods pdf nutrients
mitochondrial health 94% foods pdf nutrients
autoimmune friendly 94% foods pdf nutrients
bodybuilder 92% foods pdf nutrients
nutrient dense athlete 91% foods pdf nutrients
nutrient dense low carb 91% foods pdf nutrients
nutrient dense paleo (low carb) 90% foods pdf nutrients
mitochondrial health (low carb) 89% foods pdf nutrients
gestational diabetes 89% foods pdf nutrients
bivalve vegan 87% foods pdf nutrients
autoimmune (low carb) 84% foods pdf nutrients
nutrient dense plant based 81% foods pdf nutrients
nutrient dense carnivore 80% foods pdf nutrients
lowest energy density 77% nutrients
plant based (low carb) 76% foods pdf nutrients
highest protein 70% nutrients
well formulated ketogenic 63% foods pdf nutrients
lowest carb 56% nutrients
most ketogenic 44% nutrients
highest fat 43% nutrients
lowest fat 35% nutrients
highest carb 26% nutrients
highest energy density 22% nutrients
lowest protein 16% nutrients
most insulinogenic 3% nutrients

This table shows the macronutrient split of each of these approaches.  To make sense of all this data, I have plotted each these parameters against nutrient density and included some discussion on what I think this means in the following sections.

approach score protein fat net carbs fibre density
most nutrient dense 96% 40% 16% 29% 16% 104
adrenal fatigue 96% 47% 18% 23% 13% 107
weight loss (insulin resistant) 96% 42% 24% 18% 15% 101
pregnancy 96% 41% 18% 27% 15% 113
alkaline 96% 33% 20% 28% 18% 112
asthma 96% 41% 16% 27% 16% 102
testosterone 96% 40% 17% 28% 15% 115
nutrient dense paleo 96% 47% 17% 22% 14% 92
weight loss (insulin sensitive) 96% 51% 18% 19% 12% 85
hypertension 96% 42% 16% 27% 15% 105
excess estrogen 96% 50% 19% 19% 12% 109
autism 96% 48% 17% 22% 13% 103
hypothyroidism 95% 52% 18% 9% 9% 122
pescetarian 95% 37% 16% 31% 16% 108
breastfeeding 95% 42% 17% 26% 15% 101
female fertility 95% 55% 20% 16% 9% 110
sleep and insomnia 95% 44% 16% 28% 12% 134
nutrient dense maintenance 94% 42% 23% 26% 9% 240
depression 94% 59% 21% 12% 8% 114
mitochondrial health 94% 34% 14% 35% 17% 126
autoimmune friendly 94% 53% 21% 17% 10% 102
bodybuilder 92% 64% 23% 8% 5% 120
nutrient dense athlete 91% 39% 40% 15% 5% 366
nutrient dense low carb 91% 28% 50% 10% 12% 222
nutrient dense paleo (low carb) 90% 26% 53% 10% 11% 260
mitochondrial health (low carb) 89% 25% 47% 13% 14% 211
gestational diabetes 89% 27% 56% 8% 9% 257
bivalve vegan 87% 21% 14% 45% 20% 129
autoimmune (low carb) 84% 26% 58% 8% 8% 285
nutrient dense plant based 81% 20% 16% 45% 20% 151
nutrient dense carnivore 80% 65% 30% 5% 0% 143
lowest energy density 77% 20% 10% 52% 18% 30
plant based (low carb) 76% 17% 29% 35% 19% 241
highest protein 70% 77% 22% 1% 0% 132
well formulated ketogenic 63% 16% 73% 4% 6% 423
lowest carb 56% 30% 70% 0% 0% 361
most ketogenic 44% 15% 80% 3% 2% 466
highest fat 43% 14% 81% 3% 1% 470
lowest fat 35% 8% 1% 84% 7% 143
highest carb 26% 3% 1% 90% 6% 141
highest energy density 22% 6% 64% 28% 2% 599
lowest protein 16% 1% 27% 68% 3% 308
most insulinogenic 3% 6% 2% 90% 2% 190

The table below shows the correlation coefficient between nutrient density and each of the parameters along with the P value indicating that there is a reasonable degree of statistical significance.

parameter R2 P
protein 0.89 < 0.0001
% insulinogenic 0.66 < 0.001
carbs 0.62 < 0.0001
net carbs 0.60 < 0.0001
fibre 0.47 < 0.0001
fat 0.41 < 0.0001
density 0.32 0.004

Protein vs nutrient density

Given that protein has the highest correlation with nutrient density score (R2 = 0.89) let’s start by looking at the relationship between protein and nutrient density.

The chart below shows the relationship between the nutrient density score and the percentage of energy from protein.   It seems that nutrient density peaks in around 45% of calories from protein.

If we were to use a nutrient density score of 70% as our cut off for our minimum effective dose of nutrition we would have a lower limit of 19% protein and an upper limit of 78% energy from protein.

This optimal level is significantly above the typical protein intake of around 16% of energy and even greater than the upper end of the official Acceptable Macronutrient Distribution Range of 15 to 35%.

The chart below shows the micronutrients provided by the most nutrient-dense foods.  That is, the highest ranking 10% of foods in the eight thousand foods in the USDA food database when we boost the harder to find nutrients (shown in yellow).[25]    These foods provide the best balance of micronutrients to meet the Recommended Daily Intake Levels.

What’s worth noting here is that this shortlist of nutrient-dense foods are NOT identified by prioritising any of the amino acids.  We just happen to get plenty of protein from foods that contain more of the harder-to-find nutrients (i.e. omega 3, choline, vitamin D, calcium magnesium potassium, zinc and thiamine).

The nutrient score in this analysis is calculated based on the proportion of the area between 0 and 300% of the RDI for the various nutrients.  If we could find a group of foods that provided 300% of the recommended daily intake (RDI) of all nutrients we would get a perfect score.

If your goal was just to maintain weight or fuel your endurance activities you could argue that such high a high level of nutrient density is excessive.  You may end up fueling up with some more energy dense fat or refined carbs.  However, maximising the nutrient : energy ratio of your diet would be very useful if you were trying to reduce your energy intake to lose weight.

According to Bruce Ames’ Triage Theory,[26] maximising nutrient density enables us to maximise both our short-term and long-term health and vitality.

Perhaps with a higher nutrient : energy ratio, the body would be happier with a lower energy intake for longer without overwhelming cravings that may derail our weight loss efforts?

On the far right of the plot of protein vs nutrient density above we have the highest protein foods.  Prioritising amino acids alone gives us a massive 77% of energy from protein!  However, as you can see from the chart below, we will miss out on a number of essential vitamins and minerals (e.g. vitamin A, vitamin K, folate, manganese, vitamin D, calcium etc.).

Just prioritising high protein foods doesn’t achieve optimal outcomes.  We need to prioritise nutrients!

At the other extreme, the nutrient profile of the lowest protein foods is shown below.  If we actively avoid protein, we end up with an inferior nutritional outcome.

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If there is such as thing as ‘too much protein’ we could say that it occur when we are getting more than half our energy intake from protein (which is hard to do!).

image6

Lately, a lot of people are concerned about reducing protein to minimise insulin and mTOR.[27] [28]  While chronically high overall energy intake is indeed a problem, I am concerned that an intentionally low protein dietary approach will have a very poor nutrient outcome.  We then risk being driven to overeat in an effort to find nutrients that we are not getting from our low protein diet.

As suggested by Ames’ Triage Theory, if we miss out on nutrients by prioritising low protein foods, our body diverts our nutrients to short-term survival rather than longevity.  Pottenger’s cats suggest that our descendants will develop degenerative diseases, become lazy and eventually not be able to procreate due to our poor nutritional status.  The most logical solution seems to be to increase our nutrient intake without overdoing energy intake.

The ‘problem’ however with really high nutrient foods is that they, ironically, provide you with too much nutrition.  It’s hard to overeat highly nutrient-dense foods.  Your appetite switches off and you will lose body fat.  As shown in the chart below, it seems we have the lowest ad libitum energy intake when 40 to 50% of our energy comes from protein.[29]  This seems to align with the highest nutrient density foods shown above.

image2

Excessively high levels of protein is not a good idea from an evolutionary perspective because protein is very satiating.  We need the more energy-dense fat and carbs to fuel us to chase our food down and help us get in enough energy to store body fat to make it through the winter.

However, forcing ‘rabbit starvation’ may be a useful hack if you have body fat to lose.  For someone wanting to lose weight, a higher percentage of protein with a lower overall energy intake might be optimal.

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So is 40 to 50% protein optimal for everyone?

Not necessarily!  It depends on who you are and your goals.

For most people, consuming a nutrient-dense diet will increase the proportion of energy from protein beyond the typical 16% intake.  At the other extreme, it seems that increasing protein beyond 50% of energy intake would dilute nutrient density as well as be too satiating!

When it comes to protein, the minimum effective dose is whatever comes with more nutrient-dense foods, but not so much that satiety kicks in so hard that you can’t maintain your body weight.

The minimum effective dose appears to be around 19% of energy from protein with higher levels providing more overall nutrition.

If you are active and need to consume a lot of energy, then the optimal 45% protein will be impractical.  However, if you are aggressively cutting calories and eating a very nutrient-dense energy-restricted diet with a high nutrient : energy ratio then closer to 45% may be optimal.

Insulin load

After protein, the parameter that is most correlated with nutrient density is insulin load.  Insulin load is a proxy for the amount of insulin that our pancreas will need to produce and is proportional to the carbohydrates, minus fibre plus about half the protein.

If you have diabetes, you need to invest your available insulin wisely.  Consuming highly insulinogenic foods will make insulin dosing hard to calculate if you have Type 1 diabetes.  People with Type 2 won’t have enough insulin to keep up to overcome their insulin resistance and maintain excellent blood sugars.

Someone who already has diabetes will benefit by reducing the insulin load of their diet to help normalise their blood sugars, particularly if they have been overloading their pancreas with processed carbs and sugars.

A typical western diet has about 60% or more insulinogenic calories.  The chart below shows that we get the minimum effective dose (i.e. a nutrient density score of 70%) with an insulin load of 19%, optimal at around 41% of energy and an upper limit of 65%.  Overall nutrient density starts to suffer outside these limits and we would have to pay more particular attention to our nutrition.

image14

The current typical macro intake suggests that we are 65% insulinogenic calories on average in non-Asian countries and 73% in Asian countries.  And if this is typical it is likely that many people are consuming much more than this.

Perhaps highly insulinogenic low nutrient density processed foods could be playing a role in the epidemic of diabesity?

Carbohydrates vs nutrient density

This chart shows the relationship between nutrient density and total carbohydrates…

… and nutrient density vs net carbohydrates.

It seems the minimum effective dose of net carbs is 0% and 8% in terms of total carbs with an optimal nutritional outcome at around 30% net carbs or 35% total carbs.  The upper limit is 60% net carbs or 65% total carbs.

This upper limit aligns with the official “Acceptable Macronutrient Distribution Range” for carbohydrates of 65%.  What is worth noting here is that the typical intake is 55% which is greater than the optimal nutrient intake.  The lower limit of the official AMDR is 45% which appears to be unnecessarily high, especially for someone who is not active or is already developing metabolic syndrome.

Many people in low carb circles are fond of point out that ‘there is no such thing as an essential carbohydrate’.  However, foods that contain essential vitamins and minerals also often come packaged with carbohydrates.  At the same time, you can also get plenty of vitamins and minerals from organ meats and shellfish if green leafy veggies aren’t your thing.

If you already have diabetes you should lower your carbohydrate intake to the level that lets you achieve excellent blood sugar control.  In order to control your blood sugars, you will need to reduce your carbohydrates to a level less than the typical level of 55% and most likely less than the optimal level of 30%.

You can continue to refine your approach and ‘eat to your meter’ until you get the blood sugars you are chasing.  However, unless you require therapeutic ketosis (i.e. to manage chronic conditions such as cancer, epilepsy, dementia or Alzheimers), there is probably no need to drive carbohydrate intake much lower than 8% as you may struggle to obtain the broad range of essential nutrients.

Fat vs nutrient density

While there is a lot of talk about “high fat” or “low fat”, fat is actually a relatively poor predictor of nutrient density (R2 = 0.41).  The minimum effective dose seems to set at around 10% of energy intake with an upper limit of 65% fat.   Outside this window, it tends to be harder to get excellent nutrition.

The average intake of fat in western diets is around 28%.   Most people would benefit from consuming more than, particularly if they are not trying to lose weight.  However, there might not be any benefit in going over 65% of energy from fat, particularly if your primary goal is to lose body fat.  If your goal is to control your blood sugar and insulin levels then increasing fat is probably a better option than increasing energy from carbs if you can’t fit any more protein in.

Overall, I don’t think we need to target a specific fat or carb intake.  In the days before we had refrigerators, we would naturally cycle our intakes seasonally between more carbs in summer and more fat in the winter.  However, these days our macronutrient intake seems to be driven more by profit margins and shelf lives (i.e. less protein and more refined fats and sugars) which keeps us in a higher carb summer-like phase.

Fibre

Foods with more fibre tend to be more nutritious and less process.  I don’t think this is necessarily due to the fibre (i.e. you may not benefit by loading up on fibre supplements), but rather because plant-based foods often have nutrients that are harder to find in animal-based foods.

image20

Some people seem to thrive on a zero carb diet, especially when switching from a processed high carb diet which can cause gut dysbiosis.  However, it can be challenging to get as much of the essential vitamins and minerals from a diet with no fibre (although if you are eating nose to tail including minerals from blood this may be another matter).

Energy density

Energy density has the lowest correlation with nutrient density (R2 = 0.32).  However, as a general rule, less energy-dense foods tend to more nutritious.

image8

Energy density can be a useful tool to help us identify foods that are more filling with less energy if we are looking to lose weight.  Alternatively, we can look for higher energy-dense food that is still nutritious if we are looking to fuel high levels of activity.

image1

Carnivore vs plant based

Another nutritional battle that seems to be raging is the plant-based versus carnivorous diets (i.e. no plants).  The good thing about either extreme here is that they both generally eliminate highly processed foods.

A whole food plant based dietary approach will remove processed junk foods and leave low energy density high fibre foods that will make it hard to lose weight.  As you can see it is hard to get omega 3 or vitamin B12 on a plant-based diet there are a number of amino acids that are harder to get due to the amount in the plant-based foods and the bioavailability of plant-based proteins.  If you are consuming a diet that is predominantly plant-based you should look out for symptoms of deficiencies associated with omega 3, vitamin B12 and even protein and consider supplementing accordingly.

image10

The chart below shows the micronutrient profile of a nutrient-dense carnivore diet.  As you can see, there are a number of nutrients that are harder to obtain with this approach.  However, there is some evidence to suggest that you may not need as much of some nutrients if you are not consuming as much glucose.  Again, understanding which nutrients you are not getting in large quantities may be useful to help you identify supplements or look out for symptoms.

image5

Suggested updates to the Acceptable Macronutrient Range

The table below shows suggested minimum effective dose, optimal and upper limit macronutrient splits along with the current intake levels for comparison.

parameter protein fat total carbs insulin load
minimum effective dose 19% 10% 8% 19%
optimal* 45% 36% 35% 41%
upper limit 78% 65% 65% 65%
current (NHANES, 2000) 15% 33% 52% 60%
United Kingdom 16% 35% 50% 59%
non-Asia (PURE) 17% 28% 55% 65%
Asia (PURE) 15% 21% 65% 73%

It seems that to improve their nutrition, most people would benefit from:

  • more protein,
  • more fat,
  • less carbs, and
  • a lower insulin load.

However, food doesn’t come in neat packages of carbs, fats and protein.  Trying to increase protein by adding protein powder or fat by increasing butter or cream may not lead to an optimal nutritional outcome.  But if you focus on meeting your micronutrient requirements with real food the macronutrients will typically look after themselves.

* If you are astute you might notice that the optimal macros actually sum up to 116%.  This is to be expected given that it is not a closed system.  In reality, most people will struggle to consume “optimal” protein levels.  As a general rule of thumb starting with a three-way split of protein, fat and carbs is a reasonable starting point if you insist in thinking in terms of macros.  You can then make refinements from there to suit your goals (e.g. diabetes control, therapeutic keto, weight loss, athlete etc) and preferences (e.g. low carb, high carb, paleo, vegan etc).

Suggested minimum effective dose levels

In the end, nutrition is about getting enough nutrients without too much energy.  Percentages also don’t mean that much for a real person wanting to know what to eat.

The table below shows you the minimum amount of each macronutrient you might need to also provide a solid level of nutrition in terms of your current lean body mass (i.e. total weight minus your fat) and grammes per kilo and grams per pound of LBM.

LBM (kg) LBM (lbs) minimum effective dose (g)
protein fat  net carbs total carbs insulin load
40 88 72 17 0 30 72
45 99 79 18 0 33 79
50 110 85 20 0 36 85
55 121 91 21 0 38 91
60 132 97 23 0 41 97
65 143 104 24 0 44 104
70 154 110 26 0 46 110
75 165 116 27 0 49 116
80 176 123 29 0 52 123
85 187 129 30 0 54 129
90 198 135 32 0 57 135
95 209 142 33 0 60 142
100 220 148 35 0 62 148
g/kg LBM 1.8 0.4 0 0.75 1.8
g/lb LBM 0.8 0.2 0 0.3 0.8

These minimum levels will leave you with a shortfall of energy that you will have to make up from your body fat or other dietary inputs.  There is endless debate about which diet is optimal and leads to longevity.  However, the one thing that nearly everyone seems to agree on is that taking in too much energy is a problem.  So erring on the side of less rather than more is going to be a good thing.

Optimal intake levels

This table shows you the levels that you would need to hit the optimal nutritional outcome for each of these parameters.  In practice, most people will find such high levels of protein difficult to consume and may end up making up any energy shortfall from body fat, dietary fat or dietary carbs.  Nutrient density is important, however, it’s not the only thing.  Most people will end up diluting their nutrient density somewhat in order to get in energy from higher fat or higher carb foods.

LBM (kg) LBM (lbs) optimal intake (g)
protein fat  net carbs total carbs insulin load
40 88 171 61 114 133 156
45 99 186 66 124 145 169
50 110 201 71 134 156 183
55 121 216 77 144 168 197
60 132 231 82 154 180 210
65 143 246 87 164 191 224
70 154 261 93 174 203 238
75 165 276 98 184 215 251
80 176 291 103 194 226 265
85 187 306 109 204 238 279
90 198 321 114 214 249 292
95 209 336 119 224 261 306
100 220 351 125 234 273 319
g/kg LBM 4.3 1.5 2.9 3.3 3.9
g/lb LBM 1.9 0.7 1.3 1.5 1.8

I could show the upper limit of each nutrient too, however, don’t think there’s much practical use precisely quantifying these amounts.  If you are active then your appetite will increase to encourage you to get more food.  If you are gaining unwanted weight then you probably need to back off the intake.

Food lists

I encourage you to make use of the food lists in the table below.  Click on the ‘foods’ hyperlink to open the food list as an image or the ‘pdf’ to download to print.  You can also check out the nutrient profile to see what nutrients these food lists contain and which nutrients have been profiled.  Once you reduce the nutrient-poor foods, you will be able to trust your appetite to guide you to the foods that contain the nutrients you need.

approach score foods pdf nutrients
most nutrient dense 96% foods pdf nutrients
adrenal fatigue 96% foods pdf nutrients
weight loss (insulin resistant) 96% foods pdf nutrients
pregnancy 96% foods pdf nutrients
alkaline 96% foods pdf nutrients
asthma 96% foods pdf nutrients
testosterone 96% foods pdf nutrients
nutrient dense paleo 96% foods pdf nutrients
weight loss (insulin sensitive) 96% foods pdf nutrients
hypertension 96% foods pdf nutrients
excess estrogen 96% foods pdf nutrients
autism 96% foods pdf nutrients
hypothyroidism 95% foods pdf nutrients
pescetarian 95% foods pdf nutrients
breastfeeding 95% foods pdf nutrients
female fertility 95% foods pdf nutrients
sleep and insomnia 95% foods pdf nutrients
nutrient dense maintenance 94% foods pdf nutrients
depression 94% foods pdf nutrients
mitochondrial health 94% foods pdf nutrients
autoimmune friendly 94% foods pdf nutrients
bodybuilder 92% foods pdf nutrients
nutrient dense athlete 91% foods pdf nutrients
nutrient dense low carb 91% foods pdf nutrients
nutrient dense paleo (low carb) 90% foods pdf nutrients
mitochondrial health (low carb) 89% foods pdf nutrients
gestational diabetes 89% foods pdf nutrients
bivalve vegan 87% foods pdf nutrients
autoimmune (low carb) 84% foods pdf nutrients
nutrient dense plant based 81% foods pdf nutrients
nutrient dense carnivore 80% foods pdf nutrients
plant based (low carb) 76% foods pdf nutrients
well formulated ketogenic 63% foods pdf nutrients

Once you feel you have got the hang of eating mostly nutrient dense foods, you may wish to use the Nutrient Optimiser to identify the nutrient gaps as the foods and meals that will help you optimise your nutrition.

image28

 

 

references

[1] https://optimisingnutrition.com/2017/05/23/personalised-nutrition/

[2] https://www.nhmrc.gov.au/guidelines-publications/n35-n36-n37

[3] https://en.wikipedia.org/wiki/Hypervitaminosis_A

[4] https://www.amazon.com.au/Perfect-Health-Diet-Regain-Weight-ebook/dp/B007USA6MM

[5] https://www.bruceames.org/Triage.pdf

[6] https://en.wikipedia.org/wiki/Francis_M._Pottenger_Jr.

[7] https://www.dropbox.com/s/to3f84z77sckvjx/Interactive-Library-Nutrient_Correlation_Wheels-2.pdf?dl=0

[8] https://www.amazon.com/Nutrient-Bible-Henry-Osiecki/dp/1875239545/ref=tmm_pap_title_0?_encoding=UTF8&qid=&sr=

[9] https://www.ncbi.nlm.nih.gov/pubmed/28121382

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

[11] https://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&cad=rja&uact=8&ved=0ahUKEwigtuWKl_7WAhUIQLwKHeDdC74QFghFMAQ&url=http%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Farticle%2Fpii%2FS2212877817305379&usg=AOvVaw3NNHJwsTp33sDHvoOVdpAA

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

[13] https://en.wikipedia.org/wiki/Bliss_point_(food)

[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3313629/

[15] https://www.ncbi.nlm.nih.gov/pubmed/16332298

[16] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209489/

[17] https://optimisingnutrition.com/2015/03/22/diabetes-102/

[18] https://www.ncbi.nlm.nih.gov/pubmed/16004827

[19] https://www.nrv.gov.au/chronic-disease/summary

[20] https://www.nrv.gov.au/chronic-disease/summary

[21] https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5304a3.htm

[22] http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32252-3/abstract

[23] http://garytaubes.com/

[24] https://thebigfatsurprise.com/

[25] Note: we have not prioritised using Vitamin E and Pantothenic Acid due to the fact that the DRI targets are based on population averages rather than deficiency studies.

[26] https://www.bruceames.org/Triage.pdf

[27] http://www.meandmydiabetes.com/2010/05/07/ron-rosedale-protein-the-good-the-bad-and-the-ugly/

[28] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209489/

[29] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3192127/

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.

2017-06-17 18.34.52

IMG_9149

IMG_9138

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.

IMG_9148

img_9102

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

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.