Tag Archives: PSMF

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’.

image1

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.

image4

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

image2

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.

image2

the Ketogains method

Ever wondered what foods and meals are optimal for fat loss and muscle building?

Ketogains’ Luis Villasenor recently put a call out for recipes for their upcoming Ketogains Boot Camp, so I thought it would be interesting to see what the Nutrient Optimiser had to say about optimal foods and meals that align with the Ketogains approach.

luis villasenor

The essence of the Ketogains approach is to:

  1. consume adequate protein,
  2. limit carbohydrates, and
  3. use ‘fat as a lever’.[1]

This article unpacks each aspect of the Ketogains system.

image34.png

Protein as a goal

The Ketogains macro calculator recommends a minimum protein intake of 0.8g per pound of lean body mass (LBM) (i.e. 1.8g/kg LBM), increasing to 1.0g/lb LBM (or 2.2g/kg LBM) on lifting days.

This protein intake level is more than would be recommended in a therapeutic ketogenic approach or even the average protein intake for the general population.[2] [3] It does, however, align with Steve Phinney’s recommended protein intake level for athletes and performance and represents a more optimal protein intake for active people.[4] [5] [6]

From a sports nutrition standpoint, more than 2.2 gram per kilogram of total body weight is regarded as “high protein”.[7]  This could be as high as 3.0g/kg LBM when fat mass is taken into account.  So, while the Ketogains protein recommendations might be considered high in therapeutic keto and vegan circles, the Ketogains recommendations would be ‘moderate’ in a sports nutrition and bodybuilding circles.[8]

This chart above (from Lemon, 1998[9]) shows that, for a strength athlete, muscle protein synthesis is maximised when they consume at least 1.8g/kg BW of protein.

image53.png

Protein intake even more important when you are trying to lose weight.  The higher the energy deficit, the greater is our need for protein to prevent loss of lean muscle mass.  If we are active and/or doing resistance training, then our requirement for protein is even higher again.  As shown in the chart below from a recent review paper by Stuart Phillips, muscle mass is best preserved best when we have higher levels of protein, particularly if you are targeting an aggressive deficit.[10] [11]  If you are targetting a moderate energy deficit (e.g. 10%) then a protein intake of around 1.5g/kg BW is appropriate.  However, if we are targetting a very aggressive energy deficit then higher levels, up to 2.6g/kg BW will be beneficial to prevent loss of lean muscle mass.  If we are active then we will also need more (dashed line) while we need less if we are sedentary (dotted line).

image37.png

While it’s actually difficult to consume such high levels of protein due to the satiety effect, more protein won’t turn to chocolate cake.  [12]

image16.png

Protein contributes to your energy intake.  So if your goal is fat loss, then you want to target the minimum effective dose of macronutrients and micronutrients.

As a general rule, a higher protein intake tends to lead to a better nutritional profile[13] and increased satiety.[14] [15]  Very high protein diets (i.e. above than 80% energy from protein) will likely rely on supplements and may minimise other foods that provide more vitamins and minerals.  As you can see on the far left of this chart, actively targeting a low protein intake can lead to a poor nutritional outcome.[16]

protein (%) vs nutrient density score [click to enlarge]
[note: If your goal is therapeutic ketosis for the management of epilepsy, dementia, cancer, Parkinson’s or Alzheimer’s you will need to pay particular attention to ensure you get your share of micronutrients.]

Carbs as a limit

As you can see in the chart below,[17] you can get a reasonable level of nutrition if you consume anywhere between 0 and 60% of your energy from non-fibre carbs.[18]  However, with an exploding diabetes epidemic,[19] [20] [21] it’s probably fair to say that the majority of people would do better if they reduced their consumption of refined grains and sugars.

carbohydrates (%) vs nutrient density score [click to enlarge]
If you have already developed insulin resistance or diabetes, then reducing your carbohydrate intake to the point you achieve normal blood glucose levels is a good idea,[22] both in terms of overall health and controlling appetite that can be driven by excessive blood sugar swings.

Screenshot 2017-12-01 18.54.14.png

The fact that much of the population is already insulin resistant is likely part of the reason the Ketogains approach, with its limit on carbs, has been so successful.

image57.jpg

Low carbers are fond of saying “there is no such thing as an essential carbohydrate”.  However, unless you are focusing on getting lots of organ meat, shellfish, or fresh meat, you may benefit from consuming some non-starchy veggies to get your essential vitamins and minerals.

Twenty or thirty grams of non-fibre carbs doesn’t sound like much in the context of grains or sugars, but it can feel like a LOT of food to consume if it’s from non-starchy veggies.[23]

image62.png

Fat as a lever

So to recap before we get into discussing fat:

  1. Adequate protein is critical to support muscle growth and repair.
  2. Non-starchy veggies (which contain a small amount of non-fibre carbohydrates) provide vitamins and minerals (unless of course, you are eating heaps of shellfish, organ meat or drinking blood like the Maasai).

Recently, many people are swinging back from their fear of fat to embrace dietary fat again.  Carbohydrate is a more explosive fuel source for emergencies, while fat is a slower burning and more efficient fuel source.

While there are essential fats, we don’t require much to meet our minimum requirements of essential fats.[24]  Beyond this, where you get your energy doesn’t matter that much.

Many people do fine on a diet that obtains a lot of the energy from carbs while other do well on a diet that get the majority of energy from fat.  However, where things seem to go wrong is when people consume diet that is high in energy dense nutrient poor fat and carbs with minimal amounts of protein.

fat vs carbs.jpg

As you can see from the chart below, we can achieve a respectable nutritional outcome with a fat intake of between 10 and 65%.   More fat is not necessarily better, but very low-fat levels are not great either as they tend to have minimal amounts of protein and other essential nutrients.

fat (%) vs nutrient density score [click to enlarge]
If you are trying to reduce body fat, then maximising the nutrient density and reducing the energy density of your food is a worthy goal.  A protein sparing modified fast, an extreme version of this, provides adequate protein while limiting both fat and carbohydrates.

image31.png

If you are looking to gain weight, add muscle or perform extended feats of endurance exercise on a regular basis, it may be beneficial to load up on more energy dense foods.  However, conversely, if are not an endurance athlete but trying to use your body fat for fuel (like most of us these days living in a sedentary environment full of hyperpalatable food), you may want to wind your dietary fat intake back.

Micronutrients

Once you’ve worked out your macros using the Ketogains calculator and got the hang of using fat as a lever to manage energy intake, the next step is to ensure you are getting your share of micronutrients.

image24.png

Focusing purely on macros (e.g. Flexible Dieting, IIFYM, etc.) is short-sighted because it fails to consider micronutrients.  Chronic energy restriction without attention to micronutrients can lead to chronic nutrient deficiencies,[25] a lack of energy, increased hunger,[26] rebound bingeing due to cravings and even death.[27]

You’re likely aware that the branched-chain amino acids (BCAAs) trigger muscle protein synthesis and ensure you use the rest of the amino acids to build and repair your muscles.[28]  However, recent research has found that the amino acids arginine and lysine trigger satiety and hence we find foods that contain these amino acids more filling.[29] [30]

The chart below shows what your micronutrient profile would look like if you focused on branched chain amino acids (valine, isoleucine, and leucine) and the satiety-related amino acids (lysine and arginine) while also keeping carbohydrates low.

image59.png

While we get plenty of protein with this approach, we would not obtain the recommended minimum levels of a large number of the essential vitamins, minerals, and essential fatty acids.

As much as we like to focus on macronutrients (i.e. fat, protein, carbohydrates, fibre, ketones), micronutrients are arguably a more useful to assist us in our nutritional decision making.

Getting adequate minerals is especially important for:

  • avoiding the symptoms of the keto flu,[31]
  • reversing insulin resistance and minimising the amount of basal insulin circulating in your body,[32] [33] [34] and
  • maximising athletic performance.[35]

image7.png

The chart below shows what happens to our micronutrient profile when, in addition to BCAAs, we also prioritise foods that contain the harder to find micronutrients.  The purple bars represent the nutrients contained in the average of all foods in the USDA foods database while the blue bars represent the nutrients contained in the shortlist of foods.

nutrients - weight loss insulin resistant vs all foods.PNG

Optimal foods

In case you were wondering which foods will give you the most micronutrients while also having a lower energy density and fewer carbs, I have listed them below.

vegetables

  • endive
  • alfalfa
  • chicory greens
  • escarole
  • coriander
  • pumpkin leaves
  • asparagus
  • spinach
  • Chinese cabbage
  • lettuce
  • parsley
  • okra
  • zucchini
  • beet greens
  • watercress
  • arugula
  • portabella mushrooms
  • chives
  • chard
  • white mushroom
  • turnip greens
  • cauliflower
  • mustard greens
  • banana pepper
  • cucumber
  • pickles
  • sauerkraut
  • yeast extract spread
  • summer squash
  • radishes
  • broccoli
  • collards
  • shiitake mushroom
  • celery
  • artichokes
  • eggplant
  • cabbage
  • snap beans
  • turnips
  • red peppers

spices

  • basil
  • dill (fresh)
  • sage
  • marjoram
  • curry powder
  • thyme
  • caraway seed
  • mustard seed
  • dill seed
  • cloves

fruit

  • blackberries
  • avocado
  • raspberries
  • olives

seafood

  • salmon
  • sturgeon
  • halibut
  • fish roe
  • anchovy
  • crab
  • trout
  • caviar
  • crayfish
  • flounder
  • mackerel
  • sardine
  • oysters
  • mussel
  • rockfish
  • pollock
  • lobster
  • herring
  • haddock
  • perch
  • whiting
  • tuna
  • shrimp
  • white fish
  • cod
  • octopus

offal

  • liver
  • kidney
  • heart
  • brains
  • headcheese
  • brains

animal products

  • pork chops
  • pork shoulder
  • lamb
  • roast pork
  • pork loin
  • ground pork
  • pork ribs
  • roast ham
  • leg ham
  • sirloin steak
  • ground beef
  • chicken drumstick
  • chicken breast
  • veal
  • bratwurst
  • chuck steak
  • roast beef
  • ham
  • ground turkey
  • turkey
  • beef roast
  • lamb
  • ribeye fillet
  • bison
  • beef loin
  • ground beef

dairy & egg

  • whole egg
  • egg yolk
  • whey protein powder

You should ideally focus on the foods closer to the top of these lists.  But once you’ve eaten as much endive, alfalfa, liver and caviar as you can, feel free to move down the list to more energy dense foods or ones that you might enjoy eating more.

Supplements

If you can’t get enough nutrient-dense foods, it may be beneficial to use supplements.[36]  Keep in mind though, the nutrients from whole foods are likely to be better absorbed.

Too many minerals at once will ‘give you a dose of the salts’ and all your expensive supplements will end up in the toilet.  Whole foods are also more likely to contain other beneficial non-essential nutrients that come along with nutrient-dense foods.

What to track

“What gets measured gets managed”.[37]

But we can only manage a handful of things at a time.

“If everything is a priority, nothing is a priority.”

Rather than trying to track everything all at once you need to identify a few things to track to ensure you are moving towards your goals.

In the context of losing fat and gaining muscle the best things to track appear to be:

  1. weight/body fat,
  2. macros/calories, and
  3. performance (e.g. weight on the bar).

weight / body fat

Most people want to have more energy and look good naked.  While it’s much easier to track body weight, this ultiamte goal really about losing body fat.

There are a ton of different ways to measure body fat (e.g. DEXA, comparison photos, bioimpedance scales, Skulpt, the Navy Method, etc.).  They are all inaccurate to some degree.

You can do your head in focusing on the fluctuations on the scale or body fat from day to day.  But, you want to see your overall weight and body fat reducing toward your target levels.  People who successfully lose weight and keep it off manage their food intake, measure their weight regularly and are active![38] [39]

If you’re a fitness model you might want to measure yourself daily.  If you’re just starting to focus on eating well and lifting, then you might just want to weigh yourself weekly or monthly.[40]

If you are not moving towards your goals over the long term, something needs to change.

body fat chart.png

But first, you need to set some realistic goals.  Take the time to determine your current and target body weight, fat (in kg and %) and lean body mass (LBM).

  current target
body weight (kg)
body fat (%)
body fat (kg)
LBM (kg)

If you are disciplined, it is possible to lose 1% of your mass per week, but 0.5% is a more realistic and less aggressive target.  If you are already lean, then it will be harder to lose fat without losing muscle so you may need a less aggressive deficit.[41]

It’s not all about the weight on the scale.  You can be losing fat and gaining muscle, the weight on the scale probably is the most reliable indicator that you’ve got your inputs right.  If you’re getting enough protein and working out, incrased muscle mass should be looking after itself, and any loss should be mainly fat.[42]

Keep in mind that body weight is a lagging measurement that tells you whether you’re on the right track.  Tracking inputs (e.g. food intake and exercise) will be much more useful.

macros / calories

Personally, I don’t enjoy tracking my food, so I’ve designed a range of food lists and meals that will help most people improve from where they currently are.  It will be pretty hard to get/stay morbidly obese if you eat only the foods and meals listed above.

But eating to satiety won’t guarantee you will lose weight.  If you want to look like a fitness model, or you are not getting your desired results from ‘eating ad libitum’ you will likely need to track your food to overcome your inbuilt impulse to maintain a higher body weight and prepare for a possible famine ahead.

Tracking your food in an app like Cronometer can be a useful educational experience.

image39.png

The Ketogains calculator will give you a starting point in terms of calorie intake based on your current weight and activity levels.  If, after a few weeks, you are not seeing the progress you were hoping for you will need to adjust your inputs.

Performance/weight on the bar

Building muscle or achieving a performance goal is probably more important than weight loss, particularly if you are not trying to get down to a very low level of body fat.

The great thing about using a performance goal is that it is both a leading and lagging measure.  By going harder, faster and heavier you are providing a greater stimulus for growth.  And by measuring your performance outputs, you are ensuring that you are getting fitter/faster/healthier.

While being strong doesn’t guarantee weight loss, being stronger will improve your metabolic health, insulin sensitivity and ability to burn fat more effectively than nearly anything else.

image45.png

Having more lean muscle mass will ensure you burn both glucose and fat more efficiently.  Lean muscle mass is a key predictor of longevity.[43]

muscular woman.png

The Ketogains boot camp uses a 5×5 strength progression.  The Stronglifts 5×5 or Starting Strength uses a similar progressive overload approach.  These programs involve compound lifts (squat, deadlift, bench press, overhead press, row etc.) and progressive overload meaning that you add weight to the bar each time and continue to get stronger.   By doing this, you train your body to produce energy more efficiently.

image14.jpg

Don’t be surprised if your appetite ramps up during the first few months of intensive lifting as your body goes into anabolic overdrive to recover and build new muscle.  This should settle down though after a while, and you can then focus on dialling your diet in if you want to gain strength as well as lose body fat.[44]  You have a unique window of ‘newb gains’ during initial whne you can get stronger at in a way that you may never achieve again.  You can focus on getting to single digit body fat later.

Other stuff that you could track

There are other things that you might like to track, but they will be less useful than the things mentioned above.  Most people have limited time and don’t really want to live a completely quantified life.  Unless this is your only hobby or you are a professional athlete or fitness model, you may quickly hit ‘analysis paralysis’ and give up.

quantified self.png

There is no guarantee that technology will help you reach your goals.  In fact, it seems that you are more likely to gain weight if you use wearables like a Fitbit.[45]  It’s hard to know whether this is due to the EMF or perhaps the wearer is always allowing themselves to consume the extra calories that their technology told them that they just burned with exercise.

So, coming from a biohacker nerd….  don’t try to track too many things at once!  OK?

Heart Rate Variability

Heart Rate Variability (HRV) is a measure of the variability between your heart beats.  If you are stressed and/or exhausted your heart will be more rhythmically as well as more rapidly.   If you are relaxed and well rested your heart will be more to stresses and quickly return to rest.

HRV.png

Measuring your Heart Rate Variability (HRV) can tell you if you’re pushing too hard and need to rest recover or you’re not pushing hard enough and should be working harder to maximise your progress.  Training when you are burning out can be counterproductive and lead to injury or under recovery.

2018-01-01 11.28.18.png

HRV tells you whether your sympathetic and parasympathetic nervous system is balanced.

  • If you are “parasympathetic nervous system dominant” you might be overstressed from too much activity, not enough sleep, too much caffeine or work stress.
  • If you are “sympathetic nervous system dominant”, then it probably means your body wants to rest. You’ll probably do better if you listen to it and let it recover.
  • If your overall HRV is dropping, it means you are burning out and should consider slowing down.

After 1.5 years of measuring my HRV each morning, it’s uncanny how many times I will see my HRV fall a few days before you get the flu or hit the wall.  I don’t like to stay still long enough to meditate, so tracking each day with Elite HRV is part of my relaxation, breathing and focus at the start of each day.

image20.jpg

Blood sugar

Your blood sugar and glucose control is a powerful indicator of metabolic health.  But blood sugar readings can vary depending, not just due to the food you eat or your metabolic health, but also exercise and stress.

blood sugar ketones.png

If you have diabetes, then refining your food choices to normalise your blood sugars is critical. However, regular blood sugar tracking is likely a waste of time and money for most people who are following a Ketogains style approach (i.e. tracking their food to ensure they are moving towards an optimal weight, getting adequate protein and lifting regularly) is unnecessary.

Blood ketones

Unless you require therapeutic ketosis to help manage epilepsy, cancer, Alzheimer’s or Parkinson’s measuring your blood ketones is also largely an irrelevant distraction.

Lots of people get caught up chasing ‘optimal ketosis’ by eating more dietary fat and less protein.  However, this is exactly the opposite of what you need to gain strength and lose body fat.

Blood ketones do increase when we don’t eat. But high ketone levels don’t mean you are burning your own body fat.  It could just be the three Bulletproof coffees and exogenous ketones you just had to get that are driving your high ketone levels.

Some people, especially those who are physically fit and/or have been practising a low carb diet for a long time, seem to have lower blood ketone levels, even if they are eating a ‘ketogenic’ diet.  It’s hard to know whether this is due to the more efficient use of ketones or the fact they are burning more fat through non-ketogenic pathways.

image29.jpg
Ketones are just one of a number of ways that we burn fat (chart from Dave Feldman)

Someone who is not so metabolically healthy can load up on exogenous ketones, butter and MCT oil and get a high blood ketone reading on their meter.  But this may just mean that they have eaten a lot of fat that they are not burning (because of their lack of activity and/or poor metabolic health) and the fat is backing up in their bloodstream.

A healthy metabolism seems to keep the total energy circulating in the bloodstream fairly low (i.e. from glucose, ketones or free fatty acids).  If you are metabolically healthy, you can easily access your fat stores so you don’t need to build up high energy stores in the blood.  By contrast, someone with a less healthy metabolism seems to maintain higher energy stores in the blood (i.e. glucose, ketones, free fatty acids) as well as on their body.[46]

image26.png
This chart shows more than 3000 data points of blood glucose and ketones together from a range of people following a low carb and ketogenic diet.  Having high blood ketones and high blood sugar at the same time is not good!  Healthy people tend to have lower blood sugar and moderate level ketones.

Most people don’t need to worry about their blood glucose and ketone levels consciously.  If you focus on nutrient dense food to optimise your mitochondrial function and strength building to keep pushing your mitochondria to produce energy at peak efficiency, then your body will probably look after the rest.

[At the risk of getting too technical, it’s worth pointing out that blood ketones rise because there is a lack of Oxaloacetate (from protein and carbs) available to burn Acetyl CoA from fat in the Krebs cycle, so the body defaults to a starvation protocol to produce ketones (AcetoAcetate). 

image54.png
Figure from Amy Berger showing how fat can be burned in the Krebs cycle or via ketosis when there is not enough Oxaloacetate from protein and carbs turn the Krebs cycle.

If your NAD+ is low, AcetoAcetate will not be converted to Acetone so there will be lots of beta-hydroxybutyrate left in the blood to be measured on your meter.  So, other than fasting and/or exercising to deplete your liver glycogen levels, one ‘hack’ to achieve high blood ketone is to avoid protein and eat a nutrient-poor diet low in niacin and other B vitamins (which produce NAD+).  But don’t try this at home.  It’s not a recipe for optimal health, just high blood ketone levels.]  

image4.png

Ketogains’ Tyler Cartwright has lost nearly three hundred pounds without exceeding 0.4mmol/L blood ketones on his ketone metre (other than that time he ate nothing but lard for two weeks as an experiment and got to 0.5mmol/L).[47]

tyer cartwright.png

Breath ketones

Breath ketones are an interesting indication of your metabolic health.  But again, they’re not necessary if you are already focusing on a nutrient-dense diet without too much energy and plenty of activity.

image61.png

Waist measurement

BMI is often used to assess whether or not someone is at a healthy weight.

image33.png

However, BMI is notoriously problematic for people with more muscle.

image42.png

Waist to height ratio is a much better predictor of the years of life that you will lose due to your poor health.[48]

image58.png

Micronutrients and nutrient score

Focusing on the nutrient-dense whole foods above and the meals below will get you most of the way to optimal nutrition.  However, you can also track your macronutrients in Cronometer to help you identify the nutrients you are not getting from your diet.

image18.png

But then, once you’ve tracked your food in Cronometer, you are left wondering what foods and meals you should eat.  and if need to supplement, how much of each supplement do you require and how much?

The Nutrient Score is a measure of the micronutrient quality of your diet.  If you were able to get two times the recommended daily intake of all the essential micronutrients, you would get a perfect score of 100%.

To demonstrate what this looks like in practice, Ted Naiman’s diet got a very respectable nutrient score of 70%.

ted naiman.png

Luis’ got 72%.

luis nutrition.png

Nutrition nerd Alex Leaf (and regular reviewer of my blog posts… thanks so much Alex!!!!) scored an impressive 74%.

alex leave.png

Mike Berta also scored 74%.

mike berta.png

Brianna Theroux’s scored a very healthy 79%.

brianna theroux.png

And sitting at the top of the leaderboard is Dr Rhonda Patrick with a score of 82%.

rhonda patrick.png

But the coolest competition is against yourself.  Andy Mant managed to seriously up his nutritional game…

image9.png

… by eating a LOT of nutrient-dense seafood…

image43.png

… in preparation for his Paris wedding.

image12.png

By following the recommendations of the Nutrient Optimiser analysis, Robin was able to improve her nutrient score to 32% (junk food diet) to 68% over a number of iterations (see report 1, report 2 and report 3).

In the process, she was able to significantly improve her blood glucose levels, dropping her HBA1c from 10.6% to 6.4%.  Robin was also able to progress from taking hundreds of units of insulin per day to only needing occasional correcting doses to fine tune her blood sugars.  She also managed to lose 2.6lbs per week!

image46.png

And after a couple of rounds of following the Nutrient Optimiser recommendations and a couple of Ketogains boot camps the Matt Standridge (aka The Ketodontist) has stepped up from a nutrient score of 48% to 73%.  He says he is feeling great and continues to gain muscle and lose fat.

image35.png

The Nutrient Optimiser

While there are common themes, each person’s micronutrient fingerprint is unique.  The optimal foods and meals that will balance your micronutrient profile are unique to you.  The Nutrient Optimiser is the only tool that will tell you what foods are ideal to balance your diet while also aligning with your goals.

Currently, the Nutrient Optimiser is a manual report that will help you optimise your nutrition from the micronutrients based on your food log in Cronometer.  We’re working hard to develop an automated system that will use your goals and whatever data you have to help you refine your nutrition to achieve your goals.

If you don’t want to track your food, the system will tell you what meals and foods will align with your goals.  But if you want to step up your game and provide other data we can work with that to further refine your nutritional prescription to fill in your micronutrient gaps.  The system will also adapt with you to improve your nutrition, ideally from diabetic to weight loss to achieving your performance goals.

nutrient optimiser.png

It might just be your secret weapon to help you blitz #transormationtuesday.

Summary

  • The Ketogains protocol involves getting adequate protein (to support muscle growth and recovery) and adequate carbs to get essential vitamins and minerals. Fat is used as a level to manipulate energy intake to suit your goals.
  • If you are limiting your energy intake, maximising your nutrient : energy ratio is critical!
  • The Nutrient Optimiser can help you identify foods and meals that align with your goals and fill in your micronutrient deficiencies.
  • Chose what you track wisely. Trying to manage too many things can lead to ‘analysis paralysis’.  If you manage the most important inputs, results should naturally follow.

 

 

Meals

I’ve been building a database of to help identify the meals that provide you with the nutrients you need more of and align with your goals.

If you are tracking in Cronometer, you can sign up for a Nutrient Optimiser analysis and report here to find out which foods and meals will help you move forward.  I’ve also been working with Alex from Nutrient Hero for the past few months building a massive database of recipes we can use to optimise your nutrition.

It feels like it’s been a long time coming, but it won’t be too long before it’s all automated and online.  If you want to be the first to trial the beta version then make sure you enter your email in the pop on this page or head over to NutrientOptimiser.com now to learn more.

The recipes below are some of the highest ranking when we prioritise some of the harder to find vitamins and minerals (potassium, magnesium, calcium, zinc, vitamin D, thiamine and choline) as well as higher protein and a lower energy density.

I have included the link to the Cronometer entry as well as the nutritional profile and a list of foods that will help you balance the nutritional profile of the recipe.

Bootcamp omelette

image49.png

Gayle Louise created this simple omelette recipe for her Ketogains boot camp workout days.   Nutritional yeast has a fantastic nutritional profile and adds a cheesy taste without the calories, minimising fat and maximising nutrient density.

ingredients

method

  • cook the spinach first with ghee or butter.
  • whisk 4 eggs with salt and pepper and add too cooked spinach
  • sprinkle with nutritional yeast, cover and cook until firm.

Facebook

Cronometer analysis

https://nutrienthero.com/recipe-analysis/boot-camp-omelette

 

Potassium salted caramel coffee

potassium caramel coffee.png

Everyone loves coffee, and most people find potassium harder to get in their diet than sodium.  So why not potassium coffee?!?!  The milk and caramel syrup are not essential, but they give you that indulgent salted caramel taste.

Getting adequate minerals is critical to ensuring insulin sensitivity, nutrient partitioning, muscle building and recover and avoiding diabetes.

While most people don’t need to worry about getting too much salt, having a potassium : sodium ratio greater than two is hard to achieve for most people, even if they do eat a lot of greens.

My friend Raymund Edwards of Optimal Ketogenic Living has been doing a LOT of research into the wide-ranging benefits of alkalising electrolytes, in particular, potassium.  This recipe was inspired by Raymund after hearing that he was adding potassium to his coffee.

Raymund said, “A potassium enriched coffee in the morning really wakes the muscles.  It’s better than any warm up.  Loose and alive we can feel the difference as they soak up actively the potassium especially after the night fast (where muscles have been releasing potassium).  And  the coffee in my view tastes so much better too.”

It’s hard to get a significant amount of potassium from tablets as they are limited to 99 mg which is only a fraction of the 3,800 mg of potassium that we need each day (you would need to take forty tablets to get the DRI for potassium!).

potassium.png

You can also add the potassium citrate powder to your drinking water, coffee or pre-workout mix.  You would need more than 10g of the citrate powder to get your recommended daily intake of potassium, but, like all things, start slowly. However, in time, it might just make you feel amazing!

ingredients

method

  • Pour coffee shot from fresh grounds
  • Add potassium citrate powder
  • Add caramel syrup (optional)
  • Add a dash of full cream milk to taste (optimal)
  • Add hot water to taste (depending on how you like your coffee)

Cronometer analysis

nutritional analysis

 

Greens + eggs + seafood

image51.png

Dom D’Agostino infamously told Tim Ferriss in his sound check that his breakfast was sardines, oysters, eggs and broccoli.  It might sound bizarre, but it packs a nutritional punch.

image40.png

Most days my breakfast is some variant on frozen greens (spinach, broccoli, kale) + eggs + seafood (sardines, mackerel, oysters, mussels, anchovies) + nutritional yeast.

If you’re not focusing on losing body fat you can add cheese or peanuts for some extra indulgent taste, but leaving these out will help you increase your protein : energy and nutrient : energy ratio which is ideal if you are trying to lose body fat (and will make Ted Naiman and Luis Villasenor proud).

You could take more time to fry these ingredients up and plate them up nicely, but most of the time breakfast only needs to be time efficient and doesn’t need to look good.  If you can start the day with a high protein nutrient dense breakfast, you’ll be less likely to succumb to other cravings later in the day.

ingredients:

  • 250g frozen veggies. Spinach is always best, but broccoli or kale work too.
  • Three eggs. Consider removing the yolks if you are focussed on lower fat higher protein fat loss phase, though this will decrease the overall nutrient profile.  The yolk is where all the vitamins and minerals are!
  • 1 can of seafood (e.g. mackerel, sardines, oysters, mussels or anchovies).
  • 1 teaspoon of nutritional yeast
  • Peanuts (optional, only if not looking to lean out)
  • 1 oz mozzarella cheese (optional, only if not looking to lean out)
  • Salt (No Salt, Celtic Sea or Redmond Real Salt) & pepper to taste.

method

  • Defrost greens in bowl for five minutes in the microwave.
  • Add eggs and cook for a further minute or until done. (I often find that the eggs need a bit more cooking but stir everything in at around three minutes and then cook for another two minutes).
  • Add other ingredients
  • Salt liberally to taste.

Nutritional analysis

Cronometer entry

Photos of other variants (hey, they ain’t pretty, but they work).

image1.png

image11.png

image5.png

image56.png

 

Bacon, egg, spinach and mushroom

image41.png

This is a variant on the common bacon and eggs recipe. The spinach mushroom and tomato round out the nutritional profile of the stock standard bacon and eggs.

The spinach provides a wide range of vitamins and minerals, particularly vitamin K and vitamin A.  Most people think kale is the ultimate nutrient-dense green vegetable.  However, kale just has a lot of Vitamin K1 and not so as much of everything else.  Spinach has a much better nutritional profile across the board.

If you are focusing on reducing body fat and maximising nutrient density, consider eliminating the cream, draining the bacon fat and keeping the butter to a minimum for cooking.  If your goal is bulking and recover, then you can be more liberal with the cream and cheese to taste.  Remember, fat is a lever.

ingredients:

  • 3 large eggs
  • 200g fresh spinach
  • 2 mushrooms
  • 30g cream (optional)
  • 30g mozzarella cheese (optional)
  • butter
  • Salt (No Salt, Celtic Sea or Redmond Real Salt) & pepper to taste.

method

  • Fry bacon separately. If your priority is reducing body fat then you can let the bacon rest on a paper towel to drain the fat.  Alternatively, bacon grease can be used to fry the spinach, mushroom and eggs.
  • Fry eggs separately.
  • Add cream and cheese if not looking to lean out.
  • Salt to taste.

Nutritional analysis

Cronometer entry

 

Steak, egg, tomato, avo spinach and lettuce

image32.png

This is a fairly standard Sunday night family dinner at our place.  A solid piece of steak on the BBQ with salad.

ingredients:

method

  • Grill BBQ steak
  • Cook spinach with some butter or coconut on BBQ plate when grilling the steak.
  • Serve with boiled egg (or fried on the BBQ) along with salad (avocado, tomato and lettuce shown here).
  • Salt (No Salt, Celtic Sea or REdmond Real Salt) & pepper to taste.

Facebook

Nutritional profile

Cronometer

 

Be sure to check out the more than 300 meals on the Nutrient Optimiser Facebook Group.  You might even want to add some of your own.

 

 

 

references

[1] https://ketogains.com/2017/06/energy-balance-macros-nutrient-density/

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

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

[4] http://www.artandscienceoflowcarb.com/the-art-and-science-of-low-carbohydrate-performance/

[5] https://www.amazon.com/Art-Science-Low-Carbohydrate-Performance/dp/0983490716

[6] https://www.youtube.com/watch?v=GkQYZ6FbsmI

[7] https://optimisingnutrition.com/2017/10/15/high-protein-vs-low-protein/

[8] https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0201-z

[9] https://www.ncbi.nlm.nih.gov/pubmed/9841962

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

[11] https://l.facebook.com/l.php?u=https%3A%2F%2Fwww.dropbox.com%2Fs%2F1if7n957u66htiy%2F10.1123%2540ijsnem.2017-0273.pdf%3Fdl%3D0&h=ATNppfskJJ6fMuIVoJrC0rX_8H9KCT2SeryF0MeRrAnJz6X9p_3FPhPYUK3RGSOE-kDTeOLxKdw26vel3zBWDbOlaCQzxkxpDU8CjFs9Moo51fC9NByHYvs83uU7PvjFolOxvqx3Pw

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

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

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

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

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

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

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

[19] https://www.reuters.com/article/us-health-diabetes/cost-of-diabetes-epidemic-reaches-850-billion-a-year-idUSKBN1DD2SW

[20] http://www.diabetesincontrol.com/the-true-cost-of-diabetes-and-preventing-it/

[21] http://www.diabetes.co.uk/cost-of-diabetes.html

[22] https://optimisingnutrition.com/tag/insulin-load/

[23] https://www.dietdoctor.com/low-carb/20-50-how-much

[24] https://www.nrv.gov.au/nutrients/fats-total-fat-fatty-acids

[25] https://www.ncbi.nlm.nih.gov/pubmed/17593855

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

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

[28] https://metabolicnutrition.com/branched-chain-amino-acids-bcaas-benefits-for-muscle-growth/

[29] https://www.sciencedaily.com/releases/2017/09/170927093254.htm

[30] http://suppversity.blogspot.com.au/2013/09/the-satiating-secret-of-arginine-lysine.html

[31] https://ketogains.com/2017/06/keto-flu-electrolyte-imbalances/

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

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

[34] https://diabetesmealplans.com/6285/magnesium-and-diabetes-type-2/

[35] https://www.ncbi.nlm.nih.gov/pubmed/22150427

[36] https://ketogains.com/2016/08/ketogains-seven-must-supplements/

[37] https://athinkingperson.com/2012/12/02/who-said-what-gets-measured-gets-managed/

[38] https://www.ncbi.nlm.nih.gov/pubmed/24355667

[39] https://en.wikipedia.org/wiki/National_Weight_Control_Registry

[40] http://www.nourishbalancethrive.com/podcasts/nourish-balance-thrive/keto-masterclass-robb-wolf/

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

[42] https://www.bodyrecomposition.com/muscle-gain/calorie-partitioning-part-1.html/

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

[44] https://startingstrength.com/articles/clarification_rippetoe.pdf

[45] https://jamanetwork.com/journals/jama/fullarticle/2553448

[46] https://optimisingnutrition.com/2015/07/20/the-glucose-ketone-relationship/

[47] https://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0ahUKEwjpo5y5qu_XAhWHFpQKHV8VAXgQFggvMAE&url=http%3A%2F%2Fketogeek.libsyn.com%2F14-tyler-cartright&usg=AOvVaw04xLzYxE3tS8oa8LWvLkZk

[48] http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0103483

The nutrient-dense Protein Sparing Modified Fast (PSMF)

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

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

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

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

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

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

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

2017-06-17 18.34.52

IMG_9149

IMG_9138

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

Medical applications of the PSMF

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

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

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

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

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

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

Bodybuilding applications

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

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

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

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

Protein drives satiety

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

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

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

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

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

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

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

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

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

Thermic effect of food

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

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

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

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

Should you just eat the highest protein foods?

So, the obvious question is:

What should I eat on a PSMF?

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

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

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

NO logo

The problem with a very high protein diet

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

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

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

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

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

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

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

Bruce Ames’ Triage Theory

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

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

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

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

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

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

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

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

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

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

The nutrient-dense adequate protein diet

So, to recap:

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

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

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

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

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

Calorie math

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

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

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

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

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

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

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

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

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

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

Insulin resistant long-term fat loss scenario

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

Introducing…  Big Ted.

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

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

Big Ted is also pre-diabetic.

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

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

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

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

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

Calorie math

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

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

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

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

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

How often should I eat on a PSMF?

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

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

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

image4

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

Screenshot 2018-05-30 03.16.21.png

How low can you go?

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

Screenshot 2018-06-28 06.00.54.png

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

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

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

What about rabbit starvation

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

IMG_9148

img_9102

How to do a nutrient dense PSMF

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

Summary

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

 

References

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

post updated August 2017

optimal foods for fat loss

People with diabetes or insulin resistance may do well initially with a low carbohydrate diet to help them normalise blood glucose levels.  Managing your appetite is easier once you stabilise your blood glucose levels.

null

However, once your glucose and insulin levels stabilise, you will likely benefit from reducing the energy density of your diet while also increasing the nutrient density of the foods you eat.

Foods with a lower energy density are more filling and more difficult to overeat which is a useful hack if you want to use the fat on your body for fuel.

null

The chart below is from a recent pilot study by Christopher Gardner of Stanford (Weight loss on low-fat vs. low-carbohydrate diets by insulin resistance status among overweight adults and adults with obesity: A randomised pilot trial).  

image15

The researchers educated all participants to improve their diet quality with nutrient dense whole foods.  However,  they told half the participants to eat as low fat as they possibly could while the other half ate as little carbohydrates as they practically could.

After six months, the people who were insulin resistant generally did better with a lower carbohydrate approach.  However, the people who were insulin sensitive did slightly better on a low-fat, lower energy density approach.

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

Paul Jaminet

The chart below shows the nutrients in the lower energy density high nutrient density foods compared to the average of all the foods in the USDA food database.  Eating more of these will ensure you get the nutrients you need with less energy while also avoiding nutrient cravings or deficiencies.

Screenshot 2017-12-26 04.20.44.png

The foods are ranked using a multi-criteria analysis based on their nutrient density (i.e. they provide you with more of the nutrients that are generally harder to find) and their energy density.

A shortlist of some of the foods that have a low nutrient density and a high nutrient density are listed below.

vegetables

  • alfalfa
  • asparagus
  • spinach

spices

  • basil
  • dill (fresh)
  • sage
  • marjoram

fruit

  • blackberries
  • raspberries

seafood

  • salmon
  • anchovy
  • crab
  • trout

offal

  • liver
  • kidney
  • heart

animal products

  • pork chops
  • pork shoulder
  • lamb

dairy and eggs

  • whole egg
  • egg yolk
  • whey protein powder

the Nutrient Optimiser

For a longer list of personalised foods and meals to suit your weight loss goals we invite you to get your free report from the Nutrient Optimiser.  It’s been really exciting to see how many people have been able to reduce their energy while avoiding cravings.

NO logo

When we get the nutrients we need, our cravings decrease, and the body can use our stored body fat for fuel.

 

last updated June 2018