P:E discussion on Twitter, Amber O'Hearn versus Ted Naiman


(mole person) #22

No, it’s absolutely not total weight. It’s reference weight.

From that blog entry.

we have performed a number of studies indicating that most healthy humans maintain lean body mass and function during a ketogenic diet providing between 1.5 and 1.75 grams of protein per kg of ‘reference body weight’ (Phinney 1983, Davis 1990). Furthermore, there are no convincing human studies showing any benefit from dietary protein above 2.0 g/kg reference weight for adults following a ketogenic diet

Reference body weight is an arbitrary value for men and women based upon the medium frame values from the 1959 Metropolitan Life Insurance ‘Ideal Body Weight’ tables.


(Bacon is a many-splendoured thing) #23

I’m not clear on that, and also his thinking seems to be evolving. But he definitely has been known to say that “too much protein isn’t even a thing.” He may simply mean “don’t worry how much protein you eat,” but it’s not entirely clear.

What is clear, however, is that he thinks we should eat a higher percentage of calories as protein. In one video lecture I saw, he was promoting the idea of equal amounts of fat and protein by weight, which is a 69% : 31% ratio by caloric value.

ETA: As for the question of how much protein per how much weight, the Dudes recommend 1.0 -1.5 g/kg of lean body mass. Dr. Bikman advises going as high as 2.0 g/kg. The Virta Health recommendation, as @Ilana_Rose points out, is based on the old MetLife tables of height and weight that used to hang in every doctor’s office. (As I recall, there are actually three sets of charts, according to body frame, and one determined which set to use by some method having to do with the length of one’s forearm. But don’t quote me—I haven’t seen an actual MetLife chart in literally decades.)

Dr. Phinney is on record as saying he has no idea how much any particular person should weigh. I suspect that they chose to use the MetLife charts as their reference, because they are based on actuarial data collected before the beginning of the obesity epidemic.


(mole person) #24

This has changed. He’s now interested in targetting a ratio of protein over fat plus net carbs in grams.

He recommends the numerator be protein grams equal or greater than your desired weight in pounds and the denominator be fat plus net carbohydrate grams equal to or less than that same weight.

He’s not in favor of a high fat diet at all for those with fat to lose. He specifically advises that if you have too much body fat then you should avoid high fat foods and only get your fats from eggs and lean meats.

It’s a very different approach to the high fat/low carb ketogenic diet generally recommended here.
The protein is higher, the carbs are higher, and the fat is lower. I suspect it can work well though for people with fat to lose when all of his recommendations are followed closely.


#25

Yes, but “reference weight” is not referring to lean body mass. It’s referring to total weight. So, if someone is using the chart, they should be using their total goal weight essentially. Not their lean body mass or their lean body mass at goal, etc.


(mole person) #26

I don’t think anyone claimed that Virta uses lean mass in this thread. I said that I use the Dudes recommendation of an upper limit of 1.5 g/kg of lean mass which I far prefer to using ranges of “medium frame values” determined by some insurance company in the 1950’s.

However, if you favor using those tables than you don’t go by weight at all, neither current total nor goal weight, you go by height and it tells you what your reference weight range is.

So for myself, at 5’5, my ‘reference weight’ is supposed to be 127-141lbs. And this is exactly why I’d never use it. My actual frame is quite small. I only hit 127 lbs for the first time after menopause and that was a very matronly body size for me. My waist was completely gone. Post keto I’m at 105lbs. How do I sensibly use such a chart? This is why lean mass makes sense to me.


(Bacon is a many-splendoured thing) #27

You are probably meant to use the small-framed-person chart, but where you’d find it these days, I have no idea. I thought I had seen all three charts on the Virta site, but even if I’m not making it up, they’re not there now.

ETA: I think Naiman may be running away with himself. I find Phinney’s and Bikman’s notion of reasonable protein and filling in with fat to be more sensible, but that’s just me, of course.


(Mame) #28

This is certainly true for me currently. I can certainly overeat protein like steak and feel like i could eat some more 4 hours later. Note, overeating protein will not push me out of ketosis.
But I have a fat - pork belly limit which I cannot push past, my stomach rebels.

I think one needs to figure out what works for them and then be willing to change it in the future as needed as we are not static beings.

I love this discussion.


(mole person) #29

I think this is exactly right. I’m sure many people can lose fat on keto at protein levels that are excess to requirements. But we see again and again that for many people this isn’t so. I have a feeling that this may be especially true for older women struggling with the last 20 pounds or satiety in maintenance. Until I sorted out that protein was an issue I was basically forced to OMAD or I’d start to gain.


(L. Amber O'Hearn) #30

Just to add further clarity (I hope), I’m not saying that very high P:E necessarily hinders weight loss, but that it most definitely can.

I argued this point a bit further in my KetoCon talk this year: Measures of Dietary Quality.

Basically, protein leverage makes sense when protein is deficient, but at a certain point in many people and with some decent theoretical explanations, you’ll actually start experiencing hunger that can only be sated by more fat.


(PJ) #31

I feel best if I eat at least 120g/day protein. Like dramatically better in strength, in energy, and in psychology.

But if I eat it in meat/cheese, I feel crappier. I think maybe it’s too much digestion effort. Or perhaps anybody severely obese like me has simply got organ issues as a given.

So I intake half my protein through protein drinks, either powder stuff or premade drinks. It’s less perfect than “real food” but then I get the benefit of how more protein makes me feel, without the drawback of how eating that much protein in animal foods seems to make me feel.

PJ


#32

Dr. Ron Rosedale?


(Bunny) #33

Dr. Ron Rosedale - 'The Critical Connection Between Protein, Cancer, Aging and TOR’

Gawd I luv this lecture!


#34

Dr. Rosedale certainly got us thinking about protein.
mTOR has moved into much more nuance since Dr. Rosedale.

https://www.ihmc.us/stemtalk/episode-70/


(Ian Patey) #35

Sorry just found this thread after looking more into the P:E ratio stuff having been in a stall for a month plus. I went from 303 to 218 between March and October, but I have been fluctuating between 217 and 223 (besides the rare blowout rectified by a fast) since then. Classic stall. I have been trying the P:E ratio more lately to see if it would help break the stall, but my other concern is whether or not the extra protein versus fat is going to interfere with the autophagy - so far the fat loss has not lead to major loose skin and I have been thinking that I have physically benefited from “restricted” protein and let autophagy do its thing. Do you think that Ted Naiman’s P:E approach may be contraindicated for people with (still) 25+ pounds to lose who are cognizant of getting the most out of autophagy?


(Jack Bennett) #36

May be of interest to those who are following this topic:


(Ian Patey) #37

Great episode. Nice to see Drs. Tro and Ted really reading from the same playbook, depending on where you are in the process.


(Eric - The patient needs to be patient!) #38

I find Dr. Naiman all over the map on carbs. He talks about 100g at night and then elsewhere extols the benefits of very low carb. He uses phrases may, might, maybe a lot. Also, he does not speak much about his clinical successes. He does not cite much science. Okay, so I get that clinical experience is better in some aspects than studies. Most of us can probably relate to that experience.

The energy balance discussion between protein, fat, and carbs seems to make sense.

I wonder if his beast mode workout (he has discussed this elsewhere) grants him the capacity to eat 100 g of carbs a day? He does acknowledge that others may do better on other diets so he is not so dogmatic that his diet (eating plan) is the only way.

So there is a lot to learn from listening to a variety of clinical experiences and drawing our own conclusions.


(Bunny) #39

I would think so, if your built like Arnold Schwarzenegger, you certainly won’t be storing fat, no matter what your eating or how much, the muscle is going to absorb all that glucose and will also be telling the mitochondria in the lower filled fat cells to burn the rest while you sleep.

People like Shawn Baker or Thomas Delauer could probably eat 5 dozen donuts a day (exaggerating but you get the gist) and it would not even put the slightest dent in there metabolism.


(Jack Bennett) #40

Yeah, one of the things I like about his approach is that it unified and explains the successes of different diets.

Someone doing McDougall / Pritikin style can get success on 80% carb, 15% protein, 5% fat as long as they are getting enough protein. Someone doing keto with 75% fat, 5% carb, and 20% protein is also doing fine.

His approach basically seems to be protein leverage, with a dose of bodybuilding lore. I don’t think it explains why some people on keto don’t do well until they stop holding back on fat, and there’s obvious individual variation in metabolism, appetite, and satiety that we don’t fully understand yet.

My hunch is that an orthodox keto approach is probably best and most direct for someone who’s obese. As time goes on, if they want to titrate some carbs that’s probably OK. Especially if they increase their activity level as they drop body fat. Somebody who’s in great muscular and metabolic health like Dr Ted probably has a lot more license to add a few carbs.

The carb timing question is interesting: does the body handle carbs better if they are confined to specific times, away from when you eat fat? (And is there a real metabolic advantage to the recommendation of “don’t eat carbs and fat together” or does that just work because it prohibits highly addictive, half-fat-half-carb junk food combos?)

Another resource in this area is Cian Foley’s book Don’t Eat For Winter which I have not yet read but plan to.


(Eric - The patient needs to be patient!) #41

Jack have you read Ted’s book? I haven’t yet but probably will. You analysis above seems spot on and least that is my sense of it right now.

I was morbidly obese and now I’m just overweight. I life heavy weights but not like Ted. I think I have a ways to go before I can liberalize carbs.

Also I’m more satiated with protein + significant fat. But I start most meals with lean or not too fatty protein. Then add fat as needed. Also I seems to eat a lot more (I don’t track) now that I am doing serious Body By Science failure resistance training. That puts me into feast mode for 1 to 2 days after the early am training.