Whoa! Dr. Phinney's take on protein...correct or incorrect?

(Bob M) #1

I’m finally listening to the 2 Keto Dude’s podcast with Dr. Phinney. He says or agrees with things like “protein turns to carbs” and “there are no upsides and tremendous downsides to eating more protein than you need”. (These are not direct quotes, but close enough.)

I have to say, I think he’s completely wrong. I bought a continuous glucose monitor to test what happened to my blood sugar with massive amounts of protein (120+ grams in a single meal).

This is what I wrote about this set of pictures: “Fasted from Wednesday, November 29th after dinner until Friday, December 1. Body by Science workout at about 6am. Ate at 9:15am-9:55am. 1 can pink salmon (180 cals,3g fat, 36g protein), shrimp (not sure how much), 1 package mussels, 1 can anchovies w/oil, olive oil, vinegar, 2 chicken thighs.” This is 100+ grams of protein in a meal.

One
One.png865×398 25.7 KB

Here’s another one, for which I wrote the following: “Thursday, December 14, fasting. Friday, December 15, got up (first dot from left), had black coffee, went to gym (25 min Body by Science workout), got to work (second dot from left), ate all meat between next two dots.”

Two
Two.png918×447 24.3 KB

Here’s what I wrote for this one:

Lunch on 11/21/17, started slightly before 10am, ended 10:16am

37 hours fasting, Body by Science in the morning around 5:30-6am

I can anchovies (drained): 50 calories, 2g fat, 8 g protein, 600 mg O3

1 can sardines (drained): 200 calories, 9.4g fat, 28 g protein, 1,300 mg O3

1 can pink salmon (no bones, skin) (drained), 5.3 ounces: 159 calories, 2.7 g fat, 32 g protein, 954 mg O3

Mussels, 8.2 ounces: 187 calories, 4.7 g fat, 35 g protein, (3g carbs)

Shrimp, 10.4 ounces: 243 calories, 0g fat, 59 g protein

Totals: 839 calories, 18.8 g fat (169.2 calories, 20% by cals), 162 g protein (648 cals, 77% calories)

That’s right – 162 grams of protein in a SINGLE meal.

Here’s the results:

Blunch_11-21-17

I have many more of these, some without fasting so extensively, and NONE of them show protein being converted to blood sugar.

You have to know that I bought a CGM to PROVE that Ted Naiman’s ideas about protein were WRONG. And I have now converted from a higher fat, lower protein low carb/keto diet to a higher protein, lower fat low carb/keto diet.

I just do not think Dr. Phinney is correct about protein intake. What are your thoughts?

#2

I’ve been really perplexed by the distance between people like Phinney and Naiman on the protein question as well, and I wish I could figure it out because when I start restricting my protein per the guidelines, it just seems like not enough food for me.
My guess is that in any case, fasting and BBS workouts (both of which I do as well) would give us some wiggle room even if the low-protein folks have some good points.

Edited to add: I do think that even Phinney says that someone who is metabolically healthy doesn’t have the issue of converting excess protein to sugar as much as someone who is insulin resistant

Following! I’m very curious about this…

(Doug) #3

Bob, I think Phinney is taking the possibility of the body using protein for energy - which it indeed can do, if it has to - and projecting massively into “excess proteins turns to sugar,” if indeed he was generalizing that much.

When keto, the liver is making glucose for the relatively few parts of the body that have to have it, and when eating a substantial amount of carbohydrates then they are burned for energy. Neither situation has the body needing to burn protein.

In addition, there are important additional considerations for ketogenic eaters, as we went through on the Is the “too much protein turns to sugar” a myth? thread. The vastly different response to protein when one is fasting or keto, versus a carb-heavy diet; that protein stimulated glucagon as well as insulin, etc.

#4

There are also other concerns about too much protein (basically that it’s anabolic, and we don’t want too much of the growth signaling when we’re past childhood).
I feel like I’ve seen a lot of this kind of thing referenced in interviews:
Reduced dietary protein intake and intermittent fasting (IF) are both linked to healthy longevity in rodents, and are effective in inhibiting cancer growth (from a 2015 study)

(Justin Jordan) #5

Depends on the person, I reckon.

Monday, I ate nothing but beef, butter, and cheese. My fasting blood sugar that morning was 107 (I’m type 2 diabetic, which is relevant). I didn’t track how much I was eating, but working backwards, my protein intake was somewhere close to 200 grams for the day. My carbs would have topped out at around 10 (probably somewhat less).

My blood sugar gradually rose over the day, getting to about 140 or so. And my blood sugar the next morning (12 hours after my last meal) was 195, Today, after a 36 hour fast, back to 107.

That rise in fasting blood sugar is actually equivalent to what I’d get eating 30 or so grams of carbs, although the post prandial numbers are lower with the protein. At some point, probably next week, I’ll repeat the experiment with just beef.

But that’s generally consistent with what I’ve observed with my blood sugar - higher protein leads to higher blood sugar for me. I’m (still) massively insulin resistant, which I think makes the key difference.

(Todd Allen) #6

I think it would be more informative to track ketones than blood sugar. Ingesting protein affects hormones such as insulin and glucagon that regulate blood sugar. If elevated insulin is driving glucose from protein into muscles you shouldn’t see much rise in the blood.

Stephen Phinney’s claim, supported by testing, is that excess protein lowers ketone levels making it more difficult to be in the range he calls “nutritional ketosis”. He also acknowledges that greater carb restriction compensates for this. He suggests up to 50 g carbs/daily at which point one needs to be low on protein. Drop to 0 carbs and one can add roughly 100 g of protein and still stay in ketosis. Most of us chose something in the middle.

(Doug) #7

Justin, that’s interesting. It may indeed be that your individual situation is making the difference, here.

In general, I think the ‘protein --> sugar’ thing is far overblown, despite your experience. Here’s one good read:

http://journal.diabetes.org/diabetesspectrum/00v13n3/pg132.htm

“a number of researchers showed that the ingestion of protein by subjects with and without diabetes did not result in an increase in blood glucose levels.”

(Doug) #8

Todd, what I’ve read is that when in ketosis, with the liver making glucose, the body doesn’t send protein along the same metabolic pathways (as it might if it really needed to burn protein for energy), because the resulting increase in insulin will slow or stop the liver from making the needed glucose.

#9

Yes. I think this is key.

Phinney is now heavily involved with Virta, and therefore seeing the consequences of high protein on patients who are likely glucose dysfunctional.

For the metabolically healthy, things are v different.

(Justin Jordan) #10

Sure, but note that the numbers they’re dealing with are 50 grams of protein, over a relatively short time period. And 100 grams a day. I know from personal experience that those numbers won’t make a huge difference in my blood sugar numbers.

For me, anyway, there’s a level below which dropping my protein won’t further lower my blood sugar (this seems to be around 75 grams or so) and I think there’s a top end to it as well. I suspect on the lower end, there’s the basic level where all your protein is being used rather than converted.

I think the issue is more complex than people think. Vanessa Spina, of Ketogenic Girl, did an experiment where she raised her protein a lot for a week, using the Naiman 3:1 ration, and her blood sugar went up a lot and her ketones down.

But unlike me, Spina is by all indications pretty insulin sensitive - her blood sugar cruises in the sixties with a fasting insulin number that’s like two. So at the very least, it’s not straightforward for everyone.

I generally don’t think that most people need to worry about it. But if you’re not getting whatever results you’re looking for, protein intake is worth looking at.

(Todd Allen) #11

But glucagon also rises. The body isn’t burning it because it needs the energy, but because it runs out of other things to do with it. The body has limited means of storing protein. The blood can buffer some and muscles and other tissues take some up for growth/remodeling purposes. This amount varies for example body builders can utilize a lot more protein. But when there is an excess it gets converted to ketones and glucose (more amino acids convert to glucose than ketones) for burning or further conversion to fat for storage when glucose use and storage are maxxed out.

(Ken) #12

It doesn’t matter if protein reduces ketone levels as long as protein is kept moderate, around 35 percent. Ketones are merely an energy source, it’s normal for their levels to fluctuate. Limited gluconeogenesis via the protein pathway may or not be happening, but even that is demand driven and subject to the body’s requirements. The concept, or I should say theory that it could lead to a lipogenic reaction or State is absurd.

My suspicion is the excess protein theory is more related to the anti meat agendas more than anything else. It popped up nearly 20 years ago, primarily from the health and vegan crowd.

(Doug) #13

Todd, is it really as simple as that, though? Agreed that there’s very little protein storage and that the body has to do something with it. Yet isn’t the making of sugar - whether it be from fat or protein - demand-driven? If the body is thinking it needs more energy, then it makes sense that it may convert protein into sugar (as well as ketones). But without a perceived caloric deficit, is it necessarily still going to turn protein into sugar?

(Doug) #14

Justin, I’ll be interested to see what happens with your test with beef. I’ve read that among people with good blood sugar control, the insulin response to protein is much less than it is for us Type 2 diabetics. We’re less sensitive to insulin, but we’re producing more after we eat protein.

#15

With regard to how protein effects glucose or ketones, there is a definitive answer, but it varies by person, so it can only be derived empirically. Though experimentation (eating various foods and measuring my BG and BK) I’ve learned how my body responds to portion sizes. But unless you’re a slightly metabolically deranged, 5’9" 150 lbs, 22% bodyfat, 45 year old, perimenopausal woman, your numbers will be different than mine.

In the podcast, Phinney mentions that historical cultures even though meat based, did not eat a lot of protein, only about 15% of calories. There seems to be strong evidence that protein stimulates mTOR, IGF, and other factors that accelerate aging. Drs Valter Longo, Peter Attia, David Perlmutter and others have spoken on this. If longevity is a goal, protein should probably be restricted.

(Doug) #16

Yeah, 4dml - it sure looks that way, even just from the varying experiences of people in this thread. Makes me want to test myself…

(Adam Kirby) #17

I think Phinney is kinda out of date with his views on protein. The view of “nutritional ketosis” itself is limited since there’s a huge pool of energy usage - FFA oxidation - that’s impossible to measure. Less ketones does not necessarily translate to less fat energy usage, and that’s where the guys like Phinney get tripped up.

I think he also focuses on insulin without considering the glucagon component of protein vs carbs.

(Adam Kirby) #18

It’s true that less mTOR activation increases longevity in a certain sense, but real world humans are not the same as lab mice. Specifically, protein avoidance over a human lifetime will lead to sarcopenia and osteopenia, which will probably at least counter any longevity benefits of chronically low mTOR, if not actually decrease real-world longevity.

#19

This is the part that worries me, especially since I seem to be one of those folks that doesn’t get particularly satiated with fat. I can eat a cup or two of macadamias (or mayonnaise, or extra butter) without blinking, but four eggs and a bit of bacon and I’m good for many many hours.

(Eric - The patient needs to be patient!) #20

Dr. Bikman shows data about insulin and Glucagon ratios after eating protein for Low Carb versus SAD people. It has been awhile since I watched this but I stopped worrying so much about protein macros after watching this video. Of course your metabolic state may affect this.