Question about what my dietician said

Eleonora91
Eleonora91 Posts: 702 Member
edited April 24 in Food and Nutrition

I've done VLCKD under medical supervision for two months and I'm now transitioning to "normal" eating again, I just reintroduced fruit and all vegetables within my diet. I still want to lose an extra 10 kgs and intend on doing so while increasing my overall calorie intake, ideally working with a small calorie deficit but trying to increase my daily activity level with walks, circuit training at home and spreading out all excesses and I feel confident I can do all of the above at the moment. I discussed my ideal protein intake with my dietician and he stated that VLCKD is already slightly high protein, which I disagreed with since it's low calorie, low fat and normal protein as far as I'm aware. I worked out my protein intake while on VLCKD and it came out as in the 60 gr range; which is OK considering it's a metabolic diet and it's 800-1000 kcal per day, but surely seems to little for everyday life; before I started keto, I believe I was aiming for 90 gr per day, which was challenging as a vegetarian, but doable. My doctor claims that people only need 0,9 gr of protein per kg and that should be calculated on one's ideal body weight. So, in theory, someone who is 50 kgs overweight does not need more protein than the average person. I don't agree with that, and that amount of protein sounds too little for me; but now I'm also afraid that I might be wrong, because I'm not the one with a degree in nutrition, and I am afraid I'm messing with my liver if I have too much protein. Thoughts?

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Replies

  • tomcustombuilder
    tomcustombuilder Posts: 2,466 Member

    As far as protein look at your target weight and eat around .8 g of protein per pound of that

  • lesdarts180
    lesdarts180 Posts: 3,327 Member

    I have also seen recommendations of around 0.8 to 1 g of protein per kg of body weight. This seems to be translated to 0.8 per lb in the USA - possibly because Americans don't use kg and don't understand the terminology?

    However, as you are under medical supervision you should listen to your medical team - they know your medical condition better than random people on the internet.

  • Eleonora91
    Eleonora91 Posts: 702 Member

    Yes, but my target weight is not going to my ideal weight. It's going to be significantly higher. So, if I take into account what my doctor said, I should have approximately 51 gr of protein per day, which sounds very little.

  • neanderthin
    neanderthin Posts: 10,643 Member
    edited April 20

    So your doctor put you on an 800-1000 calories "vegetarian ketogenic diet" consuming 60g's of protein for 2 months then wants you to transition off the ketogenic diet. That makes absolutely no sense. What additional mitigation was your doctor expecting while consuming so few calories that would not be addressed when consuming so few calories? Basically why did he put you on this diet?

    It takes at least a month on average for a metabolism to fully transition into proper form where the mitochondria, hormonal adjustments, muscle and enzyme adaption and electrolyte rebalancing takes place and some people it takes longer. Personally it was almost 6 weeks.

    Just the normal nutrient deficiencies found in a vegetarian diet like B12, omega 3's and zinc and then couple that with an 800-1000 calories diet makes my head spin but that's not all. 60g's of protein from vegetarian sources do have limitations for absorption and considering the RDA was originally based on lean 25 yr old fairly athletic males who were consuming mostly animal sources for that protein, would for many reasons leave about 95% of the population requiring more and why protein in the scientific literature for the last, I don't know, decade have basically said to double that for the rest of the population and women need more and as we age those requirements go up. Sustainability is out the window simply because of the demand put on vegetarians and vegans to comply to a ketogenic diet.

    Unless you have liver disease protein doesn't pose a problem as well as the kidneys and consuming so few calories the kidneys and liver will be thanking you for your doctors oversight thinking your getting enough protein, protein are crucial building blocks, especially for organs. I suspect your Doctors have expressed some of the issues I'm bringing up and of course I'm not a medical professional and just giving you my own opinion. I do hope you find success. If I sound skeptical, it's because I am. 😊

  • Corina1143
    Corina1143 Posts: 4,725 Member

    I don't know about you, but me—-

    I have a minimum protein goal just to get by. I try to reach it every single day. It is close to what your Dr. Suggests. I have a protein goal for satiety. I find if I don't meet it, I will overeat the next day, no matter how hard I try not to, and it will often be cake and ice cream. It's closer to what you said you used to aim for. I often eat well over both goals, cause I'm a farm girl at ❤️, love my meat, milk products and eggs! No kidney problems yet.

  • Eleonora91
    Eleonora91 Posts: 702 Member

    I'm confused as to why that doesn't make sense to you. Surely one can't keep up ketosis indefinitely. I'm slowly reintroducing foods by category, fruit is first because it's got the lowest glycemic index. So you're no longer in ketosis, but you're increasing your sugar intake gradually instead of going straight back to eating cake.

    And he put me on this diet because this is one of the diets that he does, and I knew that and I sought his help because at my weight, it was either that or bariatric surgery. VLCKD are common for people who, like me, need to lose a lot of weight, especially if they struggle with compliance. I have obviously been assuming potassium, magnesium and vitamin supplements.

    However, my question was rather whether that 0,9 gr of protein per kg of weight should be calculated on one's ideal weight; which I believe is ludicrous, because one's macronutrient intake intuitively changes with their weight. But it is also true that excess protein is just secreted through urine, so I'd like to know whether he's wrong or not, because his claim seems super off to me.

  • Eleonora91
    Eleonora91 Posts: 702 Member

    800-1000 kcal per day might sound extreme to someone who's doing a regular low calorie diet; it is not as extreme in ketosis conditions, because you're getting enough energy from those ketone bodies rather having to rely nutrients from your diet. So calories are basically taken off the equation when you're doing keto; it's a metabolic diet, which is why it's done under medical supervision. I've been seeing my doctor every 10 days for the last 3 months.

  • AnnPT77
    AnnPT77 Posts: 36,365 Member

    Hello, and welcome to the MFP "protein wars". 😉😆

    I'm also vegetarian, ovo-lacto in my case, and have been for over 50 years. I lost weight by calorie counting nearly 10 years ago starting from class 1 obese, and have been at a healthy weight ever since, and in the same jeans size.

    I do agree that someone who's overweight doesn't need materially more protein than a slimmer person who has the same lean mass. Beyond that, it's hard to comment specifically on your numeric goal.

    You don't say how tall you are, what your goal weight is, or give us other facts that might influence protein goal, such as age, relevant health conditions, calorie goal, current weight loss rate, exercise activities, physical performance or athletic goals, etc. You do mention being vegetarian, which can be a reason to have a higher protein goal than non-vegetarians, but that's more nuanced - more about that later. It might also help to know what style of vegetarian you are: Strict (fully plant based), ovo-, lacto- (or both), whether you need to limit soy or gluten (and why).

    Personally, I agree with the 0.6-0.8 g per day per pound of healthy body weight (about 1.3-1.8 g per kilo), with more being fine within reason unless already diagnosed with some health condition - such as kidney disease - that might make it sensible to limit protein intake. That's generic advice.

    As context, I'm 5'5"/165 cm, 133 pounds/60 kg, age 69, in weight maintenance at 1850 calories plus exercise calories (usually end up around 2000-2200 calories gross intake). My personal-goal protein minimum is 100g daily, which is a round number just above 1 gram per pound of my estimated lean body mass. I usually exceed 100 g.

    I admit that when I was losing weight at more like 1400-1600 calories plus exercise, my protein was probably more in the 90s grams, maybe occasionally even upper 80s. That's not suggesting that I think that was optimal, but acknowledging that it is more difficult on lower calories, and that was in a context when I was still upping my own game with getting more protein on those lower calories.

    I've written at length on other threads about how to get more protein as a vegetarian, so I'll put some of that here in a spoiler in case you want suggestions on that. Since I don't know details about you - like things I mentioned above - it's very generic. It may include some things you already know, but please don't take that as implying you lack information: Like I said, it's just generic advice, since I don't have context about how experienced you are with vegetarian nutrition, among the other details. No personal criticism or doubt of you is intended. It sounds like you've been vegetarian for a while and tuned in to the nutrition issues, but I'd rather err on the side of more info.

    If you have questions you think you'd like to ask me, I'd be happy to make a stab at answering.

    People will give you a food list for non-meat protein, so here's a short one of main recommendations: Tofu, tempeh, cooked soybeans, seitan. If you eat dairy, plain non-fat Greek yogurt, cottage cheese, and some of the better-tasting 2% milk cheeses. If you eat eggs, eggs.

    Some beans other than soy aren't bad. If you don't object to it, consider protein powder or bars.

    In reality, though, the answer isn't a food list, if you really want to get adequate non-meat protein on lower calories. The answer is a process, and it will take quite a few words to explain it.

    Like I said, I'm ovo-lacto vegetarian. I technically eat eggs, but I don't eat many of them. I do eat a lot of dairy, but I'd take the same process route even if fully plant-based.

    Somewhere along the line, figure out your your protein goal. For most people the MFP default goal is a reasonable starting point, unless they're trying to lose weight too aggressively fast. It's an OK-ish starting point for a vegetarian or near-vegetarian, but might not be enough for reasons that may become clear later.

    If you want to reasonableness-check your protein goal, there's a research-based calculator here:

    https://examine.com/guides/protein-intake/

    If still quite overweight, use a lower weight, such as healthy or goal weight, in the calculator.

    As an aside, the guide at that link has a very good section about protein intake for vegans/vegetarians, and to the extent that you prefer to eat plant protein, those guidelines apply. Some fully-committed omnivores here will tell you that a person will need more protein as a vegetarian than an omnivore. That's true at the 50000 foot level, but the real issue is protein quality in terms of essential amino acid (EAA) completeness and bioavailability. Many plant sources are incomplete or less bioavailable. The guide has a more nuanced way of looking at that question. Loosely, plant-centric eaters probably need somewhat more protein than those full-bore omnivores, but the specific plant protein choices influence how much more.

    Second step is to reasonableness-check your intended weight loss rate, if loss is your goal. There's no way to get adequate nutrition, protein or otherwise, when trying to lose weight too aggressively fast for a person's current size. I'd suggest losing no more than 0.5-1% of current weight per week, with a bias toward the lower end of that range unless severely obese and under close medical supervision for deficiencies or complications.

    I suggested a short list of some solid protein source foods, and many people will give you food lists. I'm going to link the mother of all protein/calorie efficiency food lists here:

    https://community.myfitnesspal.com/en/discussion/10247171/carbs-and-fats-are-cheap-heres-a-guide-to-getting-your-proteins-worth-fiber-also

    Most of the things near the top of the linked spreadsheet there are meaty/fishy, but if you scroll down, you'll find plant and dairy sources, and there's a column that has a rough indication of protein quality. (You'd need to look further, such as with web searches, for more details.)

    Beyond the food lists, what I'd suggest is a process to improve protein intake on reduced calories. I'm going to assume you're logging your food here.

    Review your food diary. Identify foods you're eating that have relatively many calories, relatively little protein, and that you can eliminate or reduce (frequency or portion size) to free up calories, without shorting other nutrition or torpedoing your happiness.

    Using the spreadsheet in the linked thread, or any other source, find foods you like that have more protein for those calories, and work those foods into your routine habits. Repeat that process, and over time your routine protein intake will creep up. I like doing it that way so I don't need to micromanage protein every single day: Once the habits are in place, it's more automatic.

    For sure, try to include at least one major protein source in each meal, ideally an EAA complete and bioavailable source. But beyond that, try to find sides, snacks, flavoring ingredients and more that have a little bit of protein. That will add up through the day. There are veggies with more protein, grains with more protein, even fruits with some protein. Those sources tend to be less EAA complete or bioavailable, but varying the types may compensate somewhat for the completeness issue.

    At the store, read labels. Find breads with more protein, maybe protein pasta, etc. I have rules of thumb for roughly evaluating protein in foods in the store. Your specific numbers may differ, but I think having rules of thumb is helpful. For myself, I figure that something that has no more than around 10 calories (from all macros) per gram of protein is a good individual protein ingredient. For prepared foods, like a frozen meal, say, I look for ideally around 20 calories per gram of protein, up to maybe 30 calories per gram if the food is desirable in other respects.

    I'll say a little more about flavoring ingredients, because that's one thing some people aren't as attuned to. Vegans tend to use nutritional yeast to add a cheesy flavor to foods, and that has a reasonable amount of protein. Miso is another flavoring with protein. I also use peanut butter powder (a.k.a. defatted peanut flour) to add peanut flavor and a little protein to dressings, sauces, my oatmeal, etc. Those are some examples. We eat them in quite small amounts, but there's at least some protein.

    Don't let people tell you whole nuts, nut butters or seeds are a good plant protein source. IMO, they aren't. They're nutritious foods, absolutely, but are better sources of good fats than protein. The calorie to protein ratio is quite high. For example, almonds are one of the higher protein nuts. 72% of their calories are from fats, only 14% from protein. It's like 164 calories for 6g of protein. That's not great, and they're not EAA-complete (particularly low in lysine and methionine), and not extremely bioavailable, either.

    As mentioned above, protein powder can be a reasonable thing to use, especially at first while trying to get more protein from food. There are mixed-source vegan types that are reasonably complete/bioavailable, but if you eat dairy, whey protein would be better, or soy. I don't use protein powder or protein bars, etc., not because there's anything wrong with them in the abstract, but because I don't personally find them tasty or satisfying. Many people seem to enjoy them.

    If you want to see what I eat - not that I think I'm a stellar example  - my diary is open to MFP friends. If you send me a friend request, I'll accept, and you can look at my diary. MFP friends can also DM each other, and I do answer questions about how I combine the foods in my diary or similar.

    The closer you are to actually fully plant-based in your eating, the more you may need to also pay attention to some nutrients other than simply protein. I think protein is pretty easy, TBH. I'm talking about things like vitamins D, B12, iron, calcium, etc. If you eat dairy or and since you do eat eggs, some of those would potentially be well-covered. Details about food choices matter.

    For the other nutritional issues, I'll link another source I think is pretty good, also aimed at vegans but with useful info for anyone eating mostly plant-based, too:

    https://veganhealth.org/

    They have better than average info about the micronutrient side of things. The site's content is from registered dietitians who are themselves vegan, and it's much more science-based than some of the silly advocacy sites out in the blogosphere.

    I hope something in there helps. If you have follow-up questions, please ask.

    I'm sure you can work out some solid goals for yourself.

    Best wishes for continuing success!

  • AnnPT77
    AnnPT77 Posts: 36,365 Member
    edited April 20

    No. It's not that we all fail to understand the difference between pounds and kilograms. For at least some of us, it's that we believe that's too little protein for best outcomes in some contexts.

    Speaking as someone the US who generically recommends 0.6-0.8g minimum protein daily per pound of goal weight as a rule of thumb, or 0.8-1g per pound of lean body mass (LBM) for people who have a reasonable estimate of LBM, I understand the difference between kilograms and pounds. There are about 2.2 pounds in a kilogram, 2.20462 pounds if a person wants more decimal places.

    In the US, outfits like USDA also recommend protein goals much lower than I personally believe are most appropriate, and my beliefs are based on what I consider reasonably sound sources of research and recommendations. The personalized USDA calculator for dietary reference intakes is here:

    https://www.nal.usda.gov/human-nutrition-and-food-safety/dri-calculator

    It says I need 48 grams of protein. That's less than half of my personal goal of 100g minimum, because I think there are more current and appropriate recommendations. I weigh 133 pounds, which is about 60.5 kilos. 48 grams is about 0.8 grams per kilogram, so similar to what you're suggesting.

    There's a lot more to it, but loosely speaking that level of protein is IMU what's required for the average person to avoid under-nutrition. I prefer to do more than avoid under-nutrition.

    I think this is a more up-to-date source of recommendations:

    https://examine.com/guides/protein-intake/

    It says my optimal range is 72 to 97g daily, depending on what I say my goals are, and adds that for some goals "up to 145 grams per day may maximize improvements in body composition in individuals who perform regular exercise, based on limited evidence." (Note: That site doesn't sell protein supplements. They sell evidence-based nutritional research reports.)

    For aging people like myself (I'm 69), there's also this resource, from an international medical/dietetic expert group:

    https://www.jamda.com/article/S1525-8610(13)00326-5/fulltext

    That has a lot of more nuanced detail in it, but their basic recommendation is this:

    To help older people (>65 years) maintain and regain lean body mass and function, the PROT-AGE study group recommends average daily intake at least in the range of 1.0 to 1.2 g protein per kilogram of body weight per day. Both endurance- and resistance-type exercises are recommended at individualized levels that are safe and tolerated, and higher protein intake (ie, ≥1.2 g/kg body weight/d) is advised for those who are exercising and otherwise active. Most older adults who have acute or chronic diseases need even more dietary protein (ie, 1.2–1.5 g/kg body weight/d). Older people with severe kidney disease (ie, estimated GFR <30 L/min/1.73m), but who are not on dialysis, are an exception to this rule; these individuals may need to limit protein intake. 

    That would suggest my goal should be at least 60-73 grams, more for those who are active, which I am.

    Like the OP here, I'm also vegetarian. People who get lots of their protein from plants may be a sub-group who need more absolute protein grams, but that's a somewhat nuanced issue having to do with relative protein bioavailability and essential amino acid (EAA) completeness, so specific food choices matter in that context.

    It's not failing to distinguish pounds vs. kilograms. It's disagreeing about optimal protein intake.

    Honestly, I wish the rules of thumb I like had different numerals in them than 0.6, 0.8, or 1, to distinguish them from the generic governmental "0.8-1 grams per kg" guideline from some sources that makes some people believe it's an error in weight units.

  • neanderthin
    neanderthin Posts: 10,643 Member
    edited April 21

    Yeah, that's not how it works. Regardless of the diet or the substrate fueling your body it's the caloric deficit that will use your own body fat for fuel that then leads to weight loss. Yes ketones are fuel in the absence of carbohydrates but anyone engaged in a ketogenic diet is not going to lose any body fat unless they're in a caloric deficit and the reason why I ask "What additional mitigation was your doctor expecting while consuming so few calories that would not be addressed when consuming so few calories?"

    I'd also be curious what your doctor advised for you to use as a fat source considering most natural plant based sources of fat will generally have too many carbs attached to comply with a vegetarian ketogenic diet? Take care and hope things work out for you.

  • Eleonora91
    Eleonora91 Posts: 702 Member

    That is indeed how it works. While doing keto, it's not your calorie deficit that determines your weight-loss. The calorie deficit merely speeds the process up.

    And I was strictly eating medical meals while doing keto, with precisely tracked macronutrients, and olive oil in addition to it. So all my nutrients, fat included, came from those meals.

  • Eleonora91
    Eleonora91 Posts: 702 Member

    "I do agree that someone who's overweight doesn't need materially more protein than a slimmer person who has the same lean mass"

    See, I disagree with it, because if you're overweight, you have a higher BMR and a higher TDEE, and those calories should intuitively come from all macronutrients. Otherwise, by increasing your calorie intake and not increasing your protein intake, this would mean that the average ratio of 50% carb - 20% fat - 30% protein should be altered and disproportionate towards carbs and fat if your protein intake is supposed to stay the same in grams.

  • yirara
    yirara Posts: 10,513 Member

    So you're suggestion that as long as one does keto one doesn't need to be in a calorie deficit to lose weight? Can you point me to any scientific sources that verify this?

  • Eleonora91
    Eleonora91 Posts: 702 Member

    I agree, but what do I do? He's got a degree, I don't. Should I look for a new doctor?

  • Eleonora91
    Eleonora91 Posts: 702 Member

    I've been a vegetarian for 16 years. My protein goal in grams is not really the problem right now, just the rationale behind it. If I do indeed have to calculate that based on my ideal weight, then it's going to end up being maybe half of what ideally I was looking for, which could potentially lead to some serious issues - unless I'm wrong about the whole thing. I have NEVER heard of anybody say that your protein intake should be calculated based on your ideal weight rather than your actual weight

  • Eleonora91
    Eleonora91 Posts: 702 Member

    No, I was also on a calorie deficit, but that's not AS impactful as it would be in a regular low calorie diet.

  • neanderthin
    neanderthin Posts: 10,643 Member
    edited April 21

    Putting the calorie and protein conversations aside for a moment, what other impactful results have you had?

  • neanderthin
    neanderthin Posts: 10,643 Member
    edited April 21

    The original data for the RDA was based on young males, about 25 years old consuming protein from a meat based diet and fairly athletic in other words they were not sedentary, basically what I'm alluding to is it was based on mostly lean mass. Young healthy people's requirements for protein are not as crucial, it's part of the growing cycle in all humans, young people can process protein to a much higher efficiency, it's just part of growing cycle in humans, unfortunately that gets compromised as we age for many many reason, but suffice is to say for the average middle aged person or older we need at least 1.3 to 1.5 per kg of body weight and like I said that's is based on animal protein with fairly lean and active males. If you research any protein based study and I would suggest Don Layman who is a world leading PhD in the field of protein that you'll hopefully understand better.

    Ask yourself this question: why would protein and it's functionality be required for adipose tissue (our fat stores)?

  • tomcustombuilder
    tomcustombuilder Posts: 2,466 Member

    more fat doesnt increase BMR, maybe TDEE a bit.
    Forget percentages for macros go towards grams always. There is no reason to be increasing your calories when you're trying to lose fat. It's the opposite. Keep your protein the same as you lose and you lower your calories. Mostly carbohydrate, fat also if its excessive to vary your daily calorie amounts.

    as far as doctors with degrees that doesn't mean anything. You go on YouTube and you have some of these people that have degrees and some of the information they're giving out is incorrect so that doesn't guarantee that somebody knows what they're talking about

  • Eleonora91
    Eleonora91 Posts: 702 Member

    I've lost a relevant amount of weight (in kilograms and centimeters), and my body fat % has decreased. My BMI has gone from a little over 40 to 33 in the span of a year through two cycles of keto and just watching my eating in the months in between. I am now able to do more and exercise more, because I feel lighter; and I'm in general more determined to avoid excess on a daily basis. I have not regained any of the weight I lost with keto last year during several months of eating intuitively, so I think the changes stuck.

    All of this could have been obtained through different courses from keto as well; yet not for me. For the last 5 years, I have been unable to comply with any other diet, and my only chance at a BMI of 40 was bariatric surgery; which I did not want to do, or medication such as semaglutide.

  • Eleonora91
    Eleonora91 Posts: 702 Member

    Sure thing, that said I think I'm also gonna listen to my body, if I feel good on 90 gr of protein per day rather than 50, that's what I'm going to do, and potentially get some blood work done to estimate the effect of that on my liver after a year or so.

  • neanderthin
    neanderthin Posts: 10,643 Member

    Yes 90 is better. Let me ask, has some of your success on the keto diet stem from you feeling satiated, in other words your hunger was less or more manageable?

  • neanderthin
    neanderthin Posts: 10,643 Member

    Ok, thanks. Do you eat eggs and dairy products, just curious?

  • Eleonora91
    Eleonora91 Posts: 702 Member

    I do, but I was not during the first part of keto; I was only eating ISOMED premade keto meals. I am now eating eggs and dairy again; but I also eat seitan, mopur, soy products and tofu. The end goal for me is to fully transition to vegan, but not sure if I'll be able to do that.

  • neanderthin
    neanderthin Posts: 10,643 Member
    edited April 21

    Well, your choices were limited on a vegetarian keto diet. Personally I'm not a supporter of either a vegetarian or vegan diet, mostly for health reasons but accept that people have choices to make and we all have full control in what we do for reasons that are important to us as individuals. I'll only say go in eyes open, read as much as you can any scientific literature, and try to be objective. 😊

  • AnnPT77
    AnnPT77 Posts: 36,365 Member

    If intuition works better for you than research results, that's fine. Your call.

    Ironically, I think the Examine.com calculator/guide I linked would give you research-based justification for the larger protein goal you're choosing.

    Just out of curiosity, would your preferred goal of 90g protein leave you within the "30% of calories from protein" range?

    As an aside, if you're roughly around average height, I think 90g might be a little on the too-low side situationally, since you seem to be pursuing weight loss and are also vegetarian desiring to move to vegan. Just a guess, though.

    I'm going to say more, because I think leaving it there is potentially a disservice to others who may be reading.

    The ratios are less important than the absolute gram amounts. USDA says this about protein ratios, in the notes to the personalized DRI calculator:

    The Acceptable Macronutrient Distribution Range (AMDR) for protein is defined as a range of intake - with a lower and upper boundary - that is associated with reduced risk of chronic disease while providing adequate intake of essential nutrients.

    . . .

    The AMDR for protein is 5-20% of total energy intake for children age 1-3 years, 10-30% of total energy intake for
    children age 4-18 years, and 10-35% of total calories for adults.

    For more information on DRIs for protein, see the "Protein
    and Amino Acids"
     chapter in the Dietary Reference Intakes: The Essential Guide to Nutrient Requirements.

    https://www.nal.usda.gov/human-nutrition-and-food-safety/dri-calculator

    The referenced "more information" link suggests protein goals in grams per kilogram, not percentage. In other words, the strict definition of protein needs is grams per body weight unit, with a wide range of percentages possible because protein needs vary.

    https://nap.nationalacademies.org/read/11537/chapter/14

    I do think the USDA protein recommendations are too low, based on more recent research. (One of the links I offered in my PP says why.) I also think that there are situations where relatively more protein is a good idea, and one of those situations is during weight loss. So, an overweight person on low calories may benefit from more grams of protein than someone of the same size who isn't in a calorie deficit.

    Different nutrients have different roles in the body. I would think that someone who's benefitted from a ketogenic diet would intuitively recognize that, since the ketogenic diet cuts carbs way below the carbohydrate AMDR for adults, which is 45-65% of total calorie intake for adults. (That's a narrower range of percents than protein's 10-35% AMDR.) It also cuts carbs way below the 50% in your "average ratios" list.

    It seems like it wouldn't be surprising, intuitively, that there are reasons percents for other macronutrients might also vary situationally.

    To be clear: I think estimating macronutrient needs in percents is a simple, reasonable generic method, and will give the average person in an average situation adequate overall nutrition. However, estimating macronutrients in grams is a more nuanced, precise way of dialing in even better nutrition for people who want to do so.

    The roles of each macro- and micronutrient matter, when it comes to personal needs, in context of many factors, including body weight and health history.

    In general, as I'm sure you know, protein is for maintaining lean mass, primarily muscles, bones, cartilage, skin, and blood. Obese people do tend to have more pounds/kilos of lean mass than slim people of similar height, sex, age and activity level, just from carrying the extra weight around. One sane way to estimate protein needs in grams is to base the estimate on lean mass, but most people don't have any remotely accurate estimate of lean mass. That's why body weight is the more common basis, and it's also been the basis of most protein-needs research, probably because getting accurate body composition measurements is expensive, so unrealistic in large-scale studies.

    Since protein is needed for maintaining lean mass, and excess protein is largely metabolized for energy (or stored as fat), getting excess protein is mainly just expensive calories. While "too much" protein may be a bad thing, unhealthful, the upper limit for healthy people is quite high, so "too much" isn't common, and AFAIK there isn't even a huge volume of clear definitive research on that question. I admit that's not something I've looked into much, though, since I know I'm in a safe range for myself eating 100-125g most days.

  • Eleonora91
    Eleonora91 Posts: 702 Member

    The way I have it currently set up is 50% carbs, 30% protein and 20% fat with 1500 kcals per day in total; which adds up to 113 gr of protein. 90 gr of protein would be closer to 25% if I kept the calorie intake the same.

    I am not yet sure what ratio would be the most appropriate for me, and I'm surely not expecting to stick to the same ratio every day. I just need to watch my overall fat intake to make sure it's not excessively high and maybe have a general idea of what protein goal to aim for.

  • yakkystuff
    yakkystuff Posts: 586 Member

    Eleonora91 wrote:

    The way I have it currently set up is 50% carbs, 30% protein and 20% fat with 1500 kcals.

    That is what our registered Dietician just recommended.

    And…new one on me, to eat 200 cals every 2 hrs. Said body burns/uses 200 calories every 2 hours and anything eaten beyond 200 cals gets stored as fat.

    Tried not to let my jaw hit the floor. Asked about current trend approaches for keto/carivore, IF or OMAD. Told me not to listen to search on the net, she is correct, listen to her.

    Only, I can't recall ever hearing the 200 cals every 2 hrs...

    not to mention it is out of sorts with my own preferences....