How much protein is excessive?

As we discussed last week, excessive protein is turned into glucose and then to fat. But how much protein is excessive? That’s the real question that stirs up all kinds of controversy. The Recommended Daily Allowance for an adult is 0.8 g/kg per day. How did we get that number? Let’s start at the beginning.

First, I am only dealing with the steady state here. If you are trying to build muscle (body building) then you would need more protein. If you are pregnant or breast feeding or a child still growing, then protein requirements are higher because you are trying to add protein to your body. This discussion only deals with adults at a relatively stable state.

Proteins are made up of building blocks called amino acids, of which there are about 20 common ones. While we talk about protein requirements, really the body needs amino acids. This makes up about 16% of the weight of protein, so that if you eat 56 grams of steak, you do not get 56 grams of protein, but really require about 6 times more by weight (approximately).

Proteins are being degraded and resynthesized continuously. Old proteins get broken down, and the amino acids are reabsorbed to be built into new proteins. The amount of turnover is several times larger than the amount of amino acids eaten daily. However, some amino acids do get lost in the process, so we require a certain amount of protein intake. This is lost predominantly in the stool and the urine. Sweat, hair, nails etc make up a miniscule proportion of the lost amino acids.

marasmus
Marasmus

Amino acids cannot be stored for long term energy. Any protein eaten in excess needs to be converted to glucose or fat for storage. Nine amino acids are called ‘essential’ amino acids because our body cannot synthesize them – histidine, isoleucine, leucine, lysine, methionine, phenylalanin, threonine, tryptophan, and valine. We must get these from our diet or we will get malnourished. There are also essential fatty acids such as the omega 3 and 6. There are no essential carbohydrates. No, we do not ‘need’ to eat 130 grams of glucose daily for our brain. It’s a complete lie. Fasting for 1 day does not cause our brain to become ‘starved of glucose’ as we become blubbering idiots and lose control of bowel and bladder. I would vote that widely circulated ‘fact’ as ‘most idiotic statement’. I have done this 24-hr fast many times, and have not yet found it necessary to clean poo and pee afterwards.

Kwashiorkor

What happens if we get too little protein? This can occur in isolation, or it can occur as part of a general lack of food. If there is general starvation (no food at all), then there is not only protein deficiency, but also carbohydrate and fat deficiency, too. Obviously, people become skeletally thin, with no body fat, and loss of muscle. This is called marasmus.

Kwashiorkor
Kwashiorkor

But there is also a situation where people get sufficient calories, but very little protein. This typically occurs in third world countries where people have some form of food, but almost no protein. People are usually subsisting on refined carbohydrates alone, which come from food shipments donated by First World countries. These refined carbs (sugar, flour, rice, corn) provide calories at a fraction of the cost of protein, and do not require refrigeration during the long trip. So, in the 1970s and early 1980s, protein deficiency was rampant – called kwashiorkor. You see swollen feet, loss of muscles in the arms and legs, hair loss, and a big swollen fatty liver (due to excess carbs).

So, for all the teeth gnashing I heard about we must eat lots of protein, remember that we are nowhere close to protein deficiency since kwashiorkor is virtually non-existent in the developed nations. It exists primarily in war-torn nations who get food aid.

How much protein is enough?

This would depend upon how much is lost from the body daily. This varies depending upon intake. More protein intake means more turnover of protein and more losses. Less intake means less turnover. So there is quite a variation. It is also energy-dependent. That is, if you are trying to achieve negative energy balance (lose weight) then you need LESS protein. Why? Because there is all sorts of protein loss associated with fat loss. There is less skin, connective tissue, capillaries, blood, dermis etc associated with weight loss – all of which needs to be catabolized (burned up and not replaced). Think about those bariatric surgery shows on TLC where surgeons remove 20-30 pounds of excess skin after weight loss. Yes, that’s all protein that should have been catabolized. As an aside, in my clinic where we do a lot of intermittent fasting, I have not yet sent a single patient to the plastic surgeon for removal of excess skin, even though weight loss sometime is over 100 pounds.loose-skin-after-weight-loss-652x400-1-1465991756

Back to the normal daily amount. In 1985, the WHO reviewed studies of daily obligatory losses of nitrogen, and found that an average is 0.61 g/kg/day (total). Presumable, the diet should replace (roughly) this 0.61 g/kg/day being lost. Remember, this average is for normal healthy people, not people losing muscle or otherwise sick.

So the international group recommended that normal healthy people should get roughly 0.6g/kg/day. In order to make sure everybody was covered, the WHO added 25% (2 standard deviations) above the mean to get 0.75 g/kg/day which sometimes gets rounded up to 0.8 g/kg/day. In other words, 97.5% of the healthy general population loses less than this 0.75 g/kg/day of amino acids. This is not a low standard. This is a very, very high standard of protein intake.

For a standard 70-kg male this is 52.5 g/day. Remember this is for absolutely healthy adults, not gaining or losing weight and the amount needed to cover the average amino acid losses are only 42 g/day (0.6g/kg/day). Remember, that if you want to lose weight, you should be eating less protein so that you can break some down. For reference, the USDA in 1985 determined that in the US, 14-18% of calories were protein and the average consumption is 90-110g/day (male) and 70g/day (female). So the average male is eating twice the recommended amount, which is already super high. Day after day. Week after week. Year after year.

Is long term high protein diets harmful?

Hard to say. There is some suggestion that high animal protein intake may cause osteoporosis. Many of these proteins are acidic, which require neutralization in the body. This acid is buffered in the bones and then eventually the acid is excreted as phosphoric acid. Because bone consists of Calcium bound to phosphorus, there is extra calcium which gets excreted in the urine. This leads to higher urinary calcium losses and potentially osteoporosis.

Also, there is concern that long term high protein intake may cause scarring in the kidneys, although this is not proven.

So, how much protein should you take? The average necessary would be 0.6 g/kg/day (around 50 g/day) and LESS if you are trying to lose weight. However, I have seen recommendations that vary widely. Some suggest 120 g/day. Drs. Phinney and Volek recommend 1.5 – 2 g/kg/day. Yowzers. That’s super high. Do I worry about protein deficiency? No. When I start seeing a North American outbreak of kwashiorkor, I’ll be worried. Until then, the average intake is still 2-3 times what is physiologically necessary.

Dr. Phinney, in his LowCarb Vail talk suggests that fasting will cause loss of 1/4 pound of muscle per day, every day. So, I do 2 to 4 24-hr fasts per week. That’s about 1 pound of muscle loss per week or 50 pounds per year. So, in about 3 years, my body composition should be 100% fat. Funny how that didn’t happen. Actually, my body composition is about the same as it was 3 years ago. My strength is about the same.

They make the arguement that protein suppresses appetite. That may be true. What I am talking about here is what protein is necessary. I am not denying that some people do better with higher protein. But I suspect there are also many people who do worse. Another argument often heard is that protein builds muscles. Hmm. Eating protein without exercise builds muscle? Right. Dream on. If that were true, we would not have an obesity epidemic, but a muscle epidemic. I don’t see that on the front page of Time magazine. “Will America ever be able to get rid of its excess muscle?”

Dr. Ron Rosedale, in fact, suggests going even lower. In a fascinating LowCarb Vail talk (available on YouTube, and highly recommended), he said “Your health, and likely your lifespan, will be determined by the proportion of fat versus sugar you burn in your lifetime”. Remember that excess protein (see last weeks post) falls into the ‘burning sugar’ side of the equation. He also said in that talk, to a group of Low Carb aficionados that “today, it is perhaps more important to restrict protein than to restrict carbohydates“. Strong words, indeed. I tend to agree.

YouTube: please specify correct url

141 Responses

  1. powerful anchor on science based sanity. Thanks for speaking to those folks who are under the misunderstanding of what levels of protien are “dangerously low”

  2. Mr Fung, I think you really went off the deep end on this one… I thought this may have been a comedy skit or some fake story from Fox News but sadly I realize you actually believe the stuff you just wrote…I will pray for you…

    • Sal, Dr Fung is the first person to make sense of how and when we should eat. Please keep your negative, opinionated comments to yourself. We are trying to learn here.

    • Sal Adbar, apparently, probably, you haven’t read much of Jason Fung. If you had, perhaps you would be trusting him and assuming that you were mistaken, rather than the other way around.

    • TJtheGrouch

      It is painful to see an informed opinion from a highly respected authority dismissed with such a flippant response. Have some respect for those of us who think that Dr. Fung knows very well of what he speaks. I for one, a retired physician, consider myself lucky to have such a mentor in nutrition.
      Don’t pray for Dr. Fung, do it for yourself.

      • Completely agree with TJtheGrouch. I couldn’t have said it better.

        I’m fortunate to have come across Dr. Fung.

      • Personally when I first heard Dr. Fung on YouTube I thought it was crazy. However over time I read and listened more and slowly came to realize that he really knew what he was talking about. I’m even fasting a couple days a week now. Last year I wouldn’t have even considered fasting. I find Dr. Fung’s blogs very useful.

    • George Thomas

      Care to counter Dr. Fung with facts and evidence or are you just going to fling invective?

    • Its Dr. Fung you twit

    • Sal is a complete moron

  3. John Chapman

    I like your work, but let’s keep politics out of it, please. Unless you want to discuss the relative statements by Trump, Clinton, Obama, etc. Referring to: “I would vote that widely circulated ‘fact’ as ‘most idiotic statement not made by Donald Trump’.”

    Just like you want to be fact based with regards to our human body, I’d like to discuss politics with fact, logic and reason, not pure emotion.

    And still, the comment about Trump was out of place in this article / setting.

    – John Chapman

    Dr. Jason Fung: I’ve edited it. I actually don’t care much for politics. I just thought the comment, and Donald Trump is funny.

    • John, Dr Fung didn’t say anything about Trump. Did your mind insert “Trump” into the sentence. You need to re-read the article.

      • John Chapman

        Jessie,

        Please note that Jason removed the reference, and clearly states so at the bottom.

        Furthermore, I fully agree with your statement, “…You need to re-read the article.” Please, do so. I’d indeed like to keep this discussion on topic, but you interjected into a conversation between Dr. Fung and I. And, not very well, either. The fact that you do not like dissenting opinions expressed is rather amusing – as you are certainly expressing yours.

        – John Chapman

        • John, you were not giving a dissenting opinion. You were trying to belittle Dr Fung’s ideas by distraction. A method used so often to keep people off point. Quit being a troll, if you don’t want to learn about Dr Fung’s ideas, please go find another website to comment on. We love Dr Fung’s ideas and humor.

          • Jessie, you’re completely wrong on this. Jason had a comment that contained a cheap shot at Donald Trump for no good reason. John asked him to keep politics out of the conversation, and Jason agreed and edited his comment to remove the cheap shot. You then came along and attacked John, and now you’re accusing him of being a troll. He did no such thing. He asked Jason to stick to the subject of nutrition, and Jason agreed.

    • By the way, this is Dr Fung’s website. His opinions matter to us trying to learn how and when to eat. His opinions matter, please keep yours on your Facebook page.

      • Right on!

      • Richard S Stone

        Where’s the agree or like button? I’m pleased when Dr. Fung voices his opinion on things, considering that he is so rational and analytical. And amusing. If Dr. Fung thinks Trump is funny, it’s worth hearing. As for Dr. Fung only being qualified, or entitled, to voice an opinion on nutrition, or somehow that his blog must be limited to such matters? Is that a rule some reader just made up, like the way kids do when they make up the rules for the game as they go along? I think so. And it’s Dr. Fung’s blog. Trump is an emperor with no clothes, and worse (really a terrible image…). Trump mocks and humiliates people relentlessly, as a political gambit. He cannot complain about such matters. No one needs to complain on his behalf.

    • It was funny, and dead on. Regardless, great article, and thank you so much for clarifying even further, the great protein debate.

      • Love your work Dr Fung

        Thank you for keeping non nutrition related politics out of your posts. Heaven knows there is already enough nutrition politics to keep our blood pressure up.

        I convinced my Dad with type II to kindle your book, and I regularly email your posts to my family whose politics differ. No matter how ignorant the crooked Hillary supporters are they still should be given the option to not die early of hyperinsulinemia.

        PS My grandfather died of pneumonia in the seventies and I don’t recall seizures being one of the symptoms. My memory is that he would be laid out for days recovering. Does it make sense to you that Hillary could have a pneumonia/dehydration severe enough to face plant multiple times for over a decade and then an hour later be bouncing around on the street hugging a kid (infect much)? Have any of your elderly Diabetes patients gotten pneumonia and suffered insta-seizures? What would you put the odds of some as yet undisclosed neurological disease?

    • I think you need to lighten up a bit, John. Dr. Fung’s humor is what makes his science so readable. You mistook comedy for politics. So many things proclaimed by the “health” industry need to be laughed at, even more so than America is being laughed at for nominating Trump—now, >>that’s<< both health and governmental politics!

    • Hey! I’m a Trump supporter and I thought it was funny! People really need to lighten up! I’ve said this before…. Dr. Fung is donating his time for our well-being. Criticizing his free to your doorstep delivery is ill-mannered, discourteous and beyond ungrateful. Like Heather said, thank you Dr. Fung for the great article on protein…. I’m quite certain that is the area where my husband and I still “get it wrong”. Most of us truly do appreciate your time and effort on our behalf Dr. Fung.

    • Martin Williams

      Dr Fung: Sorry to see you cave in to the PC Stasi. Trump is a moron by any standard, and part of being an adult is being able to withstand the disagreeable opinions of others. What the hell is western culture coming to when a light-hearted comment like that is censured.

  4. Thank you Dr. Fung. To clarify, protein need to be under 509/day for weight loss? There are 43g protein in a chicken breast- that does not leave alot of room for anything else.

  5. Fascinating. I’ve always wondered why people living in the poorer nations looked so thin but with a big belly. That’s fatty liver. This makes me sad. Also the people with excess skin; I didn’t realize that was from excess protein. Wow. just wow!

  6. Dr. Fung. You’re correct about protein needs. It took me at least 1/2 a year to get over the mentality of 1g of protein per pound while starting Keto/LCHF. I came from a bodybuilder mentality for 7 years and was so stuck with eating every 3 hours and high protein at each meal. Also blood sugar was never ideal with high protein unless I workout 3 hours a day to get a1c at 6. For the past 1/2 a year I had to really change my mindset with protein and meal timing. I have not yet seen any lose of muscles consuming 38-45g of protein daily but nothing over 50g. My workout routine has also changed in the 1/2 year from lifting heavy to lighter weights and bands. Due to accumulated damage with CICO and intense working out non stop for 7 years. When I do consume over +50g of protein, I do see a generous boost in blood sugar the next morning (I’m diabetic). The blood monitor says it all. Dr. Fung, thanks for sharing your thoughts and studies.

  7. Protein is a mindfield for sure.

    I have spent 35 years as a sugar burner, and this year as a fat burner!!! So I have a lot of years to make up.

    http://ketogenicendurance.com

  8. Dr. Fung,I want to thank both you and Megan for sharing so much valuable information on your blog.

    I hope that will answer my question, as I am quite confused about. You refer to body weight in relation to protein consumption. For example, you were writing about consuming 0.6 grams of protein per kilogram of body mass. Some sources are more specific, referring to specifically to LEAN body mass others only mention body weight. In this article, are you referring to actual body weight (as measured on a regular scale) or are you referring to lean body mass?

    I look forward to your answer, as I am struggling with this issue.

    Thanks in advance,

    Birgit.

    • Robet Moore

      I also need clarity on this point. I would also be interested to know how you work out the protein when buying a steak, chicken breast, chicken thigh, venison, duck etc.

      Many thanks for the insight.

      • Robet,

        I did a little more research, and in line with Megan’s post about her ketogenic challenge, I believe that he is referring to 0.6 grams of protein per kg of lean body mass. If you need to estimate your lean body mass in kg. go to http://keto-calculator.ankerl.com/.

        Also if you go to the low carber forum my plan http://forum.lowcarber.org/myplan.php
        it has a log where you can calculate your daily macro nutrient intake.

        Another good source of nutrition information is http://www.bitelog.com which provides both the macro and micro nutrient content of foods. Both of these sites use the USDA Nutritional Value of Foods as their source.

        I hope that helps.

        Birgit

  9. charles grashow

    Keto diet success story?? Give me a break! Great co-author you have Dr. Fung

    https://vimeo.com/183282494

    • Vegan troll much?

      • charles grashow

        Not a vegan by any means – I eat full fat raw goat milk, whole milk kefir, eggs, grass fed meat, nuts, seeds, etc. SO – a vegan I’m not BUT back to my point – the video is of Dr. Fung’s co-author on their new book. He also complained on a receny instagram post about having his double cream and sticks of butter being confiscated by Australian customs so all he would have to eat on the flight back to the USA was an avocado – this from a man who BRAGS about his MULTI-DAY fasts yet complains about not being about to eat on a plane flight!

        • Seems not eating might make you hungry,

        • Jimmy Moore is a horrible representative of the LCHF way of eating. He is either cheating, eating a massive amount of calories, or his body is seriously messed up from years of dieting. It would serve him better to stop with the cruises, speaking engagements, and book writing and focus on getting healthy first.

          • Wenchypoo

            Unfortunately, he’s one of the ones who are experiencing rebound–he originally lost a lot of weight, but his body and work schedule are making it harder and harder to fight the good keto fight. He eats what he’s supposed to, he eats WHEN he’s supposed to (once daily), he fasts when he can, but is a stress casualty.

            He’s been on the front lines of the keto wars for a decade now, so give him a break (and maybe he’ll start giving himself breaks like you suggest). Right now, he’s busy taking the keto fight to the next level, so maybe our kids, grandkids, and great grandkids will grow up in a medical dogma-free world.

          • I agree he is probably way over stressed Wench, but looking the way he does, no one will take him serious. And those that oppose this way of eating are constantly using him as an example of why it’s bad for us. No, he should definitely stop trying to be the spokesman for this lifestyle until he gets his house in order. At this point it seems he’s only concerned with keeping the cash flowing in.

    • Well he’s looking pretty good considering he topped the scales at 410lbs once upon a time….

  10. Dr. Find will there ever be a publication about this loose skin issue?

    I looked into it all while back prior to losing weight. There is no science out there, just a lot of unsubstantiated bullshit about shea butter, cocoa butter, coconut oil, etc. People say if you lose weight from exercise you will have less loose skin but they never provide a source.

    • The autocorrect on my cell phone changed Dr. Fung to Dr. Find …

    • George Thomas

      I’d love to see a write-up about this as well. The loose skin issue has never really been sufficiently tackled…just a lot of broscience crap.

    • The loose skin issue IS addressed in the article. Dr. Fung indicates that eating LESS than .6 grams of protein (per kg of body weight) will lead to the “burning up” of excess skin, tissue, etc. that isn’t needed as the body loses weight. In his words:
      ” . . . if you are trying to achieve negative energy balance (lose weight) then you need LESS protein. Why? Because there is all sorts of protein loss associated with fat loss. There is less skin, connective tissue, capillaries, blood, dermis etc associated with weight loss – all of which needs to be catabolized (burned up and not replaced). Think about those bariatric surgery shows on TLC where surgeons remove 20-30 pounds of excess skin after weight loss. Yes, that’s all protein that should have been catabolized. As an aside, in my clinic where we do a lot of intermittent fasting, I have not yet sent a single patient to the plastic surgeon for removal of excess skin, even though weight loss sometime is over 100 pounds.”

      • George Thomas

        That’s still not enough. I’ve never seen that hypothesis about loose skin presented anywhere else. This needs its own article.

      • But how do you make sure it breaks down the skin, not muscle.

  11. OK, but I am lost now, wasn’t 56% of protein non ketogenic as such ? As those amino acids did have an insulin response ? Isn’t that how V&P calculated things ?

  12. Dr. Fung,

    I’m curious for a more detailed explanation of why you say protein intake should be less when trying to lose weight. I have always thought that, on a caloric deficit (in order to lose weight), one should increase protein consumption to minimize muscle loss. By decreasing protein consumption, would you not be “encouraging” muscle catabolism? How could that possibly be considered a good thing?

    Thanks.

    • I think he might have answered that in the post. Some (maybe even most?) lean mass catabolism is from structures that become unnecessary as fat is lost, not from muscle tissue. As Dr. Fung often says, “The body isn’t that stupid”, and I tend to agree that it would be “stupid” for the body to catabolize muscle fibers (provided they still seem necessary) when other tissue is available. That’s my guess.

      • Hi Chris, thanks for the reply.

        I agree that Dr. Fung seems to be suggesting here that, on a caloric deficit, the body will only catabolize the unnecessary proteins but I’m not sure that that idea is supported in the literature, in anecdotal observations, or even in Dr. Fung’s own lectures. There seems to be numerous sources (too many to list here) for the idea that, on a caloric deficit, a significant portion of weight loss is lean muscle mass. This is even one of Dr. Fung’s arguments for the benefits of intermittent fasting over sustained calorie restriction.

        • Hi Jon,

          This is a big question for me, as well, and fear of muscle loss is why a lot of people only fast for a portion of a day and rarely for several days in a row (let alone weeks or months). There certainly are many sources showing that a calorie deficit diet will result in loss of muscle mass, and I’m not in favor of simply reducing calories. Some folks have said that you will lose 4 oz of lean mass per day while fasting, and my question is really just, what part of that is muscle? There are obese people who water fast for months on end. If they lost 4 oz of muscle every day, they should be weak as kittens after 6 weeks, but it seems to not work that way. Even the guy that fasted for over a year was basically normal at the end. Between that and the fact that it just makes no sense for the body to burn muscle when there’s so much *flesh* to use instead, makes me wonder if the “lean mass” that is catabolized is not muscle but other stuff.

          • Dr Fung covers this in his book. Fasting will not cause massive muscle loss initially because your body switches to fat burning, muscle sparing mode. But when you go on a low calorie deficit and your body does not switch to fat burning then your muscles do get wasted as they are converted to glucose for energy.

          • Another way is to do some resistance training to failure. I do this even when fasting and this provides very strong signals to your body to spare muscle.

          • I’m just replying to myself to mention that I just watched Dr Fung’s Keto Summit presentation, and he basically confirms exactly what I was wondering. His feelings are that “protein loss” is not necessarily (and wouldn’t logically be) ‘muscle loss’. He even used the “weak as kittens” simile. I will of course assume that he got from my post, even though I know I probably got it from him somewhere along the line, lol. 🙂

          • Thanks for following up, Chris. I’m very interested in this issue and I don’t think it has been adequately addressed.

            The problem I have is that, Dr. Fung’s feelings not withstanding, there are piles of research that show that on a caloric deficit, muscle loss makes up a significant portion weight loss. Everything I have read has suggested that the best way to mitigate this muscle loss is to ensure adequate protein consumption and to engage in resistance training.

            I was hooked by the Aetiology of Obesity series and I eagerly look forward to the fasting book (which I’ve already pre-ordered) but Dr. Fung is losing me with these latest posts.

  13. Well written and something that I mentally had been tallying for a while…..

    This line in particular struck a chord-
    “There is less skin, connective tissue, capillaries, blood, dermis etc associated with weight loss – all of which needs to be catabolized (burned up and not replaced). Think about those bariatric surgery shows on TLC where surgeons remove 20-30 pounds of excess skin after weight loss. Yes, that’s all protein that should have been catabolized. ”

    I can completely understand this, as most overweight males (myself included) tend to gather a stigma from other diets and sources that we have a higher level of muscle in our bodys due to the excessive daily weight “work out” we encounter than say a similar shape male of age/height.
    While the obese would love to declare that as a small victory in our problems, it needs to be considered that as you drop that weight, your body no longer has the need to support those muscles at that level of consistency unless your going to supplement the weight in a like for like ratio.

    Therefor if your a male, that just wanted to drop weight and is not that interested in further muscle development, the best choice may be to experiment with your protein intake, and understand that as your body structure changes, your body has the opportunity to acquire some of that protein naturally.

  14. I believe the link to the Youtube Video on the Low Carb Vail Talk by Dr Fung is:

    https://www.youtube.com/watch?v=tIuj-oMN-Fk&list=PLrVWtWmYRR2BYjk-oQTlAtGCjnly3J7LB

    The link to Dr Rosedales’s Low Carb Vail Talk is:

    https://www.youtube.com/watch?v=Yv-M-5-s9B0

    I hope that helps.

    The link provided in the body of the blog is to a talk at the Aspen Institute from the Murdock Body Mind and Spirit Series featuring Dr. Neal Barnard who advocates a low fat vegan diet. The interesting (and confusing) thing is that Dr. Neal Barnard (low fat vegan) mentions many studies that seem to fly in the face of the LCHF approach that I thought Dr. Fung was recommending.

  15. Thanks again Dr. Fung. Each new bit of info helps me dial in my health a little better. My only complaint is having to wait a week for the next installment. 😉

    • I wish people could get CME credits just for reading his blog! 🙂 Hell, I wish I could get a SANE medical degree just by reading all the blogs, podcasts, Twitter posts, books, and such of the Rolodex of doctors who speak at keto conferences, cruises, summits, and expos.

      The reason I don’t go to med school now is because I couldn’t deal with the hypocrisy day by day, ad certainly couldn’t sit still and keep my mouth shut through an entire degree program.

  16. Jimmy Moore has various recommendations, based on getting into ketosis. One is eat about 1 gram/kg, or about 100 grams for a 200 pound man. I’ve been gradually reducing the protein I eat, but it’s harder than it looks. Take a steak, for instance. I can easily eat 10+ ounces of steak, which makes for a ton of protein. And, steak I can find is way too lean, with all the fat cut off. So, now I eat less steak and add more fat, but that’s a lot of butter and mayo (home made of course) to be eating. I haven’t found a good way to add in the fat.

  17. Regarding Excess Skin. From Dr. Fung’s blog above: “… in my clinic where we do a lot of intermittent fasting, I have not yet sent a single patient to the plastic surgeon for removal of excess skin, even though weight loss sometime is over 100 pounds.”

    This was a revelation for me. Since beginning intermittent fasting as my primary overall health regimen, I’ve lost about 35 lbs with great ease. As a past yo-yo dieter, I’ve lost similar amounts several times. But formerly this resulted in noticeable excess skin, particularly noticeable under my chin. So I had no clue why this is not occuring after my fasting protocol. I simply didn’t consider that autolysis or autophagy, in a protein restricted weight-loss regime, might be responsible.

    It is corroborated in my experience by the fact that severe weight loss using both lo calorie, “protein-sparing fast” methods and badly designed low-carb (i.e. excess protein) diets in my past worked in the short term, but resulted in much more excess skin.

    Just FYI for the curious, my max average weight in life was 249 on a five-and-a-half foot medium frame. When, in my 50s, I repented of dieting and went to ad libitum eating, the average dropped to about 228. Now I’m 60 and after several months intermittent fasting I am 193 and losing steadily, and I enjoy an eating routine that is entirely comfortable, including regular feasts. For the first time ever, I feel I can point and shoot at any weight I want to be over the next year, and feel no deprivation along the way.

  18. Interesting. But if I’m not eating carbs, and reducing protein so low, how can I get the fat? Swallow oil? Just a piece of hard cheese is equal fat and protein. So is an egg. Full fat yoghurt is close to half and half if I’m not mistaken. So how do you get fat without protein, without drinking olive oil?

    • pecans, macadamia, avocadoes, there is quite a list, but they are not all equally nice to the palate. Or buy your beef wagyu, that’s like a 75-25 fat protein mix

      • The problem with nuts is they’re high in omega 6 oils:

        https://proteinpower.com/drmike/2016/07/27/are-nuts-paleo/

        Macadamias have lower omega 6 oils.

        I personally struggle with this. I make my own mayo and add that to meat. I add butter (from grass fed cows) to everything. I eat high fat cheese, sour cream, high fat yoghurt, avocados. But it’s difficult, because even if you want to eat fat from beef, you can’t find the fat. You can’t go to the store and just order beef fat (other than tallow, which is rendered beef fat).

        If you’re out, too, it’s quite difficult. I’ll order the fattiest beef and add butter to it, but even that’s probably too much protein.

        My wife, however, has been advised to avoid dairy. Now try to have a high fat, low protein diet without dairy. There are only so many avocados one can eat.

        • To put this in perspective, if your daily calorie input is 2,000 calories, and you eat 50 grams of protein, that’s 200 calories. If you keep your carb content low (I keep mine as low as possible, say 50 grams only because that’s easy to calculate ;-), that leaves 1,600 calories or 178 grams of fat to eat. About 13 tablespoons of oil. About 6.5 ounces of steak for 50 grams, per DAY. A tiny amount of steak. About 2.5 cans of sardines:

          http://www.wildplanetfoods.com/product/wild-pacific-sardines-in-extra-virgin-olive-oil/

          A quite small amount of protein.

          • Allisaurus

            When you say 50 grams a day of carbs, are you referring to net carbs or total carbs? When calculating macros, you should use total carbohydrates, as even the ones that are deducted have calories. This is a mistake a lot of people make. For instance, if your 50 grams of carbs a day are high-quality carbs with lots of fiber (seeds, veggies, etc.), you can add about 1/4 to 1/2 to your total carb allowance to account for the calories from fiber. If you assume a moderate protein intake of roughly 10% (50 g, or 200 calories), that would take down your fat requirement to 75% rather than 85%. For reference, I hit 82% fat today without effort just by incorporating some olive oil and mayo throughout the day. My protein was too high, although after reading this post I am going to definitely change some things around tomorrow and all the days after! I am a female, and I lost a little over 4 pounds last week eating between 1600 and 2100 calories a day, 75% – 85% fat, with very moderate daily intermittent fasting (14/10) and two trips to the gym. I have been keto adapted for quite some time, so it wasn’t water weight.

      • Wagyu or “kobe style”–also consider lamb, duck, ground pork variants (sausage, chorizo, pork belly), and beef tongue. Those meat are more fat than protein.

    • Yes, this bugs me too. Cut the carbs… Check. But then, one still has to eat something. Proteins and fat come together in meat, and if one doesn’t want to turn vegan, it is hard to increase fat without increasing proteins.

    • Sauce on your meat, fish, or veg. High fat salad dressing. If your trying to lose weight, the fat from your body will be used to make up fat deficit.

      • I have created my own “fat bombs” for cooking–equal parts of every kind of fat in the house, melted together, poured into a silicon candy mold, and frozen overnight. The next morning, I have little bombs I use for cooking–pop one in a flat pan for cooking steaks on, pop one in the skillet for sauteeing or cooking eggs, melt enough to use as a substitute for the fat called for in baking, the uses are almost endless.

        For EATING bombs, I do the same thing, only adding a drop or two of liquid stevia, and about 1/2 t. of some sort of flavoring.

        For salad dressing, I do the same above, but don’t put in a silicon mold, and don’t freeze. Instead, I add half the amount of vinegar, spices and herbs, and leave it in a sealed mason jar on the counter for use all week.

        And above all, don’t forget BACON–the bacon grease can be re-used for just about everything (even salad dressing).

    • The easiest way to cut protein for me is to treat meat as a condiment instead of a staple. For example, A Greek salad with dressing, olives, feta, and a little bit of chopped pepperoni has plenty of fiber and fat, without that much protein.

      Instead of having a steak with a side of veggies, I have a steak salad, where just a few ounces of steak sliced very thin can be plenty across the salad, or zucchini-noodles (or spaghetti squash) with lots of alfredo sauce and just a bit of chicken or shrimp dusted with Cajun spice.

      For soup, it’s just as easy to load up on vegetables in the soup as meat – so the chicken soup is full of sautéed bok choy, celery, carrot, onion, scallion, fresh basil, and what have you, with only a little chicken. Stir fry works on the same principle – add more oil, mound up the veg, only enough meat to flavour the dish.

      Curries, too, can be full of coconut milk or coconut cream, but just enough meat to flavour the dish. (Or none at all.)

      And with soup, stir fry, or curry, you can always add a salad on the side, to increase the fat and the bulk while not upping the carb or the protein.

    • I’m eating salads with lots of grass fed butter and some hemp oil in the dressing

  19. leavemealonegoaway

    I will echo a comment I made last week re ‘where will I get fats??’

    Set up a gourmet oil bar! Mine is set up with mainly olive oils, but followed Brian’s suggestion to add various healthy others.

    Treat it like a scotch bar..do all the cooky stuff scotch geeks do re aroma, mouth feel, impact, finish etc. I am truly amazed how much delicious variety of flavor exists between producers.

    Couple of shots a day and voila, calories ‘lost’ by cutting back protein back a bit are all there.

    As a PS I visit my Oil Bar when fasting..I know it’s a cheat but it hasn’t hurt my progress. R

  20. Thanks
    I like your discussions on fasting. The protein discussion is very timely.

    Eric

  21. Darn it. I missed the funny comment you made originally. I love your humor. Mixed with your down-to-earth and intelligent explanations. Don’t ever stop cracking your funny jokes. I’m a huge fan of yours who always looks forward to your next blog post.

  22. The protein recommendations seem very low. I have helped dozens of clients lose bodyfat using a combination of Fasting, LCHF, and strength training. I’ve always achieved faster and more sustainable results when clients consume around 1 gram protein/kilo of bodyweight. Recovery from exercise is compromised with low protein intake.

    • Perhaps Dr. Fung is assuming no strength training?
      He did mention that a person trying to add muscle would need more protein, did he not?

  23. this is not as difficult as it sounds. Two meals a day, one veg*an, there is even protein room for longevity-giving beans and their extra electrolytes and fiber. One egg is only 6 grams of proteins, which can be extended nutritionally by eating only the yolk (wasteful, I know). some of the protein budget should be for bone broth or gelatin. Big salads including not just greens but also starchy veggies such as cabbage, beet, and carrots, again for fiber. The rest should be centered around avocadoes, ghee, lard, almonds, and similar foods.

  24. Great post! It’s hard enough getting “enough protein” in a full day of eating, let alone 1 or 2 meals/day if intermittent fasting. It’s good to know that adequate protein is less than some people insist.

    This post reminded me of something that I’ve been thinking about recently, especially the part about not having the same problems with excess skin that bariatric patients often have. Basically, it’s summed up in this question that I’d love an answer to if anyone actually knows:

    Does fasting (in the process of catabolizing redundant tissues and structures) also *reduce the number of adipocytes* in the body?

    If it does (and it makes logical sense that it would), that would be an amazing advantage that no other fat loss intervention can claim.

    • Yes, good question about the adipocyes.

      I am also glad that Dr Fung pointed out that after fasting for a while, we would be catabolizing redundant tissue to maintain essential lean body mass.

      May we expect the loose skin etc. from previous weight losses, including that after excessive weight gain during pregnancy, would be used asa protein source during an intermittent fasting regime?
      That would feel miraculous.

      I wonder, what research studies have shown this to work this way.

      • Am I right in thinking that autophagy is basically taking out the trash so to speak so deflated fat would serve no useful purpose? If they are deflated and just taking up space wouldn’t the body realise that the proteins that make up the fat cell structure are available for energy consumption? I’d like to hear more on this question myself.

  25. I am a 5’3″ 105 pound female ( I’m in maintenance and keep carbs in the 30 min to max 50 gram range — I seem to tolerate the higher end during summer ). I only eat twice a day — first meal around noon or one in the afternoon. I eat fatty meat to satiety and felt awful when I tried limiting myself to the Rosedale protein allowance, and I’m not particularly active. I enjoy fatty cuts of meat but still felt hungry and dumping more and more fat onto the meals in the form of olive oil or coconut oil didn’t do anything to make me feel any better. He encourages nut consumption but also says the protein in nuts must be counted. Not everyone can tolerate macadamias (lowest protein nut) and it just starts to seem obsessive and nutty (pardon the pun) to obsessively count each and every morsel of protein when I already have to count carbs. My body and mind feel better when I simply eat fatty meat and fatty fish to satiety and don’t have to start stressing over counting and measuring protein. I do eat plenty of hazelnuts because I love them and also coconut oil and avocado mayo. Sometimes I will eat macadamias but they can trigger eczema in me. I like almonds but not as much as hazelnuts. I do not do dairy. Anyone else experience feeling lousy on lower protein amounts? If one is worried about excess protein, couldn’t a person simply eat protein to satiety and then fast 24 hours once a week or once a month to offset it?

    • Try adding resistant starch and prebiotics like psyllium husk, inulin, and cocoa powder to your diet. I get the “full stomach” feeling drinking just a few teaspoons of potato starch/cocoa powder/meta mucil in the morning. Most of the carbs aren’t absorbed, so it ends up feeding your gut bacteria, which in turn release all kinds of satiety hormones.

  26. I have seen the photographic results of people throwing away the scales and just eating fatty meat to satiety. They become lean and honed without any specific added exercise, drop clothes sizes but not necessarily weight (unless they are obese), and swap muscle for fat (muscle being heavier than fat, hence the lack of weight loss). They regain their health and energy, and lose unwanted diseases, including metabolic issues.

    There are exceptions to the rule, but eating what could be construed as excess protein is not necessarily a bad thing, and using scales as a gauge of health is often meaningless…..

  27. For entertainment purposes, read the American Diabetic Association’s Facebook page (or rather, read the comments):
    https://www.facebook.com/AmericanDiabetesAssociation/

    They probably get to brag that they have hundreds of comments and public participation, I wonder if they care to add that these comments are overwhelmingly hostile.

    • Ah, the association in favor of furthering diabetes. I wish that were satire, but from the way they act what other conclusion is possible?

  28. Texas Old Guy

    Oh man, what a relief. I’ve been “practicing” fasting preparing for some 5- to 7-day fasts by doing short fasts but my really big, and really only, worry about weight loss is the loose skin. It has been a real stumbling block for me. Dr. Fung’s statement that he has not had to refer patients for skin-removal surgery even for large amounts of fat loss removes a heavy load from my alleged mind.

    It makes sense of course. Though the idea did occur to me I had not taken that thought to its now apparent conclusion. The body needs protein during a fast? Well, okay, let’s use the skin that is no longer being used. Brilliant!

    Sheesh. Sometimes one needs a slap upside one’s melon to get it going again.

    • Just how I feel! I am more scared of loose floppy skin than being filled out,somewhat firm(even fat can feel firm) and almost 100 lbs overweight. This post has received a fear I didn’t know I had until I read it and your comment. Thanks for putting out the words.

  29. I’ve watched a lot of your talks and they made sense. That said, reading this post, I think you could do with a lot less snark and sarcasm. You guys go to a lot of the same events; there is overlap. Please try to keep your disagreements academic—we all have the same goals here, and it’s possible to disagree without the sniping.

  30. None of this is science based. It is a collection of hypotheses. I’m disappointed. For anyone interested in a more useful analysis, I recommend:

    http://caloriesproper.com/dietary-protein-does-not-negatively-impact-blood-glucose-control/

    And I don’t plan on looking as emaciated and sickly as Dr. Rosedale, thanks.

    • Very interesting. Seems convincing. It would be great have Dr. Fung’ comments on this.

      • Based on my limited experience excess protein does indeed cause your glucose to be higher than normal. Since 2011 I have been following a LC diet. Lost a lot of weight on it…but could never get into true ketosis. Defined as above .5 blood ketones, even with Intermittent Fasting (eating once a day)…started limiting protein and replacing it with non-starchy vegetables and I immediately saw a drop in my morning glucose levels and my blood ketones have been above .8 for a about 2 weeks.

    • Since 2011 I have been extremely low carb. All that time I never was able to get my blood ketone’s to register above .3 or .4, once on a fast I think I touched .5. During that time I did not eat anything except beef, pork, chicken and fish with Brussels sprouts on occasion and the odd sweet potato from time to time. About 3 weeks ago I stopped eating so much protein and filled it with more non-starchy vegetables, blood ketone’s have not been below .8 since. So apparently in my case it is very much the case that protein hampers my ability to be in ketosis.

  31. Johnson Fellow

    I’m 35, male, 173cm tall and ~70kg with around 20% bodyfat. My peak weight was 105kg about 5 years ago. I’ve lost the weight primarily through a calorie restricted keto diet.

    I do very basic beginners resistance training. Three days a week, full body barbell exercises, each exercise 1. 5-2 times per week with the last set being as many reps as possible.

    I still have 5-10kg of fat to lose and it’s been clear since I passed the 80kg mark I have loose skin. Not massive amounts of it but definitely some. Here’s a pic: http://i.imgur.com/Egd6NnK.jpg . That’s in the top position of a deadlift so it’s with pretty much everything flexed so that’s the best the extra skin can look.

    I’ve been having 60-200g of protein per day (unless fasting), although almost always below 100g. The median is about 85g.

    All that taken into consideration: should I be actively trying to reduce my protein intake?

  32. Protein stimulates insulin equal carbohydrate in order to estimate storage and subsequent obesity?

  33. Thanks Dr.Fung,
    you put my mind at ease with the loose skin. I am getting better at fasting but find myself re-reading your book and articles throughout the week for encouragement! I love your sarcasm by the way!

  34. For anyone with Twitter, there’s an ongoing discussion of protein requirements and this post. Most people are saying this level is too low, and also it’s unclear how much protein gets converted to glucose via gluconeogenesis. Particularly if you’re trying to maintain a ketogenic diet, protein may have to be reduced, but how much so appears to be anyone’s guess.

  35. Andre Marcanth

    Dr. Fung, thank you for this article. I am curious, however about the amount on average of 0.6 g/kg (for a healhy person). Could you please post here the information source of your article? I like your articles very much and thank you for bringing light to this science.

    Dr. Jason Fung: Follow the link in the article

  36. Is the guy in the photo a Fung patient or a non-Fung patient? He has excess skin.

    • Tim Goffard

      He is a guy on YouTube. They just pasted his photo for the article. He is definitely not Dr. Fung’ patient.

  37. Limiting protein has helped me finally get into Ketosis for the first time since 2011. At one point I was only eating meat and still could not get my blood ketone’s past .3 to .4. Started limiting my protein 3 weeks ago and eating more non-starchy vegetables and I immediately hit .8. My morning glucose levels went from touching 130 to below 90. I lift weights and do vigorous body weight exercise as well as bike at least 3 times a week over 10 miles at a time. I am 60 and test on the intermediate strength level in weight lifting. Since around 2013 I have been eating once a day at least 5 days a week.

    I think there is a lot to the idea that all of us have to find our way by ourselves.

  38. The “loose skin” issue was a mystery and concern for me and from the comments, for many others too. May be a good topic for future post. Dr. Fung, please explain why bariatric surgery requires skin removal surgery. Is it because people lose weight by reducing calories while the protein intake remains too high, therefore the body does not catabolize the protein in skin? Probably most people would simply assume that the skin was stretched during obesity and then does not rebound back when weight is lost, like a balloon that is inflated never returns back to the original size. Your posts are very informative and appreciated.

    • I would bet that people who get bariatric surgery still eat high carb diets. I don’t imagine high protein is a problem for them, since it would be practically impossible to ingest much and keep it down.

      I think it has to be the fasting that shrinks the loose skin, not macronutrient ratios. I’m afraid the only one researching this question in a clinical setting is Dr Fung, and it’s not publishable data. It may be a long time before we get a definitive answer. In the meantime, I’m going with what works, or appears to be working.

  39. Dear Dr Fung
    In the Kwashiorkor paragraph you state
    “Carbohydrate” and fat deficiency
    Should this “calorie” deficiency
    As as I understand there is no minimal requirement for carbohydrate

  40. I have tried hard to find exactly which the per kg refers to, but may have missed it in reference.
    Is this current weight, ideal weight/approx BMI 24, or lean body weight/difficult to accurately measure and/or estimate.
    This seems picky, but assuming the main interest in minimal protein requirement is to maintain ketosis without losing muscle mass the differences are significant.
    Also the excess “skin” removed following significant weight loss includes relatively large amounts of subcutaneous fat. Subcutaneous fat is present in persons of “normal” weight.

    • It’s per kg of your current weight, although I believe the argument is that if you go below that, your body will catabolize its excess skin and tissues rather than attack your lean muscle mass.

  41. Dr. Fung, I hope you can comment on this study. “Some shorter-term nitrogen balance studies suggest that the Recommended Dietary Allowance (RDA) of protein may not be adequate for older people.”

    http://biomedgerontology.oxfordjournals.org/content/56/6/M373.abstract

  42. can someone tell me then how do I get full if eating too much protein is possibly keeping me from losing more weight and getting my ketone blood meter to read above 0.2? I need the protein to get filled up or I use the fats for filler and go over my calorie count, I cant seem to win. I want to try less protein because I know I eat it a lot with every meal so I dont get hungry but so far adding more fats, i.e. butter, coconut oil, extra virgin olive oil, ranch dressing, mayo, butter etc is not filling me up so what can I do/

  43. I appreciate how the value of 0.8g/kg was derived but it is too conservative and if a patient is after weight loss, we need to specifically target fat loss. Measures of fat mass, muscle mass, total body water and it’s % have to all be considered and monitored regularly if patients are to undergo wt. loss with a ketogenic diet. Too often, when adequate protein levels are not achieved, the resulting loss of muscle mass inhibits the body’s ability to properly burn fat and thereby maintain the wt loss. This is where patients often plateau in their quest to achieve a desirable fat mass %.

  44. Superbly interesting as always.
    An interesting question would be how much protein one needs while trying to build muscle (body building)? Especially considering if you do IF you get a less total intake. I have read your article on Fasting & Exercise, and I highly recommend it. Yes you can do IF and lift weights. But considering your vast knowledge of fasting Dr Fung, it would be most interesting to hear what you would say is the optimal combination of fasting (16/8, 20/4, 24/1) for building muscle and which would be the optimal intake of protein while on that optimal IF scheme for building muscle?

  45. Consider fat and glucose energy components and protein as more as a building block. If one really wants to understand metabolism they should get anything from Eric Newsholme. Here’s his obit. Note he was in shape and knew metabolism far better than most but died before he turned 80. http://blogs.bmj.com/bjsm/2011/04/07/obituary-for-professor-eric-arthur-newsholme-ma-dsc-phd-

  46. I am loving this bombshell dropped by Dr Fung “today, it is perhaps more important to restrict protein than to restrict carbohydrates“. Strong words, indeed. I tend to agree.”
    In case you can’t see the wood for the trees there are three choices.
    If and only if LCHF is working for you then carry on.
    If you drastically reduce proteins then you are left with fat and carbs. If you eat these to satiety it will hamper weight loss efforts seriously so you may be forced to follow the CRaP method.
    If you like to eat to satiety then your choice may be to eat a HCLF diet where fat calories do not exceed 10% of daily calories. If you choose only non starchy carbs you are making a rod for your own back.

  47. Dr. Fung I am just starting to read the things you have to say and trying them for myself. As an overeating, binger, eat because I’m bored food worshipper of 46 years I can say your words are hitting me right in the gut. Not only am I starting to understand how I got into the mess I’m in, but I’m realizing the way out. It’s so hard to find the truth when there are so many differing opinions and each are equally sincere that they have the answer. You debunk them all, and, in doing so I am finding results for the first time.

    I started weighing 265 and I’m down in the 250-255 range now. My blood work just came back, and with Nexium being the only medication I’m on (the only medicine that has worked to date with my hiatal hernia) my decision to stop taking fenofibrate (yes, with guidance from my doctor) seems to be a good one. My kidney function is restored, my triglycerides are low enough not to interfere with cholesterol readings everything seems to be on the way to falling in line naturally. I naturally walk a lot due to do my job but have incorporated weight lifting into my routine.

    The thing I fear the most is looking like the fellow in the article above. I don’t want to lose the weight being lean and fit and still wearing my old clothes. Is there anything to pay special attention to help prevent this? I’m assuming that lower protein levels when I do eat will help the body naturally return any excess skin into something more useful. That’s my conclusion from this article, anyway.

  48. How about fat as a form of dietary energy (olives, nuts, hard cheese etc?) When I’m energy starved at work, I eat a couple of olives (salt somewhat washed out of them) or a small block of cheese, and my energy levels return quickly. With carbs, I bounce – up, then down . With protein – well, I gained a lot of weight eating too much venison a couple of years ago. But with fat, I seem to be losing weight steadily. 18 lbs in 2 years and still counting, and bodyfat going from 18% to 12.5%

    And I run and swim, pretty much same as usual.

  49. To reduce my protein consumption I replace a meal with cauliflower and butter.

    Adjusted to desired protein consumption and balanced with satisfaction. Eric

  50. Easy to switch from 80 grams of protein on average to 48 grams on average. (.6 times 80 kilos)
    One meal of ten eggs or equivalent protein from fish or beef or which source available.
    Three meals over the two days of. Vegetables and fat.
    Then eggs 700 calories add 400 butter
    Three ponds vegetable 375 calories add 2400 butter
    Is 3200 from fats
    375 proteins
    324 carbohydrate
    Some from black coffee

  51. […] simple enough, when I noticed a new blog post by one of my favorite authors, Dr. Jason Fung:  how-much-protein-is-excessive   This blog post peaked my interest for a number of reasons.  I’ve always felt that the […]

  52. Re: Kwashiorkor

    The name is derived from the Ga language of coastal Ghana, translated as “the sickness the baby gets when the new baby comes” or “the disease of the deposed child”,[5] and reflecting the development of the condition in an older child who has been weaned from the breast when a younger sibling comes.[6] Breast milk contains proteins and amino acids vital to a child’s growth. In at-risk populations, kwashiorkor may develop after a mother weans her child from breast milk, replacing it with a diet high in carbohydrates, especially sugar.

    This condition is common poor African countries where the first child is weaned off the teat but there is insufficient fat and protein in the toddler’s diet due to poverty leading to over-reliance on carbs. Typically poor African people will feed their children some sort of maize porridge or “pap”. I work with adult refugee women and see the same kind of body type as they reach middle despite living in the west. Are they suffering from a kind of malnutrition I wonder, even though they live in the west? I suspect they are living on a kind of carb-based diet with very little protein and fat. Carbs are cheap and they don’t seem to care about taste or food variety.

  53. Hello Jason,

    I watched the video by Dr. Ron Rosedale and he claims that mTOR are responsible for growth -> so when we are fasting, mTOR goes down (growth as well) and autophagy starts…

    Here is my question which puzzels me: how does mTOR and HGH correlates (compete) for growth when we are fasting?

    Thanks a lot for explanation

  54. Why not look at the quintiles of protein consumption in 60 year olds and. Measure loose skin? Maybe less protein results in less loose skin? Over what time? A thousand days?
    Eric

  55. I have been doing intermittent fasting for 4 years now. Most weeks 2 days a week. When I started it, my insulin requirements went from over 300 units a day to 25 within a short time. Unfortunately I continued taking the 25 units a day; I did not know I should have cut it back to 12, then cut it out. I lost 85 lb. in 6 months doing intermittent fasting and making sure I got at least 75 grams of protein with all the amino acids every day. After about 8 months I did not lose more. After a year and a half I started gaining a bit, and required more insulin. While still doing the intermittent fasting, I had regained about 50 lb. I just turned 60 in August, and decided I would put my focus on getting off insulin after over 20 years, and getting the weight off. It might not have been the best idea, but I don’t have a doctor, mine retired, and my endocrinologist is not open to this, but I cut out all my insulin, and only take it when my blood sugars reach 20+. However, instead of intermittent fasting, I did straight fasting for 4 days, and then 23 hour fasts for most other days. I have been having normally one meal a day for a few days, and then fasting for 2 – 4 days, and since August 10th I have had about 5 days or normal eating 3 meals a day. I have lost about 36 lb. but my goal is not to lose weight, which is working fine, it is to have my body deal with the insulin resistance and that is not happening. I am on day 3 of complete fasting, and my blood sugars are not budging. They are usually around 16.3. I got to the gym and swim every day and usually 2 – 4 times a week I do weight machines for about half an hour plus.
    When I go to the gym, if my blood sugar is even as low as 13.4 like the other day, when I come home from the gym it is 20.5. All I have is a mineral supplement and water, but in 3 hours up it goes usually about 7 points. It takes all day and sometimes never comes down to 13 again. I have been doing the full fast about 4 days a week, and 23 hour a day fasts otherwise since August 10. Prior to August 10 I was taking about 30 units of long range Lantis and 60 – 90 of rapid a day. Last Thursday I had an A1C done and it was 8.7 versus 7.8 in July. I am not terribly worried about the 8.7 because it has been 8.3 a number of times while taking considerable high;in my opinion, doses of insulin. I want to reverse this, I want off insulin completely. I have been taking about 1500 units of Berberine a day if it is an eating day.
    Dr. Fung do you have any idea how long I will have to fast to get my blood sugars down. I realize you don’t know me from Adam, but I have lost 10% of my body weight since August 10, when I do full fasts it is with water and tea, no sugar or milk. I have a history of congestive heart – no symptoms at present, and I have had diabetes since 1995 on insulin since 1996.
    Is it worse to take lots of insulin and have an A1C of 8.3 versus about a total of 120 (or so) units over 2 months with an A1C of 8.7? I am really confused as to why my BS remains so high when I don’t eat for days.

    • Julia, when you do eat-what do you eat? Reversal takes time. When I started I was not on insulin but would have been if I had been going to a regular doctor. My fasting glucose was over 200(I don’t know the conversion to your units). I began with LCHF, saw significant improvements, but still not the results I wanted. I then added intermittent fasting(16:8) Again saw results but not to goal. I added regular walking and everything got a little better. Finding the right balance of all of this is specific to each individual. After a year, I am closer to my goal than ever. This month my fasting glucose have been mostly in the low 100’s. My goal is to start the day below 100 in the 80-90 range. Other changes I made was to adjust the IF from 16:8 to eating once a day. I’ve also tweaked my protein levels which has helped. It took me much longer than I expected to get even to this level of success. I believe fatty liver was to blame and it took time to coax my liver into releasing the stored fat. I too was frustrated with glucose levels that did not reflect my efforts but am finally seeing the light at the end of the tunnel. Don’t give up. Keep working to find the proper balance of each technique (LCHF, IF, exercise,meds) that works for you.

  56. Barry W. |Justice

    Once again, nice work. This article makes good sense given that ubiquination rates in our microwaved world are much higher, and constant feeding of protein encourages faster turn over at the expense of the repair pathway(AMPK) Too much exercise and too much protein is currently killing people at higher altitudes like in Utah, Colorado and New mexico, were Non Native EMF becomes more concentrated. Bros science as well as evidence based studies on fitness and nutrition have led to mostly mixed and failed results. The sad part is; many of these people look good relative to gym standards based on bulky muscle shows. Then they get hit with the “big bang” which often consists of sudden death or suicide. This is why the real science tells us that the more you exercise the less protein you should eat. Food is overrated. I have spent too many hours at the gym over the years and consumed too much protein, and certainly carbs. At 64 years of age I work out for 35 minutes or less no more than once a week, eat far less protein , 99% vegetable carbs and a whole lot of fat. I no longer struggle with strength gains or body composition. Intermittent and long term fasts have been a powerful tool for me , as has getting off technology and getting much, much more sun. Ironically less gym, technology and food along with more sun and fat have made it easy for me to be my strongest and healthiest ever. Oh , did I mention that I’ve been a T2D for 10-15 years, but my energy level is far above average. Your advice, Dr. Fung, has been an integral part of my recovery. Smaller, and more energy efficient bodies are more healthy!

    • Barry, what kind of fasting do you do? I do 23/1 daily, with a 48+ at least once a week. Food is overrated, I agree with you. I spend 2 hours a day in sunshine (if it is shining). I eat raw eggs and vegetables. Exercise: I grease the groove with bodyweight exercises throughout the day. Push-ups, pull-ups, inverted rows, air squats etc.

      • Barry W. |Justice

        I sometimes fast for 5 days or more with 3 days being the average. It seems to take 3-5 days for my BS to reach levels in the 80s. I consider myself a work in progress. I haven’t been on meds for a few years now. My blood sugar is not perfectly controlled and It seems from what I have read that longer fasts may actually put a big dent in my insulin resistance. The good news is that my energy has increased dramatically with sun exposure. I feel it will take me a year or two of LCHF while limiting insulin and BS spikes to get to where I want to be. More seafood, cold and sun exposure with less protein is where I’m headed. I suppose I’ve chosen the path of energy as my indicator of health over those potentially obsessive Bs readings. This scheme seems to keep me on a more stable course with less stress. Keep the faith, it takes time that’s not measured in hours , but months and years, depending on your environment.

  57. Great message to take home, thanks.

  58. It’s mainly Glutamine that converts to sugar. So keep that in mind when consuming foods and look them up on nutritiondata.

  59. > There is some suggestion that high animal protein intake may cause osteoporosis. Many of these proteins are acidic, which require neutralization in the body. This acid is buffered in the bones and then eventually the acid is excreted as phosphoric acid. Because bone consists of Calcium bound to phosphorus, there is extra calcium which gets excreted in the urine. This leads to higher urinary calcium losses and potentially osteoporosis.

    This thinking, though long-held, may be wrong, considering some studies that suggest otherwise:
    http://nutritionfacts.org/video/alkaline-diets-animal-protein-and-calcium-loss/

    • MachineGhost

      You could also just take a calcium supplement and not worry about it!

  60. Hello, can anybody give me an advice?. I eat low carb, practice dinner-dinner fast every day and I really like it. Its great to work and exercise with empty stomach. But Im gaining weight, in fat. I practice calisthenics three times a week and boxing two times a week, practicing hard. I hate to count my calories, but apparently with this regime I still can be overeating myself. Or can it be to much protein problem? I eat 1-1,5g per kg of BW.

    • MachineGhost

      I eat the same amount of protein than you do, so I would wager it is clearly excessive given your non-muscle building activities. Exercise should be specifically done only for building muscle, i.e. pumping iron — anything else is just recreation. Recreation doesn’t need increased protein.

  61. ann stanaway

    As a newly-diagnosed type II diabetic, I was interested to find Dr. Fung’s analysis of IR. I have begun fasting once weekly for 24 hours with significant results. I lost 30 lbs the first month and have decreased my A1C and triglyceride levels. My doctor is now reducing my thyroid medication and Metformin. I can see the light at the end of the tunnel. I will continue on my VLC diet watching my protein intake as well and will incorporate Dr. Fung’s fasting regime until I reach my stasis. At stasis, I intend to continue with Dr. Fung’s sage advice on nutrition. His explanation of the biochemistry behind obesity and diabetes has so far been very helpful in my consultations with my endocrinologist, dietician, and general practitioner.

  62. john koroloff

    Excess protein consumption is a component of excessive food consumption. Eating many times a day keeps is in the metabolic fed state that up-regulates mTOR (anabolic) and down regulates AMPK (catabolic) pathways…the AMPK pathway is critical for metabolizing “Junk proteins-damaged mitochondria, organelles, beta anyloid plaques, etc….called autophagia. FASTING long enough to deplete liver glycogen and up-regulate fat metabolism also up regulates AMPK. Besides Fasting, there are drugs like Metformin, and exercise that turn AMPK pathway “on”. From my experience, it appears that Dr. Fung is one of the few physicians I know that took and understand concepts of biochemistry, physiology and endocrinology.

  63. I’m male, 66, I lift weights once a week following Body By Science (after five years of traditional lifting.) I weigh 180lb, body fat about 15%. I average 41 net carbs a day, 76.6 grams of protein a day (though I lift only one day a week.) My goal is to ward of sarcopenia (and to look good naked. So I am not aiming to be a geriatric Charles Atlas but rather just in shape.) Three meals a day, or two. No eating at night. I also fast three days a week, two 18-hour fasts (Tuesday and Thursdays) each followed by at least 30 miles of bicycling while fasted, and one full 24-hour fast on Sunday (all just water fasts.) With that my weight is slowly going up, which I hope is muscle muscle. (I’m 5-foot-9.) The protein need for an active senior is a difficult figure to come by. Most of my protein sources are eggs, fish, some fermented dairy (goat;s milk for casein A2) sheep cheese, and on the day I lift whey protein, 30 grams. It all seems to be working but I fret about the protein. I will also note my HDL tends to be low — mid 30s — my LDL’s 110 to 130 — and my triglycerides consistently elevated around 250. Can’t seem to move those figures. No alcohol in the diet, no added sugar, no fruit other than occasional blueberries or cherries et cetera. Cholesterol ranges from 200 to 240. Fasting insulin is 9 — strikes me as high — glucose 98, AIC 5.0. I also carry the gene for high fructose intolerance but as far as I know I don’t have the disease as it usually manifests itself. I can eat fruit. But I can’t help but wonder if while not having HF intolerance it might have some effect on the numbers.

  64. I am also worried about skin folding and wrinkles while losing weight as I already see evidence of it myself.
    The protein in vegetables, avocado and nuts, I believe, are not complete proteins. When calculating the 0.6g/Kg of weight for the total protein consumed, is the protein in vegetables, avocado and nuts counted?

  65. I am new to the idea of fasting and LCHF. I only have one kidney. Is there any possibility of kidney damage?

    One reason I’m asking this is because when I follow the recommendations to supplement with salt, I retain water. I’ve only been adding 1/2 tsp to some water.

    Should only having one kidney cause this?

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