Protein Leverage Hypothesis

Inverse Carb Leverage HypothesisTM

Protein Leverage Hypothesis: Dude eats 15% protein on a 2000 kcal diet (75 g protein).  Exchange 25 grams of protein with carb, and he’s now eating 10% protein on a 2000 kcal diet (50 g protein).  Theory states Dude will increase total food intake to get back those 25 grams.

Ergo, Protein Leverage Hypothesis:

protein leverage hypothesis

Disclaimer: I don’t care much for the Protein Leverage Hypothesis.  It might be true, but that doesn’t mean it matters.  It works well in rodents, but obese patients eat tons of protein.  The rebuttal to this is that the protein in their diet is too diluted with other [empty] calories.  They’re overeating because of low protein %.

The flipside, confirmed ad nauseam in rodent studies, is that frank protein deficiency increases food intake.  Frank protein deficiency means negative nitrogen balance & tissue loss… not just skeletal muscle; organs, too.  Incompatible with survival.

Feed someone a low protein low fat diet, they get hungry.  If it’s ad libitum, they eat more.

Dr. Gosby’s recent study, the one that made waves, was not good.  I’ll discuss the much better one she did in 2011.  In brief, lean healthy people were given one of 3 ad lib diets for 4 days containing 10, 15, or 25% protein (all 30% fat).  Most of the meals in each group had a roughly similar macronutrient profile and looked like prison food:

prison food

Had no “leveraging” occurred, here’s what would’ve happened:no leveraging

Here’s what happened:IRL

10% protein group did indeed “leverage” protein… to reclaim a whopping 7 grams #fail

The 10% protein group was also the 60% carb group.  They ate the most.  The 15% protein group was the 50% carb group.  Going from the 15% to the 10% group was supposed to increase carbs by 26 grams (had no leveraging occurred).  But it increased by 39 (a 13 gram overshoot).  Protein Leveraging *makes sense* from a biological perspective, but these data suggest Inverse Carb LeverageTM is stronger.

It’s a small [weak] effect, but here are 2 more examples.

Flashback

Two studies.

First one: obese kids that stopped drinking regular soda reduced their calorie intake and lost weight.  Yeah, they weren’t getting soda calories so duh calorie intake declined.  But calories declined by more than just the soda calories.  They stopped drinking soda which made them eat fewer chips.

Second one: NHANES.  Kids who drank more soda had higher calorie intake.  Duh liquid soda calories aren’t compensated for.  But it gets better (worse): the increased calorie intake was above and beyond those attributable to the soda calories.  Inverse Carb LeverageTM

These differences were all quantitatively small, but obesity doesn’t happen overnight.

Alternate conclusion: I think the Inverse Carb LeverageTM is as strong as the Protein Leverage Hypothesis, which isn’t very strong.

calories proper

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  • http://itsthewooo.blogspot.com/ Jane Plain (Woo)

    a+ loved this entry. I agree the biggest reason protein is satisfying is because it tends to displace carbs.

    • http://www.caloriesproper.com/ William Lagakos

      thanks. high protein is somewhat at odds with super-satiating effects of ketosis… but probably very helpful for some. Need another Chris Gardner to find the subgroup of obese patients who would benefit most by increasing protein %.

    • Kindke

      disagree strongly, in my experience protein leverage is a very real thing, and certainly not because it displaces carbs.

      I do agree however that carbs can displace total appetite. I will consume much higher calories overall in mixed meals compared to ketogenic meals.

      with respect to low fat meals ( protein carbs ) I do find these quickly satiating, BUT hunger returns again 2 hours later.

      • http://itsthewooo.blogspot.com/ Jane Plain (Woo)

        I can agree that protein is required for normal appetite inhibition, but I think *most* of the reason your average individual newly initating a so called “high protein diet” loses weight and stops feeling hungry is explicitly because they are not eating carbs.

        Obese americans eat LOTS of protein, possibly more than a standard VLC dieter. Fried chicken, pizza, chicken nuggets, hamburgers, hoagies, these are all very protein rich foods. However, appetite inhibition does not happen and there is still repeating cyclical irrational hunger and progressive fat gain; this generally is course of action until the person cuts out the crappy carbs that accompany the protein.

        So IMO it’s not “either or”, it can be true that minimum protein requirements are necessary for appetite inhibition (we have all experienced this trying “extreme” diets probably) but it’s also true, and much more relevant to the larger obese population, that the PRIMARY reason LC diets work is because they cut out the carbs, not because of protein density.

        • http://itsthewooo.blogspot.com/ Jane Plain (Woo)

          My favorite meals as obese person were extremely protein rich. I loved roast beef and potatoes, I loved deep dish pizza, and I ate fried chicken with rice.

          The reason I ate so very many calories and always felt hungry, was because of my glucose intolerance, hyperinsulinemia, and my inability to normally tolerate the highly insulinogenic diet provoked by soda, iced tea, potatoes, rice, flour/bread and all the added oils of these foods.

          I have little doubt I ate more protein back in those days, only because every few hrs ravenously starving and I have always had preference for protein rich savory foods.

          • http://www.caloriesproper.com/ William Lagakos

            I wonder if something like this is what begat the grazing 6-8 meals/d thing…
            someone who was constantly hungry; coincidentally same person who writes widely publicized nutrition articles and thinks their way is the best way.

          • http://itsthewooo.blogspot.com/ Jane Plain (Woo)

            I’m sure of it, when I was very call restrict I also ate mini meals as fasting for any length of time is impossible while functioning.

        • http://www.caloriesproper.com/ William Lagakos

          Agreed, and I think some of this shows in the data. Cut carbs = greater than expected reduction in calories (from the soda studies). Increase protein% = modest reduction in calories, depending on baseline protein%… apparently no big effect of going from high to higher.

  • Raymund Edwards

    I was stalled at 20% body fat on a keto diet.
    I tried various tweaks.
    What made the huge breakthrough
    was reducing protein and replacing with fat

    I find I am best on 1 gram of protein per 1 kg of lean body mass.

    So for me I am eating 60 grams of protein ( instead of 120 grams ) I expect that I have dropped insulin levels. I eat 20 grams of carbs , and think those carbs are important to making lower protein work for you. ( if you were to eat ZC you would need a lot more protein )

    My appetite and energy are great

    I also find my muscle and strength fine.
    ( I can work out just as well )

    So a keto diet changes the protein equation imo

    • Thomas Hemming Larsen

      The protein will convert to glucose at a ~56% rate. I’ve heard it from several people that it wasn’t until they cut protien that they started to lose weight.

    • http://www.caloriesproper.com/ William Lagakos

      This isn’t uncommon… there’s been a trend recently of going lower & lower with protein levels to bypass weight loss stalls.

      Appetite, energy, muscle mass, and strength are great indicators that protein isn’t too low.

    • johnnyv

      Interesting, I am currently in the middle of a cut for summer, live in New Zealand.
      Anyway so I have started counting calories for the first time on 30/09/13 and have been trying IIFYM at 200g protein and 2000 Cal per day.
      Over this time period I have steadily reduced in weight from my starting 90kg to 85kg, I now have a much more visible non flexed abs but still not where I want them.
      I suspect because I was previously obese I suffer from adipocyte hyperplasia in the lower ab area unfortunately.
      I have striated deltoids and veins very apparent over my delts and pectorials but still lower ab fat.

      So weight loss occurs at a high protein level with controlled calorie deficit, it is just that compliance become more and more difficult over time. I have recently cut down to 0.75g per pound and the relative increase in fat has made a HUGE difference to my subjective feelings of well being. I say increase in fat because I had previously tried mixing in carbs and all they do is make me ravenously hungry on a deficit.

      All previous weight loss was ad libitum low carb followed by ad libitum low carb plus IF then ad libitum keto plus IF(8 hour eating window).
      Intial progress 102kg(40 ish % fat) – 84kg, between 84-86 over a year and a half with a slight recomposition to lower body fat with most occurring on the switch to IF then up to 90kg on ad libitum keto but lower body fat again. Resistance training over the entire period and over a year before any noticeable fat loss, surprisingly my strength rapidly increased on my switch from ad libitum low carb to ad libitum keto and that is when I really started to pack on lean mass.

      TLDR version: you can certainly lose fat on a high protein calorie controlled diet if you can suffer through it, but you probably will suffer.

    • http://itsthewooo.blogspot.com/ Jane Plain (Woo)

      Dude 60g pro on vlc for man during wt loss = muscle losses, this is going to lower scale but body comp will be worse.

      I find being catabolic inhibited appetite sometimesoso you may see net loss of fat, but yea dis def too little pro to avoid muscle loss

      • http://ashsimmonds.com/ Ash Simmonds

        This isn’t necessarily true, keto is VERY protein sparing – as long as you have enough fat available via either adipose or food, muscle wasting will only be in line with *necessary* lean body mass to support your structure.

        I’ve just recently put up a first draft/rough sketch of this, it needs a lot of work with rewording and to include robust references, but outlines why muscle wasting isn’t an issue here:

        http://ketogeniclifestyle.com/starvation-mode-and-muscle-wasting-myth-on-a-low-carbohydrate-diet/

        Feel free to poke holes in it so I can improve it. :)

        • http://www.caloriesproper.com/ William Lagakos

          “The muscle-sparing effects of fat-derived fuel” :) :) :)

          http://caloriesproper.com/?p=2719
          http://caloriesproper.com/?p=3882

          • http://ashsimmonds.com/ Ash Simmonds

            Ah yeah I remember those – I’ll pilfer what I can from them. :p

            As an aside, I posted the above post to reddit etc and had actual biochemistry students say much of it was wrong and try and tell me that quote “the medical definition of starvation, which is lack of carbohydrate intake” – therefore ketosis = starvation.

            They then went on to argue semantics and never once answered my questions of what they found incorrect nor came through with proof that the medical definition of ketosis is the same as starvation.

            I understand you can starve cells of glucose, but to conflate that with actual starvation of the entire organism seems daft, and if that’s what’s in biochem books are these kids really swallowing that?

            The way medical people have it, you and your caveman family could have a fresh woolly mammoth kill sitting in front of them, but according to biochemistry they’re going to be starving…

          • http://www.caloriesproper.com/ William Lagakos

            No, they’re wrong. Starvation means no or low calorie intake; malnutrition. Unlike ketosis, starvation can result in death. (Ketosis, not ketoacidosis)… I would, however, agree that ketogenic diets selectively mimic certain aspects of starvation, like low insulin and high fat oxidation. But during starvation, leptin levels plummet causing a whole host of pathological changes in metabolism; this doesn’t happen on a ketogenic diet.

          • http://ashsimmonds.com/ Ash Simmonds

            Some comments from biochem students:

            “Starvation and the keto diet are actually nearly identical from a biochemical perspective.”

            “nutritional ketosis = starvation, because ‘starvation’ in a biochemical sense refers to carbohydrate intake”

            “ketosis is starvation mode – we don’t eat carbs, and so we are ‘starving’ because we then have a low insulin:glucose ratio.”

            “In the metabolic starvation state the body obtains glucose from sources other than ingested carbohydrates.”

            “the medical definition of starvation, which is lack of carbohydrate intake”

            “What needs to change is brainwashed people like you misunderstanding biochemistry and spreading misinformation”

            :p

            Maybe my understanding isn’t at a proper student’s level, but in the end my thought is this:

            “If the definition of starvation in your biochemistry books comes down to ‘producing glucose endogenously’ then that’s a pretty serious flaw.”

          • http://www.caloriesproper.com/ William Lagakos

            hit me with a link to the post.

          • http://ashsimmonds.com/ Ash Simmonds
          • http://www.caloriesproper.com/ William Lagakos

            there were actually some pretty good comments in there… insulin seemed to be the major focus. Misguided, imo.

          • http://ashsimmonds.com/ Ash Simmonds

            Oh yeah there’s always some great enlightening conversations – kinda the point – and yeah I’m tired of hearing about insulin… but in the end what I was getting at is students are still being taught that ketosis literally = starvation. It wouldn’t bother me but I read it nearly every day hence I bothered to do a mini write-up as layman as possible – someone’s done a good job of telling the world that without carbs you starve.

            I guess it’s lucky I still drink the occasional beer to maintain my body, else I’d be a withered husk by now.

          • http://ashsimmonds.com/ Ash Simmonds

            For eg – I enjoyed the top voted response, but the thing is he basically said what I was saying but used bigger words and focussed on calories and losing weight, kinda what I was trying to avoid – and then said a number of points were incorrect, but didn’t say what. I’m literally asking to have holes poked so I can fix them.

            I then asked what was wrong (I’m often a bit tongue in cheek/asshole) and got what is known as “downvoted to oblivion” so the post doesn’t show – he just comes back and re-iterates that ketosis = starvation because his slides tell him so and leaves it at that. The hidden post: http://redd.it/1qm2kn

            Then again – another student pipes up about the biochem definition of starvation = lack of carbohydrates, I ask for proof… Crickets… http://redd.it/1qm2kn

            Ah well.

          • http://ashsimmonds.com/ Ash Simmonds

            Hey man, don’t mean to spam your post, but just stumbled on this very interesting discussion from last year:

            http://www.reddit.com/r/keto/comments/xph0l/dangerous_methylglyoxal_production_during_keto/c5ogo4t

          • http://www.caloriesproper.com/ William Lagakos

            no worries. Reddit has some pretty good stuff… just rarely have the patience to sort through all the crap to find it. thanks!

  • Thomas Hemming Larsen

    Hi Bill,
    I’m thinking that there has to be some sort of ‘sweet spot’ for protein consumption (which is highly individual and more or less impossible to define). If you eat too little you end up being hungry but eating too much will crowd out either carbs and fat and you end up hungry from rabbit starvation. I remember Stefansson saying that they at one point didn’t have enough fat and that they ate so much lean meat that their stomachs were visibly extended beyond their belts.
    Protein can only satisfy you to a certain extend after which you have to eat carbs or fat to feel full.

    • http://www.caloriesproper.com/ William Lagakos

      Hi Thomas,
      A sweet spot for protein… well said.

      I think rabbit starvation is worse than hunger: fatigue, malaise, diarrhea, “vague feelings of discomfort” :(

      • Thomas Hemming Larsen

        I think I know that feeling from when my anorexia was at it’s worst. You’re not just hungry, you feel like utter crap all the time in every way.

      • LeonRover

        One should never never ever eat starved rabbit – Ancel would have approved: he never “long pigged” his volunteers!

  • Robert

    Dr. Bill, on days when I’ve had Diet Coke to drink, I will always have carbs before bed. As in, I am powerless *not* to have cookies (or peanut butter toast, or some other high-carb, wheat-based crap.)

    During periods when I’m *not* indulging my Diet Coke addiction, I have no desire for bedtime carbs whatsoever. None at all.

    There’s something in soda that is destroying people. (And I think the manufacturers well know it.)

    • http://www.caloriesproper.com/ William Lagakos

      Hi Robert,
      That’d be enough to keep me off the stuff. It’s interesting, too.

    • Wenchypoo

      HFCS?

      • http://www.caloriesproper.com/ William Lagakos

        Diet Coke is sweetened with aspartame or a mix of sucralose and acesulfame K… perhaps it’s not sugar, but rather sweetness.

    • johnnyv

      When I drink coke zero in the evening I do not need nor even want carbs before bed.
      Mind you my usual dinner will be steak, eggs yolks, butter and veges which is very satiating.

      • http://www.caloriesproper.com/ William Lagakos

        Johnny, I suspect that a meal as nutrient-dense as that will likely quell all sorts of cravings. Win-win.

    • dan

      Or maybe the thing that’s triggering you to eat carbs is, in fact, the same thing that triggered you to drink the diet coke.

      • http://www.caloriesproper.com/ William Lagakos

        Ha! well done, Dan. A bona fide confounder.

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