Protein “requirements,” carbs, and nutrient partitioning 

One way to determine protein requirements is the nitrogen balance technique.  If all of the nitrogen from dietary protein intake is equivalent to that lost via feces, urine, and sweat, then one is in nitrogen balance.  Growing children and pregnant women are usually in positive nitrogen balance, because much of the nitrogen is being invested in the growth of new tissue.  Cachectic cancer patients and sarcopenic elderly may be in negative nitrogen balance, because they’re losing lean mass.

Protein requirements to maintain nitrogen balance are largely dependent on total energy intake.  More calories in, less protein needed.  For people in negative energy balance (losing weight), this usually means more protein is required else muscle will be wasted.

Exercise lowers, not raises, protein “requirements,” because exercise is a potent anabolic stimulus; it helps preserve nitrogen at any level of dietary protein.  That’s not to say more won’t improve functional outcomes; just that it’s not “necessary” to prevent muscle loss.

Need =/= optimization.

Lastly, total grams, not percent of calories, is the most relevant way to talk about protein requirements in the context of nutrient partitioning and body composition.  This is just how protein operates.

Part 2.  The poor, misunderstood Randle Cycle

“The glucose-sparing effect of fat-derived fuels” …when you’re body starts burning more fat (and fat-derived fuels; ie, ketones), it’s use of glucose declines.  Thus, it’s “glucose-sparing” (spares glucose for the brain and obligatory glycolytic tissues, yada yada yada).

During starvation, much of that glucose comes from amino acids from skeletal muscle proteins, so it can also be phrased as: “the muscle-sparing effect of fat-derived fuels,”  which is equally biologically relevant, because similar to zeroglycemia, an unabated loss of muscle is incompatible with survival.

That is, in starvation, where the “protein” is skeletal muscle, not dietary (because starvation)… but what about when following a low carb or ketogenic diet – do ketones (fat-derived fuels) exert a muscle-sparing effect in this context?

One study compared the impact of two isonitrogenous diets, low carb (Diet A) vs. high carb (Diet B), on nitrogen balance and showed that, except at very high levels of energy intake, nitrogen balance was consistently better on high carb.

carbs vs protein req


However, 51 kcal/kg is the textbook number of kcals “required” for young, moderately active adults.  With this understanding, it could be interpreted to mean that nitrogen balance is better with low carb (Diet A) for people in energy balance; and better with high carb (Diet B) if energy deficit.

edit: 51 kcal/kg is for athletes; probably about 20-25% less for non-athletes.

Or not: in another study, a low carb diet promoted better nitrogen retention albeit less weight loss than an isocaloric low fat diet.  The low carb group lost slightly more fat mass, which, combined with nitrogen balance data, suggest modestly improved body composition.  The differences were small, because this was a “non-ad lib” isocaloric diet study.  In the absence of large differences in intake, the most we can expect from such studies are subtle alterations in nutrient partitioning (which are usually difficult to detect).

Cancer cachexia is a condition of severe muscle wasting, and one study set out to determine, more directly, if ketones spared muscle in this context.  The study only lasted one week, but I suspect a certain degree of expedited ketoadaptation because: 1) it was very low in carbohydrate; 2) the fat was primarily MCTs; 3) they supplemented oral ketones; and 4) energy expenditure is elevated in this population.  Both the control and ketogenic diets were modestly hypercaloric, but nitrogen balance was more favorably improved by the high carb diet, in contrast to the above studies.

Thus, ketones don’t work in the context of a hypercaloric diet; however, pharmacologically elevating ketones via intravenous infusion in fasting subjects does work (because it’s more like starvation).

The muscle-sparing effect of fat-derived fuels is conceptually and physiologically more relevant to starvation, not nutritional ketosis.

Part 3.  Protein “requirements”

Effects of high-protein diets on fat-free mass and muscle protein synthesis following weight loss: a randomized controlled trial (Pasiakos et al., 2013) 

Protein intake was 1x, 2x, or 3x the RDA; fat was 30% of calories, and carbs made up the rest; on a weight maintenance diet and again on 30% calorie restriction (it was technically a 40% energy deficit, because they tried to ramp up energy expenditure with exercise).


All groups lost weight, but the ratio of fat to muscle loss was significantly higher in the 2x and 3x RDA groups, which amounted to ~120 and 185 grams of protein per day, respectively.  The 3x group didn’t fare as well, possibly, because that much protein induces a high degree of satiety – this group ended up consuming significantly fewer calories than the 2x group.  So the interplay between energy intake and protein requirements is back on the table: the added energy deficit apparently increased protein requirements to some level above 185 grams per day.  Not much, given the small difference in muscle loss, but increased none the less.

Side note: be cautious when interpreting a study about the amount of protein required for xyz endpoint, because such studies usually only measure one of many important markers, and they don’t report absolute changes in size, strength, etc.  Also, context matters.

For example, Moore and colleagues (2014) showed that 0.24 g/kg (17 grams for a 70 kg adult) was enough to maximally stimulate myofibrillar fractional synthetic rate (mFSR):


However, in the contexts of three square meals and energy balance (or deficit), 0.72 g/kg (50 g/d) is woefully inadequate.  Point being: mFSR (in this case) is only one measurement and shouldn’t be extrapolated to total daily requirements.  Perhaps you could eat six 17 g servings in order to fully maximize 24-hour mFSR, or you could realize that going above what saturates mFSR isn’t a bad thing, or wasteful.  mFSR is just one of many measurements of muscle protein balance.

My opinion

For those who need exact numbers, hopefully one point I’ve made is that there’s no answer to this question.  I’d guess that most people “need” 100+ grams of protein per day (more if losing weight), and 100 grams is probably too much in one sitting.  Also, need =/= optimization, and context matters.

Nutritional ketosis doesn’t appear to reduce the amount of dietary protein necessary to maintain lean mass.  The muscle-sparing of fat-derived fuels works during starvation; in other contexts, all bets are off.

calories proper

Be Sociable, Share!
  • Darell

    “For those who need exact numbers, hopefully one point I’ve made is that there’s no answer to this question. I’d guess that most people “need” 100+ grams of protein per day (more if losing weight), and 100 grams is probably too much in one sitting. Also, need =/= optimization, and context matters.

    So if my weight is 400 pounds i need 100 grams of protein, and if my weight is 100 pounds i need 100 grams of protein?

    • Michael

      You “need” to improve your reading comprehension.

      • William Lagakos

        I took it as sarcasm. Otherwise, either Darell misinterpreted my meaning or I didn’t explain it clearly enough.

    • William Lagakos


  • Dustin Sikstrom

    > Thus, ketones don’t work in the context of a hypercaloric diet; however,pharmacologically elevating ketones via intravenous infusion in fasting subjects does work (because it’s more like starvation).

    Hmm, I’m not sure I understand this comment. Are you referring to the lack of ketone production that seems to come along with a hypercaloric diet? Or the nitrogen balance of a hypercaloric ketogenic diet?

    I don’t think it’s the latter because, from the cancer cachexia study:

    > Consequently, the mean daily N balance was slightly but not significantly more positive when the patients were fed on the normal diet as opposed to the ketogenic diet (p > 0.1).

    Which is what you were talking about how the high carb diet had a slightly favorable nitrogen balance, but the study also says it’s not significant.

    So, if you wouldn’t mind, I’d love a bit more clarification.

    • William Lagakos

      collectively, ketones show a clear “muscle-sparing” effect in the context of fasting or starvation, but during weight gain, weight maintenance, or even diet-induced weight loss, this effect is mostly lost.

      In other words, theoretically, if someone eating 150 g protein on a high carb diet drastically lowers their carb intake, then it seems like they’ll still “need” 150 g/d (or more, if the new diet induces an energy deficit)…

      • Dustin Sikstrom

        > even diet-induced weight loss, this effect is mostly lost.

        Except in the case of nutritional ketosis diet induced weight loss, correct?

        So would that make “basic, non-ketogenic low carb” less muscle sparing at the same protein levels than a ketogenic diet? (theoretically).

        Overall, it still points towards the importance of enough protein.

        • William Lagakos

          “Except in the case of nutritional ketosis diet induced weight loss, correct?”

          it’s hard to say.

          At the left side of the figure, “Diet A” (low carb) showed consistently lower nitrogen balance than “Diet B” (high carb).

          The studies reviewed by Manninen in the link you sent show that low carb diets preserve lean mass during weight loss; not that low carb diets preserve lean mass *better* than other diets with similar protein intake…

          “Overall, it still points towards the importance of enough protein.”

          indeed. Even in conditions where slight differences exist, the impact on total requirements isn’t going to change by much, eg, 2-3x…

  • William Lagakos

    Mimicking calorie restriction (with carbohydrate restriction)

  • Raymund Edwards

    Bill I have come across a concept of anabolic drive connected to protein oxidation by products like ?-hydroxy-?-methylbutyrate .

    Where it is suggested that protein balance is not enough, But some level above minimum amino acid oxidation is what matters

    often these suggestion link back to the studies of Vernon R. Young

    ” The minimum physiological requirements for the indispensable amino acids in adult humans have been determined largely from results of short-term N-balance determinations. The limitations of this approach have been discussed briefly in this review. We have argued that these limitations may lead to a gross underestimation of the minimum physiological requirement for maintenance of protein nutriture and that new and alternative approaches must be developed in order to establish more definitively minimum intake levels that are consistent with maintenance of adequate protein status in healthy individuals. Studies in our laboratories concerned with the quantitative determination of whole body amino acid kinetics, using 13C-tracer techniques, are described with the purpose of emphasizing their possible value in developing a novel method for determining requirements for essential amino acids. The results of our initial studies support the view that study of dynamic aspects of whole body protein and amino acid metabolism will aid an improved understanding of the ways by which amino acid homeostasis is achieved in human subjects under differing nutritional conditions and directly lead to more reliable estimates of nutrient requirements. Furthermore, an interpretation of our preliminary studies leads to the conclusion that the minimum physiological requirements for leucine, valine and lysine in adult humans may be about two to three times higher than the currently accepted values; the latter derived from studies in which N balance has served as the sole criterion of adequacy of amino acid intake. ”

    On – > ?-hydroxy-?-methylbutyrate

    • William Lagakos

      this is partly why I used quotations around the word “requirements”

      …how much protein is required *for what?*
      to maintain nitrogen balance? to saturate myofibrillar fractional synthetic rate? etc.

      also, as protein quality increases, the amount “required” should decrease proportionately. (this can be mimicked by things like HMB, as in the link you posted).

  • This Old Housewife

    So maybe Joslin had it right by feeding mostly veggies and adding meat a little at a time (perhaps to avoid feeding into gluconeogenesis)?

    I’ve got a question for you re: Hubby–if veggies (now all but radishes, pickles, celery, sprouts, and the weekly potato salad) send his blood sugar soaring, and we back off on the meat (which is bound to give him meat cravings–it did before we were Paleo) as per exercise dictates, then what am I left with to feed him? Dairy has lactose in it, he won’t drink olive oil or eat coconut oil (unless I hide it in recipes), and pork rinds get real salty after awhile.

    It’s even gotten to the point where Amazing Maria bread (with 1/2 cup psyllium per batch of dough) sends him soaring…and that’s a hell of a lot of fiber!

    Maybe the answer is of a pharmaceutical nature: he’s likely reached the point of insulin, and I can no longer save him (try that I might).

    • William Lagakos

      has he gained weight in the last 6 – 12 months?

      this is one tough nut to crack. Oh, what about nuts?

      I’d opt for acarbose & metformin long before insulin, but double check with Doc.

      • This Old Housewife

        He has VERY SLOWLY lost weight–less than 10 lbs. tops. A shocker last night was that chicken breast (alone, with pork rind crust) caused his blood to surge into the 120’s for FBG this morning. I’m attributing that one to what the chicken eats, and am not repeating it.

        His is a genetic history–every male member of his paternal line is one type or another of diabetic, thanks to Grandma (a type 1 herself). Maybe I’m working too hard trying to fight genetics here.

        He’s currently taking up to 16,000 units of chromium daily (divided doses) along with the same amount of vanadium daily (again, divided doses). I had to stop the bitter melon because supplies have been polluted with rice flour (from various manufacturers–they’re all affected).

        I’m going to hit the older books hard to see what else I can do that I haven’t already tried. The potato salad therapy cannot be done every night, because it loses effectiveness that way–twice weekly is the closest I can feed this and still maintain a low FBG.

        I fear it may be Big Pharma time. I may have killed off most of his remaining beta cells with excess chromium–or CAN you kill off beta cells with chromium?

        • William Lagakos

          it sounds like a very complicated case…

          but I don’t think beta cells “die off” very easily.

          • This Old Housewife

            Well, SOMETHING’S happening, because it’s taking more and more chromium and vanadium to keep him in line. Maybe a growing dependency?

      • This Old Housewife

        Doc won’t play along until his FBG reaches 140 or over, and that’s precisely what I’m fighting so hard to prevent. Maybe if I took him off the chromium and vanadium, she’d then play along, but I see her dragging us into an insulin injection class, bypassing Metformin altogether.

        I don’t even want to know HOW high his FBG is on no meds at all.

        • William Lagakos

          “Doc won’t play along until his FBG reaches 140 or over”

          that’s odd; besides being formally classified as “pre-diabetic,” chronic levels of FBG over 120 mg/dL is most likely pathological

          Also, I don’t even know if acarbose would do anything at all, considering total carb intake is so low… but it’s cheap, side effects are low, and it might help if “hidden” carbs are present in his diet.

          • This Old Housewife

            I don’t know that he was officially diagnosed as pre-diabetic. All I remember is that he was handed a meter at one visit (almost a decade ago), then shown how to use it. I took over from there with diet.

            Now, every time he goes in for semi-annual physicals and blood/urine testing, his BG (fasting) is always no higher than 101, even though testing at home before he went yields a low-100’s number.

            I’m fully aware of the BG meter discrepancy thing, and how the manufacturers aren’t required to be more than abut 80% accurate in some cases, so I guess we’re supposed to start living right outside a lab for accuracy:

            One such visit yielded a 40-point difference between home meter and lab result. The next one yielded a 9-point difference. So now, we can’t even factor in a reliable point number to offset this difference, because it keeps changing. At one point, I was thinking that maybe it’s the METER and not all HIM, but without meter accuracy, all I can do is continue to try to get him (and keep him) as low as I can get him.

            I wonder how many other diabetics out there are overdosing on meds, or over-restricting carbs, because their meter is actually off? As far as I know, 13 people have died because of taking too much insulin from having a bad meter reading.

  • William Lagakos

    “Resistance training in overweight women on a ketogenic diet conserved lean body mass while reducing body fat”

    Compared to those assigned to high carb, the low carb dieters consumed fewer calories and lost more weight; they also ate more protein so it wasn’t lean mass.

    The high carbers gained significantly more lean mass despite eating less protein, probably, because of higher calorie intake.

  • This Old Housewife

    Am now reading this:

    The section on protein dovetails nicely with what you wrote here, and gives me hope for something else to try. When you get a membership request page, ignore it and click on the side where a green arrow should be, but isn’t–you can play right through the membership request page. I’m not a member, yet I’ve read a few of these books cover to cover.

    • William Lagakos

      thanks for the link (and tip)!

      • This Old Housewife

        Yep–all but the occasional single strawberry, which I give him when I buy a carton of them for smoothies. He used to be able to tolerate melon, but not any more.

        Fructose is my own downfall–I quit making avocado smoothies, and I promptly lost 4 lbs.

        Fiber is SOOOO hard to get into him without the accompanying BG rise. I even tried beans, and it took 4 hours for any kind of BG drop to occur…if I could just get him to do MCT shots or something! :)

        • William Lagakos

          There has to be more going on than just diet…

          Sleep quality

          Rx blue blockers after sunset, especially if near computer, smart phone, TV, etc.

          • Jack Kruse

            Nora Volkow’s research covers why this all happens.

          • This Old Housewife

            Issues we’re also working on–he thinks 6 hours/night is enough, in spite of me showing him countless blog posts about it not being the case. I’ve installed f.lux auto shading program on the computer, so he has no choice there–the controls are on MY side of the hard drive. We’re also looking into prescription blu-blockers for him to wear at work (history of migraines). He’s a typical blood type A health malady roster: gout, migraines, prone to diabetes, high cortisol, the works, and I’ve made it my primary mission to try to combat ALL of it. Everybody else in the family just ignores it, or lets the doctor manage it, but I’ll take on the challenge.

          • William Lagakos

            6 hours is likely not nearly enough, given his current health situation.

            May not need Rx blue-blockers: Uvex Skypers work well and provide good all-around coverage (little light gets through the top & sides)

  • DrewStearns

    Great read, Bill.

    From a bodybuilding perspective, it’s interesting that the “Diet A and B” study shows it’s best to “bulk” on a higher-calorie, lower-carb diet, and “cut” on a lower-calorie, higher-carb diet.

    Most bro-science approaches have it the other way around.

    • William Lagakos

      Hi Drew,
      Thanks. And yeah, I found that interesting as well… although it was not entirely consistent with the study in cachectic cancer patients, where hypercaloric high carb fared slightly better than the ketone-fortified low carb diet.

      My general take on these studies is that the best way to ensure positive nitrogen balance is via upping protein intake.

    • Jack Kruse

      Bill said, Exercise lowers, not raises, protein “requirements,” because exercise is a potent anabolic stimulus; it helps preserve nitrogen at any level of dietary protein. That’s not to say more won’t improve functional outcomes; just that it’s not “necessary” to prevent muscle loss.

      Need =/= optimization.

      This is why I love your blog. You just continue to show what I have been trying to get through the paleo community and the body builders………eating grass fed meat and bacon is not your friend when you’re crossfitting your life to death. Kudo’s Bill

      • This Old Housewife

        And the keto community that fixated on wrapping every stinkin’ thing in bacon.

        • Jack Kruse

          No…..just the paleo community. Most people who are running keto use other substrates for remaining ketotic. The ancestral community is no proxy for those who are using ketosis for disease management.

  • Jane Plain (Woo)

    Very factual/interesting blog entry as usual Bill.

    Interesting / related anecdote; one of the functions of low leptin (i.e. starvation) is to alter body protein use so that heart muscle protein is specifically spared. That is to say low leptin switches metabolic behavior so that more protein is stored in the heart. This is of course evolved to prevent starvation heart disease , failure, and death, a leading cause of death in anorexics.

    Unfortunately in obese who have leptin pathologies, leptin resistance, this often contributes to cardiomyopathies/megaly as decreased leptin signalling creates a state of starvation at the site of the heart where one does not exist. In actual starvation this means the heart muscle is spared catabolism in lieu of skeletal muscle, but if pathologic leptin resistance, the heart becomes extremely muscular and fails to operate normally .

    This may also contribute to the heart deaths common to athletes who are often hypoleptinemic but eating high protein/caloric diets otherwise; they are oddly anabolic while also being leptin deficient leading to cardiomegaly.

    • William Lagakos

      this is interesting; did not know. Thanks!

      can’t imagine you’d survive very long w/o food if cardiac muscle was being catabolized as quickly as skeletal muscle in early starvation.

    • This Old Housewife

      Such as Jimm Fixx?

  • William Lagakos

    Macronutrient content of a hypoenergy diet affects nitrogen retention and muscle function in weight lifters.

    Tl;dr: protein better than carbs for nitrogen retention

  • This Old Housewife

    Just finished Jimmy’s new book, and together with it, your article, and Joslin’s old tome, I have found places where I need to course-correct:

    1. Too much protein–need to find tolerance level.
    2. Not enough fat–need to find ways to increase it (I’m allergic to dairy).
    3. Probably not enough calories (see #2).
    4. Need to find a dairy tolerance level for Hubby (for lactose).

    Off to the kitchen I go…

  • This Old Housewife

    Day #2 of a higher fat/higher fiber/low protein diet, and no results on FBG, but it DID change his post-prandial spike pattern–the spikes are lower and of shorter duration. I’m using Jimmy Moore’s “buttah” for part of the fat increase (even though I cannot eat it), and Hubby LOVES it!

    He’s got an appointment next week with his doc, and I want to go with him to see about getting (beg for) a trial prescription of Metformin to help with FBG issues. In the meantime, I’m going to try the potato salad therapy in conjunction with the higher fat/higher fiber/low protein diet, and may even go to meat every other night if it comes down to it. Potato salad seems to help with high FBG, but he can’t do it every night.

    • William Lagakos

      Cool. I don’t see the doc providing a lot of resistance to metformin, and you should definitely go along! The good doctor needs to know just how closely you’ve been monitoring and tweaking Hubby’s diet.

      • This Old Housewife

        Day #3–doc is still a no-go, but I did manage to wipe out Dawn Phenomenon by mixing fiber sources (not in the same dish): coconut flour, psyllium, glucomannan, and broccoli. I made 12-hour biscuits by using a cheddar biscuit recipe, adding psyllium, and a mere handful of broccoli florets and shredded meat. Hubby had 2 with butter for breakfast, and he was good all day and half the night. For dinner, he had Miracle Rice with a little broccoli, butter, and 6 mini-meatballs made from chorizo, and couldn’t finish it all. The remainder went to work with him for lunch today, along with another biscuit and butter.

        FBG was the exact same as it was pre-bed last night. Maybe we’re starting to make some progress here, and won’t need the Metformin after all.

        I ordered some glucomannan powder so I can use it elsewhere, like those biscuits, in meat loaf/balls, pancakes, etc.

        I may have found his answer: low protein, high fat/fiber. We’ll continue on until something changes.

  • This Old Housewife

    I’ve discovered Hubby’s biggest demon: meat. We went meatless Thursday night (used nuts and cheese in green salad, with a biscuit), and his BG barely rose, and came back down again in under an hour. FBG was terrific!

    Friday night, we did meat + potato salad with 2 biscuits, and the spike was larger than normal, and took 3 hours to come back down, and FBG was higher than we’d like. We’re not serving those two together again.

    Also, a new batch of biscuits (this time with avocado in the batter) yields higher BG readings–I suspect the fructose, so we’re now through with avocados (the fructose makes me gain weight). I was trying to further combine fiber sources, but it seems I went a source too far.

    Question about protein recycling: does that include sperm as well? Men come with their own little protein factories between their legs, and does THIS protein get recycled too?

    • William Lagakos

      Hubby is a hypercarnivore, like a dolphin! super-converter of protein into blood glucose.

      As to the sperm protein recycling, I don’t know. It’s probably turned over just like protein in other tissues; but not like adding net amino acids that the liver can use for gluconeogenesis, because they might just be used to make new sperm… speculation, though :)

  • This Old Housewife

    Made this recipe into hamburger buns for Hubby last night to try out glucomannan powder:

    His BG only rose 9 points in an hour. I’m going to try to duplicate it again before I get too excited. Since he’s still asleep, I have no FBG yet.

    Using avocados in the old cheddar biscuit recipe as an additional source of fiber didn’t work out too well because of the forgotten fructose in them–now the birds get to eat them. We’ve moved on.

    I also made a batch of Amazing Maria bread with a pinch of glucomannan in it, and the bread rose higher and got fluffier. Hubby hasn’t had any yet, so i don’t know what it’ll do to him. We’ll see this morning with breakfast.

  • This Old Housewife

    I think you cracked Hubby’s nut(s)–experiment repeated, same result. This morning’s fasting was 85, last night’s spike got to only 101, and we’re going to finish the week off by rotating between meat and non-meat protein, and rotating fiber types (psyllium, glucomannan, and veg fibers). If I can keep him this low (or lower) for a month or so, I’ll begin weaning him off the chromium to see what his tolerance is for that.

    This should also take care of his gout (another family trait) and possibly his high cortisol. Meat–who knew? Obviously you did!

    I’ve informed his brothers about all this, explained gluconeogenesis, hyper-carnivorism, and protein recycling, and even mentioned the effects of grain-fed meat. Now they, too, can make dietary adjustments (and for their kids) to avoid “the curse” of diabetes that plagues the family tree. Hopefully, there will be no more family tree dry-rot (as it were).

    • William Lagakos

      Wow, excellent! This has really been an interesting (and educational) “case study.” ….I just hope it is truly resolved!

  • This Old Housewife

    Re: Hubby–we’re trying something new: the speed of protein breakdown. I’ve also discovered that one of his supplements (one I just changed) has the dreaded rice flour in it, so I dumped it. I ordered some mycellated casein powder to include in baked goods (his dinner rolls–he doesn’t do smoothies), and plan on upping his casein-carrying food intake, as well as using slow-digesting meats (still in limited quantities).

    First, I thought his meter was going haywire–we ran level 1 & 2 control solutions through it, changed the battery, and even went to his backup meter for a couple of days. Now I think it may be the food he was eating, unless weather (EM) can affect meters now. Storms have been moving through frequently.

    So now it’s going to be an oz. of hard aged cheddar before bed, more pork for dinners, and more dairy and less nuts.

    I found a list of the speed at which different foods digest, but it’s from 2008–best I could do. As usual, it’s going to be an N=1 experiment.

  • Guest

    Hello Bill, just found you/your site after hearing you with Jonathan Bailor..then I listened to you on Ask the Experts and Livin Low Smash the Fat…great info but not what I was hoping to find. What type of diet/plan would you recommend for a peri-menopausal woman, healthy otherwise, 50 years of age with 100 lbs to lose?

    • Bill Lagakos

      Thanks :)

      At that age & health status, I’m assuming some degree of insulin resistance..? If so, carbohydrate restriction may be the most promising option. I’ve written more about why here:, but in brief, adherence to the diet is better than on low fat calorie restricted diets, and appetite spontaneously declines. What do you think?

  • Pingback: How much protein? | Mark's Daily Apple Health and Fitness Forum page()

  • Pingback: Ultimate Cleanse -Cellulite Products()

  • Bill Lagakos

    Low carb diet was not ‘protein sparing’ in this study (2015):

    LC group was higher protein, isocaloric, and lost just as much lean mass as the high carb control group (NS).

    • CynicalEng

      how much was that ? doesn’t appear in abstract or appear to have been listed as an outcome. Full text anywhere ?

      • Bill Lagakos

        Protein: ~75 vs. 100g.
        Both groups lost ~1.7kg FFM.

  • Pingback: In Defense of High-Protein, Low-Carbohydrate Diets | Primal Docs()