Are You Getting Enough Protein to Avoid Starvation?

All Meat Kabobs
Tweak One: Adequate Protein

If it's been 8 to 12 weeks, or more, since you started your low-carb diet and the pounds are not coming off as quickly as you think they should, it's time to consider tweaking what you're doing to make Atkins work better.

In part 9 of this series on how I lost over 100 pounds tweaking the Atkins diet, I shared with you exactly what I did to get the scales moving downward.

Since I'm only 5 feet tall and post-menopause, I don't need anywhere near the amount of calories that you might need to stay above 50 percent of your maintenance calories.

Eating less than 50 percent of your maintenance calories is how starvation is defined within the medical community, but there are other important aspects of starvation, such as protein intake, that can trigger the starvation response within the body, even if you're eating plenty of calories.

So, how do you know if you're eating enough protein to avoid starvation mode?

Protein needs depend on your:
  • height
  • bone structure
  • muscle mass
  • age
  • activity level
  • metabolic condition
  • amount of body fat you have to lose
The amount of protein you eat affects weight loss. Go too low on protein intake, and your ketones cross over the optimal zone for ketosis and into starvation.

Crossing that line causes your insulin level to go up, cortisol and adrenaline to surge, metabolism to slow down, and other adaptions that can interfere with fat loss.

When setting up an optimal Nutritional Ketosis diet, it's vital to make sure that you've set your protein intake high enough to avoid starvation mode.

While many dieters talk about starvation in terms of calories or nutrients, not getting enough essential amino acids for adequate structure repair, growth, oxidation, and gluconeogenesis is actually the greater issue.

When tweaking a low-carb diet, your first concern is getting adequate protein.

[This is part 10 of a multi-series on How I Lost Over 100 Pounds Tweaking the Atkins Diet. If you didn't read part one, you can do that by clicking on the above link. There, you'll also find links to the other posts in this series as they become available.]

Platter Filled with Various Meats

Did You Know that There are Ketogenic Amino Acids?

On a low-carb diet, you predominantly burn fatty acids for energy. However, fat molecules are too large to pass through the blood brain barrier.

Ketones, on the other hand, can fulfill a large part of the brain's requirements because they are only a fraction of the size that a full fatty-acid molecule is. Most low-carb dieters understand that the body deliberately makes ketones from triglycerides to save the brain, but did you know that there are also ketogenic amino acids?

A ketogenic amino acid can be degraded into acetyl-CoA, the precursor to ketone bodies. Not all amino acids are converted into glucose. That is a low-carb fable. In fact ketogenic amino acids cannot be converted to glucose due to their structure.

There are two amino acids that are strictly ketogenic:
  • lysine
  • leuisine
There are five more that can be used to make ketones OR glucose:
  • isoleusine
  • phenylalanine
  • threonine
  • tryptophan
  • tyrosine
The other 13 amino acids are strictly glucogenic.

However, not all glucogenic amino acids come from your diet. The body can make those that are not essential to life.

Glutamine is a good example of a non-essential glucogenic amino acid the body makes itself. Since it doesn't come from your diet, it doesn't raise insulin levels, but it is used to refill your glycogen stores, feed your gut lining, raise your blood sugar, and many other things.

What Happens When You Don't Eat Enough Protein?

Roasted Turkey Breast, Sliced
Some amino acids can be turned into glucose,
but avoiding muscle oxidation is a top priority for the body.

On a low-carb diet, the body needs a small amount of glucose to keep your blood glucose level steady and feed body cells that don't have mitochondria. Some of your brain cells fall into this category, as well as a few kidney cells, red blood cells, and a few others.

While some amino acids can be converted into glucose, finding alternative sources of glucose that spare muscle burning is a high priority, especially during the first few weeks of your low-carb diet when the body is adapting to the state of ketosis.

Lose too much muscle mass, due to protein deficiency, and your health will deteriorate. Your:
  • metabolic rate
  • inessential body systems like hair and nails
  • hormones
  • enzymes
  • and antibodies needed to fight off invaders
will all suffer. And since body organs are also made from protein, and not just your muscles and skin, they too can be adversely affected if the lack of protein continues long term.

The body can mine your heart, liver, pancreas, and other organs for the protein it needs, as well as your muscle tissue. Blood cells also fade and deteriorate if you don't eat enough.

This is why it's vital to look at your protein intake first and make sure you're getting an adequate amount.

Why Does the Body Oxidize Lean Tissue When You're Still Fat?

Two Heavy Women Walking Their Dogs
Why would the body oxidize muscle or organs
if you still have plenty of body fat to burn?

You're probably wondering why the body would oxidize muscle tissue or organs for fuel if you still have body fat to burn.

Good question.

In 1998, O. E. Owen and colleagues asked the same question. They wanted to know why a person would die if they still had body fat to use.

To find out, they had 5 obese subjects fast for 21 days. These subjects initially lost body fat and fat-free mass (muscle and organ tissue) in parallel. The resting metabolic rate of the subjects didn't go down, but it didn't rise either.

The nitrogen losses the researchers saw reflected a continuous demand for amino acid oxidation, despite the participants' body fat.

Late in the starvation period, fat-free mass was still being lost at a rate of 7 percent, with the rest of the fasting participants' energy needs coming from body fat. The amount of glycerol used for gluconeogenesis was equal to all of the amino acids combined.

This study showed that the body has a sizable requirement for protein intake even though there is still body fat.

Dr. Phinney, when specifically asked about fasting, said that studies over the past few decades have showed similar results to the above study that I found.

Within 24 hours after you begin a fast, the body will start breaking down lean body mass to get the amino acids it needs. This was clearly shown in the last low-carb study funded by Gary Taubes and others, as well.

The studies that Dr. Phinney used to support his opinion reported muscle tissue losses of 3/4 pound starting with Day 2. These losses were determined by a physical biopsy, and not just measured nitrogen losses.

By the third or fourth week, with no food, non-fat tissue loss plateaued out, but continued at about 1/4 pound a day.

Charts posted by Dr. Fung at his blog show that muscle loss continues at a rate of 250 calories per day, even after the body adapts to using ketones for fuel. Those 250 calories, at 4 calories per gram, come to about 62 to 63 grams of non-fat tissue loss, about 1/6th of a pound per day.

By 30 days, with no food, you'll have lost about 10 percent of your muscle mass. Granted, this is for no protein intake at all, but the same principle applies, just in a smaller degree.

The body will resort to stripping your lean body mass to make up for any protein deficiency you may have. However, since protein mass is essential for survival, it will only steal enough to keep you alive. It won't steal enough for health, so you'll still have protein deficiency symptoms if you aren't getting enough.

If you're obese, rather than just overweight, the body is a bit more forgiving.

In a study that Dr. Fung linked to in that same post, muscle wasting during the first seven days for obese subjects was a little less than half a pound a day. By day eight, muscle catabolism had decreased to 1/4 pound per day.

This loss was higher than the chart posted in the same post, but does show there is a bit of variability when it comes to the amount of protein needed to avoid non-fat losses.

One of the problems with taking studies too seriously is that study data is an average of all participants, and not absolute data.

For the obese, a seven-day fast might cost you just under three pounds of muscle tissue, rather than 5-1/4 pounds if you are overweight, and more than 5-1/4 pounds if you are leaner.

How Muscle Loss During Fasting Relates to a Low-Carb Diet

Since we're talking protein deficiency while low carbing, rather than fasting and then re-feeding or true starvation, protein deficiency causes the body to mine less lean tissue daily, but those losses will accumulate as the weeks go by.

This results in lower overall lean mass, odd-shaped red blood cells, and a reduced resting metabolic rate, as well as other adaptions the body implements to try and stop the need for having to use muscle or organ tissue at all.

Hair discoloration and hair loss or slow-growing nails are minor examples of what you may expect to experience on a low protein intake. More serious issues are neck pain or pain in your joints and muscles. You can also suffer with:
  • headaches
  • insomnia
  • wounds that are slow to heal
  • water retention
  • bloated belly and/or ankles
  • dry skin or rashes
  • unstable blood glucose control
  • exhaustion
  • heart problems
And many more symptoms. For an extensive list see our blog post on protein deficiency symptoms and recommendations by Dr. Atkins on how much protein you need to eat.

If these adaptions to inadequate protein intake bring your energy output in line with what you're eating, you won't see any progress in achieving your weight-loss target.

Reductions in metabolic rate can range from 10 to 25 percent, quite quickly, depending on how huge your calorie deficit or lack of protein intake is.

In addition, if the body perceives the reduced protein intake as a threat to survival, cortisol, adrenaline, and nor-adrenaline will go up, making weight loss extremely difficult. This is because glucagon always rises when stress hormones are secreted.

It is glucagon's job to keep the liver breaking down glycogen, so it can dump it into the bloodstream for the extra fuel needed to deal with stressful situations. As long as the body is under stress from inadequate protein intake, gluconeogenesis does not shut off!

How Much Protein Do You Need to Stop Muscle Wasting?

The amount of protein you need depends on how much muscle mass you have to maintain. Common recommendations range from .6 to 1 gram of protein per pound of lean body mass, depending on your activity level and the amount of carbs you're eating.

Lean body mass is everything in your body that is not fat, so it includes water and undigested food, as well as your muscles, body organs, body fluids, and blood cells.

If you're on a low-carb diet, you need at least 0.8 grams per pound.

Those involved in strength training or lots of aerobics may find that 1.5 grams of protein per pound of lean body mass works better.

Determining how much non-fat mass you actually have can be tricky. You want to save as much of it as you can, so your maintenance level of calories will be higher, but how much is that?

In a previous post about a low-carb high-fat diet called Nutritional Ketosis, I talked about Dr. Phinney's recommendation of eating 15 to 20 percent of your ideal body weight in calories. This is what the chart on the video discussed in that post showed.

However, percentages can be just as problematic if you don't know what your optimal weight might be.

For example, my ideal weight according to the medical community ranges from 115 to 125 pounds, but my current weight loss goal is just to get back to 165 pounds, a comfortable size 14.

If I used 125 as my aim, and I stopped at 165, I'd still have the muscle mass and denser bone structure that's needed to support that extra weight, so I could reasonably end up losing lean mass after I move to maintenance if I set my protein intake too low.

In 2011, Dr. Phinney gave an interview to Shelley at Me and My Diabetes. Some of the things in that interview were quite shocking when compared to what was being taught about Nutritional Ketosis within many low-carb circles at the time.

Apparently, many claiming to be following Nutritional Ketosis are clearly not doing that, and Dr. Phinney has been trying to correct these misconceptions about his diet plan for years now.

In the interview, Dr. Phinney talked about eating a moderate intake of protein, but how much is moderate? This is what he said:

“We recommend that on a low-carbohydrate diet, people get 1.5 grams of protein per kilogram of body weight.”

This is the LOW END, Dr. Phinney said. Just bare minimum!

The 1.5 figure could go as high as 2.0 or more if you're athletic, have an an active day-job, or are extremely muscular. For the average athlete he worked with 35 years ago, he used 1.7 grams of protein per kilogram of body reference weight, which was enough to allow them to adapt to Nutritional Ketosis.

These athletes were not diabetic. Just well-trained athletes, so for us sedentary folks who may, or may not, be pre-diabetic (insulin resistant), 1.5 or slightly lower might be a better figure to use.

“That allows fuel for the brain and many other tissues when carbohydrate intake is limited.”

Notice that Dr. Phinney has no fear of protein turning into glucose. The whole concept of lowering protein intake to avoid gluconeogenesis did not originate with Dr. Phinney.

You can stay in ketosis and adapt to burning fat just fine eating at a moderate protein level, rather than a fictional moderate protein level. You don't have to switch to a low-protein diet and then lie to yourself about how much protein you're actually eating.

How to Determine Your Protein Needs in Grams

To find your kilogram weight, take your target weight (the weight you want to be) and divide it by 2.2. Since 165 pounds is my own target weight, 165 divided by 2.2 would be 75 kg.

You then multiply that kilogram figure by 1.5, which gave me 112-1/2 grams of protein.

This is much higher than what I'm currently eating, so it might be why I've been more tired lately and my hair is falling out again.

I next ran the numbers using 125 pounds, which would be my real ideal weight. When you divide 125 by 2.2, you get 56.8. For convenience, I rounded that number up to the next whole number – 57. I took 57 and multiplied it by 1.5 and got 85-1/2 grams of protein.

In my weight-loss phase, I was eating 72 to 90 grams of protein, and since I was still partially bedridden back then, due to the vertigo, and was post-menopause, this protein level was perfect for me.

Today, I'm still eating at that level, but I am no longer partially bedridden, although I do weigh less than I did when I first started my own low-carb diet.

I'm thinking that I may need to up my protein intake to see if that corrects the issues with my hair and energy production.

Keep in mind that Dr. Phinney clearly stated in the interview that this protein figure was the bare MINIMUM of what you should be eating. It is not a limit.

If you start with that figure and after a few weeks you continue experiencing the protein deficiency symptoms I talked about in the article I linked to above, increase your protein until the symptoms go away.

This amount of protein is more than what most low-carb high-fat dieters are insisting you eat today, but just ignore those who try to tell you that protein is why you're not losing weight.

While a small handful of people do have gene expression that causes them to oversecrete insulin in response to protein intake, moderate protein simply means to eat as much as your body needs to function optimally.

How Much Protein Does Dr. Phinney Eat at Maintenance?

This was really the eye opener for me, and why I took a second look at my protein intake, especially since I was diagnosed with Graves' disease a couple of years ago.

Graves' disease is the autoimmune form of hyperthyroidism, so food moves through the digestive tract faster than what can be absorbed. This means I need to eat more protein than the average low-carb dieter to make sure that the body absorbs enough.

Dr. Phinney is quite active for his age.

In 2011, he was taking long bike rides of 20 to 60 miles long about three times a week. I don't know if he still does this, but this is what he was eating back then:
  • 25 to 50 carbohydrates a day
  • 500 to 600 calories of protein
  • and the rest in fat
  • 2800 total calories
Protein has 4 calories per gram, so those 500 to 600 calories of protein equals 120 to 150 grams of protein!

Protein isn't found in foods by itself. Protein normally comes packaged with a certain amount of fat.

Dr. Phinney explained that a lightly marbled steak dials in at 50 percent protein and 50 percent fat. A highly marbled steak is more like 25 percent protein and 75 percent fat. Dark meat chicken with the skin is similar to a lightly marbled steak, about a 50/50 ratio of protein to fat.

Breast meat with skin is too lean, he said.

Unless – the person is trying to lose weight and getting fat from their body's own fat stores.” The reason why a low-carb diet is often called a high-fat diet is “because they're getting fat from their body's stores,” Dr. Phinney said.

A low-carb, high-fat weight-loss diet is not high in dietary fat.

It's all about the context and what you're currently trying to do:
  • lose weight
  • gain weight (muscle mass)
  • or maintain
In maintenance, it's essential to eat either more carbs or more fat, so you can eat at your maintenance level for calories.

If you're trying to gain muscle mass or repair the damage done during periods of famine or low protein intake, you have to eat more protein and supply the body with higher-than-maintenance calories, as well.

Muscle rebuilds extremely slowly.

Men can gain about 1 pound of lean mass a month, and women can expect to gain about half of that, but not if you're on a weight-loss diet.

Building muscle while dieting is extremely rare. You generally only see this phenomenon in an untrained, obese individual who starts to lift weights.

When trying to lose weight, it's essential to eat less fat, which forces your body to draw upon its fat stores. Dr. Phinney explained it this way:

“When you go on a ketogenic diet, you can eat less fat on your plate because you're burning the fat that comes from your inside.”

But he also noted, that:

“When burning your own fat, it looks like a high protein diet. But the scales go down because the body's burning its own fat stores.”

Percentages won't be accurate.

While dieting, you'll eat a higher percentage of protein than at maintenance because part of your fat percentage is coming from your body fat.

You can draw that type of graph on paper, which is what Dr. Phinney did in his books and on one of the videos I watched, but your food tracker will look like you're eating too much protein.

You're not.

It is at maintenance where you need to eat considerably more fat, between 70 and 80 percent. By then, the body will be so efficient at fat burning that you'll be able to eat lots of it and still maintain.

Dr. Phinney stays at under 50 carbs a day because that's where he functions best, but he was careful to note that:

If you are fat adapted and burn fat reasonably well, such as once you reach maintenance, some people can eat up to 100 carbs a day and still burn fat efficiently. It all depends on your personal carbohydrate tolerance for maintenance.

What Does 72 to 90 Grams of Protein Look Like?

In 2007, I went to Fitday and played around with some of the protein possibilities to see what 70 to 90 grams of protein looked like. I wanted to make sure that I was getting enough protein on the days when I wasn't keeping track.

I have added a few higher-fat choices to that previous listing to better resemble what I eat today. In addition, the photos provided can help you visualize portion sizes for a low-carb diet:

Baked Chicken Leg

2 large or 3 medium chicken leg quarters

2 Barbecued Chicken Thighs with Asparagus

5 to 6 medium-sized chicken thighs

Plate Filled with Baked Chicken Legs

6 to 8 medium-sized chicken legs

2 large chicken breasts, with the bone
3 small chicken breasts, with the bone

3 to 4 large hamburger patties (1/3 lb each)
3 to 4 large ground turkey patties (1/3 lb each)

Pan Filled with Sauteed Pork Chops

2 large or 3 to 4 medium pork chops

Fish Fillet with Peas and Carrots for Dinner

two 8-ounce fish fillets

1 to 1-1/8 pounds shrimp

Large Trout Laid Onto a Cutting Board

1 large trout or 2 medium, with bone

Two Large Salmon Steaks

1 pound salmon fillet

12 Ounce Steak on the Grill

1 pound of steak (photo is 8 ounces)

Other choices might be:
  • 12 to 16 slices of tofu
  • 12 to 16 eggs
  • 10 to 14 ounces hard cheese like cheddar
  • 2 to 3-1/2 cups of cooked, chopped, dark-meat chicken or turkey
  • 1-3/4 to 3 cups of cooked, chopped, white-meat chicken or turkey
  • 1 to 1-1/2 pounds of boneless chicken or turkey
  • 1 pound pork loin or pork steak
  • 3 cups chopped cooked ham
  • 1 to 1-1/4 pounds cooked ham steak
  • 4 small cans of chunk-light tuna
  • 5 Italian sausage links (1-1/4 pounds)
  • 36 slices medium-thick bacon
  • 1 to 1-1/8 pounds shrimp
Obviously, I don't eat 5 Italian sausages or 36 slices of bacon in a day. I'll eat one sausage with a couple of fried eggs on the side for a total of 28 grams of protein (16 in the sausage link and 12 for the eggs).

When one meal is a bit light, such as one small can of tuna with mayo, or bacon and eggs for lunch, I'll either add a couple of homemade cheddar cheese strips or a carton of Carbmaster low-carb yogurt (5 carbs) to bring the protein up to about 25 to 30 grams.

Likewise, if I'm planning on serving a 1 pound flat-iron steak for dinner, split between hubby and I, I might have bacon and eggs for breakfast, and a salad with some chopped cooked chicken on top or a couple of baked chicken legs with vegetables for lunch.

Now, that I'm going up my protein, however, I won't cut down earlier in the day when I serve steak for dinner anymore.

Don't overthink this.

You don't have to be exactly on point for each and every meal. There is plenty of room in Dr. Phinney's formula for some flexibility.

For example, since a fresh boneless, skinless, chicken breast weighs anywhere between 10 and 14 ounces, I'll package them up individually, and then hubby and I will share one for dinner. I count the breast as 12 ounces total, 5 to 6 ounces for me, because I know it will work itself out by the end of the week.

If you're close to goal weight, you'll need to tighten up your calories to get those last 10 to 15 pounds to melt away, but for protein counts, a ball-park figure is good enough.

Take your daily protein need, divide it by two or three, depending on how many meals a day you're eating, and then just aim for that.

Don't make it a solid goal. It's okay to go a little under or a little over for the day. It's also fine if you want to fast once or twice a week. Just eat a little more protein on the days you do eat, so you have the substrate you need to rebuild.

Nutritional Ketosis, Keto, and Atkins All Recommend Moderate Protein

When I was struggling to hang onto my losses in 2008, I had dozens and dozens of people tell me that I needed to lower my protein to 50 grams of protein a day because that's what moderate protein is.


If you're only eating 50 grams of protein a day, and your blood ketone level is higher than 3.0, you are in ketone starvation, as Dr. Phinney defines it.

If you're eating 50 grams of protein a day and your blood ketone level is less than 3.0, you are still protein deficient, which is starvation.

At 100 pounds target weight, your protein requirement would be a bare minimum of 68 grams, quite a bit higher than 50, and most people have a weight-loss goal much higher than 100 pounds – including me.

When I tried Nutritional Ketosis, I ate 60 grams of protein, and it was NOT enough. I packed on 30 pounds in three months and lost muscle mass and strength.

I need to start eating a bare minimum of 112 grams a day. I see that now. And more would probably be better since I have many of the symptoms on that protein deficiency list. Those 112 grams divided across three meals would be 37 grams of protein per meal.

If you need to tweak your low-carb diet, start by readjusting your protein intake to a moderate level, instead of a very low one, and see if that gets the scales moving downward again.

In some cases, going too low in protein can cause your weight loss to stall. Make sure to lower your fat a bit to compensate for the extra protein calories.

If this works, or even if it doesn't, I'd love to hear about your experience in the comments below. Did you try Dr. Phinney's formula of 1.5 grams of protein per kilogram of target weight? If so, how did it go?

If this doesn't get the scales moving, keep in mind that protein is only one of the three macros that you need to dial into your optimal level for weight loss. Tweaking just one macro won't work, so the last two posts in this series will discuss how to find your best carbohydrate and dietary fat level for losing.

Part 11: Are You Eating Enough Carbs? (Most people worry about eating too many carbohydrates, but you can actually be eating too few.)


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