Extreme Reducing Diet

Factual Questions
1

I hope this doesn’t end up in Great Debates or someplace, I’d really like to stick to factual information and/or studies if they are available.

If I wanted to lose weight quickly, without regard to enjoyment of eating, could I do so safely by limiting my intake to meat and vitamin/mineral supplements?

I gather that this maynot include the building blocks of serotonin, are there supplements for that? Would fish oil + tryptophan meet the full requirement or is there more needed?

I guess the hard question is: What supplements would I need in addition to meat in order to be healthy while losing weight quickly? Or is it impossible, and if so, why?

**I hereby acknowledge that you are not a doctor, or if you are, you aren’t my doctor, and in no way do I intend to accept anything said here as medical advice.

2

I recall that there’s a new diet where they stick a feeding tube in your stomach through your nose and give you a steady 800 cal/day of paste. Apparently allows you to lose 20 lbs in 10 days or something ridiculous like that.

You don’t eat and you’re not hungry - at least that’s the claims.

No personal experience, I just saw the article on yahoo in the last day or two. Maybe find out what that paste is?

3

Here it is:

K-E diet

4

You would need some amount of fiber to keep your intestines from becoming blocked. Metamucil would work, as well as green vegetables.

5

I’ve seen that K-E diet, it claims to give you nothing but protein and fat, which doesn’t sound healthy. I can’t imagine why having the tube through your nose makes a difference; except maybe that you’d be too embarassed to go to the grocery store! And the price of the paste is ludicrous, as are the protein liquid supplements - which is what led to my question.

Can it really be so difficult to ingest plenty of protein and fat along with the RDA of vitamins and minerals and be healthy while achieving high weight loss? Can it really cost $150 per day to do this through supplements instead of through normal eating?

ETA: Ninja’d by VB - good point, add daily metamucil to the mix.

6

Supposedly (according to Cecil), the Inuit got along fine on a mostly meat-based diet with no need for vitamin supplements, even Vitamin C, a lack of fiber apparently wasn’t a problem either (and until recently, they didn’t have any long-term health effects, but this was a maintenance diet, not a reducing one, and they ate a lot of meats that gross out people today).

7

You would need to make sure you are getting enough Potassium and other trace minerals, so that your muscles and organs continue to function. I see you are intending to include vitamin and mineral supplements, so my only advice would be to choose them carefully.

At one time I went on a doctor-supervised liquid protein diet, 600 calories a day, and lost an average of about 4 pounds a week for about 38 weeks. Other than the protein shakes, the only supplements were fiber and potassium (liquid, by prescription, so that it wouldn’t burn a hold in my stomach). This seemed to be healthy, and I did not seem to suffer any ill effects. The protein shakes were manufactured with all the other trace minerals, vitamins, etc. They didn’t include potassium because it tastes salty, and the shakes were sweet.

With an all-meat diet, you are also introducing at least a certain amount of animal fat. You will want to include enough fiber to help your body process that. I can never remember if it’s soluble or non-soluble fiber you want to process fat. Non-soluble fiber just pushes stuff through your intestines. Soluble fiber does other things. It’s something I would look at, anyway.
Roddy

8

It sounds like the old fashioned protein sparing modified fast.

Details of one tested version here: 60 to 75 grams of animal protein a day, no other food except for bouillon, total calories no more than 450/day, a daily multivitamin, an extra 40 Meq/d of potassium, an extra 600 mg/d of calcium, and were to drink 1.5 l of water as well.

Not advising it mind you, but it has been done, safely (albeit monitored), and with decent short term (4 weeks in the second study) results. Weight loss was about 8.7kg in the 4 weeks; main side effects were cold intolerance, dry skin, and fatigue.

9

I would recommend a diet of raw (or lightly-steamed) fish and fruit. I would vary the types of fish and fruit, and make sure you’re getting wild-caught fish, not farm-raised. That’s a fairly good maintenance diet, and if you don’t use spices/sauces, you are inclined to eat much less.

If you can find a brand of virgin coconut oil that you enjoy, it is an excellent weight-loss aid, in moderation. It speeds up the metabolism, and it simultaneously sates the appetite.

In general, fats are what really sate the appetite, so it’s important to get enough fat so that you’re not tempted to cheat.

Fasting on fresh raw fruit and veggie juice will drop about 1 pound a day, on average, but that’s not something you want to do for more than a few weeks at a time.

10

That means losing muscle though - which is counterproductive.

Mind you - I’m not actually considering this, I’m just wondering whether it really needs to be so gall-danged expensive and inconvenient.

11

A PSMF is probably the fastest way to lose fat and minimize muscle loss, but it’s pretty miserable. For slightly slower weight loss with much less hunger, a ketogenic diet has been working well for me. A common example would be the Atkin’s Diet, although I basically stay at induction levels of carbs constantly instead of increasing them.

So far I’m down 37 lb since New Years with only about 60% average compliance (I end up seriously cheating on my carb counts about 2 days a week, minor cheating almost every other day). Just another 30 lb or so to go and I will be at my goal weight of 205.

12

And the second study I linked to, old though it may be, compared the PSMF (the method you espouse) with a protein formula liquid diet … and found significant advantages above and beyond cost to the PSMF approach in that comparison. So no it does not need to cost so much. Of course for either, or any other plan to attack obesity, to actually work, as defined by longer term reduction of obesity related morbidities and overall improved health, long term behavior changes have to implemented as well. That’s always the harder and much more important part.

13

I was on the Atkins Diet for about three years, lost a considerable amount of weight, and kept it off. I was basically eating protein and fat, plus supplements. Then, as a result of some blood tests, my doctor told me that my kidneys were in very bad shape, and the only way to save them was to cut way down on my protein intake. If I hadn’t been diabetic, I probably wouldn’t have had the kidney problem to begin with, and I’d still be on Atkins. There was every indication that it was doing me a lot of good and no harm.

14

You will actually lose muscle with any reducing diet unless you are also engaging in muscle sustaining or anaerobic exercise. Your body is very efficient about reuse of protein, and adding additional protein to a diet beyond what the body needs results in the body having to reject the excess protein. Ketogenic diets attempt to force the body to synthesize needed sugars via gluconeogenesis, but this is inefficient and produces a lot of waste products that have to be excreted, particularly urea (involved in transport of excess nitrogen from protein metabolization).

The diet recommended by al27052, and particular the note to ensure that your intake includes sufficient fats, is good, and is pretty representative of the traditional Japanese and Okinawan diets that are noted for providing longevity and health. I would personally recommend including some whole grains like unhusked brown rice or whole oat groats, plus some raw or lightly steamed vegetables with a descent fiber and mineral content like broccoli or spinach. Satiety (a feeling of fullnes) will come from eating low caloric density foods plus sufficient fats. Vitamin supplements cannot really replace these, and in many instances it is demonstrable that micronutrient uptake from supplement sources is inadequate compared to natural sources. Regardless, if you don’t have a source of low glycemic index carbohydrates, the body will reject or pass many other nutrients simply because it doesn’t have the fuel to process them.

Um, except for the caveat that your “kidneys were in very bad shape,” sure. Atkins-type diets basically work because they starve the body of carbohydrates, which means it that can’t fully utilize the fats and proteins being taken. (To be fair, if you actually follow Atkins, you will be consuming a reasonable amount of low GI carbs as well, but to most people, “Atkins” == “meat and fat”.) Consuming excess protein beyond what the body is actively using to build and maintain muscle and other structures stresses the kidneys. This isn’t opinion or some kind of arbitrary speculation; it is readily observable via analysis of urine composition and blood urea levels. High protein diets are sometimes used in cases of extreme (life threatening) obesity, but as they do stress the kidneys (among other organs) they should be monitored by a physician knowledgeable in nutritional biochemistry, not just a MD-GP or DO.

Stranger

15

Really, what Stranger on a Train said. The Atkins diet is not a high protein diet. The Atkins diet is a high fat diet. If you try to maintain your calorie intake by increasing protein you can overload on protein. I do best if I maintain around 65% fat, 25% protein, and 10% carbohydrates by colories.

I guess I should add that if you spent three years eating “protein and fat, plus supplements” you weren’t really on Atkins.

16

What does this mean, “reject the excess protein”?

The body is quite good at using protein for energy actually.

Multiple studies, quoted in past threads, show that satiety is associated with fiber and protein more than fat. Fiber seems to exert its effect by both slowing down gastric emptying and by getting more undigested to distal sections. Protein by some apparent central nervous system effects.

Then a cite for that claim should be easy to provide. Nitrogen balance is usually neutral for typical adults at 0.8 mg/kg. Please provide the evidence that doubling that, or even slightly more, causes any harm whatsoever.

While your are looking I will offer this from the Harvard School of Public Health Nutrition:

Note: if someone has kidney disease then limiting to the moderate protein diet of 0.8 mg/kg up to maybe 1.0 mg/kg may be useful, and is advised. But there is no evidence that anyone else needs to be concerned about having two or even three times as much.

17

Oh. On re-read I see I am not clear. And that I wrote mg instead of gm. Sorry. Let me clarify.

20 to 25% of calories for the so called average man of 70 kg eating 2500 kCal a day is 125 to 150 gm of protein a day or put another way 1.8 to 2.1 gm/kg. The RDA of 0.8 gm/kg would be about 9% of calories for that 70kg male eating 2500 kCal per day; if he cut down to 1800 kCal then it would be about 12%.

A significant problem in nutrition discussions is trying to define what is “low”, “moderate”, and “high” protein. Stranger is defining anything over that needed “to build and maintain muscles and other structures” (which is nitrogen balance, 0.8 gm/kg/d) as “high.” By that standard Bill Door’s 25% is extremely high, at least double that depending on his daily energy intake. Studies vary in calling a wide variety of protein levels “high”, “moderate”, or “low” as well: one calls 0.8 gm/kg/d “low” and 1.6 “moderate”; another labels 17% as part of high carb and 34% as “high”; while others call that 17% “low” and use 28% as “high” … and so on. It is all over the place.

Meanwhile here’s a comparison of the macronutrient composition of different diet plans:

Atkins in practice seems to run 21 to 28% of energy as protein 41 to 54% fat. In comparison with Zone, LEARN, and Ornish it is the highest protein and fat and lowest fiber and carbohydrate. (And in that 12 month study using premenopausal overweight and obese women Atkins did quite well.) I’m with Bill and would call that high fat and moderate protein, but it is certainly way more than required to build and maintain muscles and other tissues.

Also Stranger seems to have concluded that panache45’s “high protein” (whatever that meant in that case) caused the kidney issues … I hear the story as having been found to have diabetic kidney disease which resulted in a recommendation to quit a plan that had been working.

Please note: I am not attacking Atkin’s, nor wanting to debate the wisdom long term of a low fiber high fat moderate protein diet. Just disputing the statements that put anything beyond what I’d call low normal protein as being somehow harmful and the concept that somehow the body “rejects” food sources. A wide variety of nutrition plans can work well, depending on which outcomes you are most interested in, Atkin’s among them. More power to those who feel comfortable with that approach. Witnessing for how well it has worked for you does not require providing disinformation. A diet relatively high in protein (25 to 30%, 2 plus gm/kg/d), relatively low in fat overall and in particular low in saturated fat while higher in MUFA, PUFA and omega 3s, and high in complex high fiber carbs from a variety of vegetables, fruits, legumes, seeds, nuts, and (gasp!) whole grains, also works well, with much other than weight control and lipid results as positive outcomes. As do a variety of other approaches. Pretty much almost anything is better than standard Western fare.