Anonymous says, “How do you determine if you’re
getting enough protein? I heard Dr. Stephen Phinney say, for those
on a keto diet, if ketones are greater than 3 on a regular basis, then it’s a sign you’re
not getting enough protein.” Okay, first of all, why are you on a ketogenic
diet? So, if your purpose is to get the ketones,
why wouldn’t you want your ketones higher than 3? The ketogenic diet is, regardless of what
people are doing it for, it’s best tested in terms of epilepsy, and the classical ketogenic
diet gets ketone levels up to 3 or 4 millimoles per liter or sometimes higher. Then the question is, you’re not doing it
for medical therapy, why are you doing it? If you’re doing it to lose weight, who cares
what your ketones are? There’s a ton of people out there who are
on a “ketogenic diet” who don’t care what their ketones are because they’re doing it
for weight loss, for body composition, or to feel better. If those are what your goals are, your metrics
should just be whether you’re losing weight, whether you’re getting better body composition,
or whether you’re feeling better. There’s no data backing up the fact that you
can measure your blood ketones and determine what any of those outcomes are going to be,
so you should just use the metric that you want. That has nothing to do with why you need protein. Yes, too much protein is probably going to
lower your ketones. Protein is anti-ketogenic. It’s not as anti-ketogenic as carbs are, so
I get the kernel of truth that Phinney is getting at, that the higher your protein is,
the lower your ketones are going to be, and maybe there’s some general correlation to
be seen across people that the people who tend to have ketones that high tend to not
be eating enough protein, but that’s a correlation that has nothing to do with the underlying
reason of why you eat protein. You eat protein because you need protein to
optimize your neurotransmitters, you need protein to optimize your metabolism, and you
need protein to optimize your body composition. And the number one metric that we have on
protein intakes and quantifying them is on body composition, and you want a half a gram
to a gram of protein for every pound of target body weight. So, if you’re trying to gain muscle, use what
you want to have at the end of gaining muscle. If you are overweight, use what your ideal
weight would be. And the more you care about your body composition,
the more you should aim for the top of that range instead of the bottom. And it doesn’t matter if you’re keto or not. Carole Matt says, “What would you suggest
for nutritional support for those who experience edema due to third-spacing?” Carole, I’m sorry, but I don’t know what third-spacing
is. Can you chat what you mean? I’ll go to the next question, and if you can
clarify, I’m sorry if this is a woman’s health issue, and I just am not in that area, but
if you can clarify what you mean in the chat, I’ll come back to that question.

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Methew Wade

11 thoughts on “How do you determine if you’re getting enough protein?”

  1. What about the studies that conclude that protein intake above 1.6gs per kilogram of body weight show no muscle building advantage?

  2. My Ketone is (15) … not sure if this high or low.
    The only carbs that I consume is 100 grams of dextrose per day.
    Not sure how to know if you consume "enough" protein, but one sign is if your shit sinks in the toilet it means it is high in protein and if it floats it is high in fat.

  3. Chris I think Dr. Phinney was kind of joking tongue-and-cheek when he said 'if your ketones are greater than 3 then you are protein deficient'. In other words it's a practical and a simple indirect way to gauge if one is way too low on protein (and an easy way to answer a dumb question) since holding ketones at 3 is very hard in general unless multi day fasting. There is no direct way other than that by proxy for the average person to measure amino acid levels – which by definition is too low protein if desiring to put on LBM.

  4. Any recommendations for people that have mild metabolic acidosis issues processing amino acids. Just had my genetics tested. Yikes, no wonder I don’t feel good when I eat meat. I would love to see a video it. Your videos are fantastic thank you so much!

  5. Dr Masterjohn – can you please make a video reviewing the evidence supporting various lengths of fasts? It’s hard to figure out if multiple day fasts are superior to daily 23 hour fasts. Thank you.

  6. Does it matter if the grams of protein come from plant or animal? I've heard some say animal protein is more bioavailable, the body "absorbs" more.

  7. https://blog.virtahealth.com/protein-ketogenic-diet/
    Dr. Masterjohn: 2:40 You want 0.5g-1.0g of protein per pound of target body weight.
    Dr. Phinney: You want 1.5g-1.75g of protein per pound of reference (perhaps target?) body weight. (0.68g-0.80g per pound.)
    Ketogains: You want 0.8g protein per lean body mass pound on rest days and 1.0g per lean body mass pound on heavy weight lifting days three days a week = 0.89g per LBM pound average. This also assumes you are not extremely overweight.
    https://www.dietdoctor.com/low-carb/protein

    The issue of reference or target body weight is tricky. At 6'0" average frame size, my "ideal" BMI is 21.75, or 160 pounds. On the other hand, a natural body builder at 183cm tall may target 83kg, or 183 pounds as a target weight. Many natural bodybuilders gravitate to the 27 BMI range, or 200 pounds at my height. That would place Dr. Masterjohn's protein intake range between 80g-200g a day. I believe that every adult, regardless of size, requires at least 93g of protein a day including sufficient leucine for an ongoing diet. I also believe that protein intake over about 1.2g per LBM pound is really not effective as a protein source, and instead simply gets metabolized as expensive calories.

  8. I have never heard of anyone suffering from low protein no matter what diet they are on. If you eat enough food it’s almost impossible to not get enough protein, most people suffer effects from too much protein.

  9. Dr. Masterjohn.. you should make a video debunking the keto myth that it takes 4 days to get into ketosis.. Surely we are all in ketosis every morning when we wake up. It's what actually wakes us up, adrenaline and cortisol. The only reason we don't show a lot of ketones on day 1 of a keto diet is because of all the free sugars in and around the cells being used as kindling ensuring ketones don't pile up in the blood.. fats/ketones burn in a carbohydrate flame.. By day 4 all the free sugars are used up, therefore no more kindling, therefore v slow metabolism of ketones which now pile up in the blood giving a high reading and "keto flu" (cells in a v low energy state).. I believe thousands of people are ruining their bodies because of this universal misunderstanding of ketosis..

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