Tuesday, 27 January 2009

The Protein-Sparing Modified Fast (PSMF)

What's a PSMF?

A standard PSMF is ~1g of protein for every kg bodyweight per day plus lots of green leafy vegetables plus six to ten fish oil capsules per day plus vitamin and mineral supplements plus unlimited water AND NOTHING ELSE. It's a low-carbohydrate and low-fat diet. You may find this quite literally hard to swallow! PSMF may also stand for Protein Strictly , Mother-F***er!

A 100kg person may get to eat ~400kcals per day from protein + ~100kcals per day from incidental carbohydrates and fats = ~500kcals per day.

A well-known PSMF is Lyle McDonald's Rapid Fat Loss Handbook. For more information, see https://forums.lylemcdonald.com/forumdisplay.php?f=7 and Is Rapid Fat Loss Right For You?

To make a PSMF easier to manage (but have a slower rate of weight loss), here are some modifications:-

1) Instead of six to ten fish oil capsules a day, stir ~25g of powdered linseeds into a large glass of drink and swallow the lot. Do this at breakfast-time. ~25g of linseeds contains ~10g of fat (of which ~6g is Alpha-Linolenic Acid, an omega-3 fatty acid) which does the following:-

a) It stimulates the gall-bladder to empty, thus reducing the risk of gallstones.
b) a) usually results in a bowel movement some time later. The ~10g of soluble fibre/fiber in the linseeds + accompanying fluid guarantees regularity.
c) It provides women (but not men) with all of the omega-3 fat they need each day.

Men need to eat either half a 213g tin of wild red salmon per day, or take six to ten fish oil capsules a day, as their bodies don't produce enough DHA from Alpha-Linolenic Acid. See Eicosapentaenoic and docosapentaenoic acids are the principal products of α-linolenic acid metabolism in young men and Extremely Limited Synthesis of Long Chain Polyunsaturates in Adults: Implications for their Dietary Essentiality and use as Supplements

2) Eat about 100g of protein per day. As meat, poultry and fish contains 20-25% protein, this means that you can eat ~1lb of meat, poultry and fish a day. 100g of protein per day is well within the capabilities of your liver and kidneys.

3) Eat about 22g of fat per day. This allows you to choose less lean cuts of meat and poultry, and you can even eat the skin on chicken as long as you factor it into your total fat allowance. It also allows you to use vinaigrette salad dressings or a small knob of butter or a small dollop of real mayonnaise to make your vegetables taste nicer.

4) Eat about 50g of carbohydrate per day. This allows you to eat shed-loads of leafy green vegetables and also an onion. It also allows you to eat a portion of fruit e.g. an apple or a bowl of berries/cherries with Splenda and a small dollop of whipped cream each day.

5) If you do any intense exercise (e.g. HIIT or resistance training with weights), eat an extra 50g of slow-release carbohydrates a couple of hours beforehand, to fuel it.

6) Supplement with 50iu for every kg bodyweight per day of Vitamin D3. Nowadays, many of us spend our lives mostly indoors, and this causes sub-optimal Vitamin D levels. See Vitamin D.

7) Don't get too far away from a toilet. Rapid depletion of muscle and liver glycogen results in rapid shedding of associated water. In addition, the oxidation of fatty acids results in the production of water. A PSMF makes you pee more.

n*CH2 + 3/2*n*O2 = n*CO2 + n*H2O + heat

(Saturated fatty acids are CH3-n*CH2-COOH. For Stearic acid, n=16. ∴ Stearic acid is mostly n*CH2. )

In conclusion:

100g of protein provides 400kcals, 22g of fat provides 200kcals and 50g of carbohydrate provides 200kcals, making a grand total of 800kcals per day. If you weigh over 80lbs but aren't losing weight on 800kcals per day, see your GP as you may have a thyroid problem.

The above diet should avoid the problems of gallstones, constipation, dry skin, dry hair, depression and dietary deficiencies. You get to eat real food and quite a lot of it too, for a fairly rapid fat loss diet.


TedHutchinson said...

Almost exactly one year ago I started eating low carbohydrate style.
I used Dr Dahlqvist's plan as a basis.
I went from 14st 9lbs down to 11st 6lbs in 6 months roughly 2.25lb week loss.
I've never felt better. Improved not only my blood pressure and mobility but also my mood and clarity of thought and ability to concentrate.
I can't understand anyone spending over £32 a week on the Cambridge diet when it simply isn't necessary or healthy.
The only additional item I have added to my diet is coconut oil and that I now buy in bulk at £3.75 for 500g but as that is about the same as olive oil it's not really an additional expenditure.

Although I accept that calorie counting MAY be necessary for some people I never counted either calories or carbs.

Anonymous said...

Ze Germans promptly mistranslated that as "proteinsparend" (lit. protein-saving, protein-economical).

Anyway, I think it's a better idea than caloric restriction or low fat, but is it really recommended?

1. Caloric restriction means eating less. There are lots of substances, some of them still unknown to science I bet, that are essential. Lack of any, malnutrition, strange diseases. It's sort of pissing against the wind to "supplement" them. Case in point, some fatty acids are essential, and fats in general (see rabbit starvation)
2. Fruits aren't really that healthy (fructose). Vegetables neither, although less of a problem. Main problem is fiber and other probiotics (inulin) which feed gut bacteria.
3. Small amount of carb saves proteins. Brain needs min. about 50 g/d. If not eaten, body will make these out of stuff, including glycerol metabolites, and proteins. Proteins, as in, your muscles.

Nigel Kinbrum said...

Hi Anonymous,

I'm amazed at how many people find my blog by searching for Protein-Sparing Modified Fast or PSMF. It's a very popular topic.

1) Fasting of any sort is meant to be temporary. PSMFs shouldn't be continued for more than a few weeks. The fatter a person is, the longer they can stay on a PSMF. On the subject of rabbit starvation, this is determined by total protein intake/day rather than by the percentage of energy from protein. The liver can cope with nitrogenous waste from ~300g/day of protein "burning" (less for people with impaired liver function). Therefore, the 100g/day or so of protein on a PSMF is well within an average liver's capability. Someone burning >2,600kcals/day with >90% from protein is "burning" >600g/day of protein which is way beyond an average liver's capability causing hyperammoniaemia & all of the problems associated with it.

2) I think that populations that traditionally ate a lot of fruit lived near the equator and thus had shed-loads of vitamin D to keep them insulin-sensitive so there wasn't a problem. Nowadays, many people live & work indoors and modern fruits are much higher in sugars than they used to be (except for berries), so I'm not overly keen on fruits. "Greens" are relatively harmless IMO.

3) Carbohydrate is protein-sparing as is protein. As you say, a ketone-adapted brain still uses ~50g/day of glucose, so it's cheaper to get that from carbs than it is by stripping it from dietary protein & dumping the nitrogenous waste.

Cheers, Nige.

Anonymous said...

I started a PSMF, under the direction of the Cleveland Clinic B&MI, 17 days ago. With 175 lbs. of lean mass, I'm supposed to eat 16-17ozs of lean meat per day to get 112-120g of protein, and then low-carb vegetables to try to stay under 10g carbs each day.

I've lost 16 pounds in 17 days and I'm finding it's easy to stay on this diet because it's like going cold turkey - since anything with sugar or carbs is forbidden, there's no worries about portion control. Zero is easier than Few.

I'd never heard of this before the doctor told me about it, but it's a great alternative to surgery. The course is 6 weeks, I'm hoping they allow me to stay on it longer after checking my blood results since I have a total of 100 pounds to lose.

Nigel Kinbrum said...

Hi Anonymous,
Are you taking any fish oil capsules? If your fat intake is too low (<5g/meal), you increase your risk for gallbladder stasis & sludge/stone formation. Fish oil caps also provides much-needed omega-3 fats.
Cheers, Nige.

Vikki said...

I am also on a PSMF diet under the complete supervision of a doctor in Phoenix. I have been on it for about 20 days and have lost over 20 pounds with close to 200 more to go if I want to get down to 115. It seems so far fetched to me but what the heck! I am not on any fish oils at all but I am prescribed a regimen of multivitamins plus extra Magnesium, potassium and calcium. I am curious as to what the fish oil is for? Is it to counteract the lack of fat in the diet program?

Nigel Kinbrum said...

Hi Vikki,

Fish oil is there for two reasons.

The first reason is to stimulate your gallbladder to contract and empty completely, as you need at least 5g of fat in a meal to do this. Very fat people who lose weight very rapidly are at a high risk of developing gallstones. For hormonal reasons, women are at an even higher risk than men. See
The role of gallbladder emptying in gallstone formation during diet-induced rapid weight loss
Gallbladder motility and gallstone formation in obese patients following very low calorie diets. Use it (fat) to lose it (well),
Similarity in gallstone formation from 900 kcal/day diets containing 16 g vs 30 g of daily fat: evidence that fat restriction is not the main culprit of cholelithiasis during rapid weight reduction shows less difference (17.0% for 16g/day fat vs 11.2% for 30g/day fat).

The second reason is to provide omega-3 fats, which are generally lacking in normal diets but especially lacking in ultra-low-fat ones. Omega-6 fats may also be lacking but that's not so likely, as the fats present in animal proteins usually contains sufficient linoleic acid due to grain-feeding.

Best wishes, Nige.

OnMyWayToThin... said...

Hi, have been doing Protein Sparing Modified Fast for about 15 weeks now. Down about 50 lbs. It certainly has not been easy, but seems to be working well enough. Of course my biggest concern now will be the re-feeding stage and adding the carbs back in without gaining weight. Am always looking for advice on that!

Have everything more in depth on my blog: http://thisismyjourneytothin.blogspot.com/

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