Ideal Macronutrient Percentages -- what should they be?

I haven't been checking in for a while, so hi all! Back from my 3-month stay in Nicaragua and settled back on my boat in Baltimore. Good to be home. Weight loss slowed, stopped, and then starting creeping back up in Nicaragua (the land of rice and beans), but since my return at the end of March, I've lost what I gained and then some with the availability of high-quality proteins (i.e., meats, chicken, fish, tofu).

My question is for my husband, who is not a candidate for sleeve surgery for the foreseeable future because of active ulcerative colitis and heart medication (Plavix) issues. He's 6'1", 290 pounds, 65yo, and desperate to lose weight. He has asked me to formulate a healthy eating plan for him that will allow him to lose about 3 pounds/week. I've worked out that he needs to limit his calories to 1,750 calories/day to achieve that rate of loss.

My idea is to plan a way of eating for him that parallels my way of eating as a successful sleeve patient. Except for protein, I don't keep track of the other macros, because as long as I stay within my calorie limit, meet my protein goals and eat only healthy carbs and fats, the carbs and fats kinda take care of themselves. But without a sleeve, my husband can't limit himself to 600-800 calories/day; he'd be ravenous with hunger. 

So, based on a 1,750 calorie/day limit, can someone suggest how much protein, carbs and fats he should eat (by grams) every day? I plugged his info into various nutrient calculators (e.g. healthycalculators.com), but they all go by the government guidelines that emphasize carbs over protein. Both he and I believe he would do much better on a protein-dense diet. 

Any suggestions would be very welcome.

psychoticparrot

Take a look at the Paleo diet.  It is very protein forward with limited carbs, dairy, and sugar. 

Look into Paleo and keto. Keto may serve him better, but it emphasizes fat over protein and carbs as fat will keep you full and satiated. Typical keto ratios are 75% fat, 20% protein, 5% carb, but it varies for the individual.

Honestly, I'd make an appointment at a nutritionist. They can do these calculations, but also there is an upper limit on how much protein a body can handle... And when you're going to eat a protein-heavy diet as a pre-op when hunger is a big deal and protein is the best defense, you can dance right on over that safe line. I was regularly getting 130+g of protein during my pre-op diet and my nut said my body could handle that amount, but not to go much higher.(The calculations are based on height and weight, so your DH will have a higher limit than I did.)

That said, I did lose quite a bit pre-op, and the frequency of meals was my biggest ally. Eating every 2-3 hours with high quality dense proteins was the best thing for controlling my hunger. Getting in lots of water helped too. My general ruling from nut, I could eat anything that fit the 10/10/10 rule--more than 10g protein per serving, less than 10g of fat or sugars(tho fresh fruits and veggies-like tomato didn't count because of the fiber), and sugar alcohols counted for half(16g sugar alcohol counted for 8g sugar).

None of that addresses nutrients, but it was from the nutritionist and did work for months. I should add tho, that eventually it gets harder to follow because you get weirdly hungrier. For me it happened about month five, and my portions crept up to keep somewhat satisfied and less prone to straying.

Agreed-- a visit to a doctor or nutritionist is in order. Best to trust those calculations to somebody with training and experience.

I'm reluctant to insist on his seeing a nutritionist. The nut from my bariatric clinic is okay but still behind the times with some of her suggestions. I still have all the printed information she gave me, so whatever benefit can be had from her has already been obtained.

As far as seeing another nutritionist goes, the long litany on this site of the preposterous notions of "good nutrition" that some nuts display makes me unwilling to risk time and money on someone who may or may not know what they're doing. You're fortunate that you found a good one.

I've decided to rely instead on the experience and advice of the many long-timers on this site, whose proven success with WL and healthy living makes them far more credible than a nut's certificate on the wall. 100g is a lot of protein, but my husband has routinely been eating that much and more (along with loads of unhealthy carbs and fats). It's the carbs and excess fat that are causing his problems, not the protein, IMO. But I will make sure he logs it carefully on his food log.

I agree with you that frequent meals will be healthier for my husband than 3/day, as his blood sugar tends toward diabetic levels unless he's very careful. His water intake has always been high, so that's a plus for him. If he reaches the point that his food compulsions get too hard to handle, I'm hoping that his health will have improved enough for him to have the sleeve surgery, which will, as you know, help him keep his healthful eating habits.

psychoticparrot 

I wish you both all luck! I did get very lucky with my nutritionist, she's awesome, probably colors my nutritionist expectations a bit.

He can most likely do more than 100g protein unless he's got dodgy kidneys. 100 seems a lot to us, but with a full-sized tummy, it's really not that much.

Losing to achieve better health for surgery is a totally sensible goal. I worked hard to get below 50BMI before surgery for just that reason.

Best of luck!!

Darcy G,

I have to say thanks for throwing it out there that hunger began to creep up. I'm in month 5 (will be 6 months on 5/3) and have noticed its harder for me to stay full. Because of work issues I got dehydrated and wasnt meeting my water intake goals but that has since been fixed but in the last week, I want to say I went over the calorie goal 2x. Im frustrated for sure as to why I'm hungrier. I find myself eating fast and I know I shouldn't but it's getting a little tough to pace myself.

I've always followed my instructions to the letter and I've lost about 70lbs in the nearly 6 months but I know this week I stalled. My exercise class was cancelled and life got in the way that brought my exercise routine to a slow so I haven't lost much this week which only adds to the frustration. I'm thinking of trying this "reset" thing I've heard about where you repeat the steps of the post op within a week as opposed to several weeks but I'm not sure yet.

Any suggestions on how to deal with the increased hunger?

Typical Work day meals"

B-Jello/protein bar/ shake

Hi Delta,

All my experience is pre-op before 4/7! So, I was full size tummy in my 5th month hunger surge. I went over my personal calorie goals all the time in months 5&6 of my pre-op supervised diet and weight loss almost stopped dead. I would have days of extreme hunger and days it was better. 

What I ended up doing was increasing fiber, which isn't for everyone... Lots of beans and roughage... I didn't have carb cravings increase from beans (black), but it kept me full longer. Then the next day, I would be less hungry, and the next next it'd start again. So I cycled and did my best to include as much fiber as possible.

Don't know how that will work with a modified tummy.

Good luck with it! 

I use my fitness pal.. if you go in under the my home tab and then click the goals tab they have a section for daily nutrition goals

You enter the amount of daily calories then the percentage of carbs/fat/protein -

I did mine by setting how many calories I wanted to stay within and how much protein .. then played with the other percentages until the macronutrients equaled 100%

I know it's not the answer you were looking for but I hope it helps