How to Calculate Macronutrient Ratios that Work for You | Chris Kresser
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How to Calculate Macronutrient Ratios that Work for You

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A Paleo diet offers an excellent framework for healthy eating but can leave people confused about how much carbohydrate, protein, and fat they should consume to meet their unique needs.

How to Calculate Macronutrients
Find out how to calculate your macronutrients. iStock/fcafotodigital

The high-fat, low-carbohydrate diet that works fantastically for one person may be entirely inappropriate for another, making macronutrient ratios a crucial topic. Read on to learn how to calculate the ideal macronutrient ratios to support your health, based on your health status, activity level, age, genes, and other critical lifestyle factors.

That high-fat, low-carb diet may work great for someone else, but it could be entirely inappropriate for you. Find out how to calculate your macronutrient ratios based on your existing health, your lifestyle, and your goals. #nutrition #chriskresser

Table of Contents:

What Are Macronutrients?

Macronutrients—carbohydrates, fat, and protein—are the three primary nutrients required in large (macro) amounts in the human diet. Macronutrients supply our bodies with energy and support healthy growth and physiological function. Let’s talk a bit about each of the three macronutrients in turn.

The Paleo diet is a great starting point, and creating an individual Paleo template is the next step. That means paying attention to which foods benefit the body and which ones don’t, and customizing details like macronutrient ratios. It also means making changes—potentially big changes—to daily habits and lifestyle.

Health coaches are the key to helping people make those changes. They work in the intersection of behavior change and health. They act as change agents, using their mindset, presence, and communication skills to help their clients create plans and make big changes, while also drawing on their knowledge of diet, lifestyle, and nutrition to further empathize with their clients.

In the ADAPT Health Coach Training Program, we offer comprehensive course content on ancestral nutrition, in addition to practical training in health coaching. Our expert faculty go in depth into macronutrients, offering up-to-date information and clinical perspectives on fats, carbs, and protein.

Health coaches who understand the core concepts behind Functional and ancestral health are not only better equipped to step into their clients’ shoes, they’re also more prepared to work with Functional Medicine practitioners and other healthcare providers as part of a collaborative care team.

Does this sound like the right career for you? Find out more about Functional health coaching and the ADAPT Health Coach Training Program.

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Carbohydrates

Carbohydrates are one of two primary energy sources for humans (the other is fat) and include sugars, starches, and cellulose. Carbohydrates are present in both healthy foods, such as vegetables, fruits, and starchy tubers, and unhealthy foods, namely refined flour and sugar. The consumption of refined flour and sugar in excess is potentially harmful and could contribute to the development of many chronic diseases. Conversely, eating small amounts of refined sugar now and then, ideally in foods such as dark chocolate and real ice cream, is not a problem unless you struggle with blood sugar issues or severe gut dysbiosis. “Gray area” carbohydrate-containing foods that are well tolerated by some individuals include whole grains, legumes, and full-fat dairy products.

Stick to Cellular Carbohydrates

For many years in the nutrition world, the relative healthfulness of a given carbohydrate-containing food was determined based on its glycemic index (GI), a measurement of the food’s carbohydrate content through its effect on post-meal blood sugar levels. The idea was that we should avoid eating high-GI foods because such foods will spike our blood sugar levels. However, more recent research indicates that the glycemic index is an outdated and unhelpful concept and that following a low-GI diet doesn’t translate into meaningful health improvements in real life. Instead of using the glycemic index as a guide to carbohydrate quality and intake, I propose that we use the concept of cellular versus acellular carbohydrates. 

Cellular carbohydrates are plant foods such as starchy tubers that store carbohydrates in fiber-walled living cells, which remain largely intact when cooked and thus have a low carbohydrate density. Western foods consist primarily of acellular carbohydrates that lack intact cells; flour and sugar are perfect examples of carbohydrates that have been extracted from the cells of plants and subsequently refined. Acellular carbohydrates have a high carbohydrate density and cause adverse changes in the gut microbiota, producing an inflammatory microbial environment that promotes metabolic dysfunction and chronic diseases. (1)

Whatever carbohydrate intake level you ultimately settle on, make sure to eat as many of your carbs from cellular carbohydrate sources as possible, such as vegetables, whole fruits, and tubers. If you tolerate whole grains and legumes, you may consider adding small amounts of these to your diet for carbohydrates as well.

Carbohydrate Intake Levels

Now that we’ve covered the distinction between healthy and unhealthy carbohydrate sources, how can you determine your ideal intake of healthy carbs? It is helpful to view your carbohydrate intake as a percentage of your total daily calories. The four categories of carbohydrate intake, presented as a percent of total daily calories, are as follows:

  • Very-low-carb is less than 10 percent of total calories: This translates to less than 65 g of carbs for the average man on a 2,600-calorie diet and less than 50 g for the average woman on a 2,000-calorie diet. A very-low-carb intake is best for people with neurological issues and severe blood sugar problems.
  • Low-carb is 10 to 15 percent of total calories: This translates to 65 to 100 g of carbs per day for the average man and 50 to 75 g for the average woman. A low-carb intake is ideal for weight loss, mood disorders, blood sugar regulation, and digestive issues.
  • Moderate-carb is 15 to 30 percent of total calories: This translates to 100 to 200 g of carbs for the average man and 75 to 150 g for the average woman. A moderate-carb intake supports general health, weight maintenance, HPA axis function, and thyroid function.
  • High-carb is more than 30 percent of total calories: This translates to over 200 g per day for the average man and over 150 g per day for the average woman. A high-carb intake is appropriate for athletes, highly active people, people with fast metabolisms, those who are trying to put on weight or muscle, and women who are pregnant or breastfeeding.

If you’ve been on the internet lately, you’ve probably realized that very-low-carbohydrate (aka “keto”) and low-carbohydrate diets are currently all-the-rage; however, low-carb is not a cure-all and is not appropriate for everyone. To determine whether a higher carbohydrate intake is right for you, see my blog “Do You Need to Increase Your Daily Carb Intake?

No Need to Count Carbs from Non-Starchy Vegetables

As a last note, I believe that we should only count carbohydrates from starchy vegetables, tubers, fruit, grains, legumes, and dairy, not non-starchy vegetables. The fibrous quality of non-starchy vegetables such as broccoli and cauliflower requires a lot of cellular energy (made from glucose) to break down, leaving us with a very low, if not zero, net carbohydrate content. (Net carbs are the carbs that your body can absorb. Fiber and sugar alcohols—both non-digestible carbs—would not be included in a net carb count, since your body doesn’t process these the same way it processes digestible carbs.)

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Fats

Alongside carbohydrates, dietary fats constitute a primary energy source for the body. They also help maintain healthy skin and hair, immune function, and temperature regulation and facilitate the absorption of fat-soluble vitamins. There are four classes of fats found in the human diet.

Saturated Fats

Saturated fats are found primarily in the milk and meat of ruminant animals and coconut products, including coconut oil, milk, and meat. Saturated fatty-acid chains have all single bonds and include myristic, palmitic, stearic, and lauric acids. For decades, saturated fat was demonized for its purported role in heart disease. In recent years, saturated fat has been absolved of blame by peer-reviewed research demonstrating that, in the average, healthy person, dietary saturated fat does not adversely impact blood lipids or cardiovascular disease risk. (2) While this finding holds for the average person, there are otherwise healthy individuals out there who experience dramatic increases in blood lipids in response to saturated fat. A diet high in saturated fat is not recommended for these individuals. I’ll discuss which people fall into this category when we dive into our discussion of macronutrient ratios for different health conditions.

Monounsaturated Fats

Even as the conventional medical community and low-carb/Paleo communities have butted heads over saturated fat, they have agreed upon the healthfulness of monounsaturated fats. Unlike saturated fats, monounsaturated fats have one double chemical bond in their fatty-acid chains and are fluid at room temperature. Monounsaturated fats are found in:

  • Olives and olive oil
  • Avocados
  • Macadamia nuts
  • Lard
  • Duck fat

They have beneficial effects on cardiovascular disease risk factors, raising HDL cholesterol and lowering triglycerides. (3)

Polyunsaturated Fats

Polyunsaturated fats have two or more double bonds in their fatty-acid chains and include the two essential fatty acids in the human diet: linoleic acid (LA), an omega-6 fatty acid, and alpha-linolenic acid (ALA), an omega-3 fatty acid. ALA can be converted in the body to make EPA and DHA, the omega-3s that are truly vital for our health; however, this conversion process is inefficient in many people, necessitating the inclusion of EPA- and DHA-containing seafood in the diet.

While omega-6 fatty acids have received a bad rap in the Paleo world, they are entirely healthy when consumed in fresh, whole foods such as avocado, nuts, seeds, and poultry and in balance with omega-3 fatty acids from seafood. Omega-6 fatty acids in industrial seed oils are a different story; the fatty acids in these oils are damaged during vegetable oil processing, resulting in rancid, inflammatory fats that are anything but healthy. Enjoy your avocados, almonds, and chicken skin, but steer clear of industrial seed oils!

Trans Fats

The trans fats class of dietary fats encompasses both man-made and natural trans fats. While the consumption of man-made trans fats is harmful, increasing the risk of heart disease, cancer, diabetes, and neurodegenerative diseases, natural trans fats offer several health benefits.

One of the most-studied natural trans fats, conjugated linoleic acid (CLA), is found in the meat and dairy of pastured animals and has anti-inflammatory, anti-diabetic, anti-cancer, and cardioprotective benefits. (4) Synthetic CLA supplements do not have the same benefits as naturally occurring CLA and may increase insulin resistance and oxidative stress. (5) The paradoxical health effects of natural and supplemental CLA may be due to differences in the composition of the CLA mixtures in food versus synthetic supplements and the quantity and duration of CLA intake.

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Protein

Dietary protein is not a significant energy source for the body but is essential for providing amino acids for many biological processes, including the assembly of enzymes and signaling molecules, the maintenance of skin and muscle, and for healthy growth and development. When determining how much protein to include in your diet, there are several aspects to consider.

Complete vs. Incomplete Protein

Foods that are complete proteins contain the nine essential amino acids needed by the human body for normal physiological function. Sources of complete protein include meat, poultry, fish, eggs, and dairy products. Soybeans and quinoa are often cited as complete proteins for vegans, but they come with several drawbacks, including a low bioavailability score and high antinutrient content, which I will discuss shortly.

Incomplete proteins, on the other hand, lack one or more of the nine essential amino acids required by the body. Grains and legumes are incomplete proteins; when consumed together, they provide the full spectrum of essential amino acids the body needs. However, grains and legumes have low protein bioavailability and high antinutrient contents compared to meat, eggs, seafood, and dairy.

PDCAAS score

The protein digestibility-corrected amino acid score (PDCAAS) is a measure of protein bioavailability that combines the amino acid profile of a protein with a measure of how much of it is absorbed during digestion. As I discussed in my article “What Is the Optimal Human Diet?,” animal proteins have significantly higher PDCAAS scores, and thus higher bioavailability, than plant proteins. For example, casein, eggs, milk, whey, and chicken have scores of 1 on the PDCAAS scale (with 0 being the lowest score and 1 being the highest), indicating excellent amino acid profiles and high absorption, while legumes score around 0.7, oats 0.57, tree nuts 0.42, and whole wheat 0.42. Importantly, the PDCAAS scale does not consider antinutrients in plant-based proteins, including lectin and phytate. If these antinutrients were considered, plant proteins would score even lower on the PDCAAS scale.

Balancing Methionine and Glycine

The third aspect of protein consumption to consider is the balance of methionine, from muscle meat and eggs, and glycine, from bone broth and collagenous cuts of meat in your diet. A protein intake that consists mainly of muscle meats leads to an imbalance in methionine and glycine and may raise homocysteine, a risk factor for chronic inflammation and cardiovascular disease.

While our ancestors tended to eat “nose to tail,” thus achieving a balance of methionine and glycine in their diets, most of us lack glycine in our diets today. No matter how much protein you ultimately eat, you’ll want to maintain a balance between methionine and glycine intake.

Recommended Protein Intakes

A protein intake of 10 to 20 percent of total calories is ideal for generally healthy people or pregnant women, while those seeking weight loss or gains in muscle mass or who have blood sugar problems can increase their protein intake to 20 to 35 percent of total calories.

Most people eat the right amount of protein to fulfill their needs due to mechanisms within the brain that increase or decrease the desire for protein based on physiological needs. However, you may need to consciously add more protein to your diet if you’re trying to lose weight. For more information on reasons why you may need to increase your protein intake, read my article “5 Reasons You May Need More Protein—Even on a Paleo Diet.”

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Recommended Macronutrients for 16 Health Conditions and Life Stages

1. General Health

For the maintenance of general health, I recommend an intake of:

  • 15 to 20 percent of calories from protein
  • 15 to 30 percent of calories from carbs
  • 50 to 70 percent of calories from fat

This carb intake is “low” according to conventional U.S. dietary guidelines but is moderate from an ancestral health perspective and perfectly capable of supporting good health.

2. Metabolic Syndrome and Type 2 Diabetes

Insulin resistance and carbohydrate intolerance are characteristic features of metabolic syndrome (MetS) and type 2 diabetes (T2D). Reducing carbohydrate intake thus significantly benefits people with these two conditions. A carbohydrate intake comprising 10 to 15 percent of daily calories or lower has repeatedly been shown to improve insulin sensitivity, blood sugar control, and other markers of metabolic health in people with MetS and T2D. In a small but promising randomized controlled trial, a four-week low-carbohydrate diet (carbohydrates were limited to approximately 45 g per day) led to significant improvements in metabolic health, with over half of the participants no longer meeting the criteria for metabolic syndrome post-intervention! (6) A very-low-carbohydrate diet also produces significant reductions in body weight, hemoglobin A1c (a measure of blood glucose levels), triglycerides-to-HDL ratio, hypertension, and C-reactive protein (a marker for inflammation) and reduces or eliminates the need for blood sugar medications. (7, 8)

Increasing protein intake is also beneficial for people with metabolic syndrome and type 2 diabetes. A high-protein diet (defined as consuming 1.34 grams of protein for each kilogram of one’s body weight) produces significantly more weight loss in people with metabolic syndrome compared to a standard-protein diet (0.8 g protein/1 kg body weight), reduces leptin, and increases insulin sensitivity. (9, 10) Increased dietary protein alleviates the underlying metabolic disturbances in MetS and T2D by increasing the release of satiety-inducing signaling molecules in the gut (that tell you you’re full), including cholecystokinin, glucagon peptide 1, and peptide YY, “rewiring” neuronal circuits in the brain. These rewired circuits lead to better regulation of appetite, reducing food consumption, and promoting weight loss. (11) The resulting weight loss leads to better insulin sensitivity and blood sugar control.

3. Non-Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD), a buildup of extra fat in liver cells not caused by alcohol, is considered a manifestation of metabolic syndrome and often occurs alongside type 2 diabetes. (12) A low-carbohydrate approach is beneficial for people with NAFLD, reducing visceral fat mass, improving liver enzymes, and reducing intrahepatic lipid content. (13, 14)

4. Weight Loss

As with metabolic syndrome and type 2 diabetes, a high-protein diet helps with weight loss by increasing intestinal release of satiety-inducing signaling molecules, reducing food intake and promoting weight loss.

People trying to lose weight should get 20 to 30 percent of their daily calories from protein; some people may want to increase this intake even further, up to 35 percent of calories. A little self-experimentation can help you determine the amount of protein that leaves you feeling satiated and facilitates weight loss.

Restricting carbs is often quite helpful for weight loss. However, if you are a hard-charging athlete, are under a lot of stress, or are female, adding carbs may help you lose weight! Long-term low-carb dieters who are experiencing a plateau in weight loss may also respond favorably to more dietary carbohydrates.

If you reduce your carbohydrate intake in the pursuit of weight loss, you’ll still want to include some form of fermentable carbohydrates in your diet such as sweet potato, artichoke, or onion. The consumption of fermentable carbohydrates improves insulin resistance, an underlying cause of weight gain, and reduces fat mass. (15)

5. Cardiovascular Disease

Low-carbohydrate diets are also gaining traction as a preventive treatment for cardiovascular disease. In humans, a ketogenic diet has been found to decrease triglycerides and increase beneficial HDL cholesterol levels as well as LDL particle size (larger LDL particle size is more desirable), reducing cardiovascular disease risk. (16) A non-ketogenic Paleo diet has been found to reduce multiple cardiovascular disease risk factors, including waist circumference, blood pressure, triglycerides, and C-reactive protein. These findings suggest that moderate carb restriction combined with a change in carb quality (cellular carbs instead of acellular carbs) may be enough to support cardiovascular health in the average adult. (17)

6. Familial Hypercholesterolemia

Familial hypercholesterolemia is a genetic condition in which defects in LDL receptors cause severe elevations of LDL cholesterol and premature cardiovascular disease. Medications have long been the cornerstone of therapy, with little attention given to dietary therapies. However, emerging research indicates that diet changes offer additive benefits when combined with pharmacological treatment. In this case, saturated fat reduction and a Mediterranean-Paleo style approach with a moderate carb intake and a focus on olive oil, avocado, seafood, nuts, and seeds for dietary fat is best. (18)

Foods that contain cholesterol but not much saturated fat and are nutrient dense, such as shellfish and eggs, can be consumed in moderation by people with familial hypercholesterolemia. (19) These foods offer an abundance of nutrients that are hard to come by elsewhere!

7. ApoE 4/4 Genotype

Apolipoprotein E (ApoE) is a protein involved in the metabolism of fats in the body. A variant of the ApoE gene, ApoE 4/4, is associated with an increased risk of Alzheimer’s disease; it also reduces the body’s ability to clear LDL cholesterol from the bloodstream. People with the ApoE 4/4 genotype are more sensitive to dietary saturated fat and should reduce their intake of added saturated fats, such as coconut oil. (20) People with familial hypercholesterolemia or the ApoE 4/4 variant may benefit from a moderate-carbohydrate dietary approach rich in monounsaturated and polyunsaturated fats from avocado, nuts and seeds, olive oil, and seafood.

8. Neurological Disorders

Neurological disorders, including traumatic brain injury (TBI) and neurodegenerative diseases, are characterized by insulin resistance in the brain. (21) A ketogenic diet has neuroprotective effects in TBI, Alzheimer’s disease, and Parkinson’s disease. It also decreases brain amyloid-beta accumulation in Alzheimer’s and improves non-motor symptoms in Parkinson’s. (22, 23)

The clinical application of the ketogenic diet for drug-resistant epilepsy has been known for over a century but has only recently experienced a resurgence in popularity in the medical community. (24)

9. Mood Disorders

Preclinical research suggests that a ketogenic diet may improve symptoms of depression, bipolar disorder, and schizophrenia by supporting brain energy metabolism and decreasing oxidative stress. (25) Reactive hypoglycemia, a steep drop in blood sugar after a meal, provokes anxiety and is often triggered by the consumption of high-carbohydrate foods. Reducing one’s dietary carbohydrate intake may improve reactive hypoglycemia and alleviate anxiety. (26)

10. Hypothyroidism

Up until now, many of the health conditions we’ve discussed benefit from a low carbohydrate intake. However, a low-carb or ketogenic diet may worsen hypothyroidism by compromising thyroid hormone activation in peripheral tissues.

The human body requires insulin to convert inactive thyroid hormone, T4, into active thyroid hormone, T3. (27) The low insulin levels in low-carb and ketogenic dieters may reduce T4-to-T3 conversion and exacerbate hypothyroidism.

Some proponents of the ketogenic diet argue that low-carb diets make people more sensitive to their existing levels of thyroid hormones through increased insulin and leptin sensitivity, making the total drop in T3 level insignificant. However, this remains a theory, not a fact. If you have hypothyroidism, I recommend doing some self-experimentation to determine what level of carbohydrate intake best supports your thyroid health.

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11. Athletes

The topic of carbohydrate intake as it relates to athletic performance is quite controversial. On the one hand, the American College of Sports Medicine recommends a carb intake of 6 to 10 g/1 kg body weight per day for athletes; for the average male weighing 88.8 kg (about 195 pounds), this translates into a whopping 533 to 888 g of carbs per day! (28) Considering the recommended magnitude of carbohydrate intake, it is not surprising that the average endurance athlete may be at risk for diabetes. (29)

On the other hand, scientific research increasingly indicates that very-low-carbohydrate ketogenic diets can also work well for athletes, particularly those involved in ultra-endurance activities. Sports that require explosive movements, such as martial arts, tennis, or sprinting, rely more on glucose for fuel, and athletes’ performance may suffer on a ketogenic or low-carb diet. (30)

In general, I recommend a carbohydrate intake of approximately 30 percent of total calories for athletes; this intake provides enough glucose to support exercise and replenishment of glycogen stores without putting athletes at risk for prediabetes.

Protein is also a crucial nutrient for athletes. A high protein intake stimulates mechanistic target of rapamycin (mTOR), a critical cellular signaling pathway that promotes muscle growth. A protein intake of 20 to 30 percent of total calories is sufficient for most athletes.

12. Pregnancy and Lactation

Pregnancy is not the time to skimp on carbs. Carbohydrates provide glucose, which is required by the fetus for optimal brain growth and development. A low carb intake is also ill advised during breastfeeding and may restrict infant growth (31)

During pregnancy and breastfeeding, eat balanced amounts of carbohydrates, protein, and fats. A protein intake of 10 to 15 percent of total calories is ideal, and carbohydrates should provide at least 30 percent of total calories. For women with gestational diabetes, a diet consisting of 33 to 40 percent complex carbohydrates, 35 to 40 percent fat, and 20 protein is useful for improving blood sugar control. (32)

13. Childhood

Low-carbohydrate diets are not recommended for children because dietary carbohydrate promotes healthy growth and development. For children who are overweight or obese, replacing refined carbs with cellular carbohydrates can help with weight loss and control.

Importantly, many children gravitate towards carbs and fail to eat enough protein. Children should aim for one palm-sized serving of protein at each meal to ensure an optimal protein intake.

In the clinical setting, I have observed that parents of children with gut issues often inadvertently put their children on a low-carb diet when they embark on a GAPS, Specific Carbohydrate Diet (SCD), or Paleo protocol. While their intentions are good, it is crucial that these children still eat enough carbohydrates to support healthy growth and development while we address their gut issues. Removing refined sugars and gut-irritating carbohydrates, particularly gluten-containing grains and legumes, tends to work well for these children.

14. Irritable Bowel Syndrome (IBS) and Small Intestinal Bacterial Overgrowth (SIBO)

IBS and SIBO both involve excessive bacterial fermentation of dietary carbohydrates in the gastrointestinal (GI) tract, resulting in gas production, bloating, diarrhea, and other GI symptoms. While a low-carbohydrate or low-FODMAP diet can temporarily alleviate symptoms by starving bacteria and reducing intestinal gas production, these diets do not correct the underlying causes of IBS and SIBO. A long-term low-FODMAP diet may also induce adverse changes in the gut microbiome, wiping out beneficial bacterial species. (33)

For people with digestive issues, I recommend a low-to-moderate carbohydrate diet, based on individual tolerance, that includes FODMAPs; aiming for around 100 g of carbs per day works well for many people. Contrary to other dietary plans, I recommend that you keep some FODMAPs in your diet. A moderate intake of FODMAPs may improve the efficacy of your IBS or SIBO treatment by feeding your dysbiotic gut microbes, preventing them from going into “hiding” and making them more susceptible to antimicrobial botanicals and antibiotics.

15. Gastroesophageal Reflux Disease (GERD)

A high-carbohydrate diet is associated with increased GERD symptoms, whereas a reduced carbohydrate-diet alleviates GERD symptoms and the frequency of acid-suppressing medication use. (34, 35) A high intake of refined carbohydrates may promote GERD by stimulating the secretion of gut hormones that reduce lower esophageal sphincter function. SIBO may also contribute to GERD by increasing intra-abdominal pressure, causing the lower esophageal sphincter to remain open. A low-carbohydrate diet is an excellent place to start for many people with GERD, especially those with concurrent insulin resistance and obesity, common among those with GERD.

16. Cancer

The optimal macronutrient ratios for individuals with cancer vary depending on the type and stage of cancer. (36) A ketogenic diet is a useful adjunct treatment for malignant glioma, neuroblastoma, prostate cancer, colon cancer, and endometrial and ovarian cancers. It increases the sensitivity of cancer cells to chemotherapeutic agents, improving the efficacy of conventional cancer treatment. (37, 38, 39, 40) Protein cycling, such as in the fasting-mimicking diet (FMD), may also be beneficial for cancer prevention and for boosting the efficacy of conventional cancer therapies, including chemotherapy. (41, 42)

How does a ketogenic diet favorably impact the response of cancerous cells to chemotherapy? Cancer cells demonstrate increased levels of oxidative stress—an imbalance between cellular antioxidants and pro-oxidants that damages DNA, proteins, and the lipid bilayers of cells. This process increases the resilience of cancer cells to the body’s own “quality control” processes and cancer treatments like chemotherapy. To combat that oxidative stress, cancer cells use glucose to generate reducing compounds. A ketogenic diet deprives cancer cells of the glucose required to make those reducing compounds. This metabolic switch impairs cancer cells’ defense mechanisms and increases their sensitivity, making them more vulnerable to chemotherapy treatments.

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How to Calculate Your Macronutrients

For most people, the following strategy for calculating your ideal macronutrient ratio works best.

1. Begin with Carbohydrates

Based on your health status, age, activity level, and other lifestyle factors, select one of the categories of carbohydrate intake:

  • Very-low is less than 10 percent of total calories
  • Low is 10 to 15 percent of total calories
  • Moderate is 15 to 30 percent of total calories
  • High-carb is more than 30 percent of total calories

Once you have chosen a category, convert the percent of carbohydrates into a decimal (for example, 15 percent becomes 0.15) and multiply this by your total daily calorie intake. For instance, if you are a man who eats approximately 2,500 calories per day and are aiming for a carb intake of 15 percent, multiply 0.15 x 2,500. The answer is 375, which represents your daily calorie intake from carbs. Divide this number by four, because there are four calories in one gram of carbs, to get the number of grams of carbohydrates (in this case, 94 g) per day.

2. Calculate Protein as a Percent of Total Calories

Select the protein intake category that best fits your health status, activity level, and life stage. (A generally healthy person should aim for 10 to 20 percent of total calories, while someone who is trying to lose weight, correct blood sugar problems, or gain muscle mass could aim for 20 to 35 percent of total calories.)

For example, if you are a man looking to lose weight, you may aim for 25 percent of calories as protein. Multiply your daily calorie intake, 2,500 calories, by 0.25 (625 protein calories). Then divide by four (as with carbs, there are four calories per gram of protein) to get your daily recommended protein intake—in this example, 156 grams.

3. Fill In the Gap with Fat Content

Once you’ve determined your ideal carb and protein intakes, fill in the remaining gap with fat. (There are nine calories in one gram of fat.) Adjust the types of fats you’re consuming based on your genetics and health status. If you have the ApoE 4/4 variant or familial hypercholesterolemia, you will need to limit saturated fat and focus instead on monounsaturated and polyunsaturated fats.

If you have a health condition that may be best supported by a ketogenic diet, I recommend working through the above steps backward; begin by calculating your fat intake, followed by carbs and protein. To learn more about macronutrient ratios on a ketogenic diet, check out my comprehensive article on the topic, “A Complete Guide to the Keto Diet.”

Once you’ve determined your ideal macronutrient ratio, you can keep track of your macronutrient intakes on an app such as Eat This Much, MyFitnessPal, or Carb Manager, if you are doing a very-low-carb diet. While not required, these apps are useful for visualizing how much of each macronutrient you should be consuming to reach your goals.

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