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Ask Dr. Gourmet

What is the right combination of calories, fats, proteins, and carbohydrates for my husband and me?

In February, our Cardiologist put my husband on a low carb diet to bring his triglycerides under control. He also indicated it would be good for both of us to lose weight.

We have been using a food tracker to monitor our diet. The tracker looks at Calories, Fat, Sat Fat, Cholesterol, Sodium, Carbs, Sugar, Fiber and Protein.

We enter everything we eat on a daily basis. My husband is trying to maintain a daily intake of 1500 calories with a max of 150 carbs. I try to stay under 1300 calories with a max of 100 carbs.

Once we reach the desirable weights for our age of 69, moderately active people, we would like to know the proper maintenance nutritional values. His goal weight is 230# at 6'3", large frame and mine is 140# at 5'4" and medium frame. He is currently at 256# (down from 294) and losing. I am at 150# (down from 172) and losing. See how positively I state the losing - it is a long tough go.

What I am searching for specifically is a chart giving the proper intake for nutritional values, noted above in red, for people our age. We want to know what maintenance values will look like. The only one I know for sure is 2400mg or less of sodium.

Do you have such a chart? I searched your site and did not see what I was looking for. Your help will be greatly appreciated.

Dr. Gourmet Says....

two older persons sitting together at a table looking at a laptop computer screen

There is certainly a great deal of controversy about low-carbohydrate diets, and I do not feel that this is the best plan for long term health or for sustained weight loss. There is some evidence that making substitutions of more complex carbohydrates for simple sugars can be beneficial for such markers of cardiac disease risk as triglycerides.

Some of the issue with a low-carb diet is that once they lose the desired amount of weight, most people return to the way they were eating prior to going on the diet. In the US this means a diet high in simple sugars, refined carbohydrates, and saturated fats. The diet that you are following now doesn't limit carbohydrates as severely as some do, however. As you move toward your goals, liberalizing the amount of carbohydrate can help you eat healthy for years to come.

For this reason I prefer to recommend a plan that is higher in carbohydrates but with a strong emphasis on very complex carbs such as legumes, cereals, and whole grains. This coupled with a moderate amount of protein and about 30% of the diet in fat has been time and again shown to be the most reasonable. A good weight loss and maintenance diet breaks down with these percentages:

50 - 55% of calories from carbohydrate
The emphasis should be on complex carbs like whole grain breads, cereal grains like oatmeal and other high fiber cereals, brown and wild rice, and legumes. The best sources of more simple carbohydrates are fruits, and the great thing about this is that fruit makes a terrific snack.

30% of calories from fats
The emphasis should be on reducing your intake of saturated fats and eliminating trans-fats. Eating lean red meat no more than about once a week and increasing the amount of fish in your diet, especially fatty fish like tuna, salmon and halibut, is key. Using monounsaturated fats like olive and grapeseed oil for recipes has been shown to favorably affect cholesterol profiles. Using nuts and seeds for snacking can be very beneficial as well.

Approximately 15% of calories from protein
Choosing lean meats as well as fatty fish as noted above but also eating more "meatless" meals by using legumes and whole grain products.

Here's a table of the approximate number of grams of fat, protein and carbohydrate for each of five different diet plans (1000 through 2000 calories). These tables are what the Dr. Gourmet diet plans are based on.

Calories Fat
2000 67 75 275
1800 60 66 245
1500 50 56 206
1200 40 45 165
1000 33 38 138

You are correct that the targets of around 2,400 milligrams (mg) of sodium are reasonable. My attempt is to keep Dr. Gourmet recipes well within these parameters.

Your work at losing weight and your progress is fantastic. While you mention that your progress is slow, the rate at which you are losing is nearly perfect. The ideal weight loss is between a half pound and a pound each week and you are right on target. Sometimes this goes much faster at first and then slows down. Keep up the good work: the reward is there. The research says you will live better and likely live much longer.

You might want to check the information on Body Mass Index and Waist to Hip Ratio to evaluate your target weights.

Your and your husband's changes are terrific. Keep up the good work.

Thanks for writing,

Timothy S. Harlan, MD, FACP
Dr. Gourmet