Keto vs Mediterranean vs high-protein — 12 month update

Answering the narrow version, because the broad one does not have a single answer. Distribution matters less than total but it is not nothing. Roughly 25 to 40g per sitting with enough leucine to trigger synthesis, three or four times a day, is more effective than the same total in one enormous evening meal — and on a suppressed appetite the enormous evening meal is the one you will not finish anyway.

NeuroNate said:

Distribution matters less than total but it is not nothing.

Agreed on the target, with the caveat that reference weight and current weight are different numbers. Using current weight at the start of a large loss produces a target that is both unachievable and unnecessary.

RickReta_CO said:

My appetite is suppressed enough that hitting a protein target is now the hardest part of the day, and everything I read assumes I can simply eat…

Same position here, arrived at the long way round. On a suppressed appetite the winning strategy is protein density per unit of volume, not per calorie. Isolate powders, Greek yoghurt and cottage cheese, egg whites, lean fish, and tinned tuna all deliver a lot of protein in a small physical volume. Front-load it: appetite is usually least suppressed in the first hours after waking and worst on the day or two after dosing, so get the majority in early in the day and early in the week.

Adding the clinical framing, because it changes how the question reads.

DEXA scan update relevant to protein intake:

Scanned at months 0, 6, and 12. Here are the body comp numbers:

Lean mass preserved — actually GAINED 1-2 lbs thanks to progressive overload + 1.6g/kg protein. The protein intake discussion needs to include body comp data, not just scale weight.