skip to Main Content
Diet Wars High Carb V High Protein

Study Shows 100% Pre-Diabetes Remission With High Protein Diet

Published in the BMJ at the end of 2016, results of a contest between two enemies fated to duke it out for (seemingly) all eternity.

The first ever diet trial to 100% resolution of prediabetes with diet is neither low fat nor low carb. It’s high protein. (I wish it was also low-PUFA)

Study participants ran a roughly 500 KCal per day deficit, meaning it was 500 KCal below the amount of calories they needed to avoid weight loss. It was also least 1200 Kcal per day less than the participants had probably been consuming (the average American gets 3000-3600 Kcal daily). That degree of calorie restriction forces the body to start burning body fat.

Although both study groups were eating the same amounts of calories, the different macronutrient compositions in the two groups led to very different body composition and biomarker changes. Once again, showing that as much as Coke and the sugar industry would like us to believe a calorie is a calorie, the fact is not all calories are equal in the eyes of your body.

This article is continued below...(scroll down)
Kobe Bryant

It helped. I feel great.

"It’s helped. I feel great."

Kobe Bryant
NBA baskeball player
megyn kelly

This has been life changing

"Let me tell you this has been life-changing. I have all of her books, in audible and ebooks! I have gotten rid of all the hateful 8 oils. I have trained my body to eat its own previously toxic body fat. Download that pod it's a game changer!"

Megyn Kelly
Jesse Watters

Life changing

Deep Nutrition changed my life.

Jesse Watters
Fox News Primetime host

Saved my life

I would like to thank you for literally saving my life. Back in February, I had to be hospitalized while on vacation in Phoenix with an A1C of 11% and had to start taking 2 types of insulin and 2 other meds. I read the Fatburn Fix in April, and followed the program to a tee, and I’m down by 15 pounds, 6.8 A1C, and only one once weekly diabetes medicine. Prior to reading the book, it was almost impossible for me to lose weight as a diabetic. 

Leontyne Tompkins

I feel free

For the last month, I have really been reading all labels on everything. I have completely remove those 8 oils you talk about. I must tell you, I feel great! I have more energy and I am now 197 lbs (have always been around 205 to 210lbs). I eat potatoes with real butter, grass fed steak, pasta with the right toppings. I eat everything! I seem to crave less sugar. I love it! 

Robert Kirkendall

I feel so much better

I had terrible aches and pains everywhere in my body, my hands, shoulders and knees. I feel so much better and the way I feel is motivating me every day! Thank you

Mike Deb Wootan Burcin

Better than ever

I am an anesthesiologist in Orlando and a huge fan of both of your books! I have been incorporating your principles for the last 10 months and feel that my health is better than ever.

Marnie Robinson, MD

My allergies disappeared

The biggest difference for me (and a surprising one) is that my allergies have almost completely disappeared! This is a big deal for me, because I’ve had allergies most of my life and they have often affected what I do which is a teaching music in [a public school district].  In general, I feel much better and have more consistent energy throughout the day.

Erica Turrell

Heart Palpitations have Stopped

I’ve lost 20+ pounds (also fasting 16-24 hours daily) and haven’t had palpitations except for one occasion — I had a mini bag of Fritos for the first time in July. And, I feel better now on a daily basis than I ever did all through college.

Mike Wright
Deep Nutrition and Fatburn Fix reader
Mitzi Wilkinson Champion

I’ve lost over 50 pounds

I’ve lost over 50 pounds. I’m 56 years old. Cutting processed food and unhealthy fats from my diet was one of the first things I did on my health recovery journey...I went cold turkey off the bad oils. Emptied my pantry into the trash and just started eating real food

Mitzi Wilkinson Champion

Knowledge I didn’t know I needed

Your Fatburn Fix book is amazing, my friend. Thank you! I’m an Functional Nutritional Therapy Practitioner and I know my stuff. This is the extra layer of knowledge I didn’t know I needed. Well done!

Jennifer Dillman
Fatburn Fix reader

Lost a solid 20 lbs and my bloodwork is great

I have lost a solid 20 lbs and my bloodwork (after 3 months of eating your way) was even better! I was metabolically healthy (per your book) before I read your book, but barely. Lowering my weight, sealed the deal! I have been talking about you and your book to anyone who will listen...Thank you for all you’ve done and what you continue to do! You are changing lives for the better!

Missy Cramer
FatBurn Fix reader

Lost 20 lbs I could never shed

I love your Fatburn Fix!  Has helped me so so much!  I have had the dreaded weight all my life - 20 or so pounds I could never shed.  I have lost that now. I only eat 2 meals a day lunch and dinner with a glass of milk or cappuccino around 4 to hold me over. No snacking and not bad oils.  It has been the key to unlocking my fatburn.  I work out in the am and believe I am burning fat for energy not from food!

Lauren Smith

I feel great

My waist is four inches smaller. I feel great and many of the minor aches and pains that I had (knees and lower back) are gone. Also, my muscle tone is amazing, even though I have not increased my workout routine.

Richard Janelle
Completed Dr Cate's online course
Kent Matthes

The go-to for strength and conditioning coaches

Whenever I advise my clients about eating to perform I go straight to what I have learned from Dr. Cate. Her book Deep Nutrition has become the go-to for strength and conditioning coaches across the country.

Kent Matthes
Major League Baseball Agent with WME Sports
Ken D Berry

Dismantles the lie

Dr. Cate dismantles the lie that seed oils are healthy, which may the biggest lie about nutrition and health because it’s so insidious.  

Ken D Berry, MD
Author of Lies My Doctor Told Me
Dr. Drew Pinsky

She knows the chemistry

Dr. Cate alerts us to the harms of seed oils and she’s convincing because she knows the chemistry better than anyone.

Dr. Drew Pinskey, MD
Globally recognized internal medicine and addiction medicine specialist, media personality, LoveLine Host, and New York Times bestselling author
Kelly Starrett

No one is better at communicating nutritional truth

Dr. Cate has had the single greatest impact on how we talk to people about fueling for both performance or durability. While we all are a little unique, the foundational principles of human nutrition are immutable. If you are looking to create a more durable, resilient body, no one is better at communicating nutritional truth than Dr. Cate.

Dr. Kelly Starrett
Physiotherapist coach and New York Times and Wall Street Journal bestselling author
Brian Lenkzes

Highly recommend The Fatburn Fix

Dr. Shanahan has had a significant impact on my practice of medicine. I am known as a Low Carb Doctor, but I never really appreciated the negative effects of processed seed oils on the health of my patients. I highly recommend The Fatburn Fix to my patients and have a loaner copy in my waiting room. It is amazing how quickly blood sugars and overall health improves with cutting seed oils. It is not just about the carbs!

Dr. Brian Lenkzes, MD
CEO of LowCarbMD San Diego, co-host of Low Carb MD Podcast and host of Life's Best Medicine Podcast
Chris Kaman

Respected in the sports world

Dr. Cate reordered my diet when I was with the L.A. Lakers, and the benefits, for me personally, were felt immediately and have served me to this day. I’ve come to take real food so seriously I started a small family farm. I know of no M.D./nutritionist more respected in the sports world than Dr. Cate Shanahan.

Chris Kaman
NBA Player
Mark Sisson

Brought seed oil issue front and center

Cate brought the seed oil issue front and center. Healthy fats matter. So much so that I created an entire product line to swap out bad fats with good.

Mark Sisson
Founding Father of the Primal/Paleo Movement
Dallas Hartwig

Optimal health starts with food

If you want to understand how optimal health starts with food, start with Dr. Cate. Her book Deep Nutrition leaves you with an appreciation of the profound relationship between our genes and the planet, inspiring us to be good shepherds of both.

Dallas Hartwig
Attribution author of The Whole 30
Dwight Howard

Helped me with endurance

Deep Nutrition really helped me with endurance. I started to feel better as a player. I was able to run more, I was able to be more active …and I just decided to keep going with it to this day.

Dwight Howard
NBA Player
Paul Grewal

Silver bullet for me

Dr Cate’s teachings helped me lose 60 pounds like it was nothing. It was like a silver bullet for me.

Paul Grewal, MD 
Dr Grewal Internal Medicine, MD, author of Genius Foods
Joesph Mercola

Radically improve your health…

Dr. Shanahan has provided a solid reference that deserves a place in the library of anyone who is seriously interested in nutrition. Her perspective on the vital role that healthy fat has in our diet is novel and, if implemented, can radically improve your health.

Dr. Joseph Mercola
Author of Fat for Fuel and Founder of
Dave Aspery

Pull up a chair…

I have based my work on the idea that getting the right kinds of healthy fats into your body and avoiding the worst fats is essential to optimal health. I've interviewed dozens of the world's top experts about this, and I know of no one who speaks more eloquently on this topic than Dr Cate. If she’s talking fats, pull up a chair. Take notes.

Dave Asprey
Author of the Bulletproof Diet

The key to unlocking my fatburn

I love your Fatburn Fix!  Has helped me so so much!  I have had the dreaded weight all my life - 20 or so pounds I could never shed.  I have lost that now. I only eat 2 meals a day lunch and dinner with a glass of milk or cappuccino around 4 to hold me over. No snacking and not bad oils.  It has been the key to unlocking my fatburn.  

Lauren Smith

Saved my life

I would like to thank you for literally saving my life. Back in February, I had to be hospitalized while on vacation in Phoenix with an A1C of 11% and had to start taking 2 types of insulin and 2 other meds. I read the Fatburn Fix in April, and followed the program to a tee, and I’m down by 15 pounds, 6.8 A1C, and only one once weekly diabetes medicine. 

Leontyne Tompkins

> Tears of joy

 I'm crying tears of joy and appreciation for all you've done for me and my health! Without Deep Nutrition and Fatburn Fix, I would literally still be in the vicious cycle I'd been fighting all my life! In a nutshell - I am no longer a compulsive overeating addict suffering under the crushing 'thumb' of all food and alcohol.     

Penni Wicks


As a side note, but an important one, the degree of calorie restriction was equivalent to skipping a meal every day, or fasting every three days. Keep in mind that these fasting-related strategies may actually be easier and healthier because of the superior insulin-lowering and fat-burn promoting effects compared to the frequent small meals plus snacks strategy employed here.

Here’s the study summary:

Who: 24 overweight men and women with prediabetes and an average A1c of 6. (Nearly 200 possible study subjects were excluded due to metformin use, abnormal thyroid, triglycerides, LDL, or blood pressure, and a handful of other reasons.)

Diet composition: Lean meats and fish, vegetables, nuts, whole grains, fruits, legumes and margarine (yikes), in varying amounts depending on which group–see below:

High protein diet: 30% kcals protein, 40% kcals CHO, 30% kcals fat. So for the average participant on 1800 kcal, the high protein diet provided 180g of carb and 135g of protein,

High carb diet: 15% kcals protein, 55% kcals CHO, 30% kcals fat. For the average participant on 1800kcl,  the high carb diet provided 247.5g of carb. and 67.5g of protein.

Result highlights after the six month study period ended, better performing diet in green:

Weight loss (% of initial body weight)

High Carb: 11.3 | High Protein: 9.8

Lean Mass Change (% of initial body weight)

High Carb: -3.02 | High Protein: +2.55

Fat Mass Change (% of initial body weight)

High Carb: -3.55 | High Protein -2.49

A1c Change from Baseline  (%mmol/mol)

High Carb -0.2 | High Protein -0.54

HOMA IR Change from Baseline – Marker of Insulin Resistance (bigger drop is is better)

High Carb: -1.4 | High Protein -3.21

ISI – Marker of Insulin Sensitivity (bigger rise is better)

High Carb: +1.1 | High Protein +4.2

Triglyceride Change from Baseline (mg/dL)

High Carb: -11.4 | High Protein -69.4

LDL Change from Baseline (mg/dL)

High Carb: -4.3 | High Protein 23.0

Blood Pressure Change from Baseline (systolic/diastolic)

High Carb: -8/-7 | High Protein -14/-9

TNF alpha Change from Baseline (pg/mL) – Marker of inflammation

High Carb: -2.9 | High Protein -8.0

IL-6 Change from Baseline (pg/mL) – Marker of inflammation

High Carb -1.63 | High Protein: -4.02

Reactive Oxygen Species Change From Baseline (umol/L) – Marker of oxidative stress

High Carb -0.4 | High Protein: -1.3

A key marker that didn’t change much in either group: HDL

Here’s my take:

  1. Bariatric surgeons lose. Those bariatric surgeons who claim that only by doing a gastric bypass at the cost of $30K can one cure pre-diabetes can no longer legitimately make that claim.
  2. Calories count but there’s more to it. The fact that both groups lost weight shows that yes calories do count. But the kind of calories plays a big role in where the weight loss comes from.
  3. High carb + low cal is dangerous. The high carb group lost an alarming amount of lean mass, not specified if from bone, muscle or other organs but all are possible, even brain mass loss, and have been shown to decline in other studies.
  4. Protein supports lean tissue. The fact that the high protein group gained lean mass suggests they were possibly exercising more than the other group, which would be very interesting if that were the case. Another fascinating possible explanation is that the high protein intake at every meal stimulated muscle growth, per the predictions of Dr Leyman.
  5. Carbs keep LDL up. LDL barely budged in the high carb group, in spite of greater weight loss.
  6. Carbs promote insulin resistance. The markers of insulin sensitivity and resistance barely budged in the high carb group in spite of a degree of weight loss far in excess of the 5% that doctors promise patients will lead to improved health outcomes such as reduced risk of complications of insulin resistance.
  7. …Or maybe protein promotes insulin sensitivity? The high protein diet reduced both markers of oxidative stress quite impressively. Oxidative stress is controlled in part by antioxidant enzyme systems, which are composed of protein and amino acids.
  8. Vegetable oils damage HDL. HDL did not improve because the fats in the diet came primarily from refined vegetable oils, which damage lipoproteins and low HDL is the canary in the coal mine for damaged lipoproteins. If they’d used natural fat sources like butter instead of margarine, I think HDL would have improved more.
  9. The most interesting group went missing. If they’d included a third group with carbs at 100, protein at 80 and allowed the balance to come from natural fat, I think that would have been very interesting.

Both arms of this study are nothing like the diet that I recommend, being too high in carb and unnatural fat. Still, this offers testament to the fact that simply switching from overeating to restricting calories will bring some benefits, which is why we see so many diets out there that can legitimately claim to be healthier than the standard American 3000+ calorie diet.


“Remission of Pre­Diabetes to Normal Glucose Tolerance in Obese Adults With High Protein Versus High Carbohydrate Diet” Randomized Control Trial. Frankie B Stentz; Amy Brewer; Jim Wan; Channing Garber; Blake Daniels; Chris Sands; Abbas E Kitabchi BMJ Open Diabetes Res Care. 2016;4(1)

With over two decades of clinical experience and expertise in genetic and biochemical research, Dr. Cate can help you to reverse metabolic disease and reshape your body.

Please note: Please do not share personal medical information in a comment on our posts. It will be deleted due to HIPAA regulations.

This Post Has 0 Comments

Note: Please do not share personal information with a medical question in our comment section. Comments containing this content will be deleted due to HIPAA regulations.

Leave a Reply

Your email address will not be published. Required fields are marked *

Back To Top