Hey everyone it has been a while since I posted.
I have been running a few diet trials at my clinic and just thought I would give an update. Please feel free to comment and give me your two cents.

Out of 60 people that entered, nobody had worked with me before and most people were sedentary and over 50.

Average protein intake pre diet was 35g/day for women and 49/day for men.
Average Carb intake pre diet was 240g/day for women and 321g/day for men.

So I started everyone with a one week diet journal and then at 7 days I reviewed and got their stats for pre-diet numbers. This is slightly skewed because as they began to record their food they always make slightly better choices (what they think is better).

Week one goal: Protein at 1g/pound of LBW or if they didn't have a body fat test done I gave women the goal of 75g/day with the long term goal of 100g/day. Men were higher with 120g and a goal of 150g/day.

I teach them that protein does three things which I want them to be aware of:
1. triggers hormone release in the stomach causing pyloric sphincter to close and keep food in stomach while the acid breaks it down
2. triggers release of hormone which signals satiety center in hypothalamus (feeling of fullness)
3. triggers release of insulin.

I challenge them to all eat protein part of meal 1st.

After one week of this challenge I then teach them the difference between fiber and starch and challenge them with a goal of eating high quality carbs, high amounts of fibrous vegetables. I give them a goal of one serving of fruit, one serving of another carb (so two total servings) and two to three servings of fiber. My goals for them and the details are all spelled out of course and more attention to details are given. I customize the carb numbers for each person but mostly it is a challenge of 2 to three servings of 15g carbs per day.

Week three teaches the science and theories behind keto diet, intermittent fasting, and carb cycling.

The amount of teaching varies on the person and their knowledge and of course their goals.

The main focus of the whole diet though is to increase the protein, and always eat protein first.

Week four I gave them a workout program with two lifting sessions/week and two x 30 minute cardio per week but mostly just trying to get them active (most patients were very sedentary due to arthritis/joint problems in combination with obesity...

So that is a brief summary...

After 3 months the average weight loss was 2.3 pounds/week. Of the starting patients, 25/60 were surgical joint replacement candidates and of those 25, the ones that lost over 25 pounds opted to wait and postpone surgery as the weight loss and most likely the effects of a cleaner diet lowered the inflammation had lowered their pain levels significantly.

There are bigger stories to tell but those were the averages and basics of what I am doing at the clinic...
The goal of my program is to help my patients postpone or eliminate surgery as the only option, and give non-surgical patients who are obese or in great pain some relief with conservative management.

I know this was not a very organized abstract... I just wanted to share.

Thanks!