PSMF meal plan: a sample day under 800 calories
This sample day uses four meals from the recipes page. It follows the intensive-phase rules in the Chang and Kashyap (2014) review of the Cleveland Clinic protocol: under 800 kcal, 1.5 g of protein per kg of ideal body weight, and under 20 g of carbohydrate, and no added fat. Clear it with your doctor first, and read the safety page.
Sample day
| Meal | Recipe | kcal | Protein (g) | Fat (g) | Carbs (g) |
|---|---|---|---|---|---|
| Breakfast | Scrambled eggs with spinach | 157 | 14.3 | 9.7 | 2.9 |
| Lunch | Lemon garlic chicken with broccoli (50 g broccoli) | 197 | 35.2 | 4.1 | 3.3 |
| Snack | Salmon with broccoli (no oil) | 176 | 22.6 | 6.7 | 6.6 |
| Dinner | Baked cod with zucchini | 198 | 38.0 | 2.0 | 6.2 |
| Total | 728 | 110 | 22.5 | 19.0 |
Every number comes from USDA FoodData Central. The recipes page lists the FDC ID for each ingredient. Drink at least 64 oz of fluid, and take the supplements your doctor prescribed.
The 110 g of protein is 1.5 g/kg for an ideal body weight of about 73 kg. Get your own target from the protein calculator and change the chicken and cod portions to match. Each 50 g of raw chicken breast changes protein by about 11 g and calories by 60. Each 50 g of raw cod changes protein by about 9 g and calories by 41.
The lunch uses 50 g of broccoli, less than the 150 g in the recipe, to keep the day under 20 g of carbohydrate. More vegetables add carbohydrate, so recount if you add more broccoli or swap in other vegetables.
Fat and gallstones
All the fat in this day comes from the protein foods. Each one stays under the protocol’s limit of 3 g of fat per ounce. Whole egg has about 2.7 g per ounce, wild salmon about 1.8 g, and chicken breast and cod less than 1 g.
The review says fat intake from protein foods on a PSMF, “though low (45–70 g/day), is considered high enough to allow adequate gallbladder contraction, thus decreasing the risk of gallstone formation.” It contrasts this with liquid formula diets under 10 g of fat a day, which have been linked to gallstones. This day has about 22.5 g. That is above 10 g but below the review’s range, because the lean protein foods that give this much protein under 800 calories carry little fat.
If you have had gallstones, or you are at higher risk of them, ask your doctor whether you should use fattier protein foods, such as 90% lean beef, more whole eggs or salmon. They raise fat and calories, so less room is left for protein. The review calls a history of gallstones a relative contraindication to a very-low-calorie diet.
Swaps
Other foods under 3 g of fat per ounce include turkey breast, shrimp, white fish such as tilapia or haddock, egg whites and nonfat Greek yogurt. Other low-starch vegetables include cauliflower, green beans, cucumber, mushrooms and peppers. Check labels and recount the day after any swap.