protein diets that are high in carbohydrates have been found to decrease glucose tolerance in cats. With a decreased glucose tolerance, clinical observations have confirmed that cats consuming large proportions of metabolizable energy, in the form of carbohydrates rather than protein, are more likely to develop hyperglycemia, hyperinsulinemia, insulin resistance, and obesity. Restricting phosphorus has been proven to decrease the progression of CKD. This is because phosphorus can be deposited into soft tissues and become mineralized, which can cause kidney damage. Formulating these diets with higher amounts of fat is important to make sure the food is palatable in the absence of protein and promote an increased caloric intake. The higher fat content will also spare the use of protein for energy and help decrease stress on the kidneys. Omega-3 fatty acids are included in therapeutic diets because of their anti-inflammatory properties to aid the diseased kidneys. High energy A high energy diet is generally high in fat. Compared to carbohydrates and protein, fat provides much more energy, at 8.5 kcal/g. High energy diets generally have a fat content greater than 20% on a dry matter basis. A high energy diet is appropriate for cats who are undergoing growth, recovering from illness, are pregnant or lactating, as their energy requirements are higher than otherwise. A lactating or gestating cat requires a nutrient-dense and highly digestible diet to withstand the high levels of stress being placed on her body. These conditions are found in cat food that is formulated for growth, performance, or high energy during all life stages. To maintain a neutral energy balance and thus maintain body weight, energy intake should increase with energy expenditure. Studies that relate the number of meals offered to cats per day to their daily activity levels have shown conflicting results. It has been shown that cats offered four meals a day or a random number of meals a day have similar energy levels, greater than those fed only one meal per day. It has been postulated that this increased energy level could be due to purported spikes in activity before being fed, known as food anticipatory activity. Other studies on female cats have found that increasing the daily amount of food may actually decrease their daily activity levels. The age, sex, and whether cats are intact or have been spayed/neutered are all factors controlling activity level. As cats age, there is evidence that