Updated: Mar 3, 2019
If you care about your health and are truly working to keep your weight down, then you need to know the truth about calories as well as the substances that distort how calories work in your body. Let’s face it, diet myths are abound in the health industry, especially the multi-billion dollar weight loss industry. Perhaps the biggest myths of all is the idea that you need to balance your calories in versus your calories out, otherwise called the energy balance theory. But are all calories created equal? Let’s discuss this concept.
The idea that the body works on a simple calories in versus calories out model is one of the most pervasive myths that I hear every day. The idea is that you just eat less, exercise more and you create a caloric deficit that causes you to lose weight (so in essence you give your body less fuel in and burn more out). Sounds logical right? But what if you fail to lose weight on this model? Does that mean that you lacked the will power to create that deficit over a long enough period of time?
Not so fast! While it sounds really, really rational it is not. But I will concede this, it sounds rational if you don’t understand how the human body actually works. So we need to discuss this before we go any further.
It’s true, the obesity epidemic threatens not only the health and longevity of a clear majority of people, and it also adds a tremendous burden to our health care system. So it makes sense to focus on these issues; why? Because the eight primary diseases related to metabolic dysfunction account for a staggering 75 percent of the healthcare costs in the US!
What is metabolic dysfunction? Well it refers to the way your body stops properly utilizing its energy systems to produce health. Its dysfunction leads to eight basic diseases which include: heart disease, cancer, lipid dysfunction, Type II diabetes, dementia, Non-alcoholic fatty liver disease (now affecting 1/3 of all Americans), hypertension and polycystic ovarian syndrome (affecting 10 percent of American women).
Four of these diseases (lipid dysfunction, hypertension, heart disease and type II diabetes) are conventionally associated with metabolic syndrome. However, as you can see, several other diseases fall within this scope as well. While obesity is associated with metabolic syndrome and all of these diseases, obesity is not the CAUSE of them; it is simply a marker for the disease. That means that it is an indicator of risk, not actually a disease.
So being overweight is not a death sentence but a marker of an increased risk factor for health issues later on, a wakeup call if you will. The underlying cause is metabolic dysfunction, and excessive sugar/processed carbs/fructose consumption is the primary driver of it.
It is interesting to note that 20% of obese people have perfectly normal metabolic functioning, and the excess weight will not affect their overall lifespan! That’s good news, but they are also more likely to be active too. Ditto for 60 percent of normal-weight people. However, the MAJORITY of obese people—about 80 percent of them—do not have normal metabolic function, and 40 percent of normal-weight people also suffer from metabolic dysfunction, and are therefore prone to these obesity-related diseases... All in all, metabolic dysfunction affects a clear majority of Americans.
With that in mind, it makes sense to want to keep your weight down but how do you do it? Well, the one thing that has contributed to the ever-worsening health of the Western world is the belief that "a calorie is a calorie." That weight loss is simply a mathematical equation. This is interestingly one of the first things dieticians learn in school, and so do medical doctors too. Unfortunately, this is completely FALSE...
First, it turns out that accurately calculating the calories outside of the equation is at best an awfully indirect science producing questionable results. I did my master’s thesis on this, so I have actually been touting this poor science approach to weight control for some time. Did you realize that there are dozens of formulae out there to predict metabolism? Yep, there are also dozens of formulae to predict body fat too, and depending on which formula you use, can change the outcomes considerably.
The Basal Metabolic Rate (BMR) formula is one of the most popular, it is used to determine how many calories we burn at rest. But the formula doesn’t account for muscle mass, which utilizes more calories than other body tissue at rest. Additionally, there is controversy about just how many calories a pound of muscle utilizes – some reputable scientists say that it burns 35, some say 10, my research found that the average pound of lean mass burns 16 calories per pound.
Since muscle is a part of the lean mass (about half) that would place my results in the 32-35 calories camp. Also, most methods used to measure muscle mass are fairly imprecise, or really expensive, so very few people have access to a correct measurement even if we could use that number to get an accurate BMR, which we can’t.
Besides which, a BMR-type calculation would only be reasonable if we were a car driving down a highway at exactly 55 miles per hour (or some other predetermined speed). We can calculate the fuel needs of that car because it is moving at a constant (giving variables for wind and other factors) and then have a reasonable expectation of how many miles it can go on a single gallon of gas, and what will happen when the fuel runs out if we don’t stop and gas up.
So, ready for a blinding flash of the obvious? Our bodies are not cars. The way that we utilize fuel (in the form of calories) and what happens when we run out is vastly different and extremely individualized and affected by all kinds of things including: height, genetics, sleep, stress, smoking/alcohol consumption, medications taken, illness, height, activity levels and menopause. If you think about it, our car is also not that precise on fuel consumption either. It depends if we are city driving, highway driving, and altitude driving or just too heavy on the acceleration. These are variables that affect the outcomes.
What concerns me is that semi-starvation diets are advocated based on the idea (really, the desperate hope) that a starved body will burn excess fat for fuel and thus you will lose weight. That’s not necessarily the case. Your body is really good at surviving. Its instinct is to preserve life, not to understand that the caloric deficit you just imparted upon it was specifically supposed to burn just the fat so you look and feel better. Unfortunately, it is not so good at fitting into your cultural ideal of beauty and frankly it does not care.
The body doesn’t think of calories as evil things that take it farther from an arbitrary standard of aesthetics, it thinks of calories as fuel to do its job, live, move. When you give your body less calories than it needs to perform its basic function it does not think “look how disciplined you are to underfeed me so that we can become smaller”. It thinks jiminy cricket, I’m starving myself because there must be a famine. I have to do something in order to survive!”
Yep, so let’s go back to the car example:
Let’s say I have a car that gets 20 miles to a gallon of gas. But I give my car a half gallon of gas to drive to work which is 20 miles away, it still gets the same mileage, but if I need to travel to my work, and that is 20 miles, no matter what I want, the car will stop after 10 miles. It doesn’t think, well I have to get ALL the way to work. It will simply stop working half-way through its given task. Now, if tomorrow I only give it 1/2 of the fuel it needs, I will run out of gas again, at about the same place. My car will never adapt to use less fuel, it just stops working.
So, if I give my body half the fuel that it needs for the day, and proceed to run on a treadmill, lift weights, go to work and then go dancing at night, my body, unlike my car doesn’t stop – it adapts. If I continue to underfeed my body while making physical demands it will likely drop weight at first while adapting to function on fewer calories, even if that means performing those functions (you know: thinking, breathing, heart beating, walking etc).
If I continue underfeeding for the long-term I will experience negative impacts. In other words, unlike my car which stops when I run out of gas, my body can literally cannibalize itself to keep going. But not just from fat, no-no. It will burn muscle, organ, some fat and the food it is given. It will also lower its metabolic function in certain areas of non-essential function, in order to survive, and it will increase its ability to absorb and store fat, so eating less does not necessarily mean I will store less.
But, if I decide to stop underfeeding my body, and go back to the comfort foods that people usually go back to, there is a good chance that my body will maintain its adapted lower metabolic level, and adapted increased ability to extract and store more fat from less food. At least for a while anyway. This will cause a rebound weight gain because I have lowered my metabolism to survive, lowered my metabolism to provide fuel (from muscle) to make up for the deficit. The body is just trying to survive – what it has learned is that it lives in an environment where sometimes starvation happens at the same time that massive physical labor is required, so it’s storing up fuel for the next starvation/high physical activity period.
If you continue to do this over time (as in the case of yo-yo dieting), then the damage to your metabolic rate, and your body’s functions can be severe. Don’t think so? Just look at the fluctuations of celebrities such as Opra Winfrey or Elizabeth Taylor, or some of today’s celebrities such as Christie Ally who struggle with weight, yet still take money from the weight loss companies to advertise their 90% failure programs. Elizabeth Taylor wrote two bestselling books on weight loss, she still got fat again!
Among the problems with counting calories is the extensive use of sugar, primarily in the form of high fructose corn syrup, which is added to virtually all processed foods. And this is where the fallacy of "a calorie is a calorie" comes into play, because a calorie from fat does not impact your body in the same way a calorie from fructose does.
Fructose is considered isocaloric but not isometabolic. This means you can have the same amount of calories from fructose or glucose, fructose and protein, or fructose and fat, but the metabolic effect will be entirely different despite the identical calorie count. Put it this way if you ate 1000 calories from carrots or 1000 calories from Twinkies, would the exact same thing happen in your body?
Of course not. This is largely because different nutrients provoke different hormonal responses, and those hormonal responses determine, among other things, how much fat you accumulate and what happens with your metabolism to deal with the breakdown of those foods. Now for something mind blowing. The fitter you are the more likely the body uses fat as a fuel source, but unfit people burn less fat per calories because they have not adapted in a positive way.
The average American consumes 1/3 a pound of sugar a day. That's five ounces or 150 grams, half of which is fructose, which is 300 percent more than the amount that will trigger biochemical havoc. And many Americans consume more than twice that amount! Thanks to work from researchers like Dr. Robert Lustig, as well as Dr. Richard Johnson, we now know that fructose:
Is metabolized differently from glucose, with the majority being turned directly into fat. That does not happen when you eat the equivalent in carrots.
Fructose also tricks your body into gaining weight by fooling your metabolism, as it turns off your body's appetite-control system. Fructose does not appropriately stimulate insulin, which in turn does not suppress ghrelin (the "hunger hormone") and doesn't stimulate leptin (the "satiety hormone"), which together result in your eating more and developing insulin resistance.
Fructose also rapidly leads to weight gain and abdominal obesity ("beer belly"), decreased HDL, increased LDL, elevated triglycerides, elevated blood sugar, and high blood pressure—i.e., classic metabolic syndrome. The equivalent does not happen when you eat the equivalent in carrots.
Over time all that sugar leads to insulin resistance, which is not only an underlying factor of type 2 diabetes and heart disease, but also many cancers.
This is why the idea that you can lose weight by counting calories simply doesn't work. After fructose, other sugars and grains are likely the most excessively consumed food that promotes weight gain and chronic disease. This also includes food items that are typically viewed as healthy, such as fruit juice or even large amounts of high fructose fruits.
What needs to be understood is that when consumed in large amounts, these items will also adversely affect your insulin, which is a crucially potent fat regulator. So yes, drinking large amounts of fruit juice on a daily basis can contribute to weight gain... In short, you do not get fat because you eat too many calories and don't exercise enough. You get fat because you eat the wrong kind of calories. As long as you keep eating fructose and grains, you're programming your body to create and store fat.
And all that doesn’t even touch the psychological toll that underfeeding your body takes on you. In the Minnesota Semi-Starvation Study participants who were restricted to 1,560 calories per day for 12 weeks experienced depression (up to and including serious self-mutilation), hysteria, marked food preoccupation, disordered eating patterns, guilt about eating, declines in physiological processes, concentration, comprehension and judgment, and a 40% drop in BMR. For many the disordered eating continued for 5 months or more after the study was concluded.
So while semi-starvation (also known as dieting) seems like a reasonable weight loss technique if you still believe in the calories in versus calories out equation after the above information, let’s look at it more scientifically. To begin, let’s look at the principles of validity and reliability which are the fundamental cornerstones of the scientific method.
Reliability of Methodology
Is the method valid? Well, the fact that I can’t accurately calculate how many calories my body needs to survive, or will expend or predict how my body will respond to prolonged starvation makes this methodology invalid.
Validity of Methodology
Basic biology tells us that 1kg of pure fat, converted to energy = 9000 kcal, 1lb pure fat = 0.453 kg = 4077 kcal. Theapproximation to 3500 kcal is made on the basis that adipose tissue is not 100% fat (it has some water and other tissue). So let me get this right, we made an assumption in the numbers? Huh, so we gave it a good old SWAG, nice.
So, to lose 1lb pure fat = 4077 kcal deficit, or 1lb fat tissue in the body = approx 3500kcal deficit. This equates to 500kcal per day to lose 1lb of fat in a week. They say that this has been supported by numerous studies using whole body calorimetry. Only there are no valid sources put forward, for these “numerous studies”.
To further this proposition, I looked at 15 other studies of which had data for where a specific calorie deficit had been created over a specified period of time and thus should equate to a specific weight loss if the science and the math were valid. So, using the 3,500 formula quoted by everyone, and what the average weight loss actually was (from the study data) we should have been able to determine an exact amount if the studies were properly controlled.
But, in every single study, there was a wide range of results (which means that the formula failed). In all of the other ten studies, the actual weight loss was multiples away from what the weight loss should have been. The smallest gap between actual weight loss and ‘should have happened’ weight loss (according to the formula) was 28.7 pounds (we continue to ignore water to try to give the formula a chance).
At the other extreme, the biggest difference between the fat that should have been lost and the fat that was lost was 143.9 pounds. Fact is, when you put a pound of fat in a bomb calorimeter, it does not generate 3,500 calories (kcals), period, so the validity of the method, both in scientific study and outcome study fails.
Let’s look at it from a simple math equation. If I ate 500 calories too much every day, the margin of error in a couple of yogurts, in one week I would gain a pound right? Ok, if we agree with that premise, in 52 weeks I would gain 52 pounds and in 10 years I would be 520 pounds heavier! The math does not work! It also works badly the other way. Let’s say I weigh 200 pounds and eat 500 calories less per day. In one year I would be 148 pounds, but by year two, I would weigh only 96 pounds and by the third year less than 50 pounds. We’re not even going to go a fourth year because to point out the obvious is, well, obvious.
Probability of Success
Ok, so let’s look at outcomes based on the science and the literature. The use of caloric deficit has a success rate of 5% over 5 years –is that success rate ok for you? I mean let’s flip that number and call it a 95% failure rate. Weight Watchers in 1993 was slightly better, it was 6%. In 2001 Weight Watchers amended those numbers to a higher number but took their date from non-obese populations who only needed to lose 10 pounds, so I am not including those rates of success because those numbers are too small to compare.
Acceptability of Risks
OK, so what’s the risk? Well, if the research is correct and the math is correct, after five years you will gain more weight than you had at the beginning of your diet! Your risk factor for disease would have increased not decreased. Perhaps the surgeon General should place a warning on all diets alerting people to the fact that dieting is more hazardous to your health than staying overweight!
Calorie restriction diets, can increase the stress hormone known as cortisol. When this hormone is present in your body over long periods of time, it can have myriad negative health effects. In fact, it can even increase your risk of developing heart disease, cancer and diabetes.
Obviously there are several other health issues associated with weight gain, among them includes heart disease,cancer, and diabetes.
So, your idea that an energy balance (thermodynamic) diet will cause weight loss is accurate but only in the short run. In the long term it will create unacceptable health risks. Are you okay with that?
There is not a single study in the literature in which the majority of people maintained weight loss long term, and there is definitely not a study wherein the majority of people maintained a BMI-changing amount of weight loss long term. There are plenty of studies that show that restricting calories for weight loss almost never works.
Next time you watch a weight loss add on television, make sure you note the small print at the bottom of the screen, the part where they state “Results not typical”. It is true that you can initially lose 5 to 10 percent of your weight on any number of diets, but if you look at the facts, it is mostly water weight, lean muscle and a little fat. What good is a diet where at its completion the weight to come back? If a majority of people regain all the weight, plus more, is that worth the effort and the risk of disease? Fact: Diets do not lead to sustained weight loss or health benefits for the majority of people… In addition, most studies do not provide consistent evidence that dieting results in significant health improvements, regardless of weight change.
In summary, there is little support for the notion that diets lead to lasting weight loss or health benefits. Furthermore, long-term follow-up data is hard to find, the data that does exist suggest almost complete relapse after a 3-5yr period. The paucity of data provided by the weight-loss industry has been inadequate or inconclusive.
Consider the Women’s Health Initiative, the largest and longest randomized, controlled dietary intervention clinical trial, designed to test the current recommendations. More than 20,000 women maintained a low-fat diet, reportedly reducing their calorie intake by an average of 360 calories per day and significantly increasing their activity. After almost eight years on this diet, there was almost no change in weight from starting point (a loss of 0.1 kg), and average waist circumference, which is a measure of abdominal fat, had increased (0.3 cm). The conclusion? They said that the data suggest that for many adolescents, dieting to control weight is not only ineffective, it may actually promote weight gain.
So diets, the way we have been taught anyway do not work in the long run and appear to actually increase your risk of obesity in the long-term. So what is the solution?
I believe there are three primary recommendations that, if widely implemented, could help reverse our current disease trend and reduce obesity in the US. These are:
Severely restrict carbohydrates (sugars, fructose, and grains)
Increasing healthy fat consumption
Exercise to promote muscular endurance (peak 8 and strength training).
While health authorities insist that sugar is fine "in moderation," and that grains are an essential part of a healthy diet and can actually help you prevent heart disease, they fail to take into consideration that fructose is the NUMBER ONE source of calories in the US. It’s an ingredient that is found in virtually all processed foods cannot be considered "moderate." Even most infant formulas contain the sugar equivalent of one can of Coca-Cola, which helps explain how six-month old babies can be obese.
Also, refined carbohydrates (breakfast cereals, bagels, waffles etc) quickly breaks down to sugar, increase your insulin levels, and cause insulin resistance, which is the number one underlying factor of nearly every chronic disease known to man, including heart disease.
If you have these things in your diet you will have a hard time losing weight, no matter how hard you try. And remember, when you stop the dieting, your weight will rebound and your risk factor for disease will increase.
Remember from past blogs that fats in general used to be considered the dietary villains, especially saturated fat, which many people still claim will increase your risk of heart attacks and cardiovascular disease (dieticians and doctors). However, this is simply untrue. The only really dangerous fat out there is trans-fat (margarine, vegetable oils). Saturated fats are actually vital for optimal health. Yep vital, they are building blocks for cell membranes, moderators of genetic regulation, needed for hormones to work properly, important for the absorption of fat-soluble vitamins such as vitamins A,D,E and K, and they help absorb minerals too. Eating low fat actually places you at higher risk of disease, since it cuts down vitamin absorption!
So, there you have it, caloric restriction does not work! You cannot lose weight unless you modify your diet and you need to exercise. Pretty simply huh?