CALORIES IN; CALORIES OUT: WHY ENERGY BALANCE IS NOT THE ISSUE
Let’s face it. We have been told our entire lives that the reason we get fat is because we are eating too much and not exercising enough. The energy balance model has been the gold standard theory of obesity for a very long time. This has led to an epidemic of calorie restriction diets and a painful amount of running, aerobics and lifting weights. I grew up in a household where weight was an issue. I was a chubby kid. My mom was a chubby kid. I remember my mom being on an endless cycle of diets when I was young. My mom was very careful about foods with high amounts of sugar, artificial flavors and colors. A lot of that was because both my brother and I were diagnosed ADHD at a time when it was not the most popular diagnosis. We were strongly encouraged to get into sports to be active regularly. All of these things were not bad ideas. However, they were based on limited science. So where did this idea come from?
A little history on evolutionary biology. As humans were developing, long before agriculture. The availability of food was an issue. Hunter-gatherers would cover miles a day foraging and hunting for food. Sometimes they would go long periods of time without food. The body evolved to protect the species from dying by developing a way to store energy for future use. As we fast forward to the development of agriculture, we no longer had to cover miles of terrain to secure food. In addition to having food surpluses, we also had more leisure time. Looking at today’s society, we have more food choices than our ancestors could’ve imagined and spend more sedentary time than ever before. This is why it is very easy to say that lack of energy balance is the cause of obesity.
INCREASED PROSPERITY + HIGHER AMOUNT OF LEISURE TIME = OBESITY
The concept of calories in versus calories out being a recipe for weight loss has been around for a long time. It is based on the First Law of Thermodynamics, which states that energy can neither be created nor destroyed. A calorie is simply a measure of the amount of energy in food. The problem is that this is only true in a vacuum or a closed system. The human body is far from a vacuum. It is a system of systems. So, to say that obesity is an equation of inputs outweighing outputs is undeniably simplistic.
Add in the toxicity levels in our environment and we have a recipe for disaster. But is it really that simple? Let’s take a look at some paradoxes.
The Fat Louisa Paradox
In 1846 the indigenous people in the desert southwest were highly prosperous. They had food stores and lots of leisure time. Yet, they were described as tall, thin and in good health. By 1902, after being transported to reservations, the population was one of abject poverty. The was an epidemic of malnourishment in children. Infants were dying. As a mother stood holding her malnourished, dying child. It was noticed that the mother herself was obese and that was not a singular occurrence. Now as a mother myself, I would do ANYTHING for my children. If there was not enough food, I would die of starvation to make sure they were fed. So what was the cause of this obesity? Were these mothers feeding themselves to the detriment of their children? Unfortunately, this situation was mimicked in numerous other situations. Studies were done on:
Crow Creek Reservation, South Dakota 1928
Trinidad, 1961-1963.
Bantu pensioners in South Africa, 1964-65
Factory workers in Chile in the mid 1970’s
Mexican Americans in Starr County, Texas in the 1980s.
The one thing these communities had in common was abject poverty and little access to regular food. Every single one of these studies showed that even though they had nowhere near enough food. Greater than 60% of adults were obese. If calories in vs calories out creates obesity, why were these people overweight? Let’s take a look at some of what researchers have found.
“….Malnutrition and subnutrition are common disorders in the first two years of life in these areas, and account for almost 25 per cent of all admissions to pediatric wards in Jamaica. Subnutrition continues in early childhood to the early teens. Obesity begins to manifest itself in the female population from the 25th year of life and reaches enormous proportions from 30 onwards.”
~Rolf Richards at the University of the West Indies (1973)
This statement was echoed again in 2005.
“A few years ago, I was visiting a primary care clinic in the slums of Sao Paulo [Brazil]. The waiting room was full of mothers with thin, stunted young children, exhibiting the typical signs of chronic undernutrition. Their appearance, sadly, would surprise few who visit poor urban areas in the developing world. What might come as a surprise is that many of the mothers holding those under-nourished infants were themselves overweight… The coexistence of underweight and overweight poses a challenge to public health programs, since the aims of programs to reduce undernutrition are obviously in conflict with those for obesity prevention.”
~Benjamin Caballero, Johns Hopkins University
As research into the ongoing epidemic of obesity continued, the energy balance fallacy was central to the studies, yet the results were replicated again and again.
“Weight loss achieved in trials of calorie-restricted diets is “so small as to be clinically insignificant.”
~Cochrane Collaboration, 2002
“It is reasonable to assume that persons with relatively high daily energy expenditures would be less likely to gain weight over time, compared with those who have low energy expenditures. So far, data to support this hypothesis are not particularly compelling.”
~AHA/ACSM 2007, Physical activity guidelines
AND YET….
“When it comes to maintaining a healthy weight for a lifetime, the bottom line is – calories count! Weight management is all about balance – balancing the number of calories you consume with the number of calories your body uses or `burns off.’
The Centers for Disease Control, today
Well, no wonder we are all completely confused about how to fix this weight epidemic.
Let me show you in mathematical terms why maintaining a strict energy balance is impossible. If a man eats 2700 calories/day = 1,000,000 calories/year = 10,000,000 calories/decade.Remembering that 3500 calories= 1 pound of body weight. Now if you fudge on your food intake by 20 calories /day, Here is what happens:
(20*365*10)/3500=21 lbs/decade.
That is a required accuracy of 0.8%! I don’t know about you but I am not that committed to counting calories. The reason this concept of energy balance doesn’t work is because the human body is NOT a closed system. Additionally, there are many more factors that can affect obesity.
Obesity is not an energy balance disorder, it is a disorder of fat accumulation. In order to counteract obesity, you need to understand how and why the human body stores fat. Believe it or not, this information was discovered in 1929 in Vienna by Julius Bower. He found in his study that:
“Like a malignant tumor or like the fetus, the uterus or the breasts of a pregnant woman, the abnormal lipophilic tissue seizes on foodstuffs, even in the case of undernutrition. It maintains its stock, and may increase it independent of the requirements of the organism. A sort of anarchy exists; the adipose tissue lives for itself and does not fit into the precisely regulated management of the whole organism.”
So, what is it in our bodies that regulates fat storage? Fat is stored as triglycerides. Fatty acids are burned for fuel. Fat enters and exits fat cells as fatty acids. Inside the fat cell, fatty acids continually cycle into triglycerides and back out again. The primary regulator of fat metabolism is insulin. If you want to release fatty acids from your fat cells you need a deficiency of insulin in the body.
Now we are getting to the meat of the matter. If insulin causes fat storage and we need an insulin deficiency to burn fat, anything we eat that stimulates insulin production in the body will prevent fat metabolism. When insulin is secreted or chronically elevated, fat accumulates in the fat tissue. When insulin levels drop, fat escapes from the fat tissue and the fat deposits shrink.
We secrete insulin primarily in response to the carbohydrates in our diet.
“Carbohydrate is driving insulin is driving fat.”
George Cahill, 2005
We have to make the decision to feed our body and not our fat. The British Journal of Nutrition and even Dr. Spock in all 6 editions of his baby books stated that “The amount of plain, starchy foods (cereals, breads, potatoes) taken is what determines, in the case of most people, how much [weight] they gain or lose.”.
Getting back to Louisa. The reason the populations we discussed earlier were experiencing malnutrition, starvation and obesity in the same window is that animal protein and fresh vegetable were expensive in the market economy. The most abundant, economical source of food for those populations were high glycemic carbohydrates. This dependence on those sources of energy were starving the breastfeeding babies for nutrition and making the women obese.
In 1951, Raymond Greene published a Diet for Obesity in The Practice of Endocrinology
Foods to be avoided:
1. Bread, and everything else made with flour…
2. Cereals, including breakfast cereals and milk puddings
3. Potatoes and all other white root vegetables
4. Foods containing much sugar
5. All sweets…
You can eat as much as you like of the following foods:
1. Meat, fish, birds
2. All green vegetables
3. Eggs, dried or fresh
4. Cheese
5. Fruit…except bananas and grapes
His advice still stands true today.
This week try keeping a food diary of everything that you consume. Don’t forget to make notes about your mood at the time you are eating. Our mood is an important factor in the food choices that we make. Have an amazing week!
References:
Taubes, Gary; Good Calories; Bad Calories, 2007
CDC.gov
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