Why does Bill Gates have so much money?
Because he earned more money than he spent
Why did Basketball Team X win the big game?
They scored more points than Team Y.
“Goddamnit Pete, why are you fat?”
The typical answer is that more calories went in than out of Pete’s body.
The responses to these four questions aren’t technically wrong but... they’re not helpful.
Calorie counting may induce weight loss, but why would you care about that?
Losing 10 pounds is great, but wouldn’t you want to know where that 10 lbs came from?
Was it bone, muscle or fat?
Then, if it’s fat, which is what most of us want to lose, is it subcutaneous fat or
visceral fat?
Pediatric Endocrinologist Robert Lustig points out in his book “Fat Chance” that several
studies show that the amount of subcutaneous fat you have, the fat under your skin, correlates
with increased longevity; Whereas visceral fat, the fat around your organs that gives
you a big belly, promotes inflammation and causes several health detriments meaning the
difference between dying early in your fifties or living into your eighties or longer.
A pound of fat being 3500 calories is usually the piece of data we’re provided with to
help us create our weight loss goals.
For example if you create a deficit of 500 calories per day, then in a week you will
lose a pound of fat.
But why would the body choose to discard fat first when you restrict calories?
Decreasing your energy intake is interpreted by your body as you being in a situation where
less energy (food) is available.
Thus, it will do what it can to keep the stored energy it has and slow down processes that
spend energy.
Muscle is a relatively energy expensive tissue while one of fat’s functions is to serve
as a place for energy storage.
So the body would want to preserve the fat and break down the muscle, to conserve as
much energy as it can.
And that’s what it does.
Through a process called gluconeogenesis, “new glucose making,” muscle is broken
down into glucose which can be used for energy.
So now you have successfully reduced your weight by going into a caloric deficit, but
now it’s even harder to maintain a caloric deficit and lose more weight because your
resting energy expenditure is now less due to having lost muscle.
Jonathan Bailor points out in his book “The Calorie Myth” that
“Studies show that up to 70 percent of the nonwater weight lost when people are eating
less comes from burning muscle--not body fat.
Only after it's cannibalized this muscle will our body burn fat.”
So your calorie restrictive diet may actually reduce your weight as you intended, but the
weight isn’t necessarily coming off from where you’d like it to, and this whole process
becomes an uphill battle.
Restricting calories without modifying the composition of your diet will cause your body
to lower energy expenditure and increase hunger to provoke you to get back to your normal
energy intake.
“Eat less and exercise,” the typical advice for weight loss, is a strategy fueled mainly
by willpower.
Hunger and lowered energy expenditure is going to set you up to where the last thing your
body wants to do is exercise.
Alright, maybe it’s more simple to look at how people get too fat in the first place.
Surely to get fat, one has to eat too much.
But what causes that excessive eating?
We have very sensitive receptors in our body that let us know when it is too hot, too cold,
when we’re thirsty, et cetera.
What would cause someone to eat past the point of satiety so much and so frequently that
they become overweight or obese?
Of course small fluctuations in weight throughout the year is not unnatural.
But when people get significantly overweight or obese over time through overeating, surely
something is significantly wrong with the way their body processes food and the way
their hunger and satiety receptors work.
So what calories in calories out isn’t explaining is why some people’s bodies will just raise
energy expenditure in response to eating too much, keeping them thin while other people
get fat.
Just because you eat extra calories doesn’t mean they have to be stored, they could just
be burned off automatically.
The medical journal QJM reports, "Food in excess of immediate requirements...
can easily be disposed of, being burnt up and dissipated as heat.
Did this capacity not exist, obesity would be almost universal."
So why is it that obese people don’t automatically dispose of calories, experience intense lethargy,
and have voracious appetites despite having massive amounts of energy available in the
form of fat on their body?
What is particularly interesting about this is that the satiety hormone, Leptin, is secreted
by your fat cells.
So if we are to assume that a calorie is a calorie and the type of food you eat does
not have any peripheral effects...
like disrupting the hormonal environment of the body, then fat people should have less
of an appetite than leaner people.
We would need to assume that all overweight people have something like a gene defect that
screws up their hormones, leading to this dysfunctional situation where the brain is
constantly being told to eat more food despite having plenty of stored energy available on
the body.
Robert Lustig explains that only 2 percent of morbid obesity is explained by genes.
“Researchers worldwide have scanned the human genome and have identified thirty-two
genes that are associated with obesity in the general population.
Altogether, these genes explain a total of 9 percent of obesity.
And even if one person had every single bad gene variation, it would account for only
about 22 pounds--hardly enough to explain our current obesity pandemic.
”
So when people get fat, they are of course for some reason or another, taking in much
more calories than they need to.
But, their body for some reason chooses to use nearly all these extra calories for body
fat accumulation at the expense of muscle.
"And I always had it in my head that the morbidly obese were probably pretty well muscled underneath
all that because effectively they're lifting weights all the time.
But it's not the case - their muscles are extraordinarily atrophied.
Your external oblique muscle that ought to be y'know as thick as a piece of steak, in
these people it's paper thin and stretched to the point of bursting.
Because they are having nutrient partitioning that doesn't allow energy to go anywhere but
the body fat.
So they are literally starving inside an encasement of blubber."
A good example for understanding why the body uses calories in different ways is puberty:
During puberty, young men and women develop bigger appetites, and that extra energy is
put towards developing things like sex organs and making their bodies larger in general.
But young men put on a lot of muscle during this phase whereas young women put on more
fat.
You might attribute this to the fact that young men are more likely to play sports,
but the way fat is distributed is very different between the two genders.
Most guys are not gonna find their pants are getting tighter due to butt and hip fat.
This is the effect of several hormones, particularly one named insulin.
Insulin is an anabolic hormone- it’s known as the energy storage hormone, or sometimes
the “fat storage hormone” -one of its jobs is directing how the food you take in
will be stored.
And, puberty is associated with a higher than normal secretion of insulin.
A very clear illustration of insulin’s fat accumulation abilities is the side effect
some diabetes patients experience where they develop a mound of fat at the site where they
frequently inject their insulin.
This is called lipohypertrophy.
So understanding how food affects hormones would be better for weight management than
understanding how many calories are going in and out of your body.
Other than insulin, worthwhile hormones to look at are:
Leptin and Hormone sensitive lipase
Leptin is the satiety hormone - if you have higher leptin levels and your brain has no
problem reading these levels, then you feel “full”.
And, hormone sensitive lipase breaks down fat so it can be used for energy, this of
course is important if you want to lose body fat.
Researchers at the Veterans Affairs Palo Alto Health Care System genetically altered mice
so they could no longer make use of hormone sensitive lipase.
These mice ate more and gained 70 percent less than normal mice.
Completely independent of calories, altering the mice's hormones caused a drastic reduction
in body fat accumulation.
So the ideal situation is to have high levels of leptin so you are not hungry all the time,
and you would want lower levels of insulin so your body doesn’t store too much energy,
and you would want hormone sensitive lipase to be activated so it would break down body
fat.
Losing body fat while not being hungry would be the ideal situation, right?
The problem with calories in calories out is it doesn’t tell you anything about how
to achieve this preferred hormonal situation.
But, paying attention to how much of and what kinds of proteins, fats, and carbohydrates
are in your meals will tell you much more about how your hormones are going to respond.
This brings us to the next point: Is a calorie a calorie?
For a calorie to be a calorie, we would expect all foods to be processed in similar ways
in the body without having unique effects on our hormones or other biochemical processes.
But in the case of alcohol a calorie is clearly not a calorie as it has some interesting peripheral
effects due to the fact that 10% of the alcohol you ingest is metabolized in the brain, making
you drunk and 80% of it is metabolized in the liver, leading to liver disease and other
problems.
Another one is trans-fats, which are very different from other fats.
The synthetic nature of trans-fats doesn’t allow them to be broken down in your mitochondria
and they contribute to metabolic disease and atherosclerosis.
Proteins, get broken down into amino acids in the body, and the liver will use these
for either protein synthesis, i.e. muscle growth or convert them into either glucose
or fatty acids.
These processes though depend on your insulin levels, whether you have broken down muscle
tissue through exercise and how much glucose is stored in the form of glycogen in your
body.
And there are all kinds of amino acids, some that are essential and can only come from
the diet and some that are non-essential.
Fats on the other hand get broken down into free fatty acids and they will be processed
by your mitochondria for energy or stored in the muscle or stored in your fat tissue.
And there are several different types of fat, some good, some bad.
For example you have bad ones like trans fats we just talked about and you have fatty-acids
like DHA, which is theorized to be what allowed humans to evolve their big brains.
Glucose, the carbohydrate found in things like rice or starchy vegetables passes into
the bloodstream and then stimulates the pancreas to make insulin, allowing it to get into the
cell so that it can be burned up for energy or it may be stored as glycogen.
Depending on how much glycogen is already stored in the body and how quickly and how
much glucose is entering your system at one time, glucose may be stored as fat through
a process called de novo lipogenesis.
Keep in mind that fiber in vegetables is going to slow down the rate at which glucose is
processed.
So your body will react very differently to say 50g of glucose from white bread and 50g
of glucose from broccoli.
Now there’s another carbohydrate called fructose (or “frooooctose”) found in sweet
things like fruit, juice, honey or table sugar.
The tricky thing about table sugar, or sucrose, is it’s comprised of one molecule of glucose
and one molecule of fructose, yet glucose by itself is sometimes called sugar.
For example, blood sugar is synonymous with blood glucose.
However what I’m discussing is fructose, a molecule very different and much sweeter
than glucose.
Fructose is technically a carbohydrate but it is not necessary for any biochemical reaction
in the body, so almost all of it is processed in the liver.
The interesting thing about fructose is, among other negative effects like promoting the
development of fatty liver disease, is it causes insulin resistance, meaning the more
you eat sweet things, the more your pancreas will have to secrete insulin to get its job
done, leading to higher and higher insulin levels.
Fructose, by the way, is in 74% of all packaged foods in the form of added sugars.
If you’re trying to lose body fat, you’ll want to keep an eye on insulin.
When you have high levels of insulin, hormone sensitive lipase which breaks down fat for
energy, is much less active.
In this case, if you haven’t eaten for a couple hours you start to get really hungry
because you can’t actually use any of that fat on your body for energy.
So your body fat continues to stick around and you feel pretty crappy.
Another reason behind the hunger is that high levels of insulin block your brain from seeing
the leptin signal- you become resistant to leptin.
Leptin again, is the satiety hormone.
This how eating too many things, like packaged foods or refined carbohydrates, that spike
insulin levels can cause people to be hungry and lethargic despite having so much energy
stored on their body as fat.
So yes Pete is fat because he ate too much clearly, "I'm not fat!" but the reason he
ate too much has to do with his hormones.
A calore is a calorie in the way a gram of money is a gram of money.
A kilogram of one hundred dollar bills is going to affect your bank account much differently
than a kilogram of 1 yen Japanese coins.
For some people, calories have worked as a decent rule of thumb for them, but Tracking
the macronutrient composition of your food is going to give you much more insight into
how your food is affecting your body than just calories.
There’s still a lot more to be said about macronutrients, but you can notice their effects
pretty quickly if you pay attention.
Does a breakfast high in fructose and glucose like orange juice and a big bowl of cereal
with flavored yogurt leave you feeling hungry and tired by the time you get to work?
And does a meal high in good fat, protein and fiber like salmon, eggs and vegetables
make you feel any different?