Calorie Myths

Should We Replace the Calorie System for Weight Loss?
Calories may not be an adequate way to represent the energy we need or would store. We all know people who eat little but stay heavy, and those who eat loads of junk food but are as skinny as a rail. How can that be? Are the heavy ones sneaking excess calories (maybe) – are the skinny ones with nervous energy just have a higher metabolism (whatever that means – and maybe they do).

So here are six common myths about calories and a few simple eating rules for eating.

Myth: Calories provide our Energy
Calories are not what provide the energy to fuel our body’s metabolism. Our metabolism is fueled by complex chemical reactions and energy is obtained by breaking molecular bonds of chemicals like adenosine triphosphate. A calorie is not a biology/biochemistry term, but a term mechanical engineers first used and adopted by physics.  The technical term of a calorie is this: one calorie is the amount of heat needed to heat one gram of water one degree Celsius. The calories we use are kilocalories- so multiply that by a thousand.

So calories don’t provide energy but are a measurement of the potential energy in a food.

Caloric History –
Bridging caloric physics to biology is largely credited to Wilber Olin Atwater (1844-1907), who applied the first law of thermodynamics to food: energy can be transformed, but it cannot be created or destroyed.  With that he began the use of the term of calories to food – and started measuring how food affected people, by measuring their conversions of oxygen to carbon dioxide and the calories of food. Atwater concluded that people ate too many sweets and fats and didn’t exercise enough.

Using this equipment Atwater was able to determine the relative input of food and exercise

In the early years of determining calories they would put food into a machine called a “bomb calorimeter” burn it- and see how much energy the food contained. This process has been refined, so that we know one gram of carbohydrates has four calories, one gram of protein has four calories, one gram of alcohol has seven calories, and one gram of fat has nine calories.

Myth: A calorie is a calorie
It doesn’t matter how many calories you consume, it matters what your body does with them. Your body will process those 100-calorie snacks differently than 100 calories of beef, or 100 calories of fish.

Your body cannot store protein, so when you need protein to rebuild cells, or after some muscle breakdown, it relies on your diet to get it. The various proteins are broken down in the intestines into amino acids – and your body has no idea if those amino acids came from a plant or beef. So the calories that are available in protein may not be available for energy, but instead used for building. Protein beyond that which is needed for the body’s function can be broken down and used by the body, and if too much of it is available it will be stored as fat.

Many fish are rich in calorie dense fatty acids, but your body cannot make these, so it relies on your diet to get them. Thus, the calories that are available from omega-3 fatty acids may never be used as energy, or stored as fat, because your body will be using them to build various functions.

Fructose, in its refined form, is passively absorbed by the intestines and about 1/3 of it becomes fat.  Doesn’t matter how much your body needs the fuel, one third of all fructose consumed is processed into fat.

Graph from showing the different pathways of glucose Gand fructose

Myth: Low levels of Glucose are good for you
There is an ideal range for blood glucose levels- too low or too high and you won’t function.  Glucose is important to the body because  every cell in your body needs glucose to function, from the brain to the muscles. Glucose is the currency your body uses to provide energy. Glucose is so important that your body actively absorbs glucose from the intestines to the bloodstream using specialized glucose transport cells. As your body breaks down food into is basic components in the intestine, when a  molecule of glucose is available the glucose is actively transported from the intestine to the bloodstream where it can be used as fuel.

Fructose, in contrast, cannot be used by the human body as fuel. Fructose has to be changed into other products. Fructose is passively absorbed in the intestines – which means if there is a lot of fructose present, it is absorbed into your bloodstream from the intestines. Fructose in fruit, is complexed  with the fiber, and the fiber cannot be absorbed – so you eat the 100 calories of fruit your body cannot absorb the fructose that isn’t free from the fiber. But drink 100 calories of juice, which has a lot of free fructose, and chances are you will get all of the fructose and 1/3 will go down the fatty-acid pathway.

Common table sugar is made up of 1/2 fructose and 1/2 glucose. The high fructose corn syrup used to sweeten juices, soda, cookies, and many breads is higher in fructose than glucose. We recently wrote about the health risks of high fructose corn syrup.

The 100-calorie snacks are typically highly processed cookies, or snacks, and the processed sugar is broken down and quickly absorbed by the body and your body will store that excess as fat.

Calories Don’t Matter if Your Body Can’t Use Them or Get to Them
People cannot digest the cell walls of plants, like fruits and vegetables. This means humans cannot get at those calories without cooking or mechanically breaking down those cell walls. Raw foodies take advantage of this, unable to get most of the calories from vegetables and fruits; they are able to consume large amounts of calories and still lose weight.

Myth: Exercise burns calories
A patient came to me having gained a few pounds over a month and said, “I know for a fact that I exercise 1900 calories a day.” That is impressive, so I asked how he did it- he said that he used an elliptical machine for 45 minutes a day, and the calories he used were based on what the dials on the elliptical machine said. Funny thing – look at those machines or those iPhone apps and they tell you that you are burning hundreds of calories a day – but they are not only inaccurate, they are misleading.

The average male burns a bit over 2000 calories a day- and if you work out for an hour a day you will probably only burn another 100 calories in an  hour. Discouraged? Don’t be. The majority of your calories are burned by your heart pumping, your lungs breathing, your brain thinking. Plus all those things you do during the day matter. The more involved you are in what you do, and increasing your activity, the better you will feel and the less likely you will be to waste calories on crummy food.

The easiest way to increase what you burn is to increase the things you do daily. Remember when you were a kid, and you were always on the go? It is time to get that spirit back- walk more, play more, have more fun- get out of that chair and off the couch. That will burn more exercise than going to the gym and watching your friends work out. You know that tiny lawn you have- get a push lawnmower and use that.

Exercise is good – it is empowering, it gets you out of the house.  Get a Nike Fuelband or some monitor, and use it – plan to exceed your daily activity until you get to an average of 10,000 steps a day.


Just Do It

Myth: The reason you are not loosing weight is you are not eating enough

Fred weighed 400 pounds, and he decided to get a Lap-Band to help him lose weight. He hit a plateau after 18 months when he weighed 250 pounds, so he asked me, if he needed to eat more to lose weight.  My answer is, “Yes, it needs to be more fruit and more vegetables- not processed. What it does not need to be is yogurt, cheese, or nuts.”

Fred was eating a lot less food, less than he had in years, but it was still enough to sustain his weight at 250 pounds (he wanted to get to 190 pounds). It was a combination of not just how much he ate, but also when he ate.

If you eat all of your calories at one time your body has to decide to do with the excess fuel. Does it store it, or does it burn it. Sometimes it isn’t that you are not eating enough – sometimes it is that you need to spread that same amount of calories throughout the day.

it isn’t just how much you eat – it is also when you eat and what you eat that determines your health

Myth: It isn’t the calories it is the insulin response to calories
This popular theory goes like this: you eat too many carbohydrates, the insulin level spike, store that as fat while stimulating the fat to store yet more fat and drive a person to eat more simple carbohydrates. People like the simplicity often pontificate that we should eat our calories from protein – be they Paleo, Atkins, low-carb types, or proponents of the glycemic index. People who previously ate a lot of processed food and move into more protein will lose weight – but the body isn’t just that simple.

But the body is even more complex than that – and measurements taken are not insulin levels, but often glucose levels in response to what is believed to be insulin.

Some people just are lucky
Did you ever meet someone who could eat huge amounts of food and never gain an ounce? They can eat junk food, or violate every “rule” and yet not gain a bit. They are just burners.

So they can consume 5000 calories and yet look great – while you have ice cream every night for a week and come away with an extra pound.

Think of people like cars.  Some cars are very efficient at burning gas – the Toyota Prius, Honda Civic – they are like the skinny little friends who eat lots of junk food while looking slim.  Some cars are gas-guzzlers – they are larger, don’t look as sleek – that is like many people. Both get the same amount of gasoline, but they use it differently.

Calories are Still Pretty Good for measuring
Overall, as we demonstrated with the beer and sausage diet as well as the eggs and beer diet – when you cut down on the number of calories you consume, you will loose weight. While there are some clear exceptions, the body isn’t simple, and the use of calories as a measurement of what you consume works out pretty well.

A few simple rules:

(1) Eat lots of fruit and vegetables.

(2) Lean meats are just fine

(3) Have fish twice a week

(4) Make sure you have nutrient rich foods

(5) Increase your daily activity – walk more, get up more – use that nervous energy

And if you think a lettuce wrap is better for you than bread – you are missing the point.



Here are some older references that I found -

Atwater, W. O. (1895). Methods and Results of Investigations on the Chemistry and Economy of Food. Bulletin 21, U.S. Department of Agriculture, Office of Experiment Stations, Government Printing Office, Washington, D.C.

Atwater, W. O., and Rosa, E. B. (1899). Description of a New Respiration Calorimeter and Experiments on the Conservation of Energy in the Human Body, Bulletin 63, U.S. Department of Agriculture, Office of Experiment Stations, Government Printing Office, Washington, D.C.

Atwater, W. O., and Benedict, F. G. (1905). A Respiration Calorimeter with Appliances for the Direct Determination of Oxygen, Carnegie Institute of Washington, Washington, D.C.

Obesity and Patients

Obesity and Patients
This is probably one of the best videos that I have seen recently about the causes of obesity and how we treat our patients. It is something that we physicians must remind ourselves of constantly: to treat patients with compassion and empathy.

But the second message is also important: we don’t know what causes obesity – and the old thoughts about eating too much are no longer valid. We do know this, it isn’t what you eat, it is how your body processes the food. Too much processed grains, sugars, carbohydrates – are not good – and moving away from a diet of those will be important to the lifestyle change any who wish to lose weight and keep it off will have.

If you wish to lose weight, we know that you must change what you eat. The one thing all experts agree upon now is this: avoiding processed grains and free sugars. Both plant strong diets, and paleo diets preach this. It isn’t just calories.

So the first step for many of my patients is this: learn to cook – and for me- this is the mission for all of my patients. And we like it when they start young.

JJ and the kitchen

Starting kids early – learning to cook, appreciating good food- is one of the best starts you can do for your family

What is Really in Juice Concentrate

When you buy juice and it says it contains orange juice, or any other juice in it- you probably think of it this way:

When you think of concentrated Orange juice you probably think about something like this

But if you thought more about it you would realize that to make juice you really don’t want the peel of the orange- or the peel of most fruits because they are bitter and not so sweet.

But if you thought about it you realize they would reasonably get rid of the peel and they do

Then if you peel an orange you see underneath the peel there is some pulp and unless the juice has added this back in, most of the time you think is that this material will have to be removed, because if you taste this- it is also kind of bitter and chewy:

Under the peel of the orange is some bitter pulp and in most juices you don’t want to have this

So when you really think about orange juice, or any juice- you think of the meaty part of the fruit- the tasty stuff and when you think of that you think this must be the stuff they make the concentrate from:

The beautiful inside of an orange – this must be what they put into the concentrate.

But then you think again, and realize that they have to squeeze the juice out of that. So you have juice. But that it isn’t really concentrated so what they have to do is some method to make the juice concentrated. So you imagine it looks something like you would see in a frozen can of juice – and would look like that.

But that isn’t what the companies do. What they do is they take that concentrate and they break it down further and make it into a powder that they can easily add to the other powders and ingredients that they make then bottle and sell you as juice. What does that look like?

Sugar – its just sugar

What they do is simply extract the sugar, and this means what you are drinking is a product from some oranges, or grapes, or whatever juice they say. It is just another excuse to give you more sugar, so you can buy more juice.

So next time you want some juice- remember – it probably isn’t really anything more than flavoring, coloring, and sugar. You want juice – get the fruits or vegetables and do it yourself because otherwise what you are eating is just junk food, and you are just fooling yourself.