Do Calories Count Or Not?

NOTE: I originally posted this in a thread over at Marksdailyapple.com.

Calories surely count – but you may lose weight without counting them. 
I won’t simply say that they count for some people, but not for others – that kind of answer is totally meaningless. I’d rather say that whether you’re going to lose weight – or more specifically, fat – depends on many factors. It depends on who you are, how old you are, what your lifestyle is, and what you’re eating, and how much you’re eating, and any other factors that I may not be thinking of right now. When you compare your situation to that of any arbitrary other person, you may very well observe the phenomenon that you have to count calories to lose weight, but the other person doesn’t. One obvious example would be that the other person doesn’t like junk food and leads a very active life, while you’re addicted to junk food and are quite sedentary. Now, I’d like to point out that I read Taubes’ books and I’m very well aware of the fact that those might be consequences rather than actual causes, but regardless, the point is that due to factors other than caloric intake, there might be persons who are prone to overeat unless they’re counting calories, and others who can manage to not overeat without counting calories. And that consideration includes differences in activity levels. For example, a person could eat a lot more than another person and thus seem to be overeating, but compensate it by burning off these calories. Only a week ago I heard Taubes himself talking about Dr. Oz and how he seems to be a person who more readily converts consumed calories into energy (activity) than others.
I think that some of us (including yours truly) need to keep an eye on caloric intake. People who claim that calories generally don’t count may have made the mistake of not accounting for all the variables. Maybe they managed to lose fat without counting calories – but that doesn’t mean that they didn’t restrict their caloric intake, or that there couldn’t have been other contributing factors which may or may not be present in other people.
Personally I’ve become a bit sceptical of the low-carb message in that it makes some promises which don’t hold for all people who follow it, and there are some claims made by its supporters which have been disproved. But I still think that it’s the healthiest choice for most people who have become overweight on a high-carb diet. Sure, this is also just a correlation and something other than the carbs could have been responsible for the weight gain. But when an obese person goes from high-carb to low-carb and then not only loses a lot of fat but also feels much better without being constantly hungry – I think that even without ever bothering about the actual science we can tell that person to keep doing what they’re doing. And if you find that merely switching from high-carb to low-carb doesn’t work and that you also need to count calories – well, maybe you’re simply not as good in eating in moderation than others. I know that it’s definitely one of my weaknesses.
Advertisements

Missing the Forest for the Trees

Over the last couple of weeks I’ve read a lot of health and nutrition related blogs and discussions out there which are investigating the hypotheses surrounding low-carb in excruciating detail. The following are some of the main areas of contention:
  • Is low-carb healthy?
  • How does low-carb work – by lowering insulin or by reducing caloric intake?
  • Which fats should you eat/Is saturated fat healthy?
Ok, I could go on, but you get the idea. The problem is that in most blogs whenever it comes to topics like that, people will start making elaborate posts that cite studies left and right, and quickly get to a level where it becomes next to impossible for the lay(wo)man to follow the discussion, let alone join it.
That got me thinking about how I’ll be going about with this blog. Am I going to spend hours on posts which reference dozens of studies, talk about levels of hormones and so forth? Nah – there are many bloggers out there who are much better at that than I could ever hope to be. For example, check out Healthy Skeptic.
What I’m going to do is, hopefully, to give summaries of new developments, with my two cents of common sense (with a sprinkling of skepticism) added to it.  And to get the whole thing rolling, I’ll give some quick comments on the topics I listed above. Enjoy!


Is low-carb healthy?

Sure. There are well documented societies that traditionally eat few carbs and suffer no ill consequences. A typical example are the Inuit. Could they be a genetic exception? Probably not. The thing is that when those societies are exposed to Western nutritional concepts (read: starches, sugars), they get the same problems like we do. If they were genetically so different from us that they thrive on low-carb and we don’t, how come that they react to our diet similarly to us? This is not a logical proof – it just shows that it’s not likely.
And there’s also the argument from our evolutionary history. Without going into too much detail: 100,000+ years ago we didn’t have ways to conserve food during winter. Even if you imagine an ice age as extended periods with harsh winters and not full blown artic conditions, our ancestors had to survive for months without any carbs. And when we look at what happens on a low carb diet, indeed we find that our body has mechanisms to adapt – ketosis and gluconeogenesis being the most important ones. Most of our tissue can adapt to burning ketone bodies for fuel instead of glucose (ketone bodies are made by the liver when we starve or consume very little carbohydrate for an extended period of time), and for those cells which need glucose our liver can convert protein and fat into glucose.

How does low-carb work – by lowering insulin or by reducing caloric intake?

This is a huge issue at the moment. In the previous post I comment on Gary Taubes vs. CarbSane – Taubes’s two books are based on “carbohydrate drives insulin drives fat” mantra, while CarbSane, joined by James Krieger, say that at the end of the day low-carb simply works because people involuntarily eat less on a low-carb diet, which is in part due to the satiating effects of protein and fat.
My opinion: It may be a little bit of both. First of all: the people which need to lose a lot of fat are often metabolically different from lean people. They are typically insulin resistant, and even many of those who criticise Taubes would agree that those people may react unfavorably to excessive carbohydrate, and reducing it might be instrumental in normalizing their metabolism – particularly when they’re even diabetic. But independently of all that, on top of it there’s the effect on satiation – and it even gets better. Carbohydrate and sugar are also addictive substances – that’s where the expression “sweet tooth” comes from.
So we have a three-pronged argumentation pro low-carb:
  1. Metabolism is normalized in insulin resistant persons
  2. Caloric intake is reduced
  3. Carbohydrate/sugar cravings are curbed
Now: Does it really matter so much how 1) is accomplished on the level of hormones and lipids? My beef (pun intended) with Taubes’s books is that he makes it look like the mechanism is simply “carbs -> insulin -> fat”, and since this is a gros oversimplification and essentially false, that undermines his position and essentially does low-carb a disservice.

Which fats should you eat/Is saturated fat healthy?

This is a tough one. Saturated fat gets a lot of flak from many camps, including the paleo camp and conventional wisdom. Paleo guys (with the exception of Mark Sisson and Dr. Kurt Harris) don’t like saturated fat because they claim that our ancestors ate very little saturated fat – apparently wild game doesn’t contain a lot of it. But remembering the argument from the first topic about our ancestors and ice ages, that doesn’t convince me. What did we eat in the winter? Game. Or bigger animals, but no matter which ones we ate, those critters accumulate fat in summer in order to make it through the winter. And even when they have less saturated fat than domesticated animals, if they were fatty – and hunter gatherers are known to favor the fattest cuts – we can assume that they got a lot of saturated fat for extended parts of the year.
And what does conventional wisdom say about saturated fat? Right – it clogs our arteries. The fact of the matter though – and here I completely agree with Taubes – is that most saturated fats are either beneficial or neutral when it comes to lipid profiles. Some of them raise LDL (which is the main concern), but they raise HDL along with it. And they change LDL pattern type. But hold on – now I’m about to get too technical. If find LDL pattern types fascinating, but the jury is still out there about whether “large fluffy/buoyant LDL” is really harmless. But do we really need to bother? No. If you haven’t seen the move “Fathead” – do so. Or go to YouTube and look for “Fatheadmovie” and then watch their presentation. The first part of it (and of the movie) deals with how the “lipid hypothesis” was established. Today we’re only looking at our cholesterol levels and lipid profiles because, essentially, of Ancel Keys’s seven countries study, and senator McGovern’s decision to support his conclusions before there was any evidence to do so.
I am not a doctor, and you have to decide for yourself what to do. I don’t take the cholesterol scare seriously anymore.
But I’m going to give you another argument. Imagine you’re going on an extended fast. You only drink water and don’t eat anything at all. What kind of diet are you on?
Answer: A high-fat, low-protein, zero-carb diet. Your body starts to metabolize your lean tissue (protein) and your stored fat, which is about half saturated-fat, half mono-unsaturated fat. So you’ll be on let’s say 40% saturated fat, 40% monounsaturated fat, 20% protein.
Obviously you shouldn’t be doing this for extended periods because ultimately you’ll “waste away”. But you can do like Lyle McDonald advises in his Rapid Fat-Loss Handbook and tweak the diet a little bit: You eat some protein – just enough to get your body to spare your muscle tissue. And it actually turns out that you can keep this kind of diet up for prolonged periods of time, and you’ll lose plenty of fat on it. Your lipid profile will improve, too … even though you’re on a 40% saturated fat diet.
Think about it: Why should saturated fat be bad for you if it is how your body stores energy for later use (or at least half of the energy – remember that the other half is stored as mono-unsaturated fat)? That doesn’t make any sense.

I hope you liked the explanations … please feel free to comment!

Low-Carb: Can You Eat Too Much?

Last week I talked about how when trying to lose weight on a low carb diet, you can try to find a sweet spot in terms of caloric intake – you eat enough to ensure that your energy levels don’t decrease while still maintaining a caloric deficit.
By that you can tell that I’m not one of those low carb fanatics who claim that you cannot get fat without eating carbs no matter how many calories you eat, which is my topic for this post. Taubes, Eades and others have made claims that can be interpreted to that effect, and I often encounter low-carbers in forums who argue along those lines.
Let’s examine this in more detail, but without getting into unnecessarily complicated biochemical stuff. The claim is that on a low-carb diet, fat storage is somehow blocked and/or the body either burns off excess dietary fat or disposes of it.

First off: There are undoubtedly people who won’t get fat even when force-fed excess calories. But studies also show that this is most likely a genetic trait, and those people don’t get fat no matter which macronutrients they get force-fed with – even if it’s junk food. Using these people as an indication of what happens when obese people overeat is clearly inappropriate.
About the idea that fat storage is blocked on low-carb diets: Nope. Usually people who think so point to Taubes’s mantra “carbohydate drives insulin drives fat”. This is flawed in at least two ways: a) insulin is secreted even when you eat zero carbs – protein triggers it, too, and protein is a staple of low-carb diets. And b) even when we assume that insulin levels are lower on low-carb diets, there are other pathways to store fat. Sure, type 1 diabetics can’t store fat, but they have zero insulin, which is not the same as low insulin.
When it comes to burning off excess fat, I think this is happening all the time both in lean and obese people. The question is whether this mechanism is ramped up by the body no matter how much we overeat. I don’t think that’s the case – I don’t like the “thrifty gene” theory too much, but on the other hand I don’t think the body likes to waste energy either. My conclusion is that the involuntary increase of metabolic rate in response to excess fat intake can only be effective for small amounts of excess calories, at least in obese people. I also know from first hand experience that stuffing myself with fat quickly reverses fat loss on a low carb diet.
Lastly, what about disposal? Read: Urine or fecies. #1 has been suggested by Eades as far as I remember, the idea is that when you’re in ketosis your body will secrete excess energy that way in the form of ketones. I’m not buying that – some people mentioned that ketones in the urine decrease the longer you are in ketosis. As far as #2 is concerned: I don’t see how the body would put fat back into the lower intestines. Once the foodstuff passes the small intestines, as far as I know there’s no way to add any nutrients back. Besides, if that really worked it could be easily tested and would be a great argument to convince people to go low-carb. Remember Olestra?
Summary
On any diet that makes you lose weight, you have to take in less energy than you expend. The latter part is mostly a black box which is far more complicated than many people still think – to them it’s primarily exercise, but there are many more ways for our body to expend energy. But even then, if you eat too much, low-carb or otherwise, your body will store some of the excess calories as fat. Naturally lean people may do so to a lesser degree than obese people – but then again they’re not the ones we should look to as models for how the metabolisms of obese people work.
Then why do low-carb diets work? Studies suggest that they do. The answer may be very simple: People tend to eat less calories when they remove carbs from their diet. Protein and fat are tasty and especially protein helps with satiety. Another bonus is that the fat which low-carbers eat instead of the carbs usually improves health markers – lowering LDL, increasing HDL, lowering triglycerides.
Conclusion
When you go low-carb to lose weight, don’t be obsessive about counting calories – but keep an eye on them. Especially with stuff that’s high in fat – think bacon, butter, heavy cream, olive oil, coconut oil, nuts, avocado – keep in mind that a little goes a long way in terms of both satiety and calories.