It's The Content Of Your Calories
As I've been blogging here for many years, the type of calories you consume seems to affect the number of calories burned -- and whether you gain or lose weight (or are able to maintain a desirable weight).
Personally, I've been eating a low-carb, high-fat diet since March of 2009. I stay pretty effortlessly thin, weighing in at a few pounds more (usually about 3 lbs. more) than I weighed at my skinny-minnie-est, in high school. (I wasn't always effortlessly thin -- not when I ate carbs.)
There's an op-ed on this subject -- "The case against carbohydrates gets stronger" -- by Harvard Med prof David S. Ludwig in the LA Times about the findings from research he and his team are doing. (Free access to their BMJ study here.)
People have a hard time believing that weight control isn't just a matter of calories eaten and calories burned. But there is an alternate hypothesis about obesity, which is what my group studies. The carbohydrate-insulin model argues that overeating isn't the underlying cause of long-term weight gain. Instead, it's the biological process of gaining weight that causes us to overeat.Here's how this hypothesis goes: Consuming processed carbohydrates (especially refined grains, potato products and sugars), causes our bodies to produce more insulin. Too much insulin, one of the most powerful hormones, forces our fat cells into calorie-storage overdrive. These rapidly growing fat cells then hoard too many calories, leaving too few for the rest of the body. So we get hungry, and if we persist in eating less, our metabolism slows down.
...For our clinical trial -- one of the largest feeding studies ever conducted -- we collaborated with Framingham State University and the company that manages its food service. We recruited 164 students, faculty, staff and community members who agreed to eat only what the study dictated for a full academic year.
We started the participants on a calorie-restricted diet until they lost 10%-14% of their body weight. After that, we randomly assigned them to eat exclusively one of three diets, containing either 20%, 40% or 60% carbohydrates.
For the next five months, we made sure they didn't gain or lose any more weight, adjusting how much food they received, but keeping the ratio of carbohydrates constant. By doing so, we could directly measure how their metabolism responded to these differing levels of carbohydrate consumption.
Participants in the low (20%) carbohydrate group burned on average about 250 calories a day more than those in the high (60%) carbohydrate group, just as predicted by the carbohydrate-insulin model. Without intervention (that is, if we hadn't adjusted the amount of food to prevent weight change), that difference would produce substantial weight loss -- about 20 pounds after a few years. If a low-carbohydrate diet also curbs hunger and food intake (as other studies suggest it can), the effect could be even greater.
In fact, one of the great things about eating this way is not feeling hungry -- or worse, hangry...that feeling where your blood sugar takes such a dive that you're angry-hungry.
For anyone who wants to learn how to set up habits and stick to them, there are three chapters in my "science-help" book, "Unf*ckology: A Field Guide to Living with Guts and Confidence," that get into this -- on how to not let your feelings be the boss of you and the elements of willpower. (Buying a new copy -- only $10.87 at Amazon -- supports the authors!)
Ludwig with more on the research at Medium.
You can learn from the who's who of low carb research - Low Carb Denver 2019
https://denversdietdoctor.com/low-carb-conferences-low-carb-denver-2019/
Snoopy at November 15, 2018 4:56 AM
People who ate eggs instead of bagels for breakfast ate 20% fewer calories for lunch and for the next 36 hours.
https://www.tandfonline.com/doi/abs/10.1080/07315724.2005.10719497
If you just eat eggs for breakfast instead of a high carb breakfast, your weight will drop.
Snoopy at November 15, 2018 5:01 AM
"the type of calories you consume seems to affect the number of calories burned"
No. The type of calories consumed affect the number of calories consumed. The burned side is based on activity and largely doesn't change. But look at Snoopy's link about eggs. Increasing satiation (not getting hungry) and people don't eat. Not that miraculous. But there it is. This is the same reason people on stimulants lose weight. The increased activity actually has very little effect. Instead you find stimulants reduce hunger. Consequently people on stimulants don't eat as much and then lose weight. All effective progress seems to be on the don't get hungry in the first place side of things.
Ben at November 15, 2018 5:32 AM
Actually, no, Ben. We seem to blow off calories from low-carb/high-fat foods in a way we don't carb calories, which we turn into fat very efficiently.
Amy Alkon at November 15, 2018 6:03 AM
From Ludwig:
Amy Alkon at November 15, 2018 6:06 AM
More from Ludwig:
Amy Alkon at November 15, 2018 6:07 AM
Your first rebuttal proved my point Amy. And your second rebuttal is only mildly persuasive. 250 calories isn't much and is easily explained by not feeling hungry.
Ben at November 15, 2018 7:35 AM
Sure, but what do you do when anxiously waiting for your stupid computer to finish doing something, or having accomplished a meaningless but anxiety provoking task?
jerry at November 15, 2018 8:49 AM
Dr. Oz was talking about the issue (different types of calories) this morning. On NBC, I think.
lenona at November 15, 2018 9:07 AM
There seems to be some research going on about gut health, and how much if type II diabaites is related to that. There appears to be a substantial connection. Instapundit had a link. Maybe I can find it again.
While I believe that a low carb diet is best for most people at keeping off weight and makes you feel less hungry, I am suspicious of studies that rely on self reporting because people, lie, people cheat, and people get lazy.
Ben has a point. Carbs make people sleepy and lethargic. This study couldn’t directly measure calories burned (self reporting again) so they had no idea of the activity level of the participants and where the supposed 250 calorie difference came from.
This doesn’t mean that a low carb diet isn’t best, as I personally believe it is, for a whole host of reasons, it just means that this study didn’t produce anything conclusive, or even testable, one way or the other.
As I have said before dietary “science” and research suffer from the fact that you can’t find enough people and money to lock everyone in a lab for six months or a year, and really control the variables. The only place you could run such a study might be North Korea, because to do real science, you pretty much need to be able to treat your subjects like lab rats, to be sure that they are not sneaking a plate of French fries and a coke, two or three times a week, then running a couple of miles to burn it off.
This article explores a couple of the issues with gut bacteria.
https://health.clevelandclinic.org/new-research-explores-link-gut-health-diabetes/
Isab at November 15, 2018 11:49 AM
Carbs are digested quickly and get into the blood as sugar quickly. Fat and protein take longer to digest and don't spike your blood sugar so much.
cc at November 15, 2018 12:32 PM
Amy: "The type of calories you consume seems to affect the number of calories burned..."
Ben: "No."
Actually, "Yes."
They say, "A calorie is a calorie." This is true. But a calorie isn't a substance, it's a unit of measure. "A calorie is a calorie" in the same way that "an ounce is an ounce" and "an inch is an inch".
Two and a half ounces of heavy cream has about the same number of calories as two ounces of gasoline. But consuming the gasoline will have a profoundly different effect on your metabolism than consuming the cream.
126 grams of carbohydrate has about the same number of calories as 56 grams of fat, but even though the calories are the same the carbohydrate has a different effect on your metabolism than fat. One big difference is most of the carbohydrate enters the portal circulation as glucose (sugar) and glucose causes a rapid increase in the amount of insulin in your blood. Your insulin level makes an immediate, huge difference in how your body handles carbohydrate and fat.
Insulin stimulates the use of glucose (carbohydrate) in cells for energy. It prevents the use of fat for energy. It stimulates the conversion of glucose and fatty acids into fat. It stimulates the storage of fat in adipose tissue (blubber) on your body. It prevents the release of fat from adipose tissue to be used for energy. It also causes the kidneys to retain water. The result is you gain weight.
(*Since a high blood glucose concentration is toxic over a fairly short period of time, your body makes lowering the concentration a high priority. All of the above functions of insulin have the effect of lowering the concentration of glucose in the blood)
When blood glucose concentration is low insulin level will be low. The effects of a lower insulin level are the reverse of those above. There is a decrease in the conversion of glucose and fatty acids into fat and a decrease in the storage of fat on the body. There is an increase in the release of fat from adipose tissue (blubber) There is an increase in the use of fat instead of glucose for energy. The kidneys retain less water (you don't need that extra water; it's not good for you) The result is you lose weight.
(*These all have the effect of increasing glucose concentration to keep it from going too low - there's a balance being kept)
The metabolism of fat produces ketones that can be detected in urine. Traces of ketones in the urine is a sign that your body is using fat for energy. If you're metabolizing fat there will be ketones.
Ken R at November 15, 2018 1:57 PM
That's nice and all Ken. But it doesn't refute what I wrote in the least. It also doesn't support your claim that what you eat affects how many calories you burn.
Ben at November 15, 2018 2:50 PM
A diabetic classmate/friend/fellow RN went low carb in June. She was off insulin within 2 months. Type 2 diabetes is curable.
I haven't been "hangry" in years. We actually get eggs from our own free range, super healthy, super happy chickens now. I cant recommend it enough. The yolks are such rich orange. Mmmm.
Freeraange pork is chalk full of vitamin D. So is free range grassfed beef. Soooooo tasty and good for you!
Momof4 at November 15, 2018 3:30 PM
> it doesn't refute what I wrote in the least
@Ben - I don't pretend to understand it all, but the explanation I have seen is that insulin slows uncoupling in brown adipose tissue -
https://www.ncbi.nlm.nih.gov/pubmed/29170160
which apparently would reduce one's metabolic rate.
Snoopy at November 15, 2018 3:48 PM
The thing is Snoopy, Amy et al and I aren't arguing over why a low carb diet is better for you. We are arguing over why it works better for most people.
Amy wrote "the type of calories you consume seems to affect the number of calories burned". Which may be a bit sloppy for this specific discussion between us. I can accept that eating lots of carbs spikes insulin which then makes people sleepy and lazy due to an excess of insulin in the blood and not enough sugar at that specific moment. But later she wrote "We seem to blow off calories from low-carb/high-fat foods in a way we don't carb calories, which we turn into fat very efficiently." And that is flat wrong. A calorie is a calorie.
I instead am contending that by eating a low carb diet you reduce insulin swing and thus increase satiation (lack of hunger) which then lead to people not overeating. Since people are 'full' they don't want to eat as much and they then lose weight by reducing the total number of calories in their diet.
Insulin is a signaling chemical. When you have a lot of sugar (glucose) in the blood your body releases insulin to signal your fat cells to store that energy. When blood sugar is low insulin also tracks low and then signals fat cells to release their stored fats and convert it back into glucose. The problem is when insulin is high but blood glucose is low you are telling your fat cells to store sugar that just isn't there. Then your metabolism slows down and you start to feel hungry, sleepy, and irritable. So to an extent the sugar isn't really the problem. It is the fast change in the amount of sugar which your body just can't keep up with. Tragically a high sugar diet causes people to gain weight (both from water as Ken mentions and from fat cells). This added weight slows down the signaling speed of insulin worsening the problem. Eventually you can overwork your pancreas causing it to fail and become unable to produce insulin at all (or at least not enough insulin), which is also known as diabetes.
Note, nothing I've written in that last paragraph disagrees with what Ken R wrote. We actually agree. Hence my confusion over why he claims I'm wrong.
As for your brown adipose tissue study Snoopy, that looks correct to me. It is what you would expect. High insulin without elevated blood glucose signals the body to conserve energy and slow down metabolic processes. So I would expect brown fat to shut down as well. But adult humans don't have much brown fat, so it is largely irrelevant.
Also, Momof4's experiences are also correct. While it doesn't work for all type 2 diabetes cases in many of them reducing sugar consumption which controls insulin swings results in weight loss which then results in curing the diabetes. It has also been shown liposuction (cutting the fat out) has the same effect for as long as people can keep the weight off. People who get liposuction and stomach bypasses have relatively high recidivism rates. They often don't change their habits and end up gaining the weight back.
And Isab's stuff on gut bacteria has also proven to be valid in some cases. 'Poop transplants' are becoming a thing no matter how nauseating that sounds. It has been shown to help some people reduce weight, gain weight, and cure IBS among other issues.
Ben at November 15, 2018 4:47 PM
I have hard date from my blood work over a 30 year period that eating lower carb is saving my life. Just wish I had known all this 20 years ago, when the extra weight began to accumulate. I could have made some relatively moderate adjustments. At least I know now and am losing weight, gaining energy, and avoiding heartburn. And I really wish I had known this in enough time to help my mother, who died of heart attack at 59 after steadily, helplessly gaining weight and higher cholesterol readings despite eating less and less fat.
RigelDog at November 15, 2018 5:49 PM
later she wrote "We seem to blow off calories from low-carb/high-fat foods in a way we don't carb calories, which we turn into fat very efficiently." And that is flat wrong. A calorie is a calorie.
I instead am contending that by eating a low carb diet you reduce insulin swing and thus increase satiation (lack of hunger) which then lead to people not overeating. }}}
I disagree. The lower level of hunger that results from lower carb eating is A thing, and an important thing, but that's not all that's going on with the effects of eating low carb vs. high carb. I'm going to speak loosely here: With too high of an intake of carbohydrates, insulin is over-stimulated and will take those carbs and divert most of them straight into fat instead of burning them for energy. If you eat the recommended number of calories per day and you burn them all, fine. If you eat the same number of calories but they are 60% carbs and many of those calories don't get burned, but instead get turned straight into fat, that's not great. A "mere" 250 calories that should get burned every day but don't because of carb overload equates to a weight gain of 24 pounds a year.
RigelDog at November 15, 2018 6:05 PM
"Two and a half ounces of heavy cream has about the same number of calories as two ounces of gasoline."
Caution: the definition of "calorie" is different in engineering vs. nutrition. From Wikipedia:
Radwaste at November 15, 2018 7:07 PM
“Two and a half ounces of heavy cream has about the same number of calories as two ounces of gasoline."
Caution: the definition of "calorie" is different in engineering vs. nutrition. From Wikipedia:”
Thank you Radwaste. Something I did not know, and another very good reason to steer clear of the hyperbolic claims of dietary *science*, even in studies you are inclined to agree with because they confirm your emotional prejudices on the issue.
It does make one wonder why calories are even an appropriate measure of the food stuffs we eat, as what we consume requires a much different process than a gasoline engine to covert them into glucose, and then into energy. If you have a V8 metabolism it probably converts them, and burns them much more efficiently, than my 60+ year old two cylinder golf cart of a body.
It seems to me the glycemic index attempts to make up for some of the misapplication of the calorie model.
Isab at November 15, 2018 8:16 PM
For an anecdotal story about calorie burning. Years ago, my husband used to play a lot of four wall handball.
We live in the west, and the best player in our state was a guy I am going to call LG.
My husband traveled with him, and had a chance to watch his dietary habits on a close up basis.
They would leave our town for a handball tournament 175 miles away. 70 miles north they had to stop at Burger King where the guy ate a full double whopper, fries, and a chocolate shake. 60 miles later they stopped for a bag of candy bars and a coke, and when they got to the destination, he would eat another full meal, The guy was 140 pounds soaking wet and never gained an ounce.
Isab at November 15, 2018 8:25 PM
When blood sugar is low insulin also tracks low and then signals fat cells to release their stored fats and convert it back into glucose.
Whether blood sugar is low or high, when insulin is low triglyceride in adipose tissue is converted to fatty acids that are released into the blood and used for fuel. The fat or fatty acids aren't converted back into glucose, they're used for energy instead of glucose. That's why people with untreated type 1 diabetes lose weight. They don't have enough insulin to drive glucose into the cells for energy, so they burn their fat for energy while their blood sugar goes sky high.
Ken R at November 15, 2018 10:25 PM
Agreed Ken. I have no problem with that. Most of our cells cannot measure glucose levels. Instead we have specialized cells that produce insulin as a proxy signal that is much easier to measure. Once you break that relationship by damaging those specialized cells you start to have problems.
RigelDog, the issue with 250 calories that Amy cited is the ability to accurately measure that low. Especially if it is a self reported setup like Isab says then 250 calories is well within the margin of error.
Isab, on the guy who can eat but never get fat, that is a classic example of someone with 'poor' gut bacteria. A lot of the food we eat we cannot digest on our own. Instead bacteria in our intestines break it down for us into chemicals we can digest. I forget the exact numbers but mice raised in sterile environments need to eat ~5x those with typical gut colonies. For other animals (cows, horses, and such) the ratio is far higher.
Ben at November 16, 2018 6:48 AM
Ken: Two and a half ounces of heavy cream has about the same number of calories as two ounces of gasoline.
Radwaste: Caution: the definition of "calorie" is different in engineering vs. nutrition. From Wikipedia:”
For both cream and gasoline I was referring to kcals, i.e. kilogram calories or "large" calories. 2.5 ounces of heavy cream and 2 ounces of gasoline both have roughly 300 kcals. Both have about the same amount of stored energy.
Ken R at November 16, 2018 8:47 AM
I can accept that eating lots of carbs spikes insulin which then makes people sleepy and lazy due to an excess of insulin in the blood and not enough sugar at that specific moment.
There's even more to it than that. It gets a lot worse.
Eating lots of carbs throughout the day, say three meals and a couple of snacks, plus a beer or two, will keep your insulin level high most if not all of the time. As your insulin level rises and lowers your blood sugar you'll start to feel hungry and eat again before your insulin level has a chance to drop back down to its fasting baseline.
Repeated or continuous exposure to high insulin level over a long period of time will cause your cells to become less sensitive to the effect of insulin (insulin resistance) As cells become more resistant it will take more and more insulin to push the same amount of glucose into cells and lower your blood sugar; over time serum insulin levels will creep higher and higher.
Adipose tissue (fat) is the most sensitive to insulin and least susceptible to becoming insulin resistant. As other cells become less able to take in glucose more of it gets pushed into fat cells and converted to fat. Also the higher insulin level causes more of the fat you eat to be stored instead of used for energy.
You get fatter and have less and less energy because you can't get enough glucose into insulin resistant cells and the higher insulin level keeps fat from being released from adipose tissue and used for energy. Even if the fat was available insulin keeps cells from using it, because preventing high blood sugar levels is a higher priority than preventing obesity.
You're well on your way to metabolic syndrome and type 2 diabetes; obesity, high blood sugar, high insulin level, high A1c, high lipid levels (except for low HDL) water retention, high blood pressure, low energy, and slow death.
Your doctor will tell you you need to eat less (take in fewer calories) and increase exercise (burn more calories) to lose weight. But you won't be able to increase exercise and burn more calories because you can't get glucose into insulin resistant cells, and energy starved cells will not tolerate more exercise. When every cell in your body is starving for energy you will eat more, and get fatter, because feeling like your starving all the time sucks worse than being a fat, dying diabetic.
A low carb diet reverses the above scenario. By low carb I don't mean 20% of calories from carbohydrates. At that point that's still way too much. When you can't get the glucose into cells even small amounts of carbs will raise your blood sugar too high, and keep your insulin level high, and perpetuate that whole messed up scene. Low carb means more like 5% or less of calories from carbs.
If you don't eat carbs your blood sugar level will go down; then your insulin level will go down and stay near the low side of that reference range. When insulin is low adipose tissue can't take in and convert glucose and fatty acids into fat (needs lots of insulin to do that) and it won't be able to keep stored fat from being converted to fatty acids and released into the blood (need insulin to keep that from happening) All that blubber will be available to all the other cells for energy, and there won't be the high insulin level to keep them from using it.
As your body makes this transition over a few weeks you'll have more energy, your lipid profile (cholesterol, etc) will improve, your A1c will go down, you'll retain less water, your blood pressure will go down, you'll lose weight, and you'll feel better.
That's what happened to me after I read a convincing Amy Alkon post about low carb diets in September 2009.
Ken R at November 16, 2018 11:23 AM
And I agree with all of that Ken.
What is even more fun is when you start mixing in fake sugars. Some of them cause elevated insulin levels just like real sugar would. You get that same high insulin effect as you would from sugary foods. Which is why you have the odd response where people drinking zero calorie sodas gain weight and when they stop they lose weight. They tend to eat more of other foods because they are hungry and they move less due to being tired. Once you hit full diabetic and are unable to produce your own insulin this effect disappears. Of course at that point you are injecting insulin instead of letting your body set the level.
Ben at November 16, 2018 1:22 PM
Sorry - I have learned through experience to be wary of any statement that starts with "You can eat as much as you want of..."
I have experienced some of the benefits described here, seen them in friends, and read Taubes' books - BUT I have also seen people out-eat all this lovely science, and wind up just as obese as they would have on a regular diet.
Sorry - if you are a sedentary office worker who inhales 3000 calories a day, it doesn't matter that if you get there with 3-egg omelets and cheese steaks.
The borderline obese and pre-diabetic will probably have to restrict caloric intake as well as changing the composition of their diet. Because their *psychological* notions and *physical* habits of portion size and satiety are probably way out of whack. They are on the pathway to diabetes because all these lovely feedback mechanisms have been swamped. It can take several months to a year of caloric restriction + low carb to reset them.
Have you seen portion sizes lately?
Ben David at November 24, 2018 10:50 AM
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