Im Very Disappointed in the State of Nutrition (Dogmatic and Myopic)

Date: 2020-05-08 07:15:44

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What’s more, this myopic approach spills over into approaches to nutrition, leading people to adopt diets and lifestyles which, although they may work in the short term for symptom management, can cause harm in the long-term.

Calories In – Out Model

The “calories-in, calories-out” model of obesity makes sense… at least on a superficial basis and as follows: Energy cannot be created or destroyed. Therefore, if you place yourself in a caloric deficit, you will lose weight. Theoretically, this logic holds. Practically, it’s almost useless…

You can’t accurately measure calories in because (i) even if people did measure every gram of food they ate (which they don’t), regulatory bodies don’t carefully monitor nutrition labels. (ii) Even when nutrition information is regulated, bodies like the FDA permit a 20% margin of error with respect to calories. On a 2,000 Calorie diet, that’s 400 missing Calories. (iii) Even if nutrition labels were accurate, one must ask how we measure the calories in our food? We do so using bomb calorimetry. Basically, we blow the food to ash in a little chamber and measure how much the water around the chamber heats up. This is not, at all, how our bodies work to extract energy. (iv) Even if bomb calorimetry accurately represented how our human cells’ mitochondria extract energy from the foods we eat, we are all different with respect to out gut bug ecosystems, which further influence how many calories in food end up in our bodies. What’s more, you can’t measure calories out because to do so would require knowledge of, not only how much you exercise, but also complete knowledge of your (i) non-exercise activity thermogenesis, (ii) body temperature, (iii) post-prandial specific dynamic action, (iii) age, (iv) gender, (v) genetics, (vi) hormonal profile, (vii) and microbiome, at minimum. And, even if we had half of this information, we wouldn’t know how to interpret it.

Let’s return to the big picture: thinking long-term. The insidious thing about the calories in – calories out model is that, short-term, it actually does work! That’s because, despite all the limitations listed above, if you simply eat less of the same foods you were eating to maintain your original weight, you will end up in an acute energy deficit and your body will need to resort to using stored fat. However, that approach is doomed to fail! Here’s why: (i) Over time, your body adjusts its basal metabolic rate. This means you burn less energy while at rest. Gradually, your caloric deficit shrinks and, eventually, can become caloric surplus. (ii) Your body, sensing a state of starvation, starts to fiddle with your hormones. Nobody, no matter their willpower, will choose to remain tired and hungry forever. Your hormones will drive you to make poor food choices and you will risk relapse to your original pattern of living. (iii) Not only do your hormones change, but your microbiome changes as well. This microbiome shift makes it so that you get more calories from the foods you eat. Scariest of all, the yo-yo cycling that the calories in – calories out model invites can cause you to become progressively more prone to gaining weight long-term:

Nicholas Norwitz – Oxford PhD Researcher and Harvard Med Student:

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