Ray's Take

Is a calorie a calorie? No

Does calories in calories out matter? Yes

Who I am

I'm Ray, a doctor that is obsessed with making food taste way better than any restaurant, while being as healthy as possible.

Lets start with a quick review

Nerd knowledge

What actually happens when you eat protein, fat, and carbs? What's the difference?

Protein

We outlined protein metabolism here, but the TLDR is that when you eat protein, a couple things can happen:

• used to build and repair muscle
• used for enzymes, hormones, antibodies, DNA
• oxidized for immediate energy (not direct)
• turned into glucose aka gluconeogensis (only happens when carbs low)
• very rarely turned into fat. This is bc it takes many steps to turn amino acids into acetyl-coA, which is the starting point for de novo lipogenesis

Protein is good bc it builds muscles, is used for essential functions, and is difficult for body to turn into fat

Carbs

When carbs are ingested (i'm not talking about fiber), they are broken down into simple sugars and enter the bloodstream. Here is what can come of them:

• efficiently turned into energy (ATP) via glycolysis, TCA / krebs cycle, and electron transport chain
• turned into glycogen (stored form of glucose in liver, muscle) via glycogenesis.
• turned into triglycerides, the main form of fat storage in the body, via de novo lipogenesis. This happens when insulin is high, and there is excess glucose and glycogen around (IE when you eat more calories than you burn). Fat is stored in adipocytes (fat cells), but too much leads to it being stored in liver and in muscle, this is bad (IE NAFLD/NASH in liver, HFpEF in heart, and fat in muscles are bad)

Carbohydrates are good for fast energy, but too much (IE when calories in are higher than calories out) in the presence of high insulin can easily turn into fat.

Fiber (IE from veggies)

Fiber is non-digestible carbs, usually from whole veggies. There are two kinds - soluble and insoluble. Here is what comes happens when you eat it:

• Insoluble fiber forms a stringy net. The soluble fiber turns into a gel that covers the holes in the net.
• This gel filled net starts getting formed in the first part of the intestines (duodenum), which prevents the duodenum from absorbing simple carbs (sugar). This is good bc it dampens the sugar that goes into blood stream (which reduces insulin response) and also limits the amount of sugar that goes to the liver (which can get turned into fat).
• The carbs you eat travel further in your intestine, and feed the microbiome.
• The microbiome also can feed on soluble fiber and turn it into short chain fatty acids.
• Short chain fatty acids improve insulin sensitivity, gut health, and also signal Peptide YY and GLP-1 (yes the same as the drug target) which make us feel full.

Fiber is good for gut health, feeling full, and just have a lot of benefits.

Fat

When fat is ingested, they are broken down into triglycerides, absorbed by small intestine, and transported within chylomicrons. Here is what can come of them:

• turned into acetyl-coA which is turned into energy (ATP) via beta-oxidation in mitochondria of cells. It is a dense source of energy.
• transported to adipose tissue (fat tissue), and stored as triglycerides within the fat cells.
• when carbs are low, can be turned into ketones by the liver. The ketones can be used as energy when glucose is low.

Fat provides a dense source of energy, but the body uses glucose first bc it is faster compared to beta-oxidation. If you have more calories in, than out, you will store eaten fat as fat. Keep in mind some fat is necessary for hormones and digestion.

Adding it up

You're going to eat protein, carbs and fat.

Protein tastes good, is filling, and is the only macro that contributes directly to muscle growth. It is not easy to turn into fat.

Carbs taste good, are not really filling, and if you eat more cals than you burn, will turn into fat (due to insulin being high, and de novo lipogenesis being efficient/easy).

Fiber from veggies is low calorie and has a lot of benefits.

Fat tastes good, is filling, has no insulin response, but if you eat more cals than you burn, will be easily stored as fat.

Therefore

What are good calories?
- Protein (always good)
- Carbs (from veggies)
- Fat (unsaturated fat from olive oil, avocados, fish best)

Get these from whole, unprocessed, foods.

What are bad calories?
- simple carbs which turn into sugar in your bloodstream

Avoid these from refined carbs (bread, rice, pasta, chips, crackers) and and foods with added sugar (candy, ice cream).

So is a calorie a calorie?

No.

However, that doesn't mean that to lose weight (and fat) you don't have to eat less calories than you burn.

If you eat the worst types of calories (refined carbs), but only 1000 calories a day, you'll lose weight. However, you'll be extremely hungry so please do not try this. 100% chance it doesn't work.

Interesting case study: High fructose corn syrup

Big food cos that used high fructose corn syrup wanted to prove a calorie was a calorie, and put two groups of people on the same number of calories. Half got fructose, the other half did not.

They found that there was no weight difference after 3 months. Thus they were telling everyone that a calorie is a calorie and fructose is good.

However, what they didn't mention is that the people eating fructose, were extremely hungry (due to leptin resistance. Leptin is hormone that makes you feel full). So in real life they would have ate more (more calories), and gained more weight. Also, their insulin levels were way higher, so they were literally developing diabetes.

This case study shows how calorie in calorie out still matters, but a calorie is def not a calorie.

Calorie in, calorie out still matters

If you eat good calories, can you just not care about calories at all?

No, if you want to lose weight (or not gain weight), you still need to eat less calories than you burn. Overeating calories from any source (protein, carb, fat) will cause you to gain weight (and fat).

First law of thermodynamics: Energy cannot be created or destroyed. It can only be transferred.
For humans, this means we intake energy from food and drink. And we use calories from our basal metabolic activity (breathing, heart beat, etc), the thermic energy of food (digesting), and active calories (exercising).

Those are the inputs and the outputs, and energy cannot be created or destroyed. This means too many calories will be stored in our body, usually as fat.

Why does this matter?

It matters bc the goal is to find a nutrition program that you can do every day for a long time, where you are actually eating less calories than you burn (or the same amount if you are maintaining).

We call this sustainability, and it is the most important factor of any eating program.

What does sustainability mean?

• Love what you eat
• Do not feel like you are missing out on anything
• Making progress toward your objective

The best way to do this for me is max volume, min calories.

What is max volume min calories eating philosophy?

• Eat as much as you want for foods that are are high volume, low calories
• Eat good quality, delicious higher calorie foods, but don't overeat
• On all other foods aka "bad" foods, be knowledgeable, and actively decide if its worth it (i.e. I drink beer)

By doing this, you will automatically eat good calories and eliminate bad and reach sustainability. At this point, if you just wait (and don't change anything), you're guaranteed to reach your goal.