Why the Quality and Quantity of Calories Count

Colorful healthy salad

A study reported the metabolic benefits of intermittent fasting. I think the study was fine, but have criticized the media tendency to exaggerate any particular benefits of fasting based on it. Eating for, say, 25 days out of 30 almost unavoidably means eating less than if eating every one of those 30 days out of 30, and eating less tends to produce weight loss. That’s what happened in the study.

The Link Between Excess Body Fat and Metabolic Abnormalities

Excess body fat, even at a rather minor level, is associated with sometimes subtle metabolic abnormalities—from elevated blood lipids to elevated blood pressure, high blood glucose or insulin, or even elevations in inflammatory markers that aren’t measured routinely.

In fact, one rather famous study showed that the idea of “healthy obesity” is misleading, because compared to those who are both lean and healthy, those who are overweight but apparently healthy still tend to have such subtle metabolic abnormalities far more often.

Weight loss tends to improve those abnormalities, and that was seen in the fasting study. But similar short-term improvements in markers of cardiovascular and metabolic risk are seen with just about any approach to short-term weight loss, including those that are obviously bad ideas.

Serum lipids tend to plummet, for instance, among acutely ill people being admitted to the hospital whether for a serious infection, a stroke, or trauma. Cholera will “improve” metabolic markers of cardiac and diabetes risk; that doesn’t mean it’s good for us.

So, in my view, the recent study didn’t prove anything specific about fasting. Rather, it showed that eating less leads to weight loss, and weight loss has predictable effects on all the standard markers of cardiometabolic risk.

What that means for long-term health depends on what is causing the weight loss, its advisability and its sustainability, but that can be a topic for another day. Today, I want to point out the obvious but seemingly overlooked message in the fasting study: calories, of course, really do count.

Why Calories Are Important: Both Quality and Quantity Matter

Perhaps it shouldn’t be necessary to make that point, because it is so obvious.

 However, over recent years, some rather high-profile, so-called “diet gurus” have made the opposite case, arguing in articles and even books that calories don’t count, or that a calorie is not a calorie. Recently, I have started getting messages in my inbox going one step further, telling me that calories aren’t “real,” or that “calories are nothing.”

Before refuting these arguments and pointing out the harm in them, let’s consider briefly the basis for them. The argument that a calorie isn’t real tends to be a bit esoteric, invoking the nature of energy versus matter. I don’t think it’s worth spending much time with that one. If heat is real, and cold is real, then calories are real, too. If calories are not real because they are “just” energy, then neither is heat- because it is, too. I rather doubt the argument that “heat isn’t real” will protect you if you stick your hand in a pot of boiling water—so I advise strongly against it.

The argument that calories don’t count is an extension of the “a calorie is not a calorie” argument, and basically contends that it’s the quality of food, not the quantity that matters.

 The overtly silly fallacy with this is: why choose? Why can’t both matter?

Both do matter. Consider, for instance, a fire in a fireplace. Which will influence how much heat, light, and flame you can produce—the kind of fuel you have or the quantity? The correct answer is the obvious one: both. Denser wood, for instance, burns hotter and longer; a greater supply of wood generates more total heat, light, and flame than a smaller supply. The contention that if quality of fuel matters and quantity doesn't implies that a matchstick of oak, or a pallet of it, is the same. They are not. Similarly, a log of oak is not the same as a log of paper mâché.

A famous, if contrived and rather limited study, showed that a diet of nothing but Twinkies will lead to weight loss provided the quantity consumed is limited. Less well known is a study showing that an excess of high-quality protein leads to fat gain. Both of these, and many other studies on the topic, show clearly that independent of the quality of food, the quantity matters to weight and health.

What has been peddled to us all is the idea that since our bodies process different fuels differently, some with insulin and some without, that calories can’t possibly matter. But this is tortured logic if it is logic at all. We can all agree that a gallon is a gallon, but a gallon of what matters, too. There is a big difference between water and Coca Cola, milk and gasoline. We can all agree that a mile is a mile, but walking one along a tropical beach is nothing like the final 5,280 feet up Mt. Everest. Why calories warrant convoluted reasoning we would not impose on any other measure, I really don’t know.

I do know, however, why you should care. Pulitzer-prize winning journalist Michael Moss has reminded us of a very good reason. The food industry knows full well that both the quality and quantity of food matters. They also know the specific ways to undermine the quality of our foods that reliably increase the quantities we consume. We have had reports about the manipulation of processed foods to maximize our intake of calories for more than a decade. If we are not forewarned about this link between food quality and quantity, we are not forearmed against it.

The Bottom Line: How to Make Your Calories Count

The good news is that this relationship works in reverse, too. One of the best, most reliable, least “painful” ways to control the number of calories you consume, and thus your weight, is to choose high-quality, minimally processed foods—especially vegetables and fruits. There are many virtues to wholesome, natively nutritious foods; one of the important ones is that they help to fill us up and satisfy us on a reasonable rather than excessive number of calories.

A calorie is a calorie, just like a mile is a mile and a gallon is a gallon. Calories really do count. But in my view, the best way to control the quantity of them is not to count them but to choose wholesome, minimally processed, high-quality foods, mostly plants, and let them fill you up. Drink water, not soda, as liquid calories don’t tend to offer much satiety benefit at all.

Don’t make the mistake of thinking you need to choose between the importance of the quality and quantity of fuel you provide your body. If you do, the renegade diet gurus and Big Food will both profit at your expense. You can count on it.

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