"Calories Out" -- A Rant

I don’t like that I post so many rants, but what can I say? The nutrition world gives me lots to rant about. Lots. And if I may say, many of the emails I get from you, my beloved readers, specifically mention how much you enjoy my sass and snark. So, if sass and snark are what ye seek, then sass and snark are what ye shall receive! Especially when it comes to today’s topic.

I’ve written before about the complete and utter crapstorm that is the very concept of “calories.” (That post is from April 2014. I’ve acquired a lot of new readers since then, so if you’ve never read that one, do click on over and give it a whirl. It’s a good one, if I do say so myself.) 

Okay, so, calories.

When it comes to losing weight fat loss, we’ve heard over and over again that it comes down to one thing: calories in, calories out (CICO). (Or is that two things?) Or, rather, it comes down to weight loss reduced adiposity being the result when someone takes in fewer calories than they burn. People are so stubbornly wedded to this idea that “Woo” famously calls them CICOpaths, CICOphants, or CICOtards. (With apologies to the reader who took me to task for my “Don’t Be a Ketard” series title, which has been renamed “Being Fat Adapted Versus ‘In Ketosis.’”)

As you know, I try to be careful about how I phrase things. (Case in point: the crossed out stuff in the preceding paragraph.) Part of this comes from me being an English major and language nerd, and part of it comes from knowing that when we phrase things incorrectly, they may not even be relevant. For example, I try to say “accumulate adipose tissue” more often than I say “gain weight.” Because gaining weight and accumulating adipose are not the same thing. If you gain weight, that might be water, muscle, bone, or, for the truly crunchy/hippie among you, a pounds’ worth of leg and armpit hair. And I try to say lose body fat rather than lose weight, because you can lose water, muscle, bone, etc., and when the vast majority of us talk about “weight loss,” what we really mean—and what we really want—is fat loss.

The reason why I’m such a stickler for saying things a certain way is because saying them more precisely/accurately helps us frame discussions in a certain light. And the reason why I’m explaining to you why I’m such a stickler is because we are going to frame today’s discussion in a certain light. One that I don’t think gets anywhere near enough attention in the nutrition and health world (except from me). As far as I can tell, I am one of the only people writing about this particular thing in this particular way. (If I’m wrong, tell me in the comments and share links to relevant stuff you find.)

What the heck am I talking about? What is the point that’s taking me so much prep work and blathering to get to?

Calories in, calories out.

Let’s leave the calories in part for another day. (Or, you can read this to see that I do, in fact, acknowledge that there is such a thing as too many calories, even on a low-carb, high-fat diet. Indeed, you can accumulate excess adipose on a ketogenic diet. Why? Because ketosis does not guarantee fat loss.) Today, we’ll focus on calories out.

Why? Well, we control calories in. We have total conscious control over how much food and which foods we eat. We might feel out of control as we dig for the last spoonful of the pint of ice cream we swore we were only going to have one serving of when we sat down with it on the couch, but ultimately, we are in control. No one has actually tied us up and force fed us ice cream. We might have food addictions, or “trigger foods,” and wild fluctuations up and down on the blood sugar rollercoaster might have us hoovering up donuts and banana bread, so we feel like we don’t have control over ourselves, but the ugly truth is, we do. In the end, we put the food in our mouths. I could write a whole bunch of blog posts about the effects of various hormones and signaling molecules on appetite regulation, satiety, and fuel partitioning, and how all that may affect the amounts and types of food we crave, but even in the face of all that, when it feels like we’re at the mercy of those chemical signals, we are still the ones holding the fork, the spoon, the shovel, or the handful, and even when it feels like we don’t have control, we do exert autonomy over what and how much we put in our pieholes mouths.

Not so with calories out!

When the CICO people scream that the path to fat loss—and the only path to fat loss—is burning more calories than we take in, they talk about exactly that: “burning” calories. In posts too numerous for me to list here, rather than saying “burn calories,” I have made a point to say “expend energy.” But even this doesn’t really hammer home the point I want to make today, because the word “expend” is a bit problematic.

Where to start? Oy…it’s such a big topic.

The phrases “burn calories” and “expend energy” both imply that we accomplish this—the utilization of food energy—through deliberate effort. For example, running, biking, swimming, tennis, weightlifting, etc. And, certainly, those activities do burn calories utilize energy. However, the amount of calories we burn energy we utilize during that type of physical activity is miniscule compared to the amount of energy we utilize during the entire rest of our day, week, and life.

I don’t believe fat loss does come down to CICO and nothing but CICO. But for the sake of argument here, let’s say it does. Let’s say that if you want to lose body fat, the only way to do it is to consume less energy than you expend utilize. You have to eat less and move more, OR, eat less, or possibly even the same amount, and get your body—somehow—to burn more calories utilize more energy even when you’re not moving.

As I’ve written before: “Which do we think is more important: the calories we might “burn” energy we might utilize during one measly hour at the gym every day, or how our bodies are using fuel the other 23 hours of the day? Even if we were to work out for three hours a day (and if you have time for that, my condolences on your unemployment), which would be more important: the calories we burn energy we utilize during those three hours, or what our bodies are doing metabolically and biochemically the other 21 hours of the day?”

This is such a small part of “calories out” and 

total cellular energy utilization, it’s not even funny.

See, every single thing our bodies do requires energy. Yes, intense exercise uses fuel, but so does sitting upright, and breathing, blinking, digesting food, the heart beating, the hand holding a pencil to write something—every single process that goes on inside us, whether we’re aware of it or not. Heck, even the teeny, tiny sodium-potassium pumps in our cell membranes use energy (ATP).

Other things that use energy are things that fall into the category called NEAT – “non-exercise activity thermogenesis.” This is the fancy way to classify physical movement that is not what we consider “exercise,” but which, on a cellular level, generates heat and/or uses energy. From the study in the link: “Non-exercise activity thermogenesis (NEAT) is the energy expended for everything we do that is not sleeping, eating or sports-like exercise. It ranges from the energy expended walking to work, typing, performing yard work, undertaking agricultural tasks and fidgeting.”

Do not—repeat, do not—insult my intelligence by suggesting that I can drum my fingers or tap my foot to the point of losing ten pounds of fat. I actually hate fidgeting. When I am seated next to a fidgeter, I tend to want to murder them without prejudice. (Also, I guess the author of this paper has never had a wild romp in the sack, or (s)he might’ve mentioned S-E-X as a pretty great form of NEAT, but hey, it’s not for me to judge. Also, I only had access to the abstract; perhaps a little "afternoon delight" is mentioned in the full text.)

Since NEAT encompasses things like walking (not powerwalking, but just the everyday walking we do in the course of our lives), yardwork, laundry, cooking, etc., I acknowledge that, indeed, NEAT is an important factor in a person’s overall energy expenditure. But let’s focus more on the other stuff—the stuff that’s part of the resting metabolic rate (RMR). That is, the amount of energy we utilize while doing JACK SQUAT. (Which is not to be confused with a front squat or a back squat.) The resting metabolic rate includes the biochemical reactions and cellular processes that go on in our bodies all the time, awake or asleep, moving or lying down, over which we have no conscious control. It is the amount of calories you burn energy your body uses just to keep you alive. And the RMR—the sum total of the energy utilized by all those little processes that are going on inside us 24/7—is, for most adults, far higher than the amount of energy they could force their bodies to utilize through deliberate exercise.

This is the key thing here, folks: the CICO people wrongly assume that we have conscious control over all “calories out,” or energy utilized.

We can control some of the calories we burn energy we utilize, of course, but not the vast majority. This is the point that gets me riled up every time I read about “calories in, calories out.” Every damn time. Because no one seems to get this. No one. (Except me.) I feel like a lone voice in a huge expanse of wilderness: If a nutritionist rants in the woods, and no one’s around to hear it, is she still ranting?

Let’s talk about what we can control, and then get to what we can’t control.

We can control most of the NEAT—gardening, manual labor, walking to do errands instead of driving, carrying grocery bags instead of using a cart, etc. This is part of the push behind the standing desks and just being more active throughout the day in general. It’s not necessarily “exercise,” but it’s better than sitting on our rear ends all day, every day. It’s a way to incorporate just a little more physical activity into our lives. We can also, of course, control the “exercise” we deliberately make time for: sprinting, biking, lifting, hockey (LET’S GO PENS!), etc. The fortunate among us who happen to have hours upon hours of free time every week can do insane amount of exercise. We can do so much exercise, in fact, that we do make a huge dent in “calories out.” If we do enough exercise, we can get to a point where we are burning more calories using even more energy than is required by our bodies to maintain the RMR.

HOWEVER:  When people do this much exercise, there is a COMPENSATION. I’ve written elsewhere that it’s like dropping a bowling ball on waterbed. I apologize for using this analogy over and over, but I like it a lot. There is a ripple effect. In the human body, there’s almost nothing you can do without it being adjusted for somewhere else. In science-speak, this is homeostasis. Status quo. The body hates perturbations up or down, fast or slow, hot or cold, alkaline or acidic, etc. There are redundant pathways and overlapping processes like crazy, just to ensure that the body maintains its homeostasis. It doesn’t like being moved too far in any direction from what it considers “normal,” and it will do whatever it can to bring itself back to normal if it finds itself being pushed to a place it doesn’t want to go, be it with weight, temperature, pH, heart rate, or something else. (This is part of why many people find it so damn hard to keep weight off if they’ve lost a large amount of fat after a long time of being overweight or obese, as I wrote about here.)

One of those “something elses” the body will adjust for in order to maintain homeostasis, is the amount of physical activity someone engages in. Workout intensely, frequently, and without adequate rest and recovery, and your body will tell you who’s boss. It will make adjustments somewhere else. Maybe you’ll start getting sick more often, as high exercise loads may depress the immune system. Maybe you’ll just plain feel fatigued because something, somewhere else in your body, is slowing down in order to let you keep putting your balls to the wall hitting things so hard in your athletic endeavors.

My point: even if you do exercise your way to burning thousands upon thousands of calories—that is, utilizing tons and tons of energy—something, somewhere else, will compensate so that you don’t literally run yourself into the ground/grave.

Getting more and more “calories out” via deliberate physical activity—particularly when combined with reducing caloric intake (that is, eating less and moving more)—only means that, eventually—maybe not right away, but eventually—the body will compensate elsewhere such that the end result will be a reduction in “calories out” through other means. Think of all the [usually] women out there with “adrenal fatigue.” It doesn’t come out of nowhere. It’s usually women who are exercising too much relative to the amount of sleep they get, recovery time they allow, and FOOD they eating. The body compensates for the insane amount of inadequately fueled exercise by slowing the whole body down. They get tired. They get sick. They get cold. They get depressed. AND THEY GAIN BODY FAT.

I have personal experience with this. I wouldn’t say I had landed myself quite in “adrenal exhaustion,” but stay with me here: Many, many moons ago, my (lack of) employment was such that I was able to exercise for four hours a day. I went to the gym for two hours in the morning and two hours in the evening. Admittedly, it was mostly “chronic cardio” with just a little bit of lifting (girlie lifting, since this was a long time ago, back before I had finally breeched what I had until then considered the scary “guy area” of the gym, where the free weights and squat racks were). So yeah. Four hours of “moving more” per day. And it worked. For a while. Until it stopped working. I was losing fat, until I started gaining fat. Some of you out there may even have experience with this, yourselves. I started feeling tired. I reached a point where going to the gym was a chore. It wasn’t fun anymore; I had to force myself to go. And I had stopped making progress in strength and speed. If anything, I was regressing. In addition to accumulating adipose, I was getting weaker. Why? BECAUSE MY BODY WOULD ONLY LET ME KEEP UP THAT CRAZY B*LL$H!T FOR SO LONG BEFORE IT MADE AN ADJUSTMENT. I can’t say what, exactly, happened, because this was long before any of my nutrition/health education, and I didn't know to have anything tested. With hindsight, though, I can assume that hormonal and other biochemical feedback was telling my body that it had to do something, or we were going to be in serious trouble. Since I wasn’t going to slow down voluntarily, my body made me slow down by making me tired, depressed, and weak.

(To clarify something before we move on: I don’t think that a lot of exercise, per se, causes these issues. I think it’s a lot of exercise in the absence of adequate recovery and nutritional repletion. Because that’s exactly what I was doing at that time: not enough rest, not enough calories, and, to be completely honest, probably not enough carbs. Remember: compensation in order to maintain homeostasis. If you’re resting/recovering enough and fueling yourself adequately, then your body doesn’t need to adjust.)

Okay. Let’s move on to stuff we can’t control:

The vast majority of “calories out,” or energy we utilize, is NOT within our conscious control.

You’ve all heard of the hypothalamus, right? If not, the extremely simplified explanation is that the hypothalamus is a region of the brain, and it’s kind of like the body’s thermostat. You may have heard that the thyroid gland is the “master regulator” of the metabolism. It’s true that the thyroid plays a big role in resting metabolic rate, but the kicker is, the thyroid doesn’t do anything without the hypothalamus telling it to. The hypothalamus secretes thyrotropin releasing hormone (TRH), which tells the pituitary gland (also in the brain) to release thyroid stimulating hormone (TSH), and TSH tells the thyroid to secrete thyroxine (T4) and tri-iodothyronine (T3). So the thyroid gland is a key player, but, by itself, it doesn’t do a whole lot unless it gets the right signals from the pituitary, which gets signals from the hypothalamus.

SO: Why are some people’s “thermostat” set higher than others’? Why are some people’s resting metabolic rates seemingly off the charts, while others’ are lagging behind? Why are some people—naturally, through no deliberate doing—hares, while others are tortoises?

That is, why do some people’s bodies burn so many calories/utilize so much more energy than other people’s, regardless of the amount of physical activity they engage in? Seriously, we all know people who eat a lot and wouldn’t even consider lifting a barbell or sprinting down the street, yet they’re lean. And we all know people who don’t eat a whole lot, who are active, and are not lean. I have spent my entire life hating envious of people who eat far more than I do, and who exercise far less than I do, yet who carry far less body fat than I do. Punks. So please, do NOT tell me it’s all about calories in and calories out.

(OR: if you are going to insist that it’s all about calories in and calories out, please help me understand why MY BODY utilizes so many fewer calories than someone else’s does AT REST, and then, for the love of all that’s holy, HELP ME FIX IT!)

Why, WHY, are other people’s resting metabolic rates so much higher than mine? (And maybe yours!)

Is it the hypothalamus? Is it the pituitary? Is it the thyroid? Is it all three, and then some?

When it comes to making my body utilize the same amount of energy as someone whose RMR is naturally higher than mine, why should I have to exercise four hours a day every day just to “burn the same number of calories”/expend the same amount of energy that someone else’s body expends BY DEFAULT? AND, if I do force myself to engage in that much deliberate exercise, what about the compensation that WILL eventually occur? What about when whatever body fat I managed to lose comes back, and it brings friends, and it’s even harder to lose a second time, because now, my body has compensated by lowering a resting metabolic rate that was ALREADY lower than someone else’s to begin with? (Yo-yo dieting, anyone?)

This is what no-friggin’-body—as far as I can tell—is talking about.

Now you can understand why even the phrase “calories in, calories out,” is problematic for me. Calories out implies that we can control it—all of it. So if you are not getting enough “calories out,” it is a failure on your part. You are undisciplined, lazy, slow, and slothful. It’s not that your hypothalamus is on the fritz and your resting metabolic rate is in the toilet; it’s that you—you weak-willed, moral failure of a person—are just too lazy to spend 18 hours a day at the gym. These moralistic arguments that imply excess adiposity results from some kind of character flaw have GOT TO GO. It is probably the number one reason I wanted to be a nutritionist, after having learned about the science of low-carb. Because I learned that there is a much more effective way to reduce that excess adiposity than eating less and moving more. I don’t look at other human beings and, based on nothing but the size of their body, assume that I know anything about what they eat and how much they exercise. Because I can’t. You can’t. You cannot look at someone and know everything there is to know about why they are lean, not-so-lean, or super-extra-not-so-lean.

(Click here and here to read posts from long ago where I talked about the problems with “willpower and discipline” as they relate to attempting to reduce one’s adiposity.)

Y’know, the truth is, fat loss does come down to calories in and calories out. IT DOES. The question, in case it’s not clear yet through my angry writing, is why do some people’s bodies put so many more calories out -- that is, use so much more energy -- than others’, regardless of how much deliberate physical activity they engage in?

Rather than “calories in, calories out,” I would SO MUCH PREFER if we could switch to calling it “energy in, energy utilized.” This implies energy utilized in all contexts: walking to the bus stop, running a marathon, carrying heavy grocery bags, playing the saxophone, sleeping, watching TV, and doing absolutely nothing. (Also: gettin’ it on.) It includes all the things we don’t have control over. So it removes the “shaming” and stigma I grow increasingly disgusted by on social media.

Ooookay…back on message.

From the paper on NEAT: “Hypothalamic factors have been identified that specifically and directly increase NEAT in animals. By understanding how NEAT is regulated we may come to appreciate that spontaneous physical activity is not spontaneous at all but carefully programmed.” Really? What a friggin’ shock! If the hypothalamus is firing on all cylinders, animals want to expend more energy? If a person’s hypothalamus is working harder than mine, is that why they want to fidget, while I’m a fan of sitting still and being quiet? Is a very active hypothalamus the reason why some people are physically incapable of holding one of those clicky pens without clicking it constantly? Are there some people whose hormonal signaling is telling them to be in constant motion, even if it’s just drumming their fingers or jingling the change in their pocket?

It seems like these people aren’t utilizing more energy because they’re moving more; they’re moving more because their bodies are making energy like crazy. They’re not using lots of ATP because they’re moving more; they’re moving more because they’re generating more ATP (without even trying!) and therefore have lots of energy to expend—to the point that they are literally unable to sit still for five minutes. For those of you familiar with Gary Taubes, this is very Taubes-ian. [He’s been taking a lot of flak lately in the nutrition world, but I remain a huge fan.] To paraphrase him, “People don’t burn more calories because they move more; they’re moving more because they’re burning more calories.” That is, they are driven to move more because their bodies are “burning” through a lot of energy.

Now, if we were talking about a machine, this would actually be fairly inefficient, right? In a mechanical system, the less energy required to get something done (or to “do work” in the physics sense), the more efficient the machine or system is. So a body that is using lots of energy is sort of inefficient, while one that conserves energy, or gets the same amount of work done using less energy is more efficient. (If Mr. Peterson, the physics teacher, still reads my blog, please chime in in the comments if I’m wrong. ;-) ) Of course, we are not machines; we are human beings. And I guess we could say we’re not getting the same work done. If we were, then the slow metabolism people among us would have faster metabolisms and we would be doing the same amount of work. (At the cellular level…the stuff we can’t control.) Sorry; I know that’s kind of a weird tangent. I just wanted to talk about the concept of “energy efficiency” for a sec in order to make us slow metabolism folks feel better. In a way, our bodies are more efficient than the people who run hot all the time. We’re staying alive while using less energy. So there!

The secret, it seems to me, is how to get the body to use more energy without triggering the aforementioned physiologic/hormonal compensations. That, I think, might be the holy grail of lasting fat loss without having to decrease caloric intake year after year, until you reach a point where things have gotten so off track that you’re eating about 300 calories a day and not losing fat. The secret is how to crank up that thermostat so that your RMR is higher regardless of whether you’re sitting on the couch or training for a triathlon. We shouldn’t have to devote ungodly amounts of time to deliberate exercise in order to achieve the same amount of leanness others enjoy through no deliberate action on their part whatsoever.

To use the physics/machine angle again, what we would want to somehow achieve is getting the machine to be less efficient -- that is, use more energy or burn through more fuel -- without incurring any of the negative consequences we might expect in a machine, such as overheating, wearing out, or flat-out breaking down.

Good luck.

HOWEVER: Based on the lasting, long-term fat loss many low-carbers and Paleo eaters (and adherents to other diets) out there have achieved—without starving themselves, and without amounts of exercise that border on the neurotic—obviously, this can be done. To be honest with you, I’m not sure I understand how it happens, but we can’t deny that it does happen. Maybe some of the metabolic changes that occur on these plans actually affect the hypothalamus and pituitary. Maybe, even in the absence of adding a great deal of new muscle mass, the resting metabolic rate somehow increases. That’s really the only way I can see this working, especially for the people who lose a lot of body fat and maintain that loss over the long term while eating normal amounts of food and not doing a bunch of strength training.

…Or maybe they just fidget a lot.

P.S. For more sass and snark about the morass that is “calories,” the podcast Robb Wolf recently did with Dr. Jason Fung is highly recommended. Dr. Fung has a way of using some pretty hilarious analogies to point out how utterly ridiculous this all is.

Disclaimer: Amy Berger, MS, CNS, NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.