Calories In Calories Out or CICO is an outdated theory and has, in my mind, less credibility than say The Hyperinsulinemia Theory of Obesity. Although I believe calories do matter ultimately if you are a body builder or fitness athlete or desperate to get those last “ten pounds”, most of us will not have to ever be concerned with this. Very few of us will ever need to count calories in order to gain quality health. That doesn’t mean we don’t count, we just are not as concerned with energy but instead focus on the quality of that energy.
I am going to share my experience since I started doing Dexascans in April of 2017. For those who do not know a Dexascan is a dual x-ray that was originally designed to measure bone mass. Because bone is relatively easy to identify the other easily identifiable body element is body fat as the other measure. Thus bone and body fat added together and subtracted from total body mass would equate to one’s lean mass, a conglomerate of muscle, organs, fascia, ligaments and cartilage. It can be expressed as
Body mass – (fat + bone) = Lean Mass
The Body fat percentage is then simply total Fat / Total Mass = BF %.
But first let’s make sure calories are not the sole factor in weight loss and weight gain regardless of body composition.
Perhaps total calories made an impact on my weight? I had been eating Ketogenically since December of 2016. I had been consuming 70-85% of my nutrients as fats, another 15-20% as protein and the rest carbohydrates roughly 1-5%. What I did next was average my calories and weight daily, then monthly and averaged this monthly value out over years. As you can see in the chart my daily calories averaged monthly do not correlate well to my daily weight also averaged monthly. Striking is January of 2021 where my calories averaged 2800 per day but my weight plumetted. Conversely my weight gained mightly in 2018 when my calories averaged 300 less per day. GAIN WEIGHT WITH LESS CALORIES? What was happening? Could it be a delayed reaction? Possibly Calories Out? I will assume my activity at my employer and my home have not changed. This would possibly leave my resistance training. I had suffered some setbacks in 2020 unrelated to COVID-19. I did switch from an external gym back to my home gym and my volumes did go down. I only have records for 2019- now.
|Total Lifting Days||Total Sets||Total Reps||Total Volume|
Yes I dropped total volume lifted in 2020 and as of now I am on course to not even hit my 2020 mark at ½ way through the year. But even so just a cursory look shows that calories consumed shows very little impact on output. I could remain at a similar calorie load lifting heavy or not. Simply stated it was not the output that changed my body weight. Perhaps body Compostion was the key?
This next chart reflects the use of a Dexascan to measure my body fat relative to my weight gains or loses. During these last five years I either conducted monthly 5 day fats, Alternative day fasts or time restricted eating or just Keto. I also quit chewing tobacco and nicotine is a known insulin inhibitor as far back as the 1920’s cigarette companies advertised weight loss as a benefit of smoking. I notate in my next chart when I quit and its effect on my body composition. Then you can see the subsequent body fat loss again when I quit daily use of sugar alcohols followed by yet another gain due to a torn pectoral muscle and a further complication of a bifascicular block and subsequent pulmonary embolism and arrhythmia all of which seem to be under control and which I now have on the mend. One last gain came as a result of some ADF fat loss followed by me freaking out over my feelings in my heart and I began to eat Cod Livers Daily which added a crushing amount of dietary fat. Overall for my age I am in the top seven percent of male Americans with the lowest amount of Bodyfat.
At this point we can make two very valid points based on my n=1 results. First calories in or out alone do not determine body weight. The second is that body weight is not a good predictor of body composition. But then is body composition a predictor of poor health as assessed by the Body Mass Index which is the tool most physicians use in assessing health risks?
Using this Dexascan chart it is possible to look at some health issues in particular as a measure of my metabolic health. Let us consider how it is used then as a health marker. The Body Mass Index or BMI is a health marker that has gained prominence and it does have some uses, but it is my belief that it is seriously flawed as a predictor of metabolic health and the jury is being swayed that it is also not a good marker for prediction of longevity. The pink chart is my weight, Body Fat percentage and BMI charted. The first striking measure is my BMI as seen in the red line, in particular the months between September 2020 and March 2021. When my BMI is at its lowest I also have more body fat as measured by the green bars. In fact as a percentage of my weight it has never been higher since tracking it. Ouch. BMI clearly does not assess the risk for subcutaneous fat. At two other points my BMI is exceedingly high but my body fat percentage is low.
Based on this, Who in their right mind would ever advocate for MORE body fat in pursuit of a lower BMI? Conversely prior to that notated dateline in 2018 I had a very high BMI of 29.9 bordering on obesity technically but looking closely we see highlighted next to it is a body fat of 22.9% which placed me on average above 78% at the age of 56 of my fellow American’s body composition. Obviously something was not correct. BMI was not an absolute predictor of body fat percentage and minimally should not be applied to the more athletic and lean Americans.
Pouring over my data I began to consider Visceral Adipose Tissue or VAT. My VAT had gone up, not dangerously but significantly. Plotted over the same course of time my VAT does rise dramatically at the end of 2018 but corresponds haphazardly with body fat gain. However the level of body fat alone does not seem to have enough correlation to VAT. What if I add in BMI to VAT?
Dang It. BMI does not seem to correlate with the VAT score either. Why then would I chase a lower BMI when it does not account for body composition in either subcutaneous fat or visceral adipose tissue? The answer I have arrived at is I shouldn’t.
Showing my cardiologist these results he is hesitant to concede. He points out the “research & studies” that show links between high BMI and mortality. Conversely I tell him my experience suggests otherwise. Had his studies accounted for body composition? Had they accounted for macro-nutrients as a percentage of total calories? Had they accounted for insulin secretion? The list goes on. His short answer was akin to “I don’t know” but instead on saying that these are good points he demurred and continued to lean that direction. At least he no longer advocates ( to me) a plant based diet.
I started by saying calories might actual matter. I think they do. I think that a surplus of energy over time will lead to storage in the body. There is strong discussion as to which is first subcutaneous or visceral. I need to explore this at a greater depth. This exogenous energy can easily and most often be carbohydrate, less so fats and I think protein of the three macro-nutrients is the least worrying.
Over the last few years documented here and my five years following keto this has been my experience that generally, calories do not matter.
Updated 8/16/2021 Richard Morris on the 2 Keto Dudes Podcast at the 48 minute mark talks about why some of my results could be happening. Well, not me in particular but in general. https://2ketodudes.com/details/204