Someone I know gave me a look at a book by a guy named Dr. Gregory Ellis, who is a Ph.D. body builder and an ex-pro footballer, and asked me to take a look at it. The book suffers from being self published and not having the helping hand of a professional editor. It is way overwritten and about three or four times as long as it needs to be (it’s about the size of the Little Rock, AR telephone directory) to make the case Dr. Ellis is trying to make.

Dr. Ellis, like many people who should know better, is a firm believer in the calorie is a calorie is a calorie theory. In fact, he is such a firm believer that it seems to have reached the point of almost being a religion to him. His book contains 26 chapters, and starting with Chapter 3 (I don’t know why he didn’t start with Chapter 1, but he didn’t) and going all the way through the rest of the 26 chapters, he puts this statement at the top of the chapter page:

Calories Count! The Energy Balance Equation is weight control’s Golden Rule: it’s Ultimate, Irrefutable, and Holy Law. Calories consumed cannot exceed those burned off without gaining weight. The myth of the “fast” and “slow” metabolism that varies widely from person to person – is just that, a myth. It’s a myth that Uncle Harry “eats everything in sight and remains slim.” It’s a myth that Aunt Alice “gains weight at the whiff of a hot muffin.” Resting metabolism depends on body size and we can predict it by a formula; we aren’t that different. And large differences in the amounts eaten only come because one person is far more physically active than another. The Law is always obeyed. It’s unbreakable. All are accountable. No one escapes; no one is above the Law. This is the First Principal, failure to learn the Law will lead you to failure in bodyweight regulation. “But,’ you say… there are no Buts! [all bold text in the original]

This same statement – word for word, bold text for bold text – is how 21 chapters out of 23 start, so it’s got to be assumed that Dr. Ellis finds this important.

Extremely important.

(It is obvious that he is unfamiliar with or oblivious to the multitude of overfeeding studies that give the lie to this notion, but we won’t go in to that now.)

The reality is that our bodies have the capacity to deal with calories by changing the rate at which we burn them. Calories in and calories out are dependent variables, not independent variables: the one depends upon the other. Let me show you what I mean and explain why it’s often so difficult to lose weigh while dieting.

It always drives me nuts when people use a car or another piece of machinery as an analogy to the human body.

Why?

Because in a car the gasoline in/gasoline out equation (the energy balance equation for a car) works the way Dr. Ellis thinks it does in the human body. You put gas in the tank, and if you run the engine harder (exercise for the car), you burn more gas. And it can be easily calculated how much you’ll burn at a given engine speed on level ground. And it can be replicated. As the gas runs low in the tank, the car can’t help itself get better mileage to conserve.

If a car is going to be used as an analogy to the human body, we need to include the driver to make the system perform more human-body-like. We have a body and a brain – the car has a body and a brain (the driver).

A few years back MD and I were driving through the Ozarks in southwest Missouri where I grew up. We had just been to visit Hodson’s Mill, pictured above, the mill where my maternal grandfather used to take corn on mule back to be milled when he was a kid circa the turn of the 20th century.

The countryside is beautifully picturesque with loads of hardwood trees, rolling hills and large bluffs, the Ozark Mountains. We were riding in an SUV, and as we motored along, I suddenly noticed that the gas gauge was banging on empty. Then it dawned on me that it was a Sunday, and it was likely that in rural America there weren’t going to be a lot of service stations open. Especially not out where we were. And I didn’t even know exactly where we were relative to any towns because I hadn’t been paying close attention to the road signs.

I went into gas conserve mode.

As we approached hills, I timed my speed so that we would barely make it to the top, then be able to coast down and halfway up the next hill before I had to hit the gas pedal. I let my coast speed build up to way more than I felt comfortable with given the winding roads and blind curves, all the while trying to ignore MD’s sharp intakes of breath, her legs and feet pushed against the floorboard braced for collision, and her death grip on the handhold.

Even though I was driving a gas-guzzling SUV, I’ll bet I milked 40 miles to the gallon out of that sucker until we finally found an open service station, and the day was saved.

Once we were filled up, and I was back at the wheel driving normally, we probably dropped back down to the 18 mpg range.

If I’m running late and in a hurry, I get a lot less gas mileage than normal. I race up to stoplights, slam on the breaks, floor the accelerator when the light changes – all activities that minimize gas mileage, but get me wherever I’m going a little sooner.

In both of the cases described above, it’s the car/driver combo that makes the difference. It’s the same with our bodies. Numerous overfeeding studies have shown that when weight-stable people are overfed huge numbers of calories over varying periods of time, their body weights change minimally, at best, just a fraction of what would be estimated based on their increased caloric intake. Why?

Because their body/brain combination is performing much like my driver/car example when I’m trying to get somewhere in a hurry. I waste gas in exchange for speed; these overfeeding subjects waste calories in exchange for stable body weight.

Underfeeding or starvation studies show just the opposite. When people are fed calorically-restricted diets, they go into kind of a metabolic slow down process to conserve fuel just as I did with the vehicle when we were running out of gas. These calorically-restricted subjects become lethargic – they move less and they sleep more. Their reduced calories in induces their bodies to reduce the calories going out.

This phenomenon is called adaptive thermogenesis, which is defined as increase or decrease in energy expenditure in response to overfeeding or underfeeding (or even temperature change).

Adaptive thermogenesis is the reason that my friend from Down Under, who is so taken with his metabolic ward studies showing no difference in weight loss irrespective of dietary macronutrient composition, doesn’t understand or believe in the metabolic advantage. In his book he has assembled a number of studies done in metabolic wards (sort of; but that’s a topic for another post) showing that subjects fed primarily fat or primarily protein or primarily carbohydrate all lose the same amount of weight. These papers show that it doesn’t really matter what the protein/fat/carbohydrate composition of these restricted diets are, the subjects all lose the same amount of weight. Which to our friend, who hasn’t really bothered to think it all through, proves that dietary composition doesn’t matter. He, like Dr. Gregory Ellis, believes it is simply a matter of calories, not macronutrient composition. And most of the studies he lists seem to corroborate his belief. But there is a problem. A big one.

Virtually all of these studies are ones in which the subjects are severely restricted in calories. In some the caloric restriction is so great (500 kcal total intake per day) as to be truly starvation diets. When the body is severely calorically restricted, it uses every scrap of food that comes in. It burns protein; it burns fat; and it burns carbs. And it burns them efficiently. During starvation it doesn’t matter what the composition is, the body simply consumes the calories. And, under those circumstances, it makes perfect sense that there would be no difference in weight loss regardless of what the ratio of macronutrients happens to be.

As the caloric intake increases, a point is finally reached at which the body can afford to be a little more discriminating as to what it does with the calories coming in, and at that point the macronutrient composition begins to matter. As the caloric intake increases, as it does in the overfeeding studies, there comes a time at which the body again doesn’t particularly care what the macronutrient composition is – there is simply too much of everything, and so the body blows it all off.

In between these two points, in the caloric range where most of us operate most of the time, macronutrient composition does matter. In fact, in our friend’s book, he actually lists a couple of studies in which there does appear to be a metabolic advantage.

And guess what?

Those are studies in which the caloric intake is up more in the range one would expect while dieting, not starving. And those studies do indeed show that a low-carb diet brings about more weight loss than an equal number of calories given as a high carb diet. These studies were done in Germany under metabolic ward conditions by a researcher named Udo Rabast.

Dr. Rabast did the studies mentioned in this book plus a few that weren’t mentioned because, although they were done under metabolic ward conditions, they didn’t fit the selection criteria of our friend, i.e., they didn’t show what he wanted them to show to substantiate his argument.

The Rabast studies do indeed show a fairly robust metabolic advantage to the low-carb diet. The two studies that were mentioned were sort of included in the book chapter as oddities, I suppose. So how did our friend deal with these studies. He blew them off. He simply stated that since all the other studies he presented don’t show a metabolic advantage, then these have to be aberrations and should be ignored.

Don’t believe me? Here he is in his own words:

Regardless of whether Rabast el al’s findings were the result of water loss from glycogen depletion, pure chance, or some other unidentified factor, they should be regarded for what they are: An anomaly that has never been replicated by any other group of researchers. For a research finding to be considered valid, it must be consistently reproducible when tested by other researchers. As proof of the alleged weight-loss advantage of low-carbohydrate diets, the findings by Rabast and colleagues fail dismally on this key requirement.

Could the “some other unidentified factor” possibly be a metabolic advantage? Methinks so.

There is another study in his list showing a large metabolic advantage that he totally misinterprets, but we’ll leave that one for another day. I want to write on it in more detail because it shows all the problems inherent in these kinds of studies. And in the interpretation of them by people with little experience and/or an axe to grind.

Following a low-carbohydrate diet that is in the calorie range where the metabolic advantage exists makes one able to lose weight without the weight-retaining effects of adaptive thermogenesis kicking in. You can, so to speak, have your cake and eat it too. The body is getting enough calories to keep it from going into starvation mode yet the macronutrient composition of the diet leads to enough of a caloric deficit to ensure weight loss. The best of all worlds.

The phenomenon of adaptive thermogenesis is getting a lot of play currently in the scientific literature. There are a number of researchers who feel that certain factors have changed in our environment making it more difficult for us to lose weight once we’ve gained it. And making it easier to gain in the first place.

I’ll address these factors in a later post and show how you can overcome them.

Photo at top of Hodgson Mill, near Gainesville, MO. Built in 1884 Photo by Hemant

40 Comments

  1. The body definitely conserves energy during calorie restriction and after weight reduction. Some people are better at conservation (in famine), some are better at wasting (in excess), and some are equally good at both. Ellis is a fool if he truly believes metabolisms do not vary widely.
    I am in the rare position of being able to have RMR tests every couple of months. I have lost 160 lbs and am maintaining a low BMI of 20 for years. Every time my RMR is measured it comes in at about 1000 calories on the nose – an expected RMR is 1350. I am certain my weight loss is the reason I burn so few calories relative to other women with my stats.
    The most recent RMR test came in at 1200 calories. The reason it increased so much is because the night before this test I ate a little bit more food than I usually do before the test (about 500 cals more than I did on other days). I was also in the luteal phase of my menstrual cycle (higher progesterone = higher RMR). In spite of these I was still well below the expected number.
    You know what? I really don’t feel that tired, cold, or lethargic in spite of my incredible metabolic efficiency. I cringe to think what my RMR may have been back when I actually did feel the sting of metabolic conservation (when I was eating less, and weighed less, so my body was in freakout mode).
    In fact, I only think I am able to eat as much as I do (about 1650cals) and not gain weight because of the metabolic advantage. It is my intuitive belief that when you eat a very low carbohydrate, high fat diet as I do, only a small amount of food actually is available to cells as energy – the rest is wasted in heat (fatty acids & low insulin increase uncoupling proteins) or in the cost of converting proteins to glucose (which wastes a bit of energy doesn’t it). There’s no way my daily activities are 650 cals.
    I can gain weight on a low carb diet, though, if I hit the calories higher than this… so the metabolic advantage does definitely have limits… but it is a hell of a lot better eating 1650 cals than 1350 cals (which is probably what I would need to eat on a low fat high carb diet).

  2. So the big question now is how do we determine where that sweet spot is? I assume that’s what you mean when you say “I’ll address these factors in a later post.”
    You determine the sweet spot kind of by trial and error, but it works out pretty nicely that for most people a good quality whole-food, low-carb diet keeps the calories at about 1500-1700 per day.
    The other posts will address other things that alter our metabolism, changing the levels at which adaptive thermogenesis kicks in.

  3. Here’s what I believe is the biggest problem with getting people to grasp the concept of adaptive thermogenesis: we like simple math. We like inputs equals outputs. It’s just plain easier to wrap our heads around those equations, even if they don’t explain real results.
    For example: I’ve tried — until I’m blue in the face — to get some of my friends to understand that if you raise taxes by 10 percent, it doesn’t mean the government will have 10 percent more money to spend. People adapt. They spend less, hire less, change their investment strategies, find more tax shelters, etc.
    When New York jacked up cigarette taxes, they ended up losing revenue; people adapted by going elsewhere. The projected revenue increases didn’t materialize.
    So while I believe you and have my own experiences to back it up, this will always be a tough sell.
    Hey Tom–
    Good analogy with the taxes. Increases taxes invariably reduces revenue or, at best, keeps it about tey same, a fact that people who love to raise taxes never seem to figure out. Or maybe they do figure it out, but want to raise taxes to be punitive against those who are successful despite the fact that it won’t raise revenues. Conversely, lowering taxes generally raises revenues simply because if rates are low enough, it’s easier to just pay the taxes than to spend the time and effort to avoid them. People may ask why we are running a huge deficit right now despite the lower taxes of the Bush administration. It’s because the Bush bunch along with congress have been spending money like water, especially on the war in Iraq.
    Cheers–
    Mike

  4. Hi Michael,
    Thanks again for the interesting post! One of the things that has fascinated me for a while now is the individual differences people show. We all know how fattening carbs can be, yet some people — most of my friends for example — eat a ton of carbs and are very thin (10-15% bodyfat). Most do a lot of exercise (my brother was an elite swimmer for Australia, but retired 7 years ago, actually does very little exercise now, but is still quite close to competition shape, I don’t know why lucky guy)… some don’t. Regardless, we are all very thin.
    When I ate loads of carbs each day under the mis-guided impression it was healthy I had a body fat of 13-14% with moderate exercise (couple hours a week). Now on low carb, and having reduced my calories, it’s under 10%.
    Is there a single mechanism which allows some of us to be thin no matter what? Is it insulin sensitivity? Something else?
    I really appreciated one of your older posts where you stated that, for some people, gaining weight is incredibly hard. In the past if I wanted to gain muscle I had to literally force feed myself to almost being sick on top of a heavy weights program. These days it seems easier… not sure why.
    Thanks very much,
    Michael
    P.S. I apologize if this is a basic topic. I am relatively new here, and have just ordered all your books on amazon last night (except Protein Power which I already have)… plus Taubes. I’m hoping that studying these will quickly fill in the holes in my understandings.
    Hi Michael–
    There are a number of factors at work. One is age. People can get by with a lot of dietary indiscretion when they are young, but it usually catches up with them. Extremely active people can get by with some dietary indiscretion, but when they slow down on the activity, they pay the price. It’s called the ex-jock syndrome. And some people – about 25 percent – are kind of metabolically gifted in that they seem to be able to eat a lot of carbs and still do okay.
    A young person who is extremely active can seemingly get by eating almost anything without showing any negative effects. I was such a person when young. But although it seems that there are no negative effects, there really ar: they are just hidden. I was undermining my own insulin sensitivity with my high-carb, high-everything diet, and when I reached my early to mid thirties, I suddenly ballooned up like a whale without doing anything differently. It was a struggle after that until I started a low-carb diet. It’s still somewhat of a struggle, but I maintain my normal weight.
    Cheers–
    MRE

  5. The more I think about this the more it baffles me how the calories-in-calories-out mantra can be seen as a ‘no-brainer’ by educated people who should know better than to see the highly complex human body as something so simplistic. The fact that it is even possible to use driving a car as an analogy – in spite of its having a genuinely and comparatively simpistic mechanism – is a stark illustration if this.
    Methuselah
    Pay Now Live Later

  6. If you’re opened nominations for this year’s Reckless awards, you might want to got to http://www.newstin.co.uk/tag/uk/76475223 and read the story headed “Surgery is ‘only means to healthy weight loss’.”
    But, wait, what about the American Academy of Pediatrics, which recommends giving toddlers skim milk and putting eight-year-olds on statins? I’m afraid you’ll have no shortage of candidates.
    The fact that there is no shortage of candidates is a real problem.

  7. While there is certainly an emphasis on weight lose, there does not seem to be much discussion of body composition that results from the weight loss. Macronutirents do count.
    Go on a high carb calore restricted weight loss diet and yes you will lose weight, but frequently at the expense of muscle tissue. Restrict calories on a low carb diet and you will find that you preserve muscle, your skin will tighten, and not be loose which is the experience of many who restrict calories on a high carb diet. Weight loss should not be a be all end all; afterall you want to preserve muscle which is more metabolically active than fat and needed to allow you to carry out your activities. Same calories, but one diet that is high carb lots of grains vs low carb natural foods diet. The latter will have you look better while each will produce weight loss.
    I agree completely. But at very low calories over a period of time, the weight lost with either diet is about the same. We’re just talking weight loss, though, not body composition.

  8. Would this thermogenic effect also be dependent on the macronutrient? Where I work we often have seminars, etc. and afterward cookies (yeah! that’s why I go). I don’t usually eat a lot of carbs much less simple carbs, but on the occasion that I do take one or two cookies, I find myself back at my desk about 20-30 minutes later sweating and feeling very hot. It can take up to an hour to subside. I attributed it to the sugar, but maybe my body is compensating.
    If you are normally on a low-carb diet, I would say that your symptoms are more likely from the hyperglycemia induced by the cookies and the time it takes to get blood sugar back under control.

  9. “You determine the sweet spot kind of by trial and error, but it works out pretty nicely that for most people a good quality whole-food, low-carb diet keeps the calories at about 1500-1700 per day.”
    The only problem with trial and error is that most people simply don’t want to do it.
    Either they eat whatever is convenient and end up overweight and in poor health, or they want to be told exactly what to do by a ‘diet guru’
    Getting people engaged in their own health shouldn’t be this difficult.
    A little too much nanny state and not enough personal responsibility

  10. Your post brings up a question I’ve always been curious about – whether indulging in a large amount of sweets all at once or doling them out over time results in a different end weight gain. I’ve always been of the opinion that going “face down in the donuts” occasionally is better than a few cookies per day based on the body simply being overwhelmed and tossing the excess in a single sitting. I would also suspect it is worse to have slightly elevated insulin over a longer period of time. What do you think?
    I don’t know that this has ever been studied, but I’m in favor of the ‘face down in them’ approach. Why? Because we were designed by the forces of natural selection over a long period of time. And during this ‘developmental’ period, there weren’t any concentrated forms of carbohydrate other than honey, when it could be had, and fruits in season (a short time). I suspect that our Paleolithic forebears went face down in the honey and ripe fruit when they could get it and not all the time. If this were the case, and I suspect it was, it would seem that we would be endowed with the ability to deal with carbs this way better than a ‘few cookies per day,” which would represent about 60-100 grams of refined carbs unlike any or ancestors would have been exposed to.

  11. I can’t believe anyone still believes “a Calorie is a Calorie is a Calorie” anymore.
    My 18 year old son’s a vegan, eats a tremendous amount of bread, potato chips, and other processed foods, i.e., lots of empty calories, and he’s thin as a rail. He spends all day on the computer, and doesn’t do anything physical.
    There’s no way I (57 years old) could eat what he eats, and exercise as little as he does, and get away with it.
    Neither will he (get away with it) when he’s your age. You can tell him that now, then be able to gloat in not too many years.

  12. As warm blooded creatures our core temperatures do not rise as we walk from shade into sun – blood vessels dilate; we sweat. The body actively monitors and reacts to maintain temperature using complex mechanisms. If you didn’t know this you might be tempted to apply physics in an oversimplified way: take a rock from the shade and place it in the sun and it MUST get warmer. Therefore we must get warmer in the sun. But the reality is more complicated.
    For the vast period we were hunter gatherers, periods of feast and famine must have been the rule. Surely berries have a season which is fairly short but bountiful. A lucky kill of a large beast might mean an enormous meal followed by days of slim pickings. The body MUST have a mechanism for dealing with this roller coaster. This is why I suspect statements like “a calorie is a calorie” and “ketosis is dangerous” are mostly nonsense. They don’t fit at all in the bigger picture. They smell more like entrenched memes with little actual basis in fact.

  13. A good example of adaptive thermogenesis is Michael Phelps. If it’s true he takes in 10,000 to 12,000 calories a day, even if he works out 6 hours a day (he doesn’t) and burns an average of 1,000 calories an hour in workouts (almost impossible) that still leaves 4,000 to 6,000 calories per day for RMR and maybe a few minor chores. Thermogenesis is the reason he doesn’t weigh 400 lbs by now.
    One other thing. I have a term I call “the context of calories” which basically recognizes that while carbohydrate functions almost exclusively as an energy-producing macronutrient in the body, protein and fat have additional important structural functions as well. In the case of protein, structure is in fact primary over energy. As a result, I suspect that the first 20 or 30 grams of daily protein are often allocated to structure/function/turnover (and, therefore, not directly related to energy) whereas carbs can only be used as energy immediately or stored as future energy. That non-energy structural use of protein might be even greater coming off a severe calorie restriction. That’s where context becomes important. I explored this in-depth recently http://www.marksdailyapple.com/the-context-of-calories/ but I wonder why this angle is overlooked in metabolic advantage discussions. What am I missing?
    Hey Mark–
    Nice post. I, too, believe that the first 20-30 (or maybe even more) of protein intake goes for structural functions (muscle, enzymes, hair, skin, nails, and other protein structures), but during starvation I think most goes for energy. People on low-carb diets use a fair amount of dietary protein to make blood sugar, which is why I like to make sure they get plenty. They need it both for sugar and for structural functions.
    Best–
    MRE

  14. Tom Naughton,
    Get the people with whom you talk to examine and drop the precept of taxation and income redistribution.
    Time well spent.
    Best,
    MK

  15. Re: “the first 20-30 (or maybe even more) of protein intake goes for structural functions (muscle, enzymes, hair, skin, nails, and other protein structures), but during starvation I think most goes for energy.” Kat James addresses this issue as it relates to beauty in her book, The Truth about Beauty. So many people worry about their appearance and fret over a few pounds, yet fail to connect their dull, sagging skin and falling hair with a lack of protein in their diets as they intentionally malnourish themselves into thinness.

  16. How does adaptive thermogenesis play out when you exercise regularly and eat the purist version of the PP diet? I’ve hit a wall after 40 lbs of weight loss (2/3 of it fat) and weight-cardio training 4x/week.
    If you’ve hit a wall, you probably need to take a look at calories. If you haven’t read this post, it will explain what I mean.

  17. Hi Dr. Mike,
    Thanks for the pointer to your calories article. I’ve been aware that as one nears goal, calories matter, even though a human body is not just a classical thermodynamic system. I’ve been monitoring my intake via software for a week, and without cheese and nuts, found that I was eating about 2000 C/day. This week, I’m cutting back on protein and fat a bit to 1700 C/day. I hope that’s sufficient, because I’m quite hungry much of the time, and I can’t fight that forever.
    A long battle with hunger is one you’re always going to lose. Make sure your carbs are low, and bump up the fat a little. That usually does the trick. The other thing I often have patients do is to consume three protein shakes per day (including some fat in them) and a normal meal in the evening. And you might want to avoid dairy. There have been a number of commenters on this blog who stated that when they removed dairy from their diet, their weight loss picked up. Enough anecdotal evidence usually indicates something is going on even if we don’t know the exact biochemical/physiological mechanism.

  18. Dr. Mike
    Whatever happened to your friend from Down Under? I assume you’re talking about Anthony Colpo. There has been nothing on his website since the last blast at you and his other site, the body building one, is kind of going dark. He hasn’t been on there for months. Do you know what happened to him?
    Uh, don’t know and don’t really care. I guess after that last savage caning I gave him, he skulked away to lick his wounds. I wish him well.

  19. Thanks Michael for your response. Do you know what the mechanism is behind it being harder to stay thin as one gets older? Really curious what actually changes as people get older than shifts their metabolism. Thanks, Michael
    One thing is that as people age, they tend to become more insulin resistant. More insulin resistance begets more insulin which begets more fat. Another is that they lose lean body mass as they age, usually at the rate of about one percent per year after age 30. Less lean body mass means lower metabolism.

  20. I was waiting for a chance to bring up these studies. Here’s one on pigs (very similar to humans metabolically). When fed a high-carb diet, they waste 7% of calories in their feces. When fed a ZERO-CARB diet (!), they waste 25% of calories in their feces. Looks like a metabolic advantage to me. They would have to eat 25% more calories to weight the same.
    http://www.ncbi.nlm.nih.gov/pubmed/6735620
    Here is another study on mice. It deals with cancer. The mice eating zero-carb weighed 15% less than the mice eating low-fat high-carb or Western Diet (high-fat high-carb). The mice on the zero-carb diets had no more cancer than the mice eating 1/7th as much fat. The fat was 10 parts milk fat, 10 parts lard, and 1 part corn oil. I wish they used 10 parts milk fat, 10 parts beef fat, 1 part lard, and no corn oil. But anyway, the mice eating zero-carb had the longest survival rates after they had cancer xenografted into their body. They also had less fatty liver infiltration than all of the other mice. But the fact that they had to be overfed to weight the same as the mice eating carbs says all that you need to know.
    http://www.ncbi.nlm.nih.gov/pubmed/17999389
    There were some flaws in this study, like they fed the zero-carb mice fiber like all the other mice. This could have caused weight gain. Contrary to popular belief, fiber has calories and carbs. In fact, fiber has up to 2 kcal per gram – for humans.
    http://www.scientificexploration.org/jse/articles/pdf/18.1_kauffman.pdf
    Hey Bruce–
    Thanks for the interesting links. Good work in digging these out.
    I wish the first paper listed was written in English instead of German because I would love to read it. As you probably know, I’m always a little suspicious of abstracts verses the actual paper.
    And in the last paper, I loved Kauffman’s review of The Protein Power LifePlan:

    For overweight people who want more information and more diet plans, the book by Eades and Eades is superior, followed closely by Atkins.
    Between clear writing, the use of a plethora of American colloquialisms, and many doses of humor, this book comes closest to being literature in this group, as well as one of the most scientifically solid and useful.

    I particularly like that last line because it encapsulates what we were trying to do in writing the book. We felt that diet books didn’t have to be devoid of wit and humor, so we set out to write one that was scientifically accurate yet approachable. According to Kauffman, we succeeded.
    Best–
    MRE

  21. A question for you…
    By consuming extra calories (protein/fat) when pregnant, but still keeping carbs pretty low, how does this affect both metabolisms?
    I recently found out that I’m pregnant–but was doing TSF at the time…so am attempting a proper intake of protein/fat/carbs (diabetic, too). I know that glucose (carb intake) affects the baby’s size, but how about protein & fat? Just curious.
    Thanks for the great insight on the topics!!
    The best thing is to keep sugars and refined carbs limited during the first trimester, which is the time that the fetal pancreas is developing. A load of sugar does the same thing to the fetal pancreas as it does to the adult pancreas, which is not good. So keep sugars and refined carbs down. In the third trimester it is important to increase protein and fat, which are the building blocks of a human, and the third trimester is when the fetus is growing its fastest.
    As always, you should check with your own physician before instituting any dietary changes during pregnancy. These are just the recommendations I make to my own patients who are pregnant.

  22. “I wish the first paper listed was written in English instead of German because I would love to read it. As you probably know, I’m always a little suspicious of abstracts verses the actual paper.”
    Maybe someone here lives in Germany or speaks German and can dig up the study. It seems to be well-designed. They gave the pigs 3 weeks on each diet in a cross-over design. So, Anthony Colpo and Gregory Ellis can’t say they didn’t give them enough time to adapt. And this is better than metabolic ward, it’s a study using respiration calorimetry. And this just shows that food is not perfectly digested on a low-carb diet. The pigs were eating 85% fat and no carbohydrates, so that’s about as extreme as you can get. Colpo and Ellis also can’t say that pigs are nothing at all like human, because they are quite similar.
    I agree on all points. Any one out there read German who is willing to translate?

  23. Hello there,
    Thank you for putting all this together for us for free!!! I’ve learned a lot!
    I do have one question that I’m confused about. I thought you said what happens during ketosis is basically the same thing that happens during starvation mode(maybe I misunderstood that too). If that’s true then why does it make a difference if I eat 500 calories of protein and fat while in ketosis versus 1700 calories while in ketosis?
    Thanks for taking the time to answer our questions!
    Miguel
    Ketosis is a starvation response, but it’s not only a starvation response. Without going into all the biochemistry of ketosis to explain why, it can be said that the state of ketosis indicates that fat is being burned. If you are eating 500 kcal of fat and protein, you will probably (the jury is out on this right now because it hasn’t been studied as far as I know) experience a fall in metabolic rate in an effort to conserve calories. At 1700 kcal of fat and protein you will lose nicely without a compensatory drop in metabolic rate.

  24. Thanks for the kind note…trying not to overeat and not to undereat, all the while deflecting polite requests to bump up the carb consumption!
    Chin up…and keep low-carbing!
    Can’t wait for the new book… 🙂

  25. I would not exactly call Dr Ellis a “firm believer”. He does a have a chapter on metabolic adaptations. From page 175
    “The truth, now understood, is that the Energy Balance Equation is
    affected by changes occurring in the body. One’s Total Daily Energy
    Expenditure (TDEE), one’s food intake, one’s bodyweight, and one’s body
    composition definitely affect the Equation.”
    He is also very pro low-carb. From page 245
    “Dr. U. Rabast confirmed that the low-carbohydrate diet increases
    bodyweight loss. He studied 21 obese adults using 3 different diets: all three
    diets were low in calories and two were low-carbohydrate diets and the third
    diet was a high-carbohydrate (67%-carbohydrate and 12%-fat). Weight loss was
    21 pounds on the high-carbohydrate diet, 25.1 pounds on one low-
    carbohydrate diet, and 27.5 pounds on the other low-carbohydrate diet.
    All low-carbohydrate studies have the same result: the low-carbohydrate
    group loses more bodyweight than those eating a high-carbohydrate diet…..”
    It is true that he does make the first statement, but then goes on to say that in most cases it doesn’t really matter.
    You didn’t finish the second statement you quoted. The rest of it goes on to say that even though subjects on low-carb diets lose more than those consuming the same number of calories on high-carb diet, the weight loss difference is all water. Which simply isn’t true.

  26. Reading about all these people who had healthy metabolisms as teens makes me jealous! I’ve been metabolically screwed up since childhood. I actually feel like an energetic 6 year old now that I am 26 … when I actually *was* 6 I was depressive, lethargic, and steadily gaining weight. In childhood I managed to remain only moderately fat in spite of obvious lack of energy (mental and physical) … the hormone changes of adolescence triggered rapid morbid obesity (and naturally a worsening of depression and fatigue).
    Steve: Loose skin is a consequence of obesity and has little to do with how weight is lost. People without lose skin simply don’t have damaged skin because they have very resilient skin and probably weren’t that obese. I lost all of my weight on strict low carb and had to have surgery to remove skin; I still have more that needs removing.
    Javier: Sweating and warmth, did this occur with energy, because it sounds like the cookie made you hypermetabolic? Are you naturally thin or only moderately heavy? It’s normal for metabolically normal people to get a “sugar rush”. Because I am a metabolic defect I never get sugar rushes, but I do get “fat rush” where I eat lots of oil, or nuts, especially with caffeine, and then proceed to spend the next few hours beyond hyper dancing around like a manic retard.
    Mark: You need to consider that hormones control metabolism. When in a starvation state, hormones change to favor breaking protein down into energy rather than building muscle, hair, etc from the protein. That’s why people who restrict cals look sickly and wasted even if they take in lots of protein – the calorie deficit alters growth hormone function so protein is used for energy much more. Protein deficit does cause growth hormones to decrease, but it is not logically true that eating more protein increases growth factors above what the body would otherwise have (which is controlled by factors like calorie intake/weight, sleep, stress, age, sex).

  27. Hi Dr. Mike,
    In response to Michael above you said:
    “One thing is that as people age, they tend to become more insulin resistant. More insulin resistance begets more insulin which begets more fat. Another is that they lose lean body mass as they age, usually at the rate of about one percent per year after age 30. Less lean body mass means lower metabolism.”
    Also for males, does it have to do with testosterone decreasing?
    I mentioned before I was very successful losing 130 lbs with Protein Power. I got to 180 lbs last February and am at 180 today.
    The thing I’m concerned about is that it seems my % body fat has slowly increased, without weight gain, meaning gaining a little fat and losing a little muscle (just by a couple pounds). I want to stop this small trend before it gets big. I eat lots of protein (150-200 grams/day), lean body mass of 145 lbs.
    I do a lot of exercise, including walking 5 miles a day, stairclimbing 30 minutes 4 days a week, and doing a slow burn workout once a week.
    I think Fred Hahn might think that’s too much aerobics, but I like it. Is it possible to lose lean body mass with a routine like that even when eating lots of protein?
    It could have to do with testosterone decreasing, but you don’t know unless you get tested. If you want to maintain muscle mass, you’ve got to a) eat plenty of protein, especially protein with a high l-leucine content, and b) continuously challenge yourself with resistance exercise. You can’t simply stick with the same weight – you’ve got to increase.

  28. Great analogy, Dr. Mike!
    I use the light bulb analogy to explain thermogenesis and entropy: halogen light bulbs represent high carb diet, and the old-fashioned ones go for low carb diet. I came up with this idea watching my husband when he replaced every light bulb in our house for the energy-efficient, producing less heat halogen bulbs.
    Great analogy yourself! Thanks. Problem is that now we low-carbers will be accused of not being green enough.
    Cheers–
    MRE

  29. To all those who still believe it’s all about the calories and that hormones have little or no effect, the Jay Cutler story should be instructive. He just found out he’s diabetic, Type I, which means his pancreas couldn’t produce insulin.
    He lost eight pounds in a week — not something he wanted. He continued losing weight during a period in which he described his routine as eating, going to sleep, eating, going back to sleep. He ended up losing 35 pounds, which is not something a quarterback who must deal with linebackers determined to crush him wants to do.
    Now that he’s on insulin therapy, he’s regained 25 pounds.
    Can anyone read about his situation and really think weight control is all about the calories?
    Cutler’s is the pretty standard history of an adult who develops type I DM. Unexplained weight loss despite ravenous hunger and a lot of lethargy. Some of the weight is lost because people with untreated type I DM urinate away a lot of sugar, all of which contains calories.

  30. I would be willing to make the translation of the paper. Where can I download it? On pubmed there’s only the abstract for us mere layfolk. Of course, a native english speaker should revise the document afterward.
    Having tee’d this whole issue up, I find that I can’t get the full-text of the study through my sources either.
    Do you by chance have it, Bruce?
    MRE

  31. gee, a fella asks a simple question, ie, “what about Anthony and all his metabolic ward studies?”, and a year plus and a several thousand words later, I finally gets an answer! thanks! makes sense to me!
    now where’s that bottle of jameson’s…
    Several hundred thousand words later more like…
    I’ve thought and thought about the best way to address Colpo’s misunderstanding of the metabolic ward studies. At first, I planned to write a study by study explanation of each one, but I figured that would bore people (myself, included) to tears and make for a very long post. It finally dawned on me that I could do them all at once this way.
    One thing I do have to give Anthony credit for is that, like him, I had always considered metabolic ward studies to be the gold standard of nutritional studies. In my evaluation of the studies he lists, I realized that most aren’t really metabolic ward studies – they are purported to be metabolic ward studies. Often subjects were hospitalized overnight, but free to go to their jobs or student activities or whatever during the day, giving them all more than enough opportunity to cheat, while at the same time, the researchers were presenting the data as being obtained in a metabolic ward setting. And I’m sure that the people in these studies were less prone to report their cheating than those who aren’t supposed to be in a metabolic ward, but are merely dieting while free living.
    Colpo disregards one of the tightest metabolic ward studies in his list because the authors discussed the great difficulty they had in preventing their patients (who truly were inpatients on a metabolic ward) from cheating. One of studies AC uses to bolster his point was actually a reanalysis of the data from a previous study. When I dig out the original study, which took place years before, the lead author commented on the difficulty they had in dealing with cheating. So, sadly, cheating is rampant, even in metabolic ward studies. One can only hope that the cheating is equal in each arm of the study.
    So, you see, it’s already starting to get eye-glazingly boring, and I’m just responding to a comment. Imagine if this were to go on and on, study by study for an entire post. It would be as boring as, as, as…Anthony’s book maybe.
    What bottle of Jameson’s?
    Cheers–
    MRE

  32. oh, sorry to confuse, I was just muttering to myself about the whereabouts of that bottle of jameson’s. my way of saying time to move on, for me anyway, to more interesting issues than anthony colpo’s views on metabolic advantage.
    I do like the way you handled it. AC foams and spews and basically reveals what nutcase he really is, issuing challenges and ultimatums and declaring himself victorious in this “debate”, etc. etc. You calmly ignore him, for the most part, and after the sea’s have calmed, offer up a clear way to interpret the same data in another light.
    AC can claim you never met his lopsided challenge. blah blah blah, but anyone with a shred of objectivity can see that these metabolic ward studies are not conclusive proof of much of anything.
    If they were truly well done metabolic ward studies using the number of calories the free-living studies use (somewhere between 1200-2000 kcal/d), and they showed no difference in weight loss as a function of macronutrient composition, then it would get my attention. Especially if there weren’t the others out there (also metabolic ward studies) showing the existence of a metabolic advantage.

  33. I find a hard time seeing where the controversy is regarding the metabolic advantage.
    1) I mean, I have proven the metabolic advantage exists. Regular people like me prove it every day. I have my RMR logs; my RMR is about 1000 cal. I keep rigid food diaries. My food diaries average out to 1650 cals over a year. There is no way I am burning 650+ cals in activity. Clearly a great deal of this food isn’t being used for energy.
    When I eat carbs, and keep my calories similar, I gain weight.
    Where is the controversy?
    2) What about studies like this:
    The effect of a high-carbohydrate meal on postprandial thermogenesis and sympathetic nervous system activity in boys with a recent onset of obesity
    The study demonstrates that boys with a recent onset of obesity have a higher TEF and sympathetic nervous system activity after eating a high fat diet (70% fat, 20% carb 10% pro) than when eating a high carb diet (70% carb, 20% fat, 10% pro).
    There are no differences in meals for thin boys.
    The high fat meal brings recently fat boys to the same metabolic activity as a thin boy.
    This demonstrates what I’ve always thought of it – it is not that low carb provides a metabolic “advantage”, it is more that there is a metabolic DISadvantage of carb sensitivity! Whether or not someone gets a metabolic “advantage” is directly proportionate to how carb sensitive they are. Boys who become obese are a good indicator of harboring carbohydrate sensitivity… and these boys show a restoration of normal metabolism when eating lots of fat, just as expected (whereas high carb suppresses their metabolisms).
    If you only used thin boys, it would appear there is no metabolic difference between a calorie of carb and a calorie of fat, since the thin boys seem to metabolize it the same (there is no difference between the meals in heart rate or TEF).
    To find the metabolic “advantage” you need to use people who truly have metabolic abnormalities – fat people, especially people who are gaining weight steadily and slowly. If you use healthy normal weight people you’re going to see a calorie is a calorie is a calorie. OF course you will… otherwise, they wouldn’t be thin, would they?
    You wrote:

    To find the metabolic “advantage” you need to use people who truly have metabolic abnormalities – fat people, especially people who are gaining weight steadily and slowly. If you use healthy normal weight people you’re going to see a calorie is a calorie is a calorie.

    Not necessarily. Almost all the overfeeding studies were done on normal weight people, and they all showed a huge metabolic advantage.
    Cheers–
    MRE

  34. Hi Michael (again),
    I have been thinking about this post of yours, and there’s one aspect I can’t quite understand yet. Wondered if you could clarify for me please.
    Why would our bodies have evolved to waste excess calories when we get “lucky” enough to hit upon a jackpot of food? On the evolutionary planes of Africa, shouldn’t the rewards of a big pay-day, so to speak, be conserved maximally in case of famine? I understand how adaptive thermogenesis is an evolutionary beneficial process when it comes to low-calories (times of famine, for example), but not when it comes to high calories.
    Thanks for your input!
    Michael
    It’s a difficult explanation, but here is a paper that lays it our pretty well. I hope it’s not too technical.
    Cheers–
    MRE

  35. You made the point earlier, that you and Anthony were arguing over a 200 calorie difference of opinion. Your bailiwick is fat loss, low carb and health, Anthony’s is body building, low carb and health. The two of you are opposite sides of the same coin. Most Aussies I’ve met were just as irascible as Anthony, suggesting it’s not personal.
    His book on cholesterol alone is reason enough for him to get more respect than these websites bestow.
    I think AC’s behavior is beyond ‘irascible.’ And I’m not the only one who feels that way. Take a cruise through some of the comments on other posts, and you will see that his fellow Aussies who have dealt with him more than I have feel much the same way as I do.
    I think his book is okay at best. Certainly not brilliant enough to overlook his despicable behavior. A much better bookthan AC’s is Malcolm Kendrick’s of the same title.

  36. ME:
    “If a car is going to be used as an analogy to the human body, we need to include the driver to make the system perform more human-body-like. We have a body and a brain – the car has a body and a brain (the driver).”
    If one wants to use a car or even a gas engine as an analogy to support the calorie theory then they must also take in to account the fact that gasoline is not the only source of calories that must be supplied to an engine. If one starts with crude oil as the raw material, gasoline as a source of calories is one of the products produced. But in order for the engine to run, lubricating oil, which is also a source of calories, must be put in the crankcase. While many calories from gasoline are consumed during the running of an engine insignificant amounts of calories derived from the crankcase oil are consumed. And unless the engine is inefficient only very small amounts of crankcase oil are used in relation to the amount of gasoline.
    As one poster commented the problem is that simplistic concepts like “calories in must equal calories out” and “eating fat will make you fat” appeal to those who like to rely on their perceptual skills which are often notoriously unreliable when based on superficial observations of which the calorie theory is a prime example.
    I’m not sure I get your point here, but I’ll post it for all to see. Maybe it will be more obvious to others.

  37. Dr Eades,
    I haven’t seen these studies, but is it true that overfeeding of a high fat, low carb diet has more of an advantage for thin people than a low fat, high carb diet?
    Many of the overfeeding studies were done on normal-weight subjects. The diets were high-everything, and the subjects didn’t gain the weight that the increased caloric intake would have predicted. So these diets definitely provided a metabolic advantage.
    If you eat enough of anything you will use some of the calories for the body’s energy needs, you will store some as fat, and you will burn some off. That which you burn off is the metabolic advantage. People who have insulin resistance and hyperinsulinemia will store more and burn off less since they have a lot of insulin and insulin is the fat storage hormone. Thin, young, insulin-sensitive people will store less and burn off more. Decreasing carbs and increasing fat will reduce insulin, increase insulin sensitivity and make people store less and burn more.

  38. ME:
    “I’m not sure I get your point here, but I’ll post it for all to see. Maybe it will be more obvious to others.”
    My point is that that the calorie theory is based on the overly simplistic concept that because you can get a caloric value for the 3 macro nutrients and that you can demonstrate through metabolic ward studies done at starvation levels that it does not matter which macro nutrient you restrict the same weight loss results that you can treat protein, fat and carbohydrate as if they are all just calories to the body. This ignores the fact that a certain amount of protein and fat is relegated by the body to roles other than sources of energy. For this reason calories in do not necessarily equal calories out.
    In the same manner the calorie theory proponents in using a car or engine as an model to illustrate calories in must equal calories out focuses only on the gasoline consumed to cover a specific distance. In order to run, even crude internal combustion engines require some form of lubrication in addition to gasoline. If I apply the same argument as the calorie theorists I can maintain that crank case oil has a caloric value which must be considered in the calories in side of the equation. Since the crankcase oil is partially consumed in the combustion process but is never completely consumed but replaced after a time I can then argue that in an internal combustion engine calories in do not equal calories out.
    If anyone is having a hard time getting my point then it makes my point about the calorie theory. It is absurd and pointless because it ignores the related processes.

  39. Hi Dr Mike
    I still get newsletters from AC, and he updated his ‘MAD’ pdf a couple of days ago. I wouldn’t even read it if I were you. My eyes glazed over after about the sixth personal insult in the first two paragraphs. Apparently your post here is another ‘libellous attack’, and anyone of right mind can see it clearly isn’t.
    I don’t believe AC is mentally balanced. People in the past have commented on ‘roid rage, but I don’t think that’s the problem here. I have a bipolar relative, and his behaviour reminds me very much of hers. He has the classic signs of grandiosity and irritable mania. Seems to me he always had signs of it but it’s been getting worse over the years along with his online behaviour, which is typical of disease progression. He’s of the right age for it. I really hope someone helps him before he does something harmful. It’s obvious the guy is boiling over with rage and not in his right mind, goodness knows what he’s like to live with.
    Ketogenic diets are thought to help not just epilepsy, but bipolar disorder too. This was true of my relative, though as the disease has progressed she now needs medication. I myself probably have cyclothymia, but I’m able to control my mood very well with diet.
    The symptoms AC used to describe as having that were helped by going low-carb sound a lot like the depressive aspect of bipolar – from what I remember, tiredness, depression, hypoglycemia, sleep problems, etc. It’s not uncommon for people who are bipolar/cyclothymic to believe very strongly in low carb diets because of how much they have been helped by them. But I really think he needs to start taking some valproate now to calm him down.
    All in my humble opinion of course.
    I think that you may have hit on the correct diagnosis. But, we can’t really diagnose anyone with bi-polar disorder via their rantings on the internet. Another possibility is one of the many personality disorders in the most recent DSM.

  40. I’ll address these factors in a later post and show how you can overcome them.
    As you may have noticed from some previous comments I’ve made in the past 24hrs (thank you for your responses, btw, I can’t tell you how encouraging seeing you respond so diligently to so many comments, mine and others, is) I’ve just discovered your blog and doing my best to hold off on asking you so many questions before I’ve had a chance to go through all your posts, but my searches for posts on metabolism and adaptive thermogenesis did not seemingly come up with the factors followup, so I was curious if you had had a chance to write them up yet (or if it is in your new book)?
    I’m just 3 weeks in and pretty much eating just grass fed beef or wild fish so far. I have so many food allergies and a suspected candida issue that I haven’t wanted to take any chances with eating a food that may unknowingly prevent me from losing (though would be interested in hearing if you think I’m being silly and believing unproven information).
    Given that you say the calories one’s body could intake and still lose weight never recovers because of adaptive thermogenesis if calories are too low at some point that the body slows down its metabolism, I have a question to hopefully make sure that I’m not permanently screwing up my metabolism… I’ve been eating anywhere from between 1000 to 1300 calories a day (usually probably 1200), judging by the tables FitDay has provided me, and at least 50% fat, depending on whether I’ve eaten more fish than beef that day, it may even be as high as 60%. From what I’ve read so far that doesn’t seem to be a problem, but what does concern me is that I feel “hungry” all the time. My stomach always feels empty, almost to the point of growling, even if I just ate a 5 oz hamburger patty 10 minutes before. Now, normally I assume the answer would be that I need to eat more (or more fat), because you’re supposed to feel satiated on this diet… however, I find that although I experience the sensation of hunger in my stomach, I lack motivation and appetite to eat, to the point where I will sit for hours feeling the hunger feeling because I just don’t really feel like eating again (which, is a huge change from when I consumed carbs, because if my stomach felt then how it feels now, I’d be eating anything I could get my hands on until it went away). If I eat that 5 oz hamburger, I get full to the point of feeling horribly full like I’d be sick if I ate any more of it, yet then literally 10 minutes later my stomach feels completely empty. So, which do you recommend I believe? My stomach or my appetite, the former which tells me that I need to eat a hamburger every 10 minutes or my appetite, which is fine with just 3 meals a day with several ounces of meat each meal? Is my stomach still adjusting from not having starch fill it up all the time, or is it really my body telling me that I’m starving myself? I remember feeling this sensation when I began my first few attempts low carbing years ago, but also remember it going away after a few days when the carb cravings subsided, and I’m wondering what has changed this time. I just don’t want to do anything to myself that will forever ruin my ability to have success losing weight, not to mention making myself unhealthy as well (though so far I feel fine… I’m not feeling the “I feel great all of a sudden and everything is so much better!!!” that others seem to, but I certainly don’t feel worse other than the hunger pains). Thank you very much in advance for a response and your time; it’s so much appreciated.
    Kimberly
    I would believe your appetite. Maybe you need to get something that takes a little work to eat – beef jerky springs to mind – and chew on it when your stomach feels hungry.

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