Dr. John Day, Cardiologist

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5 Reasons Why You Shouldn’t Count Calories

The Chinese don’t calories.  Could counting calories actually cause weight gain?

Recent medical studies have shown that a calorie is not a calorie.  In this article I review the science on calories and share with you 5 reasons why you shouldn’t count calories.  I will also teach you how to “hack” unwanted body fat without feeling hungry.

I Grew Up Counting Calories

Calories were counted in my home growing up. I quickly learned what a calorie was and how to read labels.

I was excited to learn that one serving of Fruit Loops had just 110 calories.  Like most people, I had no idea how little a one cup serving size really was.  Because there were so few calories in one serving, I thought I was OK eating half the box.

Strangely, even after so many calories at breakfast, I could never seem to make it to lunch time until I was famished again.  On the other hand, I made the observation that if I just had a few tablespoons of peanut butter (each tablespoon has 100 calories) for breakfast that I could easily make it to lunch without getting hungry.

Calorie Didn’t Exist in Chinese

At the age of 19 I lived among the Chinese immigrant community in New York City as part of a volunteer church missionary assignment.  When I tried to discuss “calories” with recent immigrants, they just gave me a blank stare.

Let me explain, the word for calorie in Chinese, kaluli, is a loan word.  In other words, the sounds were borrowed from English as the word didn’t previously exist in Chinese.

Thus, not only do the Chinese not count calories, they didn’t even have a way to discuss calories before English loan words invaded their culture.  Could there be wisdom in not counting or discussing calories?

The Science of Calories

The definition of a calorie is the amount of energy required to raise one gram of water by one degree celsius.  While this works in a test tube, it simply does not work that way in our body.

Food is information for our genes.  Food affects our hormones.  Food either turns up or down our metabolism.

It is the “effective” calories that matter.  The problem is that everyone’s effective calories from food is different.  Thus, the calorie label on food is not reliable.  A calorie is not a calorie.

Real Fruit vs. Energy Bars

The conventional wisdom is that a “calorie is a calorie.” If conventional wisdom is correct then it shouldn’t matter how you get your calories, right?

In a fascinating study, researchers in Brazil gave overweight women one of three different food supplements in their diet.  Study participants were told to eat this food supplement three times a day.  These food supplements consistent of an apple, pear, or an oat “energy bar.”  Each food supplement had the same number of calories.

To better understand the effects of these food supplements, under the direction of a nutritionist each participant’s diet was the same–15% protein, 30% fat, and 55% carbohydrates.

If a calorie really is a calorie then you would expect that everyone’s weight should be the same at the end of the study, correct?  At the end of the 3 month study, participants assigned to fruit for their food supplement lost approximately 3 pounds whereas the participants assigned to the oat energy bars did not any weight loss.

Good vs. Bad Foods

Most people believe that weight loss is simply a function of calories in minus calories out.  Surprisingly, that is exactly what researchers did not see in this landmark study published in the most prestigious medical journal, the New England Journal of Medicine.

In this study, led by my former Stanford University classmate, Dr. Dariush Mozaffarian, they followed 120,877 well educated health professionals for 20 years.  These people were healthy and were not obese at the beginning of the study.

Overall, most people gained 20 pounds, or one pound per year, over the course of the study.  However, there were medical outliers.

For example, people whose diets consisted of fruits, vegetables, nuts, whole grains, or yogurt either lost or maintained their weight over 20 years.  In contrast, people whose diets consisted of refined grains, sugary drinks, fruit juice, fried foods, processed meats, red meat, deserts, potato chips, or butter all gained weight over 20 years.  Interestingly, milk and cheese did not seem to have a significant impact on long-term weight gain.

If a calorie is really a calorie then how do you explain why certain foods caused weight gain and other foods caused weight loss?  Clearly, what happens in a test tube and what happens in real life are really two completely different things.

Foods Determine Metabolism

To further drive home the point that a calorie is not a calorie, in this interesting study researchers demonstrated that what you eat can determine your body’s metabolic set point.  In this study, Harvard researchers enrolled young overweight adults and tried them on three different diets.  These three diets included a low fat diet, low glycemic diet, and a low carb diet.

On each diet they burned the same amount of calories and ate the same amount of calories.  Interestingly, metabolism was highest for the low carb and low glycemic diets and lowest for the low fat diet.  Not surprisingly, the hunger hormones were the lowest for the low carb and low glycemic diet and highest for the low fat diet.

The low carb diet did come at a cost.  The low carb diet had the highest levels of inflammation and stress hormones.  Given these findings, the low glycemic diet might be the best.

Food is information for your DNA.  What you eat turns on or off different genes and hormones.  Your metabolism is also turned up or down based on what you eat.

5 Reasons Why You Shouldn’t Count Calories

Now that I have hopefully convinced you that a calorie is not a calorie, let me give you 5 reasons why you shouldn’t count calories.

1. You May Eat More

You would think that people who count their calories would eat less.  The problem is that we either make mistakes or are not honest with ourselves.  For example, in a classic study, people underestimated their daily calories by 47%!

It is true that for some people counting calories can bring mindfulness of what you are actually eating.  For these people, I would recommend tracking your nutrition with a handheld device rather than count calories.  If you do want to count calories, from personal experience, I would recommend either lowering your daily caloric intake target or overestimating your calories to prevent weight gain with this approach.

I know that for me, tracking nutrition was especially helpful in teaching me to eat more mindfully and to maintain my weight loss.  Like so many people, I often don’t get the internal cues that I am full.  As a result, if I don’t track my nutrition with the LoseIt app, I will probably overeat.

2. Gut Flora Determines Calories Absorbed

Even though you may be diligently counting your calories, studies show that the bacteria in your gut may have the final say on whether you absorb all or just part of your calories.  Perhaps the key to weight loss is not restricting calories but rather promoting the gut flora that will cause you to loose weight like fermented foods and fiber.

3. Processing and Cooking Unlock Calories

In general, the more prepared food is the more calories you will store as fat.  If you want to gain weight then eat a lot of processed foods and cook everything you eat well.

For example, studies show that cooking food unlocks more calories than raw foods.  The same thing is true when it comes to grains.  Studies show that refined grains cause weight gain whereas whole grains cause weight loss.

Perhaps this explains why people lose weight with nuts.  Studies show that nuts have much less “effective calories” than what you would predict because they require so much effort to digest.

4. Metabolism Trumps Calories

While one cup of fruit loops and one tablespoon of peanut butter have the same number of calories, the fruit loops will slow your metabolism and the peanut butter will speed things up.  Thus, the effective calories of a cup of fruit loops is far more than a tablespoon of peanut butter.

In general, refined grains and sugar slow metabolism.  Protein speeds up metabolism.  Fiber not only promotes the weight loss bacteria in your gut but also speeds up metabolism.  Even capsaicin may rev up your metabolism.

The time of the day you eat also affects metabolism.  Erratic eating patterns slow metabolism whereas regularly timed meals speed up metabolism.

There are also many other factors in metabolism.  For example, muscle mass and exercise speed up metabolism.  Consuming a lot of water also speeds up metabolism.

Even things like altitude and air temperature affect metabolism.  Studies show that high altitudes increase metabolism.  Metabolism is also increased when it is cold or hot.  Room temperature seems to slow metabolism.

5. Hunger Hormones Determine Intake

While you might like to think that you can control your food intake by counting calories, at the end of the day your hunger hormones decide when and how much you eat.  What you eat and your lifestyle can determine whether these hunger hormones are working for you or against you.

For example, as discussed from the study above, low fat diets activate hunger hormones whereas low glycemic and low carb diets turn hunger hormones off.  High stress levels and sleep deprivation also dramatically turn on hunger hormones as I discussed in a previous article.

Are You Still Counting Calories?

A calorie is simply not a calorie.  Weight loss is not a function of calories in versus calories out.  It is far more complex.  Calorie counters often undercount and end up eating more.

Food is information for our DNA.  What we eat determines if our gut bacteria even allow us to absorb the calories or not. Processed and prepared foods favor calorie absorption and raw foods make it hard to absorb calories.  Metabolism sets your burn rate and hunger hormones dictate how much you eat.

If your goal is weight loss you have to learn how to “hack your weight.”  When did you stop counting calories?

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6 Ways to Stop Feeling Hungry All the Time

The holidays are the worst time of the year for Josie.  Josie is just 16 and all she can think about is food.  She is obsessed with food and is hungry all of the time.  Regardless of how much she eats, she is always hungry.

According to her mother, “Ever ingredient is meticulously measured and the calories counted.  When she was younger, screaming tantrums would begin if the clock ticked past the allotted serving time.”

To save her from overeating, her mother shares,  “We pile up the meal on a small dish so it looks fuller. We cut food in half and tell her it’s twice as much. We keep empty raisin boxes and fill them with half the number they’d normally contain so she can have an extra box.  We always keep back a bit of her meal so that if there’s a dropped spoon disaster, and three peas go on the floor, then three peas get replaced.”

Josie has a rare genetic condition, called Prader-Willi Syndrome, which causes her hunger hormone, ghrelin, to be extremely high.  Unless people suffering from this condition are physically restrained from eating, they will literally eat themselves to death.  If left unchecked, Prayer-Willi patients typically die young from obesity related complications.

Can the same thing happen to us?  Can our hunger hormones also get so far out of the normal range that we also feel hungry all the time?  In this article I will share with you 6 ways to stop feeling hungry all the time.

The Hunger Hormones

Before we discuss how to stop feeling hungry all the time, let me first introduce the “hunger hormones” and discuss the reasons why we feel hungry.  Below are the main hunger hormone players:

1. Ghrelin

Ghrelin, also called the “Ghrelin Gremlin,” is the one to fear the most.  Another easy way to remember the roles of ghrelin and leptin is that ghrelin “grows” your appetite whereas leptin “lowers” your appetite.  Ghrelin levels are extremely high with the Prader-Willi Syndrome.

When there is nothing in our stomachs, the hormone ghrelin is released.  On the other hand, when our stomachs are full then ghrelin secretion stops.  Once released, ghrelin acts on receptors in the brain to make us feel hungry.

The frustrating thing is that ghrelin not only makes us feel hungry but also activates the “reward center” of our brains.  Activating the reward center of our brains makes us crave the addictive or “comfort foods” like pizza or chocolate chip cookies.

Now that we understanding how ghrelin works, one obvious way to suppress ghrelin production is to fill our stomachs with water, fiber, or other low calorically dense foods at meal times.  If we can “stretch” our stomachs with a big salad and a tall glass of water then perhaps we can quickly shut down the body’s production of ghrelin.

2. Leptin

Leptin is another hunger hormone.  Leptin is released from the fat cells when they are “full” to signal to the brain to stop eating.

Leptin has the opposite effect of ghrelin.  Thus, for most people, letpin is a good thing if the goal is to stop feeling hungry all the time.  To help remember the effects of leptin just remember “lucky leptin.”

A young boy’s medical case, we’ll refer to him as “T,” was recently described in the most prestigious medical journal, The New England Journal of Medicine.  “T” is two years old and lives in the country of Turkey.  As with Josie, “T” is also hungry all of the time.  He ravenously devours any food he can get.  He never feels full.

“T” has a rare genetic condition where his brain cannot detect leptin.  While “T’s” height is just a litter bit taller than average, at the young age of just 2 he weighs 67 pounds!  Unlike Josie, T’s parents have not restrained him from eating.

“T’s” condition is something that has been well described in adults.  This condition is called “Leptin Resistance.”  With leptin resistance, even though leptin levels are high the brain cannot detect leptin.

The purpose of leptin is to prevent us from gaining weight.  The problem is that even though leptin levels are high in obese people, the brain never “registers” the leptin.  While leptin resistance in adults is not as severe as with “T,” leptin resistance may play a significant role in the worldwide obesity crisis.

Researchers are just starting to learn why obese people’s brains do not register the leptin signaling that they are “full.”  New research suggests that we can block the effects of leptin from eating a diet high in sugar and simple carbohydrates.  These simple carbs raise our triglyceride levels which has been shown to block leptin signaling to the brain.

Of course, the obvious way to help our brains to sense leptin and stop feeling hungry all the time is to minimize sugar and simple carbohydrates in our diets.

3. Insulin

Insulin is a hormone released by the pancreas.  Insulin is released when blood sugar levels rise.  The main effect of insulin is to cause us to store fat.

A diabetic patient recently told me, “as soon as I went on insulin I gained 10 pounds!”  This is not unusual.  If you talk with many people with diabetes they will often tell you the same thing.

A high sugar meal, like bread, pasta, or breakfast cereals, will cause a high spike in your blood sugar levels.  When this happens, the pancreas releases insulin causing the extra sugar to be stored as body fat.  Once the blood sugar drops you are hungry and the cycle begins all over again.

A simple way to prevent hypoglycemia from making you hungry is to eat foods that don’t spike your blood sugar.  Minimizing or avoiding sugar and simple carbohydrates will keep your blood sugar levels stabilized.

4. Cortisol

Have you or a loved one ever taken a short course of prednisone or another steroid?  Were you always hungry?  Did you gain 5 to 10 pounds from just a week of taking prednisone or another steroid?

Cortisol is the body’s steroid hormone.  Cortisol is released from our adrenal glands.  When we are sleep deprived or chronically stressed, cortisol levels are high.  As long as cortisol levels remain high our appetite will remain high as well.

5. Neuropeptide Y

Neuropeptide Y is a brain neurotransmitter and is also considered by many to also be a “hunger hormone.”  Neuropeptide Y is a powerful brain chemical that compels us to eat.

In a classic study, researchers in 1985 injected male rats with neuropeptide Y.  Within just minutes of the injection, male rats became obsessed with food and lost all interest in sex.  Even though a willing sexual mate was readily available, these male rats, under the influence of neuropeptide Y, craved rat chow more than sex.

Studies show that neuropeptide Y is released in response to stress as well as a high sugar, high fat diet.  Interestingly, intermittent fasting has been shown to lower neuropeptide Y levels.

Clearly, if we want to stop feeling hungry all the time, we also need to keep neuropeptide Y levels down.  The best way to do this is to minimize or avoid unhealthy fats and sugar, manage stress, and, under the direction of your physician, consider intermittent fasting.

I Have a “Double Dose” of the Fat Gene

I have had my genome analyzed and I have two copies of a variant of the FTO gene which is also known as the “Fat Gene.” Having two copies of the “Fat Gene” (one from my mother and one from my father) means that my ghrelin levels are genetically programmed to be high.

This means, that for those of us with two copies of this gene, we don’t feel full when we eat.  Studies show that most people in the U.S. with a “double dose” of the Fat Gene are obese.

While eating the Standard American Diet (SAD), I was overweight and yet was always hungry.  Since changing my lifestyle, my weight has dropped 30 pounds and I have maintained this weight loss now for more than 3 years.  While a healthy lifestyle has helped me to control my hunger and ghrelin levels, if I am not careful I can quickly become very hungry very fast.

Despite having genetically high levels of ghrelin, at least I can feel fortunate that I don’t have the same constant hunger pains that someone suffering from the Prader-Willi Syndrome might have.

6 Ways to Stop Feeling Hungry All the Time

Now that we understand the brain chemistry of hunger, we can now “hack” our hunger to keep ghrelin, cortisol, insulin, and neuropeptide Y levels low and allow our brains to shut down the hunger signals by being able to sense leptin.  Here are my 6 very best ways to stop feeling hungry all the time.

Ghrelin Release from the Stomach

1. Fill Your Stomach to Stop Ghrelin Release

If you want to keep the “ghrelin gremlins” at bay, stretch your stomach with low caloric density food.  In other words, drinking water with your meals, eating high fiber foods, or just filling your stomach with lots of vegetables can fill your stomach to suppress ghrelin and keep you at a healthy weight.

In contrast, very caloric dense food, like a piece of cake or a piece of candy, doesn’t fill your stomach.  Because the stomach is not stretched from these calorically dense foods, ghrelin levels remain high.  As long as ghrelin levels remain high, your brain will drive you to eat more.

When you feel hunger coming on, and it is not yet time to eat, reach for a bowl or bag of fresh vegetables and a glass of water to drive the “ghrelin gremlins” away.

2. Minimize Sugar and Simple Carbs

“Lucky leptin” is the signal that comes from our fat cells and tells our brains we have had enough food.  This is the hormone that is supposed to keep us at a healthy weight.

The problem is that most obese people are “leptin resistant.”  Unfortunately, studies show that sugar and simple carbs block the effect of leptin on our brains.  In addition, sugar and simple carbs increase insulin and neuropeptide Y release.

In order to prevent leptin resistance and keep insulin and neuropeptide Y levels down, minimize sugars and simple carbs.  I have found that for most of my patients, if they can just minimize or eliminate sugar and simple carbs, their weight quickly normalizes.

3. Get At Least 7 Hours of Restorative Sleep

Sleep is probably the most under appreciated weight loss strategy.  Besides the obvious that we are not eating when we are sleeping, getting enough sleep at night keeps ghrelin levels low and leptin levels high.  This is exactly the right combination which will help us to stop feeling hungry all the time.

In contrast, sleep deprivation increases cortisol and neuropeptide Y levels as well.  With all of these hunger hormones working against us, sleep deprivation makes it exceedingly difficult to maintain a healthy weight.

Don’t worry about going to bed hungry as sleep quickly raises leptin levels to prevent hunger from awakening you at night.  If hunger is waking you up at night then there is a good chance you are “leptin resistant.”

4. Practice Stress Management Each Day

Along with sleep, another under appreciated way to stop feeling hungry all the time is to manage stress.  When we are feeling stressed out, studies show that ghrelin, cortisol, and neuropeptide Y levels go up while leptin levels fall.  Once again, this is the perfect storm for feeling hungry all the time and gaining weight.

As chronic stress and weight gain go hand-in-hand, is it any wonder that yoga and meditation have both been shown to be possible weight loss options?  The key point here is to find what helps you to “de-stress” and do that each day.

5. Minimize or Avoid Unhealthy Fats

As a diet high in the unhealthy fats has been shown to induce neuropeptide Y, the goal is to minimize or avoid the unhealthy fats.  The main source of unhealthy fats in our diet is from processed foods, fast foods, and most restaurant foods.

6. Intermittent Fasting

It seems counter intuitive to fast in order to help control hunger.  However, if you are healthy, intermittent fasting for periods as short as 12 hours, has been shown to have beneficial effects.  For example, intermittent fasting may help with leptin resistance as it lowers triglyceride levels.  In addition, fasting lowers neuropeptide Y levels.  If you are interested in intermittent fasting, please discuss this with your physician first.

Are you always hungry?  What has helped you to stop feeling hungry all the time?