Your Trainer May Be Making You Fat!

To say the least, I’ve been busy.  Too busy to blog, but not too busy to read.  When my youngest recently started driving, I finally felt I had time to share some of the more thought-provoking books I’ve read over the last year on the science of exercise and nutrition.  One of these was Gary Taubes’ new book “Why We Get Fat:  And What To Do About It”.

If your trainer has lead you to believe that “it’s all about calories in, and calories out”, it is time for you to find a new trainer.   It’s a misleading theory and a good sign your fitness professional is not well-educated – relying on old, outdated research or the oft-misinformed fitness magazines to get you in shape (like Dr. Oz).

For the most part, new nutrition research (i.e., Nutrition Science Initiative)  is attempting to move beyond “calories in, calories out”, focusing more on the complicated processes at play that determine if energy is stored or expended.  Whether energy is stored as fat or burned as energy is determined by numerous complicated bio-chemical interactions: how our bodies respond to different macronutrients, the variety of hormonal conditions and mechanisms that signal your body to do something at any given time, our genetic makeup and epigenetic expression, our physical environment, etc.

For years, medical professionals, fitness and nutrition experts have relied on the First Law of Thermodynamics to explain why we gain weight:  if you eat too much and exercise too little, you will get fat.   In Gary Taubes’ new book “Why We Get Fat: And What To Do about It”, he addresses the numerous conditions involving excess fat storage that cannot be explained via the positive caloric balance hypothesis:

• Increased Prosperity:  Increased prosperity and abundance has often been cited as a leading contributor to the obesity epidemic.  We are fat because we have access to more food than we have had in the past.  Taubes shares what he coins the “Fat Louisa Paradox” to illustrate how the Pima Indians were prosperous in 1846 and very fit, but by 1902 they were living in poverty and the majority of the population had become obese.  But Taubes shares similar studies from around the world that demonstrate time and time again that poverty is also associated with obesity.  These obese subjects were poor, often physically active, and actually consumed “fewer” calories than the USDA daily recommendation.
•   Calorie Restriction – Another flawed idea believed to support the “calories in, calories out” hypothesis is to east less to lose weight.   A review of the literature repeatedly states this is not the case.  Even in the 50s, researchers were defining obesity as the inability to lose weight when calories were reduced.  The Cochrane Collaboration (2002) took an unbiased review of the data from nutritional clinical trials on reducing calories and found the results were “clinically insignificant”.  Even the Handbook of Obesity (1998) begins by recognizing calorie reduction as the cornerstone of weight loss, but later in the same book cites that the results of calorie restriction are “poor and not long lasting”.
•  Increased Energy Expenditure – Taubes discusses several studies from the 1900s to present that illustrate that exercising more does not always ensure weight loss.  I have seen this same phenomenon in the gym every single day.  Folks exercising frequently (sometime frantically) with little to no change in body composition over time.  Much of the research indicates exercise results in increased weight gain.
•  Practicing Energy Balance – As one of the more thought-provoking discussions in the book, Taubes illustrates the impossibility of “doing the math” in relation to counting calories and balancing expenditure over a lifetime.  It is not only impossible, but equally absurd to believe this can be done with precise accuracy (especially when compared to animals that remain lean without counting calories).
•  Genetics – “Calories in, Calories out” is an inefficient model to explain the role genetics play in determining how fat is accumulated and stored.  Taubes shares numerous stories (and photos) illustrating that, despite the number of calories consumed, fat is distributed differently among same-sex individuals, as well as between men and women.

Occam’s razor  states the hypothesis that makes the fewest assumptions is most likely to be correct.  After reading this book, it is becomes glaringly obvious that there are too many flawed assumptions in the “calories in, calories out” hypothesis for it to accurately explain why we have an obesity epidemic in this country.   Although you can gain weight from eating too many calories, this theory does not accurately explain why we are getting so fat.

Is Taubes trying to say that the universally accepted First of Law of Thermodynamics is flawed?  No, but he does not believe it provides an accurate explanation of “why” we are getting fat.  Once again, “calories in, calories out” becomes another case of assuming causality.  Peter Attia, MD of The Eating Academy has written an excellent blog post explaining how the First Law of Thermodynamics has been erroneously applied to explain excessive weight gain.  Click on the image below to read his excellent explanation.

Click the image to read Dr. Attia’s excellent blog post titled “Causality”.

So, why do we get fat?   Gary Taubes furthers the discussion by exploring several obesity hypotheses that have developed through the years around the world.  Based on his extensive review of the literature (“Good Calories, Bad Calories“, and beyond) he comes to the conclusion that excessive weight gain is due to a metabolic defect.  In addition to this defect, once the fat has accumulated in excess it creates another host of metabolic disorders that exacerbate the problem.  Overeating and lethargy become side effects, not the cause of obesity.

To better understand how this metabolic defect drives obesity, Taubes reviews basic information that would be taught in any Biochemistry 101 college course.  Fatty acids are burned as fuel for energy production.  Combine 3 fatty acids with a glycerol and you’ve created the storage form of fat – a triglyceride.  The more fatty acids that that enter  the cell and are attached to a glycerol and are stored as triglycerides, the fatter you will become.   The more triglycerides within the cell that are broken down and released to be utilized as energy, the thinner you will become.  Insulin is the hormone that regulates this process.

As I have discussed in my nutrition lecture since 2009, it’s common knowledge that insulin is known both as the “storage” and “locking” hormone.  Insulin is responsible for driving glycerol into the cells so that the fatty acids can be converted into triglycerides for fat storage.  These triglycerides are also locked into the cell when insulin is present.  Insulin must be low for cells to release fat stores to be utilized for energy.  Insulin is also a dominant hormone, and when present will override other hormones that signal the body to burn fat (i.e., growth hormone, adrenaline, epinephrine, and glucagon).

What triggers the pancreas to produce insulin? Rising blood glucose levels.  What causes blood glucose to rise? The consumption of carbohydrates – specifically the dense, starchy carbohydrates found in bread, cereals, pastas, and, of course, sugar.    Constant consumption of dense, starchy carbohydrates will result in constantly high blood glucose levels which makes glycerol available to bind to fatty  acids which in turn creates the storage form of fat (triglycerides).  From Tolstoy to Dr. Spock, Taubes shares numerous documents that reflect over 150 years of understanding that carbohydrates make us fat.   In addition, chronically high insulin levels have also been correlated with inflammation.  Inflammation has been implicated in metabolic syndrome, Cardiovascular Disease, Alzheimers and other diseases of modern civilization (click here to see the results of  a simple “Google Scholar” search).

Occam’s razor would lead you to conclude that after reading this book all one would need to do to be healthy and lean would be to simply keep insulin levels low.  By keeping insulin levels low, you can avoid excess fat accumulation as well as avoid future diseases associated with inflammation.

Sadly, Ancel Keys and the low-fat movement have led us to fear the one nutrient that does not raise insulin levels – fat.   We are sicker and fatter than ever.

It’s time to try something new, folks.

P.S. – By the way, The Paleo Diet is a naturally low-carbohydrate diet!

Additional Reading:

•  Forbes Magaine:  13 To Watch in 2013: The Unsung Heroes Changing Health Care Forever  – Gary Taubes and Peter Attia, MD
• Nutrition Science Initiative 
• Gary Taubes’ Website 
• What would happen if…? Thoughts (and thought experiments) on the calorie issue by Gary Taubes
• What if It’s All Been A Big Fat lie? by Gary Taubes
• Why We Get Fat:  And What To Do About It by Gary Taubes
• Good Calories, Bad Calories by Gary Taubes
• Peter Attia, MD’s website