I had an interesting conversation at a dinner party last night. One of the women at the table was making a huge fuss over counting calories and, when she was challenged on it, she insisted, “Everyone knows it’s calories in, calories out”.

“Bullshit”, I thought out loud. (Oops)

The food industry has convinced the population that a calorie is a calorie; calories in, calories out. They say it's about "energy balance" therefore it's about two behaviours; gluttony and sloth.

And, because, as they tell us,  it's about two behaviours; if you're fat it's your fault.

The food marketing guys insist that “(almost) any calorie can be part of a balanced diet so don't pick on our calories. Go pick on somebody else’s calories”.

All of that comes from this notion that calories are fungible; that it doesn't matter what you eat, it matters how much you eat. That's basically what they say, that it's personal responsibility. So what they've done in one fell swoop, with one concept, is put the onus on the victim and assuaged their own culpability.

It works for them.

The question is, is it true? Is a calorie just a calorie?

The answer is, we have a lot of data to show that this is biggest lie in the history of medicine. It is so wrong. It was wrong from the day it was ill-conceived and it will be wrong ‘til the day we finally get the message out. The challenge is that the food industry won't give it up easily because it is their protection. It is their gravy train. They have convinced us all that it's true.

But it is not true.

So, how did I explain it to our calorie counting dinner companion?  I noticed that before dinner she had been hitting the bowl of almonds pretty hard.  She didn’t think anyone had noticed. I figured she obviously liked almonds so it was a good example to use and I let her know that her whole calorie counting thing was for show. Almonds are relatively high density in terms of calories. If you have a typical handful of almonds you’re eating about 160 calories.

So, I asked her, “Assuming you ate a handful of almonds, how many of those calories do think you absorbed?”

The answer is that she absorbed around 130. She ate 160 calories and absorbed 130. The fibre in the almonds made sure of that.

There are two kinds of fibre; soluble and insoluble. Soluble fibre is like pectin and inulin; hydrogels. Insoluble fibre is cellulose -  the stringy stuff like in celery.

Almonds have both.

The stringy stuff sets up a latticework on the inside of the duodenum like a fish net.  The soluble fibre are globular so they plug the holes in the fishnet. Together they form an impenetrable barrier. You can actually see it on electron microscopy - a whiteish, secondary barrier that inhibits the absorption of simple sugars; glucose, fructose, sucrose -  simple starches in the duodenum. This ensures they do not go via the portal vein to reach the liver  and subsequently overwhelm the liver. The liver stays healthy. You are protecting the liver with the fibre in the almonds.

The liver doesn't get the excess. If it did it would turn the excess into fat through a process called novo lipogenesis (new fat making) which is what fructose does. And, you don't generate an insulin response because you didn't generate a glucose response. This all has to do with the concept of glycaemic load to keep the insulin down and keeping a handle on insulin resistance. That keeps you metabolically healthy because insulin is the bad guy in this story.

Insulin drives chronic metabolic disease because insulin drives growth - abnormal growth. It drives vascular smooth muscle growth - that's why you get coronary artery disease. It drives prostate and breast growth - that's why you get breast and prostate cancer. It’s because of the insulin.

“So”, I continued. “You didn't generate as big an insulin response because you didn't absorb those calories”.

Those 30 calories went further down the  intestine to the jejunum. That’s where the bacteria are. That’s where the microbiome is. Those bacteria, they want those 30 calories. They chew it up for their own purposes.

You have 10 trillion cells in your body. You have 100 trillion bacteria in your intestines. They outnumber you 10:1. Those bacteria have to eat something to stay alive and, since they eat what you eat, the question becomes “how much did you get versus how much did they get?”

When she consumed all those almonds, and we all saw her do it, she consumed them with fibre. That fibre meant that those 30 calories weren't for her; they were for her microbiome. Even though she ate them, even though they passed her lips, even though they registered as a calorie eaten, they were not a calorie absorbed.

“Nobody cares how many calories you ate”, I assured her. “What matters is how many calories you absorb.”

Was that measured in a calorie-in, calorie out calculator?

No.

Therefore, a calorie is not just a calorie because if a calorie comes with fibre, that calorie is not for you.

 Of course, there’s more.

Protein.

Protein is made-up of amino acids. There are 20 amino acids. Some of them are essential amino acids - you have to consume them. Some of them your body can make from those essential amino acids. If you are building muscle you need amino acids because muscle is primarily protein. Bodybuilders who are building muscle take huge scoops of protein powder and put it in their Vitamix to make their smoothies. They're building muscle and so they need those amino acids because they're essential - they have to consume them. Are they choosing wisely about what protein powders to put in their smoothies? Probably not, but that’s another topic for another blog post.

But, what if you’re not a body builder?  What if you’re a mere mortal like me? And, what if you consume excess protein, excess amino acids?

Our host had barbecued steaks that evening and they were impressive. Grass-fed giants. An entire herd had given up their lives to feed us. Nice and big and juicy. So, I asked my calorie counting friend, “What if you end up eating that entire steak because it is so delicious and you end up eating more than you should? Where is the protein going to go?”

“Muscle!” She shot back at me imagining it to be game, set and match. “Muscle is a storehouse for protein.”

I don’t know which gym brochure she’d read that in, and, while she wasn’t wrong, she wasn’t entirely right, either. If you’re not building muscle then that’s not your storehouse.

So what happens to the excess? Well, that protein went to the liver. The amino acids went to the liver and the liver has to turn it into energy. The liver has to take the amino group and perform a deamination. Once that happens, that amino acid now becomes an organic acid. That organic acid can now enter the Krebs cycle (aka the citric acid cycle) which is the cycle that makes the ATP. You can generate energy from that amino acid once it's deaminated.