Blatant Misunderstandings and Oversimplifications: Calorie Edition Part 2

breaking-diet-myths

Because the response to Part 1 was so positive, I figured I might as well go ahead and publish Part 2, alongside Dietitian Cassie’s “I HATE CALORIES: Part 2“.

Now, just so people understand my motives: I’m not doing this for popularity. I don’t care what people think of me. And, although I wish Cassie would respond so we could have some productive dialogue on the topic, this post is not meant to get a rise out of anyone.

This series is merely to point out misinformation and provide the readers of this blog with the objective evidence rather than rambling, misleading nonsense.

I don’t usually feel the need to justify my posts, but I want y’all to know where I’m coming from. Moving on…

Part 1 of this series (read it here) sparked some very interesting commentary and debate, namely from very popular “calorie denier” and low carb advocate Sam Feltham. Sam has made a name for himself doing wacky experiments, most notably the 5000 calorie high fat challenge and now the 5000 calorie processed carbohydrate challenge, in an attempt to reveal that calories don’t matter in the way we believe them to.

These experiments don’t prove much, but that’s another post for another day. Evelyn (AKA Carbsane) has written about his experiments quite extensively here, along with some excellent commentary from Stephan Guyenet in the discussion section.

I just wanted to bring up my mini debate with Sam because I was pleasantly surprised by his politeness and willingness to debate a controversial topic sans the emotional attachment. My experiences with low carb gurus and zealots in the past have been nothing short of agonizing, but Sam was a good sport.

Although we disagree on pretty much everything, I want to give him props for participating in a civil debate.

However, don’t think I’m going to let up on the overall message. The “calories don’t count” idea seems to be spreading, and it’s very misleading to the general public.

Sure, you can lose fat without counting calories, but don’t use that as an argument that calories don’t count. You must be in a caloric deficit to lose stored body fat.

So with that, let’s move on to my dissection of Dietitian Cassie’s latest post, which further displays her “hatred” for calories and a general misunderstanding of basic physiological concepts.

Blood Sugar Babbling

Cassie begins her post with a brief overview of Part 1, basically rambling about calories as they relate to metabolic slowdown (which I covered extensively in Part 1 of my breakdown), insulin, and “sugar and carbohydrate overload”.

To kick off the meat of the article, Cassie discusses sugar and processed carbohydrates, a very controversial topic and one I’ve written about in the past as well. Oddly enough, this section of her post is very short. I say this is odd because in order to completely explain this topic without being reductionist, one would have to write at least a full post, if not a series of posts.

She writes:

Stay away from added sugars and processed carbohydrates. Carbohydrates are the macronutrient that spike your blood sugar most, so if your goal is to keep your blood sugars balanced you should really try to avoid processed carbohydrates.” (the bold emphasis is Cassie’s)

Yes, carbohydrates do spike blood sugar more significantly than the other macronutrients. However, this doesn’t tell the full story.

First off all, while carbohydrates do tend to cause a large-scale increase in blood sugar, they don’t always cause the largest insulin response. Insulin response is something Cassie is typically quite concerned with, but for some reason, she leaves that little factoid out of this section. Which is quite a shame, that would have added some depth to her analysis.

Interestingly enough, protein seems to cause a drop in blood sugar, which is something that low carbers fear (the quick rise and fall of blood sugar). However, the insulin response seems to be an appetite suppressant rather than an appetite stimulant. Anyways, I’m going on a tangent. Back on point…

At the end of that little section above, Cassie writes:

“…if your goal is to keep your blood sugars balanced you should really try to avoid processed carbohydrates.”

This is an all-encompassing failure of a statement. First off, if you’re going to eat foods based upon how well they balance your blood sugar or how little they spike your blood sugar, you could say that one should choose white bread over white potatoes. White bread has a lower glycemic index than white potatoes; yet white potatoes are chock-full of nutrients and deliciousness.

You might as well avoid fruits also; they cause just as much if not more of a blood sugar spike than processed cereal grains. So right off the bat, let’s toss the blood sugar balancing nonsense out the window. A mixed meal throws estimated blood sugar responses all out of whack, so much so that it becomes pointless to discuss.

So her statement that you should “avoid processed carbohydrates” because they don’t contribute to keeping blood sugars balanced is faulty, simply because many processed carbohydrates spike blood sugar on a much smaller scale than many whole, nutritious, satiating foods.

Processed Carbohydrates and…..Cigarettes?

Cassie goes on to write:

“Consuming high amounts of processed carbohydrates when trying to be healthy and lose weight is like smoking with hopes of avoiding lung cancer.”

This is the kind of statement that gets you a book deal, folks. I mean look at the author of the latest sorry excuse for a book Grain Brain stating, “Gluten is our generation’s tobacco.” All you have to do is be an alarmist “authority”, and BAM, book deals are flying in your direction.

To avoid getting overly emotional with regards to this fear-mongering analogy, I’ll direct Cassie to a study that compares two hypocaloric diets, one high in sucrose (43% of daily energy intake, which is very high), and the other low in sucrose (4% of daily energy intake). And interestingly enough, the results showed “that a high sucrose content in a hypoenergetic, low-fat diet did not adversely affect weight loss, metabolism, plasma lipids, or emotional affect” (1).

How in the world could someone lose weight on such a high intake of sucrose? Oh yeah, calories matter. The group was in a caloric deficit, so they lost weight in spite of an extremely high intake of sucrose.

Let me make myself clear: I’m not advocating that someone should consume a high sucrose diet or loads of processed carbohydrates, but they can most certainly be a part of a well-balanced weight loss diet. Comparing processed carbohydrates to smoking in this context is downright silly, as well as downright incorrect.

I would also like to direct you to an excellent article written by obesity researcher Stephan Guyenet, in which he dismantles claims that sugar is inherently fattening in the context of a hypo-energetic diet.

Cassie ends the section with this:

Simply cutting out added sugars and refined carbohydrates and shifting toward real food will dramatically improve your metabolism, energy levels, sleep, focus and likely many more aspects that will improve your day to day life. Focus on getting your carbohydrates from natural forms with unprocessed sugar: vegetables and fruits. The fiber in these slows down the assimilation of the sugar into the blood stream, so they don’t spike your blood sugars in the same damaging way that a slice of bread or serving of pasta do.

I agree that one should focus on consuming primarily whole foods, but I cannot condone someone using scare tactics such as comparing the consumption of processed carbohydrates to smoking. Again, processed carbohydrates can certainly have their place in, you guessed it, moderation.

I agree that people should focus on consuming more fruits and vegetables.

And, as we discussed earlier, the last part of the above paragraph is misleading. One should not make food choices based upon how much a given food spikes blood sugar, unless of course the person is diabetic.

Spikes in blood sugar are not “damaging”, they are a normal physiological response to food consumption. But, Cassie must know this, right?

Glucagon, the Potent Fat Burner: Wait, What?

In the next section of the article labeled “Undoing the Damage”, Cassie states:

“So, now you must be wondering how to reverse the damage done by past dieting and calorie counting by utilizing that stored fat for energy! This happens as we are striving to prevent further damage by eating in a way that doesn’t spike our blood sugar levels”

Now she’s insinuating that counting calories is actually damaging! I would love to hear her (or anyone else’s) explanation of this gem; it makes no sense whatsoever.

Cassie then creates a false dichotomy, saying that we “reverse the damage done by past dieting and calorie counting” by burning stored body fat for fuel. What she doesn’t seem to realize is that the body alternates between fuel sources continually throughout the day. Sometimes we’re burning glucose, sometimes we’re utilizing stored body fat.

It’s not one or the other all the time. You’re not a “sugar-burner” or a “fat-burner”. Everyone does both, alternating between the two constantly dependent upon which fuel substrate is available.

Also, to address the last sentence, it’s almost impossible to eat “in a way that doesn’t spike our blood sugar” unless you’re eating all fat, all the time. Again, blood sugar spikes are normal, and in non-diabetic individuals, they are completely harmless.

She goes on to write:

“The hormone opposite to insulin is glucagon, also known as your “fat-burning” hormone. This hormone is released to burn fat for energy when your blood sugar levels are stable (by eating a combination of protein, fat, and carbohydrates at meals and snacks: PFC!). With stable blood sugar levels, you are able to prevent fat storage and instead promote fat burning!”

Cassie once again takes an overly simplified approach to complex hormonal processes. Insulin is often pegged as the fat-storage hormone because of it’s inhibition of lipolysis and promotion of lipogenesis. So, based on that oversimplified endocrinology, glucagon must be the “fat-burning” hormone because it is insulin’s antagonist.

However, what seems logical doesn’t always play out in the real world.

Considering Cassie’s obsession with keeping blood sugar levels stable, you would think she would hate glucagon just as much, if not more, than insulin. Glucagon’s main function is to raise blood glucose levels (mostly by converting liver glycogen into glucose, then releasing it into the bloodstream) to prevent one from going hypoglycemic. You know Cassie doesn’t like blood sugar spikes based on the previous sections of this article, so why the admiration for a hormone that raises blood sugar? Beats me.

Let’s also address her false labeling of glucagon as a fat-burning hormone. While glucagon is indeed the opposer of insulin, at normal physiological levels, glucagon seems to have little to no effect on adipose tissue lipolysis (2, 3). So the idea that glucagon is some powerful fat-burning beast is a fantasy.

Glucagon certainly promotes gluconeogenesis in times when glucose levels are low, but it doesn’t have the fat-burning effects in the sense that Cassie has promoted.

In addition, a discussion of fat-burning hormones that doesn’t touch upon the catecholamines (namely epinephrine and norepinephrine) is immediately bunk. Ignoring the catecholamines in a discussion of burning fat for fuel means ignoring the big picture, oversimplifying a complex system, and being reductionist in your explanation.

She then writes:

“With stable blood sugar levels, you are able to prevent fat storage and instead promote fat burning! You’ll also have consistent energy levels, moods, and focus when you’re not riding the blood sugar roller coaster.”

Again, Cassie creates a false dichotomy. Like I said earlier, the body constantly alternates between fuel substrate.

Also, she seems to be implying that less carbohydrates equals less fat storage because of stable blood sugar levels. This, again, is a massive oversimplification and an incorrect statement altogether. As I expanded on in Part 1, the conversion of carbohydrates to fat (de novo lipogenesis) is a very inefficient process and is largely irrelevant in humans (4). Carbohydrate consumption actually increases glucose oxidation much more so than fat consumption increases fat oxidation.

Everyone needs to read Lyle McDonald’s article How We Get Fat, as it clarifies much of the confusion surrounding the topic of nutrient oxidation.

Insidious Inflammation

Cassie goes on to discuss what she feels is a major part in “undoing the damage” of dieting: inflammation.

She writes:

“Another part of undoing the damage from harmful nutrition and dieting approaches, is addressing underlying chronic (systemic) inflammation. Any time your body has inflammation going on inside (whether it is from years of consuming too much sugar, trans fats, artificial sweeteners or even taking an antibiotic) your body will always focus on healing this first, before anything else.”

Gosh, I feel like such a broken record, but I’ll say it again: yet another massive oversimplification. Inflammation is an extremely broad term, which means it is also multi-factorial, to say the least.

Her proposal that inflammation could be caused by “consuming too much sugar, trans fats, artificial sweeteners or even taking an antibiotic (HA!)” is largely speculative and she provides no evidence for these assertions, which is becoming a recurring theme (the “HA!” is mine, by the way, just to be clear).

I would love for her to clarify exactly what she means by inflammation, and I would be ecstatic if she would provide evidence that the factors she mentions are inherently inflammatory, context be damned.

She goes on to write:

“If you’re feeling sluggish, down in the dumps or are having a difficult time losing weight, this could be what’s going on. The quickest way to speed up the healing process is to consume healthy fats (like avocado, butter, coconut oil, nuts and seeds) and take daily probiotic, L-glutamine and fish oil supplements.”

If you’re feeling sluggish, especially if you’re on a very low carb diet, you’re probably not on the right diet. Cassie recommends to eat more fat if you’re feeling sluggish. The only way this will work is if you’re sluggish due to a deficiency in fat soluble vitamins. If not, more fat consumption will not magically make you some energetic machine.

If you’re feeling sluggish, eat some fruit! Eat a potato! Eat some rice! Eat some oatmeal! Goodness gracious, this idea that carbohydrates are some sort of fattening villain is nonsensical. Glucose is your body’s preferred fuel source, and if you’re not getting enough, you’re going to feel sluggish. This does not make you a sugar addict, it makes you a normal human being.

This especially applies to athletes and those who are highly active. High activity levels and a low carbohydrate diet don’t jive in most situations, so I would certainly recommend against it.

As for her supplement recommendations, they’re fine, but they’re not going to make up for an energy insufficient diet.

Cassie’s Keys to Successful Weight Loss

Cassie writes:

“Everyone is different, but what I’ve found time and time again to be successful with my clients is significantly lowering carbohydrate intake while increasing intake of healthy fats, along with moderate protein consumption. This supports metabolism, brain function and helps your body run as it was designed to run.”

Yes, you’re right, everyone is different. And yes, many people will benefit from lowering carbohydrate intake and increasing fat consumption. However, many people won’t. It seems as though the inherent advantage of low carbohydrate, high fat diets is the increase in protein intake.

Protein allows one to maintain and increase lean mass, it’s extremely filling which often leads to a spontaneous reduction in calorie intake, and it has a high thermic effect.

In addition, the increased consumption of whole foods comes along with an increase in fiber consumption, which again, leads to a spontaneous reduction in overall caloric intake. There’s no magic here. The fact that consuming more filling foods will lead to reduced caloric intake is not rocket science, nor is it evidence that calories are irrelevant. Quite the opposite, in fact.

Processed foods can certainly be enjoyed in moderation in the context of an overall well-balanced diet. As always, it comes down to personal preferences and what’s sustainable for the individual over the long term. For example, I love to eat ice cream, so I adopt dietary habits that allow me to fit in ice cream on a daily basis. If I had to abstain from ice cream, the diet would not be sustainable.

Remember, if you don’t enjoy your eating habits, you’re not going to stick to them over the long haul.

Also, as for the last sentence in Cassie’s above paragraph, I would love to know her definition of how the body is “designed to run”. Again, that is a very broad statement that she doesn’t expand upon. Not to mention, her assertions that lowering carbohydrate intake and increasing fat intake are supportive of metabolic rate and brain function are not backed by any sort of evidence.

She then writes:

“Most of my clients who make this dramatic shift in their nutrition regimens report they feel better within a day or two and are able to naturally lose weight without even trying.”

This is outstanding, and trust me, I’m very appreciative of coaches and dietitians who are able to get their clients results. However, I also understand the importance of spreading correct information that is backed by evidence, which is something that Cassie has been unable to do in these past two articles.

And in conclusion, Cassie asserts:

The underlying key to healthy weight loss, consistent energy levels, focused minds and balanced moods is blood sugar regulation.

Again, not necessarily true. If you have an inability to regulate blood sugar, the problem lies within your inability to oxidize glucose effectively, which is the sign of a faulty metabolism. If you cannot eat a potato without crashing an hour later, you have an inability to regulate blood glucose.

This is not the potato’s fault, it’s the fault of a damaged metabolism. I think this is an instance of missing the forest for the trees. We have to look at the big picture. Improving overall lifestyle habits such as optimizing sleep, exercising, and focusing on dietary habits fit that the individual’s situation and preferences are all keys to improving overall health.

We cannot put weight loss into the tiny box of blood sugar regulation. Does it play a part? Certainly. However, saying it’s “the underlying key” shows a lack of appreciation for the big picture and the complexities of body fat loss.

My Final, Final Thoughts

Even though the article is titled “I HATE CALORIES”, Cassie didn’t even address the  supposed problems with energy balance and calorie counting. Instead, she expressed a misunderstanding of various hormonal processes and a seemingly one-size-fits-all view of body weight reduction.

The facts remain: energy balance reigns supreme in all dietary situations. Calories count, whether you want to believe it or not. No one, including Cassie, has been able to present any evidence to the contrary. Calorie counting is extremely effective for some individuals, while some can get by without it.

However, a caloric deficit must occur in some way in order to lose fat. You can ramble on about biochemistry and hormones and blood sugar all you want, but no caloric deficit, no fat loss. You can hate calories all you want, but that doesn’t make them irrelevant.

The belief that calories are to be ignored is a huge issue, and one that has caused problems for dieters who go down the low carb path. They are told not to worry about calories, only carbohydrates. For some people, this works. They feel full, and they spontaneously reduce calorie intake.

But what about the people who still overeat and end up not losing fat on a low carb diet?

They think that calories don’t count, so they proceed to lower carbohydrates even further. When that doesn’t work, they proceed to binge because they think that dieting doesn’t work for them. They think that it’s their fault.

In reality, this situation is simple. Eat a diet of mostly whole foods to ensure optimal vitamin, mineral, and fiber intakes, eat a good amount of protein, eat foods that you enjoy, and fit your diet to your personal situation while remaining cognizant of caloric intake.

Don’t mislead people by telling them to ignore calories. It’s unscientific and damaging to a confused and vulnerable population.

Thanks for reading. Share the post if you enjoyed it, and drop a comment with any questions, concerns, or feedback.


Facebooktwittergoogle_plusredditpinterestlinkedinby feather

Comments

  1. says

    Awesome! I especially like the glucagon part — SO SO SO wrong. But this is a properly educated dietitian who abandoned all the “wrong info” she learned to be educated by nutrition experts like Jimmy Moore and Gary Taubes. Very sad really.

    • Jake Johnson says

      Thanks for commenting Evelyn!

      Yeah, her section on glucagon literally hit me in the face like a brick. Not sure how someone of her “authority” status can be so misinformed, but as you said, trusting in the so-called “experts” in nutrition nowadays can certainly lead one in the wrong direction. It seems that they’re more interested in fairytales and mythical, evil insulin fairies than the actual objective evidence. You’re right, it’s sad.

      Jake

  2. says

    So hey again and thanks for covering the most recent cassie-post-fiasco. If you hadn’t I probably would have tackled it because at the part about the glucagon I almost started hyperventilating. Glucagon = gluconeogenesis = normal rise in blood sugar. Unless there’s some new research out there saying that beta-oxidation has been thrown out the window and glucagon has morphed into also breaking down fat. But I doubt it.
    The blood sugar argument is really frustrating to me, because (as I’m sure you know) high blood sugar levels do not cause weight gain, which is essentially what she is saying. And like you pointed out, it is perfectly normal for those levels to fluctuate throughout the day along with everything else because, HELLO that’s homeostasis and that means insulin and glucagon (and all the other hormones) are doing their thing! It’s when they are consistently high that you’re looking at diabetes territory, which is due to lack of insulin response, because we NEED that insulin response. And besides the physiological symptoms of high blood sugar, there are also some really helpful bloodwork panels that should be run – fasting glucose, HbA1c, lipids, etc. So Cassie diagnosing everyone who doesn’t eat paleo and is overweight as struggling with high blood sugar is absolutely ridiculous, unless she has some fancy-schmancy lab testing thing in her office that automatically gives those readings. And the whole glycemic index is actually not been shown in the research to be that effective because of the concept of the mixed meals that you pointed out. I kind of laughed because on my professors was talking about glycemic index and how faulty it was the other day.
    The supplements she recommends, I mean whatever, they probably won’t hurt (and they will definitely hurt less than all that coconut oil and butter), but they aren’t going to do what she says. L-glutamine is what you add to tube feeding during major wound healing or something of that nature. On a normal basis, a diet with complete protein sources (or complementary ones) should provide plenty of L-glutamine. It’s kind of a pet peeve of mine when people go around taking individual amino acids, fyi.
    And while I agree with you that the solution is seemingly simple, and essentially still comes down to the “eat less + exercise more = weight loss” mantra – even that is so complicated for people to do because they’re human! Our eating does not operate in a vacuum separate from what happens in life. Also, often people will get into the groove of losing weight, because we have that figured out. But it’s the weight loss maintenance that is really tough and that the research is still kind of out on what method works the best. *sigh* my advisor/lab supervisor is doing research on it right now. And she’s pretty awesome in her field so I’m pretty dang sure that she wouldn’t be spending time and money to do this if the answer was magically out there as Cassie implies. I could be wrong, but I really don’t think I am. I don’t know why I feel the need to smack my additional rant onto the end of your posts, but thanks again. 🙂

    • Jake Johnson says

      Hey Kelsey,

      I like your rants, they’re very insightful!

      And I agree with all of your points. As far as the solution being “simple”, I was more referring to the context of the role that calories play in weight loss. I believe people make it very difficult on themselves when they completely disregard calories. When you know, at least roughly, how many calories you’re consuming on a daily basis, you know where to make adjustments if needed. And yeah, weight loss maintenance certainly seems to be one of the biggest issues. We know that people can lose weight on a huge variety of different “diets”, it’s sustaining the “diet” and lifestyle changes over the long term that’s most important, but often the most difficult task.

      Thanks for commenting.

      Jake

  3. Lindsey says

    Jake, another fantastic breakdown exposing Cassie’s lack of understanding and misleading messages. If only her devout followers would all have a chance to see how truly uninformed their leader is.

    Evelyn–you hit the nail on the head. As an RD myself, it IS really, really sad to see a fellow RD who has fallen so far. The public is the real loser in all of this, though, and that is the most heart-breaking part.

    • Jake Johnson says

      Hey Lindsey,

      Thanks for the positive feedback. Sadly, it becomes an issue of people shedding their own confirmation bias and seeking the objective answers. However most people seem unwilling/unable to do so. But I do hope that Cassie has at least seen the posts. If she chooses not to address them, that’s fine, but hopefully she will take the time to actually think about what she’s writing and actually support her assertions with evidence in the future.

      Jake

    • says

      She is following in a long line, sadly, Lindsey 🙁

      I was pretty shocked to learn of this new co-host of Jimmy Moore’s Low Carb Conversations podcast. The podcast had been the brainchild of his original cohost Mindy Noxon Ionatti (always thought it odd that she was “and friends”) and I can’t imagine the content requires more than an hour or so to prepare for each week. Nonetheless this became too much for Mindy. Why not another staunch low carber? I don’t know, but onto the scene flashed Cassie. An unlikely replacement as a former vegetarian and endurance athlete who really does not eat like these low carbers espouse. Another Janie come lately to the LC scheme … er …. scene like Zoe Harcombe …. looking to capitalize 🙁

      • Lindsey says

        Evelyn,
        Again, your insight is spot on.

        She may have started out on the right path, but it’s pretty easy to see she is a natural-born guru who just needed the “right” teachers to lift her from evidence-based nutrition drudgery into pseudoscience enlightenment. And after her new persona started gaining popularity, I’m sure it was all too easy to sell out and start cashing in as the RD “breaking through conventional wisdom and speaking nutritional TRUTH”–ethics and actual science be damned.

        My guess is the book is already in the works…#PFC anyone?

        Again, the worst part is her role in stymying progress in the nutrition field by spreading misleading and flat-out wrong information and desperately confusing laypeople– all for her own fame and monetary gain. Reprehensible.

  4. Brittany Miller says

    Jake- thank you for your articles. I have read many of Cassie’s articles and they are very intriguing. As an RD I automatically wish to see the science behind any claim. I have asked her more than once to show evidence supporting her claims and I have gotten no response. This is a shame to me. I do believe all claims should be backed by science! Thank you for your scientific writing and siting. I look forward to your future posts 🙂

    • Jake Johnson says

      Hey Brittany,

      Thanks for the comment. Yes, Cassie seems to be quite engaging with her writing. It’s too bad that she never provides any evidence for her claims, and consistently shows the inability to get basic concepts correct. This may seem a bit harsh, but when you’re in an authority position, you better do your homework! Good on you for asking for the evidence. Too many people blindly accept the claims of experts today, and more often than not it leads them astray.

      Again, thanks for the comment and positive feedback, and keep on pursuing the evidence! We need as much science-based knowledge as we can get around here 🙂

      Jake

Trackbacks

Leave a Reply

Your email address will not be published. Required fields are marked *