Bill Lagakos: The Poor Misunderstood Calorie

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Jonathan: Hey everybody, Jonathan Bailor back with another bonus Smarter Science of Slim show. As you know, TheCalorie Myth book is right on the horizon or potentially already out depending on when we air this show. All this talk of calories – maybe one of the best parts of it was my getting introduced to an amazing nutritional biochemistry and physiology researcher by the name of Bill Lagakos.

He has written a book called The Poor Misunderstood Calorie and he has a blog called The thing that I love about Bill is he perfectly reflects our little catch phrase that biology isn’t a matter of opinion. Bill just comes out and says, look, here is the actual research about obesity, inflammation, insulin, here’s what calories actually are, here’s what the research actually shows. Not dogma, not sound bites, nothing about opinions. Just straight science.

I love that and I love that he’s here chatting with us today. Bill Lagakos, PhD, welcome to the show, brother.

Bill: Hi, Jonathan. Thanks for having me.

Jonathan: Thank you so much for being here. Bill, can you tell us real quick, before we dig into the science, a little bit of your story and what got you interested in calories and helping to dispel some of these calorie myths?

Bill: Well, I started to jumble down this rabbit hole because I think when you’re talking to the common people who don’t really understand what these calories are and they want to learn about them, you get into this problem where you talking about there’s calories in food, and then you’re talking about, oh, but you got to go exercise to burn calories. And how are those two things having the same name? How are they related? One of them is food that’s in your refrigerator, and one of them is you in the gym lifting weights.

So those two concepts are so fundamentally different. That’s why I started to write the book The Poor Misunderstood Calorie. It was really just about that word: how it’s used, how it’s misused, how it’s used to support what they’ve been trying to use to treat obesity since all of time which is the calories in, calories out model. I don’t think that works very well in practice, because it just doesn’t take into account any of the other more important factors like nutrient partitioning.

What happens to the food after you eat it? Does it get stored in the adipose tissue? Or is it burned by muscle? All of those things are regulated by physical activity, by your hormones. I think your hormones are probably one of the most important things in determining your body composition and quality of life. However, hormonal biology is just not captured in that calories in, calories out equation.

Jonathan: Bill, that is such a great encapsulation. I appreciate it because you get the science. It’s very easy to kind of go off the deep end and really get into the science, which we are going to do. But you also have a way to communicate this stuff in a very engaging fashion, which I am a fan of. The point you made about how calories are used as this least common denominator, that equivalence class, all types of physical movements and anything that can provide energy to your body glosses over – tell me if this is an overstatement. But it glosses over so much that it borders on almost being more harmful than it is helpful to just think about calories.

Bill: Sure. Yeah, no, I agree with that totally. I’m not going to argue that the calories in, calories out equation is wrong. It’s right, you know, if somebody loses weight, then they were in an energy deficit. However, it’s a useless equation because the obese patient comes to the doctor, the doctor says, “You’ve got to expend more calories than you’re ingesting.” So the patient goes home, and what’s he going to do with that advice? He or she is going to try to eat less food and try to exercise more and there’s 99,000 ways where that could not work.

For example, they could cut out some of the healthy food out of their diet. They’re eating less. And they could try walking or parking further from their workplace or whatever and walking a little bit further. And so they are exercising more. But then energy balance could drop down a couple hundred calories per day, and they are no longer in an energy deficit, and they are not going to lose weight. I think that happens all too commonly when people focus on the number game, the calories and not food quality, what you’re eating, which macronutrients, and you know a million other factors.

Jonathan: Bill, to highlight and to really make sure it hits home with the listeners because it’s such an important distinction, you said and I agree with and anyone who disagrees with has no idea what they are talking about – it’s not that calories don’t exist or that the calories in, calories out energy balance doesn’t exist. It absolutely exists. It’s just as useful as saying to a coach of an athletic team, “Hey, coach of the athletic team, why did you lose the game?” He says, “Well, the other team scored more points than we did.” And then you said, “Well, what are you going to do about that?” And the coach says, “Well, in the future we’re going to try to score more points than our opponents.”

Bill: Absolutely.

Jonathan: But how or why, right?

Bill: Right, that coach should be fired because they are not going to win any games.

Jonathan: Exactly. You talked about the things that matter more and that drive energy. Again it’s not that the energy balance doesn’t exist; it’s just that thinking that we should consciously regulate calories in, calories out to balance energy seems to not make any sense once you understand the biology.

Bill: I agree with that, totally. Another way that it could be wrong – you could be in energy balance. You know, eating just as much as you are expending. But you know if you are eating poor quality foods or junk foods, it could result in something catastrophic like you could lose three pounds of skeletal muscle and gain three pounds of visceral fat. In that situation, you know you’re still in energy balance: calories in did equal calories out. However, the person’s quality of life is going to be remarkably deteriorated now they are predisposed to metabolic disease, to obesity, to inflammation. Hey, that’s within the boundaries of calories in, calories out and it’s not mentioned by that equation.

Jonathan: This energy partitioning and what actually happens in the body in terms of the body not just being a passive vessel, that’s what you cover a lot in your work too. You show that this model of calories in, calories out as traditionally taught assumes that the body just sits back. And if you cut 500 calories, then you’re going to burn 500 calories of body fat, which is like kindergarten logic. That’s not at all true. Correct?

Bill: Yes. I agree with that 100 percent. I think that the way the hormones work in the body – they’re going to be controlling a lot of things. They can be manipulated by good dietary choices, but they’re going to be pretty much the end determinate as to – nutrient partitioning is one of those things I harp on a lot. I think you can be in energy balance and still, I shouldn’t say “lose weight,” but improve your body composition. Which I think is a far more important outcome than just losing weight, per se. That’s something that has to do with hormones and that’s not really calories.

Hormones are going to regulate what your body does with the nutrients and they’re also going to impact appetite, satiety, hunger, and all of these things are very important. That’s where we need to be focusing on, is treatments that bear in mind what happens on the inside of the body, the hormones, the nutrient partitioning, and don’t worry about the calories. Once you get the hormones right the person’s not going to want to be eating excessive calories. I mean once you get the right diet and hormones get corrected, that’s going to fix a lot of the problems.

Jonathan: Bill, in your book The Poor Misunderstood Calorie, you highlight some specific examples where individuals could be in a state of “energy balance” and gain fat, which again should be “impossible”. Or gain muscle or be in a state of energy balance and lose fat and lose muscle. Or even most shockingly, you provide a study I believe where in animal models, these animals were in a state of negative energy balance but actually gained body fat.

Bill: That’s one of my favorite rodent studies ever. They were feeding the mice 5 percent less than what they were supposed to be getting, 5 percent less than the other group. Their body weight didn’t really change very much and that sort of baffled the researchers. They actually did the entire study twice to confirm. Once they did the comprehensive body composition analysis, they said they couldn’t come to the conclusion that the mice got fatter.

But I wrote about this on my blog and in the book, and I said they got fattier because body composition results actually showed that the adipose tissue did increase. At the expense of muscle, organ tissues, everything else went down just a little bit. They were in negative energy balance, but it didn’t work. I think that happened because in that sort of study when they want to reduce the food intake of a mouse, they give the mouse the food all at once, the mouse – sort of a stressful regiment. So I think that happened because of the stress, which is another thing I focus on in the book, is all of the negative impacts of having too much stress.

In this case it made the mice have this nutrient anti-partitioning where they got increased adipose tissue at the expense of the muscle tissue. I mean they were eating less. I don’t think physical activity was changed very much in that study but I mean it doesn’t really matter too much.

Jonathan: Bill, the thing that I liked most about reading your book was: one, you get straight into the science. So there is no, lose five pounds in five days. It’s just here’s what the science says, and it starts to hint at big, big holes that I think once people can wrap their head around them, they can free themselves from these calorie myths, which are otherwise so hard to escape from because it’s “intuitive”. It’s intuitive – like eating less is a good way to burn fat. It’s also intuitive that the world is flat, but it’s not. Here’s just one thing that I’d love to get your expert take on. I mean, you study this professionally; you are a professional researcher. This is what you do.

Recently we’ve been having discussions on other shows of this kind of energy balance, blah, blah, blah. Let’s say you have a person; let’s call this person Samantha. Samantha has 100 excess pounds of fat on her body. Why would Samantha ever get hungry for calories? Considering that she has, “350,000 of them” in surplus. She’s already in a state of caloric surplus even without eating anything, so why does she get hungry?

Bill: I’m going to say straight up that’s because of hormonal biology. That adipose tissue is going to be holding on to that energy tightly because of the hormones, and there’s going to be a failure of the satiety mechanisms in the brain. That also comes in part from the adipose tissue. We’ve got the two major players here. The diet she’s eating I’m imaging isn’t going to be a healthy diet full of whole foods. I think she’s going to have probably too much insulin signaling, and that causes adipose tissue to grow, to accumulate fat mass. There’s this enzyme in the adipose tissue. It’s called hormone sensitive lipase.

That’s what pretty much controls fat release from the adipose tissue. It got its name because it is the most hormone sensitive lipase in the body, the most hormone sensitive enzyme. The hormone that we are talking about in this case is insulin. Once you get even the smallest amount of insulin that enzyme shuts down and you’re no longer releasing energy from the fat tissue. Now that’s a big player, I think that’s a huge component to what’s contributing to Samantha’s obesity.

Another mechanism is the adipose tissue is secreting lepton that’s supposed to be causing satiety in the brain, but it’s not because she’s also lepton resistant, which also seems to be an indicator of a poor diet, poor diet quality. All of these things have to do with the hormones regulating the energy balance. And poor Samantha, tell her to give me a call.

Jonathan: Bill, I so appreciate that you said “poor” Samantha. Because this situation we see – there are hundreds of millions of Samanthas around the world now, hundreds of millions. This is what breaks my heart, Bill, and you know we have two scientists on the phone here. And I just want to get a little more right brain, little bit more heart rather than head here for a second. According to the popular literature, Samantha is just weak and she’s just overeating.

Let’s be very clear Bill, there’s probably 1 percent of the population just like there’s 1 percent of the – well, I don’t know what the percentage is that takes crack. If you take crack bad things are going to happen. You probably shouldn’t take crack.

Bill: We can agree on that.

Jonathan: The Samanthas of the world, 99 plus percent of them, eat when they’re hungry and stop when they are full. To tell them why can’t you just be hungry for the rest of your life…

Bill: Right. That’s not a cure.

Jonathan: …is absurd.

Bill: Any diet that results in the patient being hungry or having to excessively restrict their diet, which means they’re hungry – that’s not a cure. That’s completely unsustainable. You’ve got to find a diet that works where they don’t need to have a notebook with them counting calories because that’s socially awkward, and it will fail.

Jonathan: You’ve just got to ask – there are some key “why” questions. I’m curious if you can give a little bit of science on this situation here, Bill. Walk into any school cafeteria. It’s not like 30 percent of students are eating salads and drinking sparkling water and 70 percent of the students are eating pizza and French fries and drinking Coke. All of the students are eating pizza and French fries and [drinking] Coke and some of the students are pre-diabetic and overweight and some of the students aren’t. We talk about, “Oh my god, 70 percent of the population is overweight.” I think the more interesting question is why isn’t 100 percent of the population overweight?

Bill: Sure. I do think there are distinct physiologies going on. Some people are resistant to obesity and that’s the kind of person that will have that pizza and Coke and all of a sudden be bouncing around the room. Their body will warm up, which indicates increased energy expenditure from the thermic effects of feeding. They will have more motivation to go outside and do things. That’s the lean phenotype. I think that’s unfortunately a little bit rare, but that’s also going to be dictated to they got lucky with good hormonal biology. It could be in the DNA.

And on the other hand, you have the obesity phenotype, this person who’s going to tend to secrete a lot of insulin in response to their food, the same amount of food the lean person is but the increased insulin is going to result in increased fat storage. This person is not going to have the energy to go outside and play, they’re not going to warm up that much after meals, they might just even get more hungry, and that’s an unfortunate scenario. I think that’s probably the major driver of the obesity epidemic.

Jonathan: Sounds like, Bill, correct me if I’m wrong, but to summarize what you just said there is a percentage of the population who respond to more in with more out. Then there’s a larger percentage of the population that responds to more in with more stored fat.

Bill: Yes, I do believe that is true. I think there are people that are going to be – insulin resistance plays a big part in this too and also plays a part in how you’re going to respond to dietary therapy. There’s this class of obesity called the metabolically healthy obesity. So they are actually insulin-sensitive, and they seem to do well on any kind of diet. You give them a good meal plan, you can reduce fat a little bit, you can reduce carbohydrate a little bit, and they respond well. Unfortunately that’s also the minority of the obese population.

When you have the insulin-resistant obese people, metabolically unhealthy, they have to watch their diet, they need to sort of be very mindful of the carbohydrate quantity. They need to cut the carbs basically is what I’m saying for the majority of the obese population. That has to do with the fact they’re insulin resistant.

Jonathan: We talk about carbohydrates, we talk about energy balance, we talk about what the body can do in response to an increased food intake. Case studies or concrete examples that everyone can associate with I think are very helpful. I can’t think of maybe a better example, Bill, and I’d love to again get the scientific explanation here of body builders. A body builder will consume – as a former attempted amateur body builder myself – will consume 4 to 6,000 calories per day while not doing, like not Michael Phelps-style, not submerging themselves in cold water for seven hours a day, doing a reasonable amount of physical activity, consuming an abundance of calories and maintain, for men, single digit body fat percentages and for females, very low in the teens body fat percentages. How can a body respond to so many calories with such leanness?

Bill: There’s a couple things going on there. One, I’m pretty sure that that person is going to be extremely conscious of the foods they are eating, the diet quality. This person’s not eating snack packs, they’re not eating cookies and ice cream, they’re probably eating a high percentage of protein, high quality fats, and that’s a very, very important mediator here. Also the type of exercise they’re doing, if you’re doing the resistance exercise, you are stimulating muscle growth. That’s important because one, just the fact that you’re increasing protein synthesis and protein turnover that’s energy expensive, that’s going to burn off a lot of those excess calories that they’re eating.

Also, when you have more muscle mass and that more functional strength, you’re going to be expending more energy all day long because you’re going to have, basically, the energy to live. You’re going to be okay walking somewhere because you don’t get so tired. Another thing is the act of exercising itself is a very potent nutrient-partitioning agent. That’s kind of weird to phrase it like that, but when you exercise all the blood flow goes to the muscles, to the contracting muscles. Also, the muscles will start to take up all the nutrients, so if you have a big meal and then go exercise, the blood flow is going to drive those nutrients into the muscle tissue away from adipose so you get this profound nutrient-partitioning effect.

This is sort of the exact opposite scenario as to somebody who has a big carbohydrate rich meal and takes a nap. That’s going to be basically the opposite body builder effect. All of the excess fat will be stored in the adipose tissue. I think it’s a combination of the exercise and the actual specific diet they are eating.

Jonathan: Bill, you touched on – we’ve used the phrase “nutrient partitioning” many, many times already in this conversation, so I want to take a step back and define that for folks real quickly and then also just encourage people again to check out your book The Poor Misunderstood Calorieas well as your website Calories Proper. A lot of the concepts we’ve touched on here, we haven’t and won’t have the time to dig into the specific studies and science. What’s so great about what you’re hearing here – it’s not my opinion, it’s not Bill’s opinion, we can provide and Bill has done so definitive – clinical. These aren’t observational studies. They are taking muscle biopsies and getting definitive data.

Talk about nutrient partitioning for a second here and just to foreshadow what nutritional partitioning is, think about the following listeners. Let’s say you do eat a lot. Why does that for many of us cause us to store more fat rather than to make our hair grow faster or our nails grow longer? Because technically those take up energy too. Why doesn’t overeating, like it may make your fat stores grow, why doesn’t it make your hair grow faster and your nails grow longer?

Bill: Well, they aren’t insulin-sensitive tissues. Well, they might be. I don’t know. They’re not storage tissues; they’re not storage. When I talk about nutrient partitioning – to summarize it, I’m looking at two tissues. I am looking at adipose, even though adipose can be subdivided into torso extremities, visceral subcutaneous, I’m just going to lump it all together now and say adipose tissue is one of those tissues and skeletal muscle is the other one. When we talk about nutrient partitioning you can be in energy surplus, in energy deficit, in energy balance. We’re talking about the nutrients being directed away from the adipose tissue and toward muscle.

That’s sort of affected by both the hormone and the physical activity. Nutrient anti-partitioning, the opposite, would be you’re eating – I associate this more with junk food and maybe sedentary behaviors, is when instead of getting the protein synthesis, the skeletal muscle anabolic response from the meal, the excess – or not even the excess nutrients. As the mouse study we discussed earlier, you could be in an energy deficit, but the energy you’re eating still ends up getting shunted into the adipose tissue instead of muscle. So that’s my perspective on nutrient partitioning.

Jonathan: From a very high level, Bill, would it be fair to define nutrient partitioning as what the body decides to use calories for?

Bill: Absolutely, sure.

Jonathan: Brilliant.

Bill: Brilliant.

Jonathan: So we shouldn’t, for example, I’m losing my hair. I shouldn’t fear that the thirteen fewer calories I’m going to burn per day because I’m losing hair and calories are no longer being spent helping my hair grow, that over time those thirteen fewer calories won’t make me weigh 1,000 pounds, as they technically should if calorie math the way it was presented was accurate.

Bill: Right. I would say your best bet would be to embrace the loss of hair and be happy about it so that you’re not stressed out. Because if you get stressed about it, then it’s going to promote the nutrient anti-partitioning.

Jonathan: Bill, this is fabulous, and listeners, we’ve only touched on the surface here. Again the reason I wanted to have Bill on the show and the reason I’m wholeheartedly encouraging that you check out his work, which again is the book The Poor Misunderstood Calorie as well as the website Calories Proper, is because there’s no ideology, there’s no bias. This is science. When you actually look at the science it is so liberating because it shows, one, why what we’ve been told hasn’t worked. Two, what does work and it’s really not ambiguous once you understand the science, nor is it hunger inducing, nor is it time consuming. Am I painting too idealized of a picture, Bill, or is that pretty fair?

Bill: No, no. I mean I do agree with that totally. A long time ago I stopped trying to dig into the history of why people think the way they do now, and I just started to devote that energy to looking at the clinical trials, looking at the intervention studies to see how do things work in real life, how do things work in the studies. It becomes very clear that the way people respond to food and behaviors and the hormones are sort of what’s going to be the answer at the end of the day, not calories.

If we go back to the example of Samantha, I used to joke about somebody who has a 2,000 calorie energy expenditure going on a diet where they eat nineteen of those 100-calorie snack packs per day. I actually read in the news the other day there was someone who was doing that, and I just felt horrible because it’s not going to work. I mean the body will so easily compensate for that hundred-calorie deficit by reducing energy expenditure by 150 calories, so you are no longer in a deficit. Furthermore, anything of that surplus is probably going to be put in that adipose tissue because you’re hungry and you’re stressed out.

Jonathan: And not to mention that that poor individual is on a bullet train to diabetes and cancer and heart disease because you know what? Calories aren’t what give you diabetes, heart disease, and cancer in the first place. They’re units of energy. So if you’re concerned about not dying of avoidable diseases, those are not diseases of excess calories. Those are diseases of other things besides calories.

Bill: Right. Poor nutrient quality, poor diet choices. That’s the more important thing.

Jonathan: Bill, this is just super-helpful, and we can certainly talk for hours and hours and hours and we will definitely be chatting more in the future. But what’s next for you and what can the readers hope to see coming from

Bill: I’m still blogging; I’m very active on there. What’s next for me? I am working on another book. It’s different but I’d like to think it’s the volume two. The unofficial title of my first book is The Poor Misunderstood Calorie Volume One. I am working on a follow-up to that where I’m including a lot more things – for a guy who despises discussion of calories and the numbers, I sure do talk about them a lot. I’m talking about more things, like getting a good night’s rest. I mean, that can royally screw up body composition and cause nutrient partitioning to work against you.

You know vitamin D metabolism, playing outside in the sun. A lot of things that are sort of more important than the number of calories you are eating. That’s going to be a big focus of the next book.

Jonathan: Brilliant. Well, Bill Lagakos, PhD, thank you so much for helping to dispel these devastating calorie myths and for sharing with us a much smarter science. I hope I can chat again with you soon.

Bill: Sure. Thanks for having me. It’s been an honor to be here.

Jonathan: Well, listeners, again our wonderful guest today was Bill Lagakos, PhD. He is the author of The Poor Misunderstood Calorie, which I would highly recommend, as well as the proprietor of the website Give him some love, free yourself from the calorie myths and remember, this week and every week after, eat smarter, exercise smarter and live better. Chat with you soon.

[Audio Ends 30:01]

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