Saturday, June 1, 2013

A Calorie is a Calorie, Right?

Barb Goshorn RN MSACN

“The Nurse Nutritionist”

How long have we been hearing this? Since the 1960’s, this is the foundation of our belief in what causes obesity. If we take in more calories than we expend, we get fat. There are many researchers who are no longer buying into this theory, though. One is Dr. David Ludwig, of Boston Children’s Hospital and his collaborators. The Journal of the American Medical Association recently published the results of his research and instead of excess calories being implicated in the obesity epidemic, the hormone insulin appears to be the culprit. 
Until the 1960’s, carbohydrates were indeed considered a likely suspect in obesity. “Every woman knows that carbohydrate is fattening” as two British Dieticians began a 1963 British Journal of Nutrition article.  Carbohydrates stimulate the secretion of the hormone insulin, which works, among other things, to store fats in our fat cells. In 1921, insulin was discovered and nicknamed, “The fat storage hormone”. For a number of reasons though, conventional wisdom shifted and obesity became an energy imbalance issue. Carbohydrates, with less than half the calories per gram of fat, became the heart-healthy diet food. With this transformation, fat was removed from foods and we were told to eat low-fat, carbohydrate-rich foods that would keep us thin.
Unfortunately, this theory hasn’t seemed to work. Each decade the obesity epidemic grows exponentially. It may be time to look at an alternate theory as to why we get fat. Dr. Ludwig and his team concluded that it was the nutrient composition of the diet that triggered weight gain independent of calories consumed. The fewer carbohydrates eaten (simple versus complex), the less weight gained and the more carbohydrates eaten, the more weight the subjects gained. It was concluded, that the carbohydrates were fattening, and obesity triggered by elevations in insulin, triggered fat storage.
This is the polar opposite of what we have been told to eat for decades: eat a low-fat, carbohydrate-rich diet. The results and conclusion are naturally very controversial. Yet what we have been educating people to eat obviously hasn’t been working. I know from a clinical perspective, my clients are most successful when their carbohydrate intake is from vegetables and fruit with a minimum of grains. Instead of counting calories, think about eating to avoid huge spikes in insulin.