Why Calories Matter Less Than You Probably Think

A doctor explains why you should pay more attention to the quality of your food


When it comes to “dieting” for weight loss, there are so many different approaches and programs to choose from. Some revolve around eliminating certain types of foods while others place a large focus on simply reducing calories or portion sizes.

Which type of method is most effective?

According to Dr. Michael S. Fenster, M.D., a board certified interventional cardiologist and author of The Fallacy of the Calorie: Why the Modern Western Diet is Killing Us and How to Stop It, if your goal is to lose weight, and more importantly, improve your health, you actually shouldn’t be approaching your diet so methodically at all.

“The first problem is how we define diet. So often, when we speak of diet everyone assumes that we are using the verb form in reference to weight loss,” he said. “There is also the unspoken assumption that if a certain goal weight is achieved that health and wellness will unerringly follow; which is of course balderdash and poppycock.”

Fenster said over a five year period multiple studies have shown that more than 90 percent of “diets” fail and explained that the problem with “dieting” is that the vast majority of programs posed as weight loss solutions are heavily based on deprivation.

“Once you achieve your goal you are faced with the original question—what is a healthful diet?” he said. “Here we are referring to the term diet in the noun form to mean that which we ingest for sustenance and pleasure. Working within this frame of reference we must concentrate on food value.”

According to Fenster, this means being mindful of both the quality and quantity of our food. And he says that from a caloric perspective, all foods are not created equally.

To support this claim, he referenced a 2012 study published in the Journal of the American Medical Association which examined groups of people who followed diets that were structured differently (low-fat and high glycemic, or a typical low-fat diet; low-fat and low-glycemic, or a typical low-glycemic reduced-carbohydrate diet; and a very low-carbohydrate Atkins-type diet) but had the same amounts of calories.

“Each of these restrictive approaches had differing but significant impacts on markers of inflammation, metabolic rate and metabolic syndrome—a precursor to diabetes,” Fenster said. “One diet was more inflammatory, another produced a higher risk of metabolic syndrome and so on. The researchers correctly concluded that when it comes to determining food value by comparing calories, it is a flawed method. As they observed, both common sense and such scientific findings urge us to ‘challenge the notion that a calorie is a calorie from a metabolic perspective.’”

In other words, while the amount of food that you eat certainly has an affect on your weight, there's certainly significance in the quality and value of the types of foods you choose, and not just when it comes to weight loss, but your overall health, too.

Fenster said that the overwhelming focus on quantity rather than quality is a part of the reason why many people struggle with diseases like heart disease and diabetes. The root cause, he says, is low-level inflammation.

“Springing from this common origin we find not only cardiovascular disease and diabetes, but many of the afflictions that we deal with today—cancer, autoimmune disease, neurodegenerative diseases, inflammatory bowel disorders and the list goes on," Fenster said.

He explained the societal advancements in the way that we produce food have not only affected what we’re eating, but our “food pathways” as well.   

“Our basic physiology remains essentially unchanged from hundreds of thousands, if not millions, of years ago, “Fenster said.

“We remain hardwired to seek out those things that would have enhanced our survival in a Pleistocene world—sugar, salt and fat. Now due to the manipulations of agribusiness and the food industry what was once a survival advantage has become an addictive Achilles’ heel in a world where any food we desire is an Internet order away, 24-7, 365. It is this overwhelming quantity without regard for quality that leads to the incredibly poor food value that is intrinsic to the modern Western diet.”

Another example of the “calorie fallacy” Fenster shared: diet soda.

“Especially those using zero-calorie artificial sweeteners,” he explained. “This is a discourse of great depth in my book, which discusses the studies that have consistently shown that women who consume zero-calorie diet beverages tend to be among those with the highest body mass index, the highest likelihood of developing diabetes and suffering cardiovascular disease and complications.”

So yes, artificial sweeteners don’t contain any calories and as Fenster explained, “may have no significant direct biological interaction upon the cells of the human gastrointestinal tract,” but what they do have an effect on is the bacteria that live there.

“These changes, in short, make us more likely to become obese and develop diabetes,” he said. “All from consuming a product, that if fewer calories make the healthier choice, would be among the most healthful options on the menu.”

But as the research that Fenster points out (and other studies) has shown, just because a food has the lowest amount of calories, doesn’t automatically make it the healthiest option.

So then if simply reducing your intake or even following a specific type of diet isn’t the answer, then what is?

Fenster said that one of the key aspects of the program in his book is simply eating delicious food.

“Using fresh, wholesome quality ingredients, there is an effort to learn and build flavor profiles based on herbs and spices,” he said. “These not only add a palate-pleasing punch, but pack a powerhouse of nutrition. Combined with simple and various culinary techniques that can enhance the range of flavors and textures; we learn to taste again.”

In other words, one of the most important parts of building healthy eating habits involves finding enjoyment in fresh, whole foods.

“Such an approach frees us and sustains us. Eating great tasting food makes us feel good and keeps us coming back for more,” Fenster said. “It provides the proper balance and nutrition for our bodies and our gut microbiome so that it keeps us healthy and well.”

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