Starving Dietitian

Nutritious Lies: Calories In, Calories Out.

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Both Photos Depict 200 Calories

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The debate of the last century. How far we’ve come, how far left to go.

If I had to pick a question for Nutrition experts to solve once and for all, this would likely be it.

I’ll try my best to give a good summary, but be gentle, I am but human.

The question seems easy enough; Is weight loss just a physics problem?

Too much energy = store fat, Too little energy = Burn fat

Give me a quarter to flip and you’d be just about as close as everyone else to solving this problem. Most people tend to fall into “Yes” and “No” categories. Easy enough.

However, both camps are riddled with holes.

Energy In = Energy Out.

  • Pros: Simplifies nutrition, generally works, easy to track.
  • Cons: Oversimplifies nutrition, frequently doesn’t work.

Energy In ≠ Energy Out.

  • Pros: Complete view, works for some.
  • Cons: Complicated, varied solutions, difficult to track.

Welcome back to ground zero, please keep your seatbelts fastened until fully stopped.

So therein lies the issue. A truly complete view of nutrition would involve Genetics, Biochem, Biology, Physiology, and Psychology to name a few, it would be masterfully accurate and absolutely zero people would use it.  Even if we perfectly calculated your calorie use, we’d still only know half the equation. There are countless factors that dictate whether a calorie is stored as fat or something completely different.

Clear your schedule, we’re gonna need some more tests.

In the clinical setting, I can confirm that CI = CO is pretty much routine for MDs and RDs alike. I asked an RD recently whether the calculation could be wrong or the patients weight fluctuated much. You know what she replied? “If they’re not tracking to the calculation, we’d pretty much lose our job”. All signs point to go.

It’s strange to see the difference between Clinical and Mainstream Nutrition. Caring for a patient on the verge of respiratory failure might as well be another species from the 20 something college bachelor. This makes it imperative that RDs stay educated in both schools of thought.

If you asked me to bet for accuracy, I would say that Energy In ≠ Energy Out. There’s plenty of evidence to support this idea and the human animal is simply too complex to simplify that many factors. Purposeless reduction is to err, but simplification brings knowledge to the masses.

Be honest, if you walked into your doctors office asking about a rash and he pulled out textbooks and biochemistry charts you’d probably have a heart attack .

Dietitians are often criticized for encouraging the CI = CO approach, after-all it more or less implies that weight loss could be had with a Twinkie-diet, assuming they still existed. Then again people have lost weight on these diets,  Twinkie Diet. So looks like both sides have their problems.

The truth is that CI=CO is a good starting point, but doesn’t work for everyone. Calories may need adjusted down further, activity increased, meal composition changed, etc. If it doesn’t work for you then at least you have your personal answer to the question of the century. Take a deep breath, pat yourself on the back, and  go talk to your RD.

Be good to yourself, and each other.

More depictions of 200 Calories

-J. Iufer

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