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Edition 76: Bio Education Starvation & The Paradox of CICO
‘Calories in, calories out’ is a weight loss principle that has frustrated the masses for decades. The logic suggests we should simply burn more calories than we consume, and just like that, body mass will steadily reduce. Though incredibly easy to understand, actually creating the significant deficit people are looking for can prove elusive when the nuance is not addressed - giving the feeling that the principle cannot apply. Before diving into a topic like this, I mention first and foremost that I am not a nutrition expert, and these are just my observations and existing knowledge of physiology. For *facts* on anything about nutrition or the way your body processes food and you need to seek an expert - that would be a dietician, nutritionist, endocrinologist etc.
So what is the ‘nuance’ people are missing which leads to confusion over the principle? When it comes down to making decisions about food, understanding ‘the basics’ about nutrition is important but rare. Understanding how our body really works should be for everyone, and drilled into children from a young age throughout their school years so that no young person leaves school not knowing the absolutely crucial things about diet. So here we go, pop quiz: What are fats, carbohydrates and protein, and their purpose for the body?
Name 5 types of foods predominantly made up of each? Eg. Pizza is mostly ‘x’ (score out of 15)
How much protein should I be consuming each day in grams? (Bonus point if you know the difference between what the government suggests, and what actual sports scientists suggest)
How much carbohydrates should I be consuming each day in grams?
How much fats should I be consuming each day in grams?
What are the different types of fats and which foods are each type commonly contained in?
What are the different types of carbs and which foods are each type commonly contained in?
What is the difference between a processed food and non-processed food?
Why and how could two identical calorie intakes have completely different outcomes on one person?
Why and how could two identical macronutrient intakes have completely different outcomes on two people?
How many did you know the answer to? (Either look up the answers or message me).
To me at least, these are simple but not obvious things about nutrition - and I repeat, I am not a nutritional expert. What do I mean by ‘simple but not obvious’? Simple because they are not hard to teach, but not obvious because they will not teach themselves, they need to be taught. It’s like that all-important ‘divorced, beheaded, died, divorced, beheaded, survived’ rhyme that has served us all so well in life and really prepared us to leave school ready to tackle the challenges of life head-on. Sadly a large majority of people in Britain would not be able to say they knew the answer to all 10 quiz questions, but could pass a test about King Henry VIII who, let’s face it, sounded like a bit of a dick and is better off in the past, so you would think we could admit that we have a problem here?
But we can’t. So this is the horrible price society now pays, after being both neglected and abused, emotionally and intellectually about nutrition. A hefty cost for the NHS, as we mistreat our bodies to the point of failure, whether that is from back pain, mobility issues, cholesterol medication, heart conditions or any other obesity driven health issue. Eating disorders are one of the biggest killers in society today, which is a heartbreaking manifestation of the misinformation people of all ages are receiving on a regular basis, and the false affirmations that result from it.
“Eating disorders are among the deadliest mental illnesses, second only to opioid overdose. 10,200 deaths each year are the direct result of an eating disorder—that's one death every 52 minutes. About 26% of people with eating disorders attempt suicide.”
I hope those statistics illuminate why a concept like calorie counting could be an extremely bad idea for people who may be vulnerable to mental health problems and eating disorders. It might be a suitable tool for some, but not all, and therefore calories in, calories out (CICO) is not as straightforward a concept as it should be. So what is most crucial is that regardless of the tools we use to go about creating the ideal energy balance and healthy relationship with food, we are educated correctly about our human biology so we aren’t led down these social media rabbit holes of despair when it comes to evaluating ourselves and our diets.
You would think it’s ok to not know about this stuff, but there are influencers with zero background in nutrition masquerading as experts. Again, it is far more complex than the CICO concept which most people do actually understand (despite the fact I will suggest it does play the most decisive role, getting to that place in a healthy way is a whole different challenge which is largely being ignored). The great depth of knowledge required to not only understand the biology, but be able to compute and refute the relentless barrage of bullshit we have been fed on a daily basis for decades is enormous, and certain influencers and predatory ‘entrepreneurs’ are showing themselves to be incapable of admitting they could be wrong about the fads and theories they push and promote to the masses.
While the concept of CICO is a fundamental principle in weight management, it's important to recognise some of its limitations and nuances. Scientific research has shed light on various factors that can complicate what sounds like a straightforward process.
1. Metabolic Variability: People have different metabolic rates, and this can be influenced by genetics, age, gender, and other factors including muscle mass (*cough* get lifting). Some individuals may naturally burn calories at a slower rate, making it more challenging to create a calorie deficit solely through diet. A study published in the journal "Obesity" in 2015 found that individuals with similar diets and exercise routines could have varying rates of weight loss due to differences in metabolic rate.
2. Hormone Influence: Hormones play a crucial role in weight regulation. Hormonal imbalances, such as those related to thyroid function or insulin resistance, can affect how the body stores and burns calories. Research published in the "Journal of Clinical Endocrinology & Metabolism" highlighted how hormonal disorders can interfere with the expected outcomes of a calorie deficit.
3. Nutrient Quality: Not all calories are equal. Consuming highly processed, sugary foods can lead to blood sugar spikes and crashes, which can trigger hunger and overeating. In contrast, foods rich in fibre and protein tend to be more satiating. A study in the "American Journal of Clinical Nutrition" demonstrated that the type of calories consumed can impact appetite and overall calorie intake. This is why a huge spiced-up dinner full of vegetables, legumes and tofu will fill you up twice as much as a little cheeseburger from McDonald’s, but the cheeseburger contains double the calories and leaves you still feeling starving afterwards.
4. Adaptive Thermogenesis: Prolonged calorie restriction can lead to metabolic adaptations where the body becomes more efficient at conserving energy, making further weight loss challenging. A review in the journal "Obesity" in 2016 discusses how the body adapts to calorie restriction, making sustained weight loss harder over time. In other words, thinking you are helping your body lose weight by starving it is counter-intuitive. Your body will work harder to conserve the very little you *do* give it. Instead you could just be eating normally with your body burning at a higher rate for similar results.
5. Psychological Factors: Emotional eating, stress, and other psychological factors can influence calorie intake and the ability to maintain a calorie deficit. The "International Journal of Obesity" published research in 2015 highlighting the complex interplay of psychological factors in weight management.
6. Muscle Mass: Losing weight through calorie restriction alone may result in the loss of muscle mass, which can impact metabolism. Building and preserving lean muscle through resistance exercise can counteract this effect. Studies in the "Journal of Applied Physiology" (2009) and "Medicine and Science in Sports and Exercise" (2014) emphasize the importance of resistance training in preserving muscle mass during weight loss.
While CICO is a valuable and important overarching concept, weight management is a multifaceted process influenced by factors well beyond simple calorie counting. These scientific insights highlight that individual variation, hormonal regulation, nutrient quality, metabolic adaptation, psychological factors, and muscle mass all play significant roles in determining whether a person loses, maintains, or gains weight, even when a calorie deficit is present. Therefore, a holistic approach that considers these factors is essential for successful and sustainable weight management.
Thank you, Gabriel