A Calorie is Still a Calorie, According to Rigorous New Evidence

Abstract

Chronic degenerative “diseases of civilization” are the top challenges of all health systems globally[1]. Among them, obesity is the most pernicious because it a) has survived several meritorious lifestyle initiatives undeterred, b) is associated with intractable environmental promotion, c) there is no longterm medical treatment available, but also d) negatively affects several other cardiovascular risk factors, and e) is the leading cause of preventable life-years lost in the United States[2]. The misbelief that an unrestrained, permissive “diet,” effortless exercise “program”, or magic “diet pill” may exist continues to permeate popular thinking and media pieces. The combination of such fantasies, denial, and rejection of scientifically proven nutrition principles has enabled the triple epidemics of obesity, diabetes, and cardiovascular risk to continue. One of the controversies that recur is the question of whether a low-fat or low-carbohydrate is “healthier”[3]. Some authors argue a special case which, in their view, will help clarify the issue: do dietary calories count and are they equal? Classical experiments, particularly ones that used meticulously-controlled environments and metabolic ward measurements, indicate that calories do count[4]. Usually considered basic physiology, obesity ultimately results from a calorie intake in excess of calorie utilization, and the initial clinical approach is to correct this imbalance[5,6]. When done, it succeeds. Calorie utilization is comprised of the energy cost of resting metabolic processes (REE), physical work performed, and the thermal effect of food (TEF), with the most practical, safe and clinically meaningful target being physical activity. In contrast with the classical, accepted paradigm of excessive dietary calories as the most important cause of weight A Calorie is Still a Calorie, According to Rigorous New Evidence