Weight Loss- The Problem with Calories

Calories in < Calories out= weight loss.
Calories in >Calories out= weight gain.

Is this the formula for weight loss? Sometimes... but not all the times. It's a simple equation and a mantra of fitness and diet enthusiasts everywhere. Many gyms have this proudly posted on their walls. You'll even read this on many diet focused websites. The problem with calories is that they are simply a unit of energy available in food. This perspective on food doesn't account for the message that food sends to your body. It assumes that all calories are created relatively equal.

Gary Taubes has a great book, Good Calories, Bad Calories, that thoughtfully explores our fascination with calories and the way it came about. A science journalist, Taubes has his share of critics as he blasts our conventional understanding of presumed nutritional gospel about cholesterol and calories.

Even my favorite reality television show, The Biggest Loser, regularly touts the simple mantra, "Calories in should be less than calories burned!" While I am routinely inspired by the contestants and impact of the show, that is one area where I will disagree.

Follow this reasoning.

1. Food initiates hormone responses. We know that insulin release is necessary for appropriate metabolism of foods. This is standard, textbook human physiology.

2. Insulin talks and interacts with other hormones... such as cortisol, testosterone, leptin, estrogen and more. This is an area that science continues to explores. Cutting edge clinicians are constantly amazed at the web-like interactions of different components of our body. The reality is that 1000 carbohydrate calories will cause a different insulin response than 1000 calories of fat or protein.

3. These hormones often take on a life of their own. For example, high insulin will promote insulin resistance over time. This promotes more cortisol release in an unusual stress response. Cortisol then promotes even more insulin resistance in a vicious cycle. As your body is now under a stress response, hormones like testosterone, estrogen and others can be shortchanged as the enzymes that produce them have altered activity.

Now let me ask you some questions;
a) What is the effect of high cortisol? It's bad.
b) What is the effect of low testosterone? It's bad.
c) What is the effect of altered estrogen metabolism? It's bad.
d) What is the effect of altered progesterone levels? It's bad.

...and the biggest question of them all...
e) What set this off to begin with? High insulin secondary to carbohydrate heavy meals... regardless of calorie content!

Let me make a point here. I am not a hard core low carb advocate. You must eat carbohydrates... the good ones. Your body loves carbs and they are designed to be utilized efficiently in the body. But I do think the Standard American Diet is carb heavy. Think about your meals and snacks. They are likely to be carbohydrates that promote an insulin surge.

The "calorie model" is useful to some degree.  But it is the foundation of "old school" nutrition and does not effectively consider the many other variables involved.

Milk & Hormones

We've determined that the presence of growth hormone itself in milk may not be a major concern. Rather, the IGF-1 that results is more likely the cause of chronic health issues related to milk. Does this mean that there are no hormone-related issues with milk? Not necessarily.

Let's look at the conclusions of several research studies.

1. "Among the routes of human exposure to estrogens, we are particularly concerned about cows' milk, which contains considerable amounts of estrogens....milk and dairy products, which account for 60-70% of the estrogens consumed." Med Hypothesis 2001 Oct;57(4):510-4.

Some authors argue that the amount of sex hormones present is so small that it is not likely to have an effect. But remember that a little may not hurt an adult, but that same amount may injure a child.

2. "Exogenous contributions of estrogens will therefore constitute a relatively higher proportion of sex hormone activity in the immature child." Analytica Chim Acta 2007 Mar 14;586(1-2):105-14.

Many researchers agree that there is increased risk to young children due to these small amounts of sex hormones.

3. "Sexual maturation of prepubertal children could be affected by the ordinary intake of cow milk." Pediatr Int 2009 May 22
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Many chemicals, including various hormones and cellular signals, produced in our bodies appear in breast milk. The same is true for cows. They produce milk containing many chemicals including sex hormones. So the question of organic versus non-organic milk becomes a moot point with respect to sex hormone levels. Even so, let's see what research has shown.

4. "Conventionally labeled milk had significantly less estradiol and progesterone than organic milk. ... Milk labeled rBST-free had similar concentrations of progesterone vs. conventional milk and similar concentrations of estradiol vs. organic milk..... Conventional, rBST free, and organic milk are compositionally similar." J Am Diet Assoc 2008 Jul;108(7):1198-203

This is not to say that organic milk and conventional milk are the same. It means that the sex hormone content is roughly the same.

Is exogenous intake of hormone good for you? Most of us have the visceral instinct that this is not good. Let's remember that even organic dairy is full of these hormones. It is pesticides that they are missing (which is a good thing). But removing one evil doesn't automatically remove all of them.

Milk and rBST

Recombinant bovine somatotropin (rBST) (aka cow growth hormone), is routinely used to increase milk production in cows. This hormone is banned in Canada, European Union, Australia and New Zealand but the United States continues to allow it.

The National Institutes of Health states that rBST is not present in significant amounts in milk as it is destroyed during the pastuerization process. However, rBST causes an increases in levels if IGF-1. IGF-1 is present in cow's milk and survives the pasteurization process.

The obvious question is, "So what? Is consumption of extra amounts of IGF-1 in cow's milk harmful to humans?"

This journal article makes some important points about IGF-1.

1. Milk protein consumption induces postprandial hyperinsulinaemia and shifts the growth hormone/insulin-like growth factor-1 (IGF-1) axis to permanently increased IGF-1 serum levels.

2. Insulin/IGF-1 signalling is involved in the regulation of fetal growth, T-cell maturation in the thymus, linear growth, pathogenesis of acne, atherosclerosis, diabetes mellitus, obesity, cancer and neurodegenerative diseases, thus affecting most chronic diseases of Western societies.

3. Of special concern is the possibility that milk intake during pregnancy adversely affects the early fetal programming of the IGF-1 axis which will influence health risks later in life.

Clearly, disruption of the IGF-1 axis has significant implications.

Folks, many people will tell you that even if we give rBST to cows, it is not a big deal because it doesn't make its way into milk. But that approach is incredibly short sighted. rBST does something to cows... that something is an increase in IGF-1. IGF-1 enters our body and according to some authorities, has a significant role in most chronic diseases.

Milk has the potential for damages. So is organic milk better for you? We'll address that in the next entry.

Heart Disease- Testosterone

The hormones in our body play a significant role in heart health. Boston University researchers say, "the evolving role of androgens in metabolic syndrome and cardiovascular disease is of paramount importance."

Testosterone, the most famous androgen, has a protective effect on the heart (at least in men). Atherosclerosis tends to increase as testosterone levels drop. Low testosterone was once considered to be relatively rare phenomenon since men don't have the dramatic fall in sex hormones that women experience during menopause. But we now understand that low testosterone levels are "frequently unrecognized but also common." Int J Clin Pract 2007 Feb;61(2):341-4.

This doesn't meant that older men should run out and begin testosterone replacement therapy. In fact, the use of testosterone therapy is still a matter of large debate because of mixed findings in clinical studies. A better method may be to identify the reason for the drop in testosterone. These previous entries in this blog identify some reasons for loss of testosterone.

A large part of the problem is insulin resistance and poor blood sugar regulation. Insulin resistance will drive down testosterone levels in men. The result? A relatively unprotected heart.

If you have heart disease, has your doctor talked to you about your testosterone levels?

Running: Overtraining & Hormones

Let's dig a little deeper into the effects of overtraining.

Testosterone levels will decline. A team of researchers grouped 286 subjects into moderate or heavy exercise groups. They ran for 2 hours, 5 days per week for about 1 year. After that, they spent 9 months with a low intensity running schedule. They found that the pituitary hormones LH and FSH (luteinizing hormone, follicle stimulating hormone) decreased, testosterone levels decreased, and sex hormone binding globulin levels increased. Levels improved back to normal during the low intensity recovery period. They concluded,

"Long-term strenuous treadmill exercises (overtraining syndrome) have a deleterious effect on reproduction." Journal of Endocrinology 2009 Mar;200(3):259-71. Epub 2008 Dec 9

Females can also experience reproductive dysfunction. While the mechanisms are still to be determined, the probable suspect is decreased estrogen production as a result of overtraining. This does more than set women up for poor athletic performance. It sets you up for osteoporosis, infertility, decreased muscle mass & behavioral problems. Journal of Endocrinological Investigation 2001 Nov;24(10):823-32.

The hormone cost of overtraining is considerable. The consequences of these shifts are significant.

Running: Overtraining

Overtraining may involve more than just a drop in your athletic performance. Common symptoms include: headaches, insomina, pain, loss of enthusiasm for running, increased number of injuries, slower healing time, slower recovery time, frequent infections, loss of appetite and more.

Classically, the treatment for overtraining syndrome is rest. Depending on the extent of compromise to your body, this may require complete rest or a substantial reduction in your training time. Let me explain a little of the hormone physiology behind the syndrome.

1. Cortisol production is a priority in your body.
Just as we can say your heart is more important than your feet and your brain is more important than your spleen, we can say that cortisol is simply "a little more important" than many other hormones.

2. Cortisol, testosterone and estrogen have a common mother.
The precursor to all these hormones is pregnenolone. Generally, there's enough pregnenolone to go around so we make adequate amounts of all hormones, but when physical (or emotional) demands are extraordinarily revved up, cortisol production takes priority.

Do you remember the old Star Trek episodes where the Captain would say, "more power to the shields!" during times of attack? Presumably, sending the available power to shields took priority over the lights in the kitchen, powering the microwave oven or whatever else required power. The limited amount of available resource needed to be carefully distributed to get through the day.

Similarly, our pregnenolone needs to be transformed into what matters most at the time.

3. Over time, you won't even make enough cortisol.... or testosterone... or estrogen... to get through the day.
In Star Trek; eventually, the shields went down.
In California; eventually, you'll run out of water.
In overtraining; eventually, you'll run out of cortisol.

When your cortisol production "dries up", other hormone production will also suffer.
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Let me ask women a question? What happens when estrogen levels decline?
The answer is; the classic symptoms of menopause. Muscle mass declines, bone density decreases, fatigue, discomfort, insomnia etc. Sounds familiar?

Now to the men. What happens when testosterone levels decline?
The answer is: muscle mass declines, bone density decreases, fatigue, discomfort, insomnia etc.

Now a question to all runners. What happens when you are overtrained?
The answer is: muscles don't recover as well, bone loss, fatigue, discomfort, insomnia etc.