When Is a Calorie Not a Calorie?

The energy balance paradigm assumes that caloric intake and output can be accurately, consistently measured, and that “eat less move more” is the answer to everything. If actual experience stubbornly belies the ability of this formula to cover every case, it might be assumed that something is wrong with how intake and/or output are being measured. Maybe the grad student who crunched the numbers was having a bad day. Perhaps the patient or the research subject supplied incorrect data, or simply lied.

The energy balance concept is closely linked with the idea that all calories are created equal. Food obsession is very similar to other mental/emotional disorders in which a person is held in thrall by a substance (cocaine) or experience (gambling) to the point where we call it an addiction.

But with food, there seem to be sub-categories. Are people loving the food itself, or the familiar, habitual, comforting actions and sensations involved in eating? How much of the preoccupation with food has to do with quality, and how much is dependent on a simple desire for quantity? Things get complicated, and outlier behaviors confuse the issues. Dr. Pretlow once mused,

From the difficulty we’ve encountered recruiting young people for our study, who are willing to reduce their food intake, it portends of an obesity Armageddon.

Most youth in our studies seem to want to engage in calorie counting to lose weight, even though we’ve stated firmly up front that our app does not involve calorie counting. I suspect the reason is that they can eat large amounts of “low calorie” food.

Calorie counting would seem to still leave the individual hooked on food, even though low calorie.

As it turns out, no matter what anyone thinks they know about calories, somebody else thinks they are wrong. Childhood Obesity News has mentioned a report that was said to “move the debate beyond calories.” The 22 scientists who contributed to the paper determined that there are specific pathways and mechanisms that account for the mysterious ability of some calories to be more harmful than others. About this significant research, Dr. Pretlow said at the time,

The paper finds that soda and other sugar-sweetened beverages increase health risks when compared with the same number of calories from other carbohydrates such as starch. That’s a big deal because it contradicts the beverage industry claim that “all calories are created equal.”

Nutrition researcher Kris Gunnars has a bachelor’s degree in medicine and founded the website Authority Nutrition, which later joined up with Healthline. In an article titled “8 Ridiculous Nutrition Myths Debunked,” he took apart one belief related to child obesity. By giving three examples of how foods can affect our hormones and our hunger levels in different ways, Gunnars showed how “a calorie is NOT a calorie”:

— Fructose vs. Glucose: Fructose is more likely to stimulate hunger, increase abdominal obesity and insulin resistance, compared to the same amount of calories from glucose.
— Protein: Eating protein can raise the metabolic rate and reduce hunger compared to fat and carbs.
— Medium vs. long-chain fatty acids: Fatty acids that are of medium length (such as from coconut oil) raise metabolism and reduce hunger compared to longer chain fatty acids.

What about the science? It is there, in great detail, a trove of easily-assimilated information for anyone inclined in this direction.

Your responses and feedback are welcome!

Source: “8 Ridiculous Nutrition Myths Debunked,” AuthorityNutrition.com, 05/22/13
Image by j_lai/CC BY 2.0

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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