# Not all calories the same **URL:** \ **Category:** In My Humble Opinion\ **Created:** [June 28, 2012, 1:24am UTC](https://boards.straightdope.com/t/not-all-calories-the-same/626530 "2012-06-28T01:24:52Z")\ **Posts on this page:** 6\ **Page:** 1
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [June 28, 2012, 1:24am UTC](https://boards.straightdope.com/t/not-all-calories-the-same/626530/1 "2012-06-28T01:24:52Z")
Right off I want to apologize for bringing this overdone subject up but [this news report](http://www.medscape.com/viewarticle/766443) sheds some actual light on the question. The report is about [this just published JAMA article](http://jama.jamanetwork.com/article.aspx?articleid=1199154). From the news report version: > [@](#): > > not all calories are alike from a metabolic perspective … Senior author Dr David S Ludwig (New Balance Foundation, Obesity Prevention Center) told heartwire : "Extreme restriction of fat or carbs can have bad effects. The best long-term approach will be to avoid restriction of any major nutrient–either fat or carbohydrate–and instead focus on the quality of nutrients. This is not to say that the number of calories isn’t important, but it’s now saying we should also pay attention to the quality of those calories. So the argument that the food industry likes to make–that all foods can be part of a healthful diet as long as you watch calories–is really misleading at best. > > “Relatively unprocessed, low-glycemic-index foods are best, things that our grandmother would recognize. Choose relatively unprocessed foods whenever you can and cut back on white bread, white rice, potato products, prepared breakfast cereals, and, of course, concentrated sugars.” … From the actual JAMA article: > [@](#): > > The results of our study challenge the notion that a calorie is a calorie from a metabolic perspective. During isocaloric feeding following weight loss, REE was 67 kcal/d higher with the very low-carbohydrate diet compared with the low-fat diet. TEE differed by approximately 300 kcal/d between these 2 diets, an effect corresponding with the amount of energy typically expended in 1 hour of moderate-intensity physical activity. … > > … Although the very low-carbohydrate diet produced the greatest improvements in most metabolic syndrome components examined herein, we identified 2 potentially deleterious effects of this diet. Twenty-four hour urinary cortisol excretion, a hormonal measure of stress, was highest with the very low-carbohydrate diet. Consistent with this finding, Stimson et al31 reported increased whole-body regeneration of cortisol by 11β-HSD1 and reduced inactivation of cortisol by 5α- and 5β-reductases over 4 weeks on a very low- vs moderate-carbohydrate diet. Higher cortisol levels may promote adiposity, insulin resistance, and cardiovascular disease, as observed in epidemiological studies.32 - 34 In a 6-year prospective, population-based study of older adults in Italy,35 individuals in the highest vs lowest tertile of 24-hour cortisol excretion, with or without preexisting cardiovascular disease, had a 5-fold increased risk of cardiovascular mortality. C-reactive protein also tended to be higher with the very low-carbohydrate diet in our study, consistent with the findings of Rankin and Turpyn.36 Other studies also have found reductions in measures of chronic inflammation, including CRP with a low–glycemic index diet.37 - 39 … In conclusion, our study demonstrates that commonly consumed diets can affect metabolism and components of the metabolic syndrome in markedly different ways during weight-loss maintenance, independent of energy content. (REE=Resting energy expenditure; TEE=total energy expenditure) An [editorial](http://jama.jamanetwork.com/article.aspx?articleid=1199129) in the same issue has criticisms of the study but not with the concept that not all calories are the same from a metabolic perspective. One criticism was that such is already known, it is already known > [@](#): > > that protein produces greater increases in REE and TEE than fat or carbohydrate.12 The editorialist bottom line is that not all calories are the same but calories still matter most: > [@](#): > > It may be possible to have a more individualized approach to weight loss, rather than a one-size-fits-all approach. The most efficient treatment approach incorporates periodic reassessments and adjustment of the weight loss regimen based on a patient’s success at any given time. Although the exact relationship between dietary composition and weight maintenance remains unclear, calorie restriction is more important than diet composition in administering weight loss regimens. Honestly I am not so interested in debating this again but thought some here would find it of interest. Enjoy. ---
**Author:** ![artemis](https://avatars.discourse-cdn.com/v4/letter/a/91b2a8/32.png) [@artemis](https://boards.straightdope.com/u/artemis)\ **Post date:** [June 28, 2012, 12:55pm UTC](https://boards.straightdope.com/t/not-all-calories-the-same/626530/2 "2012-06-28T12:55:08Z")
Thanks for posting this. Very interesting study! ---
**Author:** ![redtail23](https://avatars.discourse-cdn.com/v4/letter/r/3e96dc/32.png) [@redtail23](https://boards.straightdope.com/u/redtail23)\ **Post date:** [June 28, 2012, 3:22pm UTC](https://boards.straightdope.com/t/not-all-calories-the-same/626530/3 "2012-06-28T15:22:33Z")
That is interesting. I think a lot of the problem with figuring this stuff out is that everyone is different. Some people do great and lose weight on low-fat diets. Others don’t. Low-carb works for some but not others. Ditto all of the various routines that have come and gone. Why do “fad diets” become so popular when they don’t work? Because they _do_ work for some people. Just not everyone. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [July 2, 2012, 2:50pm UTC](https://boards.straightdope.com/t/not-all-calories-the-same/626530/4 "2012-07-02T14:50:46Z")
A [very informed analysis](http://wholehealthsource.blogspot.com/2012/07/why-did-energy-expenditure-differ.html#more) of the study. I have nothing to add to it. ---
**Author:** ![aruvqan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aruvqan/32/2891_2.png) [@aruvqan](https://boards.straightdope.com/u/aruvqan)\ **Post date:** [July 2, 2012, 4:28pm UTC](https://boards.straightdope.com/t/not-all-calories-the-same/626530/5 "2012-07-02T16:28:30Z")
> [@DSeid](#): > > \It may be possible to have a more individualized approach to weight loss, rather than a one-size-fits-all approach. The most efficient treatment approach incorporates periodic reassessments and adjustment of the weight loss regimen based on a patient’s success at any given time. Although the exact relationship between dietary composition and weight maintenance remains unclear, calorie restriction is more important than diet composition in administering weight loss regimens. . I get a nutritionist consult every couple of years to tweak my nutritional plan, the endocrinologist has a very good educational section. I find it very helpful even though I don’t learn anything new, but it helps keep my glucose controlled better than just drugs alone. I do find it somewhat amusing that the pre-insulin manner of controlling diabetes was actually going as low carb and low calorie as possible. We are finally free of the standard food pyramid and being given lower carb profiles now. [though I piss mine off because I refuse to go with margarine and use real butter, and refuse skim crap milk and go with 2%. I feel real food and in moderation is better than fake and modified crap.] ---
**Author:** ![drewtwo99](https://avatars.discourse-cdn.com/v4/letter/d/d07c76/32.png) [@drewtwo99](https://boards.straightdope.com/u/drewtwo99)\ **Post date:** [July 2, 2012, 4:32pm UTC](https://boards.straightdope.com/t/not-all-calories-the-same/626530/6 "2012-07-02T16:32:22Z")
I think that in 50 or 100 years time, it will be common wisdom that refined carbs are about the worst thing you can possibly eat (up there with transfats, probably). They are just so engrained into our culture it’s hard for us to grapple with it and realize it. Refined carbohydrates are such a staple for people around the world, and for desserts, it’s hard for us to fess up to the idea that they don’t really belong in our diet if we can help it. I am not a fan of fad diets like Atkins or the Paleo stuff, but I think there is a lot of wisdom to reducing the number of “white” carbs from things like potatoes, bread and rice. I know that when I lose weight, I lose it easiest by going on a low carb diet, and eating lots of healthy protein and vegetables.