Why the Energy Balance Theory is pseudoscience

Why the Energy Balance Theory is pseudoscience

First of all, its basis is a mere tautology (i.e. needless repetition of an idea) referred to the adipose tissue:

if the adipose tissue accumulates energy, in that tissue more energy comes in than gets out

This is just a truism, because that is what “accumulation” means, since energy can’t come out of nothing nor can it disappear, but this tautology tells us nothing about why the accumulation of triglycerides is happening. The tautology (in its correct form) is useless. The false sense of utility provided by the Energy Balance Theory comes from a deceitful transformation of the useless tautology: the trick is that the boundary for the application of the First Law of Thermodynamics is unjustifiably considered to be the whole body’s boundary, instead of the correct boundary, which is the adipose tissue’s boundary. Understanding this deception is crucial: if you want to apply the First Law of Thermodynamics, you must have a clearly defined physical boundary in its use. The Energy Balance Theory violates that principle and that fact makes this theory a hoax.

A thermodynamic system is that part of the world to which we are directing our attention. Everything that is not a part of the system constitutes the surroundings. The system and surroundings are separated by a boundary.

Internal energy is the totality of all forms of kinetic and potential energy of the system

When the “Calories In” and “Calories Out” terms are used, the physical boundary is the whole body’s boundary. This is mandatory. And, therefore, the totality of all forms of energy in the body have always to be taken into account. It is unjustifiable and deceitful to only consider the energy stored in a specific tissue (e.g. the accumulation of triglycerides in the adipocytes).

Calories In = Calories Out + Change in FAT DEPOSITS
←  WRONG

Calories In = Calories Out + Change in ALL ENERGY STORES
←  CORRECT, BUT USELESS

Any energy that’s left over after the body has used what it needs is stored as body fat (source)

That is a theory that doesn’t derive from physics’ laws.

The faux causality problem

Moreover, the Energy Balance Theory relies on an unfounded attribution of causality. It is easy to understand this point, just by comparison with any other growth in a biological system. What does the Energy Balance Theory tell us about conditions such as fatty liver, muscle hypertrophy, giantism or a tumor’s growth? What does it tell us about how anabolic steroids work? All of those situations represent the growth of tissues inside of the body, and therefore they represent energy accumulation in one or several tissues, just as obesity does.

Fatty Liver

Fat accumulates in the liver, therefore

it is an incontrovertible fact of physics that fatty liver happens when calorie intake exceeds expenditure […] the laws of physics ensure that any person will reverse its fatty liver if calorie intake is reduced sufficiently

it is an incontrovertible fact of physics that weight increases when calorie intake exceeds expenditure […] the laws of physics ensure that any obese person will lose weight if calorie intake is reduced sufficiently

Giantism

Your body can’t grow unless you eat more than you expend:

An imbalance between energy intake and energy expenditure is the primary etiology for giantism.

An imbalance between energy intake and energy expenditure is the primary etiology for excess weight gain.

Muscle mass

Muscle tissue can’t grow unless there is a caloric inbalance:

Muscle hypertrophy is defined as a state of increased muscle mass resulting from chronic nutrient excess, where energy intake significantly exceeds energy expenditure

Obesity is defined as a state of increased adiposity resulting from chronic nutrient excess, where energy intake significantly exceeds energy expenditure

Tumor

A tumor can’t grow unless more energy comes in than gets out:

A key determinant of a tumor’s growth is the balance between ingested calories and the body’s basal energy expenditure. The tumor’s growth therefore results when small positive energy balances accumulate over a long period of time

A key determinant of obesity is the balance between ingested calories and the body’s basal energy expenditure. Obesity therefore results when small positive energy balances accumulate over a long period of time

Anabolic steroids

Do anabolic steroids increase your muscle mass by making you hungry or sedentary?

if anabolic steroids don’t increase energy intake […], and don’t decrease energy expenditure, then how exactly are they supposed to cause energy accumulation in the body as fat? There is no energy fairy

if insulin doesn’t increase energy intake [… ], and doesn’t decrease energy expenditure, then how exactly is it supposed to cause energy accumulation in the body as fat? There is no energy fairy

Your energy expenditure is not a controllable input of the system

The Energy Balance Theory hoax is supported with rethorical fallacies where the energy expenditure is alluded as if it were a controllable input of the equation. It is not. If both energy intake and energy expenditure are considered inputs of the system, and if the decepcion explained above is used (i.e. considering only the energy stored in a specific tissue), a false impression of causality is created:

When calorie expenditure decreases and calorie intake increases, the energy balance equation leaves only one possible outcome: fat gain (source)

When calorie expenditure decreases and calorie intake increases, the energy balance equation leaves only one possible outcome: fatty liver or muscle hypertrophy or giantism or a tumor’s growth or you are pregnant and the fetus grows

As explained above, to assume a result for an output (“calorie expenditure decreases”) is cheating. It is not an input we can control.

When calorie intake increases, in the case where the calorie expenditure decreases the energy balance equation leaves only one possible outcome: fatty liver or muscle hypertrophy or giantism or a tumor’s growth

The energy balance equation can NEVER be used to predict the response from a living tissue to a stimulus, because that law has nothing to do with biology. Its use related to the study of obesity is based on rethorical fallacies and it is, therefore, unwarranted.

Does this mean that the First Law of Thermodynamics is not valid in a biological system?

That idea is not correct: the First Law of Thermodynamics is always fulfilled, and, therefore, it is also fulfilled in biological systems. It is the Energy Balance Theory what is a fraud, because it is both a misapplication and a misinterpretation of what the First Law of Thermodynamics says.

The pseudoscience is the pretension that the Energy Balance Theory is rightfully derived from the First Law of Thermodynamics and that, therefore, it must be used to deduce causes and solutions for obesity. The Energy Balance Theory is a hoax and it can’t be used for that purpose, just as it is clearly inappropriate to deduce how to cure your fatty liver, how to increase your muscle mass or how to treat a kid that suffers from giantism. Obesity is not a special condition.

Ultimately, obesity reflects energy imbalance, so the major areas for intervention relate to dietary intake and energy expenditure, for which the main modifiable component is physical activity (source)

Giantism also reflects energy imbalance, right? What are the major areas for intervention in that case? A tumor’s growth also reflects energy imbalance, right? What are the major areas for intervention in that case?

Further reading:

Sugar-sweetened beverages and obesity

DAILY calories from sugar-sweetened beverages among U.S. adults (1980-2010):

imagen_0462 (source,source)

CUMULATIVE TOTAL increment in the percentage of obese adults (orange stars) versus CUMULATIVE TOTAL calories from sugar-sweetened beverages (blue line; numerical data not shown in the figure):

Are these data consistent with an important effect of sugar-sweetened beverages on body weight? Do they suggest, on the contrary, that sugar-sweetened beverages are highly unlikely to be an important cause of obesity?

Further reading:

If your today’s sugar intake is lower than yesterday’s, do you slim down?

Introduction

This article is an extension of an article that I posted a few days ago. The idea that I want to discuss is the one below:

We have data from the time evolution of two parameters, named A and B. Some people believe that there is a dependence relationship between A and B so that A has a significant effect on B, but we know that A suffered a trend change and B didn’t, so other people say that this fact suggests that it is highly unlikely that A has a significant effect on B.

For the purpose of explaining the failures in the previous idea, I will assume a very simple model of obesity: we gain 3 g of body weight for every 100 g of sugar consumed. Please, don’t bother to criticize this model: I will only use it as a tool to explain the errors in the idea explained above. What we will see is that, under the premise that sugar is determining our body weight gain, the correlation between sugar intake and body weight may be low. That is the main conclusion and the specific model used for the explanations is irrelevant.

DAILY and CUMULATIVE TOTAL parameters

As said above, our assumption is that we fatten 3 g for every 100 g of sugar consumed. If our intake of sugar were 50 g, we would fatten half that amount: 1.5 g.

imagen_0440

Given a specific sugar intake, the DAILY increase in body weight will be directly related to that DAILY sugar intake.

If I’ve consumed a certain amount of sugar PER YEAR, the PER YEAR increase in body weight would also be directly related to the PER YEAR sugar intake. For example, if one year’s sugar intake were 33 kg, our body weight would increase by 1 kg that year. Had I consumed only one third of those 33 kg, my body weight would have increased that year one third of 1 kg.

Let’s say that over the years our DAILY sugar intake has changed according to the blue curve in the graph below. In this scenario, our DAILY body weight gain would change as indicated by the red curve (calculated according to the hypothesis of that we fatten 3g per each 100 g of sugar consumed).

imagen_0441

DAILY sugar intake and DAILY body weight gain are directly related variables. Their correlation, i.e. the mathematically-computed resemblance between them, is maximum.

If we compute (in blue) the CUMULATIVE TOTAL sugar intake since 1980 (i.e. for each year we compute the total amount of sugar consumed since 1980 until that year), versus (in red) the CUMULATIVE TOTAL body weight increase since 1980 until that year, we get this:

imagen_0442

Again, as we saw with DAILY body weight increase and DAILY sugar intake, there is a direct relationship between CUMULATIVE TOTAL sugar intake and CUMULATIVE TOTAL body weight gain. This is also to be expected: under the premise that body weight gain is directly proportional to the sugar intake, if the CUMULATIVE TOTAL sugar intake over the past X years gets bigger you are expected to gain more weight, and if it gets smaller you are expected to gain less weight.

In order to clarify what comes next, let’s assume we are filling a bucket by pouring into it daily glasses of water. Every day we pour into the bucket the contents of one glass of water. Let’s assume that the volume of water in the glass has been progressively rising, day after day, until reaching a peak at 110 ml, and then, for the last 15 days we have gradually reduced the volume of water in the glass until reaching 95 ml, is the cumulative total water in the bucket expected to be reduced at the end of those 15 days? Does anyone think that if I reduce the volume of water poured daily, the volume of water in the bucket has to decrease? When we confirm it doesn’t decrease, do we conclude that it is highly unlikely that the volume of water in the glass has an important effect on the volume of water in the bucket?

Let’s get to the point, but first remember that the correlation between DAILY sugar intake and DAILY body weight gain is maximum, and remember, too, that the correlation between CUMULATIVE TOTAL sugar intake and CUMULATIVE TOTAL body weight gain is also maximum. Now, what kind of relationship exists between the DAILY sugar intake at a given year and the CUMULATIVE TOTAL body weight gain at that same year? A direct relationship is not to be expected: if the DAILY sugar intake is reduced, the CUMULATIVE TOTAL body weight is not expected to be reduced, in any case that year the body weight will go up by a smaller amount, but it will continue to increase, and the effect of a smaller DAILY sugar intake will also be small in relative terms, since we have only changed the data for one year that has to be accumulated to the rest of the years in the CUMULATIVE TOTAL: we have been accumulating body weight for years and the sugar intake during the last one of those years is expected to have a small effect in the CUMULATIVE TOTAL.

From another point of view, the CUMULATIVE TOTAL sugar intake —including the contribution from last year, but with a weight that depends on how many years are being considered—, is the variable which determines the CUMULATIVE TOTAL body weight gain to that year. It is nonsense to expect a direct relationship between DAILY sugar intake and CUMULATIVE TOTAL body weight gain. And, in fact, that relationship is not a direct one. Assuming that a man weighed 80 kg in 1980, the graph below shows his CUMULATIVE TOTAL body weight (red curve) versus his DAILY sugar intake (blue curve):

imagen_0443

We know that the red curve is completely determined by the blue curve, but they don’t have a good correlation. Or in other words, we confirm that a low correlation tell us nothing about the existence of a dependence relationship between two variables. If for the same situation, we had chosen the two previous graphs, we would have concluded that the relationship between sugar intake and body weight gain is undeniable.

If we recall the idea at the beginning of the article, A (blue curve) has changed, and the effect on B (red curve) is apparently small, but we know for a fact that A completely determines B.

What are we seeing?

In the last graph I presented above, the red curve is completely determined by the blue curve and the correlation between them is low. How is that possible? Because these two variables, while they are completely related, they don’t have a direct relationship. One variable is the CUMULATIVE TOTAL body weight gain, the effect of several years of fattening, while the other variable is just the DAILY sugar intake for one of those years. The fact that one of them goes on rising, albeit more slowly, when the other one decreases DOES NOT suggest that a cause-effect relationship between them is unlikely. The CUMULATIVE TOTAL body weight gain is not supposed to go down when the DAILY sugar intake is reduced: a “negative consumption of sugar” would be needed to produce such an effect on body weight. And, in any case, it would be the level, i.e. the fact that sugar intake is negative, what would produce a decrease in the  CUMULATIVE TOTAL body weight gain, not the change, i.e. the fact that sugar intake decreases. Even if it were possible to consume negative amounts of sugar, neither there would be a direct relationship between both variables nor a high correlation would be expected.

anyone who defends that sugar intake is a main cause of obesity and diabetes is proposing that there is a direct relationship between those variables

That’s a fallacy. The hypothesis that sugar is fattening means that the DAILY sugar intake affects the DAILY body weight gain. Nobody says that the DAILY sugar intake is directly related to the CUMULATIVE TOTAL body weight gain to that date: it is stupid to expect that when your DAILY sugar intake goes down your CUMULATIVE TOTAL body weight has to go down. This is not mathematics: it is just common sense.

Does the data presented by Guyenet in his graph suggest, as he says, that “sugar is highly unlikely to be the primary cause of obesity“? No, it does NOT suggest that. His graph is absolutely consistent with a direct effect of the DAILY sugar intake on the DAILY body weight gain: it can easily be seen that when the DAILY sugar intake was decreased, the DAILY body weight gain also decreased.

pastedimage

Summary

The main Guyenet’s mistake, or the base of his attempt of deception, is that he assumes that the CUMULATIVE TOTAL body weight gain and the DAILY sugar intake are directly related, and that hypothesis is both nonsense and inconsistent with the hypothesis that he is trying to refute. No one proposes that the DAILY sugar intake has a direct relationship with the CUMULATIVE TOTAL body weight gain: this specific relationship is expected to be non-linear! Had he compared DAILY body weight gain with DAILY sugar intake, he would have found a direct relationship (consistent with the hypothesis that sugar is fattening). Had he compared CUMULATIVE TOTAL body weight gain with CUMULATIVE TOTAL sugar intake, he would have found a direct relationship (consistent with the hypothesis that sugar is fattening).

imagen_0430 imagen_0432

We have seen in this article, with help from a simple model of obesity, that although CUMULATIVE TOTAL body weight gain and DAILY sugar intake are not well correlated, that doesn’t suggest that there isn’t a causal relationship between both variables.

On the other hand, Guyenet confuses a lower intake of sugar with a negative consumption of sugar. Logic says that if sugar is fattening, reducing its consumption doesn’t make us slim down.

Endnotes

  1. When in this article I use the term “direct” what I’m saying is that when one variable goes up the other variable also goes up and that when one variable goes down the other variable also goes down. Note that a direct relationship is not necessarily one of proportionality.
  2. the data used by Guyenet as support for his hypothesis is epidemiological. This is relevant, since when part of the population chooses to decrease their sugar intake, they probably take additional measures related to improving their health, such as not eating grains/flour, not consuming processed products, cooking more at home, less frequently eating out, etc. And, in addition, those who make these decisions have not been chosen at random: they are the ones who have decided to take care of themselves, so we’re not just comparing sugar intake: we are comparing lifestyles. That is an important difference with respect to a randomized controlled trial (RCT), where participants can’t decide if they decrease their sugar intake (and perhaps its replacement by another product). In the case of a RCT that reduction is supposed to be the only difference between goups. Guyenet’s data is far from being that case.
  3. We are talking about total sugar intake, regardless of its format, regardless of when it is consumed, regardless of which products accompany it in the mouth. A lot of information is missed.
  4. We are talking about the average sugar intake of a population and the percentage of adults above a specific level of obesity. The interesting data would be to compare individualized DAILY sugar intake and DAILY body weight change, and we would want to have this data for a large number of people.
  5. Guyenet says the variation in the percentage of obese adult has been small —he even expected a decrease! — but, actually, the change has been bigger than expected from the small reduction in the DAILY sugar intake (gradually decreasing the intake from 110 g/d to 95 g/d is an average reduction of 9% relative to the baseline: it is not an 18% decrease!). May be people who have decreased their sugar intake have also taken, at the same time, other measures to improve their health, and those additional measures could be contributing to the undeniable trend change perceived from year 2000 in the percentage of obese adults.

Further reading:

Guyenet refutes the idea that sugar causes obesity

Assume that each year you gain an amount of body weight that is directly proportional to the amount of sugar you eat. Or, in other words, if you consume 100 g/d of sugar and you fatten a few kilos, if you eat 50 g/d of sugar, you fatten half that amount.

Suppose you’ve been consuming more and more sugar and you were getting fatter. Your consumption peaked at 110 g/d. Nevertheless, in the last 15 years your consumption has gone down progressively, and today you are eating a little less than you used to: 95 g/d. What is the expected evolution for your body weight? Under the assumption that sugar is making you fatten, your body weight is expected to go on rising, but at a slightly lower rate.

That is what I show in the graph below, created assuming that fattening is directly proportional to sugar intake. The blue curve represents sugar consumption (grams/day); the stars show what the body weight would have been in case we hadn’t changed the sugar consumption trend 15 years ago; the orange curve shows the actual body weight evolution (assuming that instead of consuming more and more sugar, we have progressively and slightly reduced our consumption in the last 15 years, as indicated by the blue curve):

sgen

Again, if sugar is fattening, what effect would be expected if our consumption were reduced? We would keep getting fatter, but at a slightly lower rate. That is what the orange curve in the graph above confirmed.

A few days ago (see) Stephan Guyenet, PhD wrote an article trying to refute the idea that sugar is fattening us. In his view, the explanation is simpler than that: we eat too much unhealthy food because we like it. His is just another version of the pseudoscientific energy balance theory.

One of the arguments presented by Guyenet is that added sugar intake has declined between 1999 and 2013, but the percentage of adult obese has not. He says, those facts make “highly unlikely” that sugar is the primary cause of obesity. This is the graph he uses as proof:

His reasoning is that if consuming 110 g/d of sugar makes us fatten, consuming between 95 and 110 g/d should make us lose weight! Since epidemiological data says we kept getting fatter and fatter, he concludes that  sugar is “highly unlikely to be the primary cause of obesity”.

Americans have been reining in our sugar intake for more than fourteen years, and not only has it failed to slim us down, it hasn’t even stopped us from gaining additional weight. This suggests that sugar is highly unlikely to be the primary cause of obesity or diabetes in the United States, although again it doesn’t exonerate sugar.

What he is saying is that if hitting your head against the wall ten times produces pain, hitting your head against the wall only nine times shouldn’t be less painful, it should be pleasant. If you realise it is not pleasant, if you realise nine times is still painful, albeit to a lesser extent than doing the same ten times, this suggests that there is no relationship between the hitting against the wall and the pain you suffer. Extremely stupid reasoning.

Moreover: between 1980 and 1999, sugar consumption was in the 85 to 110g/d range and people gained weight. Guyenet says that between 2000 and 2013, when sugar consumption was between 95 and 110 g/d, body weight should have decreased.

On the other hand, note that Guyenet interprets data from the graph as if it were a controlled experiment, when it is just observational data. No controlled experiment was carried out.

Note also that the y-axis for the blue curve in Guyenet’s graph doesn’t begin with zero g/d, and this makes the decrease in sugar intake seem greater than it actually is.

Edit (1/18/2017): there is a second part of this article, providing a more thorough explanation:
If your today’s sugar intake is lower than yesterday’s, do you slim down?

.

Further reading:

Insulinic regulation of the adipose tissue metabolism

Just a few quotes from scientific articles. I found them suggestive.

Metabolic actions of insulin in men and women

Adipose tissue lipolysis and free fatty acid release into plasma are exquisitely sensitive to insulin and half-maximal suppression of lipolysis occurs within the range of normal fasting plasma insulin concentrations

Fatty Acids, Obesity, and Insulin Resistance: Time for a Reevaluation

Fat mobilization is suppressed rapidly by insulin. Plasma NEFA concentrations therefore fall after any meal that contains carbohydrates, which stimulate insulin release. Spillover fatty acids somewhat reduce this effect but do not override it. Circadian profiles of plasma NEFA concentrations therefore show the highest concentrations after an overnight fast, with suppression after each meal

Tracing the fate of dietary fatty acids: metabolic studies of postprandial lipaemia in human subjects

adipose tissue is a net importer of dietary fat for 5 h following a single test meal and for most of the day during a typical three-meal eating pattern

[…]

Over the 24 h period, there was net uptake of fatty acids immediately after the first meal, and this continued until approximately 17 h after breakfast, i.e. during the whole of the daytime adipose tissue takes up and stores fatty acids.

Regulation of Lipogenesis by Glucocorticoids and Insulin in Human Adipose Tissue

These observations do raise the intriguing possibility of differential nutritional regulation of lipogenesis. In the fasting state, low insulin levels and high endogenous GC levels will stimulate lipolysis and simultaneously switch off lipogenesis though serine phosphorylation of ACC1, decreasing fuel storage and increasing FFA availability for other more metabolically active tissues. Conversely, in the fed state, insulin levels are high, and here insulin and GC may act together to promote lipid storage.

Dietary fat modifies lipid metabolism in the adipose tissue of metabolic syndrome patients

The AT triglyceride content depends primarily on the balance between lipogenesis and lipolysis, two opposing processes regulated by a complex interaction of several factors including circulating hormones, such as insulin, as well as by adipose-derived factors, such as leptin and adiponectin, which in turn have an important role on insulin action

Regulation of Lipolysis in Adipocytes

Refeeding attenuates adipocyte lipolysis, primarily through the potent antilipolytic actions of insulin. This regulatory pathway has also been studied and reviewed extensively. Rapid, acute regulation of lipolysis by insulin involves both cAMP-dependent and cAMP-independent mechanisms.

Advances in adipose tissue metabolism

Regulation of TAG synthesis in AT is stimulated by insulin at multiple stages; the net effect of insulin on TAG stores is strongly ‘anabolic’.

[…]

Lipolysis and fat mobilization is also under powerful inhibitory control by various hormones and secreted factors. Fat mobilization is potently suppressed by insulin acting through its usual signalling pathway for the control of acute metabolic events, that is, through phosphatidylinositol-3′-kinase and protein kinase B activation, which in turn phosphorylates and activates phosphodiesterase 3B, which hydrolyses cAMP to AMP and reduces the lipolytic activity.

Insulin signalling mechanisms for triacylglycerol storage

Insulin signalling is uniquely required for storing energy as fat in humans.

[…]

At the cellular and molecular levels, insulin’s actions indeed coordinately enhance the synthesis of triacylglycerol, the central currency of stored lipid in humans.

[…]

Insulin signalling enhances lipid storage in adipocytes by both stimulating triacylglycerol synthesis and inhibiting its breakdown.

[…]

Insulin’s potent inhibition of lipolysis not only favours lipid storage but also markedly decreases circulating fatty acid levels.

[…]

insulin action to inhibit lipolysis in this multifaceted mode provides a powerful restraint on the release of fatty acids from triacylglycerol within adipocyte lipid droplets.

[…]

Two pathways stimulated by insulin contribute to the pool of fatty acids that is esterified into triacylglycerol in adipocytes: fatty acid uptake from circulating triacylglycerol and de novo fatty acid synthesis.

The role of adipose tissue dysfunction in the pathogenesis of obesity-related insulin resistance

Fat mobilization is strongly inhibited by insulin

Glucocorticoids and fatty acid metabolism in humans: fuelling fat redistribution in the metabolic syndrome

Insulin is the major hormone encouraging lipolysis of circulating TAG-rich lipoproteins, while also suppressing the release of NEFAs from adipose tissue and promoting re-esterification of NEFAs within adipocytes

Further reading:

On calories, morons and stupidities blessed by the majorities

(versión en español: pinchar aquí)

This is my favorite post among all that I’ve already posted, and if someone asked me how to start reading this blog, I think I would give him/she a link to this page. Here I write about the nonsense of using the energy balance in nutrition, and I believe I have been able to do that it in a way that makes it possible for anyone to understand that what we have been told is indisputable —the use of calories and energy on nutrition—, is in fact a blatant stupidity. It is very difficult to make other person understand that talking of calories is irrational, because it is an unbalanced fight: what I tell goes against entrenched prejudices (e.g. “people are fat because they eat too much”), huge economic interests and a message that, by dint of repetition, has become conventional wisdom.

It is a rather long post, but I have no doubt the issue is important: talking about calories is the ultimate cause of the obesity epidemic, never its solution. We need a change.


A few days ago an editorial article (see) was published in the Open Heart journal in which the authors claimed that we need to stop counting calories and begin to talk about healthy diets (and they proposed a high fat Mediterranean style diet). The request to stop counting calories was described as “idiotic” by a supporter of the energy balance paradigm (see). In the past they have also used the term “stupids” (see,see) referred to those who believe, like I do, that talking about calories is a mistake that does more harm than good.

I’m too going to talk about stupidity, but this entry is not an angry reaction to people calling me “stupid”. I think that it is ok to use the terms stupidity, idiocy and morons, not used as insults, but describing the apparent lack of intelligence of so many “experts” on nutrition and the nonsense of using the energy balance theory in nutrition. If someone wants to say that an idea is stupid, it is difficult to transmit that message with other words without distorting the essence of the message. I am going to say it, and I will give you my reasons.

Let’s start.

Overweight and obesity happen over time when you take in more calories than you use (see)

The problem of a stupid diagnosis…

Imagine that you are the manager of a restaurant that is going through a bad time, and a business expert gives the following advice to you: “behold, economic problems happen when incomes are consistently lower than costs (see). Therefore, the solution to your problems are measures that a) increase your revenues, as raising the prices, combined with others that b) reduce the costs, like for example cutting down the staff by half or reducing the salaries of your employees“.” You’d certainly think that that person has an incredible intellectual problem, to put it kindly. But it is even more serious than you thought, because when you try to explain to him how stupid his advice is, he says “I can hardly believe you are denying something as basic as that having benefits requires a positive difference between income and cost” .

You summon all your patience, and you tell him that as you see it, the problem with your restaurant comes from the opening of two fast food restaurants in the neighbourhood, and young people, possibly by fad and low prices, are now clients of these places. And you try to explain that, in your opinion, the solution to the problem is finding a way to make those people come back to your restaurant. The business expert has been quietly listening to you, and he says: “ok, what you say may be important, but at the end of the day if your incomes are lower than your costs, your business is not going to survive. You must increase your income and reduce your costs. Any effective solution must comply with something as simple as that“. Now you have no doubts: he has no brain.

The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended (see)

There we have the stupid diagnosis…

… followed by an even more stupid solution

The ‘economic balance’ equation:

Profits = Incomes – Costs

Do you think that the equation above this line gives you the keys to decide how to fix the problems of your restaurant? If you follow the expert’s advice and cut down your staff, you reduce the costs and therefore, according to the maths, you increase your benefits. And if you double the prices, maths say that the benefits also increase. A combination of all of those measures are all you need to solve the problems of your restaurant, right? It seems to me that maths without thinking are useless to solve the problem of the restaurant.

Only a moron would propose a measure as “cut down your staff by half” without considering first the foreseeable consequences for the business in the short-medium-long term. But the “economic balance” equation can’t tell you nothing about that. It can’t! Because it’s generic and descriptive, not specific and explanatory. It is the same equation for an illegal seller of pirated DVDs, for a Chinese restaurant or for a factory with thousands of employees. The same equation for your restaurant and for my daughters and their weekly pay. That equation has no clue about the particular business we are talking here. That’s really important: this equation doesn’t know the consequences of changing the inputs of the system, like doubling prices, firing half of the staff, or cutting down by half the sallary of your workers. According to maths all that measures increase the benefits, but the knowledge of how a restaurant works tell you that adopting those measures will lead the business to bankruptcy. Taking decisions using just maths is being very very and very moron. I will say it again: very very and very moron. And very moron.

Would you say that looking for ways of recovering the lost clientele implies denying that profits depend on incomes and costs? It doesn’t. But you probably have no doubt that talking about the “economic balance” is a no-brainer that never will give you the keys you need for managing your business. Talking about the “economic balance” is a stupidity that leads to stupid solutions.

In the nutrition field the situation is exactly the same as I have been describing by using analogy of the restaurant. There is no difference. The obesity “experts” propose solutions based on a generic law of physics, which is valid for the human body, for a machine in a factory or for the formation of a star:

Change in accumulated energy = energy IN – energy OUT

And they give us solutions to obesity that are deduced from the equation above this line. Those solutions are stupid, because they ignore the actual behaviour of the system, as was the case with the restaurant’s analogy.

To lose weight, you have to eat less or move more or do both (see)

Really?

For the same reasons that firing half of the employees is stupid (because in that you may not be even able to keep the restaurant’s door open), an advice as “eat less” ignores how that action will affect the ‘system’ we are considering, and indeed that reaction will be producing hunger and changing your metabolism with the consequence that your energy expenditure will be decreased and fat accumulation will be favored (see,see). What seems reasonable in the maths domain is actually blatantly stupid, for the simple reason that is doesn’t consider the changes in the behavior of the system, a system that in this case is something as extremely complex as the human body. Increasing your physical activity produces too a compensatory reaction of your body, which tends to reduce your energy expenditure or increase your caloric ingest (see,see,see). In the long run, the most likely output will be bankruptcy in the case of the restaurant, and making even more difficult losing weight in the case of obesity (see). None of that can be deduced from maths: it is the knowledge of how the particular system works what gives us that information and what, sometimes, allows us to predict a result. If the question is “how to lose weight”, thermodynamics will not give us an answer. Because thermodynamics know nothing about the effects of reducing your caloric intake, cutting down sugars and grains on the diet or exercising more. Thermodynamics only allows us to know in advance a feature of the outcome, but doesn’t tell us what is going to happen. What about the energy balance? Is it fulfilled? Yes, it is. No one is denying the laws of physics, just in the same way that nobody denies that profits depend on incomes and costs. In the case of the human body, the system will behave as it has to behave, and at all times the accumulated energy will satisfy the above equation. But the output can’t be deduced from mathematics, only from understanding the behavior of the particular system that we are talking about. And it is not the same talking about the human body, than talking about the body of a mouse or talking of a machine in a factory. Using another analogy, thermodynamics says is that if I want to distribute 10 dollars among my daughters, the sum of the money given to both of them will be 10 dollar. Undeniable. We know that for sure. But thermodynamics don’t impose conditions on how the sharing out will be. Any result is possible as long as it meets the condition that the sum of money is 10 dollars. Knowing that feature of the result doesn’t tell us a thing about how that money will be distributed.

Thermodynamics says that if a fat cell, an adipocyte, fat is accumulating, in that cell enters more energy that it comes out. Thermodynamics can NEVER tell us under what conditions the cell will accumulate or lose fat, because that depends on the physiology. In no case, never, we will find a solution to obesity that is deducted from the laws of thermodynamics. Never talking about calories is going to give us the answer we are looking for: let’s talk about metabolism: the behaviour of the human body.

if you want to prevent obesity, eating less and moving more works every time (see)

There you have the stupid solution (please, don’t believe it works every time: it has never worked) and…

… that they only use for obesity

If I wanted to build my muscles a little, that would increase the accumulated energy in my body. Do you agree with that?

Do I have to become a glutton and a sloth to become a body builder? Doesn’t that ring a bell? How can the experts explain that the advice to build your muscles and the advice to increase your body fat is different, if, according to their theories, in both cases what we need is a positive energy balance? Why don’t they use the energy balance theory to tell us how to build our muscles? I think that question is really important and I believe the answer gives us a big understanding of the problem.

Why is it that nobody says bodybuilders are gluttons and sloths? Have you ever wondered why people increase their energy expenditure in the gym when in accordance with the theories of energy balance what they need to build muscle is a positive balance, not a negative one?

The questions above lead us to an obvious conclusion: the calories are use in obesity because they blame people with weight problems of being responsible for their condition, because the “experts” know that obese people are sloths, lazy, inactive and have no willpower. Without prejudices towards them we wouldn’t talk about calories. Without prejudices towards them, the “experts” would be looking for the real cause of the problem, which, as in the case of the restaurant, it is not an imbalance, neither of power nor of money.

Let’s talk about a new example. If I want my hair (see) to grow, what do the laws of thermodynamics say I have to do? It is clear that I “need” to create a positive energy balance, right? Should I become a sloth and a glutton again? Or, may be, the hair will grow if it has to, and the end result will simply be that part of the energy consumed is stored in those hairs? The laws of thermodynamics are met, no doubt about that, but thermodynamics aren’t going to tell us if the hair is going to grow or not, no matter if I force a certain deficit or surplus of energy. Eating more that you spend won’t make your hair grow, and eating less than you spend won’t make your hair shrink.

From the thermodynamic point of view, obesity is a disease of simple etiology, the consequence of a prolonged positive energy balance. (see)

From the thermodynamic point of view, the hair growth is a process of simple etiology, the consequence of a prolonged positive energy balance.

In the above quote, I’ve replaced the original text, “obesity” by “growth of hair”. In both growths there is a positive energy balance, but only in the case of obesity, the “experts” say that the energy balance is the cause. And anyone who said hair removal could be achieved with a negative caloric balance (see) would be considered a moron.

Why is it that we talk about energy in the case of obesity, but not in the case of hair growth nor in the case of muscle development, nor in any other cases? Because talking of energy is the excuse the “experts” need for telling us what they “know” from the beginning: obese people are gluttons and sloths.

A thermodynamics problem: yesterday your energy intake was 2000 kcal, with an energy expenditure of 1995 kcal and the remaining 5 kcal were stored in the form of hair growth. How many calories do you have to ingest today so that your hair doesn’t grow?

If you haven’t tried to solve the problem above, do so, please.

Summing up…

“Eat less and move more” is a solution deduced from maths, not from the knowledge of the human body works. An its deeply stupid origin is compatible with the fact of that for the majority of us it doesn’t work for long term weight loss .

Compute your costs and adjust your incomes so you have profit. Problem solved

Even the village idiot understands that the economic problem of the restaurant is not caused by having less incomes than costs, or that thinking in those terms can never help solve the problem. If we understand that — and only a moron wouldn’t —, it is easy to see that obesity is not caused by ingesting more energy than is spent, and thinking in those terms can never help solve the problem.

Saying that obesity is caused by an intake too big for your spending is a stupid diagnosis that leads to stupid solutions. To correctly diagnose the problem and find a useful solution, you have to understand the behaviour of the system we are talking about. However complicated the human body may seem, thermodynamics don’t simplify the problem, because they don’t help to diagnose correctly the problems nor to find solutions to obesity. Talking about energy is the cause, not the solution to obesity (see).

The problem is the excessive fat accumulation in adipocytes, right? The questions should be what controls the accumulation of fat in an Adipocyte. An excess of circulating fatty acids? Too high levels of one hormone in regards to another one caused by an excess of fast-absorbed dietary sugars?

There are people that no matter how you explain that talking about calories is stupid, they reply with claims like this one :

FACT: You can gain fat from eating too many calories (Healthy food or junk food)

Do we see the errors in their logic? Although I don’t want to go into detail about this comment now (I leave that to a next blog entry), it should suffice to express that sentence in terms of the analogy of the restaurant to see the absurdity of the comment:

FACT: If your income is lower than your costs, the restaurant won’t have profits, no matter if you regain your old customers or you don’t

Does anyone believe that increasing the incomes and reducing the costs is the law that allows us to save the restaurant? It is not easy to accept that people can be so oblivious.

Everybody can’t be a moron!

It is the fallacy of quantity: all that people can’t be wrong! But no one said everybody is wrong. A lot of people are, too many, if you ask me, but not everybody. Have you noticed how many people out there is “forget the calories, forget processed products, cereals and seed oils”? Not everybody is saying calories should be considered.

The first thing I want to point out, is that we talk here about a herd of buffaloes: if the leading buffalo changes his mind, the rest of the buffalos will follow him to death. They are not a lot of buffaloes that are wrong: the only one that is wrong is the leader, i.e. the U.S. Government. The rest of the world simply don’t have a saying. They follow their leader.

I recognize that this kind of sarcastic comments make me uncomfortable. So you say all the Governments on earth are incompetent in matters of nutrition?The purpose of this strategy is trying to avoid thinking, by trying to finish the conversation by ridiculing the other person calling him/her crazy. This tactics are typical of those who work as preachers of the official truths: they claim to be the safe, sensible options, and anything else are “fad diets” and health risks.

I don’t have an explanation that seems sensible to why so many people are so wrong, when it is assumed that so many people can’t be wrong. And I am sure that looking for explanations to this fact is a trap, because no possible explanation makes favors the one who gives it.

When someone uses this type of fallacious arguments, you have to understand that already have made the decision to not questioning the sayings of the majorities. They won’t have critical thinking, no matter what you answer to the question. They want to follow the leader of the herd without questioning their decisions. No answer, no matter how ingenious and clear it may seem to you, is going to force that person to think for him/herself and question their beliefs.

“No one has said that all of them are morons. There are lot’s of people who understand that talking about the energy balance is nonsense”

“I can’t explain it. May be you can explain to me how is it that we have let the prejudice towards the obese people determine the policies in the fight against obesity”

“Are you you saying that those who think like I do are the morons? Can you give me the reference of just one scientific study where caloric restriction has proved being useful for long term weight loss? You seem to be so sure that it works…”

In general people don’t want to hear you, when what you tell them goes against what is officially established. People link what comes from “official” sources with the sensible, safe option. Moreover, they think their knowledge about nutrition is not enough for questioning the official guidelines. They criticize what they perceive as “alternative”, something very human, but the reality is that those who use these arguments have never questioned their own beliefs or have a formed opinion, they only repeat dogmas.

Although almost all the Governments on earth, and most of the scientists, may recommend “eat less and move more” to prevent/cure obesity, that doesn’t change the actual effectiveness of the method according to the scientific literature, which is none (see, see, see). They are legion and they are the ones who impose the guidelines, but that doesn’t make their message right. The answer is: Yes, they are wrong. And the important question is how you can we escape from the chaos created by the energy balance theory. Looking for an answer to how it is possible that they are so wrong usually leads to nowhere.

semm

Hardly in the history of human errors we will find something as amazing as the energy balance con

Just to end the entry, and increasing the risk of making it even larger, I’ll briefly tell the story of Ignác Fülöp Semmelweis, a Hungarian physician. This doctor, back in 1840, observed that, in his hospital, the mortality rate among mothers when giving birth was different between the two existing delivery rooms. Semmelweis realized that there was a difference between those two rooms: one of them was used by the medical students, while the other one wasn’t. And since medical students helped in childbirth after having forensics lessons in which corpses were manipulated, he postulated the hypothesis that perhaps some kind of matter that those students were carrying in their hands, coming from the corpses, was the cause of the higher mortality rate in that room.

The medical establishment of that time rejected the need to take hygiene measures during childbirth. Semmelweis wanted to force the students to wash their hands before entering the delivery room, and he was fired because of that. His supervisor dismissed Semmelweis’ theory and blamed the high rate of mortality to the incompetence of the students, expelling lots of them.

A couple of months later, Semmelweis returned to the hospital, working this time in the other delivery room, the one not used by the medical students. He did some tests, e.g. he lead the students to his delivery room and checked how that change increased the mortality rate (and he was the good guy!), but according the european leading surgeons and obstetricians ignored or rejected his discovery and they even accused him of using falsified data.

In the words of Professor hebra: “When the history of human errors is written one day, it will be difficult to find such a striking example, and people will be amazed at how such able and specialised persons could be so blind and stupid in their own field of science“.

When you know what is happening in the nutrition field with the energy balance and calories, the history of Semmelweis causes no surprise. What I find striking is the use of the term “able”.

Further reading: