Weight Loss (1 of 3): Why doesn’t calorie counting work so well as we get older?
Help! Why Isn’t Calorie Counting Working For Me Anymore?
Do you ever wonder why calorie counting and the “eat less, move more” approach to dieting becomes harder to stick to, as well as less effective as we get older? Does our willpower just become weaker with age? In the first of this series of blogs that looks at dieting, healthy eating, exercise and weight loss, we discuss why calorie counting becomes ineffective as the body very slowly goes out-of-kilter over the course of several decades, making us fatter, fatigued and unwell with diet related illnesses, such as diabetes. In later blogs, we’ll look at what we can do about it for optimal health.
Most of us don’t start out fat and tired and unwell. And most of us don’t suddenly get fat and tired and unwell. So what happens in between?
How We’re Supposed to Work
Let’s get the theory of how we’re supposed to function out the way first, just so that we can understand the pivotal role that insulin occupies in all this. We’ll be quick!
A typical Western diet is rich in carbohydrates which get digested into glucose and fructose. The glucose component is used as the primary fuel for the body and brain. When the level of it in the blood rises, the hormone insulin is secreted from the pancreas. This tells the cells to “open up” and let the glucose in so that it can be converted to the energy the cells require. Insulin is also responsible for instructing the liver to convert any surplus glucose to fat, after which it then gets sent off to fat stores in the muscles and skin, for use at a later point.
Key point: high insulin (from eating carbs) = fat storage mode
A few hours after a meal, the cells will need another energy top-up. In the absence of more glucose from another meal, stored body fat is mobilised and used for energy. So, a kind of two-way flux goes on: surplus energy is temporarily stored as fat after a meal, and then released for use a few hours later. And this usually happens very effectively when we’re young. (That’s the main theory out the way, incidentally!)
As we get older, however, we usually become more sedentary as a result of our jobs, gadgets and lifestyles. Now, when we get hunger pangs that we probably wouldn’t have previously noticed, we top up with some instantly available, usually high carbohydrate food. That two-way flux of our fat cells is now predominantly in the direction of fat storage. After a while, we may need to go on a diet and think that calorie counting is the place to start!
Time For Calorie Counting
Most people’s first foray into the world of dieting is based around calorie counting food eaten, and trying to make it less than calorie expenditure, often referred to as CICO (Calories In v Calories Out). This undoubtedly gives you the most flexibility of all styles of dieting. You can do a healthy diet, or you can have a thousand calories of jaffa cakes, or you can do anything in between, just so long as you eat less calories then you expend. And up to a point it works, just as long as you can ride out the hunger waves, so that the body gets some of its energy from stored fat.
The reason this works is precisely because we can ride those hunger waves. Without glucose from food, insulin levels dip low enough for fat to be mobilised from storage. Although fat flows in and out of fat cells, it is one-directional at any point in time. If insulin is about, then fat is going into storage, because that is its job. So to get fat out of storage and used for energy, we need to get insulin to dip below a certain level.
Key point: Fat can’t be used for energy until insulin dips below a certain level.
What usually follows at some point from here is a number of cycles of CICO. We lose the weight, keep it off for a while, slowly gain it back, and then go back on a diet. We might tweak things a bit, usually because it is getting harder to ride out the hunger, so maybe we up the exercise to increase calorie expenditure so that we have a bit more leeway with calorie consumption, but essentially we are doing the CICO thing. This might be starting to sound familiar to you. So why does it gradually become less effective?
Why doesn’t my change to healthy wholegrains seem to be helping very much?
The problem is, we weren’t designed to be fuelling from a continuous supply of glucose. Even if they are healthy wholegrains, they require a pretty hefty shot of insulin to be dealt with, and so, even with periodic dieting, we are producing an almost continuous supply of insulin, and this is where the problem comes in.
You see, after years of being told to “open up” by a constant supply of insulin, cells become a bit deaf to its message. They need more insulin to be told what to do. This is known as insulin resistance and is the precursor to type 2 diabetes.
Insulin resistance means that, because cells don’t open up enough to use the available glucose, more of it gets converted to fat. Because the body puts such a high priority on removing glucose from the blood (because it is toxic to most of the body’s organs), fat starts accumulating in and around the liver and central organs quicker than the body can deal with it. This is known as visceral fat, and it wreaks all sorts of havoc. One effect is to accumulate in the pancreas and interfere with insulin production. This is full-blown diabetes type 2, and is dangerous because now nothing is in place to stop blood glucose poisoning body organs.
“But I’ve been eating healthily, I’ve been exercising all the time even though I’m exhausted and I gain weight with one slice of bread! AND now I’m losing muscle mass! How can that be?”
Back to the stage of insulin resistance, before the pancreas flatlines. This is the stage where you are getting fatter, because the cells don’t open enough to the insulin message, meaning that more glucose has to be turned to fat. But your cells still don’t have enough glucose to make the energy they need. So you’re getting fatter, more tired, and you are driven to eat more as a result. Other hormones start going out-of-kilter to exacerbate the situation as well. For example, your brain actually drives up your hunger hormones because it is getting deaf to the message that tells it how much on-board energy (fat) is present so thinks it needs to replenish your depleted fat stores! Even if we try and starve for a short time, the brain doesn’t even think there’s any fat to use, so we don’t drop weight like we used to.
Further down the line, the body get so stressed from calorie counting it can perceive “starvation” and thinks it is a life or death situation (it kind of is, just the death bit is a bit more drawn out) and pulls the emergency cord, whereby “anything goes”, even if it may have far-reaching negative consequences later on: your body starts breaking down muscle into glucose to try and get those poor hungry cells some energy. But wait. You’re in insulin resistance anyway, so the glucose that came from muscle is on its way to fat storage, too. It didn’t even help.
Well, at least it can’t get any worse than diabetes, right? Wrong!
A lot of people already know that frequent high levels of insulin over the course of many years is the root cause of type 2 diabetes, but actually, it is also associated with many types of cancers, with dementia and Alzheimers (sometimes called type 3 diabetes – now you know why), and with cardiovascular disease. We’ll talk more about this in a further blog, but obviously it pays on more than just the weight-loss level to address high insulin, known as hyperinsulinaemia.
Incidentally, most of us are somewhere along this process. We don’t just suddenly get insulin resistance one day; it takes years to develop, as you now probably realise.
Ok, enough of the calorie counting horror story. In the next blog, we’ll look at the proven dietary approaches to getting back on track.