Are all calories the same?

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Are all calories created equally – regardless of whether they come from a low-carb, low-fat or a vegan diet?

Sam Feltham decided to do some self-experimentation investigating just this, and ate almost 6,000 calories on a low-carb diet, a vegan diet and then high-carb fake food. The results varied widely, to say the least.

But what are the implications for the way you’re eating? He answers that in this interview.

Watch a part of the interview above, where he explains how he came up with and conducted his self-experiments (transcript). The full video is available (with captions and transcript) with a free trial or membership:

Are all calories equal? – Sam Feltham

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7 comments

  1. 1 comment removed
  2. Andrew Graham
    Sams experiment is not at all accurate.
    His high fat diet was full of nuts which are not fully digestable.
    He failed to take this into his equations.
    His high fat diet also induced glycogen depletion - so he lost water weight, as his lead in diet was a moderate carb diet.
    I would refer people to the nusi study performed by Kevin Hall - this disproves the CIM - carbohydrate insulin model.
    Simple take away for your readers - Calories count! I know this is not popular as it will not sell any quick fixes or books.
    Reply: #3
  3. Crystal Pullen Team Diet Doctor

    Sams experiment is not at all accurate.
    His high fat diet was full of nuts which are not fully digestable.
    He failed to take this into his equations.
    His high fat diet also induced glycogen depletion - so he lost water weight, as his lead in diet was a moderate carb diet.
    I would refer people to the nusi study performed by Kevin Hall - this disproves the CIM - carbohydrate insulin model.
    Simple take away for your readers - Calories count! I know this is not popular as it will not sell any quick fixes or books.

    This article reflects Diet Doctor's stance on counting calories. https://www.dietdoctor.com/low-carb/calories

  4. Andrew Graham
    The article you referred me to contained a study that was not a metabolic ward study so you have no proof what they did or did not eat.
    Self reporting is not accurate, so any conclusions are hard to prove.
    Kevin Hall's NuSi study was a metabolic ward study that ensured calories were controlled as per the study design.
    His study showed that calories count!
    Reply: #5
  5. Crystal Pullen Team Diet Doctor

    The article you referred me to contained a study that was not a metabolic ward study so you have no proof what they did or did not eat.
    Self reporting is not accurate, so any conclusions are hard to prove.
    Kevin Hall's NuSi study was a metabolic ward study that ensured calories were controlled as per the study design.
    His study showed that calories count!

    Multiple studies were cited in the article which led to the conclusion that Diet Doctor recommends "Rather than counting calories, make all of your calories count by eating nourishing, well-balanced low-carb meals."

  6. Andrew Graham
    Thanks for the replies Crystal.
    Do you have any metabolic ward studies that show a difference in weight loss for low carb diet vs other diets where protein levels are matched and subjects are in the similar caloric deficit?
    Reply: #8
  7. 1 comment removed
  8. Dr. Bret Scher, MD Team Diet Doctor
    Hi Andrew. Thank you for your comments. We have a couple posts addressing our concerns about balancing short term metabolic ward studies with longer term "real world" studies. Here are a couple examples https://www.dietdoctor.com/unpublished-study-challenges-the-insulin-m...
    https://www.dietdoctor.com/all-calories-are-not-created-equal

    A big issue with metabolic ward studies to "prove" or "disprove" the CICO or CIM models is the period of adaptation to burning fat for fuel. It is clear that the adaptation doesn't happen right away, and likely requires at least 4 weeks. That would make a 2-week study inadequate, and a 4-week study just starting to see the full effect, but without enough time to see the most important data. Here is a review Dr Ludwig wrote about the adaptation period https://medium.com/@davidludwigmd/adapting-to-fat-on-a-low-carb-diet-...

    That makes it a challenge for a metabolic ward study to fully answer the question you are asking. From a practical standpoint, the longer studies are likely more helpful for seeing what works in the "real world" even if they are less controlled. Although, that is one of the benefits of studying a keto diet - measuring ketones is an easy measure of compliance.

    I know that is not a very satisfying answer for the question you posed, but I think it is a much more complicated question for a 2- or 4- week study to answer. Thanks again for your comments!

    Bret Scher MD FACC, Medical Director, DietDoctor.com

  9. Andrew Graham
    Thanks for the reply Bret, to quote the article from Dr Ludwig that you referenced describes the 4 week study:
    "In a study by a chief critic, 17 men with high body weight were first given a standard diet, followed by a ketogenic diet. Unfortunately, the study wasn’t randomized, and for many reasons considered elsewhere, was biased against the ketogenic diet. Even so, you can see that for the first 2 weeks on the ketogenic diet (left arrow), the rate of fat loss decreased. But after 2 weeks (right arrow), there was a clear acceleration in fat loss on the ketogenic diet."

    To be fair this study was in part funded by NuSi who were led by Peter Attia and Gary Taubes, and they had to approve the study design to test this exact hypothesis, the CIM of obesity.
    I agree with you about longer timelines would be beneficial, however at present the body of evidence does not support this hypothesis.
    As per the results of the above study, it was the caloric deficit that induced the weight loss, so the unfortunate reality currently is that calories in vs calories out is the proven way to lose weight.

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