There’s a lot of confusion about calories out there. Long believed to be the key to losing weight and maintaining optimal health (the reason for their prominent real estate on packaged foods), they’ve since been eyed with more skepticism, as people in the wellness world promote the consumption of high-calorie foods like avocado and coconut oil, macros be damned. What’s the truth? Should we be counting calories? If not, what should we be paying attention to? We asked some of the country’s best functional medicine practitioners and registered dietitians in order to get to the bottom of things.
Yup, calories matter.
Calories matter as our primal metabolic pathways are geared to respond to periods of calorie deprivation with responses that heal and promote health. The excess of calories and the number of hours we eat daily prevent the activation of these reparative responses called hormesis. Reducing calories for several days in a row, called a fasting-mimicking diet, can unleash energy, improve metabolic status, and a lead to a more optimal weight. I use this strategy routinely in my clinic and personally eat only two meals a day.
—Joel Kahn, M.D. and renowned cardiologist
No, calories don't matter as much as we've been told.
We need to step away from the notion that calories are the most important consideration in choosing our foods. It's an overly simplistic view and fails to take into account the nutritional quality of food. Often we see that the foods advertised as low-calorie are actually devoid of nutrients and are sometimes highly inflammatory. In my practice, I see a lot of women who have struggled with their weight for years by chasing the calorie myth. When we focus on a whole foods, low-inflammatory diet that provides them with an array of nutrients, the weight struggle ends and they find themselves feeling more energized, enjoying better moods, and feeling more confident about the foods they eat.
Calories don't matter. We already saw that going through a decade plus of eating a low-fat diet (fats have the most calories per serving), which led to a carbohydrate-heavy diet, which contributed to many chronic conditions like heart disease, hormone imbalance, and cancer. Calories also get utilized differently depending on a person's metabolism and when they work out. If people find themselves still hungry an hour or two after they ate, then it's important to look at the amount of protein, fats, or fiber in a meal (all help keep satiated and balance blood sugar spikes), or if they even ate enough (or until 80 percent full). Furthermore, if weight loss or gain is still an issue even with adjusting diet, then a closer look at gut health, genetics for metabolism, or identifying any other organic causes like thyroid or sex hormone imbalance is going to be imperative for their optimal health.
—Serena Goldstein, N.D.
Calories don't matter as much as the type of calories you choose. Processed carbohydrates and sugars are absorbed quickly into the body and can cause weight gain around the belly and increased hunger. Eating whole, nonprocessed foods that are full of fiber, healthy fats, and protein can help you feel satiated so you don't have to focus on counting your calories.
It's not that calories don't matter; it's that so many other factors also matter, and some of them even influence how many calories we're likely to ingest and burn. Metabolism, fat distribution, and weight are influenced by stress, hormones, gut flora, insulin behavior, sleep, physical activity, nutritional status, and so many other factors. Weight is not determined by a simple equation of calories in minus calories out. It's a multifactorial web of influences. When I'm choosing what to eat, whether it's food shopping or navigating a buffet, I ignore calories altogether. Instead I pay attention to chemicals, nutrient density, and an intuitive listening for what my body needs in that moment. If you pay attention to calories over chemicals, you'll find yourself cut off from your body's intuition and consuming diet soda and 100-cal snack packs, rather than loading up on olive oil and—dare I say?—pork belly. I strongly believe that the person eating the olive oil and pastured pork belly ends up with better nutrition and a healthier body. The person eating the low-calorie foods is often hungry, cranky, insulin resistant, and struggling to maintain a healthy weight. When you give your body real foods, it knows how to use them in service of your health, and even better, you relearn how to recognize when you're hungry and when you're full. Once you've gotten reacquainted with real satiety signals, you end up consuming the exact number of calories your body needs.
Caloric intake should be balanced with physical activity to achieve and maintain a healthy weight since obesity, a national epidemic, is associated with increased incidence of most chronic diseases (including diabetes, hypertension, cardiac events, cancer) and early death. The nutritional content of our food is equally, if not more, important than the number of calories we consume. In order to optimize physiology at both the cellular and whole-person levels, and hence to optimize overall health, the foods we eat must be highly dense in nutrients (high levels of vitamins; minerals; quality proteins, fats, and carbohydrates; antioxidants; and anti-inflammatory phytonutrients) for each calorie taken in. In other words, food quality is equally or even more crucial than quantity.
Even the healthiest diet is often missing this key ingredient—is yours?