Can anyone explain the energy balance model (versus the CIM) to me?

(Bob M) #1

This is yet another study by David Ludwig comparing the energy balance model (EBM) with the CIM (carbohydrate-insulin model):

https://www.nature.com/articles/s41430-022-01179-2

I recommend looking at the author list. It’s an interesting mix.

Anyway, I’m trying to make sense of the EBM. In particular, when I went keto a while back (over 10 years ago now), I remember (1) not being hungry all the time, which was shocking; and (2) eating as much as I wanted to eat - of food that tasted good. Yet, I lost quite a bit of weight pretty quickly.

I think the EBM is basically food tastes too good, so therefore we overeat it and that overeating causes us to gain weight. There’s some modicum of truth there, as even on keto, there are things I avoid eating because I eat too much of them: bacon; nuts; berries and yogurt (I could eat 3 bowls of those and want more).

But I eat things every day now that I think taste really good, yet I’m still sloooooowly losing weight. Why am I not “overeating”?

Or is what I’m eating just not “tasty” enough for me to not gain weight?

Of course, if you read the cited paper, they have a laundry list of what they think is wrong with the EBM, but I’m just trying to figure out why it’s a theory at all. I mean, if the food I’ve been eating for 10+ years tastes good, often great to me, why am I losing weight instead of gaining weight?

#2

What has tasting good to do with weight changes (beyond the fact that many of us tend to eat more from tasty food)? It’s clearly all about satiation effect to me. For normal items. There are those weird triggering items where you don’t get enough satisfaction even if you get satiated. I have quite few of those. But if I eat right (not necessary what is tastiest or what I want most but it got close enough for me), I get barely satiated, get my nutrients and it’s… Enough. (And full satiation arrives later.)

I just skimmed the article. And I wonder how the rodents were fed, not like it matters so much as they (the rodents) clearly had different goals and pitifully less choices (like, eating or starving) than I had when I lost fat instead of gaining maximal amounts on not exactly 60% fat and 20% carbs but not too far from that… I can gain fat with these percentages, no problem but it’s not necessary, there are so many factors.
I am still very sure it’s highly individual, there are the actual person (or rodent), the actual circumstances and the specifics of the diet. I doubt ultraprocessed stuff can do so much in my case (except I probably would eat less as I am not into ultraprocessed things… my thinking and knowledge about these are highly different from rats… poor rats, surely no one educated them or cared about their choices. I feel super lucky) but timing, mealsize, determination and of course, the actual food choices have a lot to do with my intake. Even if we fix the percentages and everything else except the actual items, I will eat vastly different amounts with different food choices.

Carnivore food tastes the best (except some keto sweets and fruits) and I still eat the least on carnivore. Taste only helps me to feel satisfied and it’s important - but has little to do with my energy intake unless my food is so bad I refuse to eat it. And the more satisfaction the food gives me, the less reason is to overeat it just to get more joy. If I get satiated with awesome food, it’s enough for me, I don’t want to eat more and more, that’s what triggering food, compulsion and Insatiable Hunger does (and they don’t necessarily mean I will actually get more food joy. even if it’s a blissfully tasty thing, compulsion can spoil it. eating a ton of salted, roasted peanuts isn’t much more joy than eating 5g or something. yes I am lucky to feel so but I still needed to try carnivore to stop myself early enough).

I have no model, merely thoughts. It is VERY complicated and I am more interested in individual cases than trying to figure out a model that works for a fragment of people… As one that works for most people? I don’t believe it exists.

(Edith) #3

You may enjoy reading this book. The author discusses how additives and flavors trick our bodies into thinking they are getting the nutrients they need but they aren’t. When our bodies realize they didn’t get the nutrients they thought they were going to get, say from something flavored like a strawberry, but not containing the nutrients of a strawberry, it sends the signal to eat more to get those nutrients.

I’m guessing on keto you are eating real, whole foods. There is nothing to trick your body, so what you eat not only tastes good, but provides the nutrients your body expects to get from those foods, resulting in feeling satiated and not wanting more.

#4

I don’t think my body wants nutrients from a strawberry either but maybe it works like that for some.
Good thing I use coconut flavoring only in coconut dishes then (I can’t help I come up with the most glorious, nostalgic, tasty recipes since I made carnivore-ish my chosen default woe. my curious recipe making mind need something to do on off days and things happen) though I consider flavorings pretty innocent… Not something to use willy-nilly but they are handy sometimes. I get my nutrients just fine but I did it when I ate flavored things too. As I still needed my protein sources, great flavors (normal ones. flavorings are a bit weird, not so satiating, most of the time) and I ate a lot. You can’t make egg flavor without eggs :smiley: Vegans try but I bought black salt and I can confidently say it doesn’t taste like egg. Inactive yeast powder is cute on fried cucchini but it has NO cheese flavor if you ask me. Maybe vegans trick their tastebuds with more skill, I don’t even try. Most flavorings are well, fake. The coconut flavoring I use is nice and even reminds me of coconut but coconut tastes differently. Maybe it’s the fat and other stuff that I can’t consider a separate thing? One can’t replace the other at all, that’s why my Bounty Bowl (as I won’t waste energy on making them bar shaped) badly needs both coconut flakes and coconut flavoring.

Oh well, I eat good food so it doesn’t matter much if I use flavorings too or not. I won’t miss out nutrients.

I never thought about nutrients this way. I mostly blame the carbs especially in triggering foods. They seem to take the room for properly nutritious food somehow. Not from me and others who can’t help but crave protein, fat and some essential micronutrients so we get them even for the price of overeating but I am aware many people manage to fill themselves with satiating food (actually, it can happen on low-carb too…) and ends up not getting enough nutrients. Something may be broken in them but maybe they are just different, potentially tricked by edible items far from normal food.

(Doug) #5

They’re both going to apply. Perhaps the CIM will provide more of a mechanistic explanation, especially with insulin-resistent people (where I’d say it makes more of a difference, by definition), but if the energy balance is a certain way, then no amount of theory or modeling will change that.

A person is gaining weight (fat). Whether it’s because of intake exceeding expenditure, and the body’s evolutionarily-programmed tendency to store fat when it can, against possible starvation, or it’s because the person is eating lots of brutally refined, massively processed carbohydrates, and they’re rather ‘locked in fat-storage mode due to high insulin,’ the same thing is happening. They’re making triglycerides and the triglycerides are being added to fat cells. Whether we consider the weight of them, or the energy contained in them, or theories about all the “whys” of it, doesn’t change anything there.

Quoting from the paper: “For instance, Hall and Guo assert that, “for all practical purposes, ‘a calorie is a calorie’ when it comes to body fat and energy expenditure differences between controlled isocaloric diets varying in the ratio of carbohydrate to fat.” While acknowledging that dietary composition influences oxidation rates of respective macronutrients, the EBM holds that diet ultimately drives fat deposition by increasing total energy intake, not through calorie-independent effects on substrate partitioning.”

I think Kevin Hall is beholden to the medical-industrial complex, big food processors, big sugar, big pharma, and the ‘status quo’ (of the 1980s and 1990s, say) - some selection or combination of all those things. In some of his studies he’s willfully disregarded results that show some validity in the CIM, and engaged in silly pretense to try and dance away from the logical conclusions.

This current paper sounds like a spat between Ludwig and Hall, so Ludwig is taking potshots at Hall. They’re likely talking past each other, generalizing from the particular, etc.

“A calorie is a calorie” on the intake side is not true as stated if we’re looking at all the possible effects. If Hall says, “The EBM proves that the CIM never applies,” then he is wrong. If Hall is neglecting energy expenditure, then there too he’s wrong.

Likewise, so is Ludwig wrong if he says, “The CIM proves the EBM is invalid.”

To start with, we need to know how much a given person or group of people will be affected by carbohydate intake. If it’s one of those people who can “eat anything and never gain weight,” then it’s not going to support the CIM much. If it’s insulin-resistant people, then that’s right in the CIM’s ballpark.

The “food tastes too good” stuff - how do we quantify that? :smile:

"Obesity results from “increased availability and marketing of a wide variety of inexpensive, convenient, energy-dense, ultra-processed foods that are high in portion size, fat, and sugar, and low in protein and fiber.”

Luwig says this is part of “the new EBM of Hall et al.” If so, that sounds pretty solid to me, i.e. I imagine that that does apply, a lot of the time. But that doesn’t “rule out the CIM” or anything…

A person could eat a whole lot of totally-unprocessed, low in fat, high in fructose, high in fiber fruit, and become obese because of it. It fits with both the CIM and the energy balance.

Totally agree, as above.

#6

Google Dr.Stephen Guyenet. Or watch one of his videos. He is also the founder of Red Pen Reviews. They provide expert reviews on nutrition books with the aim to elevate the quality of info available to the public.(non-profit).

(You've tried everything else; why not try bacon?) #7

It’s a paradox! :rofl::rofl: (Like all those French people who eat all that fat, stay thin, and refuse to die of heart attacks, lol!)

As far as I can tell, our fixation on calories derives from a time when calories were all anyone could measure. Hormones hadn’t been discovered yet, and the effects of various foods on body chemistry were unknown. But by God, we could put things in bomb calorimeters and burn them to a crisp! So that’s what we did.

(KM) #8

The challenge, really, is that energy content as measured by a BOM calorimeter is … well, somewhat relevant. Putting more energy into your body than you can utilize does often result in weight gain - I know, Sam Feltham, mike drop. Can anyone name Someone Else, please? :laughing:

My own guess is that there are some similarities between a BOM measurement and what our bodies actually do to food in terms of energy extraction or overage, dependent on the molecular makeup of the food and our particular body’s specifics. But it’s much more complicated than just incinerating things.

… Imagine what a different place the world would be, historically, if we all just pooped out little lumps of charcoal.

(Doug) #9

The energy the calorimeter gets is very close to what the human body gets, closer than 95%, usually. If we want to get really accurate, put the person in a calorimeter - there are now whole-room ones where even the gases exhaled by the person are kept track of. Sam Feltham or not, the math will work out.

(You've tried everything else; why not try bacon?) #10

The problem, from the point of view of estimating caloric intake, is that 1 g of carbohydrate or protein does not contain precisely 4 kilocalories, but 3.something-or-other. And the number of calories in 1 g of fat is not precisely 9, but varies from as low as 6.something to 10 or 11.something, depending on the fatty acid in question.

And of course, in a closed system such as a metabolic chamber, the values can be measured fairly precisely.

I still maintain, however, that (kilo)calories are a silly measure for the energy value of foodstuffs. What we should really be looking at is how many ATP molecules can be derived from the item. And protein shouldn’t be counted, since in the normal course of events, amino acids are not metabolised, but rather used for building and repairing tissues. A body that is having to break down tissues in order to make energy from the amino acids is in a difficult position, such as famine or the like.

(Doug) #11

It’s still really the same thing, Paul. When we break ATP to get energy, it’s measured in calories. A mole of ATP is 7.3 kilocalories.

I also don’t think that really matters all that much or changes anything - the physics of the situation are what they are. The real problem in the study that Bob mentioned in the original post is that people - Ludwig in this case - appear to be talking past each other, as with Kevin Hall. And probably vice-versa, too.

(You've tried everything else; why not try bacon?) #12

So how much arachidonic acid, say, does it take to get a mole of ATP? And how much glucose? Knowing that would tell us something.

All I’m saying is that the real energy value of a foodstuff to the human body is how many net ATP molecules it can yield, not how much heat is released from combusting it. The more ATP molecules, the more work the body can do. The caloric value of combusting ATP is irrelevant in that context.

I simply don’t see why we insist on relying on technology that’s a century-and-a-half old, when there is a more accurate measure available. It just makes no sense. I guess that the mental inertia in the field of human nutrition should not really surprise me, but it does, nevertheless.

(Doug) #13

Depends on how many calories are in them - we use energy to make ATP.

It isn’t the technology that’s a problem. If we want to measure things to a degree of accuracy vastly beyond 150 years ago, we can.

Making a mole of ATP - it can be figured, exactly, by what the chemicals we begin with are. It’s just stoichiometry - which follows known relationships/laws of how volumes and weights combine, and which also follows (of course) all the laws about conservation of mass and energy.

However, with ATP it’s still going to be theoretical or a guess, because we don’t know everything that’s going on in a given human body. If we’re metabolizing fats, the amount of ATP we get depends on what fatty acids we are using. For proteins, it depends on what amino acids. If it’s glucose - that splits into the Krebs cycle and glycolysis, each one giving different amounts of ATP. The mix of those is also altered by how much lactic acid is present in muscle tissue, as well.

And - things will change depending on what our demand for energy is. For really intense, short-term stuff, we take phosphates off of creatine phosphate to recycle ATP. It’s the fastest way, but there isn’t much ATP and creatine phosphate in muscles, so we get tired really fast. This is like sprinting for 100 meters (or 50 meters for some of us).

The next fastest way is glycolysis of carbohydrates. It’s a fast way, but not super-efficient. we can do it for longer than the creatine way, but still only for a couple minutes or so. The ATP produced varies by how aerobic or anerobic the exercise is.

Then there’s the always-aerobic way, which is the slowest but most sustainable. We can do it with fat, glucose and glycogen - each giving differing amounts of ATP.

And - we’re also not just doing one of the three ways (fastest, faster, or all-aerobic) at one time. Rather, our energy is being supplied by a mixture of them.

(Jane) #14

I can be strict keto at home and maintain my weight, I can go on vacation and not go crazy (no sugar) but definitely more carbs and come back with 2 lbs lost. And a LOT of walking because that is what we do on vacation. Can’t tell you the mathematical formula because if I could I would calculate it for my screwed up metabolism (years of CICO dieting) body!!! And be rich insead of working LOL

(Edith) #15

If comparing the EBM and CIM, I believe it is truly a combination of the two with a slider that shifts the balance between one or the other depending upon one’s metabolic/mitochondrial health.

If you are metabolically unhealthy, calories won’t matter because your cells can’t use the energy you are giving them. That is why people with metabolic disease can’t seem to lose weight no matter how much they cut back on calories. Their insulin levels are just too high. The slider is almost all the way to CIM.

If you are metabolically healthy, you can eat what appears to be a lot more calories and not gain weight because your body can use the energy it is being fed via moving, repairing, heat creation, etc. Thus the slider is all the way towards EBM.

Lack of sleep and any other kinds of stressors can send the slider towards CIM. Healing mitochondria, building muscle, improving diet and sleep, move the slider towards EBM.

That’s the VirginiaEdie theory anyway. :smile:

(Bob M) #16

Not to mention that it takes more energy to process protein than it takes to process carbs than it takes to process fat. So, if you’re eating a lot of protein, you’re going to be burning more energy, and none of that is indicated by the intake. HPD = high protein diet. DIT is diet-induced thermogenesis. A HPD = higher DIT. There goes the whole “second law of thermodynamics” theory.

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Furthermore, if “a calorie is a calorie” is really part of the EBM, that’s ludicrous. If I eat ice cream, I am hungry afterwards. Why? Because ice cream causes my blood sugar to crash, leading to hunger. Every single time, and the more ice cream I eat, the hungrier I get. And I have CGM data to show this.

Oops, forgot the citation:

(Bob M) #17

@VirginiaEdie That’s not a bad way of looking at it. There was a guy who ate 4,000 cals/day of a carnivore diet and lost weight over 3 weeks, but then ate 4,000 cals/day of a SAD (and we’re talking pop tarts, bread, frozen pizza, made my heart race just seeing what he was eating), and he gained weight but not to the extent calculated. But his fasting insulin on the SAD went from below 2 to below 3. That’s a ridiculously low fasting insulin, and indicates to me he’s highly insulin sensitive.

(Doug) #18

Doesn’t matter, Robert. :wink:

Whether you’re burning it via digestion, or by muscular activity, or by something else, you’re still burning it.

(Doug) #19

I agree. They both apply. The problem, as I see it, is thinking that either one somehow negates the other.

(You've tried everything else; why not try bacon?) #20

Yes, that is very true. However, it’s not heat energy that we use, it’s the electrical potentials involved in turning ADP into ATP and ATP into ADP. Breaking down fatty acids and glucose into carbon dioxide and water requires the use of ATP to fuel the reactions, but fortunately, there is a net yield of ATP, because the body does most of its work with catalysts and enzymes. Or so I understand, at any rate.

I just can’t seem to shake the feeling that we are stuck in an unhelpful paradigm, and instead of calculating the heat value of food when combusted, we should be looking at the amount of net ATP yielded, since that is the energy currency of the cell, not heat. Of course, it takes ATP to make ATP in the process of converting fatty acids and glucose into carbohydrate and water, so it’s the net yield of ATP we need to go by. I can’t claim to know all that much about these reactions, but I do know they are not fueled by heat energy, but rather by the electrical potential from separating a phosphate ion from ATP.

So as I say, I just can’t help think we are barking up the wrong tree by focussing on the heat energy in food and not on its ATP-generating potential. Oh, well.