Calories II. Life is not fair: discuss

You are a conventional GP (dietician, nutritionist) who still believes that saturated fat is the work of the devil and that pharmaceutical
companies are charitable organisations whose raison d’être is to save lives. You have a new patient.

NM is 35 kg overweight. He used to exercise a lot in his twenties and early thirties, endurance training for up to 20 hours a week. In the last few  years life has been getting in the way, other priorities have replaced sport  from his mind. Now he exercises 3 times a week, each session lasting 100-120  minutes.

He struggles to estimate the caloric value of his diet. He doesn’t know his  lipid levels or fasting blood glucose. NM also seems superbly unconcerned about  measuring his waist circumference. He fills out a food questionnaire. Here is a  copy. Being a conscientious practitioner you record the calories and the only other vitally important characteristics of each meal: total and saturated fat content.

Breakfast – none. Upon questioning, NM shrugs his shoulders and says that  he doesn’t feel hungry in the morning. Occasionally he has a cup of coffee with about 1/4 cup of thickened cream.
Calories 173 Total fat 18.4 Saturated Fat 11.8

Morning Snack – none.

Lunch – this is normally the first meal of the day for NM. He never prepares a home-cooked lunch as he claims the lack of time, instead ordering it from his favorite takeaway. Lunch choices normally include breakfast foods like eggs and bacon, washed down by a litre of full cream milk.
Calories 1638, Total fat 86.5 Saturated fat 40.1

Afternoon snack – NM likes to snack on nuts. Instead of measuring out 12 almonds, he just grabs a big fistful and mixes them up in a huge bowl of full fat yoghurt.
Calories 557 Total fat 47.3 Saturated fat 17.6

Dinner – NM has dinner out about 3 days a week.  When NM eats at home, he chooses unprepossessing Aussie meal of “meat and 3 veg” all drowned in butter. If out for dinner, he goes through 2-3 courses, most of them involving meat.
Calories 1425 Total fat 94 Saturated fat 49.9

Dessert – NM considers himself a bit of a connoisseur of fine chocolate. He normally shares a block with his other half. No prizes for guessing who gets the lion share.
Calories 317 Total fat 27.6 Saturated fat 16.8

Total daily calories 4110
Total daily fat 255.4
Total daily saturated fat 136.2

You are horrified. This guy is a ticking time bomb!
According to Australian Medical Association, Diabetes Australia and the latest Swap It campaign and other helpful organisations which make it their business to tell us what not to eat, NM and his lifestyle have some serious issues.

1. Skipping breakfast slows his metabolism and doesn’t give him enough energy to power through the day
2. Only eating 2-3 times a day predisposes him to glucose spikes and troughs and probably results in overeating later in the day (you’ve got it all figured out)
3. High total and saturated fat intake puts NM at higher risk of heart disease, diabetes and cancer (absolutely no doubt about it in your mind)
4. High meat intake is a risk factor for bowel cancer (you have read an article about it in BodyNSoul)
5. Fruit and vegetable consumption are well below the recommended 2 and 5 serves a day (no specific reason exists for those numbers, but everybody knows that fruit and vegetables are an important part of the diet)
6. Where are the healthy whole grains??? Where does he get his fibre from? Are things…ahem… moving down there at all?
7. Total exercise is within the recommended amount however NM would be better off spacing it out through the week.
8. Overall, in view of his obesity, he needs to reduce overall calorie consumption, by changing his high fat meals for low fat options, bump up his exercise, eat 5-6 small meals a day, consuming heart healthy wholegrains with every meal and finally aim for 2-4 fruit-vegetables daily.

Do you agree? This assessment is a pretty standard example of conventional wisdom. Even if you don’t agree with some of it, you might still think that this guy is in a “positive calorie balance” and needs to eat less and move more.

At this point you are probably imaging someone like this.

Now go back and read his bio again but skip the first sentence.

I have a confession. Everything in this bio is true except NM is not overweight. In fact, NM is pretty damn fit. Those of you who know me well have probably guessed who he is. Let’s just say he looks more like this (although I am probably a little biased):

So what does this tell you?
Only that being judgmental comes easy. Whether a professional giving advice on weight loss or just an avid fan of “The Biggest Loser”, everyone is an expert. Funny thing, it is the lifestyles of the overweight and obese that normally go under the microscope. If somebody is healthy and fit (and sufficiently unobsessed about their weight), nobody ever calculates their calorie intake or how much they burn during an indoor cycle class. If NM was obese and unfit, any self-styled diet guru would be jumping out of their skin to tell him exactly what is wrong with his weight, his diet, his attitude and what he needs to do about it.

We all have a friend like that: the lucky bastard who never knows how many calories are in a burger or when to step away from the table at a family barbeque.

Same diet, same exercise. If you are obese, this makes you a glutton and a sloth. If you are skinny, you are an object of intense envy.

If it is all about calorie balance, how come it only applies to fat people? Why the double standard?

If it is all about the calories, why do some people have to exercise 5 times a week just to maintain their weight while others can eat to their heart content and exercise for pleasure and still keep their lean physique?

Disclaimer: calorie and fat content sourced from CalorieKing.com.au. You all know what I think of these numbers and their value. Here they are used as a mere demonstration of their usefulness or lack thereof. If you have a lot of time of your hands you can weigh a steak and then tell me that I have misplaced or overestimated by 26 calories. Guess how much I care.

 

link here

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