Dr. Rocio Arellano, MD, M.Sc., Professor at the Autonomous University of Queretaro and MD at the San Jose Hospital, Queretaro (roare2001@yahoo.com), Mexico, February 2009.
We all have heard about the “good” and “bad” cholesterol. LDL Cholesterol accumulates in blood vessels causing atherosclerosis, while HDL protects our vascular system by transporting back cholesterol from cells to the liver, and as a potent antioxidant. Something similar happens with kilocalories. Our body energy requirements need to be covered every day, and even when someone wants to lose some weight still needs kcalories. But the question is not only how many, but their quality content. Obesity is a public health problem worldwide and even though we know a lot about its causes, consequences and treatment, there is still the problem of educating people on how to eat healthy and light in kcalories.
Empty calories is a term used to refer to those energy dense foods with a lot of fat and carbohydrate content but with little or none of other nutrients, so these are the “bad “ kcalories. We’ll name as “good kcalories” those that provide a nutrient dense content with less kcalories.
Our internal energy balance is perfect under physiological conditions, so every kcal in or out should count. But not in the way it is listed on the tables of nutrient and kcal content of foods. Tables are not counting for the increased energy expenditure caused by the thermic effect of foods or the greater basal metabolic rate in individuals with larger muscle composition or under exercise conditioning. Neither the effect on energy storage when eating large amounts of food in sedentary hours as compared to eating the same kcalories while being physically active. So counting strictly the kcalories from a list of foods may not be the best way to quantify a diet and make it a healthy one.
Patients become overwhelmed and confused about these issues. They may ask how much more exercise should they do if with 30 minutes of aerobic exercise with an energy cost of 200-250 kcal, they can’t burn those extra calories ingested from a couple of beers over the weekend. Others are more concerned about the costs of dieting, considering that “diet foods” are expensive or even worse, some would choose to use some magical pill to avoid the effort of dieting and/or exercising.
So people at this moment need to stop counting calories, and stop having unrealistic expectations about dieting and drugs and other chemical compounds that promote weight loss, and understand more the concept of diet balancing and include all the good kcalories required for the purposes of a healthy diet and body weight loss and maintenance. People need to master the way they eat and feel confident about the fact that their diets are promoting a better quality of life and feel pride about it for being able to take good care of themselves.
Each country has established a public policy to provide nutrition education; in other words a system for people to understand what are the good kcalories they should be eating everyday. Basically all systems are consistent in including something of the three food groups in each meal:
- Vegetable and fruits. Providing a vitamin C rich food every day, and green leafy vegetables frequently, and giving variety according to season. Avoid creamy dressings by using instead vegetable oils or lemon and salt and adding flavor with herbs,
- Protein foods that are low in fat, like legumes, nonfat dairy products and meats, egg whites and some seeds and nuts, using non greasy preparations at the kitchen.
- Bread and cereal group of high fiber content such as grains (wheat, oatmeal, rice, corn) in amounts that vary with the exercise level of each individual. But that in a moderately active adult woman or man may not exceed 6-8 portions a day respectively. The “bad kcalories” from high fat and carbohydrate dense foods are usually included in fast foods, fried or sweet snacks, soft drinks, and with some meal planning and discipline we can avoid including these type of foods.
The best way to maintain a healthy body weight is eating the good kcalories, keeping yourself physically active, and stop worrying about counting each kcalorie, because what matters is the balance between energy consumption and expenditure according to individual metabolism.