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There Is No Such Thing As A "Calorie" (To Your Body)
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March 22, 2013
9:59 pm

Noko, nobody is arguing that the variation of our bodies' internal energy is given by the sum of the net external work and the heat received by it (some of that from food).

One of the points being made is that different foods eaten under different conditions but labeled at the same calories can lead to different internal energy balances. Of course you acknowledge that and, as you said, that balance can be "tweaked".

But much more important than this first point (by itself) is one that is related to it: the same variation on a system's internal energy can lead it to different changes in state. In the case of our bodies' it's (at least to a big measure) the actual foods eaten and the very circumstances when they're eaten, rather than just the net heat they give us, that will determine to which of the many possible "states" (using the term loosely here) a difference in internal energy will lead us. And that's what actually matters. You can loose weight (even if you're overweight to begin with) and actually get less healthy for that. The converse is also true.

So there are quite a few good reasons to say that focusing too much on calories is a big mistake, and I know you agree with that, and that was the point of the article, I believe. Now you may understand it makes no sense to put calories above every other property of the food itself and an other circumstances, but many people don't.

Also, as J. states, diets, even when taken seriously, rarely work in the sense of retaining desirable weight loss over the long term. There are quite a few possible reasons for that, but it means that most of people won't live on some "deprived" state most of the time, and in this sense, coupled with the above, CICO IS quite the oversimplification: it can lead people to believe the "quality" of the foods being eaten matters less than the net amount of heat they're giving you compared to the net amount of work you're doing. And it gets to be a dangerous one at that, because they may succeed for a while, even if that's, in general, neither healthy nor sustainable.

What's more, he puts forward that "food quality" (and "quality exercise"), coupled with our own bodies' mechanisms will tend to set us on a healthy homeostatic level, and that that should be our goal. If you attain that level you shouldn't need to count anything, because your body itself will be doing a fine work at sensing it and informing you.

I realize now I may have written more than necessary. I also did it in kind of a rush, so I apologize for the possibly bad structure.

March 22, 2013
10:34 pm

Yes! That's a philosophy I can get behind. I just can't get behind these "refutations" of CICO, which are always either strawmen or poor science (in Taubes' case). For many people, eating a diet of unprocessed foods, and even going farther and restricting foods like grains, will be great for reducing calories. They won't feel hungry or accidentally overeat. Unfortunately, some people have awful appetite regulation, whether that be genetic or caused by some other factor. For these people, calorie counting will be a critical step in the process.

Take me, for example. I'm naturally lean, so in general I don't worry about calories. At the moment I'm trying to gain weight, so I'm doing my best to maintain a caloric surplus, so every once in a blue moon I'll count calories for a day to make sure I' on track.

My point, though, is that people are leaping from "not everybody NEEDS to count calories" to "you SHOULDN'T count calories", or even worse, stating that CICO is flat out false.

March 22, 2013
11:00 pm
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Like I said, that would be a biochemistry textbook…and I have enough incomplete series-in-progress that I probably shouldn't start another one!



"But I (and thousands of other women like me) am here to tell you that counting calories DOES work."

Sort of.  If you restrict "calories" deeply enough, you've dramatically decreased the amount of food you're eating — and the decrease in total quantity becomes enough to overcome the inherent errors in reducing everything to "calories".

"Calories" are, in effect, a very rough approximation to the amount of food eaten…and the equivocal results we obtain (having to reduce "calories" by far more than the expected value to result in weight loss, or increase "calories" by far more to result in weight gain) support my hypothesis that they are not a very good approximation!

"With all the single-minded emphasis on obesity today, it would be good to see some articles in the popular press such as "Yes, too many calories can make you gain weight, but did you know that the calories you eat can also do these things. . .?""

It would be good, but I'm not holding my breath.  Meanwhile, I'm doing my best to get the information out there.


Jen W, tess, X: 

Thank you!



Exactly.  The calorie-counters all say that what you (and so many other low-carbers) do is impossible, and that you must have been lying about your food intake on the low-fat diet while eating much less than you think on the low-carb diet.  At some point, one must entertain the possibility that the "calories über alles" paradigm is not entirely correct!



I'm not sure I'm important enough to shill…but I do assume the Internet is full of paid shills.  Paying people to sit on Google Alerts and propagandize the comments of news articles doesn't cost much relative to "real" advertising.

OTOH, I think most of the people screwing up MDA are just crazy Peatarians.  The irony is that there are only about four of them…but they post in every single thread.

And thank you for reminding everyone of my article "You Are A Radical, And So Am I."  My predictions at the end have (unfortunately) turned out to be excellent.

(Keoni blogs over at Hawaiian Libertarian.  Warning: mandrosphere.)



"i like what Dr. Attia said re. CICO: it's descriptive but not explanatory"

Exactly. By definition, we are in "energy balance", because physics is true.  But it turns out we are not in "energy balance" in the same very simple way a bomb calorimeter is in "energy balance", because we are more complicated than a bomb calorimeter!  Cue the classic essay "Of Taubes And Toilets."  


Catching up,


March 22, 2013
11:42 pm
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"can the brain really only burn glucose?"

Yes, I oversimplified that a little bit in the interest of not writing the entire biochemistry textbook.  The problem AFAIK is that long-chain fats are too big to cross the blood-brain barrier, unlike simple sugars, lactate, ketones, etc., all of which the brain can use for energy.

"we know right off the bat that animals are evolved to eat substances which are in different forms than the substances their actual body is formed of. "

However, they all convert it to something more closely approximating their own makeup.  All that plant matter, for instance, gets fermented into short-chain fats in a ruminant's digestive tract.  This is a central point of Perfect Health Diet...that once you realize what's absorbed is not the same as what enters the mouth, all animals "eat" a reasonably narrow range of macronutrients.

That being said, our bodies' need for energy substrate is large and some nutrients can be interconverted, so we have some leeway in what we can eat.  But given our relatively simple digestive tract and limited capacity for conversion, it seems prudent to eat as close to what we are made of, and what we directly use, each day.

Your reply to Brian was excellent, by the way.  That's exactly what I meant.



"Excess starch" is relative to your degree of daily activity (large, in the case of ancestrally living islanders); your insulin sensitivity and metabolic flexibility (good, in their case); the amount you smoke, which is an appetite suppressant (like chimneys, in their case); how often you eat (big meals only once a day, in the case of Kitavans); whether you're a product of many, many isolated generations of living on the same high-carb diet (all the Polynesian islanders); whether your diet contains plenty of iodine to help metabolize the carbs (all the examples, from seafood); whether your diet is otherwise low in toxins like omega-6, gluten, etc. (all the examples)...

Also, the traditional Okinawan diet isn't anywhere near 85% carb...that's propaganda put out by the people who push the "Okinawan Diet" book.  "According to respected gerontologist Kazuhiko Taira, the most common cooking fat used traditionally in Okinawa is lard. . . Dr. Taira's findings differ from those of the Okinawa Centenarian Study in that he reports that healthy and vigorous Okinawans eat 100 grams each of pork and fish each day."  (Source.



Thanks for the suggestion!  I know Jason is a fan of mine...and though I've just done a podcast, I'll keep them in mind when I'm more ready to do another one.



"JS, I should add, CICO is a necessary effect, not the cause."

Exactly.  Physics still applies...but thermodynamics just isn't a very useful way to approach the problem in this case.  See my reply to pam, above.


E Craig:

"Because that system of CICO encourages you to pick the food that you can make the most palatable with shortcuts (which is usually something processed, artificial flavors and flavor enhancers) for the least amount of calories."

Quite true: Beowulf made a similar point.

Also, people get hung up on "fat has 9 calories per gram", not realizing that (for example) because real food contains water, rice cakes are actually more calorie-dense than prime rib!  (More surprising examples in this article.)



"So if building with protein and glucogenesis costs energy, does that mean you never get 4 calories from a gram of protein?"

It's unlikely. If you use it to build something, it costs energy.  Gluconeogenesis is only about 70% efficient, if I recall correctly.  And even if it's directly oxidized, the 4 calories/gram is an approximation, as different amino acids each have different entries into the citric acid cycle and slightly different energy values.  

These are the reasons that protein has such a high TEF...all that "waste energy" ends up as heat.



"Over the past month I've added 2 pounds! Calorie magic!"

Exactly!  We can invoke magical properties like "set points"...

...or we can understand the different possible fates of food, and realize that a calorie is not a calorie.  Nor is the metabolism of a 24yo male Crossfitter the same as a 55yo post-menopausal woman, or me, or you.



"you will still become a fat-ass unless you limit overall (dum-dee-dee-dum) CALORIES!"

You're not limiting "calories"'re limiting food.

More specifically, you're limiting the supplies of hundreds of different nutrients, with effects that may or may not approximate the oversimplification of treating food as a bag of "calories".  See my reply to Marilyn, above.


More soon!


March 23, 2013
12:48 am
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Let me highlight these sentences from the paper you linked, because they're so monumentally self-contradictory -- and highlight the deficiencies of the calorie model so well.

"Evidence indicates, however, that the difference in energy expenditure is small and can potentially account for less than one-third of the differences in weight loss that have been reported between high-protein or low-carbohydrate diets and high-carbohydrate or low-fat diets."

In other words, the CICO model, while trivially true in the physics sense, is completely inadequate to explain observed reality.  (By which I mean "Attempting to adjust the "calorie"-based calculations for all the factors I discussed in my article is apparently, in practice, impossible.")

"As such, a calorie is a calorie."

Wait, what?  They've just said that it isn't.

"Further research is needed to identify the mechanisms that result in greater weight loss with one diet than with another."

And now they admit again that the calorie-based model fails to explain observed reality.



"The only people who misunderstand calories in/calories out to this degree are, ironically, your paleo/keto/vegans etc."

OK, I see you're a Lyle McDonald follower, which explains everything, including your lumping together of paleo and keto.  That's so 2009.  Will you start calling me a "paleotard", too?

The irony, of course, is that Lyle's article and mine are making the same point, except on different levels.  Lyle is enumerating all the "adjustments" one has to make when we treat food as comprised of "calories" (as measured by a bomb calorimeter), which include all those sciency-sounding acronyms like TEF, SPA, NEAT, etc.

However, as I explained to pzo and Sofie above, TEF (to choose one example) is not a magical property: it's a direct consequence of the different metabolic fates of food -- the very ones I enumerate and explore in this article.  Some protein is used to build and repair tissues, enzymes, and secretions; some undergoes gluconeogenesis, which is (AFAIK) only about 70% efficient; and if you're eating grains, some of it might not be digested at all!  

Result: a variable amount of waste heat, which is all lumped together under "thermic effect" (or "diet induced thermogenesis").  

In support of my hypothesis, I note that TEF is not a constant: it's an empirically measured value, and it changes with both aerobic and anaerobic training (source), as well as a host of other factors.  Again, this is exactly what we'd expect, given that TEF is a result of nutrients meeting a varying combination of the fates I enumerated, depending on our nutritional and metabolic state and the circumstances of their consumption.

Yes, the other sciency-sounding acronyms in the equation from Lyle's article can be explained in terms of these fates, just like TEF.

And now, a question for my readers.  Here's the equation from Lyle's article:

Energy In (corrected for digestion) = (BMR/RMR + TEF + TEA + SPA/NEAT) + Change in Body Stores

In other words, this is the fancy footwork you have to do in order to make the "calorie" model approach accuracy...

...which involves correcting it by a bunch of empirically-measured factors that vary both on an individual level and over time.

Is this really a useful way to think about what, and how much, you should eat for dinner?


More soon,


March 23, 2013
10:20 am

Noko, one thing is what CICO really is, and another is what the people understand about CICO.
The "strawmen" is this bad understanding of CICO.

March 23, 2013
3:27 pm
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A few thoughts:

The problem with 'calories' as used in modern dieting is that it is a single dimension by which to look at food.  The CI side is hard to quantify as the calories in food are difficult to measure.  The ripeness of food or how well cooked it is can all affect the availability of calories.  (In some cases, and for some species, even the time of day!).  How you masticate (the thoroughness of chewing) can affect digestibility of foods and this is something we see with, for example, sweetcorn.  The kinds of foods you eat together can have some influence on digestion and hormonal response.


CO is interesting and a lot of the themes have already been mentioned, among them gut flora which have independent DNA and their own metabolism to satisfy.  They are part of a microbiome which is effectively an organ within an organ – they consume our food along with us, help our digestion and with the extraction of vitamins and minerals from food.  Our diet can influence the population of gut flora in a little as a day.  Although the gut flora are affected by CI, they can influence our behaviour and general activity(and so CO).  This is one of many feedback mechanisms in the human body and this is without going near the epigenetic effects we may have on the DNA of gut flora (they will produce many generations in our one lifetime, thus passing on their own epigenetic traits and modifications).


We also need to consider the influence of epigenetics and mitochondrial expression (the latter well illustrated by a great talk on TED by Terry Wahls) the former which can strongly determine your 'bodyfat set point' about which you are likely to generally return to.  Tim Spector (Professor of Genetic Epidemiology at King's College London) writes "…we believed that different metabolic rates and different types of fat were the genetic factors in why people differed.  We now know that the brain may be more important.  The first and strongest gene found so far is called FTO, and is expressed in the brain, especially in the key reward centre of the hypothalamus in the base of the brain (hypothalamus means under-chamber in Greek).  For some rare humans who have two copies of the variant, chances of being obese increase by up to 70 per cent."


There are also the dynamics of our hormonal environment to consider.  As Taubes said, teenagers don't grow because they eat more; their hormonal environment is driving them to eat more (and do less), to conserve energy for growth.  So we know that hormonal drivers can have profound influence.  But now it is becoming evident that our hormones can be affected by diet, inflammation, stress and sleep (amongst others), so again we see further feedback mechanisms.  Fat is not inert and has its own chemical messaging mechanism(s).  An empty fat cell needs to be interpreted in its evolutionary context.


CI and CO are both moving targets in a system with various feedback mechanisms.  The system is adaptive, it can grow and shrink, it can upregulate or downregulate its activity.  It can live off itself (autophagy). 


IS CICO true?  Of course it is (cue talk of the laws of thermodynamics).  Does CICO explain obesity? Not really, at best it just restates the problem.

March 24, 2013
5:08 pm
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noko said:


I think you misunderstand. "Output" is not poop, it's how many calories you're burning.



Let's just say that there is a calorific output in "poop" and if you have really had a good look there is also a fair amount of undigested food in there, which would need to be accounted for in the CICO equation. They run to quite a large percentage of output which is why they need to be included.

I was of course being facetious but there is a point in that..provoking a little more thought to what is obvious but overlooked.


March 25, 2013
4:16 am

This is an excellent article.

I used to use CICO, very low fat foods, and calorie-counted cardio exercise. I yo-yoed around a stone off and on, was tired all the time, and felt like my thyroid medication didn't work.

So now I avoid sugar and wheat products - bread, pasta etc. and most other grains with the exception of small portions of brown rice and potatoes. It's not low-carb as such, but I eat more meat, eggs and vegetables than anything else. Sure I still eat fruit, but not in massive amounts. I also took up strength training, and stopped weighing myself.

Guess what? I eat more, calorie-wise, than I ever have. I lift heavy and train hard. Sometimes I eat so much I get sick of eating...

...and I have dropped a dress size and can out-lift most of my male friends in the gym. I have energy, my skin and hair look great, and I very rarely feel deprived - which is something my female friends "on diets" complain about a lot.

Of course, I slip up occasionally - I'll have a night out with beer or a takeaway curry - but now these things are very occasional treats rather than regular occurrences so I don't feel guilty.

I will never go back to CICO.

March 26, 2013
2:46 pm
Healthy Paleo

I have never felt better since I started "depriving" myself with meat, fresh veggies, fresh fruits and nuts. There is great freedom in sitting down with a plate of real, delicious food and not worrying about the calories or fat content.

March 27, 2013
12:32 am
Halifax, UK
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Well said, Healthy Paleo. Better still when local and seasonal variations are considered; nature figures out your plate for you AND keeps it interesting the whole year through.

Living in the Ice Age

March 27, 2013
5:33 am

A long time reader from the UK here, but this is my first comment. I just wanted to express my appreciation of this exceptional, cogent article. Thank you.

March 29, 2013
9:49 pm
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Yes, the intestinal microbiome does make a difference...and it's very difficult to calculate.


eddie watts:

"we (by that i mean humans) can only control the CI part of that equation and not the CO part"

That's a very good insight, stated simply.  


Mr. Chevy:

I realize you're being facetious, but if we alter the analogy just a touch, it's actually not bad.

Imagine that cars had, like humans, only one hole into which you put all the fluids your car needed.  Gasoline (or diesel), engine oil, antifreeze, transmission oil or ATF, windshield washer fluid, power steering fluid, brake fluid, several different kinds of grease...everything goes in the hole, and your car takes care of filtering, processing, and sorting out what goes where.

All these fluids, like food, have some sort of heat of combustion (once you boil off the water, in some cases) it's reasonably easy to come up with a "calorie" value for each of them.  Gasoline has so many "calories" per does brake fluid, so does antifreeze.  

But a car doesn't burn anything except gasoline for energy!  So if you're short on antifreeze, your car will overheat no matter how much gasoline you give it...and the problem is not that your car is out of "fluid balance".  In a car, none of these fluids substitute for the other, so the concept of "fluid balance" is meaningless.  

I don't want to push the analogy too far, but I hope my point stands.



"nobody ever has claimed that we can 100% accurately track every last calorie in and every last calorie output. However, we can do so accurately enough – based on estimates – to gain/lose weight when we want to."

Really?  That explains why almost all diets fail, (to a first approximation) no one who loses a substantial amount of weight keeps it off, why it's impossible to calculate RMR and BMR except by individual experimentation, why low-carb diets have an appx. 300 "calorie" metabolic advantage over high-carb diets, etc.  The varying amount of heat lost to the atmosphere based on ambient temperature, subcutaneous fat, and how much clothing we wear, is also a confounding factor.  And there's the inconvenient fact that Americans were much skinnier in the days before nutrition labels, when no one knew how many "calories" were in any of the food they ate!

Yes, "calories" are an approximation to how much food we are eating...but as eddie said above: we can control calories in, but not calories out.  Remember all the propaganda we heard for years?  "Eat one less slice of bread a day and you'll lose 10 pounds a year"?  

Yet that never works.  In order to achieve significant weight loss we have to restrict "calories", and increase activity, by far more than the equation predicts.  What I'm doing here is enumerating some reasons why, and (I hope) working toward a better understanding of both fat and lean mass gain and loss.


Catching up...


March 30, 2013
12:23 am
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Thank you for the thoughtful essay.

"One of the points being made is that different foods eaten under different conditions but labeled at the same calories can lead to different internal energy balances."

Absolutely true!  

To use an extreme example, 225 calories of pastured eggs (that's three "large" eggs), full of complete protein and fat-soluble nutrients, will lead to a different nutritional state, and therefore a different internal energy balance, than 225 calories of Coca-Cola (a 20-ounce bottle of Coke). 



Note that I'm not stating any of those things.


If people only argued against what I actually wrote, my comment section would be a lot shorter!



Several good points and information bits in there...particularly the "time of day" observation about plants.  I wonder if that applies to fruits or salad greens?

However, I don't like the term "set point", because it's just handwaving away a homeostasis we don't understand.  There's no "fat thermostat" in our brains that we could turn up or down if we could just find the dial!  (Though it's popular amongst neuroscientists and other brain researchers to assign that task to the hypothalamus, I think that's optimistic...just because you can break the hypothalamus of a genetic knockout mouse and make it fat doesn't mean people are fat because they have a broken hypothalamus.  There are trillions of cells in a human body, and they aren't passive hand puppets of the hypothalamus...each one has its own homeostases it attempts to maintain through expressing receptors, secreting hormones, and otherwise signaling its nutritional and metabolic state.  Add up a few trillion of these in dozens of different organs and hundreds of different cell types, each with its own unique needs, and you get a homeostasis...

...or a "set point".)

"CI and CO are both moving targets in a system with various feedback mechanisms. The system is adaptive, it can grow and shrink, it can upregulate or downregulate its activity. It can live off itself (autophagy). 

IS CICO true? Of course it is (cue talk of the laws of thermodynamics). Does CICO explain obesity? Not really, at best it just restates the problem."

Well put.



Undigested output is just one of the possible confounders!



Exactly.  It's indeed possible to lose weight by cutting "calories" sufficiently...but as you've found, paying attention to the quality of the foods you ingest has a much greater impact, and is much more sustainable over time.


Healthy Paleo, Paul:

Isn't it terrible?  We're all depriving ourselves of those delicious plates of lentils and brown rice (no butter or salt, of course), and forcing ourselves to choke down all these horrible steaks and fresh fish...salads with avocado and fresh Caesar...baked potatoes drenched in butter...fresh fruit...yuck!



Thank you for the support.  I know I have a huge readership from my Web statistics, but it's good to know that I'm helping real, individual people.


I'm caught up...for now.  Thank you all for the support...

...and special thanks to those who bought a copy of The Gnoll Credo or a T-shirt, both of which saw meaningful sales upticks this week.  You keep the lights on and the articles coming.


April 3, 2013
12:09 pm
K. Harris

Overcomplicating it is just as bad as oversimplifying it. The calorie theory does work and is easily measured. The fate of the food we eat is called our metabolic rate, the amount of energy we expend at rest in a day. Once your individual resting metabolic rate is determined, one can easily determine the amount of calories needed to sustain, gain, or lose body weight, based on gender, height, weight, age, and activity level. Once you know the math, it's almost too easy. Bodybuilders have been counting calories for years and can predict their weight and bodyfat % pretty much down to the day of competition. A calorie is a calorie; it is the human metabolic rate that's not just a human metabolic rate that is the changing factor. Learn your individual metabolic rate and daily energy expenditure, and you can very easily determine your daily caloric needs for whatever your bodyweight goals are.

April 4, 2013
5:15 am
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Body builders/fitness models/etc are a subset of the population at large.  Perhaps their bodies and brains are more tolerant of the restriction/overconsumption necessary to develop their bodies in the way they want to.

April 4, 2013
5:36 am

I've twice used calorie counting on the first time to lose the last 12 pounds, the second time to lose the 7 pounds that had crept back on a couple years later after some emotional eating got the better of me. My experience is that in the 10 weeks or less that I've used it, it works perfectly. Not only does the weight drop off at a reasonable 1-2 pounds per week, my eating habits are reset such that after returning to ad libitum eating, my weight stays at the new lower weight.

Oddly enough, even paleo foods can cause weight gain if eaten in excess. It's a very strange phenomenon, and I accept that I may be an extreme outlier in this regard.

April 4, 2013
7:31 am

Calories (not macronutrient ratios) have been repeatedly shown to be effective in weight loss or gain in metabolic ward settings. This applies to health and overweight people. Any difference in metabolic rates between individuals is trivial.

April 4, 2013
1:03 pm
Madison, WI, USA
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I think the more important question here is "weight loss" of what?  Water, fat or lean body mass?  If you loose "weight", but that weight is lean body mass instead of fat or water, I'm not sure that's a good thing, hence why I've really stopped "weighing" myself and starting going by weekly, sometimes  bi-weekly measurements. I get a much better idea of whether I've lost fat or not, which is where I want the weight loss to come from and NOT lean body mass.


Anyways, again, many people seem to be missing the point of the article in that calorie counting may work, but it's an OVERSIMPLIFICATION to just count calories at the exclusion of what nutrition or lack there of is in those calories.



"Often we forget . . . the sky reaches to the ground . . . with each step . . . we fly."  ~We Fly, The House Jacks

April 4, 2013
3:35 pm

Body builders prepping for a competition are HUGELY concerned with macros, not just calories. I know a couple women that compete regularly, and they get very excited when their trainer says they can have something like ten almonds or half an avocado a few times/week. They pretty much live on straight protein with very little carb and fat to cut down to competition leanness.

My point is that if a calorie were a calorie, then they could achieve their desired results eating a certain number of peanut-butter cups each day. It doesn't work that way. They are eating particular items to create an internal hormonal state that sheds fat mass (and some lean mass likely as well since they both report losing strength near competition time).

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