Energy Balance > CICO

The regulation of energy balance is a long-term process, and it can’t be maintained by counting calories on a day-to-day basis.  Taubes once wrote that exercise doesn’t cause weight loss because it builds up an appetite, so you end up sucking down a Starbuck’s Jumbo Calorie Bomb on the way home from doing Yoga at the gym.  This is probably somewhat true, but this little gem from 1955 exposes some very interesting nuances.

Edholm(Edholm et al., 1955)

These researchers rigorously measured food intake and did a comprehensive assessment of energy expenditure during a wide variety of activities – lying down, standing, walking, gun cleaning, stair climbing, dressing, etc., etc.

Divide and conquer

The individual differences: big people expend more energy on life.  most of the time.

Take subjects #5 & #9 in the table below.  #5 weighs 157 lbs and #9 weighs 137 lbs.  #5 is the bigger guy and expends more energy during almost every activity.  While lying down, his greater amount of muscle mass is driving a higher resting metabolic rate.  And when he’s doing stuff, he expends more because he is moving around a lot more body weight.   This makes sense.EE data

But now take subjects 4 & 11.  #4 weighs 176 lbs & #11 weighs 152 lbs.  #4 is the bigger guy, and he expends more energy on almost every daily activity except lying down, but this could make sense too because when you’re lying down, the effect of increased body size is least likely to affect your energy expenditure – it’s the only time when you’re not moving around all that extra weight.  Right?EE 4 and 11

#5 expended more than #9 while lying down, but #4 didn’t expend more than #11.

Why: more muscle (ie, body composition)?  Undetermined :/stats

…or just individual variability?

Daily energy intake didn’t match energy expenditure in any subject, for any day, over the entire 2 weeks.  #4 was in an energy deficit of 645 kcal by the end of the study, whereas #6 was in a 1864 kcal surplus at one point.  This graphic just about sums it up:

CICO Ha

There was absolutely no relationship between CI & CO at any time point during the entire study.  Shotgun –> broad side of a barn?  The subjects were free to eat as much of whatever they wanted the entire time.  CICO expects you  to walk on the orange line.  Good luck!

More interestingly:

FI CICO

And the accompanying graphic:2 days later

That’s two days later.  This is NOT a Starbuck’s Jumbo Calorie Bomb on the way home from doing Yoga at the gym.  It’s two days later.  The figure above is far from perfect, but it’s worlds better than trying to match CI to CO on a day-to-day basis.  It’s energy balance, and it’s self-regulating (at least in healthy cadets with Lean Metabolisms).

The authors go on to say: “African farmers recoup their nutritional debts when the new harvest came in (Fox, 1953),” further extending the regulation of energy balance from 2 days to weeks-to-months.  And: “German men whose intakes had been forcibly restricted in 1945-6, eat enough food to provide themselves with 6000 Cal./d for weeks on end when they were given the chance (Widdowson, 1951),” pushing this out to months-to-years.  Eating well probably helps too, as empty calories would easily hijack this system (none of these populations would’ve had access to highly processed sugary junk foods).

Energy Balance > CICO

calories proper <– Kindle edition!

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  • George

    Very good and makes sense – who wants to stuff themselves when busy and motivated? I also imagine they slept less on high-CO days and made that up later too. Interesting implications all round.
    But – where is the CO data re: gun cleaning? Surely this is the reason for the obesity epidemic – Americans don’t have enough guns to clean to compensate for the availability of fast food. Someone should tell the NRA.

    • Carole Sampson

      “Americans don’t have enough guns to clean to compensate for the availability of fast food.”
      LOL!
      I was also confused by the gun cleaning reference :(

      • http://www.caloriesproper.com/ William Lagakos

        :)

        the study was in cadets at some sort of army camp.

    • http://www.caloriesproper.com/ William Lagakos

      LOL!

      I agree with the dynamic sleep balance… same probably goes for productivity too. unless you’re a Wall Street banker on modafinil.

  • http://nigeepoo.blogspot.com/ Nigel Kinbrum

    “CICO expects you to walk on the orange line.”
    We must have different interpretations of CICO. To me, CICO means that weight fluctuates from day to day (going up when CI > CO and going down when CI < CO). CICO doesn't mean that CI must equal CO at all times. To me, Energy Balance ? CICO

    • http://itsthewooo.blogspot.com/ Jane Plain (Woo)

      Cals in cals out (CICO) is an acronym describing the diet advice everyone gives to eat less and move more every day to lose weight.

      CICO is not describing energy balance as an entity, because no one with a working brain denies that fat tissue is made of energy/energy balance. It’s like saying my keyboard existing of plastic and wire produces keyboard. It is redundancy. CICO as a concept is not merely describing energy balance and you know this – it is specifically referring to the pat diet advice given by “everyone knows” to eat less and move more every day.

      Here you merely arbitrarily decide to define CICO this way at this opportune moment so as to preserve your religious faith in CICO.

      (BTW, on our favorite roid rager blog we have featured a “help me ant-a-nee !!* ” letter from a devout CICO apostle. Apparently our follower of the church of CICO thinks calories are like money in the bank – you can just withdraw today and deposit tomorrow, lol. Turns out that doesn’t work too well. Woopsie! Looks like if you try not to eat anything at all your body is like F U, B*TCH!! and alters neuroendocrine dynamic to starvation and this is true even if you “add calories to your CICO bank” the next day. LOLOL. Ant-a-nee’s advice basically amounts to GRRR LOW CARB SUCKS!!! Um?? I thought A.C. was busy pouncing on LC diets for being all you can eat fat people spectacles, apparently self starvation is also the fault of low carbing too. Weirds!)

      *My mom is from Brooklyn and I come from a long line of Anthony’s; cant help but say ANT A NEE although I am well aware Colpo is spewing spittle in an oz accent all the same.

      • http://nigeepoo.blogspot.com/ Nigel Kinbrum

        “Here you merely arbitrarily decide to define CICO this way at this
        opportune moment so as to preserve your religious faith in CICO”
        And I could say exactly the same about you. You arbitrarily define terms to suit yourself. Touché!

      • http://marksissel.blogspot.com/ Honey Razwell

        Hi Jane :)
        Colpo is indeed a total dolt with a piss poor understanding of basic biology and an even poorer understanding of physics.
        This is dircted at the pro Colpo trolls:
        These Colpo/McDonald trolls do not understand that many obese subjects ate LESS than their thin counterparts in Dr. Leibel’s studies YET did NOT lose weight or even gained. Their energy balance was positive over time. It does not mean they were overeating.
        The trolls are extrapolating the first law. The first law does not address how the body defends fat mass and exerts control to thwart us.
        These trolls are missing that the body has involuntary defense mechanisms and the body itself ultimately powerfully exerts control over energy balance. Thjis always gets lost in the discussion and explains a lot.
        Eating less and moving more and NOT losing weight odes NOT AT ALL contradict the firts law.
        ALL the first law says is this: IF a person gained weight, they had to have a consistent positive energy balance over a certain period of time SOMEHOW. That is it. That is the extent of its reach. End of story.
        The first alw does not at all address the enormous amount of factors that go into the “somehow”
        I would LOVE for McDonald or Colpo to debate me because my info comes straight from the best physcists in the world who I went out of my way to personally ask questions to

        The human body is an open, non-equilibrium DISSIPATIVE thermodynamic system. McDonald’s and Colpo’s understanding of physics is LAUGHABLE.
        I have NEWS for Colpo and McDonald: The world renowned physcists I spoke with ALL UNANIMOUSLY AGREE with Gary taubes’ assesment of the first law 100 %
        HOW does THAT make you pro Coplpo trolls feel. These genius scientists SUPPORT TAUBES. NOT Colpo’s nonsense and bastardization of the first law.
        Take care,
        Raz

      • http://razzwell.blogspot.com/ Razwell

        You are very intelligent, Jane. What you wrote here is very true and insightful.

    • http://www.caloriesproper.com/ William Lagakos

      CICO = ELMM = counting calories, literally.

      If your favorite online calculator says you burn 2500 kcal/d, it’d be like eating twenty “100 Calorie” snack packs/d & expecting to lose 2.3 ounces of fat/d or 1 lb/wk.

      • http://nigeepoo.blogspot.com/ Nigel Kinbrum

        Referring to Lyle McDonald’s Energy Balance Equation http://www.bodyrecomposition.com/fat-loss/the-energy-balance-equation.html
        Energy in = Energy out + Change in Body Stores
        CI = CO + Change in Body Stores
        This is why I say “Energy Balance ? CICO”

        Since there is no agreement as to the exact definition of CICO, maybe it would be better to stop using it?

        Weight loss doesn’t follow the 3,500kcal deficit = 1lb rule, as it all depends…on the proportion of FAT MASS:LBM that is lost.

        Also: calories count ? counting calories

        • FrankG

          CICO means exactly “Calories In = Calories Out” what possible other definitions are there?

          Lyle McDonald’s equation is a better representation of real life but he adds the rider “+ Change in Body Stores”. If that were already implicit in CICO there would be no need for him to add it would there?

          • http://nigeepoo.blogspot.com/ Nigel Kinbrum

            CICO is short-hand for Energy in, Energy out, which is what the EBE is all about. If you stick “+ Change in Body Stores” on the end of CICO, it’s not short-hand any more, is it? Jeez!

            Perhaps you could devote your energies into stopping playing stupid games & stopping using fallacies like http://en.wikipedia.org/wiki/Non_sequitur_%28logic%29

          • donald rosart

            Not quite true. Some of them expect the insulin fairy to bring them muscles. 😉

            Motivation is a sticky word. We tend to be motivated to do things that bear fruit–it doesn’t take discipline for a budding Oscar Peterson to practice piano, it takes discipline for him to tear himself away from the piano. A body that just naturally wants to move (or to grow muscle) in the first place is more likely to end up in sports or bodybuilding. They’re outliers, not a good sampling of the general population.

          • http://www.caloriesproper.com/ William Lagakos

            good points, thanks. There are gonna be people with “Lean Metabolisms” who can eat whatever they want and stay lean & fit. Fatigue-resistant.

          • http://nigeepoo.blogspot.com/ Nigel Kinbrum

            Hi Donald,

            1) Thank Disqus for telling me when someone replies to my comments!

            2) I’m guessing that you don’t frequent sites like http://www.muscletalk.co.uk/ The members there are ordinary Joes & Josephines.

            Some started-off fat & in poor physical condition (I’ve seen the “before” pics). They forced themselves to maintain a significant caloric deficit for a long time (which takes a lot of dedication & support) and they did resistance training. They lost a lot of body fat & gained some muscle mass, losing weight in the process.

            Others started off skinny. They forced themselves to maintain a slight caloric surplus for a long time (rather easier) and they did resistance training. They gained a bit of body fat & gained some muscle mass, gaining weight in the process.

            Weight change is about calories in vs calories out (CICO, or Energy Balance). Body composition is about improving nutrient partitioning by doing resistance training.

            3) See http://impruvism.com/why-calories-count/ Are 148 references enough for you?

  • http://ashsimmonds.com/ Ash Simmonds

    The 2-days-post-hence observation is interesting, are there any others like it out there?

    When people go on about CICO as a daily calculation I tell them to try instead smoothing it out to a week – THEN you will find a much better correlation. But no, people are determined to think energy balance is on some 24 hour clock.

    Personally, I am much more active on the days that I eat less/nothing – indeed, when I have a significant activity approaching I’ll fast for up to 24 hours before the event. If I were a zealot to the CICO framework I’d be somewhat dismayed at my results – I nearly always put on 2-4kg in the days following a physical event.

    Here I apparently burned 4,500 calories after a whole day of not eating – so somewhere approaching 10,000 calories out with ZERO calories in – 2 days later I was 4kg heavier: http://ashsimmonds.com/2012/10/06/50km-trailblazer-hike-in-the-adelaide-hills-fat-powered/

    • http://www.caloriesproper.com/ William Lagakos

      The only other observations I’ve seen are the two cited in this paper (farmers & Germans), but I couldn’t even track down those papers. The weekly thing is cool theoretically, but still has the same drawback – do you prescribe a 17500 kcal per week diet? (seems even harder to gauge).

      • http://ashsimmonds.com/ Ash Simmonds

        I prescribe not counting, but you just CANNOT get this through to some people – this is my method of reducing the froth at their mouth. CICO is a neurological/eating disorder.

  • http://itsthewooo.blogspot.com/ Jane Plain (Woo)

    Yep, the body knows when you aren’t eating enough. It doesn’t care one whit of calories; the body controls adipocyte energy balance via leptin feedback.

    Here is a colorful cartoon I created to illustrate the relationship of nom nom’ing, leading to adipocyte growth, leading to energy wastefulness & inhibited appetite, leading to adipocyte atrophy / fatigue / hunger, leading to nom noming:

    http://itsthewooo.blogspot.com/2013/06/how-leptin-works-picture-book-version.html

    I have definitely discovered this in of myself; high energy and low appetite leads to fatigue and high appetite, rinse repeat. Weight stable people remain weight stable throughout this process.

    For example, after a few days of body fat loss, I have finally (and quite expectedly) developed a progressively augmented appetite. I am RAVENOUS right now as I write this in spite of high cal intakes :D. Tomorrow will definitely be fatty meat binge like the good old days!

  • Kindke

    The inverse relationship between food intake and energy expenditure is thanks to the SNS. I was reading a paper recently talking about the “mona-lisa” hypothesis of obesity, I may blog about it. Basically they say that *most* forms of obesity involve suppressed/reduced SNS activity. And that energy expenditure and food intake are always inversely related.

    high SNS -> high energy expenditure -> reduced food intake

    low SNS -> low energy expenditure -> prompts increased food intake

    • http://www.caloriesproper.com/ William Lagakos

      Autonomic dysregulation is definitely involved in a LOT of these processes. Eg, bromo is sympatholytic. Not sure if that is independent of its dopaminergic activity, but in either case it further supports the point.

      • http://itsthewooo.blogspot.com/ Jane Plain (Woo)

        Bromocriptine increases SNS? Interesting. Most of what I read suggest increased dopamine suppress central stress response and indirectly SNS (CRH is essential for adequate SNS drive).

        It may be that a strong D2 receptor agonist like bromocriptine suppresses stress response *without* suppressing, even augmenting, the SNS. This is exacty consistent with what normal leptin signalling does, and as I’ve argued for years, most of leptin’s therapeutic effect depends on manipulating the dopaminergic system.

        • http://itsthewooo.blogspot.com/ Jane Plain (Woo)

          For someone like myself I become hungry and hypoglycemic via interventions to suppress central stress responses. Leptin , OTOH, did not produce this effect; there was a clear linear decrease in cortisol, as well as a clear and rapid increase of SNS.

        • http://www.caloriesproper.com/ William Lagakos

          sympatholytic = suppressive
          Could be something like this: bromo (in the morning) –> D2 –> decreased central SNS activity

          • http://itsthewooo.blogspot.com/ Jane Plain (Woo)

            Ah yes that does make sense :) for some reason I read your comment and gathered opposite.

            I’m discovering through personal experience that pure dopamine agonists are actually not effective for wt loss which may explain the modest weight benefit of bromocriptine… sympathetic agonists which raise dopamine indirectly are much more effective for weight problems, thus the use of stimulants/parodoxical effect of serotonergic agents.

            Every time I use a dopaminergic I develop atypical depression symptoms, which are mediated by exaggerated suppression of central stress / sympathetic nervous system which leads to increasing body weight.

            When I use a sympathetic agonist like a norepinephrine / serotonin potentiating agent, particularly a stimulant, it is total opposite.

            It stands to reason then dopamine agonists (pure) would be most effective for diabetes and not for the total metabolic syndrome with obesity/hyperphagia/fatigue which responds more to increased central stress and SNS stimulants that raise dopamine indirectly with NE. Suppressing the SNS/stress response always improves diabetes and often increases body weight.

      • http://nigeepoo.blogspot.com/ Nigel Kinbrum

        Here’s a book you might find interesting http://www.bodyrecomposition.com/bromocriptine

    • http://itsthewooo.blogspot.com/ Jane Plain (Woo)

      Absolutely correct.

      Low SNS translates into hypoglycemia and insulin supersensitivity of adipose. At the same time your peripheral nervous system prevents normal thyroid hormone activity and normal fat oxidation, your adipose is logically that much more sensitive to insulin mediated nutrient sequestering / suppressing lipolysis.

      Thus “I AM A 400 POUND WOMAN WITH BP THAT IS 120/80 AND BLOOD SUGAR OF 80, I’M TOTALS HEALTHY” <–this person has a profound SNS deficit, like a genetic or acquired brain defect.

    • Nihil

      The mona lisa hypothesis is interesting. It’s by Dr. Bray, several of the papers are free to read: http://www.ncbi.nlm.nih.gov/pubmed?term=Bray%20GAAuthor&cauthor=true&cauthor_uid=1861165

      but then he also authored papers like this: http://www.ncbi.nlm.nih.gov/pubmed/9846842

      • Kindke

        haha right on, alot of doctors are like that in the obesity field though.

        • Nihil

          Well its occam’s razor alright. Body fat = dietary fat, therefore only fat makes fat. Fat fat.

          Fat.

          • http://ashsimmonds.com/ Ash Simmonds

            That’s why I stopped eating toenails, my toenails were getting too toenails.

  • Franziska Spritzler

    Another great post, Bill! As a dietitian, I’ve seen first hand that CICO and ELMM don’t deliver for many of my obese patients. Thanks to you and your knowledgable commenters, I’m continuing to learn about the intricacies involved in energy balance, which will hopefully allow me to really help people rather than just providing a handout telling them to eat more vegetables and less fat. Much appreciated!

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  • CynicalEng

    http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=802564 is similar, small group of students observed in a lab. Table 9 shows over 2 weeks only one ate less calories than expended, and he lost weight whereas the others ate more than they expended and gained weight.

    • http://www.caloriesproper.com/ William Lagakos

      I love it: calories burnt while “writing a letter” vs. “listening to the boat race.” And dancing the Petronella doesn’t expend nearly as much energy as the “Eightsome reel.” Thanks for the link!

  • http://marksissel.blogspot.com/ Honey Razwell

    The information PERSONALLY TOLD to me by top astrophysicsts completely DISCREDITS the “work” of Armi Legge, Lyle McDonald and Anthony CONpo.
    “References” mean NOTHING if they do not support what you say. Further, not all studies carry the same WEIGHT.
    Lastly, Colpo was BUSTED recently giving phony and bogus references to the work of Dr. Ornish to deliberately mislead his low intelligence audience. His “references” meant NOTHING.
    Veracity of argument based on established principles are what matter, NOT the number of “references.”
    The Firs Law has an extremely limited scope and reach( as do all laws). it says NOTHING WAHTSOEVER about rhe many causes of obesity. This is directly from Dr. Jarzynski and Dr. Hawking themselves. ( brief reply).
    Down this path, the McDonald et al trolls do NOT want to go with me. I have researched this for 4 years every single day- taslking with the best physcists in the world- to publicly discredit Lyle McDonald. The guy is a total idiot with a very poor udnerstanding of physics.His article about physuics is LAUGHABLE
    The human body is an OPEN, NON -EQUILIBRIUM DISSIPATIVE thermodynamic system
    hUMANS exchange energy AND matter with the environment,
    Humans WASTE A LOT OF ENERGY- VERY SUBSTANTIAL
    WE POOP OUT ENERGY. We WASTE energy as dissipated heat- LOST ENERGY and substantial.
    Dr. Jarzynski HIMSELF personally told me “obesity is BIOCHEMCIAL/BIOLOGICAL. It’s NOT a matetr of physics. it is best understood within the framework of physiology”.
    And realize there is NOTHING abnout a law that makes it ” better than”, “above” or “more true ” than a theory.
    ALL THE WORLD RENOWNED PHYSCISTS I SPOKE TO UNANIMOUSLY AGREE WITHJ GARY TAUBES ABOUT THE FIRST LAW BEING MISUSED BY PEOPLE IN THE COMMEFCIAL WEIGHT LOSS INDUSTRY. THEY ALL AGREE IT SAYS NOTHING ABOUT THE CAUSES OF OBESITY- POINTLESS TO MENTION IT.
    HOW DOES THAT make you feel. Lyle McDonald trolls/
    Stephen Hawking himself is NOT saying what you frauds are claiming

  • http://marksissel.blogspot.com/ Honey Razwell

    The more we learn about obesity and the science of body fat regulation , the more we realize how LITTLE we know.
    This is not the case with the pro- Anthony Colpo/pro -Lyle McDonald trolls. They do not even know enough to realize how little they know.
    Only low intelligence FOOLS are 100 % certain. Intelligent scientists (Dr. Jeffrey Friedman, Dr. Leibel) admit vast unknowns and uncertainties.
    Two words to describe Anthony Colpo, Lyle McDonald and their trolls:
    DUNNING KRUGER !
    DUNNING KRUGER STRIKES AGAIN!

  • http://www.caloriesproper.com/ William Lagakos

    Day-to-Day Variation in Food Intake and Energy Expenditure in Healthy Women: The Dietitian II Study
    http://www.andjrnl.org/article/S2212-2672(13)01119-2/abstract

    … Human beings show corrective responses to deviations from average energy and macronutrient intakes with a lag time of 3 to 6 days, but not 1 to 2 days. These corrective responses are likely to play a role in bringing about weight stability…

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