On 11th May, new government plans to force restaurants, cafes and pubs with more than 250 employees include calorie counts on their menus were revealed in the Queen’s speech. This follows the announcements of July 2020 where the government planned to “tackle obesity” in Britain, with the goal of encouraging people to lose weight in order to save the NHS and reduce the risk of COVID-19. The implication of these calorie counts, according to care minister Helen Whately in July last year, is that more information about the food we’re eating will help consumers make an “informed choice”.
This is only the latest in a series of public health campaigns and diet pitches which rest on the idea that all it takes to get healthy is some self-control and basic arithmetic. Ever since the calorie was introduced to the public imagination as a way of measuring (and therefore controlling) your food consumption, it has driven the mentality that understanding your body is a matter of measuring calories in vs calories out. But as with BMI and 10,000 steps a day, the measurement of calories and their relation to our health isn’t as simple or successful as the numbers suggest.
Where did calorie counting come from?
The term ‘calorie’ was first used by French physician and chemist Nicolas Clément in the 1820s while lecturing to his Parisian students about heat engines. It only transferred its definition to measuring energy in food specifically when it was introduced to America in the 1890s by Wilbur Olin Atwater, who embarked on an exhaustive study to burn and then measure the caloric content of over 500 foods with the purpose of helping impoverished people understand how to get the most out of their food. From this study, Atwater determined the average number of calories in the three main sources of energy in food: fat, carbohydrates and protein. He found that fats were worth around 9 calories per gram and carbs and proteins were worth 4 calories per gram. The 4-9-4 method, or the Atwater system, is still how calorie values on food labels are determined today.
Until this point, the concept of calories remained outside public consciousness. It was only when American physician and author Lulu Hunt Peters (the so-called ‘queen of calories‘) wrote her bestselling diet book Diet and Health: With Key to the Calories in 1918 that calorie counting, and dieting more generally, really took off. With her engaging writing, Peters took the complicated concept of calories and made it digestible for a mass audience. Simply put, food was no longer understood in units of slices or pieces. A slice of bread was now 100 calories of bread. And according to her, if you consumed under 1,200 calories per day, no matter what you ate you would lose weight.
Peters actually positioned dieting in this way as both a moral and patriotic duty for women during World War One. To reduce the number of calories you ate yourself was to better distribute them to troops on the front line (or at least to your children). Consequently, to ‘hoard’ the valuable commodity of fat was to be unpatriotic. Her patriotism was intertwined with fatphobia: she called overweight people “fireless cookers” who were hoarding in a time of war.
Since then, the popularity of explicit calorie consumption (and restriction) as a route to weight loss and being ‘healthier’ has ebbed and flowed but whether you follow Weight Watchers or the grapefruit diet, restricting your calorie intake is usually fundamental. No matter what formulation of macronutrients you consume, calorie (and calorie control) is king. This was ingrained further when it became part of food packaging in the UK in 1998. From that point on, you couldn’t escape knowing the exact nutritional content of a portion of pasta or a chocolate bar, with calories being listed in pride of place.
Besides the fatphobia at the root of Lulu Hunt Peters’ positioning, the problem with this is that it all presupposes that the measurement of calories, and calories themselves, is accurate, and that if you eat less and move more you will always lose weight.
How accurate are calories?
There is far more guesswork in working out calorie amounts than the numbers suggest. The aforementioned Atwater system is still in use today, as is the fundamental structure of the bomb calorimeter he and his team used (a thick-walled steel container used to calculate the energy contained in a substance by measuring the heat generated when it burns). But the Atwater system was created based on no prior data and despite having far more understanding of our bodies than we did in the 1890s, this method of calculating calories has never been retested. The problems with it are known to the scientific and health establishments but changes to the system seem far off. As reported by Peter Wilson for The Economist: “Officials at the WHO acknowledge the problems of the current system, but say it is so entrenched in consumer behaviour, public policy and industry standards that it would be too expensive and disruptive to make big changes.”
Even if we take Atwater’s 4-9-4 method at face value, it still presupposes that a calorie is always a calorie. In other words, that the caloric value of something is always true and stable. However everything from the temperature of the food and the time of day it’s consumed to the preparation can shift how much a calorie is ‘worth’ before it enters your system. Once it is in your system, there is evidence to show that each person will process food differently. From your hormone levels to your history of dieting to your basal metabolic rate, all of this will alter how much energy you will gain from something. Jess Griffiths, the clinical training lead at the UK’s eating disorder charity Beat, tells R29 that two people of identical weight will still have different caloric needs. “There’s evidence out there to suggest that you can take two people who are the same weight and give them exactly the same calories, and actually their body might need different things. They don’t always have the same energy requirements.”
Registered dietitian Kirsty Barrett echoes this. “I think calorie estimate can be useful in a very general way but everyone’s energy needs vary depending on their size and activity, and it will also vary on a day-to-day basis as some days we’re more active than others. It’s the overall trend rather than the calories each specific day that matter.”
Unlike Lulu Hunt Peters’ assertion that people are “cookers” with energy they either spend or hoard, Jess emphasises that our bodies do not work like a bomb calorimeter. “The body is a lot more complicated than how food is measured. To get the calorie intake from food it’s burned to see what energy comes out of it, but bodies aren’t furnaces! We have different enzymes at work, we have a really complex digestive system.”
So can counting calories really make us healthier?
Despite all these complications and questions around calorie counting and reducing intake, the question still remains: can calorie counting work? There are plenty of success stories, public health campaigns and diet programmes that would lead you to believe that it does. But reducing calories has been shown time and again not to lead to better health, especially when low calorie is the sole focus while sugar content and nutritional value more generally is not questioned. Take the fact that the trend and appetite for low calorie and low fat diets coincided with the biggest rise in obesity worldwide. Jess states point-blank: “There’s no evidence to support that calorie counting makes anyone healthier.” And even if there’s a short-term reduction in weight, there’s the blunt fact that about 90% of dieters eventually regain all the weight they lost.
With regards to the government’s latest initiative, there’s not even evidence to suggest that printing calorie counts on menus helps people make ‘better’ choices. However increased knowledge and awareness of calorie counts can be actively harmful.
Calorie counting is exceptionally common in disordered eating and eating disorders. Jess cites many of the people she works with as a psychotherapist as having developed a distorted view of what their body needs based on calories. “It becomes about rules rather than intuitive eating and learning when you’re hungry or when you’re not.” Once it becomes a way you view the world and what you eat, it’s exceptionally hard to shake off. This is only more true when calorie counts are plastered wherever you go.
Jess goes on to point out how calorie counts on menus in particular can exacerbate eating disorders and delay recovery. “We know from research that when calories are on the menu, people with anorexia in particular are more likely to choose low density foods so it could really impact their recovery and their energy intake.” And it’s not just an issue of restriction. “Anything that’s encouraging restrictive eating could actually lead to more binge eating episodes. Our stance is regular eating is the best way to combat restriction or bingeing. So of course, anything that is encouraging restriction could lead people’s symptoms to get worse.”
The Beat position is that eating disorders are not about food but about feelings, and in particular tied up with self-esteem. Anything that damages someone’s self-esteem puts them at greater risk. “I think that the level of shame that surrounds us at the moment, through public health strategies and various articles, can be so dangerous for the mental wellbeing of people with eating disorders and everyone in general,” says Jess.
Why the obsession with calories?
Considering the range of evidence, from scientific to anecdotal, that calorie counting does not make one healthier, why do we hold on to it? Beyond structural resistance to change, the sheer simplicity of calories is addictive. Dr Sheri Jacobson, director of Harley Therapy, tells R29 that as humans we want things to be as simple as possible. Calorie counting, much like the 10,000 steps rule, makes taking care of ourselves ‘easy’. “Our minds tend towards reductive thinking: the simpler for our brain, the better. So if we can reduce a dietary rule to a maxim, it’s easy for us to stick to.” The numerical aspect in particular adds to the draw: it makes it concrete and measurable, unlike a feeling of hunger or fullness which is much more amorphous. “All of that is generally appealing to most people, unless you make a conservative effort not to be drawn to it because it’s not healthy for you.”
Jess echoes that the certainty offered by calorie counting plays off the perfectionism that many people with eating disorders reckon with. “A lot of life isn’t that certain, feelings aren’t that certain, but an eating disorder really seeks to bring that certainty… I think that a huge aspect of it is that eating perfectly (thinking, I eat what the government says) can really feed into that kind of a perfectionistic style of thinking with certain numbers per day and numeric goals.”
Plus, Sheri says that achieving those numerical goals can release a hit of dopamine that our brain gets addicted to, in the same way we get addicted to social media. “When you’re doing well and you’re moving towards your goal, you’re going to get a boost of dopamine and it’s going to encourage you to want to go back to check again.” It can get obsessional or addictive precisely because it’s so simple and built to satisfy our brain chemistry.
There is a case to be made that calorie counts in the most generalised sense could be useful as a benchmark. For people with anorexia who are working on their recovery, knowing higher calorie options can be helpful, for example. The moment it becomes a be-all and end-all is when you have a problem. “If you get to the point where you’re ruminating over it, and churning over it, and obsessing over it, it occupies too much space,” says Sheri. “Something [whether it’s in relationships or being present] has to yield.”
There doesn’t seem to be a way of using calorie content as a benchmark which doesn’t somehow demonise food choices or gloss over the nuances of every dietary choice people make, unless it is made entirely optional. Kirsty suggests making calorie information available on request to potentially circumvent “feelings of guilt or anxiety when eating. I feel like this information should be available for customers if they request it but not pushed onto everyone.” This however is a small plaster on a much larger wound. How we eat and the choices we make is as much a psychological issue as it is a nutritional one. Everything from socioeconomic background to geography to time shapes what food we have access to, while trauma, stress, shame and poverty all impact how we use food to cope with the world.
If guidance about calories and counters are meant to be routes to a healthier public then they will only fall short, and demonise fat people and people with eating disorders (both thin and fat alike). For any campaign like this to really work, much more needs to be put in place: financial security, psychological support and a radical acceptance that bodies do come in all shapes and sizes. Without that, it is just a self-perpetuating cycle of shame which undermines any healthy relationship someone could have with food – a relationship that is free from shame and based on intuition, not punishment.
If you need support managing an eating disorder or would just like some more information, Beat can help. Give them a call on 0808 801 0677. It’s free and lines are open 365 days a year.
Credit: Original article published here.