CICO: Calories May Matter, but They Sure Don’t Count!

It took me a while to figure out what “CICO” stood for: Calories In Calories Out.  I should know that one by heart, since I spent most of my adolescence listening to my mom go on about it!  One of the phrases I learned to hate: ‘bank your calories.’  It’s right up there with ‘in lieu of a meal.’  Both of those phrases make me really want to hit someone! (so not kidding here!)

As some of you know, I have been educated in ‘calories’ since I was about 13 years old until about two years ago: 35 years of calorie counting! It eventually became the dull roar in the background that I learned to ignore.  My mom meant well of course but it never stopped feeling like there was something inherently wrong with me.  I was always ‘broken’ or ‘substandard.’ I seriously think it’s why most of my pets are the ones no one else wanted: I needed to show them that they had value and they were precious.

When most of the fitness and nutrition world starting condemning the CICO model, I laughed.  Calories are not what weight loss is about after all! All those “experts” were dead-wrong (they were wrong about fat, too!) Calories do count, because if you eat too much of anything, you’re going to gain weight, but keeping your calories under a certain number isn’t what’s going to help you lose weight.  It’s not the calories you need to control: it’s your hormones!

Specifically: insulin, cortisol, ghrelin, leptin and melatonin.  Those are the chief hormones that you want to keep tabs on, because when those are out of control, they can make you miserable! Not to mention stressed out, overweight and sleep deprived!  This is the part where I remind you I am not a doctor and have no medical training at all.  (Unless living for 50 years in an overweight body counts!) Since I’ve begun losing weight, nutrition, weight loss and fitness have become a huge part of my life. Since I spent years doing it wrong, I want to make sure I don’t trade one health problem (super morbid obesity for another- malnutrition)!  This happens way more than people think!  Many of the patients seen by Dr. Nowzaradan (TLC’s My 600 lb Life) weigh more than 500 lbs, have a body mass index of at least 85 and many of them are malnourished.  This is because a lot of what they eat is unhealthy junk food or nutritionally vacant simple carbs (like chips or bagels): lots of calories but no nutrition.  Most people who focus on weight management do so at the expense of nutrition.  They are so busy counting the calories they are eating, they don’t think to count the nutrients they are (or aren’t) getting in those calories!

It’s not the calories in what you eat that matters: it’s what you are actually eating!  Shane Pace (Metabolic Radio podcast & website) likes to remind listeners that calories are information. They are a unit of energy, not Weight Watchers points. (He also likes to remind listeners that calories are invented unit of measurement- “people eat FOOD, not CALORIES!”)  Three hundred calories of beef, three hundred calories of coconut oil and three hundred calories of whole wheat bread are all the same number of calories, but they all affect your metabolism- and your hormones- very differently! Generally, what you want to keep control over is the insulin.  Insulin reacts to the glucose in your blood stream and anything you eat or drink (except maybe plain water) is going to have an effect on the glucose levels, and consequently the insulin levels.  The more glucose in your blood, the more insulin, and this matters because while insulin is present in your bloodstream, your body is storing fat, not burning it.  Your body metabolizes the food you eat into either glucose (carbs), fat/ triglycerides or amino acids (proteins).  The more carbs and the simpler the carbs, the more glucose in the blood and the more insulin in response to the glucose. What you want to manage is the insulin response to the foods you eat, which can be done by making sure the carbs you do eat are the complex carbs that come from non-starchy vegetables.  Starch=sugar=glucose= more insulin in the bloodstream.

So getting back to three hundred calorie examples above: 300 calories of beef will break down to fat and amino acids; the coconut oil is only fat and will enter the blood as a fat/ triglyceride, and the whole wheat bread (a starch) will break down into glucose. The starch will metabolize quickly, will spike the glucose and subsequent insulin response to clear the glucose, which will cause the blood sugar (glucose) levels in the blood to drop dramatically.  This is the after-eating “crash” that hits a lot of people about 2:00-3:00 p.m. after their chips-and-sandwich lunch at the office.  This is why people have that afternoon slump about 3:00 p.m.

The beef and the fat however won’t cause an insulin spike or the subsequent “crash.”  Both of these macronutrients (fat and protein) take longer to break down so there is a slower and steadier release of nutrients into the blood so instead of sending you on an energy rollercoaster, you cruise along at the same pace.  Your brain and body like to have the blood sugar as even as possible.  The  steady nutrient release from the fat and protein will do that, unlike the starchy whole wheat bread.

There is also another side effect from the “after lunch crash”: most people get hungry again.  Their brain receives the signal that blood sugar is low and triggers ghrelin, the hunger hormone. For a lot of us, this also manifests as cravings for starchy things like chips, crackers and breads.  These are most quickly metabolized into energy and so that’s what the body wants- fast energy to get that falling blood sugar back up! The problem is that this is one more ride on the glucose rollercoaster: you go up fast and fall just as quickly- there is no steady even ride with starches!  This is something I can speak to from personal experience: this is the ride I was stuck on for a couple of decades at least: I’d eat something starchy, go up, crash, get hungry and do it all over again!  The problem is “300 calories!”  300 calories of bread for breakfast; 150 calories of granola bar snack, 300 calories of bread for lunch, another 150 calories for bagel snack, 300 calories of pasta for dinner and another 200 calories of cookies for dessert.  That’s 1400 calories, assuming I didn’t eat or drink anything else during the day (which was really unlikely)!  “I’m hungry so my body must need fuel!” What my body needed was for the glucose levels to stay even and steady- not jump up and down every couple of hours!  So while my brain was trying to even out the blood sugar, I was eating way more calories than I needed, most of which was just getting stored since I never had a chance to get out of fat-storage mode thanks to the glucose and insulin in my bloodstream, and I kept gaining weight and kept getting tired and hungry all the time.  My hormones were a wreck and I kept bouncing between insulin and ghrelin releases.

The other hormones mentioned above (cortisol, leptin and melatonin) are all necessary to keep your body in a healthy balance. Leptin is the satiety hormone.  It’s ghrelin’s counterpart and turns off your hunger, but it takes a little bit of time to hit the brain.  This is why one of the strategies for weight loss includes eating more slowly.  Remember Thanksgiving where you felt like a beached whale because you ate too much?  You probably ate too much too fast so by the time the leptin hit your brain, your stomach was already way too full.  Eating more slowly allows the leptin to be released (triggered by the fat in the blood) and get to the brain to turn off the hunger.  This is another reason the protein and fat are more satisfying: since they take longer to metabolize, they are in the blood longer and the more leptin (“hunger is off” hormone) to send that message to the brain.

Leptin is also affected by sleep: poor sleep habits lead to poor leptin production.  This is because the body is always tired and the brain is turning off the leptin, because you obviously need more energy(cue the ghrelin and carb cravings!) This is where the melatonin and cortisol come into play!  Melatonin is a sleep hormone and cortisol is a stress hormone (bit of oversimplification here).  Cortisol is the hormone that wakes you up in the morning and it has another surge later in the day, and drops off in the afternoon.  Melatonin does the opposite (the same as ghrelin): it surges later in the day and early evening and wanes early in the morning because melatonin promotes relaxation and sleep.  When there is too much cortisol in the blood, melatonin production is off so all those sleepless nights when you tossed and turned because of job stress? You can thank the cortisol for that!  You were stressed out over something and the body reacts to stress by releasing the cortisol for alertness and energy in a dangerous situation.  (Obviously if you are about to be eaten by a bear, being sleepy, mellow and relaxed are not conducive to your survival!) Cortisol also intensifies the insulin spike in the morning (grab that energy so you’ll have it when you need it to run from that bear- or irate boss!) So that breakfast sandwich you have not only spikes your insulin, the cortisol makes sure the insulin is in the blood for as long as possible!

Melatonin however is carb friendly, and the more carbs you have, the more melatonin is in the blood, the more relaxed you are and the easier it is to sleep.  The more rested you are, the more leptin is produced and less ghrelin is released. To put it simply:

  1. Stay away from starchy carbs, especially in the morning;
  2. Eat more nutrient dense non-starchy foods like meats, leafy or cruciferous veggies, and healthy fats like olives or avocados or their oils;
  3. Manage your stress;
  4. Develop consistent healthy sleep habits.

[Elizabeth Benton (Primal Potential) has distilled this into what she calls The Golden Rules of Carbs and Fat Loss. You can find it on her website by doing a simple search!  She’s awesome!]

For those of us who were raised on the CICO model and cannot imagine trying to lose weight without counting calories, let me tell you flat out: managing hormones worked for me! After 35+ years of counting calories and NOT losing weight, I’ve followed the hormone management model above for the last eighteen months (I went Paleo in April 2015) and I’ve lost 171 lbs, reversed type 2 diabetes, lowered my blood pressure and resolved my asthma.  So, yes, this works!  Despite this, I do know people who’ve had a lot of success with the CICO model; they manage their calories and have lost weight. However, it has never worked for me and for most people I know!  Even if I (or my friends) do lose weight on CICO, eventually the weight comes back.  But if you can manage your calories and stay under (or at) the right number, then go for it!  If you can be happily productive by staying at 1500 calories (0r whatever number), then ignore what I’m telling you here!  Most people don’t want to look at calorie numbers all day every day. They just want to eat healthy delicious food (not calories as Shane reminds us!)

As I’ve said over and over, I am not a doctor (or any kind of health professional) but this is what I’ve learned from other professionals. Namely: Elizabeth Benton at; Shane Pace & Taylor Empey at; Alan Misner at 40+;  Dr. David Ludwig Always Hungry?; Dr. Jason Fung The Obesity Code among others.  I’m also a fan of Living Paleo for Dummies and Nutrition for Dummies for some basic information.  If you are interested in eating Paleo, I also subscribe to Paleo Magazine (and their podcast) as it’s a great resource for all things Paleo and Primal.  Another awesome tool for information and support is My Fitness Pal.  It’s set up as a calorie counting site/ app, but it’s a lot like Facebook for fitness/ nutrition minded people and has some great resources (not to mention all my awesome friends!) I did a blog post on my favorite resources (“Sharing is Caring”).  You can also reach me at




















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