1st law of thermodynamic

This law has been over simplified, energy in = energy out. 1st law
states that in a closed system in a thermal equilibrium form of
energy may change but the total energy is conserved.
Put 5 liters of petrol in a car and the car will run for 50 kms this
proves energy in = energy out. Put 5 liters of diesel in the same car
and the car will go nowhere, energy is conserved. In this case the
1st law is fulfilled (energy conservation). In this case energy in is
not = to energy out but energy is conserved. Thus energy in =
energy out + energy stored is an apt equation.
1st and 2nd law together say that in a closed system in thermal
equilibrium energy will be conserved, human body though is not a
closed system and definitely not in a thermal equilibrium, thus
energy will be used & energy will be lost in making available
energy.
We make assumptions about energy and weight which does not
hold true. The energy ( calories) that goes into a human body
translates directly into weight at 4 cals /gm for carbohydrates and
proteins and 9 cals / gm for fat. This is applicable for both weight
in aswell as weight out.
It simply does not happen in this way. We will take a look at a few
examples to see whether the assumptions hold true or not. say
you consume 1000 kcals of carbs i.e 250 gms (4 kcals / gm) & say
you burn 1008 kcals from fat i.e 112 kcals (9 kcals/ gm). So despite
of burning more calories than you consumed still you end up
gaining weight ( 250-112= 138).
Now lets look at another example: you burn 1008kcals from fat
and then you consume 1000kcals of carbs. This will now be stored
as glycogen and glycogen does carry twice the amount of water
 along with it so 250 gms of glycogen with 500 gms of water so in
this scenario ( 750 112= 640gms) so you have gained 640 gms of
weight.
So in the above examples you need to consume 1000 kcals
(111gm) from fat to show some weight loss (112-111=1 gm)
Even if you consumed 1000 kcals containing 990kcals (110 gms)
from fat and 10 kcals (2.5 gms) from carbs u end up gaining half a
gram of weight ( 112.5-112= 0.5 gms).
So if you want to consume 111gms of food, calorie wise you would
end up eating 444 calories of carbs/protein as oppose to 999 kcals
of fat.
So to correct the oversimplification of the law of thermodynamics
of energy balance, energy stored is of significant importance
rather than just energy in = energy out.
Its obvious that in humans body weight is about fat stored versus
fat utilized. So energy in and energy out would be understandable
if it had a perfect correlation with fat storage and fat utilization.
Thus obesity is all about what facilitates fat storage and what
prevents fat utilization.
Fat storage
There are two forms of fat triglycerides and free fatty acids (FFA).
Human (stored) fat is made up of triglycerides, when we talk
about huan fat we refer to triglycerides, whereas FFA are utilized
as fuel.
Trig are made up of 3 FFA which bound together on a glycerol
backbone.
FFA move in and out of the cell. Trigs are too big to move across
the cell membrane.
 FFA keeps cycling in and out of the cell, during this process it gets
utilized as fuel as and when required and if not it gets stored back
in the fat cell.
Once the FFA gets bound to glycerol to form trigs it gets restricted
within the cell and cannot leave the cell till the time trigs get
broken back into FFA and glycerol.
Glycerol plays a critical role in the process of fat storage. Since
glycerol provides the back bone to form trigs it determines the
rate at which trigs are formed.
glucose is required to form glycerol so more glucose more
glycerol formation thus more chances of fat accumulation.
When we consume more and more carbs in out food we are
creating a efficient and favourable condition for fat storage.
When carbs are broken down it gets converted to simple glucose
which thus increases blood glucose levels which makes glucose
readily available to the body.
We came to know in 1920 itself that fat is not just an inert
receptor but it is a metabolically active tissue.
In 1930 rudolph schoenheimer and david rittenberg showed in
one of their studies that FFA keeps cycling In and out of the fat cell
. and there is a continuous formation of trigs from FFA and
glycerol and breakdown of trigs to FFA and glycerol.
In 1948 in the article the physiology of adipose tissue Ernst
Werthheimer and benson Shapiro said that mobilization and
deposition of fat happens continuously regardless of the
nutritional status of the animal they went on to say that the
classical theory of the deposition of fat in the fat cell is due to the
excess calorie consumption has thus been proved wrong.
But what is shocking is that the theory which was proven wrong in
1948 is still being held 65 years later.
 The focus of energy in = energy out has to shift towards the
endocrine system esp to hormone insulin which is stimulated
primarily by carbs.
Primary role of insulin is to return the blood glucose to normal. In
this process the glucose is shuttled to the liver and the muscles
and insulin assists to convert it to glycogen and once the liver and
muscles are topped up with glycogen then the excess is shuttled
to the adipose tissue to be stored as fat. Thus insulin is said to be
the primary fat storage hormone.
Rosalyn yalow and Solomon berson showed that type I does not
release insulin at all (insulin deficient). In type II though
substantial insulin is released by the pancreas but the cells of the
body which are insulin dependant (to take in glucose) fail to
recognize it thus failing to regulate the blood glucose levels. Hence
type II is considered to be insulin resistant.
Type I requires insulin admin since no insulin is produced by the
pancreas, where as in type II it can be managed by medication by
making the cells receptive and responsive to insulin and help
overcome insulin resistance.
Both types of diet can be very well managed with the carb free
diet. In the absence of carbs type II cannot manifest itself.
Obesity will be less common if we follow a low carb diet which
was shared by William banting in 1869.
In type I people start to lose weight, energy intake increases and
the energy output decreases significantly. This raises the curiosity
of the violation of the law of theromodynamics. How can energy
intake be higher with reduced energy out put and still lose weight.
Sugar is lost in urine in type I ( diabetes = sweet urine in greek)
 in one of the obesity conferences in wales in 2010 DR Jeffery
stephens a diabetologist stated that glycosuria (loss of glucose
through urine) estimated to about 500 kcals/day.
What we can see here is that body refuses to store fat in the
absence of insulin.
Still type I are adviced to consume carbs and take insulin which
resumes the ability to store fat. Hence people struggle to avoid
obesity for the rest of their lives.
Just as type I cannot store fat, type II are masters at it.
People who are pre diabetic are insulin resistant and just keep
eating carb and keep storing fat, they become fat storing
machines and eventually they suffer with full blown diabetes.
Type I onset is sudden and dramatic. Whereas type II emerges
over time and can remain undiagnosed for months sometimes
even years.
The advice to the type II diabetics is to avoid carbs coz it is the
macronutrient they cannot tolerate.
the current contrary advice to people (diabetics or not to)
consume starchy food in small portions and at regular intervals.
Edgar gordan had written in the journal of American medical
association the storage of fat and therefore obesity cannot
happen in the absence of glucose metabolism. Glucose cannot be
utilized by most cells without the influence of insulin. Thus it can
be said that obesity is virtually impossible in the absence of
adequate insulin concentrations.
Consuming carbs in abundance converts most of the glucose
metabolized into process called as lipogenesis ( fat formation). On
the other hand low carb intake results in less fat storage and
optimum lipolysis ( fat utilization).
 There are a lot of medical journals and research articles which
show the relation between insulin and weight gain. Almost all of
them conclude that insulin leads to weight gain. Thus we can infer
that carbohydrates lead to weight gain.
Fat utilization
Just as fat storage requires insulin, fat utilization happens coz of
the absence of insulin in circulation.
Fat utilization can only occur when carbs are not available.
When non diabetic consumes carbohydrates his pancreas which
are functioning normally release insulin, insulin facilitates glucose
uptake by the cells, converts glucose to glycogen and converts all
excess glucose to fat.
Pancreas also secrete another hormone called glucagon. Its
function is to convert glycogen to glucose.
Insulin and glucagon work in equal and opposite direction to
regulate blood glucose levels.
When blood glucose levels rise insulin is released which triggers
glycogen storage. Conversely when blood glucose levels are low
glucogon is released which converts stored glycogen into glucose
and is released in the blood stream to regulate blood glucose
levels.
Glucagon also stimulate insulin so that the glucose that is released
in the blood is taken up by the cells which are insulin dependant
for glucose absorption.
Insulin and glucagon are part of a feedback system which
constantly work to keep blood glucose levels stable.
Glucagon also stimulates the breakdown of trigs by stimulating
hormone sensitive lipase when no more glycogen is available for
energy.
 Brain is another facilitator of fat breakdown. It can trigger fat
breakdown coz in the absence of glucose it can utilize ketones
formed from the breakdown of fat and also glucose formed from
the glycerol molecules through a process called as
gluconeogenesis.
Presence of glucagon and absence of insulin causes fat
breakdown.

Misapplication of 1st law of thermodynamics.

Eat less exercise more will compel the body to try restore the
energy intake to the level needed by the body through hunger
driving the individual to eat more and conserve energy by driving
the individual to reduce his physical effort. Thus eat less exercise
more leads to eat more exercise less.
When we are adviced of eating less we automatically make food
choices which are low in calories. Thus we end up eating more of
carbohydrate (4kcals/gm) than fat (9kcals/gm).
This misapplication has led us to give a wrong advice to people
who want to lose weight.
Weight loss is not just a matter of calorie in v/s calorie out. Rather
its about fat storage v/s fat utilization. And this is dependant on
carbohydrate intake which increase fat storage and reduces fat
utilization. Eating more carbohydrates is fundamentally wrong and
most damaging part of the current dietary advice.
Body is just unable to store fat in the absence of insulin (insulin is
the primary fat storage hormone). When we consume
carbohydrates, glucose levels in the blood rises causing pancreas
to release insulin in case of non diabetic people. In case of type I
insulin needs to be administered since pancreas do not produce
insulin. In type II the pancreas only release insulin after
 carbohydrate consumption. If you do not consume carbohydrate
there is no necessity for insulin response or insulin administration
in case of type I and thus fat storage cannot occur.

Is calorie a calorie ?
1st law of thermodynamics cannot be applied in isolation as it can
be only applied to a closed system in isolation and thermal
equilibrium. Human body is not a closed system and definitely not
in a thermal equilibrium though it tries to achieve it. The human
body carries out a lot of metabolic reactions and hence 2nd law of
thermodynamics must also be considered along with the 1st law.
2nd law suggests that energy will be lost and energy will be used
up to convert to other forms of energy.
E.g: in case of heating the water in a vessel on gas . gas energy is
used to heat the water. Gas energy is used to heat the water by
converting gas energy to heat energy. Some energy is lost in the
process where the vessel gets heated and some is lost out of the
vessel since the vessel is not closed.
In humans energy will be lost and thus the 2nd law must be applied
which is a law of entropy.
This 2nd law has been ignored by the proponents of calorie is a
calorie.
2nd law is the holy grail from the perspective of weightloss coz
people would want as much energy to be lost from the body and
as much energy used up in making energy available to the body.
The weight loss pill orlistat works on the principle that the fat is
not digested by the body and thus directly eliminated in your
bowels. In this way energy is lost from the body.
 With respect to the second law (entropy) energy used up in
making usable energy is the thermic effect of food
(thermogenesis).
Thermogenesis is 6-8% in carbohydrates,2-3% fat and 25-30% in
protein.
Thermogenesis is a process where percent of nutrient is used up
in digesting and converting it into fuel to be used by the body.
This suggests that carbohydrates are easy to convert into usable
form of energy. Carbohydrates start to digest in the mouth with
the help of salivary enzymes.
Protein breakdown is a much more complex process and thus
difficult for the body to convert into usable energy.
If we apply thermogenesis to a 2000 kcal diet with the
composition being 55% carbohydrate, 30% fat and 15 % proteinit
will yield 1825 kcals available for energy. And if it was for 10%
carbohydrates, 30% fat and 60% protein it will make 1641 kcals
energy available for the body to use. This alone should end the
debate of cal is not a calorie.
As we have just seen that calories from carbohydrates and calories
from protein are different so if a calorie is a calorie the 2 nd law
(entropy) would have been violated. Coz if all calories were the
same then there would not be any difference in making energy
available and the law of entropy would be violated.

Calorie is not a calorie

Prof Alan Kekwick and Dr Gaston pawan performed 3 experiments
which were published in the lancet journal in 1956.
o In the 1st experiment they gave a nutrient composition of
47:33:20 of carbohydrate , fats and proteins respectively.
They kept nutrient composition the same changing the
 amount of calories consumed with 2000, 1500, 1000, 500
kcals/day respectively. There was a definite relationship
between low calories and weight lost which they found but
the relationship was not a straight line. Thus the belief of 1
lb of weight lost with every 3500 calorie deficit was not
accurate.
o In the 2nd experiment they split the subjects in to 3 groups
gave each group 1000kcals but the type of food given was
different. Group A was given 90% carbohydrates , group B
was given 90% fat and group C was given 90% protein. What
they found out in this experiment was that the group that
lost most of the weight was the group that consumed 90%
fat , the group that consumed 90% protein was just
marginally behind the fat group in terms of weight lost but
the carbohydrate group was way behind. Despite of the
calories being the same the weight loss which occurred was
different. Thus it was proven that the composition of the diet
was more important than just counting calories for weight
loss to occur.
o In experiment 3 they took subjects who maintained weight
on a 2000 kcal/ day diet on a 47% carbohydrates,33% fat, &
20% protein. They divided the subjects Into 2 groups one
group was given 2000 kcals/day of high carbohydrate diet
and they all gained weight and the other group was given a
2600 kcals/day diet which was high in fats and proteins and
despite of higher calorie consumption they happened to lose
weight. Then they swapped the group and the group which
was on 2000 kcals of high carbohydrate diet was put on
2600kcals of high fat & protein diet and the other group on
 2000 kcals of high carbohydrate diet. In this case the group
which was put on a high fat & protein diet lost weight and
the other group gained weight. Which confirmed the
composition of diet out the importance of calories.

Is it greed and sloth or something else

Even if we get to see the association between overweight and
sedentary lifestyle. Still people are not overweight coz they are
sedentary but the are sedentary coz they are overweight ( more
weight makes it difficult to move). Thus it compels us to look at
sedentary behavior as the effect and not the cause of being
overweight. This does not mean that the association shown
between sedentary lifestyle leads to being overweight. The effort
is being made to show you that we have been assuming only one
direction of causation and that is sedentary lifestyle causes
obesity it can just as well be the other way round.
The quality of activity done by you is dependent on both quality
and quantity of food (fuel) consumed. E.g if we put in less fuel in
the car then it wont go too far and if we put in the wrong fuel it
will not go anywhere. So if that is true then how do we expect
ourselves to work efficiently when we give them 1000 fewer
calories to lose weight. We have always been assuming that there
are only 2 reasons for being obese gluttony and sloth.
There are other factors which are responsible to gain weight.one
of them is the endocrine system.
o Pineal gland secretes hormone called melatonin which is
secreted during darkness. It works to regulate sleep cycle. It
 is associated with the biological clock. Lack of sleep during
shift work is known to induce weight gain.
o Hypothalamus is a part of the brain. It connects the CNS to
the endocrine system through pituitary gland. Pituitary gland
is known as the master gland and it consist of 2 lobes
anterior pituitary lobe and posterior pituitary lobe.
Anterior pituitary secretes HGH, TSH( to release
thyroxin), ACTH to stimulate adrenal cortex to release
cortisol and androgen with other corticosteroids like
luteinizing hormone which brings ovulation, follicle
stimulating hormone which is responsible for
menstural cycle & interstitial cell stimulating hormone
to produce sperm.
Corticosteroids : cortisol, cortisone, cortisterone and
aldosterone. 1st 3 are known as glucocorticoids as it
plays a key role in glucose metabolismand thus fat
storage and utilization.
Posterior lobe secretes mainly aldosterone ,an anti
diuretic hormone.
o Thyroid gland secretes thyroxin which is important for
metabolism and for BMR. Thyroid is an important factor in
terms of weight loos or weight gain. Under active thyroid
( hypo) results in weight gain, decreased BMR and lethargy
and over active thyroid ( hyper) results in weight loss,
hyperactivity and increased BMR.
o Pancreas: in the total review of hormone and weight gain
pancreas is the single most important part of the endocrine
system.
It secretes enzymes in the small intestine.
 Amylase: to breakdown carbohydrates to simple
glucose.
Lipase: to break down triglycerides into FFA.
Protease: to breakdown proteins into amino
acids.
It secretes insulin and glucagon in the blood.
Insulin as a fat storage hormone was well known as far
back as 1925 when Wilhelm Falta used insulin to treat
underweight adults and anorexia.
o Females after hysterectomy ( removal of ovaries) which
results in no estrogen can lead to excessive hunger and
inactivity and lead to weight gain. Ovaries stop to function
after hysterectomy or during menopause. So when the
ovaries stop the production of eggs the levels of estrogen
falls.
o Estrogen and testosterone decreased adiposity and
progesterone on the other hand increase fat content.
o Progesterone is what increases from the 14th day of the
mnstural cycle and coincidently it is that time when women
complain of weight gain. Women who are on progesterone
only pill have reported of weight gain.
o These hormones induce behavioral change which alter body
weight and adiposity.
There are other causes of obesity other than just energy in and
energy out.
o Had a person not being type I diabetic s/he would not have
lost weight initially and then struggled to control weight for
the rest of his/her life.