By Dr. Colin Michie of AUC Medical School
Dr. Colin Michie has worked as a paediatrician in the United Kingdom, Africa, the Caribbean and the Middle East. He is specialised in nutrition, haematology and infectious diseases. Now the Associate Academic Dean for the American University of the Caribbean Medical School in St. Maarten, his enthusiasm is training medical students and healthcare teams to ensure they deliver better value health care.
The human gut is particularly efficient. Calories from food are absorbed at different rates depending on the nature of the food. For instance, sugars are absorbed faster and more efficiently from fruit juices or fruit pulp rather than from the whole fruit. Cooking makes the fuel components of foods more readily available. For instance, foods such as plantain, cassava and dasheen become more palatable and sweeter with cooking. Soft foods yield up calories more readily than those containing large amounts of fibre.
Once absorbed, food fuels are carefully stored in the body as a carbohydrate store called glycogen or as fat. We have a number of metabolic or glandular systems to ensure calories are carefully stored – another of our biological efficiencies.
If one knows how active a person is, and calculates their basal metabolic rate from their weight and height, it becomes possible to estimate how many calories they require each day. Calories were used during wartime in the last century in different ways. Rationing in Germany during the Second World War limited each person to 1300 calories per day. Because nobody could live off this official allowance, a black market in a range of foods rapidly emerged.
In the UK, members of the public were told that if one household gave up toast for a year, there would be 2000 extra bullets for the war effort. During the 1948 post war Olympics in London, named the austerity games, athletes were entitled to an increased food ration of 5467 calories a day – the same as coal miners – and more than twice the allowance for everyone else. Recent developments of measuring minute by minute how much oxygen one uses, and carbon dioxide one breathes out, it is possible to find out what foods one is burning and how quickly – the procedure of indirect calorimetry.
Calories have redefined foods in a new way to all of us. A generation has grown up knowing that a doughnut, a potato, a slice of pizza or a cold bottle of beer not only looks good and enticing, but that each will deliver in the region of 250 kCal, a fuel kick that will take two hours to walk off.
This new knowledge should be linked very powerfully with the Swedish idea of “lagom”, a modesty they left behind in some traditions in St. Barths. Lagom can be described as “not too much, not too little; just the right amount” – leave the last slice of pie or cake! Another practical strategy from Michael Pollan, a journalist who explored how many of us eat, is to “eat food – not too much – mostly plants”.
Most of us on St. Maarten collect calories and do not do enough physical activity. The consequence is that we build up fat, becoming heavier with larger waistlines and necks. Medical complications develop with this type of obesity.
Counting calories may be a first step to looking at your fuel inputs, your calorie bills and improving your health. Telephone apps such as Edo (scan a food item to understand its health rating) or Foodmaestro (shopping for those with food intolerances or allergies) are useful.
MyFitnesspal tells you when you have reached your calorie limit each day; its graphs provide a report each week. Systems for helping you take on new physical activities on a phone app are becoming increasingly popular, from Lolo Abs to Dailyyoga, Pocketyoga and Sweatco.in, an app that pays you in bitcoin to exercise.
Understanding calories may help us embrace and count them. Without the energy they define, none of us could read this newspaper. May they fit to the curves of your energy.
