"The groundwork of all happiness is health." - Leigh Hunt

Should I cut calories or increase exercise?

Ask the doctor.

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Question To shed extra pounds, should I focus more on my calorie count or how much time I spend exercising?

Oh It may be very difficult to shed extra pounds without watching your calories and exercising recurrently. But it is just not that straightforward. For years, doctors (including me) have told patients: “You have to burn more calories through exercise than you eat. If you do that, you'll be at a healthy weight.” We even said that not having the ability to maintain a healthy weight, since it was really easy, showed a weakness of character.

It's true that calories in, calories burned, and self-discipline are necessary. However, in my view, it has all the time been clear that some people have more trouble attending to a healthy weight than others. All you needed to do was observe your mates and family. People who all the time have seconds are still skinny. People who eat their food, are still heavy. Now, we're learning why.

Over the past 20 years, medical science has discovered lots of body chemistry that regulates our appetite and metabolism. Some animals are born to be more hungry: natural hormones that increase appetite override those who suppress appetite. The same might be the case with humans. Also, a few of us are born to burn calories more easily. And over the past 10 years, we've discovered a brand new incontrovertible fact that can profoundly affect our ability to realize a healthy weight: the microbiome.

We have known for over a century that many microorganisms (for instance, bacteria and viruses) continue to exist us and in us, akin to in our gut. All of their genes, collectively, are called our microbiome. And, boy, are there lots of them: Our microbiome incorporates 250 to 800 times more genes than human genes. Why this is very important is that these microbial genes make natural chemicals that may enter our bloodstream and affect our body chemistry.

As only one example of how the microbiome affects our weight, we've long assumed that the calories we ingest every day are all absorbed into our blood and distributed around our bodies. , including in our fat cells. This is just not entirely true. Without getting too graphic about it, a few of what we eat leaves our bodies as waste, taking some calories with it. There are people whose gut microbiome seems to soak up more calories than they eat before the calories are lost.

Finally, don't forget that regular exercise has health advantages even for individuals who haven't achieved a healthy weight. Regular exercise is the one reason to shed extra pounds.