April Showers bring May flowers and May turns into June

Basal Metabolism – What is it?

A clinical measure of resting energy expenditure (the calories you burn while resting) performed upon awakening 10 to 12 hours after eating and 12 to 18 hours after significant physical activity. In short, it is the minimum energy expended to keep a resting and awake body alive. Please note that the amount of energy needed varies between individuals.

Quick Calculations for BMR

Body weight in kg (lb divided by 2.2 = ____kg)

Body height in cm (inches multiplied by 2.54 = ____cm)

Females:  body weight kg x 0.9 x 24 = ____kcal

Males: body weight kg x 1 x 24 = ____kcal

Thermic Effect of Exercise (TEE) Physical Activity

Very Lightly Active: 30% BMR = ___kcal

Lightly Active: 40% BMR = ____kcal

Moderately Active:  50% BMR= ____kcal

Heavily Active: 65% BMR= ___kcal

Thermic Effect of Food (TEF) or Specific Dynamic Effect of Food

(BMR + TEE) x 10% = Thermic Effect of Food (TEF)

Estimated Total Energy Needs for 24 hours

(BMR + TEE + TEF = Total Energy Needs)

Example:

Body weight in pounds = 124 lbs

Body weight in kilograms = 56.36kg (124lbs ¸ 2.2 = kilograms)

Body height inches = 62 in

Body height centimeters = 157.48cm (62in x 2.54 = centimeters)

Female:  56.36kg x 0.9 x 24 = 1217 kcal

Moderately Active:  50% BMR

1217 x .5 = 609 kcal

TEF

1217 + 609 x 10% = 183 kcal

Estimated Total Energy Needs for 24 hours

1217 + 609 + 183 = 2009 total kcal

Mifflin-St. Jeor Formula

Females:

RMR = (9.99 x weight in kilograms) + (6.25 x height in centimeters) – (4.29 x age in years) – 161

Males:

RMR = (9.99 x weight in kilograms) + (6.25 x height in centimeters) – (4.29 x age in years) + 5

Activity Factor

Lightly active/ sport 1-3 days each week = 1.375

Moderately active/ sport 3-5 days each week = 1.550

Very active/ sport 6-7 days each week = 1.725

Extra active/ sport and physical job = 1.900

Estimated TOTAL energy needs for 24 hour period

BMR x Activity Factor = total needed

Example

Female

[9.99 x 56.36] + [6.25 x 157.48] – [4.92 x 20] – 161 = 1288 kcal

Estimated TOTAL energy needs for 24 hour period

1288 x 1.550 = 1996 kcal needed

Body Mass Index (BMI)

Kg    

M²      

Example

56.36   = 22.7

2.48

The BMI is not the only way to determine body fat. In fact, it is not the most accurate form of measuring body fat either.

Hydrostatic weighing- the patient is submerged entirely underwater and their body density is measured.

·         accurate

·         fat is less dense than lean tissue

·         fat floats

Bioelectrical impedance

·         Low energy current to the body that measures the resistance of electrical flow

·         Fat is resistant to electrical flow

X-ray photon absorptiometry

·         An x-ray body scan that allows for the determination of body fat

Infrared light

·         Assesses the interaction of fat and protein in the arm muscle.

DEXA and Bod Pod

·         DEXA scans your bone mass density and body fat.

·         DEXA scans are pricey. The price varies by region but you can bet on paying approximately $200.00 per scan.

·         Bod Pod is one of the MOST accurate ways to determine your body fat amount.

·         If you can find some place with a Bod Pod you can pay $20 and up for a scan.

And then there’s the common way which involves a measuring tape and calipers. With these methods you are looking for skinfold sites which are:

-tricep                                                -abdominal

-subscapular                                       - thigh

-suprailiaca                                         - midaxillary

- sums

Going back to BMI, once you get your number you’ll need to know the BMI spectrum to know if you’re overweight or not.

Obesity: BMI >30

Overweight: BMI 25-30

Healthy: BMI 19-24

Underweight: BMI < 18.5

Body fat distribution comes in two different forms.

·         Gynoid obesity (pear shape figure) is more common in women.

·         Android obesity (apple-shaped figure) is more common in men.

o   Increases the risk of heart disease and diabetes mellitus

There are several influences on weight gain and obesity

·         40% is heredity and genetic factors

o   Race and ethnicity

·         Sociocultural influences

·         Age and lifestyle factors

·         Gender and ethnicity

·         Socioeconomic factors

o   Socioeconomic status

·         Psychological factors

The health risks involved with obesity are as such:

-heart disease and stroke

-diabetes

-cancers

-joint diseases

Now let’s explore the other extreme of weight…underweight.

Causes:

-illness

-eating disorders

-metabolic factors

Eating disorders:

-          Anorexia nervosa

-          Bulimia Nervosa

Nervosa means disgust with one’s body.

Anorexia nervosa is a psychological loss or denial of appetite. It is characterized by a body weight of less than 85% of expected weight.  Victims of anorexia have an intense fear of gaining weight. 3-10% of anorexia cases result in death from either suicide, heat ailment, or infection. Anorexia often occurs in adolescence and proceeds into adulthood, if they live long enough to reach adulthood. Teens with chronic disease such as diabetes or asthma are especially at risk. Anorexia nervosa occurs in 1 in 200 adolescent girls. 10% of anorexia sufferers are male. Those with anorexia find security in control and is obsessive competitive. The warning signs of anorexia nervosa are hiding and storing food, excessive exercise, withdrawing from friends and family, self-critical, and sleep disturbance. The physical effects of anorexia nervosa are as such:  “skin and bone” appearance, lowering body temperature, appearance of lanugo and loss of hair, lower BMR and decreased heart rate, and depression.

Bulimia nervosa is a binging and purging eating disorder. Vomiting is not the only way they purge. They also use laxatives, diuretics, enemas, and hypergymnasia. They are super secretive in their behaviour. They think that immediately purging the food will keep the body from absorbing the calories, but actually their body easily absorbs 35%-75% of the nutrients and calories by the time they purge. Most bulimics are female young adults, most likely college students. Surprisingly, they are usually at or slightly above normal weight.

Treatment for these two eating disorders is extensive. It requires a team approach with a dietitian, physician, psychologist, nurse and supporting family members.

There is no simple cause for these disorders. Some sufferers have a predisposition for eating disorders but there are still many causes.

-Social factors

                -Expectations for body size and shape.

- Psychological factors

                - Peer relationships

                -Family expectations

                -Emotional trauma

-Biological factors

                -neurotransmitter levels

There are more eating disorders besides the two most common ones known. They are defined as Eating Disorders Not Otherwise Specified (EDNOS). An example is Binge-eating disorder and infantile anorexia.

There is also disordered eating, but do NOT confuse it with eating disorders. Disordered eating is a mild, short-term change in eating patterns in response to a stressful event, illness, or desire to modify diet. It rarely, if ever, requires professional attention.

Now onto dieting and how silly it truly is. Here is the trouble with ‘diets’. The body naturally defends itself against weight loss. It does not want to let go of the fat it’s already accumulated. This happens because thyroid hormone concentrations drop during weight loss and therefore make it more difficult to lose weight. Also, there’s really no such thing as dieting and losing weight and then being fine for the rest of your life. No, no. If you want to lose weight and keep it off, you don’t need a diet…you need a LIFE STYLE CHANGE!!! Obesity is a chronic disease and the treatment for it requires long-term lifestyle changes. Another trouble with diets is weight cycling also known as yo-yo dieting. Here’s the thing, any weight gained after losing weight is primarily more than the weight you originally lost. The first weight loss is basically water weight. When you lose 1 pint of water, you lose one pound of weight. In rapid weight loss, very little fat is lost. So if you plan to lose weight, it is best to go slow and steady. It is never a good idea to put your body through an extreme change. You should not attempt weight loss unless you are committed and motivated because otherwise you will gain the weight, plus even more weight, when you fail your diet. Don’t bother with weight loss drugs. They don’t work and they suck up your money!!! And surgery should be a VERY LAST resort!!!!

Let’s observe some popular diets. VLCD, Very Low-Calorie Diet…I’m just going to say this now. BAD IDEA!! Calories are energy…you need energy to live and get through the day. Besides that, it can cause ketosis, which I will explain soon. This diet may help you lose 3 to 4 pounds a week but it decreases your basal metabolic rate. It also requires CAREFUL physician monitoring and the health risks include cardiac problems and gallstones.

Ketosis is a severe carbohydrate deficiency and forces the body to convert fat to ketones. Ketones are then used as an alternative energy source. CARBS ARE AN ENERGY SOURCE, JUST SUCK IT UP AND EAT THEM!!!

Ketogenic diets are high in protein and fat and low in carbohydrates, never a good idea. Health risks from this diet includes reduced athletic performance, keto breath (smells like finger nail polish remover), orthostatic hypotension, failure to keep weight off, constipation, kidney stones, rising blood pressure with age, gout, osteoporosis, heart disease risk increases, risk of certain cancers.

And so losing weight is not a short-term thing, it's a long-term lifestyle change. You have to be willing to make this change and keep it up. Frivolous diets will not help you. 

Lemme know if you have any nutritional question and I'll research and answer.

Cheers,

Claire