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Determining Individual Nutrient Needs

Dietary Guidelines for Americans (DGA) 2010 Key Recommendations

Balancing Calories Enjoy your food, but eat less Avoid oversized portions Foods to Increase Make half your plate fruits and vegetables Switch to fat-free or low-fat (1%) milk Foods to Reduce Compare sodium in foods like soup, bread, and frozen meals and choose the foods with lower numbers Drink water instead of sugary drinks

Energ y Needs: Indirect Calorimetr y

o Gold standard for res-ng energy needs o Metabolic cart measures amount of heat energy produced by an individual by determining the amount of oxygen consumed & quan-ty of carbon dioxide eliminated

Energ y Needs: Predictive Equations

Harris-Benedict Equa1on o Tradi-onally most widely used equa-on o Determines res-ng metabolic rate (RMR) o RMR is then mul-plied by an ac-vity factor (AF) and injury factor (IF) o HBE predicts RMR within 10% of measured RMR in 69% of individuals o More likely to overes-mate needs (27% of -me) than to underes-mate (4% of -me)
American Diete,c Associa,on, Nutri,on Care Manual, 2005

Energ y Needs: Predictive Equations

Harris Benedict Equa1on o Men: Res-ng metabolic rate (RMR) = 66.47 + 13.75(W) + 5(H) 6.76(A) o Women: RMR = 655.1 + 9.56 (W) + 1.7 (H) 4.7 (A) o Equa-on uses weight (W) in kilograms (kg), height (H) in cen-meters (cm), and age (A) in years o Online HBE calculator, Cornell: h]p://www-users.med.cornell.edu/~spon/picu/calc/ beecalc.htm
American Diete,c Associa,on, Nutri,on Care Manual, 2005

Energ y Needs: Predictive Equations

Miin-St. Jeor Equa1on o Most reliable, predicts within 10% of measured RMR in more nonobese and obese individuals than any other equa-on

Energ y Needs: Predictive Equations

Miin-St. Jeor Equa1on o Men: RMR = 9.99 X weight + 6.25 X height 4.92 X age + 5 o Women: RMR = 9.99 X weight + 6.25 X height 4.92 X age 161 o Equa-on uses weight in kg, height in cen-meters o Online Miin-St. Jeor calculator: h]p://www.calculator.net/calorie-calculator.html
Academy of Nutri,on & Diete,cs, Evidence Analysis Library, 2006

Energ y Needs: calories per kg

Desired Outcome To lose weight To maintain weight To gain weight Mul1ply 20-25 calories per kg body weight 25-30 calories per kg body weight 30-35 calories per kg body weight

Macronutrient Distribution Ranges

Macronutrient Distribu1on Range: Percent of Energy/Calories Macronutrient Carbohydrate Fat Protein Children, 1-3 years 45-65% 30-40% 5-20% Children, 4-18 years Adults > 18 years 45-65% 25-35% 10-30% 45-65% 20-35% 10-35%

Application: Kcal Needs, Wt Loss

o 40 year old male, new dx Type 2 Diabetes o Height: 58 (68 inches, 173 cm) o Weight: 200 lbs (91 kg) o BMI: 30.4 (obese category) o Desired outcome is weight loss o Using the kcal/kg method, determine how many calories per day he should consume

Solution: Kcal Needs, Wt Loss

o For weight loss, mul-ply weight in kg by 20-25 kcal/kg o 91 kg X 20-25 kcal/kg = 1820-2275 kcal/day o Days with no exercise: use lower end of range o Days with exercise: use upper end of range o Midpoint of range: 2050 kcals

Application: Est. Carb, Fat, Pro

o Gentleman from previous example needs roughly 2,050 kcal/day for weight loss o But what should those calories consist of? o Sample breakdown is:
55% calories from carbohydrate 25% calories from fat 20% calories from protein

o How many grams of carb, fat, protein per day should he eat?

Solution: Est. Carb, Fat, Pro

Macronutrient % of Calories To get calories from [carbohydrate, fat or protein] per day To get grams of [carbohydrate, fat or protein] per day Solu1on 1,128 calories from 2,050 calories X 0.55 carb 4 calories per = 1,128 calories from g carb = 282 g carbohydrate carbohydrate/day 2,050 calories X 0.25 = 513 calories from fat 2,050 calories X 0.20 = 410 calories from protein

Carbohydrate

55%

282 g carbohydrate

Fat

25%

513 calories from fat 9 calories per g fat 57 g fat = 57 grams fat/day 410 calories from protein 4 calories per g protein = 103 grams protein/day 103 g protein

Protein

20%