7/28/2019 Lecture Slides Week1 1-9 DeterminingIndividualNutrientNeeds

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Determining IndividualNutrient Needs

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D i e t a r y G u i d e l i n e s f o r A m e r i c a n s ( D G A ) 2 0 1 0 K e y

R e c o m m e n d a t i o n s

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 numbersDrink water instead of sugary drinks

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Energy Needs: Indirect Calorimetry

oGoldstandardforres-ngenergyneedsoMetaboliccartmeasuresamountofheatenergyproducedbyanindividualby

determiningtheamountofoxygenconsumed

&quan-tyofcarbondioxideeliminated

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Energ y Needs: Predictive Equations

Harris-BenedictEqua1on

o Tradi-onallymostwidelyusedequa-ono Determinesres-ngmetabolicrate(RMR)o RMRisthenmul-pliedbyanac-vityfactor(AF)andinjuryfactor(IF)

o HBEpredictsRMRwithin10%ofmeasuredRMRin69%ofindividuals

o Morelikelytooveres-mateneeds(27%of-me)thantounderes-mate(4%of-me)AmericanDiete,cAssocia,onNutri,onCareManual2005

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Energ y Needs: Predictive Equations

HarrisBenedictEqua1on

o Men:Res-ngmetabolicrate(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-onusesweight(W)inkilograms(kg),height(H)incen-meters(cm),andage(A)inyears

o OnlineHBEcalculator,Cornell:h]p://wwwusers.med.cornell.edu/~spon/picu/calc/beecalc.htm

AmericanDiete,cAssocia,onNutri,onCareManual2005

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Energ y Needs: Predictive Equations

Mifflin-St.JeorEqua1on

oMostreliable,predictswithin10%ofmeasuredRMRinmorenonobeseandobeseindividualsthananyotherequa-on

AcademyofNutri,on&Diete,csEvidenceAnalysisLibrary2006

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Energ y Needs: Predictive Equations

Mifflin-St.JeorEqua1on

oMen:RMR=9.99Xweight+6.25Xheight4.92Xage+5

oWomen:RMR=9.99Xweight+6.25Xheight4.92Xage161

oEqua-onusesweightinkg,heightincen-metersoOnlineMifflinSt.Jeorcalculator:h]p://www.calculator.net/caloriecalculator.html

AcademyofNutri,on&Diete,csEvidenceAnalysisLibrary2006

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Energy Needs: calories per kg

DesiredOutcome Mul1ply

Toloseweight 2025caloriesperkgbodyweight

Tomaintainweight 2530caloriesperkgbodyweight

Togainweight 3035caloriesperkgbodyweight

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Macronutrient Distribution Ranges

MacronutrientDistribu1onRange:PercentofEnergy/Calories

Macronutrient Children,13years Children,418years Adults>18years

Carbohydrate 4565% 4565% 4565%

Fat 3040% 2535% 2035%

Protein 520% 1030% 1035%

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Application: Kcal Needs, Wt Loss

o40yearoldmale,newdxType2DiabetesoHeight:58(68inches,173cm)oWeight:200lbs(91kg)oBMI:30.4(obesecategory)oDesiredoutcomeisweightlossoUsingthekcal/kgmethod,determinehowmanycaloriesperdayheshouldconsume

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Solution: Kcal Needs, Wt Loss

oForweightloss,mul-plyweightinkgby2025kcal/kg

o91kgX2025kcal/kg=18202275kcal/dayoDayswithnoexercise:uselowerendofrangeoDayswithexercise:useupperendofrangeoMidpointofrange:2050kcals

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Application: Est. Carb, Fat, Proo Gentlemanfrompreviousexampleneedsroughly2,050kcal/dayforweightloss

o Butwhatshouldthosecaloriesconsistof?o Samplebreakdownis:

55%caloriesfromcarbohydrate 25%caloriesfromfat 20%caloriesfromprotein

oHowmanygramsofcarb,fat,proteinperdayshouldheeat?

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Solution: Est. Carb, Fat, Pro

Macronutrient %ofCalories

Togetcaloriesfrom[carbohydrate,fat

orprotein]perday

Togetgramsof[carbohydrate,fat

orprotein]perday

Solu1on

Carbohydrate 55%

2,050caloriesX0.55

=1,128caloriesfrom

carbohydrate

1,128caloriesfrom

carb4caloriespergcarb=282g

carbohydrate/day

282gcarbohydrate

Fat 25%

2,050caloriesX0.25

=513caloriesfrom

fat

513caloriesfromfat

9caloriespergfat

=57gramsfat/day

57gfat

Protein 20%

2,050caloriesX0.20

=410caloriesfromprotein

410caloriesfrom

protein4calories

pergprotein=103

gramsprotein/day

03gprotein

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For More Informationo Na-onalIns-tutesofHealthMenuPlanner:h]p://hp2010.nhlbihin.net/menuplanner/menu.cgi

o Interac-veDRIforHealthcareProfessionals:h]p://fnic.nal.usda.gov/fnic/interac-veDRI/

o USDASuperTracker:h]ps://www.supertracker.usda.gov/default.aspx

o FAONutri-onalRequirements:h]p://www.fao.org/ag/agn/nutri-on/

requirements_pubs_en.stm