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
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