DIETARY COMPUTATION

BASAL METABOLISM
Is the measure of energy needed by the body at rest for all its internal chemical activities Also known as Required Energy Expenditure (REE)

Calculation for REE

Rule of Thumb = 1 kcal per kg per hour (male)

= 0.9 kcal per kg per hour (female)

Harris-Benedict formula (use of weight, height, age and sex) REE = 66 + [13.7 x wt(kg)] + [5 x ht(cm)] [6.8 age(yr)] REE = 655 + [9.6 x wt(kg)] + [1.8 x ht(cm) [4.7 x age (yr)]

 Biologic Body Weight raised to the power

Determine Metabolic body size is known based on weight in kilograms (see table) multiplied by 70

Body Weight in kg and Metabolic Body Size (kg)

Kilograms 5 10 Metabolic Body Size (kg) 3.3 5.6

15
20 25 30

7.6
9.5 12.1 12.8

35
40 45 50

14.4
15.9 17.4 18.8

65
70 80 90

21.6
24.2 26.7 29.2

100

31.6

Factors Affecting the Basal Metabolic Rate (BMR)

Surface area
The greater the body surface area, the greater the amount of heat loss will be, and in turn, the greater the necessary heat produced by the body.

Sex
Women have a metabolism of 5-10% lower than men when they are of the same weight and height.

Age
Metabolic rate is highest during periods of rapid growth (1st and 2nd year of life) Peak through the ages of puberty and adolescence BMR declines slowly with increasing age

 Body composition
Large adipose tissue = lowers BMR Muscular development = increase in BMR

State of nutrition
Starvation/undernourishment = lowers BMR as much as 50 % below normal

Sleep
BMR falls approximately 10-15% than of waking levels.

 Endocrine glands
Secretion of endocrine glands are the principal regulators of the Metabolic rate.

Fever
Increases the BMR about 7% for each degree rise in the body temperature above 78.6 F.

Computation of Desirable Body Weight (DBW)

Ador Dionisios Method
Height
For every 5 feet, allow 100 lbs for female and 110 for male For each additional inch, allow 2 lbs each

Age
for every 5 years between 25 to 50 years, 2 lbs additional

Tannhausers Method
Height in cm 100 cm Take 10% of the remainder and subtract the answer from the remainder Example:
DBW of 45 years old male, 54 tall Height = 54 = 64 inches = 162.56 cm 162.56 cm 100 cm = 62.56 10% of 62.56 cm = 6.256 62.56-6.256 = DBW (kg) 56.7 kg = DBW 126 lbs = DBW

ESTIMATING TOTAL ENERGY NEED

Total energy need of an individual is the composite of energy necessary to replace basal metabolic needs, energy expenditure for physical activities, thermogenic effect of food and other factors

Methods of Estimating Total Energy Needs

Method I
Based on desirable body weight (DBW) according to occupation; often used in clinics and hospitals. Example:
50 kg man doing moderate activities 50 kg x 40 (moderate work see chart) = 2400 kcal/day

Occupation or activity

Female kcal/lb kcal/kg 12 14 16 18 25 30 35 40 kcal/lb

Male kcal/kg 14 16 18 20 30 35 40 44

Bed Patient Light Work Moderate Work Heavy Work

Recommended Dietary Allowances for Filipinos

Age 20-39 40-49 50-59 Men 2580 2450 2320 Women 1920 1820 1730

60-60
70-79

2060
1810

1540
1340

Method used by the WHO

Basal Metabolic needs Multiplied by Type of Activity
Example: 50 kg man doing moderate activity Get the REE first REE of 50 kg is 1326 (using Biologic Body Weight raised to power) 1326kcal x 1.7 (moderate activity see chart) 2254 kcal

Types of Activity Very Light Light Moderate

Men 1.3 1.6 1.7

Women 1.3 1.5 1.6

Heavy
Very Heavy

2.1
2.4

1.9
2.2

BODY MASS INDEX (BMI)

Is the ration of weight to height How to calculate for BMI:
BMI = weight in kg (height in meters)2