Re: Caloric Accuracy & Under Reporting

[Guest guest]

--- In , Jeff Novick <chefjeff40@...>

wrote:

>

> from another discussion list I am on....

>

> Many of us have heard the stories of 30+BMI clients

> who report that they eat no more than 1,000- to 1,200

> calories a day. When Dr. Heymsfield put 17

> such clients (average BMI: 33) into his metabolic lab

> he found that 16 of 17 had REEs ±15% of

I guess I consider 10% or 15% of predicted REE very signifcant. I

think the rule of thumb to predict REE is 10 times body weight. I

guess we could use -Benedict, Owen, or Mifflin, or one of the

other estimates but why not just pick the rule of thumb -- 10

calories per pound.

A 200 pound person's predicted REE would be 2,000 calories. But it

could also be 1,800 or even 1,670, but let's take the 1,800 (80%

falling within +/- 10%).

That means that all else being equal, a person who's REE is 1,800

but thinks it's 2,000, and counts calories scrupulously, is going to

accumulate a pound every 18 days (1 pound = 3,500 calories). That's

20 pounds a year (again, all other things being equal).

I don't dispute that a lot of people believe they are consuming

1,200 calories per day when they really are consuming 2,000 or more

calories. I've done it myself.

Despite my best efforts over the years, I put on about 10 lbs a

decade, more or less linearly, after college graduation. I would

acclimate to each increment and consider it normal. I don't any more.

These days, I scrupulously count calories. My routine is a lot like

JW's. Simple foods, weighed, along with a set of standard recipes, I

make notes immediately after eating. Eventually, I'll reach the

point of standard quantities, for a limited food set (relatively)

and notes will be superfluous.

There are dozens of papers (at least) comparing different methods of

estimating REE. Here's a recent one. It suggests that Mifflin has

the best predictive value compared to indirect colorimetry.

http://tinyurl.com/oj8a6

Also, I wouldn't enjoy spending a day or two in a jumbo calorimeter

bomb. Here's an outfit that offers indirect calorimetry (by

measuring oxygen uptake and expiration). Jeff: Do you know how that

compares to a metabolic chamber?

Mike

--- In , Jeff Novick <chefjeff40@...>

wrote:

>

> from another discussion list I am on....

>

> Many of us have heard the stories of 30+BMI clients

> who report that they eat no more than 1,000- to 1,200

> calories a day. When Dr. Heymsfield put 17

> such clients (average BMI: 33) into his metabolic lab

> he found that 16 of 17 had REEs ±15% of

> predicted,()(Heymsfield) which is considered to be

> within the normal range.([ii])(Buhl) Their initial

> self-reported energy intake was 1,054 ±211 kcals/d,

> while their measured intake was 2,227 ±647 kcals/d.

> Other metabolic studies of subjects with

> " self-reported diet resistance " have found comparable

> underreporting of energy intake.([iii])(Lichtman)

>

> In healthy people the " normal " range of measured REE

> falls in a standard bell curve distribution with 80%

> of measurements falling ±10% of predicted, and 95%

> falling ±15% of predicted. (Note that Dr. Heymsfield's

> subjects fit this range). The remaining 5% fall within

> ±20% of predicted, which is considered to be either

> high or low.(7)(DuBois) In this case " healthy " means

> euthyroid, disease free and not on medications which

> may affect REE.

>

> Heymsfield's study reminds us that underreporting of

> energy intake is the norm rather than the exception.

> Heymsfield's subjects underreported an average of 53%.

> The data indicate that most subjects underreport

> energy intake; in general underreporting increases as

> BMI increases;([vi])(Johansson) overweight/obese

> persons may have intakes approximately 40% higher than

> reported, while those with a £25 BMI underreport by

> about 20%.18(Lichtman)

>

> Subjects underreport for a variety of reasons, and we

> clearly have much to learn in understanding this

> phenomenon. The most obvious is that it's difficult to

> accurately estimate portions without weighing and

> measuring. If records are written at the end of the

> day, or the next day, incomplete recall contributes to

> underestimation. There may also be psychosocial

> motivations ( " impression management, " the desire to

> appear to be doing what is perceived to be expected)

> as well as the unconscious process of

> denial.(16)(Heymsfield) Some data indicates that

> locally labeled baked goods frequently contain

> significantly more calories than labeled

> for,([vii],()[viii])(Young) therefore, in some

> cases subjects may be regularly consuming mislabeled

> food items.

>

> Underreporting of energy intake represents a

> significant challenge for nutrition professionals

> attempting to facilitate weight loss. The problem: you

> cannot help your client problem solve what has yet to

> be acknowledged. Therefore, if the fallacy of

> underreported intake cannot be " confronted " the path

> forward is effectively blocked. Being confident in

> your knowledge of REE supports nutrition professionals

> in addressing underreporting of energy intake.

> Physiologically plausible reported intakes should (at

> minimum) fall 1.25 times REE, although the range for

> low to moderately active individuals is usually 1.5 to

> 1.7.(14) (2002 NAS)

>

> Heymsfield SB, Darby PC, Muhlheim LS, Gallagher D:

> The calorie: myth, measurement, and reality. Am J Clin

> Nutr. 1995;62:1034S-41S.

>

> [ii] Buhl KM, Gallagher D, Hoy K, s DE:

> Unexplained disturbance in body weight regulation:

> Diagnostic outcome assessed by doubly labeled water

> and body composition analyses in obese patients

> reporting low energy intakes. J Am Diet Assoc.

> 1995;95:1393-1400.

>

> [iii] Lichtman SW, Pisarska K, Berman ER, Pestone M:

> Discrepancy between self-reported and actual caloric

> intake and exercise in obese subjects. N Engl J Med.

> 1992;327:1893-1898.

>

> [iv] enfield DC, Rowe WA, JS, Cooney RN.

> Validation of several established equations for

> metabolic rate in obese and non-obese people. J Am

> Diet Assoc. 2003:103;1152-1159.

>

> [v] In Press: J Am Diet Assoc. 2004 (new review of

> predictive equations by the ADA Evidence Based Work

> Group on Indirect Calorimetry).

>

> [vi] Johansson L, Solvoll K, Bjorneboe G-EA, Drevon C.

> Under- and overreporting of energy intake related to

> weight status and lifestyle in a nationwide sample. Am

> J Clin Nutr. 1998;68:266-74.

>

> [vii] D, Heshka S, Sepulveda D, Heymsfield S:

> Counting Calories--Caveat Emptor. JAMA.

> 1993;270:1454-1456.

>

> [viii] Young L, Nestle M: Food labels consistently

> underestimate the actual weights of single-serving

> baked products. J Am Diet Assoc. 1995;95:1150-1151.

>

[Guest guest]

Hi Jeff,

For some time, I have thought that Basal Metabolic Rate (BMR), aka

Resting Energy Expenditure (REE), may be a good biomarker for Caloric

Restriction because BMR responds to long-term trends in feeding

behavior. BMR decreases with caloric restriction, as reported in the

Biosphere reports, Keys, PMID 15870104, etc. Also, BMR increases with

overfeeding (PMID: 3538842).

The difference in the actual BMR of a CR-adjusted body from the BMR

calculated from predictive equations like -Benedict and

Mifflin-St_Jeor could be used as an objective biomarker of successful

CRON.

Do you know what type of reference Haymsfield used to calculate the

" predicted " REEs?

Tony

>

> from another discussion list I am on....

>

> Many of us have heard the stories of 30+BMI clients

> who report that they eat no more than 1,000- to 1,200

> calories a day. When Dr. Heymsfield put 17

> such clients (average BMI: 33) into his metabolic lab

> he found that 16 of 17 had REEs ±15% of

> predicted,()(Heymsfield) which is considered to be

> within the normal range.([ii])(Buhl) Their initial

> self-reported energy intake was 1,054 ±211 kcals/d,

> while their measured intake was 2,227 ±647 kcals/d.

> Other metabolic studies of subjects with

> " self-reported diet resistance " have found comparable

> underreporting of energy intake.([iii])(Lichtman)

>

> In healthy people the " normal " range of measured REE

> falls in a standard bell curve distribution with 80%

> of measurements falling ±10% of predicted, and 95%

> falling ±15% of predicted. (Note that Dr. Heymsfield's

> subjects fit this range). The remaining 5% fall within

> ±20% of predicted, which is considered to be either

> high or low.(7)(DuBois) In this case " healthy " means

> euthyroid, disease free and not on medications which

> may affect REE.

>

> Heymsfield's study reminds us that underreporting of

> energy intake is the norm rather than the exception.

> Heymsfield's subjects underreported an average of 53%.

> The data indicate that most subjects underreport

> energy intake; in general underreporting increases as

> BMI increases;([vi])(Johansson) overweight/obese

> persons may have intakes approximately 40% higher than

> reported, while those with a £25 BMI underreport by

> about 20%.18(Lichtman)

>

> Subjects underreport for a variety of reasons, and we

> clearly have much to learn in understanding this

> phenomenon. The most obvious is that it's difficult to

> accurately estimate portions without weighing and

> measuring. If records are written at the end of the

> day, or the next day, incomplete recall contributes to

> underestimation. There may also be psychosocial

> motivations ( " impression management, " the desire to

> appear to be doing what is perceived to be expected)

> as well as the unconscious process of

> denial.(16)(Heymsfield) Some data indicates that

> locally labeled baked goods frequently contain

> significantly more calories than labeled

> for,([vii],()[viii])(Young) therefore, in some

> cases subjects may be regularly consuming mislabeled

> food items.

>

> Underreporting of energy intake represents a

> significant challenge for nutrition professionals

> attempting to facilitate weight loss. The problem: you

> cannot help your client problem solve what has yet to

> be acknowledged. Therefore, if the fallacy of

> underreported intake cannot be " confronted " the path

> forward is effectively blocked. Being confident in

> your knowledge of REE supports nutrition professionals

> in addressing underreporting of energy intake.

> Physiologically plausible reported intakes should (at

> minimum) fall 1.25 times REE, although the range for

> low to moderately active individuals is usually 1.5 to

> 1.7.(14) (2002 NAS)

>

> Heymsfield SB, Darby PC, Muhlheim LS, Gallagher D:

> The calorie: myth, measurement, and reality. Am J Clin

> Nutr. 1995;62:1034S-41S.

>

> [ii] Buhl KM, Gallagher D, Hoy K, s DE:

> Unexplained disturbance in body weight regulation:

> Diagnostic outcome assessed by doubly labeled water

> and body composition analyses in obese patients

> reporting low energy intakes. J Am Diet Assoc.

> 1995;95:1393-1400.

>

> [iii] Lichtman SW, Pisarska K, Berman ER, Pestone M:

> Discrepancy between self-reported and actual caloric

> intake and exercise in obese subjects. N Engl J Med.

> 1992;327:1893-1898.

>

> [iv] enfield DC, Rowe WA, JS, Cooney RN.

> Validation of several established equations for

> metabolic rate in obese and non-obese people. J Am

> Diet Assoc. 2003:103;1152-1159.

>

> [v] In Press: J Am Diet Assoc. 2004 (new review of

> predictive equations by the ADA Evidence Based Work

> Group on Indirect Calorimetry).

>

> [vi] Johansson L, Solvoll K, Bjorneboe G-EA, Drevon C.

> Under- and overreporting of energy intake related to

> weight status and lifestyle in a nationwide sample. Am

> J Clin Nutr. 1998;68:266-74.

>

> [vii] D, Heshka S, Sepulveda D, Heymsfield S:

> Counting Calories--Caveat Emptor. JAMA.

> 1993;270:1454-1456.

>

> [viii] Young L, Nestle M: Food labels consistently

> underestimate the actual weights of single-serving

> baked products. J Am Diet Assoc. 1995;95:1150-1151.

>

[Guest guest]

Hi Tony:

Worth noting that not everyone defines basal metabolic rate as

synonymous with resting metabolic rate. And the latter is

appreciably higher than the former.

Here is a paper which found that, as measured in 'kcal/kg body

weight', RMR was 12% to 22% (two groups) higher than BMR:

http://www.vard.org/jour/04/41/1/bauman.html

Rodney.

>

> Hi Jeff,

>

> For some time, I have thought that Basal Metabolic Rate (BMR), aka

> Resting Energy Expenditure (REE), may be a good biomarker for

Caloric

> Restriction because BMR responds to long-term trends in feeding

> behavior. BMR decreases with caloric restriction, as reported in

the

> Biosphere reports, Keys, PMID 15870104, etc. Also, BMR increases

with

> overfeeding (PMID: 3538842).

>

> The difference in the actual BMR of a CR-adjusted body from the BMR

> calculated from predictive equations like -Benedict and

> Mifflin-St_Jeor could be used as an objective biomarker of

successful

> CRON.

>

> Do you know what type of reference Haymsfield used to calculate the

> " predicted " REEs?

>

> Tony

>

>

> --- In , Jeff Novick <chefjeff40@>

wrote:

> >

> > from another discussion list I am on....

> >

> > Many of us have heard the stories of 30+BMI clients

> > who report that they eat no more than 1,000- to 1,200

> > calories a day. When Dr. Heymsfield put 17

> > such clients (average BMI: 33) into his metabolic lab

> > he found that 16 of 17 had REEs ±15% of

> > predicted,()(Heymsfield) which is considered to be

> > within the normal range.([ii])(Buhl) Their initial

> > self-reported energy intake was 1,054 ±211 kcals/d,

> > while their measured intake was 2,227 ±647 kcals/d.

> > Other metabolic studies of subjects with

> > " self-reported diet resistance " have found comparable

> > underreporting of energy intake.([iii])(Lichtman)

> >

> > In healthy people the " normal " range of measured REE

> > falls in a standard bell curve distribution with 80%

> > of measurements falling ±10% of predicted, and 95%

> > falling ±15% of predicted. (Note that Dr. Heymsfield's

> > subjects fit this range). The remaining 5% fall within

> > ±20% of predicted, which is considered to be either

> > high or low.(7)(DuBois) In this case " healthy " means

> > euthyroid, disease free and not on medications which

> > may affect REE.

> >

> > Heymsfield's study reminds us that underreporting of

> > energy intake is the norm rather than the exception.

> > Heymsfield's subjects underreported an average of 53%.

> > The data indicate that most subjects underreport

> > energy intake; in general underreporting increases as

> > BMI increases;([vi])(Johansson) overweight/obese

> > persons may have intakes approximately 40% higher than

> > reported, while those with a £25 BMI underreport by

> > about 20%.18(Lichtman)

> >

> > Subjects underreport for a variety of reasons, and we

> > clearly have much to learn in understanding this

> > phenomenon. The most obvious is that it's difficult to

> > accurately estimate portions without weighing and

> > measuring. If records are written at the end of the

> > day, or the next day, incomplete recall contributes to

> > underestimation. There may also be psychosocial

> > motivations ( " impression management, " the desire to

> > appear to be doing what is perceived to be expected)

> > as well as the unconscious process of

> > denial.(16)(Heymsfield) Some data indicates that

> > locally labeled baked goods frequently contain

> > significantly more calories than labeled

> > for,([vii],()[viii])(Young) therefore, in some

> > cases subjects may be regularly consuming mislabeled

> > food items.

> >

> > Underreporting of energy intake represents a

> > significant challenge for nutrition professionals

> > attempting to facilitate weight loss. The problem: you

> > cannot help your client problem solve what has yet to

> > be acknowledged. Therefore, if the fallacy of

> > underreported intake cannot be " confronted " the path

> > forward is effectively blocked. Being confident in

> > your knowledge of REE supports nutrition professionals

> > in addressing underreporting of energy intake.

> > Physiologically plausible reported intakes should (at

> > minimum) fall 1.25 times REE, although the range for

> > low to moderately active individuals is usually 1.5 to

> > 1.7.(14) (2002 NAS)

> >

> > Heymsfield SB, Darby PC, Muhlheim LS, Gallagher D:

> > The calorie: myth, measurement, and reality. Am J Clin

> > Nutr. 1995;62:1034S-41S.

> >

> > [ii] Buhl KM, Gallagher D, Hoy K, s DE:

> > Unexplained disturbance in body weight regulation:

> > Diagnostic outcome assessed by doubly labeled water

> > and body composition analyses in obese patients

> > reporting low energy intakes. J Am Diet Assoc.

> > 1995;95:1393-1400.

> >

> > [iii] Lichtman SW, Pisarska K, Berman ER, Pestone M:

> > Discrepancy between self-reported and actual caloric

> > intake and exercise in obese subjects. N Engl J Med.

> > 1992;327:1893-1898.

> >

> > [iv] enfield DC, Rowe WA, JS, Cooney RN.

> > Validation of several established equations for

> > metabolic rate in obese and non-obese people. J Am

> > Diet Assoc. 2003:103;1152-1159.

> >

> > [v] In Press: J Am Diet Assoc. 2004 (new review of

> > predictive equations by the ADA Evidence Based Work

> > Group on Indirect Calorimetry).

> >

> > [vi] Johansson L, Solvoll K, Bjorneboe G-EA, Drevon C.

> > Under- and overreporting of energy intake related to

> > weight status and lifestyle in a nationwide sample. Am

> > J Clin Nutr. 1998;68:266-74.

> >

> > [vii] D, Heshka S, Sepulveda D, Heymsfield S:

> > Counting Calories--Caveat Emptor. JAMA.

> > 1993;270:1454-1456.

> >

> > [viii] Young L, Nestle M: Food labels consistently

> > underestimate the actual weights of single-serving

> > baked products. J Am Diet Assoc. 1995;95:1150-1151.

> >

>

[Guest guest]

> Do you know what type of reference Haymsfield used

> to calculate the

> " predicted " REEs?

I will look into but am on the road till Sunday.

Jeff

[Guest guest]

I try to be as accurate in measuring my caloric intake and expediture as I can be, but in many cases I'm using an practiced estimate of wieght on for example a vegetable salad, or mashed potatos. I realize that I'm in many instances about 10% under on the estimate and occasionally a little bit over. On the expediture side I'm following FitDay which calculates the calories burned in exercise. I'm pretty accurate on the time spent in my exercise so I'm more confident on that figure. I find that with time it is easy to start fudging a little on the amount of calories I consume. I'm betting that most of us have to do an integrity check from time to time on that calculation.

sake Jim