Kcal  & Energy Balance:

'Kcal (technically kilocalories but in common

talk people often say calories, actually a 1000
times smaller unit)'
Kcal are actually a unit of measuring energy as are kilojoules

.... and a bit (.184)

Think of your body as a train engine that

needs refuelling every so often, that why you get hungry
- well the physical part but we'll get onto that later...

'The average person needs 2000-2500kcal a day'

Question: Is anyone average?
 Refer to your country's/region's
specific RNIs/RDAs/DRVs for general
guidelines - see end of section
An alternative approach is to just taken into
account the activity from 
someone's job in calculating the PA ratio
then calculate the energy expenditure from
exercise seperately using METs 
 METs (Metabolic Equivalent Tasks):
(1 MET is equal to the kcal burned by the average person sitting at rest for 1 minute)

These are a way of calculating energy of a given activity so a client can see how much extra they will burn
off from different activities. METs were compiled into the compendium (see appendix 2) in the 1980s and
now equations exist to correct for differences in height, age, gender and weight.

An equation to estimate kcal for an activity given perceived effort is given below:

Effort on 1-10 scale (0 being sitting, 10 being maximal sprint) converted into approxiamte METS using the
table below × 3.5 × bodyweight in kg ÷ 200

This gives kcal burned per minute of activity and is the easiest method of accounting for individual
differences in ability

0-1 being 1.6 METs (40% max heart rate* 20% VO2 max**)
1-2 being 1.6-3 METs (40-55% max heart rate 20-40% VO2 max)
3-4 being 3-6 METs (55-90% max heart rate 40-60% VO2 max)
5-6 being 6-9 METs (70-90% max heart rate 60-85% VO2 max)
7-10 being 9-15 METs (>90% max heart rate >85% VO2 max)
 METs (Metabolic Equivalent Tasks):
(1 MET is equal to the kcal burned by the average person sitting at rest for 1 minute)

For strength training:

Scale is equivalent to 1-5 METs:

8-10 = 4-5 METs

6-8 = 3-4 METs
4-6 = 2-3 METs
2-4 = 1-2 METs
1-2 = 0-1 METs
 METs (Metabolic Equivalent Tasks):
(1 MET is equal to the kcal burned by the average person sitting at rest for 1 minute)

The other way is to use the compendium of physical activities included in appendix 2.

To get corrected (by age, height & weight) MET values:

 

MALE: METS × (3.5 ÷ (66.4730 + 5.0033 × (Height cm) + 13.7516 × (Weight kg) – 6.7550 ×  (Age yr)

FEMALE: METS × (3.5 ÷ (655.0955 + 1.8496 × (Height cm) + 9.5634 × (Weight kg) – 4.6756 × (Age yr)

Definitions: *maximum heart rate can be estimated as 220-age in years,

**VO2 max is measured as the maximum volume of oxygen per minute
that then body can use
 METs (Metabolic Equivalent Tasks):
(1 MET is equal to the kcal burned by the average person sitting at rest for 1 minute)

The key here is to use this information to estimate kcal burned or that will be burned by activity in
addition to that used to calculate energy balance for the purpose of introducing a kcal deficit e.g. if
energy balance is 2000kcal then exercise that burns 500kcal will in most people over time result in 1
pound of weight lost a week

Target training levels by fitness, aim for 30 - 90 minutes 3-5 days a week for a minimum of 2.5 hours of cardio
exercise a week, aim for a full body weight training regime twice a week with 48 hours rest between sessions
and a full body stretching routine 3-5 days a week
 Hydration:
To maintain proper hydration you need to have one ounce or 28ml of fluid per kg of body weight
plus 750-1500ml per day if in a tropical climate. Clients should be encourage to weigh themselves
before and after exercise and replenish 1.5L of fluid per 1Kg in weight lost during the event/exercise.

Chocoloate milk is a relatively okay post workout drink, as are isotonic sports drinks ONLY if working out for
over 60 minutes and particularly can have a sporting benefit in events lasting over 80 minutes where they can
delay central fatigue by the sugars combining with free tryptophan preventing it crossing the blood brain
barrier and increasing serotonin (the happiness AND tiredness hormone)

A DIY sports drink can be made by adding 150mg of salt (low sodium, high potassium salt is good here) per
100ml of fluid using low kcal cordial as a base and 8g of sugar (2 teaspoons/cubes), an alternative to delay
gastric emptying in sensitive bladder clients, for example wheelchair athletes is to add up to 30g of sugar to
the drink instead - however be aware this should be done on a case by case basis and should be deducted
from the athletes daily carbohydrate requirements and sugar allowance (no more than 5-10% of kcal - the
lower the better)
 Protein:
'Protein provides around 3.75 kcal per gram It is the
building block of structures in the body made in the
ribosomes from the building blocks of proteins called
amino acids'
'Some amino acids are essential - we can't make them in our bodies
we need to get them from our diets, others are conditionally essential
.... and a bit (.184)
in that we need them in times of stress, for example when the body is
injured and its structures need more than normal repair from general
wear and tear. Others are non-essential as we can make them from
the aforementioned essential/conditonally essential amino acid's.

'The average person needs around 50g of

protein a day'

Question: Is anyone average?

 ''We're not going to go into what all the amino acids are used for
or the structure of things like beta sheets etc its unnecessary unless you are bioengineering
molecules or working in a medicines lab, just bare in mind that proteins can all have different
shapes giving different functions and that there shape and hence function can be affected by a
number of factors including heat, pressure and the presence of reactive oxygen species or
oxidants hence the reputed beneficial effects of certain anti-oxidants that can protect the bodies
structures and proteins. Instead we will focus on the 'conditionally essential amino acids' as
these come into play when we are injured or under stress'

Note: antioxidants can also protect proteins called lipoporoteins from becoming oxidised and
depositing fat and cholesterol in arteries leading to heart disease (myocardial infarction) and stroke
(e.g. cerebral vascular disease/accident). You may have heard of some lipoproteins:

LDL - the bad (the subtypes with smaller more dense particles
size and higher concentrations of apolipoprotein B)
HDL the good
VLDL and IDL - the just plain ugly

(In general high LDL reflects high VLDL and IDL and
apolipoprotein B(more about this later) - in very general!)
What are good sources of protein?

Remember the protocols:

20g of protein per 3 0unces (around 100g of meat, double in insects - good old Sainsuburys!) or 3
ounces of key vegetable sources e.g. beans, peas and other pulses have the highest amount here, nuts
and seeds also have a high concentration of protein as well as healthy(ier) fats, milk around 3g per
100g, eggs 15g and cheese 25g (note full fat dairy is high in saturated fat which in most but not all
people has a negative effect on cholesterol, eggs are high in dietary cholesterol which in most people
will effect blood cholesterol levels, though generally cutting fat and in particular saturated fat is a better
dietary intervention).

Protein is found in small amounts in most foods typically 3g of protein is found in half a cup/handful of
starches and 2g per half a cup of most veg with the exception of those listed as key protein sources
above (i.e.legumes/pulses - same as peas, lentils and beans folks) - soy is a bean, tofu is made from soy
bean curd
 What does conditionally essential mean?
(... and why it might be relevant when planning someones diet)

In particular lets look at arginine, tyrosine and glutamine

as these are popular supplements and lysine as it is often
deficient in vegan diets
Arginine helps the body produce nitric oxide and relax blood vessels insuring blood flow to
injured areas or to our limbs when we are under acute stress, it can be helpful in regulating
inflammation after injury as well as for supporting the remodelling matrix that follows.
Research shows arginine may be beneficial in boosting endurance though the mechanism
isn't clear.

Be aware though that some more recent research indicates arginine might not be very
beneficial in highly trained athletes as they already have high nitric oxide levels and good
blood vessel relaxation due to their bodies response to the intense exercise they do on a
daily basis.
 What does conditionally essential mean?
(... supplementation strategy?)

In particular lets look at arginine, tyrosine and glutamine

as these are popular supplements; and lysine (which is
essential) as it is often deficient in vegan diets
Tyrosine helps the body send signals through contributing to neurotransmitter function, a
neurotransmitter is a chemical that stimulates the nerves sending signals up and down the
body, to and from the brain.

Tyrosine as a supplement at around 500mg/day is used to boost energy and fight fatigue,
the evidence base is fairly weak and relies strongly on animal studies. One study looked at a
higher dose of 2.5g a day and saw a small positive effect on reducing self reported fatigue
 What does conditionally essential mean?
(... adequate in diets of adequate energy value, possibly
deficient in vegans on energy restricted weight loss diets)

In particular lets look at arginine, tyrosine and glutamine

as these are popular supplements; and lysine(which is
essential) as it is often deficient in vegan diets
Glutamine helps the body repair and grow and is essentially following wounding or injury as
well as during periods of accelerated growth, like puberty when there is an argument to
made about it being an essential nutrient.

Glutamine is found in all major protein sources and is not usually deficient in the diet, some
studies have shown positive effects on injury recovery rates with supplementation and post
exercise recovery at around 15g a day, however again the evidence base is fairly weak
 What does conditionally essential mean?
(... hardly ever accounted for in vegan diets)

In particular lets look at arginine, tyrosine and glutamine

as these are popular supplements; and lysine (which is
essential) as it is often deficient in vegan diets

Lysine is an essential amino-acid that is normally present in sufficient amount in the diet,
however supplementation is often necessary in vegan diets unless high protein grains are
combined with high protein meat alternatives, this is because vegan sources of protein like
beans and pulses are short on lysine. High protein grains include whole-grains that have
been sprouted, buckwheat, millet and quinoa, sprouting beans and pulses also increases
their lysine content, having two servings of these grains in an evening meal and one at lunch
should ensure an adequate lysine intake as long as protein, and vegetable
recommendations are also met. Lysine is needed as a site for protein(histone) methylation
to modify the activity of DNA suppressing problem genes and increasing the activity of
helpful ones - at least that's how it's supposed to work!
 Carbohydrates:
Carbohydrates & Glycogen:

Carbohydrates contain 4kcal of energy per gram. They are the body's preferred fuel source, followed by fat then
protein. They are stored in the body as glycogen along with 3g of water per 1g of glycogen. A lot of the initial
weight loss effect from ultra low carbohydrate diets is from water loss. In scarcity the body can make
carbohydrates from fats or proteins via a process called gluconeogenesis. The process of storing glycogen is called
glycogenesis and breaking it down for energy is glycogenolysis. The process of burning off carbohydrates already
in the bloodstream is called glycolysis-refer to the energy systems chart.

A healthy balanced diet incorporating fibre (soluble (bulking effect and helps with bowl fluidity) and
insoluble(prebiotic effect stimulating good bacteria in the gut - the gut microbiome)), fructo- oligosacharides
(prebiotics) and vitamins C , vitamin K, potassium and magnesium makes it hard to follow an ultra low
carbohydrate diet for prolonged periods. Research shows that ultra low carbohydrate very high fat diets in the long
run increase risk of all cause mortality (death), although in the initial 6 months of said diet weight loss tends to be
greater than that from low fat diets. Theoretically this makes a weight loss* diet that is a little lower in carbs
(30-50%, normal recommendations are less than 55%) whilst low in fat and in particular has less than 10% of
kcal from saturated fat and less than 5-10% from added sugars the best all round diet option to lose weight
without potential adverse health effects. Protein should be between 8 and 40% of kcal with athletes needing nearer
20% of energy balance kcal from protein (more on this later).  
 Energy Chart:
"Pyruvate goes on to produce ATP(adenosine triphosphate) the body's energy currency
through aerobic and anaerobic respiration (with/without oxygen) the latter resulting in a
build up of lactic acid causing muscle fatigue and pain (this is when an athlete 'hits the
wall'). In aerobic respiration carbohydrate metabolism results through the production of
pyruvate in the fuel needed to burn fat and produce vastly more energy 2 verses 36 ATP"

(Body's carbohydrate
store, muscle+liver)
(2 ATP)

(Oxygen present then

Krebs cycle
+ 36 ATP)

(Oxygen not present

then
* * lactic acid, + 0 ATP)
(*Types of sugar)
 Betaine + Choline (for vegans)

"Betaine and choline are important for adequate gut health - in particular the lining of the gut walls and gut
signaling and may play a role in obesity, type 2 diabetes and metabolism as well as disease of the
gastrointestinal tract or gut" they are pseudo vitamins involved in methylation (important for Liver health
and detoxification - more on Liver health later!)

80

(G+B = germ plus bran)

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 Additional Information
(Protein, Fat & Carbs Recommendations the 101):
Protein:
Sedentary individuals 8-12% of kcal 0.6-0.9g per kg of bodyweight (bw)

Active individuals exercising at recommendations for health (see this later) 10-15% of kcal 0.7-approximately 1g/kg bw

Athletes and people exercising greater than 5 hours a week 20-40% kcal 1.1-1.4g (endurance sports) 1.2-1.4g (mixed sports), 1.4-1.8g (strength),
1.8-2.0g (body building) - Note: this is superseded by the performance protocol which contains more exact information

Fat:
Shouldn't be higher than 50% of kcal no matter what diet you follow, typical WHO and UK recommendations quote around 35% of kcal, however lots
of research shows positive health effects of a mediterranean diet pattern which typically has 40-49% of kcal from fat, but which is typically low in
saturated fat (less than 10% of kcal from sat fats) and incorporates eating 2-3 portions of oily fish a week as well as lots of fat in the form of olives,
avocado, eggplant and fat from a variety of nuts and seeds. When following this type of diet don't cook with vegetable oil use rapeseed/canola oil,
sunflower oil and/ or olive oil(if roasting rather than stir frying then use non-virgin olive oil). Diets lower than 20% of energy balance kcal from fat can
negatively affect athletic performance

Trans fats should ideally be less than 2% of kcal, however as these often aren't listed on labels this is a hard dietary intervention to check up on,
instead recommend stir frying, grilling and cooking food from fresh wherever possible as this will lower trans fats in the diet naturally.Trans fats are
fats that aren't quite unsaturated and aren't quite saturated they are easily oxidised when transported through the blood and hence have the highest risk
of causing heart disease and stroke, followed by saturated fat. Omega 3's (a type of unsaturated fat, fat with double bonds that can be protective due to
its antioxidant effect should ideally make up 5% of the diet with
250-500mg from fish sauces (EPA & DHA). Recent research suggests omega 3s don't prevent heart disease, but other research shows you are
more likely to SURVIVE heart disease and less likely to have a second heart attack as omega 3's also help make blood less sticky and clots and
blockages clear easier
Carbs:
Carbohydrates 30-55%. Below 30% is fine for short periods but can lead to the so called 'carb flu' as the body suffers from carbohydrate withdrawal,
the most common reason why people stop following an ultra low (less than 10% of kcal from carbs) diet. Athletes having less than 30% of kcal from
carbs typically suffer from poorer endurance and greater fatigue. The body can technically survive with no carbohydrate, unlike fat and protein which
are needed for the body's structural components (protein in all structures and enzymes, fat in the protective layer around cells (phospholipid layer) that
selectively allows some molecules/substances in and keeps others out as well as playing an important role in insulation and hormone functioning)

Fat is the fuel source the body predominantly uses at rest providing 9kcal of energy per gram burned. It takes a kcal deficit of 3500kcal (500kcal a
day) to burn roughly 1lb / 0.45kg of fat - though this rate varies across time and from individual to individual. Carbohydrate is the fuel source for
endurance or prolonged exercise. The performance protocol contains more precise information on carbohydrate needs for athletes

Note: Only weigh yourself first thing in the morning on the same day no more often than once a week it's unlikely you'l see anything other than
changes in food and water storage otherwise
 Vitamins & Minerals:
"Refer to the addendum at the end of this section for notes
on the different vitamins and mineral functions as well as
RDA/RNI (reference daily and nutrient) levels and common
nutritional abbreviations, what follows is a list of sources of
common nutrients for client specific recommendations -
focus on shortfall nutrients following dietary questionnaire
and symptom analysis"
(Use Retinol Eq for Total Vit A)
(Vitamin B1)

(Ignore this)
 (Vitamin B12 - cobalamin)
(Vitamin B2) (Vitamin B3) (Vitamin B6 - pyridoxine)
(Vitamin B9)