Specific learning objectives

Define calorie with its units, How are calorific value

measured
Mention the calorific value of carbohydrates, proteins
and fats
Define RQ. List the RQ of proteins, fats and carbs
Define BMR, factors affecting, measurements and
normal values of BMR
Describe SDA
List the different types of physical activity, add a note
on energy requirement
Food energy is the chemical energy derived from food
through the process of cellular respiration
Measured in Kcal/C or kJ
Calorific value refers to the energy content of
nutrients released on complete combustion of food in
bomb calorimeter
 ENERGY EXPENDITURE OF A
PERSON-DIRECT CALORIMETRY
Subject kept in
insulated chamber
surrounded by water
Rise in temperature of
water over a period of
time measured
Energy produced per
hour or min is
calculated
ENERGY EXPENDITURE OF A
PERSON-INDIRECT CALORIMETRY
Measures the number of
calories the body burns at
rest/calories the body burns
after eating.
Energy produced is measured
from the volume of CO2
eliminated and the volume of
O2 consumed by a person
over a fixed period of time
RQ- To know total amt. of
energy expended by a person
Respiratory quotient (RQ) of foodstuffs

Factors affecting RQ
1. Role of diet – Ketogenic
2. Interconversion of carbohydrates to fat
3. Muscular exercise
1. Role of diet
Carbohydrates- completely oxidised
C6H12O6 + 6O26CO2+ 6H2O RQ=6CO2/ 6O2=1
Fats have low oxygen content, require more oxygen for
oxidation
C16H32O2 + 23O216CO2+16H2O RQ= 114CO2/ 163O2=0.7
Proteins RQ= 0.8
Normal Mixed Diet RQ= 0.8
With an RQ of 0.8, every Litre of O2 consumed represents
energy production of 4.825kcal or C
2. Effect of interconversion of carbohydrates into fat
Carbohydrates fat, RQ will rise
Oxygen rich substance oxygen poor fat
O2 liberated will be used for oxidation
Less oxygen is consumed from outside, co2 production is
more
RQ will hence rise
3. Muscular Exercise
Moderate exercise- no change in RQ
Vigorous exercise- ↑ tissue metabolism & ↑ pulmonary
ventilation - more CO2 produced, Oxygen consumption
is not ↑ proportionally . RQ= more CO2/ less O2>1
Significance of RQ
1. Total energy expended by a person over a given period
can be calculated from RQ
2. Type of food being used as fuel can be determined
3. RQ ↑ by carbohydrate feeding / immediately after food
4. Febrile conditions, muscular exercise- RQ rises
5. Acidosis- CO2 produced is > O2 consumed, RQ rises
6. Alkalosis- Resp rate is low, CO2 retained in body, low
CO2 expired , RQ falls
7. RQ↓ when lipid is used as fuel(as in DM, ketolysis or
prolonged fasting)
8. Helps us to study and understand acidosis, alkalosis &
DM
Review RQ (2 or 3 marker)

Carbs=1, lipids=0.7, proteins=0.8, mixed diet 0.8

RQ=0.8, for 1L of O2, energy given out= 4.825kcal
RQ rises in carb rich food, carb fat, muscular
exercise, acidosis, fever
RQ falls in DM, ketolysis, Prolonged starvation,
alkalosis
Total energy expended, type of food used as fuel,
metabolic changes in DM, acidosis, alkalosis
Energy requirements of an individual

Total energy required by an average normal person is

the sum of three energy requiring body processes
I. The Basal Metabolic Rate (BMR)
II.The requirement for diet induced thermogenesis
(SDA- Specific Dynamic Action of food)
III.The requirement for physical activity

Periods of growth, pregnancy, lactation require extra

energy
BASAL METABOLIC RATE (BMR)
Minimum amt. of energy reqd by the body to
maintain life at complete physical and mental rest in
the post absorptive state.
Energy reqd. by an awake individual during physical,
emotional & digestive rest (Basal conditions)
1. Awake, complete rest- physical & mental
2. Without oral intake for atleast 12 hours
3. Recumbent, supine position
4. Thermoneutral environment , normal pressure &
humidity and 20-25°C
BMR is the energy Required for vital functions…..
1. Respiration
2. Circulation, activity of heart
3. Muscle tone
4. Visceral functions- kidney, liver, brain, maintenance
of body temp.
5. Ion transport, maintenance of cation differences
across membranes, nerve impulse conduction
During this basal state…
Constant ratio of endogenous carbs, lipids & proteins
are metabolised under basal condition. RQ=0.82
Each Litre of O2 consumed represents 4.825kcal of
energy output
 Metabolic rate during sleep is < BMR
RMR- sometimes used interchangeably with BMR- pt
nonfasting but awake (RMR is 3% > BMR)

BMR is measured
1. Directly by heat evolved
2. Indirectly by O2 consumed and CO2 produced per
unit time measured
a)Open circuit system- Tissot Method, Douglas method-
accurate but cumbersome,
b)Closed circuit system- Atwater Benedict Roth Basal
Metabolism Apparatus
c) Double labeled water – not accurate; used to measure
energy reqd during growth, pregnancy & lactation
BMR is measured
• Closed circuit system- Atwater Benedict Roth Basal
Metabolism Apparatus
• Awake, physical & mental rest, supine, 10-12 hr fast in an
environment at 25°C.
• Subject breathes O2 through a mouthpiece for 6 mins
• Vol. of O2 breathed is recorded (‘Y’ litres)
• 1 L of O2 consumed means 4.825C of energy released
• ‘Y’ Litres of O2 in 6 mins will give= 4.825 C x Y Cal
• Heat produced in 1hr(60 mins)= 4.825Y x 10
• Heat produced in 24hrs= 4.825Y x 10 x 24
Units of BMR
Expressed as kilocalories per square meter of body
surface area per hour i.e., Cal/sq.m/hr
Body surface area is calculated using the formula
devised by Du Bois and Du Bois
A = H0.725 x W0.425 x 71.84
Where A = Surface area in cm2
H = Height in cm
W = Weight in Kg.
Nowadays nomogram charts that give BSA for ht & wt
BMR by Read’s formula

At the bed side BMR may be roughly estimated using

the formula

BMR = 0.75(P.R + 0.74 x P.P.) – 72

Where,
PR = Pulse rate
PP = Pulse pressure
Normal values of BMR
Adult man 35 – 38 Cal/sq.m/hr (1600 Cal/day)

Adult Woman 32 – 35 Cal/sq.m/hr (1400 Cal/day)

For easier calculations, BMR is fixed for an adult at

24Cal/kg body weight/day
Factors affecting BMR
1. Surface area- directly proportional. BSA is related to
weight and height
2. Gender: Male BMR (↑lean muscle mass & ↓ adipose
tissue)>Female BMR by 5%
3. Age: active growth ↑BMR (max at 5 yrs). ↓by 2% per
decade of life(↓ lean muscle mass & ↑ adipose tissue)
4. Physical Activity- ↑BMR , ↑cardiac o/p & Muscle mass
5. Hormones- hyperthyroidism, epi, cortisol, GH ↑BMR
6. Environmental temperature- cold climate ↑BMR to
maintain body temp
7. Starvation/ undernutrition- ↓BMR due to ↓muscle mass
Factors affecting BMR
8. Fever- for every 1°C ↑ in body temp, 10-12% ↑ in BMR
9. Disease states- ↑ BMR in infections, leukemia,
polycythemia, hypertension, burns
10. Racial variation- eskimoes ↑ BMR , Asians ↓ BMR
11. Drugs- ↑ BMR in smoking(nicotine), alcohol,
theophylline, stress, anxiety. ↓BMR in beta blockers,
anaesthetics
12. Pregnancy- After 6 months gestation, BMR ↑ - sum
total of maternal and fetal BMR
Clinical application of BMR :
a. Used to be diagnostic tool for disorders of
thyroid (Hypothyroidism ↓BMR by 40%,
Hyperthyroidism ↑BMR by 70%)

b. Used to calculate energy/calorie requirement of

an individual & for planning diets

c. To observe the effect of food & drugs on BMR

Specific Dynamic Action/SDA/ Diet induced
thermogenesis/ post prandial thermogenesis
Increased heat production after eating
Due to energy used for digestion, absorption,
transport and subsequent processing of food
(synthesis of glycogen, TAG, proteins)
250g carbs should give 250 x 4= 1000kcal
Before 1000kcal is trapped by the body, about 10%
(100kcal) of energy is drawn from the reserves of the
body for digestion, absorption etc
Net energy generation is only 1000 – 100= 900kcal
If a person wants 1000kcal energy, he must take food
worth 1100kcal
 PARENTS IN NEW MAIL YOU AN
DELHI OUTSTATION
CHEQUE TO BE
ENCASHED IN
BANGALORE

YOU REQUIRE
Rs.1000

BANK GIVES YOU ONLY

Rs.900
IF YOU NEED Rs.1000, THEN
Rs.100 IS THE FEE FOR
AN OUTSTATION CHEQUE
PROCESSING AN
FOR Rs.1100 WILL HAVE TO
OUTSTATION CHEQUE
BE SENT
 FOOD TO BE
EATEN EAT FOOD THAT
WOULD GIVE YOU
1000 C

YOU REQUIRE 1000

C

BODY USES SOME ENERGY

(SDA) TO PROCESS THE
IF YOU NEED 1000C, THEN
FOOD SO YOU MAY GET
EAT FOOD THAT WILL GIVE
ABOUT 900C
1100C
SDA
Additional calories equivalent to SDA has to be added
to a diet

SDA for mixed diet =10%, proteins= 30%, lipids 15%,

Carbohydrates 5%

For every 100g of proteins consumed, the energy

available for doing useful work is 30% less than the
calculated value

For a mixed diet, an extra 10% calories must be

provided to account for loss of energy as SDA
PHYSICAL ACTIVITY OF THE BODY
 Physical activity done by any individual is variable
 The amount of energy needed for this depends mainly
on the duration and intensity of muscular activity,
lifestyle and occupation
Type Occupation Energy required
Light Teachers, office workers, doctors, 30-40% of BMR
Work accountants, architects
Moderate House wives without mechanical 40-50% of BMR
Work appliances, students, industry
Heavy workers
Agricultural labourers, miners, 50-60% of BMR
Work factory workers, athletes
Very heavy Construction workers, rickshaw 60-100% of BMR
work pullers, blacksmiths
During pregnancy, +300 kcal/day, during lactation + 500 kcal /day is
added to the basic requirements
Dietary advice for optimal health
RDA
Factors like age, sex, work, growing phase, to be
considered
Ideal Body weight – IBW
BMR
SDA
physical activity
Ratio of Macronutrients
Mutual supplementation
Simple, palatable, locally grown
Dietary advice for 60 kg adult
male
1. Calculation of total energy expenditure
2. Assessment of macronutrients
3. Convert calculated proximate principles in terms of
common food stuffs
4. Prescription of meal plan
Calculate the energy requirement of a 60kg male
student 21yrs= BMR+ PA + SDA
60 kg male, moderate work
BMR (24kcal/kg/day)= 60kg x24= 1440 kcals
Physical activity= 40/100 of 1440= 576kcals
BMR +PA= 1440+ 576 = 2016 kcals
Need for SDA= 10/100 of 2016= 201.6 kcal
Total energy requirement=BMR + PA+ SDA=
2016 + 201.6= 2217.6
2220 kcals
EXPECTED QUESTIONS
BMR- define, normal values, factors affecting (5
marks)
SDA (5 marks)
RQ- define, write RQ values of carbohydrates, lipids
and proteins (3 marks)
RQ-define, name two conditions associated with
lowering of RQ (3 marks)
Activity