4/19/2013

1

Energy Balance, Components, and Popular

Misconceptions:

The 3500 kcal/pound Rule is Obsolete

Steven B. Heymsfield, M.D.

Pennington BiomedicalResearch Center

Baton Rouge, Louisiana USA

19

80

19

80

19

80

19

80

19

90

19

90

19

90

19

90

20

00

20

00

20

00

20

00

20

10

20

10

20

10

20

10

20

20

20

20

20

20

20

20

19

40

19

40

19

40

19

40

19

60

19

60

19

60

19

60

19

20

19

20

19

20

19

20

18

80

18

80

18

80

18

80

WWIWWIWWIWWI WWIIWWIIWWIIWWII

"What is the caloric equivalent of one pound of body weight gained or lost?"

Max Wishnofsky 1958

Wishnofsky concluded:

“The caloric equivalent of one pound of body weight lost" or "gained will be 3500”

4/19/2013

2

“An energy deficit of approximately 3500 kcal is needed to lose 1 lb of body weight"

James O. Hill 2006

Modern Nutrition in Health and Disease

“To get an idea of how much weight you could lose, remember that

to lose one pound you need to reduce your caloric intake by 3500 calories. So, if you replace your soda with water, and don’t replace

those calories elsewhere in your diet, your potential weight loss

could be substantial”. “Replace your 12 ounce can of Coke with water every day and save 51,100 calories per year or about 15

pounds per year.”

A 12 ounce can of Coke is 140 kcal, so after 365 days (1-yr) without that can of soda ES is -51,100 kcal (-140 kcal/d x 365 d) and this

value divided by 3500 kcal/lb is equal to ~15 pounds rounded to the

nearest integer.

M. Frey M About.com Weight Loss Web site. 2013

6

Energy

Input

Energy

Output

Energy

Storage

periphery

BodyWeight

dU = δQ – δWRobert von Meyer 1841

Energy Input = Energy Output +/- Energy Storage

Energy Output = Energy Input +/- Energy Storage

Energy Storage = Energy Output – Energy Input

How much does the person eat?

How much energy does the person expend?

How much weight does the person lose?

d(ρW)/dt =I-E

4/19/2013

3

Atomic Level

Molecular Level

Cellular Level

Tissue-Organ Level

Whole-Body Level

Oxygen

N & Other Elements

Minerals, CHO and

other molecules

Other Tissues

Hydrogen

Carbon

Water

Lipid

Protein

Cells

Extracellular

Fluid

Visceral Organs

Bone

Adipose

Tissue

Skeletal

Muscle

Head

Trunk

Appendages

Adipocytes

Extracellular

Solids

Atomic Molecular Cellular Tissue-Organ Whole-Body

Five-Level Model of Body Composition

FFM, fat-free mass; LST, lean soft tissue mass

Fat

ProteinG

H2O/Minerals

Body Mass

Energy Exchange

intake output

Fuels

+

O2

CO2

+H20

+

Urea+

HeatATP

Energy Exchange at the Cell Level

Lavoisier

1782

4/19/2013

4

Fuels

+

O2

CO2

+H20

+

Urea+

Heat

Newton’s Law of Cooling

food intake ∝ W0.66

H

C

VT

(MT)

C, circumference

H, heightMT, total mass

SA, Surface AreaVT, total volume

SA

EE ∝∝∝∝ SA

Y = aXb

EE ∝∝∝∝ M0.66

Rubner’s Surface Area Law - 1883

4/19/2013

5

Kleiber’s Law - 1932

H

C

V (M)C, circumferenceH, height

M, massSA, surface area

V, volume

REE ∝∝∝∝ M0.75SA

Lo

gari

thm

of

(kcal

per d

ay

)

Body Weight (kg)

-Resting Metabolic Rate = 70 x M0.75

0

10

20

30

40

50

60

70

80

0 200 400 600 800 1000 1200

Body Mass (kg)

RM

R/B

od

y M

ass

(kc

al/

kg

)

Bogardus et al. NEJM 1986 Heymsfield et al. AJP 2002

y = 20.5x + 481

R2 = 0.62

0

500

1000

1500

2000

2500

3000

0 20 40 60 80 100

Fat-Free Mass (kg)

RM

R (

kcal/d

ay)

y = -0.18x + 39

R2 = 0.24

0

10

20

30

40

50

60

0 20 40 60 80 100

Fat-Free Mass (kg)

RM

R/F

FM

(kcal/kg

/day)

Muscles (13)Liver (200)

Kidneys (440)

Heart (440)

AdiposeTissue (4.5)

Organ-Tissue Specific Metabolic Rates (kcal/kg/d)

Brain (240)

0

50

100

150

200

250

300

350

400

450

500

Adip

ose T

issu

e

Skele

tal M

uscle

Liv

er

Bra

in

Heart

Kid

ney

s

Resid

ual

Sp

ec

ific

Me

tab

olic

Ra

te (

kc

al/k

g/d

ay)

0

5

10

15

20

25

30

Adip

ose T

issu

e

Skele

tal M

uscle

Liver

Bra

in

Heart

Kid

neys

Resid

ual

Ma

ss

(k

g)

4/19/2013

6

REE

DEE

AEE

TEE

ACTIVITY

DIET

RESTING

TOTAL

EE & RQ

measurement

system

physical activity

& exercise

measurement system

behavior

monitoring

system

cooling & heating

environ-

ment

control

& moni-

toring

measure-

ment &

calibration

instru-

ments

noise

filtering

& alarm

sensors

for chair,

mattress,

commode,

bike, food,

scale, TV,

standing

event

recordings

for meal,

exercise,

sleep,BMR,

standing,

biking

Energy Expenditure Evaluated in Respiratory Chamber

2H218O

2H labels water pool 18O labels water &bicarbonate pools

2HHO 2H218O CO18O

rH2O rCO2 + rH2O

rCO2

TissueFuel

CO2

Heat

O2 H2O

Lo

g E

nri

ch

men

t

Time (days)

Deuterium

Oxygen-18 rCO2

HH22OO22HH22

1818OO

Schoeller, 1982

4/19/2013

7

National Academy of Sciences equations for Total Energy Expenditure

normal and overweight/obese adults (age>19)

Men

TEE (kcal/d) = 864 - 9.72 x Age [y] + PA x (14.2 x Wt [kg] + 503 x Ht [m])

Women

TEE (kcal/d) = 387 – 7.31 x Age [y] + PA x (10.9 x Wt [kg] + 660.7 x Ht [m])

0

500

1000

1500

2000

2500

3000

3500

0 20 40 60 80

Age (years)

TE

E (

kcal/d

)

man

woman

Weight Maintenance Calorie Requirements

0

500

1000

1500

2000

2500

3000

sedentary low active active very active

Kc

al/d

ay

Relative Weight Maintenance Calorie Requirements

0.0

0.2

0.4

0.6

0.8

1.0

1.2

sedentary low active active very active

4/19/2013

8

Maintenace Calorie Requirements

0

1000

2000

3000

4000

5000

6000

21 18.5 24.9 30 40

Body Mass Index (kg/m2)

kcal/d

ay

Relative Calorie Requirements

0

0.2

0.4

0.6

0.8

1

1.2

1.4

21 18.5 24.9 30 40

BMI (kg/m2)

FemaleSubject

FemaleSubject

REE

1970

4/19/2013

9

Protein Loss During Fasting

Fasting and Protein Loss

VLCD, Very Low Calorie Diet

4/19/2013

10

Day

Week

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

0 5 10 15 20 25

ΔE

C /

ΔW

eig

ht

(kca

l/k

g)

Week

CALERIE Study

Components of RMR

0

200

400

600

800

1000

1200

1400

1600

1800

0 50 100 150 200 250 300 350 400

Time (days)

En

erg

y R

ate

(kc

al/d

ay)

Total RMR

Cost of Fluxes

Body Composition Effect

Adaptive Thermogenesis

4/19/2013

11

∆W = W0-∆EI x (1/3500) x T

Wishnofsky’s Rule: 1958

The theoretical value of one pound (454 g) of

adipose tissue is 3,750 ‘ In clinical studies by

Strang et a!.’ on weight reduction on obese

individuals who were on a low-calorie diet a

value of 3,500 cab was obtained for each

pound of body weight lost. The conclusion

can be drawn that 3,500 is the caloric value of

one pound of body weight lost.

ADIPOSE

TISSUE

Fat

Protein

Water

1973

1979

4/19/2013

12

Scientists unveil incredibly complicated

weight loss formula

Thomas Model:

http://www.pbrc.edu

Hall Model:

http://www2.niddk.nih.gov/NIDDKLabs/

LBM/

3500 kcal Rule

Predictions

Dynamic Model

Predictions

-50

-45

-40

-35

-30

-25

-20

-15

-10

-5

0

-50 -45 -40 -35 -30 -25 -20 -15 -10 -5 0

Predicted ∆W (lb)

CALERIE Phase I 31 days

Passmore

CALERIE Phase I 84 days

Bouchard

Benedict and Kerndt

Hall

Minnesota Starvation

4/19/2013

13

Why do People Not Lose More

Weight With Exercise?

1. Metabolic Adaptation

2. Changes in Non-Exercise Activity

3. Dietary Compensation

4. Body Composition Effects

Potential Mechanisms

4/19/2013

14

RMR

Metabolic Adaptation

Evidence for Dietary CompensationEI=ES+EE

SS EI0(kcal/d) EIf (kcal/d) ∆EI (kcal/d)

1 2818 3543 724

2 2594 2987 393

3 2938 3434 496

4 3726 3911 184

5 2508 2993 485

6 3153 3410 258

7 2699 3432 733

8 2484 3240 756

9 2365 2716 352

10 2389 2479 90

11 1887 2731 844

12 2412 2937 524

13 2317 2270 -47

Westerterp KR et al. Long-term effect of physical activity on energy balance and body composition. Br J Nutr. 1992;68:21

Body Composition Effects