Chapter 3: Obesity - Putting Your Calorie Equation to Work

Chapter 3: Obesity - Putting Your Calorie Equation to Work

If you don’t understand and manage your Calorie Equation, you will not be managing your weight.

We have now learned a great deal about metabolism. Time to develop your Calorie Equation. The Calorie Equation is based, of course, on the principles discussed in Chapter 2 but I want you to actualize it – apply it daily to your life. Take the numbers and turn them into foods, choices of foods, portion sizes, and activities.

Your Calorie Equation and how you make it work for you can be highly personalized. You may, as many of my patients do, work your Calorie Equation on a weekly basis. For example, you might prefer to start the week with 10,500 calories in your “bank”, rather than 1500 calories per day. Few people eat the same number of calories daily so why develop a plan that is more difficult to use. A weekly Calorie Equation allows greater flexibility in number of calories consumed each day and addresses the reality that activities, or the opportunity to engage in activities, can vary depending on the day of week.

A weekly Calorie Equation allows you to apply the Fixed-Free Plan. We will discuss this Plan in more detail later in this chapter. In simple terms, you set up a calorie plan that is based on a portion that is “fixed” – for example, a well-defined 1000 calories, and another portion that is “free” – for example, 500 calories – on a 1500 per day or 10,500 calorie per week Calorie Equation. If you eat the fixed calories for 3 days, you have saved up 1500 calories to be added to the remaining 4 days. This is a very useful strategy and will be emphasized in several other postings.

From the knowledge you gained from Chapter 2, you can calculate your energy requirments. If you have had your resting energy expenditure (REE) measured you can use that to construct your energy equation. If not,use the REE formula provided in Chapter 2 or use the factor method.

Remember some of the key Tips and Tools from Chapter 2

3500 Calories = 1 pound of fat
100 less calories a day is about 11 pounds lost in 1 year

And for a sedentary individual
Current calorie intake = REE x 1.3
OR
Current calorie intake = your weight x 9-11 if female, 10-12 if male (use the lowest factor if you are greater than 300 pounds)

Given the number of variables that effect metabolism as discussed in the prior chapter, you understand that “current calorie intake” is an estimate. You can refine it further as you track you calorie intake and expenditure against the weight you lose.

Let’s use an example to see how to set up a Calorie Equation. In this example, we will deal primarily with calories expended and food calories consumed. I will show you how to work activity or exercise calories into your Calorie Equation when we deal with the issue in the Exercise Chapter. The individual in our example is Jean.

First, Jean decides which method she would like to use to determine her average total energy expenditure. She decides to use the REE method. Jean is a 40 year old 5’6” female that weighs 232 pounds. She looks up her uncorrected-for-age REE on a Mifflin-St Jeor chart and reads off 1968 calories. Since she is 40, she multiplies that times 5 (40x5=200) and substract that from her uncorrected REE; 1968-200 = 1768. The REE needs to be multipled by 1.3 to yield her average total energy expenditure assuming an “average” sedentary lifestyle. Therefore, her average daily energy expenditure is 1768 x 1.3 = 2,298 caloires.

As I stressed in Chapter 2, these are estimates so don’t get wrapped up in decimal points and don’t be afraid to round off these numbers. So let’s call 2,298 calories the same as 2,300 to make it an easy number to work with in subsequent calculations.

Jean is now ready to consider a weight loss goal. She decides that 1 pound each week is reasonable for her. Since 3,500 calories = 1 pound, she would have to knock off 500 calories a day for 1 week to realize 3,500 calories (500 x 7 = 3,500) or consume, on average 1800 calories per day. Using the weekly Calorie Equation concept, she would normally need 16,100 calories (2,300 x7) to maintain her current weight of 232 pounds. To lose 1 pound a week, she would need to consume 12,600 calories per week.

If Jean decided on 2 pounds a week, she would need to cut her intake by on average of 1000 calories per day (1000 x 7 – 7000 calories divided by 3500 calories/pound = 2). She would, therefore, be eating just 1300 calories per day or 9,100 calories per week. That is a fairly restricted calorie intake.

Now, you hear stories or testimonials from some people advertising various diets claiming that they followed the diet and lost 5-10 pounds in the first week. In fact, some will even attach a money back guarantee to the diet. If you don’t lose the 5-10 pounds, you can get a full refund. Can you eat and lose this kind of weight in a week? Can that happen? Well, you do the math and tell me what you think.

Take the example of Jean. We have already determined that she needs 16,100 calories to maintain her weight of 232 pounds. A 10 pounds weight loss represents 35,000 calories.
16,100 calories – 35,000 calories is equal to a minus 18,900-calorie deficit for the week or a minus 2,700 calories per day. Would that be possible? In other words, she would need to eat no food at all and burn up 2700 calories a day in exercise (that is roughly 17 and ½ miles of walking a day) in order to achieve this 10 pound weight loss.

So what do you think? Do you think Jean can pick up the latest fad diet, eat it, and also realize a 10 pounds weight loss? I think a refund is in order.

But some people do lose quite a few pounds more than predicted in the early days of highly restricted diets. Where does that come from? It is water. Assuming someone is not using laxatives or diuretics to artificially pull water out of the body, there is a natural water loss that occurs when anyone starts dieting. Carbohydrates are stored with water in the muscles and liver. With depletion of these stores, the water is mobilized. As weight is lost, wastes that require excretion by the kidneys increase. This requires to kidneys to excrete more water as well. Ketones are an example of a by-product of fat metabolism that can increase with weight loss and require excretion by the kidney. The extent these ketones increase is related to the degree of carbohydrate restriction and level of calorie intake. The ketones are excreted as salts, pulling sodium, potassium and water out with them. Also, water intake often goes down when people start dieting unless they make a conscious effort to drink more water. Normally, about ½ of our water intake is derived from food. Milk has a water content of 87%. Fresh carrots are 88% water. Many solid foods contain very significant amounts of water. Whole wheat bread, for example, is 35% water.

There is also the usual water loss that occurs through urination, perspiration, bowel movements and breathing. Every time you breath out, for example, you lose water vapor, adding up to one or two glasses a day. Even if you're not dieting and pursuing the usual sedentary lifestyle, your body loses up to 80 ounces of water a day. That is why experts often talk about 6 eight-ounce glasses of water a day. Combined with the water in food, this will give you the water intake you need to stay in balance.

When you diet, particularly if the calorie restriction is aggressive, drinking 6 twelve ounce glasses of water a day may be necessary to keep up with the water losses that can occur. Of course, many of us in American drink almost anything but water – coffee, diet sodas, juices, a variety of non-caloric flavored beverages. These all count toward your total fluid intake as well. Water, frankly, is cheaper and better for you. Caffeine, by the way, is a mild diuretic and can actually enhance water loss.

So back to Jean and the fad diet resulting in the loss of 10 pounds of weight loss in just one week. Yes, it could happen. If she starved, ate absolutely nothing, we could account for 16,100 (Jean’s calorie requirement for the week) divided by 3,500 calories, or 4.6 pounds of real weight loss. The rest - 10 pounds minus 4.6 or 5.4 pounds - can be explained by water loss and dehydration. Jean would be feeling pretty lousy with her 10-pound weight loss. As soon as the fluids were replenished she would gain back that 5.4 pounds of weight in water.

Now, let’s return to Jean’s original Calorie Equation calculated using the REE charts or formula. If she had used the factor method, she would have come up with a very similar result. Her weight (232 lbs) times a factor of 10 is about 2300 calories as well. Again, these are estimates. You can re-determine your Calorie Equation as you track you calorie intake and expenditure against the weight you lose.



In order to put your Calorie Equation to work, you will need to learn about food. At first, these will seem complicated but it will become easier over time. If you follow the suggestion of Chapter 4 What Calories Do I Eat, it will become much easier since you will be consuming a lot of low calorie foods where portion size and caloric content are not as critical.

Numerous studies have shown that people do not estimate either portion sizes or calorie content in foods accurately. The problem is made worse by misinformation and misleading advertising about foods. It is extremely important for anyone who is serious about losing weight and keeping it off to become very familiar with the calorie content in foods and be good at estimating portion sizes. The Table provides a few suggestions that may help you estimate portion sizes. Better yet, use a food scale and measure exactly what you are eating, at least until you are confident you are a pretty good “estimator”.

Portion sizes

Help to assist you in estimating portion sizes


Your fist equals 1 cup or 1 medium whole fruit

Your thumb equals 1 ounce of meat or cheese

Your thumb tip equals 1 tablespoon of anything

Your fingertip equals 1 teaspoon of anything

Your cupped hand holds 1 or 2 ounces of pretzels, nuts, popcorn, or beans

Your palm equals 3 ounces of cooked poultry, fish, or meat
(minus your fingers)

Common measures and Equivalents

Fluids:
1 cup = 8 ounces
1 ounce = 2 tablespoons

Dry and fluid foods:
1 cup = 16 tablespoons
1 tablespoon = 3 teaspoons
1 ounce = 30 grams

Always use a standard measuring cup to measure the amounts you list in your calorie record.

Abbreviations:

Tablespoon = Tbsp or T
Teaspoon = tsp. or t
Ounce = oz
Cup = C
Slice = sl
Grams = g


In fact, the following are what I would call the essential tools for anyone who is serious about losing weight and keeping it off:

Essential tools

Calorie book
Food scale
Calorie record book

When you eat, guess the portion size, and then find out the true portion size by placing the food in a measuring cup or on a food scale. Look up the calorie amount. Write it down. See the chart below for guidelines on how to record food in your record.

Guidelines for recording foods in your food record

For mixed dishes prepared at home, record approximate amounts of the main ingredients eaten.

Example: For beef-noodle casserole, record –
2 ox beef
½ C noodles
2 T mushroom soup

For sandwiches, list the ingredients separately.

Example: instead of recording “ham sandwich” list as follows:
Bread, whole wheat 2 slices
Ham 2 oz
Lettuce 1 leaf
Mayonnaise 1 tsp.

Do not forget to list the following:

Spreads used on bread, rolls, potatoes, etc
Jams, jellies, preserves
Salad dressings
Sugar and “cream” in coffee
Milk and sugar on cereal
Fats and oils used in cooking
Snacks – candy, nuts, chips, popcorn
Soft drinks
Alcoholic beverages

Developing a skill around estimating calorie values is extremely important for long-term success. With the ever-changing food supply, in terms of preparation, portion size and packaging, this is on going project for the weight conscious individual. The chart of calorie values provides some estimates to help give you the idea but a variety of good calorie books are available to give you more precise values.

Calorie Values in Foods

There are many good calorie books available which can give you fairly exact calorie values for foods.

The foods listed in each group below are just examples with estimates of calorie values. Many other foods can be part of your daily meal plan.

Starch/Bread

Each of these equals one starch/bread choice (about 80 calories)

½ cup pasta or barley
1/3 cup rice or cooked dried beans and peas
1 small potato (or ½ cup mashed)
½ cup starchy vegetables
(corn, peas, or winter squash)
1 slice bread or 1 roll
½ English muffin, bagel, or hamburger/hot dog bun
½ cup cooked cereal
¾ cup dry cereal, unsweetened
4-6 crackers
3 cups popcorn, unbuttered, not cooked in oil


Vegetables

Each of these equals one vegetable choice (about 25 calories)

½ cup cooked vegetable
1 cup raw vegetables
½ cup tomato/vegetable juice

Milk

Each of these equals one milk choice. The calories vary for each choice.

1 cup skim milk (90 calories)
1 cup lowfat milk (120 calories)
1 cup whole milk (150 calories)
8 ounce carton plain lowfat yogurt (120 calories)

Meat and Substitutes

Each of these equals one meat choice (about 75 calories)

1 oz cooked poultry, fish, or meat
¼ cup cottage cheese
¼ cup salmon or tuna, water packed
1 tbsp. peanut butter
1 egg
1 oz. Low-fat cheese, such as Mozzarella, ricotta

Each of these equals 2 meat choices (about 150 calories)

1 small chicken leg of thigh
½ cup cottage cheese or tuna

Each of these equals 3 meat choices (about 225 calories)

1 small pork chop
1 small hamburger
cooked meat, about the size of deck of cards
½ of a whole chicken breast
1 medium fish filet

Fruit

Each of these equals one fruit choice (about 60 calories)

1 fresh medium fruit
1 cup berries or melon
½ cup canned in juice or without sugar
½ cup fruit juice
¼ cup dried fruit

Fat

Each of these equals one fat choice (about 45 calories)

1 teaspoon margarine, oil, mayonnaise
2 teaspoons diet margarine or diet mayonnaise
1 tablespoon salad dressing
2 tablespoons reduced-calorie salad dressing


Now, lets us assume you are female with weight 200 pounds. You have decided your factor is 10. You estimate that it requires 2000 calories to maintain your weight. You would like to lose 1 pound a week. You will need to drop 3500 calories per week since 1 pound equals 3500 calories. You, therefore, want to average intake of 1500 calories per day in the absence of any major new activity or exercise program.

So, if you are on a 1500-calorie diet plan, you have 1500 calories to “spend” each day. Think of these calories as your budget for the day. How do you want to spend them? You should be thinking a good nutrition with a variety of fruits and vegetables, but you also want to save up a little for a treat now and then. Remember, there are no forbidden foods, only calories.

Just today, I was scouting out some investment property with a friend and we stopped at Subway for lunch. My friend has diabetes, takes one medication to help control the blood sugar, and is overweight. He is constantly asking me about the latest diet fad or gimmick. In fact, on the nearly 1 and ½ hour drive to our destination, I was peppered with all kinds of questions ranging from the Atkin’s diet to a “new” product (a pill) guaranteed to enhance the metabolic rate and let you lose weight while you sleep.

I let him order first. He chose a 6-inch steak and cheese sandwich with chips and a diet drink. I then suggested he consider a selection from the “6 grams of fat” column of sandwiches and drop the chips. “Boy”, you are saying about now, “glad I don’t have a friend like that!” Normally, I’m not this obnoxious but he had been directing the conversation around this topic for the last hour so I felt it was reasonable for me to make this suggestion. He then chose the 6-inch turkey breast and decided he didn’t need the chips.

Now examine the calorie values:

6 inch steak and cheese sandwich = 390 calories
Bag of chips = 150 calories
Total calories 540 calories

6 inch turkey breast sandwich = 280 calories

The difference is 260 calories.

I then pointed out to him that a different choice like this one, done on a daily basis for 1 year would result in a 27 pound weight loss, just short of the 30 pounds that he would like to lose.

Now making this choice wasn’t necessarily easy because my friend enjoys steak and cheese sandwiches. However, it was made easier by examining the calorie values and the implications of the choice. What if his calorie equation called for 1500 calories a day? He now has 1500 – 280 for the turkey sandwich = 1220 calories left to spend for the day. On the other hand, if he really wanted the steak and cheese sandwich and chips, he would have 1500 – 540 = 960 calories left to spend for the day.

See, part of the choice should be based on what you want to eat later that day as well. My choice of sandwich was partly based on the fact that we have an office party to attend later this evening. That is going to mean more eating than usual because of the host of hor'dourves, drinks and main courses we will find there.

This brings up another issue. It is extremely hard to eat 1500 calories every day. What usually happens is one is quite good for a few days, averaging 1500 calories per day, when the “event” occurs – the Christmas party, someone comes to visit, the graduation party, etc. We then forget the 1500-calorie equation and overeat, often totally unaware of how many extra calories were consumed, then go back to the 1500-calorie plan. Well, the extra 1000-2000 calories consumed wipes out several days of hard work. I then hear the lament - “I tried 1500 calories and it didn’t work”

That is why a Fixed-Free Plan to the calorie equation is often useful. In essence, you should be thinking about a weekly calorie equation rather than a daily equation. For example, if you are trying to stick to a 1500 calorie a day plan, think of it as 1500 x 7 days or 10,500 calories per week.

To apply the Fixed-Free Plan, you decide how much of the 1500 will be fixed and how much free. Let’s choose 1200 to be fixed and 300 free. You then devise a fixed daily menu that is about 1200 calories. This should be rather straightforward and uncomplicated. For example, you might choose to have a simple breakfast of 250 calories, salad and sandwich lunch of 350 calories, and a prepackaged Health Choice Chicken Parmigiana dinner with bread and extra vegetables (about 500 calories) with a evening snack of popcorn or something else worth about 100 calories. Total 1200 calories.

You eat pretty much the same thing except for different prepackaged entrees for 3 days saving up 300 x 3 days of 900 calories on your Fixed-Free Plan. Therefore, on the 4th day, you have your 1500 calories to spend plus the 900 free you have “banked” for a total of 2400 calories. Now when the special event comes up, you can overeat and still be sticking to your 1500 average calorie /day intake.

Behaviorally, this is a good approach as well because it starts to develop the habit of eating less so you can overeat. In other words, overeating is part of life – it doesn’t go away just because you are now lean. The difference is that you now overeat with full-awareness of the calories involved and no longer feel guilty about overeating because you have planned for it, staying within the calorie equation you have devised for yourself.

I recently read an article directed at the female reader entitled “Tips to get your figure back”. The first tip was wear jeans. According to the article, there is no reality check like putting on a pair of jeans. The article went on to say that you will always know if your weight is going up or down if you wear this “good” pair of jeans once every week. That is ridiculous. Get on the scale to check your weight and know your calorie equation. Then you can replace the jeans with a smaller size if you want. My son, on the other hands, wants his jeans as baggy as they can be and still hang-on. I can’t figure this jean thing out.


Calorie Equation

Tips and Tools

1. Determine the number of calories you require per week to maintain your wieght
2. Set a wieght loss goal in pounds per week
3. Use your CalorieEquation to determine the calorie intake required to achieve this goal on a daily basis and a weekly basis.
4. Use a weekly Calorie Equation to allow some flexibility in calorie intake and activities.
5. Consider using the Fixed-Free Plan to better define the flexibility you want during your week and help you stay within your Calorie Equation.
6. Purchase a calorie book(s) and food scale.
7. Maintain a food record
8. Remember to drink adequate amounts of water on a daily basis.
9. There are no forbidden foods (mostly true), just calories.