Wednesday, May 30, 2012

Calories in = Calories out? Factor Affecting the Energy Balance Equation

Calories in = Calories out? Factor Affecting the Energy Balance Equation
Jennifer Koslo, PhD, RD, CSSD, CPT
FT Faculty: Health & Wellness & Nutrition Dept

When I first started my career as a cardiac dietitian, I memorized the Harris Benedict equation, which is a long mathematical equation for calculating the resting energy expenditure for men and for women.  Resting energy expenditure (RMR) is the number of calories that a person needs to stay alive while resting. RMR accounts for about 60-75% of total daily energy expenditure so it is important that the equation used to estimate this number is pretty accurate. While Harris Benedict has been around since 1919 and is generally considered to be the gold standard, The Mifflin-St. Jeor Equation created in 1990 has a smaller overall margin of error and is consider most accurate for the average US population. If you have ever calculated your energy needs using an online tracking system like, MyFitness or the government tool, then you most likely entered your height, weight, gender and age and a number was spit out stating that you need XXXX calories per day. This number was most likely calculated using one of these formulas. However, similar to how the calculation for BMI (Body Mass Index) does not account for lean and fat mass, neither do either of these RMR equations. There is another formula you can use if you have these numbers, the Katch-McArdle formula, but accuracy still depends on a correct measurement of body fat percentage.

So why am I telling you all of this math mumbo jumbo? Because energy balance is so much more than calories in = calories out. On top of the calories needed to sustain life, we burn calories in our day to day activities, through food digestion and in physical activity. A couple of important points here: The American College of Sports Medicine recommends 2000 calories of exercise per week for weight loss and 1000 per week to improve health. When people start a weight loss and exercise program they often have that 1000 calorie number on their minds which might mean about 2-3 hard spin classes a week not realizing that they need double that for weight loss.

In light of all of these challenges, why not shift your initial focus away from calorie goals and number of calories burned in structured physical activity to your NEAT (nonexercise activity thermogenesis) activities throughout the day. NEAT calories can vary drastically from one individual to another and can add up quickly. Think things like fidgeting, walking to the bathroom at the very end of the hall, taking several walk breaks throughout the day, chopping vegetables and cooking instead of going through the drive-thru, etc. Simply list your typical Monday-Friday schedule on a log similar to this:

Midnight-06:30 am
06:30-07:30 am
Preparing for work
Continue with your schedule

Use this information to identify the problematic areas of your day, i.e. times when you are sedentary for long periods of time, and challenge yourself to get moving more.  You might be surprised how increasing your NEAT is just the boost your metabolism needs to jump start your weight loss or break out of that plateau. Hopefully you will find that the more you move the more you will want to move!

Tuesday, May 22, 2012

LI 4 for Headaches (and More ) !!!

By Mary Oleksowicz, L.Ac
As an acupuncturist, I am often asked which points are also effective for acupressure techniques. Undoubtedly , Large Intestine 4 ( LI 4 ) would have to rank as one of my favorites.   The point has many traditional associations such as being “ the command point of the head and face” meaning that it sends large amount of energy to this part of the body . The point is also designated as a “ Yuan Source “ point which means that the point is strongly connected to our source or core energies. The point is easily located  on the back of the hand between the thumb and first finger in the fleshy part of the hand. DO NOT USE DURING PREGNANCY !!

When applied for the use of headache relief, the point is thought to help move energy that may be stagnate in the head area. In Traditional Chinese Medicine, many headache patterns are due “qi stagnation” which most Americans would relate to as the muscle tightness associated with stress.

Use of LI4, is relatively simple. After locating the point in the aforementioned fleshy portion of the hand, you can rub the point until it is stimulated. For most people, the sensation is one of a deep achy. A young client I once treated describes the sensation as “ The Boomies, like feeling your heartbeat , only not really” . Manipulation should be applied to both hands and is especially useful for frontal headaches and those caused by cold or flu symptoms.

The wonderful thing about LI4 is that it can also be used for allergy symptoms, toothaches, and generally stress relief. It is a drug free alternative and you always have it available!

Thursday, May 17, 2012

Huang Qi for Me !!!

By Mary Oleksowicz, L.Ac, MSTOM,

Huang qi also known as Astragulus Root is an herb in Traditional Chinese Medicine that is historically noted for its ability to “tonify the lung and spleen”.  For the novice herbalist, this means that the herb has the ability to strengthen the immune system, reduce mucus within the body and increase digestion. Western herbalists view Astragulus as an adaptogen, which means that it is an herb that can gradually builds your endurance and immunity over time.

In clinical practice, I have found Huang qi especially helpful during the allergy season. Traditional Chinese Medicine formulations partner the herb with others that are useful for respiratory health, especially for conditions where a weakened immune system may be a factor. Western Medicine use would include standardized extracts available in pill or liquid form .

The nice thing about Huang qi is that it can be a food-based medicine and a few pieces of root can be added to chicken stews or placed in a cup of hot water for 10-15 minutes. The root has a naturally sweet but also can be purchased  stir-fried with honey. This form can also be chewed and is a wonderful oral substitute for those quitting smoking.

So next time you would like to combat seasonal allergies , cold and flu season , or just “ get a boost” , think Huang Qi for me !!

( As with any change in your nutritional program , please be sure to consult your primary care practitioner and herbalist regarding safe use of this herb within your lifestyle) .
Saturday, May 12, 2012

Sugar: Just Say No! Part III

For this third segment, I’d like to share this KQED Radio Forum MP3 “The Trouble with Sugar”. In this episode, host Dave Iverson interviews UCSF professor Claire Brindis, Stanford professor Fredric Kraemer, and Registered Dietician Jo Ann Hattner. In this engrossing interview, the participants discuss the health, economic, social, and political issues surrounding sugar.

The Trouble with Sugar
Thursday, May 10, 2012

Sugar: Just Say No! Part II

For part II of my Sugar: Just Say No blog, I’d like to share a UCSF Mini Medical School for the Public video. In this video, Dr Robert Lustig explores the reasons behind the obesity epidemic in the U.S. According to his research, the rise in obesity in our country is not necessarily due to a simple increase in calories and a lack of exercise. Instead, he argues that the culprit is too much fructose and not enough fiber. This dietary combination leads to altered biochemical effects and ultimately increased fat storage.

Please take some time out of your day to watch his important, interesting, and passionate lecture.

Nancy Silva, ND
Faculty, Health Science Dept.

Wednesday, May 9, 2012

Sugar: Just Say No!

Yes, I’ll admit – I have been called a fanatic, the food police, etc. Whenever I am offered sweets, I look down my nose and make comments like “sugar is bad for you”.  I obsessively read ingredient labels - scanning them for hidden sugars. It doesn’t matter if the food is something I may purchase – or something simply sitting on a friend’s kitchen counter. And so, you can imagine how and why my friends make fun of me – but now – at last - I have been vindicated! Studies now back me up: New research is showing a connection between sugar and many chronic diseases such as obesity, type II diabetes, hypertension, and cardiovascular disease. In addition MRI studies have shown that sugar stimulates the reward/pleasure regions of the brain (just like drugs do) – in other words: Sugar is addictive.

Here’s the big problem: It’s in everything! Sugar comes in many forms (high fructose corn syrup, evaporated cane juice, etc) – and it is added to most processed foods. The average American consumes 130 lbs of sugar each year.

Please take a moment to watch this enlightening 60 Minutes segment: Is Sugar Toxic?
Tuesday, May 8, 2012

Barriers, Busted: Part III (The Oldies but Goodies)

I hope all of you enjoyed your walk this morning and are eager to learn yet more strategies that make exercise an activity you do have time for. 

Let's recap.  Why don't people exercise (and I'm ignoring those people who just don't "like" it, c'mon, that's almost all of is)?  Number one, because they don't have time.  Number two, because they don't have a gym membership/equipment/fancy exercising stuff.  Number three...well, I know there is a number three, but it doesn't help strengthen my blog post arguments, so I'm stopping at two.

We saw that walking is something you can do anytime, anywhere.  But what about strength training and higher intensity stuff?  Now that's something that requires machines, gyms, trainers, spandex and smoothie bars, yes?  No.  Even strength training and higher intensity exercises can be done at home, with zero or minimal equipment.  Impossible you say?  Read on.

Remember in grade school when you had to take a fitness test?  Then again, maybe you were out "sick" that day.  Well then remember PE in general?  What did you do?  Fancy stuff with bells and whistles?  I doubt it, if you went to a school like mine.  I went to public school, we didn't have a budget for fancy stuff.  We did old-fashioned drills, sprints, jump rope and the like.  And guess what?  These exercises still work today, they didn't become obsolete like last year's smart phone.

What you need for a strength training program you can do at home.

1) Your body.
2) See: 1

Now here's your program.  Choose from this list:

Body weight squats
Walking lunges
Sit Ups
Pull Ups
Flutter Kicks
Box Jumps (jump or step on something high and stable, like a ledge or stairs)
Mountain Climbers
Jump Rope (yes, I understand it isn't just your body weight, but a jump rope is an excellent tool to have at home and adds a whole new element to workouts)

That's enough.

Choose 3 or so of the exercises and do them in succession.

For example:
100 jump ropes
15 pushups
20 flutter kicks
Repeat 3-5 times


35 Mountain Climbers
10 box jumps (or step ups)
15 sit ups
1 20 meter sprint
Repeat 3-5 times

Or, just choose a few exercises to work on each day.  For example, try to do as many pushup repetitions as you can.  Every-other day, try to do two more reps.  By the end of the month, BOOM, you're doing 50. 

The best part of exercising at home is, wait for it, you're at home.  Chances are, you spend a lot of time at home, probably watching TV.  So while the TV is on, take 15 minutes and choose from the menu above and get your exercise in at the same time.  It's what I call "multitasking".  You do have time to exercise.  You do have time to improve your health and with these at-home classic moves, get fit at the same time.
Monday, May 7, 2012

Barriers, Busted: Part II (Walk This Way)

In Part I of "Barriers, Busted" I alerted you to a little known fact that most American adults don't exercise enough.  What's that?  Everyone knows that?  Hmmmm...

In my first post I observed that many of the clients I work with use the excuse, "I don't have time to exercise" as the reason they spend most of their 24 hours sitting on their backsides.  As promised, I'm going to break-down the "no time" barrier by giving you efficient, anywhere exercise that costs nothing.

Too good to be true?  Would I lie to you, dear reader?  Without further ado, drumroll please!  The first exercise that you do have time to do is....Walking!

Did I just sense a collective eye roll from the internet?  Walking can't certainly be a magic bullet to fighting the inactivity and obesity crisis in America, can it?  But it can!  It is!

Walking is probably the single best thing you can do to improve your health.  Just 30 minutes per day of moderate intensity walking conveys significant health benefits.  In fact, Dr. Steven Blair of the University of South Carolina, has dedicated much of his career to researching the link between moderate activity (walking, in most cases) and longer and healthier lives.  I won’t even list all the research studies that say walking is excellent exercise.  But if you’d like some examples, here’s a good article by Harvard Medical School. Raise your hand if you'd like to live a longer, healthier life. 

Let me repeat this for dramatic impact.  Walking.  Will.  Save.  Your.  Life.

I think part of the reason why many American adults don't get enough (any) exercise, is because they think it was to be exhaustive, requires many hours per week (per day?) and is expensive by nature of gym memberships, home fitness equipment and the like.  But walking is the exception to those rules.  Here's why I walk:

1) Walking is actually enjoyable.  It's relaxing, unlike running, which leaves me asking the question, "Haven't I gone far enough?"

2) It's social.  Walking with my husband, co-workers or friends is a great way to spend time together and still be able to chat.  Unlike running (can you tell I'm anti-running?) you can actually hold a conversation without *gasp* having to *gasp* take a *gasp* breath *gasp* between every word. 

3) I'm always 30 seconds away from a walk.  I don't have to drive anywhere, pack special clothes or need special equipment.  As long as I've got appropriate footwear, I'm ready to go, any time, any place.  This means that the 30 minutes I walk is just 30 minutes -- not 30 minutes plus the 10 minutes to drive the gym (and home), the 5 minutes getting checked-in, the 10 minutes waiting for a machine... Walking is just walking.

4) Child care is no problem, kids can walk (or ride in a stroller).

5) I'm outside.  I love being outside, but since I have a desk job, I don't get out as much as I'd like.  Walking is an exercise that allows me to enjoy being outside (without gasping for air).  I'm not even talking about heading out to the countryside.  My favorite time to walk is 6am with my dog.  The city is totally different in the morning.  It's peaceful without traffic, the city sprinklers make the streets appear exotic (and the dog likes to stick her head in them) and the sunrise is beautiful.  I love a morning walk, and my dog does too.

So start walking.  Make today the day.  Your health (and your dog) will thank you. 
Wednesday, May 2, 2012

Barriers, Busted: Part I

According to Healthy People 2020, 80% of American adults do not meet the guidelines for both aerobic and muscle-strengthening activities.  80 percent!  Dude, that's like, almost everybody!  Does this statistic mean that 80% of American adults are unaware that exercise is good for them?  Does it mean that the majority of us don't have a clue that moderate intensity exercise helps protect us from mean and nasty diseases like heart disease, high blood pressure, type II diabetes, osteoporosis and depression?  Does it mean that throughout their entire lives most people have been told, and thus believe, that sitting (or riding, elevator'ing, escalator'ing, moving-walkway'ing...) are healthier than moving more?  No.  In fact, I would be willing to bet that all 80% of those Americans not meeting the recommended amount of exercise know, for a fact, that exercise is good for them and they should be doing it regularly.

So why aren't they?  Why are 80% of people not getting the recommended amount of exercise?  Well I can't speak for every individual who constitutes that 80%, but I can take a guess at what they would tell you.  They would tell you they "don't have time." 

Sound familiar? 

I'm not going to lecture about how we all get 24 hours, how you need to prioritize your time and make your health more important.  What I am going to tell you is how to workout efficiently, at home, so you do have more time. 

I think in today's fast-paced, high-tech world, we think our exercise routine has to also be fast-paced and high-tech.  We think we need bells and whistles, muscle-bound trainers who scream "ONE MORE REP" while we flounder on the mat.  We think we need to drive somewhere to workout, that we need machines on which to exercise and places with smoothie bars.  Definitely need the smoothie bars.  And when we think we need fast-paced, high-tech, what we really think is, "I don't have time for that."  And honestly, you probably don't.  Who has time for personal training sessions, driving to and from the gym (in traffic!), time to wait for the fancy machine, time to take the group fitness class du jour?  Certainly not me.  And I'm guessing, probably not you, and 80% of adults.

On this week's blogs, I'm going to bust your "I don't have time" barrier.  I'm going to convince you that you do have time to exercise, because you're going to do it efficiently, and you're not going to drive anywhere to do it. 

Posted by Rachel L. May
Adjunct Faculty, College of Health Sciences

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