Predictive Value of Equations to Calculate Your Resting Metabolic Rate (RMR) Flawed: Results Can Be 14-29% Off

Would she still look so happy, if she knew that thee treadmill just lied to her?

I have written, said and, in person, even shouted it out often enough: Once you start to rely on the figures certain formulas generate (and this includes what your treadmill, your heart rate monitor etc. will produce, 'cause they use the same flawed formulas), you are lost.

The message of today's SuppVersity article is therefore by no means a new one. What's pretty new, though, is the study by V. Bonghana and colleagues from University of Campinas who have compared five predictive equations that are supposed to predict your and everyone else's basal (=excluding physical activity) energy demands (Bonghana. 2013).

"Start with a 15% energy deficit" - based on what?

The above, i.e. to start dieting by consuming ~15% less energy than you usually do, is my usual suggestion for anyone who's not in the "so fat that your health is in danger" zone, someone like you, maybe - someone who wants get rid of his/ her belly to finally see a at least the uppermost portion of his / her abs.

Table 1: The five equations the researchers used to calculate the predicted resting metabolic rate (RMR) that was then compared to the measured RMR (indirect calorimetry by respiratory gas analysis) of the 43 participants (Bonganha. 2013)

Now, what do you think would happen if this person was a postmenopausal women (of whom many, as we all know, love to "diet" exactly as they are told to, counting calories and what not) who is too lazy to follow my even more important advice to track her caloric intake for 2 weeks in order to get a "baseline reading"? What would happen if this woman, instead of doing just that simply used one of the calculators on the Internet and build her diet right according to the number the machine vomits out?

Figure 1: Comparison of the predicted resting metabolic rates and the mean difference to the "real" (=measured) RMR of the 43 healthy postmenopausal women who participated in the study (Bonghana. 2013)

Actually a cursory look at the data in figure 1 should suffice to tell you what the result would be. If she was lucky and the calculator used the rather uncommon Mifflin-St Jeor equation she would not lose a single pound, because she would end up right at the 1,063 kcal/day she, a 52-year young women, who's 159cm small has a totally age-appropriate BMI of 25kg/m², but a slightly high body fat level of 33%, just like the "average subject" in our experiment, needs to fuel her most basic metabolic demands (measured those are 1063.8 kcal/day). The former obviously implies that she did also take into account that she spends a few extra calories, even when she does not exercise.

Use the WHO calculation and you are lost

Guess how she got in in shape? Right! The EDC Program (learn more)

If she was not just as lucky and used the WHO equation as a baseline, she would not only overestimate her basal energy requirements by more than 30%. No, even with the 15% reduction she would be continuously gaining gaining wait... now, imagine she had also started to work out and had for once heard received some good advice, which is not to freak out about the weight gain, because it's all muscle. What? Right, she would be working away instead of towards her goal to lose weight and fat, 'cause one thing is sure.

Unless you expend more energy than you eat it is almost impossible to get rid of the belly. Unfortunately, simplistic calories in vs. calories out calculations won't help you find out whether this is the case..

The notion that exercise "alone" can, especially for those who are pretty chubby to begin with, have a "repartitioning effect" may still hold here, but it is more  likely that our imaginary post-menopausal training rookie is - if anything - gaining more muscle than fat and that's certainly not going to give her the look she is aspiring. In fact the situation would probably not be much different from the one in the study I had in the Facebook News a couple of days ago (Tibana. 2013).

Adding exercise on top of a proven (your N=1 experience) obesogenic diet rarely helps

In the course of this 8-week intervention study, the subjects, a group of 14 middle-aged (33.9 ± 8.6 years) overweight/obese women (body mass index - BMI 29.6 ± 4.1 kg/m²) underwent 24 sessions (3 times per week) of a whole body RT program with 3 sets of 8–12 repetitions maximum (RM). Unfortunately, for them without any dietary advice / incentive to modify the baseline diets that were obviously to blame for the extra-weight they were carrying.

Figure 2: Body mass, waist, hip, neck circumference, body adiposity index and visceral fat volume in middle-aged women before and after an 8-week 3x/week full body weight training intervention (Tibana. 2013)

The net result of this "intervention" was thus by no means representative of what you can achieve, when you really commit. If you discard the diet component, or even worse, fall for the common idea that you've worked out for an hour and could thus "afford" that piece of pizza, pie or panacotta, you are effectively bulking. Therefore, you should thus not be surprised, if you got strong and bulky, but don't see improvements in your body fat level, your waist line and any of the biochemical variables, i.e. fasting glucose, HbAIc, insulin,  triglycerides, HDL, and the TG/HDL ratio (not shown in figure 2), your doctor will be eyeballing.

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Without taking a "baseline reading" and accessing where you want to go, you ain't going to succeed (read more)

Bottom line: In conjunction, the results of the Bonghana and Tibana papers only underline the necessity to (a) make a baseline assessment of your current, individual food quantity and quality(!), before you embark on any kind of diet and (b) that the notion of "exercising the fat away" is only useful when you are not making the mistake to chart your dietary intake up against whatever you believe your exercise induced energy expenditure would look like. Even if it's not pizza, pasta and panacotta you are thinking of, when you look at the figure your treadmill or heart rate monitor calculated based on similarly whacky formulas as those used for the RMR, you are still lost whenever you put more faith into a impersonal arithmetics than the signals of your own body... and this, gentleman, is true irrespective of your age and sex.

If you still insist on calculating something, you may also want to take a look at Part III / III of the Female(?) Athlete Triad Series, but please be aware that I am not liable for the damage this type of calorie counting is going to do to your physique and your psyche.

References:

• Bonganha V, Libardi CA, Santos CF, de Souza GV, Conceição MS, Chacon-Mikahil MP, Madruga VA. Predictive equations overestimate the resting metabolic rate in postmenopausal women. J Nutr Health Aging. 2013;17(3):211-4.
• Tibana RA, Navalta J, Bottaro M, Vieira D, Tajra V, Silva AD, de Farias DL, Pereira GB, de Souza JC, Balsamo S, Cavaglieri CR, Prestes J. Effects of eight weeks of resistance training on the risk factors of metabolic syndrome in overweight /obese women - "A Pilot Study". Diabetol Metab Syndr. 2013 Feb 28;5(1):11.

Grape Seed Extract Protects EPA & DHA From Intestinal Oxidation. Niacin Shifts Muscle Fiber Type. Cholesterol & Sialic Acid Build Babies' Brains. Pro-Diabetic GUMPs 4 Kids

"What? Don't gimme that look. I did walk to the fast-food outlet. I swear!" - When it comes to how much they sit around, people love to lie... ah, I mean they often overestimate their activity level - especially the really lazy ones ;-)

It's not always easy to find a "figure of the week" and actually the on I am going to present you today is not "week specific". It is rather related to yesterday's post on the statistics of the diabesity epidemic. That said, you may remember that the gap between "more" and "less" active individuals was widening, but on average the NHANES stats would suggest that the average US citizen is not sitting around much longer today (or rather in 2004) than 40 years ago. Now, the NHANES data is based on a questionnaire of which Healy et al., who have analyzed the accuracy of these self-reported activity levels in a 2010 paper (Healy. 2011), found that the difference between the real and the claimed sedentary time increases by one hour for every 3h of sedentary time (at least for people with a sedentary time of >7h)

In other words, someone who actually sits on his booty for 10h will be telling you that he would be sitting around for 9 hours. It should be said though that there are outlier on both sides so that it may well be that the guy will boldly lie to you and tell you he would sit around max. 7h per day. The chances that he underestimates his activity level, on the other hand, are slim; and if he does it's by no more than 1h.

Now that we have already been talking about health, why don't we simply keep on this track and take a look at a handful of recently published studies which may help you to do what it takes to keep "healthy, happy and lean" (cf. "bottom line" of yesterday's post): learn what's good for you (and your family) and take responsibility for your own well-being.

Grape seed extract to protect and deliver unoxidized omega-3 fatty acids

(Maestre. 2013) -- If we assume that you want your omega-3 fatty acids unoxidized (this is by no means sure, see link beneath the image on the right), it would be prudent to ingest your fish, but even more so the unprotected fish oil from caps with some grape seed extract.

Surströmming, a Swedish delicates that's essentially rancid fish. Can't be healthy? Well, even with pure, yet oxidized fish oils did not have any negative health effects in previously healthy individuals in (read more)

That's at least what a recent study by scientists from the Department of Seafood Chemistry at the Instituto de Investigaciones Marina in Vigo, Spain and their US colleagues from the Department of Nutritional Sciences at the Rutgers University in New Brunswick, NJ, would suggest.

In their latest paper that has been published in the last issue of the Journal of Nutrition the scientists report that the addition polyphenol-rich grape seed extract (GSE) during the in-vitro digestion of omega-3 fatty decreased the amounts of oxidation products in the stomach compartment and intestinal dialysate and would thus facilitate a higher uptake of intact omega-3 fatty acids in the intestine.

Want more type I and less type II fibers? Niacin is your friend, then

(Ringseis. 2013) -- Hard do believe but after one months of niacin supplementation (750 mg/kg diet niacin aka vitamin B3, also "nicotinic acid") the obese Zucker rats in a recent study by Robert Ringseis, Susann Rosenbaum, Denise K. Gessner et al. exhibited a statistically significant shift towards a more oxidative (type I) muscle type.

Is there a connection between niacin and the diabesity epidemic or is the increase in niacin intake (also due do fortification) and the explosion of the obesity and diabetes rates coincidence?
(Figure from Zhou. 2010)

Unfortunately the latter are not without side effects - especially for those who don't really need to lower their blood lipids, where the administration of high dosages of nicotinic acid will induce transient insulin resistance (Poynten. 2003). And contrary to hyperlipidemic obese individuals the he increased use of fatty acids by the skeletal muscle is a cold comfort for healthy people like (I hope) you, especially in view of the fact that it adds to already existent negative modulators of insulin sensitivity such as aging (Chang. 2006)

And while these "pro-diabetic" effects may not be as pronounced from nicotinamide (the stuff that's usually in supps, because it won't make you flush), the latter has also been shown to reduce insulin sensitivity in people with at high risk of insulin dependent diabetes mellitus (Greenbaum. 1996).The increased oxidative capacity went hand in hand with the well-known lipid lowering effects of niacin (Creider. 2012).

The main difference being that the 2g of nicotineamide the subjects in that study received lack most of the beneficial effects of "real" niacin. So is the common practice to "fortify" foods with this stuff turning all of us into diabetics (cf. Li. 2012)? I tend to agree with Paul Jaminet who wrote an excellent article on that matter back in the day that it is - on it's own - probably not a problem, but if you add tons of multivitamins and other niacin / nicotinamide laden supps on top, you could in fact risk running into trouble without even the slightest chance to see any benefits.

Sialic acid and cholesterol two vitally important bad guys

Low (or insufficient?) sialic acid (in mmol/L), another reason for the inferiority of formula vs. breast milk (Wang. 2001) - use your brain and make sure your kids will be able to use theirs, as well (Wang. 2001).

(Scholtz. 2013) -- I guess you are by now over the "dietary cholesterol is bad for you" mantra and probably did not even know that sialic acid (SA) is another of those supposedly bad guys, which do eventually turn out to be as bad as the jacketed metal bullets are made of.

The latter is what a recent study from the University of Kansas Medical Center clearly indicated for both of them cholesterol, as well as sialic acid, a monosaccharide with a nine-carbon backbones that's a derivate of neuroaminic acids. While it has been implicated in cancer development, influenza infection or bacterial infections (as a food for the bacteria), the recent paper by Scholtz and her coworkers clearly shows that it's high presence in human milk is just like that of cholesterol necessary for optimal brain development:

"Cholesterol exposure from conception to P32 increased cortex weight (P = 0.003) and the concentrations of cortical cholesterol (P = 0.006), protein (P = 0.034), and ganglioside SA (P = 0.02). Independent of cholesterol feeding, SA fed from P17 to P32 [post natal day 17 to 32] increased the cortical ganglioside SA concentration (P-trend = 0.007)."

Their conclusion that "[d]ietary cholesterol and SA independently contribute to brain cortex composition during early brain development." (Scholtz. 2013) also puts a huge question mark behind the current nutrient composition of infant formulas which are significantly lower in both these "bad" nutrients than mother's milk. And I guess I don't have to mention that the "healthy" soy "milk" is almost devoid of both this vital nutrients.

Pro-Diabetic formula - "Growing Up Milk Powders" today, insulin therapy tomorrow?

(Brand-Miller. 2013) -- It's really amazing how parents are fooled by the industry to believe they would do their kids a favor, when they buy "milk products" that have been specifically formulated for kids: Sweet and delicious, just like kids like it, so that parents who are worried about the health of their kids don't have fret, when the little ones refuse to drink their milk. If only they knew,...

What to make of this study? The study was sponsored by the Fonterra Research Centre, who certainly have a vested interest in pointing out the weaknesses of the sugary "dairy" products of their competition. And the "milk replacements" that have been tested in the study are mainly used in Asia (in fact, all products are sold and were purchased in Malaysia and Indonesia), but that does not nullify the results and the validity of the scientists conclusion that "there is the potential for the risks to outweigh the benefits if manufacturers do not take a responsible approach in formulation" (Brand-Miller. 2013)

Yeah, if only the knew about the results of a recent study by Jennie Brand-Miller, Fiona Atkinson and Angela Rowan who studied the glycemic index and glycemic load of 7 products that had been specifically selected to represent the full spectrum of 58 previously analyzed so-called "Growing Up Milk Powders" (GUMPs) and found that:

"[Milk p]roducts containing maltodextrins, corn or glucose syrups increased the GI by more than 2-fold, and glycemic load (GL) by 7-fold compared to milk powders with no added  carbohydrates." (Brand-Miller. 2013)

Just to make sure no one misses the crucial point here. Even products that contain maltodextrin or corn syrup and could thus carry a label like "no added sugar" will raise the insulin level 2x more than regular milk and an even 7x higher glycemic load.

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That's it for today, but obviously there is more for those of you who feel the weight of the initially mentioned responsibility on their shoulders and want to make sure they don't mess up on the SuppVersity's facebook wall. Let's see, what do we have?

"Strong is the Better Sexy!" Study Shows: Athletes Are Better Role Models for Women Than Sexualized Cover Models for young women (read more)
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• Healthy marathon running - if at all, only for women!? Men 5.7x more likely to suffer from sudden cardiac arrest (SCA) during a marathon. 11/13 men with SCA are 40+ (read more)
• Sex differences in body dissatisfaction and its effects on eating behavior in athletes: Women hate themselves for each lbs of body fat. Men are more complex (also consider BMI) and don't change their diet if they feel they are too fat / skinny (read more)
• Common CoQ10 wisdom debunked: CoQ10 + Selenium do not reduce statin induced myopathy (read more)
• Woman with slimmer waistlines improve their significant other's sexual performance... or if your girlfriend has a 120er waist your chances of having erectile dysfunction increase significantly (read more)
• There is more & still more to come in the course of the next 24h @ www.facebook.com/SuppVersity

Assuming you are still hungry for more, I suggest you head over to CasePerformance to learn why supplements are so freaking expensive and price is no indicator of quality let alone efficacy in the 2nd installment of the CasePerformance New Year's Resolution Series.

References:

• Brand-Miller J, Atkinson F, Rowan A. Effect of added carbohydrates on glycemic and insulin responses to children’s milk products. Nutrients. 2013 Jan 10;5(1):23-31.
• Chang AM, Smith MJ, Galecki AT, Bloem CJ, Halter JB. Impaired beta-cell function in human aging: response to nicotinic acid-induced insulin resistance. J Clin Endocrinol Metab. 2006 Sep;91(9):3303-9. Epub 2006 Jun 6.
• Creider JC, Hegele RA, Joy TR. Niacin: another look at an underutilized lipid-lowering medication. Nat Rev Endocrinol. 2012 Sep;8(9):517-28.
• Greenbaum CJ, Kahn SE, Palmer JP. Nicotinamide's effects on glucose metabolism in subjects at risk for IDDM. Diabetes. 1996 Nov;45(11):1631-4. 
• Healy GN, Clark BK, Winkler EA, Gardiner PA, Brown WJ, Matthews CE. Measurement of adults' sedentary time in population-based studies. Am J Prev Med. 2011 Aug;41(2):216-27.
• Li D, Sun WP, Zhou YM, Liu QG, Zhou SS, Luo N, Bian FN, Zhao ZG, Guo M. Chronic niacin overload may be involved in the increased prevalence of obesity in US children. World J Gastroenterol. 2010 May 21;16(19):2378-87.
• Maestre R, Douglass JD, Kodukula S, Medina I, Storch J. Alterations in the Intestinal Assimilation of Oxidized PUFAs Are Ameliorated by a Polyphenol-Rich Grape Seed Extract in an In Vitro Model and CACO-2 Cells. J Nutr. 2013 Jan 16.
• Poynten AM, Gan SK, Kriketos AD, O'Sullivan A, Kelly JJ, Ellis BA, Chisholm DJ, Campbell LV. Nicotinic acid-induced insulin resistance is related to increased circulating fatty acids and fat oxidation but not muscle lipid content. Metabolism. 2003 Jun;52(6):699-704.
• Ringseis R, Rosenbaum S, Gessner DK, Herges L, Kubens JF, Mooren FC, Krüger K, Eder K. Supplementing Obese Zucker Rats with Niacin Induces the Transition of Glycolytic to Oxidative in Skeletal Muscle Fibers. J. Nutr. 2013; 143: 125-131.
• Scholtz SA, Gottipati BS, Gajewski BJ, Carlson SE. Dietary Sialic Acid and Cholesterol Influence Cortical Composition in Developing Rats. J Nutr. February 1, 2013; 143(2):132-135.
• Wang B, Brand-Miller J, McVeagh P, Petocz P. Concentration and distribution of sialic acid in human milk and infant formulas. Am J Clin Nutr. 2001 Oct;74(4):510-5.
• Zhou SS, Li D, Zhou YM, Sun WP, Liu QG. B-vitamin consumption and the prevalence of diabetes and obesity among the US adults: population based ecological study. BMC Public Health. 2010 Dec 2;10:746.