Diet and Nutrition Misconceptions

hmrambling

I wrote the following email to BePureWellness who is an affiliate of Blue Cross Blue Shield who is promoting Live Better Louisiana for Louisiana State Employees:

This program suggests a heart healthy diet which has a daily calorie goal of 1200 calories. When I exercise, it does not include that day's exercise in my calorie goal. For instance, my daily calorie goal is 1200 calories. When I exercise and burn 600 calories, this program still has my calorie goal as 1200 calories. It does not suggest that I eat any additional calories if I burn 600 calories in a day. My net calories for that day would be 600 calories if I ate 1200 calories and burned 600 calories when I worked out. Is this program suggesting that 600 net calories a day is acceptable?

This is the response I received:
The caloric range you've been prescribed would be dependent on how you answered the health assessment. Did you indicate a goal to gain, lose or maintain your weight? Also, your body burns calories throughout the day whether at rest or during a workout. If you consumed 1200 calories and burned off 600, your body still recognizes that you had the 1200, not that you only consumed 600. If maintaining your weight is the goal, you would need to burn as much as you consume, if weight loss is your goal you would need to burn more than you consume, etc. Factors such as your current weight, your goal, current activity level, etc. will determine that amount. Please let us know if we can be of further assistance.

Let's discuss the suggestions given by this program that is supposed to help encourage Louisiana state employees to get healthy.

1. If you consumed 1200 calories and burned off 600, your body still recognizes that you had the 1200, not that you only consumed 600.
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What? This program is saying it is okay consume 1200 calories and to go work out and burn 600 calories, and that my body knows that I consumed 1200 calories at some point throughout the day, so it is okay.

2. If maintaining your weight is the goal, you would need to burn as much as you consume, if weight loss is your goal you would need to burn more than you consume, etc.
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So I really need to burn 1200 calories when I consume 1200 calories if I want to MAINTAIN weight. ?
And I really need to burn more than 1200 calories when I consume 1200 calories if I want to LOSE weight. ?


FYI
I am 5'5" and 148 lbs.
SW 175
GW 125

I used this program in June and July, where I quickly lost 15 lbs. I was tired and I had trouble concentrating. When you look at their recommendations, you will easily see why. The remainder of the weight I lost since I have been here at MFP. I set my macros. I eat 1468 calories. When I work out (which is most days), I eat about half or more of my calories back. My TDEE is right around 2057.

It is amazing that our state signed off on this program that suggests that in order to lose weight that I have to consume more than 1200 calories when I consume 1200 calories.

I passed an email along to some of my coworkers stating that I don't believe that this program is a healthy way to lose weight.

soozy_q

Oh dear, tht person really didn't have a clue. Their response actually made me burst out laughing. Especially when they said you have to burn as many calories as you consume to maintain.

SideSteel

Especially when they said you have to burn as many calories as you consume to maintain.

Except you do.

If your goal is weight maintenance, calories in should roughly equal calories out.

soozy_q

What I meant is that they suggest if you eat 1200, they made it sound like you would have to work out to burn of 1200 on top of whatever you burn anyway during the day.

SideSteel

Let's discuss the suggestions given by this program that is supposed to help encourage Louisiana state employees to get healthy.

1. If you consumed 1200 calories and burned off 600, your body still recognizes that you had the 1200, not that you only consumed 600.
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What? This program is saying it is okay consume 1200 calories and to go work out and burn 600 calories, and that my body knows that I consumed 1200 calories at some point throughout the day, so it is okay.

I think they are using these numbers as examples to discuss calories in vs calories out.

2. If maintaining your weight is the goal, you would need to burn as much as you consume, if weight loss is your goal you would need to burn more than you consume, etc.
----
So I really need to burn 1200 calories when I consume 1200 calories if I want to MAINTAIN weight. ?
And I really need to burn more than 1200 calories when I consume 1200 calories if I want to LOSE weight. ?

Yes, and yes.

I used this program in June and July, where I quickly lost 15 lbs. I was tired and I had trouble concentrating. When you look at their recommendations, you will easily see why. The remainder of the weight I lost since I have been here at MFP. I set my macros. I eat 1468 calories. When I work out (which is most days), I eat about half or more of my calories back. My TDEE is right around 2057.

It is amazing that our state signed off on this program that suggests that in order to lose weight that I have to consume more than 1200 calories when I consume 1200 calories.

I passed an email along to some of my coworkers stating that I don't believe that this program is a healthy way to lose weight.

I don't see where this program is telling you that you need to eat 1200 calories. Maybe I'm reading it wrong but when they mention 1200 calories it sounds to me like they are using that number as an example.

Can you clarify -- did this program tell you specifically that based on your goals and your stats, you should eat 1200 calories?

SideSteel

What I meant is that they suggest if you eat 1200, they made it sound like you would have to work out to burn of 1200 on top of whatever you burn anyway during the day.

I don't read it that way. I read it as -- if your goal is to maintain weight, and you consume 1200 calories, you need to burn 1200 calories. They specifically mention that there are non exercise factors to caloric expenditure.

The reality is that the OP likely burns far more than 1200 calories and thus should probably eat more than 1200 calories but I don't see any blatant misinformation in the info she posts. Once again though I could be reading it wrong or misunderstanding how they are presenting it.

hmrambling

The program suggested I eat 1200 calories. When I work out and enter a 600 calorie work out into their system, it does not suggest that I eat any more food. So their suggestion is that if I eat 1200 calories, and I burn 600 calories in a workout, that I do not eat any more food.

They have an app called Healthy Now that reflects what I am talking about. It is available for download for iphone.

hmrambling

What I meant is that they suggest if you eat 1200, they made it sound like you would have to work out to burn of 1200 on top of whatever you burn anyway during the day.

Exactly. My question specifically says that I work out and I burn 600 calories. Their program doesn't suggest eating back ANY calories that are burned in workouts. Their program suggests that I only eat 1200 calories regardless of how much I work out.

My question in the OP and to the program:
When I exercise and burn 600 calories, this program still has my calorie goal as 1200 calories. It does not suggest that I eat any additional calories if I burn 600 calories in a day. My net calories for that day would be 600 calories if I ate 1200 calories and burned 600 calories when I worked out. Is this program suggesting that 600 net calories a day is acceptable?

Their program does NOT suggest eating any more calories when someone works out. The reply I received supports how their program works.

darkangel45422

What I meant is that they suggest if you eat 1200, they made it sound like you would have to work out to burn of 1200 on top of whatever you burn anyway during the day.

Exactly. My question specifically says that I work out and I burn 600 calories. Their program doesn't suggest eating back ANY calories that are burned in workouts. Their program suggests that I only eat 1200 calories regardless of how much I work out.

My question in the OP and to the program:
When I exercise and burn 600 calories, this program still has my calorie goal as 1200 calories. It does not suggest that I eat any additional calories if I burn 600 calories in a day. My net calories for that day would be 600 calories if I ate 1200 calories and burned 600 calories when I worked out. Is this program suggesting that 600 net calories a day is acceptable?

Their program does NOT suggest eating any more calories when someone works out. The reply I received supports how their program works.

So, just so I am clear as to your issue with their program, you don't like that they don't require or tell you to eat back your exercise calories?

I don't personally see an issue with that. Exercising is one way of burning more calories, and the entire way to accomplish weight loss is to burn more calories than you consume, whether you burn them through exercise or just existing. So yeah, if you're trying to lose weight and you exercise, you don't necessarily want or have to eat back the exercise calories. Obviously there's a point where, if you take it too far for too long, it could cause issues, but I've never been big on eating back your exercise calories unless it's causing you problems (like low energy, insatiable hunger, etc.). If I burn more calories through exercise, good on me I say - just means faster weight loss because it means more fat my body has to dip into.

hmrambling

Yes, you are correct.

I sent them another email that should make it more clear about what my point is.

I entered that my goal is to lose weight. I am 5'5' and I weight 148 lbs. Your program recommended a 1200 calorie heart healthy diet. When I log that I have consumed a total of 1200 calories, and I log a 600 calorie burn from exercise into your program, the BePureWellness program does not suggest that I eat any more food.

Let's say my BMR is 1400 calories and my TDEE is 2057. When I eat 1200 calories, I am at a calorie deficit already. When I exercise and I log the 600 calorie exercise into your system, the calorie goal remains 1200. With your program, the calorie goal does not increase when I work out.

If my BMR is 1400 calories, and I eat 1200 calories for the day, and I have a 600 calorie exercise, then I have an 800 calorie deficit for the day. I have burned 2000 calories, but I consumed 1200 calories. Your program does not account for calories burned by exercise. If I follow the suggestions on your website I will have an 800 calorie deficit when I eat 1200 calories and burn 600 calories by exercising.

In order to eat at maintenance I would have to eat 2057 calories. In order to lose 2 lbs a week I would have to eat 1200 calories. What about when I exercise? Your program is not accounting for calories burned in exercise.

When I eat 1200 calories, and I burn 600 calories in a workout, shouldn't the calorie goal increase?

FredDoyle

I understand the OP's confusion.
They're assuming her TDEE is 1200 calories whether she lays on the couch with an intravenous or runs a marathon.
Not very clear, and misguided.

seltzermint555

So why don't you use MFP instead?

hmrambling

I am using MFP. This program is being pushed by the state for state employees. The communication I have with BePureWellness is in hopes that I can help other state employees. The state is really pushing this Live Better Louisiana as a healthy way to diet and exercise. Those who are not so fortunate to participate in MFP might be ignorant to the fact that this program being promoted by the state is not the healthiest way to lose weight. I am hoping to make a difference by corresponding with the company. I use MFP and have been for since July. ONLY because I have read and learned here am I aware that this suggested program might not be the healthiest way to go about it. There are those, though, who are unaware. I am hoping to make a difference for them.

onefortyone

I am not sure if they asked for an activity level when you first signed up - but it sounds to me as though they gave you a calorie expenditure based on everything, including activity level. If you set it up as sedentary then they may be simply assuming that you won't/don't exercise. But they should give you a higher calorie allowance if you plan on exercising a few times a week, or have an active job or something. It seems like their setup is to give people 'one number' to eat and not worry about other factors. Which could be overly simplistic, yes, but simplicity can work!

seltzermint555

I am using MFP. This program is being pushed by the state for state employees. The communication I have with BePureWellness is in hopes that I can help other state employees. The state is really pushing this Live Better Louisiana as a healthy way to diet and exercise. Those who are not so fortunate to participate in MFP might be ignorant to the fact that this program being promoted by the state is not the healthiest way to lose weight. I am hoping to make a difference by corresponding with the company. I use MFP and have been for since July. ONLY because I have read and learned here am I aware that this suggested program might not be the healthiest way to go about it. There are those, though, who are unaware. I am hoping to make a difference for them.

Gotcha! That's cool.

FredDoyle

If it has "wellness" in the title, I'm immediately suspicious that it is woo.

QuilterInVA

My doctor told me not to eat back exercise calories. 1200 is the lowest amount of calories you should eat because that is what is required for good nutrition. You would just lose weight faster.

WalkingAlong

I agree with that org. "Net calories" and "eating back" are pretty unique to MFP, and in my opinion, usually kind of misguided for someone trying to lose weight, not eat more.

HeidiCooksSupper

Aha, the problem is one of bureaucracy and low bid contracts, I'm guessing.

BePureWellness has been swallowed by Cerner. If you look at the news page of BePureWellness, it hasn't been updated since it's purchase by Cerner was announced in February 13.

If you try to go to bepurewellness.com you are automatically flipped to http://www.cerner.com/solutions/member_engagement/cerner_wellness/


The state must have a contract with Cerner to provide these services to state employees. Cerner is huge. The health coaches may be working from a script. The health care coaches may be in a completely different "silo" from those who determine how the software labels you.

You have a mountain of bureaucracy between you and this level of detail. As an individual employee of the state, you may well not get attention to a matter of quality control like this one. What you might want to do is contact state HR and find out who is the ombudsman for this to get your complaint/correction headed somewhere other than a wastebasket somewhere.

FredDoyle

Aha, the problem is one of bureaucracy and low bid contracts, I'm guessing.

BePureWellness has been swallowed by Cerner. If you look at the news page of BePureWellness, it hasn't been updated since it's purchase by Cerner was announced in February 13.

If you try to go to bepurewellness.com you are automatically flipped to http://www.cerner.com/solutions/member_engagement/cerner_wellness/


The state must have a contract with Cerner to provide these services to state employees. Cerner is huge. The health coaches may be working from a script. The health care coaches may be in a completely different "silo" from those who determine how the software labels you.

You have a mountain of bureaucracy between you and this level of detail. As an individual employee of the state, you may well not get attention to a matter of quality control like this one. What you might want to do is contact state HR and find out who is the ombudsman for this to get your complaint/correction headed somewhere other than a wastebasket somewhere.

Brill, and right on.

lemurcat12

I am not sure if they asked for an activity level when you first signed up - but it sounds to me as though they gave you a calorie expenditure based on everything, including activity level. If you set it up as sedentary then they may be simply assuming that you won't/don't exercise. But they should give you a higher calorie allowance if you plan on exercising a few times a week, or have an active job or something. It seems like their setup is to give people 'one number' to eat and not worry about other factors. Which could be overly simplistic, yes, but simplicity can work!

This was my thought too. The question is how they come up with the 1200.

hmrambling

Yes, they ask the activity level. I checked moderately active. I have a desk job. They ask how many times I work out a week. I a answered 3 to 5 times a week with rigorous workouts.

chouflour

Do they ask how quickly you want to lose weight? With a TDEE of 2057, eating 1200 calories a day gives an estimated loss of 1.7lb/week, which is considered a safe, rapid weight loss for a starting weight of 175.

I'm not in favor of eating back exercise either, though. Machines often give freakishly invalid numbers of calories burned, and even with the best individualized testing, your body adapts to exercise and becomes more efficient. You can easily end up "eating back" far more than you're actually burning.

extra_medium

I am using MFP. This program is being pushed by the state for state employees. The communication I have with BePureWellness is in hopes that I can help other state employees. The state is really pushing this Live Better Louisiana as a healthy way to diet and exercise. Those who are not so fortunate to participate in MFP might be ignorant to the fact that this program being promoted by the state is not the healthiest way to lose weight. I am hoping to make a difference by corresponding with the company. I use MFP and have been for since July. ONLY because I have read and learned here am I aware that this suggested program might not be the healthiest way to go about it. There are those, though, who are unaware. I am hoping to make a difference for them.

hopefully it does some good. I have a friend who was using an app that was actually subtracting her exercise calories from her total rather than adding them. it's amazing how many misguided programs there are out there, but that's the worst I've seen.

hmrambling

Do they ask how quickly you want to lose weight? With a TDEE of 2057, eating 1200 calories a day gives an estimated loss of 1.7lb/week, which is considered a safe, rapid weight loss for a starting weight of 175.

I'm not in favor of eating back exercise either, though. Machines often give freakishly invalid numbers of calories burned, and even with the best individualized testing, your body adapts to exercise and becomes more efficient. You can easily end up "eating back" far more than you're actually burning.

Yes. On my initial member profile I responded that I wanted to lose 2 lbs a week.

I passed on my concerns to human resources and have not heard a response. Not have I heard a response from the last email I sent to BePureWellness who sends it to Blue Cross (?).

smarionette

I agree with that org. "Net calories" and "eating back" are pretty unique to MFP, and in my opinion, usually kind of misguided for someone trying to lose weight, not eat more.

Umm...no it isn't unique. MFP uses a methodology called NEAT (non-exercise activity thermogenesis) which looks at your BMR and makes an assumption of what you burn based on a stated activity level (not your stated exercise level). The number NEAT gives you (assuming you have a goal of maintaining) is the number of calories it is assumed you burn throughout your day to day activities. So, when you tell MFP (or any NEAT calculator) that your goal is to lose weight it just subtracts from your non-exercising maintenance number. You eat back the calories to maintain your stated desired weight loss.

Example - Maintenance
30yo sedentary woman, desk job, commutes by car, 5', 130lbs. This lady has a BMR of 1361 calories. Her daily calorie expenditure according to NEAT methodology is 1633 calories. Meaning to maintain her weight she should eat somewhere around, but not over 1633 calories a day.

Example - Weight loss
30yo sedentary woman, desk job, commutes by car, 5', 130lbs. This lady has a BMR of 1361 calories. Her daily calorie expenditure according to NEAT methodology is 1633 calories. To lose 1lb per week she needs a weekly deficit of 3500 calories or there about, so 500 calories a day, making her target 1133 calories (please put the pitchforks away, this is just math).

When using a NEAT methodology the second woman would want that 500 calorie deficit to remain consistent. So, if she goes and runs 3 miles, burning 250 calories her deficit would be 750 calories that day - which is unnecessary given her stated goals. She can indeed eat more, and if she exercises regularly like this should eat more.

Back to the OP it seems like the state program 1) uses a TDEE methodology which does include exercise calories in it's assumptions and 2) has questions answered not by fitness people, but by just general scripts. Overall I think TDEE is great for people with consistent exercise routines and activity levels, but might not be for you.

The formula I used for calorie expenditure is the Harris Benedict Equation. There are others that take in more factors, but this one works well enough for demonstration purposes. For sedentary it looks like (BMR) x 1.2 = NEAT

It should be noted that for overweight women and african american women some studies have shown that it overestimates calorie expenditure (one such here - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2598419/)

If you just want to read more and don't mind following even more links to confirm things yourself you can start at the wikipedia entry - http://en.wikipedia.org/wiki/Harris–Benedict_equation

lemurcat12

Yes, they ask the activity level. I checked moderately active. I have a desk job. They ask how many times I work out a week. I a answered 3 to 5 times a week with rigorous workouts.

Do they explain what they mean by activity level? Just for kicks, I filled out the questionnaire for the weight management assessment offered by my insurer (also BCBS), and it told me I was classified as "very active" based on the exercise I do and recommended based on that, my age, height and weight, and the fact I want to lose weight, that I eat 1790 calories. (I'm assuming this means without eating back exercise calories, of course.)

chouflour

Do they ask how quickly you want to lose weight? With a TDEE of 2057, eating 1200 calories a day gives an estimated loss of 1.7lb/week, which is considered a safe, rapid weight loss for a starting weight of 175.

I'm not in favor of eating back exercise either, though. Machines often give freakishly invalid numbers of calories burned, and even with the best individualized testing, your body adapts to exercise and becomes more efficient. You can easily end up "eating back" far more than you're actually burning.

Yes. On my initial member profile I responded that I wanted to lose 2 lbs a week.

I passed on my concerns to human resources and have not heard a response. Not have I heard a response from the last email I sent to BePureWellness who sends it to Blue Cross (?).

Well, that's how you got 1200 calories. If your TDEE is 2057, you need to eat fewer than 1200 calories per day to lose 2lb per week. (14399 per week TDEE - 7000 calorie per week deficit = 7399 weekly calories or 1057 calories per day) Since 1200 is the standard floor for intake, that's what they recommend.

Since TDEE includes your exercise calories, I don't see what the concern is here. If you have a TDEE of 2057+600 on three days a week and 2057 on 4 days of the week, you'd have a weekly TDEE of 16199. That gives you an intake of 1314/day.

I agree that the issue is conflating NEAT with TDEE methods.

hmrambling

Let's take a quick step back. The website collects a lot of data and spits out numbers and does not use terms such as TDEE or BMR. And this could very well be part of my issue. It collects a LOT of data but does not fully explain at how they arrive at their recommendations. Does anyone have experience with DRI calculations? (The terms TDEE and BMR used in this thread were from when I sent an email to the website. They have used *neither* term on their site.)

I changed my goals and this is what I got back:

My Nutritional Needs
The DRIs (Dietary Reference Intake) are actually a set of four reference values: Estimated Average Requirements (EAR), Recommended Dietary Allowances (RDA), Adequate Intakes (AI), and Tolerable Upper Intake Levels, (UL) that have replaced the 1989 Recommended Dietary Allowances (RDAs). RDAs and AIs may both be used as goals for individual intake. RDAs are set to meet the needs of almost all (97-98 percent) individuals in a group. For healthy breastfed infants, the AI is the mean intake. The AI for other life stage and gender groups is believed to cover needs of all individuals in the group, but lack of data or uncertainty in the data prevent being able to specify with confidence the percentage of individuals covered by this intake.


Recommended Daily Allowances (DRI) for female of age 38
Calculations performed are based on your last weight entry of 146 lbs on 9/17/14
Daily activity level (from profile): Moderately Active
To maintain your weight based on your profile: Consume 2088 calories per day
To Lose Weight (1 lb. per week) consume: between 1588 and 1838 calories per day

chouflour

DRI uses EER (Estimated Energy Requirement) to calculate calories. It isn't based on BMR+burn. The equations are different, but they do include exercise. There's a wiki article here with the formulas and some of the background - http://en.wikipedia.org/wiki/Institute_of_Medicine_Equation - but none of the calculation links work. http://fnic.nal.usda.gov/fnic/interactiveDRI/ claims that it uses the Institute of Medicine EER calculations.

You kind of have to calculate average daily activity by combining generally sedentary work with 3 hard workouts a week. I would probably call that between low-active and active, and that seems to be about where the usda calculator puts your numbers.

Either way, it's coming up with a number that includes your exercise. So when you exercise, the calories you want to "eat back" should have already been averaged through the week. It looks like their maintenance number is right around what MFP and experience tells you your TDEE is - so their numbers seem reasonable.

That said - generally weight/calorie calculations need to be taken with a big pinch of salt. The data sets are small in comparison to the variety of bodies in the world. The Institute of Medicine numbers are derived from a number of combined studies, and still only have 530 adults - most of whom they don't have activity data on. Some other studies rely on inaccurate self-reports of calories consumed or exercise completed. If you've lost a lot of weight, adaptive thermogenisis means you'll need fewer calories to maintain that weight than someone who never weighed more than that.

That doesn't mean that the DRI numbers are wrong. They're as right as anything else out there. It just means that the nature of population-based calculations is that they aren't quite right for anyone, but they're good enough for most people.