Jacalyn J. Robert-McComb, PhD, FACSM Texas Tech University

1. Chapter 29: Nutritional Guidelines, Energy Balance, and Weight Control: Issues for the Mature Physically Active Woman Jacalyn J. Robert-McComb, PhD, FACSM Texas Tech University

2. Learning Objectives • After this presentation, you should have an understanding of: • Energy balance and weight control • Dietary Guidelines for the mature woman • Important nutrients, vitamins, and minerals for physically active women

3. Introduction • Worldwide, micronutrient status is inadequate for several micronutrients (iron, calcium, iodine, vitamins A and D) • A balanced intake of nutrient-rich food and nutrient supplements are the two best ways to achieve a female’s nutritional needs. • Energy balance is important in the prevention of chronic disease.

4. Energy Balance and Weight Control • An accurate assessment of energy needs is a necessary component to maintain energy balance. • Resting Metabolic Rate (RMR) is by far the largest single component of total caloric expenditure • The double labeled water technique in conjunction with direct calorimetry is the most accurate yet expensive way to assess RMR

5. Energy Balance and Weight Control • Predictive equations are the most practical way to measure RMR • Miffin-St Jeor (most commonly used) • Harris-Benedict Owen • World Health Org./Food and Agriculture Org./United Nations Univ.

6. Comparison of Equations • A systematic review of four commonly used predictive equations to estimate RMR (Miffin-St Jeor, Harris-Benedict, Owen, and World Health organization/Food and Agriculture Organization/United Nations University) revealed that the Miffin-St Jeor equation is more likely than the other equations to estimate RMR within 10% of that measured (Frankenfield, Roth-House, Compher, et al. , 2005).

7. Miffin-St Jeor Equation used for Energy Balance and Weight Control • Derived from a sample of 498 normal- weight, overweight, obese, and severely obese individuals ages 19-78 (44.5 ± 14.1) • Underestimates occur more commonly than overestimates. • The maximum underestimate was 20% and the maximum overestimate was 15% of measured RMR in nonobese and obese subjects 20-82 years old (Frankenfield, Rowe, Smith, et al. 2003)

8. Miffin-St Jeor Equation STEP 1: Estimate resting metabolic rate using the Miffin St Jeor Equation Resting Energy Expenditure (REE) = 9.99 x weight (kg) + 6.25 x height (cm) – 4.92 x age (yr) + 166 x sex (males, 1;females, 0) –161.

9. Determine additional caloric requirements based on level of activity STEP 2: Activity level Percentage above resting level Bed rest 10 Quiet Rest 30 Light Activity 40-60 Moderate Activity 60-80 Heavy Activity 100 Additional caloric requirements = REE x percentage above resting level = x Additional REE Percentage above Caloric Reg. Resting Level (Note: From Physiology of Fitness (3rd ed.) (p. 359) by B. J. Sharkey, 1990, Champaign, IL: Human Kinetics)

10. Determine Predicted Total Energy Expenditure STEP 3: Total Energy Expenditure= REE+ additional caloric requirements based on activity = + Total Energy Resting Energy Additional Expenditure Expenditure Caloric Requirements Based on Activity

11. Energy Balance and Weight Control • Caloric expenditure is less in women than men largely due to differences in FFM (fat-free mass) between genders • Caloric expenditure also decreases due to the aging process (largely due to decreases in FFM) • Women should increase their FFM through exercise throughout the aging process to maintain energy balance

12. Dietary Guidelines for Americans • The Dietary Guidelines of Americans is published jointly every five years by the Dept. of Health (HHS) and Human Services and the Dept. Of Agriculture (USDA) • The USDA provides a website in which a food plan can be customized: http://www.mypryamid.gov

13. Dietary Guidelines for Americans • The Dietary guidelines describe a healthy diet as one that is balanced and is composed of: - fruits, vegetables, whole grains, and fat- free milk or low-fat milk -lean meats, poultry, fish, beans, eggs, and nuts -low in saturated fats, trans fat, cholesterol, salt, and sugar

14. Recommendations for active females, age 50 Grains: 7 oz. Vegetables: 3 cups Fruits: 2 cups Milk: 3 cups Meat & Beans: 6 oz. Recommendations for active female3, age 80 Grains: 6 oz. Vegetables: 2.5cups Fruits: 2 cups Milk: 3 cups Meat & Beans: 5.5 oz. 2005 Dietary Guidelines for Women (www.mypyramid.gov)

15. Key Recommendations for Women Over Age 50 • Recommendations for women over age 50 -consume vitamin B12 in its crystalline form -should meet their Recommended Dietary Allowance for vitamin B12 by eating foods fortified with vitamin B12 such as fortified cereals -consume extra vitamin D if exposed to insufficient ultraviolet band radiation

16. Key Recommendations for Women in the Childbearing Years -Eat foods high in heme-iron and consume iron-rich plant foods or iron-fortified foods with an enhancer of iron absorption, such as vitamin C-rich foods -Women of childbearing age who may become pregnant and those in the first trimester of pregnancy should consume adequate synthetic folic acid daily (from fortified foods or supplements) in addition to food forms of folate from a varied diet.

17. Hypertension is a Major Public Health Problem Affecting Millions of Adult Women • A Dietary Approach to Stop Hypertension (DASH) was made to address the problem of hypertension • DASH is compared to USDA Food Guide at the 2,000-calorie a day level on the next two slides

18. USDA Food Guide (2,000 Calorie diet) Fruit: 2 cups (4 servings) Vegetable: 2.5 cups (5 servings) Grain: 6 oz equivalents Meat & Beans: 5.5 oz. equivalents Milk: 3 cups Oils: 27 g (6 tsp)

19. DASH Eating Plan(2,000 Calorie diet) Fruit: 2-2.5 cups (4-5 svgs) Vegetable: 2-2.5 cups (4-5 svgs) Grain: 7-8 oz equivalents (7-8 svgs) Meat & Beans: 6 oz or less (meat,poultry,fish) 4-5 svgs (nuts,seeds,dry beans) Milk: 2-3 cups Oils: 8-12 g (2-3 tsp)

20. Important Nutrients, Vitamins, and Minerals for Physically Active Women • For physically active individuals, their micro and macronutrient needs have always been a subject of debate. • Intensity, duration, and frequency of physical activity, as well as the overall nutrient intake of the individual, all have an impact on whether or not micro and macronutrients are required in greater amounts.

21. Important Nutrients, Vitamins, and Minerals for Physically Active Women • It has been shown that frequently women, of all ages, do not meet their nutrient needs through diet alone, therefore supplementation may be necessary. • Older adults are at greater risk for nutritional deficiencies than are younger adults due to physiologic changes associated with aging.

22. Important Nutrients, Vitamins, AndMinerals For Physically Active Women • Research has shown that the Dietary Reference Intake (DRI) for the following micronutrients may be greater in exercising individuals - Vitamin B12 (DRI=2.0 mg/day) - Folate (DRI=320 mg/day) - Thiamin (DRI=.9 mg/day) - Vitamin C (DRI=.60 mg/day) - Vitamin E (DRI=.12 mg/day) - Calcium (DRI=1000 mg/day age 19-50; 1000 mg/day over 50 ) - Iron (DRI=8.1mg/day age 19-50; 5 mg/day over 50 )

23. Important Nutrients, Vitamins, AndMinerals For Physically Active Women • Vitamin B12 and folate -lower homocysteine level -important in lowering the risk of certain types of cancers • Thiamin -requirements may be greater for those who train several hours a day

24. Important nutrients, vitamins, andminerals for physically active women • Vitamin C -individuals who exercise may require at least 100 mg per day of vitamin C, and if competing in marathons one may need up to 500 mg per day • Vitamin E -plays a role in prevention of oxidative damage due to exercise

25. Important nutrients, vitamins, andminerals for physically active women • Calcium -DRIs for calcium for adult women over age 50 is 1200 mg/d -Intakes of 1500 mg/d may be appropriate for postmenopausal women or women over the age of 65 -supplements are best absorbed if taken in 500 mg or less between meals

26. Important nutrients, vitamins, andminerals for physically active women • Iron -supplements may be necessary since female athletes do not consume proper amounts -most widely used form of supplementation is ferrous sulfate - for adults diagnosed with iron deficiency anemia, a daily dose of at least 60 mg of elemental iron taken between meals is recommended

27. Conclusion • A food-based approach is ideal for meeting macronutrient and micronutrients needs of women. • Among the micronutrients, the significant ones that may be associated with deficiencies in the older women include vitamin B12 ,vitamin A and C, calcium, iron, zinc and other trace minerals.