#### II. Protocol: Step 1 - Estimate Resting Energy Expenditure (REE)

1. Based on Mifflin-St Jeor Equation
2. Males Resting Energy Expenditure
1. Start: 10 x (Weight in kilograms) + 5
2. Add: 6.25 x (Height in centimeters)
3. Subtract: 5 x (Age in years)
3. Females Resting Energy Expenditure
1. Start: 10 x (Weight in kilograms) - 161
2. Add: 6.25 x (Height in centimeters)
3. Subtract: 5 x (Age in years)

#### III. Protocol: Step 2 - Estimate Daily Caloric Need

1. Consider Activity factor (AF) of 1.0
1. AF >1.0 grossly overestimates caloric needs
2. Using activity factor of 1.0 may be weight neutral
1. Mucha (2007) HP Primary Care Medicine, Lecture
2. Bezera (2001) J Amer Dietetic Assoc 101 [PubMed]
2. Determine Daily Caloric Need
1. Resting Energy Expenditure x Activity Factor

#### IV. Protocol: Step 3 - Calculate Adjusted Caloric Intake

1. Determine daily caloric deficit (typically 250 to 500 kcals/day)
1. Deficit of 500 Kcals/day = 3500/week (1 pound/week)
2. See precautions below regarding over-estimation of weight loss with 3500 calorie/pound rule
1. Daily Caloric Need - Daily caloric Deficit (500)
2. Do not lower intake below 1000 Kcals/day
3. Consider using REE x0.8 for weight loss program
1. Mucha (2007) HP Primary Care Medicine, Lecture
2. Bezera (2001) J Amer Dietetic Assoc 101 [PubMed]
4. Consider calorie intake goal based on body weight range
1. Body weight <200 pounds: 1000 Kcals/day (500 kcal deficit per day)
2. Body weight 200-249 pounds: 1200 Kcals/day (750 kcal deficit per day)
3. Body weight 250-299 pounds: 1500 Kcals/day (1000 kcal deficit per day)
4. Body weight 300-349 pounds: 1800 Kcals/day (1250 kcal deficit per day)
5. Body weight >350 pounds: 2000 Kcals/day (1500 kcal deficit per day)
6. Klein (2002) 123(3): 882-932 [PubMed]

#### V. Precautions: Over-estimation of weight loss with 3500 calorie/pound rule

1. Weight loss estimates based on 3500 calorie deficit per pound weight loss will markedly overestimate loss
1. Naive weight loss approximation with 3500 calorie rule (due to compensatory mechanisms)
2. For every 100 calorie deficit, expect 10 pound weight loss over time
1. Year 1: Weight loss of 50% of total estimate (5 pounds per 100 calorie deficit/day)
2. Year 3: Weight loss of 95% of total estimate (9.5 pounds per 100 calorie deficit/day)
3. Resources
1. FPnotebook Resting Energy Expenditure Calculation
2. NIH Body Weight Simulator
1. http://www.niddk.nih.gov/research-funding/at-niddk/labs-branches/LBM/integrative-physiology-section/body-weight-simulator/Pages/body-weight-simulator.aspx
4. References
1. Lesser (2015) Am Fam Physician 91(9): 634-8 [PubMed]

#### VI. Resources

1. Relative calorie intake infographic (Mads Cykelvalg)

### Ontology: Energy Intake (C0006777)

 Definition (NCI_NCI-GLOSS) Refers to the number of calories (energy content) consumed. Definition (MSH) Total number of calories taken in daily whether ingested or by parenteral routes. Definition (CSP) amount of food energy consumed in the diet. Concepts Quantitative Concept (T081) MSH D002149 SnomedCT 162533000, 139806001, 13210007, 226320007 English Caloric Intake, caloric dietary content, Caloric intake, nutrient ingestion, nutrient intake, intake energy, energy intake, intakes nutrient, caloric intake, energy intakes, Energy Intake, Dietary calorie intake (finding), Caloric intake, function (observable entity), Dietary calorie intake, Nutrient intake, Energy intake, Dietary calorie intake (observable entity), Nutrient intake (observable entity), Caloric intake (function) Spanish ingesta energética, Ingestión de Energía, Ingestión Calórica, ingesta calórica (entidad observable), ingesta calórica, ingesta calórica (función), ingesta calórica de la dieta, ingesta de nutrientes (entidad observable), ingesta de nutrientes, ingesta dietaria de calorías (entidad observable), ingesta dietaria de calorías Swedish Energiintag Czech kalorie - příjem, energie - příjem, příjem kalorií, kalorický příjem, energetický příjem Finnish Energiansaanti French Prise calorique, Consommation calorique, Consommation de calories, Ration calorique Russian ENERGII POTREBLENIE, KALORII POTREBLENIE, КАЛОРИЙ ПОТРЕБЛЕНИЕ, ЭНЕРГИИ ПОТРЕБЛЕНИЕ Japanese エネルギー摂取量, カロリー摂取量, 熱量摂取量 Croatian ENERGIJA, UNOS Polish Spożycie kalorii, Zapotrzebowanie kaloryczne, Spożycie energii Norwegian Not Translated[Energy Intake] Portuguese Captação de Energia, Ingestão Calórica, Ingestão de Energia German Energieaufnahme, Kalorienaufnahme Italian Assunzione giornaliera di calorie Dutch Energie, opgenomen, Opgenomen energie