Obesity Algorithm (2017 - 2018) Sneak Peek

Assessment and Evaluation | Energy Expenditure

Component of NEAT Often the widest variance in energy expenditure among individuals is non-exercise activity thermogenesis (NEAT)

• Take stairs instead of elevators; park further from your destination, etc. • Monitor number of steps per day via a pedometer: The number of steps recorded by different pedometers can vary – < 5,000 steps per day is average number of steps for U.S. adults – < 5,000 steps per day is sedentary – 5,000-7,500 steps per day is low active – 7,500-10,000 steps per day is somewhat active – ~10,000 steps per day is active • Although variable due to a number of factors, in general, one calorie is “burned” for every 20 steps (i.e., 3,000 steps / 20 = 150 calories) • 10,000 steps per day per week = 3,500 calories “burned” = one pound of fat

• Working, fidgeting, and other activities of daily living, not including physical exercise • Can range between 150-500 kcal/ day, which is often greater than bouts of physical exercise • NEAT can help explain perception that some individuals: – Are “naturally skinny” – Can maintain body weight compared to others, even with the same caloric intake and same exercise activity • Increasing the number of steps taken per day can be achieved by

altering daily activity, or by increasing walking/running.

• Compared to being seated for hours (such as in the workplace), it is better to walk around at least 10 minutes per hour.

Metabolic Rate

Basal Metabolic Rate • Energy expended while fasting, rested, and supine in a thermoneutral environment • Increased with increased body weight

Resting Metabolic Rate (RMR) • Energy expended at rest, does not require overnight supine measurement • Increased with increased body weight • For most individuals: – Muscle accounts for < 25% of RMR – Liver and brain accounts for ~ 50% of RMR

Reference/s: [118] [119] [120] [121] [122] [123] OBESITYMEDICINE.ORG

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