1. Counting Calories and
Beyond
Lupus Club Meeting Lecture
Allan D. Corpuz, MD
Fellow, Section of Rheumatology

2. Objectives
Learn to compute your ideal body weight and BMI
Learn cutoffs for obesity
Compute calorie requirements
Learn calorie counting
Understand basic principles in dieting
Learn about <100 calorie snacks

3. History
“Bomb calorimeter” (Wilbur Atwater)
Calorie counting: how many calories were consumed
when eating particular foods, and "burned" when
engaging in different activities

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Understanding Your Caloric Requirements

5. Carbohydrates and
Protein: 4 calories per
gram
Fats: 9 calories per gram
Identify your total
caloric requirement
using Ideal Body Weight

6. Determine your Body Mass
Index (BMI): measure of fatness
BMI = Weight in kg /
(Height in meters)
70kg/(1.6m) = 27.34
2
2

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Where do you belong?
Our patient:
Overweight by WHO
Obese Class I by Asia-Pacific

8. Tannhauser Formula for
Ideal Body Weight (IBW)
IBW (in kg) = (height in
cm minus 100) less 10%
example: 5’3” (convert
to cm: 63in x 2.54cm/in
= 160.02cm)
160.02 - 100 = 60.02
less 10% = 54.018 kg

9. Next… find out level of
physical activity
Standard Average # of Calories burned
(Krause)
Bed rest: 25
Sedentary: 30
Light activity: 35
Average: 40
Heavy: 45
Multiply IBW with Physical activity
Example: 54kg x 30 = 1620 calories
This is the energy required to maintain body
weight (no loss/gain)

10. Set goals… with your
doctor/dietician
TCR = 1620 cal/day
Goal: reduce by 1
pound/week
500 calories less: weight
loss of 1lb/week
1620-500 = 1120 cal/
day

11. How do we break it down?
50-60% Carbs
30% Fats
12-15% (max 20%)
Protein

12. Apply what you’ve learned…
1120 calories
60% Carbs (4cal/g) =
168grams
30% Fats (9cal/g) = 37g
10% Protein (4cal/g) =
28g

13. Vegetables: 16 calories per
cup or 90grams (cooked)
ampalaya fruit
ampalaya leaves
Baguio beans
Puso ng saging
Cabbage
Cauliflower
Chayote fruit or leaves
Eggplant
Kangkong
Malunggay Leaves
Mushroom
Okra
Patola
Onion Bulb
Pechay
Saluyot
Upo

14. Vegetables: 1/2cup = 16
calories
coconut shoot (ubod)
Munggo bean sprout (togue)
Sitaw
Canned Green Peas
Sweet corn
Tomato juice

15. Fruits and desserts: 40 cal
per serving
apple (1/2)
atis (1 fruit)
lakatan, latundan, chico (per pc)
dalanghita (2)
duhat (20 pcs)
durian (30g)
grapes (10)
guava (2)
guyabano (1 slice)
langka (40g)
lansones (7)
mangosteen (3)
melon (1 slice)
papaya (1 slice)
pineapple (1 slice)
rambutan (8)
santol (1)
star apple (1/2)
buko water (1 cup)
banana-Q (1/2)
mango chips (2)
maruya (1/4)
turon (1/2)

16. Meat/Fish, etc: 41 calories
tenderloin, porterhouse,
shank, sirloin, shoulder, rump,
chicken leg, breast (1/4)
meat internal organs (3/4
cups)
bangus, lapu-lapu, dalag, etc
(1 slice) = 45 cal
avocado, 1 tsp peanut butter,
pili nut (5pcs), 1 tsp peanut
or olive oil = 45 cal

17. Sugar products: 20 calories
table sugar (1 tsp)
taho with syrup and sago (1/4
cup)
ube, halaya (1 tsp)
yema (1)
polvoron (1/2 pc)
halo-halo (2.3 cups) = 80 calories

18. Rice and rice products: 100
calories
rice (1/2 cup)
lugaw (1.5 cup)
bibingka, galapong (1 slice)
malagkit (1 slice)
biko (1 slice)
cassava cake (1/2 slice)
espasol (2)
kalamay, latik (1)
kutsinta (1)
palitaw, no coconut grating
(4)
puto bumbong (2)
sapin-sapin (1 slice)
tikoy (1 slice)
pan de sal (3)
lady fingers (5)
Mammon tostado (3)
Hopia hapon (1.5)
Ensaymada (1)
bihon, sotanghon (1 cup)
kamote (1/2)
ube (1.3 cups)
kastanyas (11pcs)
sago (1/2 cup)

19. Other carbs:
145 calories
buko pie (1 slice)
bitso-bitso (1)
hopia baboy (1)
hot cakes (1)
fruit cake (1 slice)
chocolate cake (1 slice)
Spanish bread (1)
Cinnamon roll (1)
1/2 donut = 190 cal
croissant = 235 cal
muffin = 290 cal
eclair = 212 cal
century egg = 135 cal
embotido (2.5 pcs) = 187 cal

20. Dishes:
Adobong baboy 1 cup = 302 cal
Callos 1 cup = 260 cal
Dinuguan 1 cup = 124 cal
Kare-kare 1/2 cup = 103 cal
Kilawin 1/2 cup = 113 cal
Lechon baboy (50g) = 273 cal
Lumpia fresh with sauce = 273 cal
Lumpia with peanut sauce = 403 cal
Menudo 2/3 cup = 144 cal
Okoy = 184 cal
Pochero 1 cup = 282 cal

21. Alcoholic drinks
Pure water = 0 cal
Beer 11oz = 163 cal
Cognac = 75 cal
Gin dry = 107 cal/jigger
Ginebra 1 bottle - 832 cal
Martini = 143 cal
Whisky = 107 cal
Wine Red = 73 cal/glass
Wine White = 85 cal/glass
Champagne = 85 cal

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What about if I exercise?
Physical activity burns calories

25. Average calories burned in
30minutes
Sleeping = 35
Typing on computer = 50
Ironing = 63
Cooking = 86
Light housework = 115
Mopping floor = 119
Shopping = 102
Fishing = 119
Climbing Hills (no load) =
232
Walking slowly = 106
Walking briskly = 120
Running slowly = 280
Running fast = 384
Jogging = 215
Cycling = 123
Swimming = 311
Ballroom dancing = 98
Aerobic dancing = 198
Volleyball = 96
Football = 253
Basketball = 265
Golf = 140
Tennis = 209
Badminton = 186
Foreplay x 15mins = 22.5
cal
Actual Intercourse x 15
mins = 67.5 cal

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Think of this general rule…
Estimated caloric burn for 10minutes of
moderate physical activity is 100 calories

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Not “losing” weight does not mean lack of success
Muscle gain causes weight gain
Hence, sometimes, you can estimate appropriate weight loss by
checking your clothes: looser clothes mean a smaller waist.

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Balance Caloric intake and Caloric burn
Intake minus burn will determine whether one
will lose or gain weight

29. Example:
1247 calories intake
Breakfast: Pandesal 3pcs (100cal) + taho 1 cup (80 cal) + papaya 1 slice
(40cal) = 220
Lunch: rice 1 cup (200cal) + adobo 1 cup (302 cal) = 502
Snacks: Donut (380 cal)
Dinner: rice 1/2 cup (100cal) + bangus1 slice (45 cal) = 145
Walking slowly for 30 mins = 120 calories
1247 minus 106 = 1127 calories

30. What if I overeat? What if I like to eat
a lot of donuts and sugary foods?
2426 calories
3 pieces of banana: 40cal/pc x 3 = 120 calories
2 pieces of donuts: 380cal/pc x 2 = 760 calories
5 cups of rice = 200cal/cup x 6 = 1000 calories
Lechon baboy 100g = 546 calories

31. What activities will burn calories
to target TCR of 1120?
You need to burn 1306 calories
How:
Jog for 1 hour = 430 calories
Swim for 30mins = 311 calories
Aerobic dancing for 45mins = 297
Have sex 3x = 270 calories

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Basic Principles in Dieting
Avoiding Diet Mistakes

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Do NOT rely on Crash diets
-too fast
-vegetable or fruits only
-less than 1000 cal/day
-metabolism slows down, body burns calories more slowly

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Skipping Breakfast
-this will make u hungry the rest of the day
-unplanned snacking or supesized lunch
-eat breakfasts high in protein and fiber

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Losing Track of Your Snacks
-take note of the nibbles in between
-milk tea, cake, ice cream, pizza, donuts
-mindless munching
-use a smartphone or a notebook to keep track

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Not Snacking at All
-several small meals and snacks a day are more likely to control hunger and cause weight loss
-snacking puts metabolism in high gear (esp protein rich snacks)
-nuts are GOOD

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Loading Up on Low-Fat
-low fat is not the same as low calorie
-eating too much of “low-fat” cake may have you end up with more calories than a smaller size of
regular cake
-always check the nutritional level

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Sipping Too Many Calories
-we tend to overlook what’s in our drinks
-fancy coffee and alcoholic beverages have more than 500 calories
-watch out for calories in fruit juice and soda
-liquid calories don’t curb hunger

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Drinking Too Little Water
-water is essential for burning calories
-dehydration drags metabolism = slower weight loss
-more water = more calorie burn

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Ditching Dairy
-this may be counterproductive
-body burns more fat when it gets enough calcium; it produces more fat when it’s calcium-deprived
-calcium supplements do not appear to yield the same benefit
-stick to non-fat or low-fat

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Taking the Drive-Thru Bait
-fast food is habit forming
-fastfood 2x a week: 10 lb weight gain

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Weighing Yourself Every Day
-daily weighing leads to frustration
-more important to look for a long-term trend (weekly)
-full-pound drops are more motivating

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Setting Unrealistic Goals
-do NOT attempt to lose 20lbs in your first week
-talk to a dietician

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How to Stay on Track
General Dieting Tips

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Tip No. 1: Drink plenty of water or other calorie-free
beverages.
-people confuse thirst with hunger so they end up eating extra calories
when an ice cold glass of water is all they really need
-try flavored sparkling water or a cup of fruit-infused herbal tea

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Tip No. 2: Be choosy about nighttime snacks.
-snacking in front of the TV: one of the easiest ways to throw diet off course
-close down kitchen
-allow only low-calorie snack

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Tip No. 3: Enjoy your favorite foods.
-be a slim shopper
-buy one fresh bakery cookie instead of a box
-moderation is key

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Tip No. 4: Eat several mini-meals during the day.
-you will lose weight by eating fewer calories than you burn
-but when you’re hungry all the time, this will be difficult
-eat 4-5 meals/snacks per day

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Tip No. 5: Eat protein at every meal.
-protein is the ultimate “fill-me-up” food
-protein keeps you feeling full for longer
-seafood, lean meat, egg whites, yogurt, cheese, soy, nuts, beans

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Tip No. 6: Spice it up.
-food that is loaded with flavor will stimulate your taste
buds and be more satisfying so you won’t eat much

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Tip No. 7: Stock your kitchen with healthy, convenient foods.
-have ready-to-eat snacks and meals-in-minutes on hand to avoid the urge to eat fast-food
-frozen vegetables, whole grain pasta, reduced fat cheese, canned tomatoes, canned
beans, pre-cooked grilled chicken breast, whole grain tortillas or pitas, bags of salad greens

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Tip No. 8: Order children's portions at restaurants.
-this is a good way to cut calories and keep portions reasonable
-another trick is to use smaller plates
-this helps the portions look more (if the mind is satisfied, so will the stomach be)

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Tip No. 9: Swap a cup of pasta for a cup of vegetables.
-reduction in the portion of starch and increasing
the amount of veggies saves 100-200 calories

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Tip No. 10: Always eat breakfast.
-not eating BF can make you hungry later leading to too much
nibbling and binge eating at lunch and dinner
-try high fiber cereal, low-fat milk and fruit

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Tip No. 11: Include fiber in your diet.
-fiber aids digestion, prevents constipation and lowers cholesterol
-women: 25g/day; men: 38g/day = 14g per 1000 calories
-Good sources: oatmeal, beans, whole grain foods, fruits and veggies

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Tip No. 12: Clean the cupboards of fattening foods.
-Chips in the pantry and ice cream in the freezer makes weight loss harder than it has to be
-Purge your cupboard of fattening foods
-Walk to the mall/resto/snackhouse

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Tip No. 13: Lose weight slowly.
-dropping pounds take time
-realistic goal: 1-2 pounds per week
-health benefits start to appear when you’ve lost just about 5%-10% of your body weight

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Tip No. 14: Weigh yourself once a week.
-so as not to be derailed by daily fluctuations
-weigh yourself at the same time of the day, on the same day of the
week, and in the same clothes

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Tip No. 15: Get enough sleep.
-sleep deprivation: overproduction of ghrelin (appetite-stimulating hormone)
and underproduces leptin (hormone that tells you when you’re full)
-sleep makes you feel rested and full and keeps you from unnecessary snacking

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Tip No. 16: Understand portion sizes.
-use kitchen scales and measuring cups to measure meals for a week or two
-use smaller plates and glasses to downsize your portions
-split restaurant servings in half
-portion out snack servings instead of eating them directly from the container

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Tip No. 17: Eat more fruits and vegetables.
-Best “diet”: eating more food, not less
-it is important to feel full
-choose smart snacks

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Tip No. 18: Limit alcohol to weekends.
-alcohol has empty calories
-5oz glass of wine: 125 cal
-bottle of beer: 153 cal
-our body doesn’t use these calories well; they get converted directly to fat
-try weekends only: 1 drink for women, two for men

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Tip No. 19: Chew sugarless gum.
-this manages hunger, control snack cravings,
aid in weight loss

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Tip No. 20: Keep a food diary.
-writing down what you eat and drink tends to make you more aware of what, when, and how
much you’re consuming
-Study: food diary 6days/week lost 2x more weight than those who kept a diary one day a week or
less

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Tip No. 21: Celebrate success (but not with food).
-buy a CD, watch a movie, go shopping, travel

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Tip No. 22: Get help from family and friends.
-tell your family and friends about your efforts
-use apps: LIFT, LIVESTRONG, MYFITNESSPAL.COM

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Food Frauds That Can Wreck Your Diet

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Caesar Salad
- 300-400 calories; 30 grams fat
Food Fix: Use only 1 tablespoon of dressing and 2 tablespoons of
tangy Parmesan cheese.

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Fresh Smoothies
-80grams sugar, 350 calories or more, little protein, no fresh fruit
Food Fix: Get the small cup. Ask for fresh fruit, low-fat yogurt, milk, or
protein powder to blend in protein and good nutrition.

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Energy Bars
-up to 500 calories; small size does not curb hunger
Food Fix: Choose bars that have 200 calories or less, some fiber, and at least
5 grams of protein, which helps provide energy when the sugar rush fades.

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Chicken Burrito
-1000 calories, plenty of saturated fat - cheese, sour cream, fat in the jumbo flour tortilla
Food Fix: Share one. Or try a soft taco with fajita-style grilled meats and veggies on a
corn tortilla with tasty, low-calorie salsa.

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Sugar-Free Foods
-if it gives you the license to have a large order of fries or big dessert
(adds 300 cal)
Food Fix: Watch your total calories.

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Enhanced Water
-may have added 125 calories
Food Fix: Refrigerating tap water may make it more appealing. Or try
packets of crystallized lemon to add flavor without calories.

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2% Milk
Whole milk (3.25%) = 150 cal., 8g fat, 5g sat. fat
Reduced-fat (2%) = 130 cal., 5g fat, 3g sat. fat
Skim (nonfat) = 80 cal., 0g fat, 0g sat. fat
Food Fix: If you like whole milk, blend it with 2% for a while, then 1%, then skim, until you get used to the taste of
nonfat milk.

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2% Milk Latte
-whipped cream: 580 calories and 15g saturated fat (per 20oz white choco mocha)
Food Fix: A sweetened, frothy beverage is a diet splurge. Limit the damage with nonfat (skim)
milk and no whipped cream. You'll avoid 130 calories and two-thirds of the saturated fat.

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Turkey Hot Dogs
-variable fat content
Food Fix: Compare nutrition labels for the lowest fat content. There are some
really good choices now available. Or eat them only a few times a year.

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Breakfast Muffins
-muffins beat donuts (500 cal with 11 teaspoons of sugar)
Food Fix: Go no larger than 2 1/2 inches in diameter. Or look for 100-calorie muffins
at the store. Some brands are a surprisingly good source of whole grains and fiber.

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Low-Fat Granola
-low fat version only has 10% less calories and is still full of sugar
-low fat label encourages overeating
Food Fix: Look for low-sugar, whole-grain cereal, and sweeten it with fresh fruit.

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Low-Fat Yogurt
-some brands add lots of sugar (30g fructose, sucrose or other sweeteners)
-compare plain to fruited yogurts
Food Fix: Six ounces should be 90-130 calories and under 20 grams of sugar. Avoid sugary "fruit
on the bottom" yogurts. Or blend sweetened yogurt with plain, nonfat yogurt.

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Multigrain Products
-check if they used “refined grains” such as wheat (this is stripped of natural fiber and many
nutrients)
Food Fix: Look for "100% whole grain" (oats, wheat) as the first ingredient. Or choose the brand
with more fiber.

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Light Olive Oil
-light olive oil has the same calorie and fat content; it’s just lighter in taste and color
Food Fix: Some light foods do help you save calories. Compare the labels in the
store.

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Added Omega-3
-they may not have EPA and DHA (they instead have ALA, which is not as beneficial)
Food Fix: Try 6 ounces of salmon. It has 100 times more omega-3 than is in a serving
of fortified yogurt. Vegetarians could consider algae-derived omega-3 supplements.

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Iced Tea
-20 oz bottle can have >200 calories and 59 grams of sugar
-C2: 35 cal per 200grams
Food Fix: Skip "sweet tea" in favor of unsweetened iced tea. Lemon or artificial sweeteners add
zing without calories. Herbal and berry teas taste mildly sweet without sugar.

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Microwave Popcorn
-9grams fat into each “snack size” bag
Food Fix: Compare nutrition labels, and get a lower-fat popcorn that has no trans fat at all.
Sprinkle with Parmesan cheese or low-salt spice blends for added flavor without a lot of fat.

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Iceberg Lettuce
-the problem is in the dressing
Food Fix: Add spinach or arugula to the mix. Crumble 2 tablespoons (100 calories) of blue cheese
or feta on top. Then splash the salad with a little oil and vinegar to spread flavor without a lot of
calories.

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Salty Toppings
-limit anything that comes out of a can; pass up cured meats; choose beans or tuna but not both
Food Fix: Radishes, bell peppers, cucumbers, and other fresh vegetables are low in sodium.
Rinse canned beans to remove a lot of the salt.

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-small cup (4.5 oz) = 260 calories, 21g fat (mayonnaise)
Food Fix: Some places make a healthier slaw, so ask for nutrition
information. At home, try low-fat mayonnaise or mix with nonfat yogurt.

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Banana Chips
-1 oz =145 calories, 8g saturated fat (same as fastfood hamburger)
Food Fix: Try a fresh banana: four times more food, 0 grams of fat, all
for about 100 calories.

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Super Snacks
Snacks with 100 calories or less

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3/4 Cup Frozen Mango Cubes
Saturated Fat: 0g
Sodium: 0mg
Cholesterol: 0mg

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Apple Slices With Peanut Butter
Saturated Fat: 0.8mg
Sodium: 2mg
Cholesterol: 0mg
Don’t use more than 2 tsp of peanut butter

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Nonfat Greek Yogurt with Honey
Saturated Fat: 0g
Sodium: 53.5mg
Cholesterol: 0mg
Protein: 12g per 1/2 cup

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Yogurt With Sunflower Seeds
Saturated Fat: 0.26g
Sodium: 53.5mg
Cholesterol: 0mg

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20 Pistachios
Saturated Fat: 0.8g
Sodium: 53.5mg
Cholesterol: 0mg

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Frozen Banana Pop (coated with plain yogurt)
Saturated Fat: 0.35g
Sodium: 3mg
Cholesterol: 7mg

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1 Cup Tomato Soup
Saturated Fat: 0.19g
Sodium: 471mg
Cholesterol: 0mg

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1 Cup Grapes
Saturated Fat: 0.1g
Sodium: 2mg
Cholesterol: 0mg
High in Vitamin K and Manganese, fiber

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Pls visit my site:
www.allancorpuzmd.com/patient-education/

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Thank you for your attention!