Worksheet for Assessment of Caloric Needs

Name ______

Worksheet for Assessment of Caloric Needs

Height in inches ______cm______(inches x 2.54 = cm)

Weight in pounds ______kg ______(lb ¸ 2.2 = kg)

Age ______

Ideal Body Weight ______Female: (IBW=100# + 5# each inch over 5 ft)

*if you are shorter than 5 ft, subtract 5# for each inch

Male: (IBW=106# + 6# for each inch over 5 ft)

%IBW ______(%IBW = Actual wt ¸ IBW x 100)

Is % IBW 125% or GREATER? ______

IF NO, use your Actual Weight IN KG in Harris Benedict Formula below

IF YES, calculate Adjusted Body Weight (ABW) using next formula, and use THAT IN KG in the Harris Benedict Formula, below.

*Remember: do not calculate ABW if your %IBW is LESS than 125%

Female or Male/ABW= ([Actual Weight-IBW] x .25) + IBW

ABW ______ABW in KG ______

Harris Benedict Formula for Females

[655+(9.6x wt. in KG) + (1.8 x ht in cm) – 4.7 x age in years] x activity factor*

Harris Benedict Formula for Males

[66.5+(13.7 x wt. in KG) + (5 x ht in cm) – 6.8 x age in years] x activity factor*

ACTIVITY FACTORS:

Activity levels see below Sedentary Low Active Active

Physical Activity Coefficients

MALES 1.0 1.11 1.25

Adults 19 and older

FEMALES 1.0 1.12 1.27

Adults 19 and older

Explanation of Activity Levels:

SEDENTARY: means a lifestyle that includes only the physical activity of independent living. In the scientific literature, SEDENTARY is often defined in terms of little or no physical activity during leisure time.

LOW ACTIVE: means a lifestyle that includes at least 30 minutes per day of moderate* physical activity (equivalent to walking about 1.5-3.0 miles per day at 3-4 mph/moderately brisk) IN ADDITION to the activities of independent living.

*Moderate is associated with activities that burn 3.5-7 kcal/minute, resulting in achieving 60-73% peak heart rate. An estimate of a person’s peak heart rate can be obtained by subtracting the person’s age from 220. Examples of moderate activities: walking briskly, mowing the lawn, dancing, swimming, bicycling on level terrain. A person should feel some exertion, but should be able to carry on a conversation comfortably during the activity.

ACTIVE: means a lifestyle that includes at least 60 minutes per day of moderate physical activity (equivalent to walking more than 3 miles per day at 3-4 mph/moderately brisk) IN ADDITION to the activities of daily living.

Using HB formula on front page, calculate your caloric needs multiplying by your AF.

My estimated daily caloric needs are: ______