Measuring your required kilojoule intake accurately is crucial to maintaining a healthy weight. Guy Crankshaw, founder of Access a Meal, provides some insight
The latest statistics show that South Africa has one of the highest rates of obesity and Type 2 diabetes in the world! People with mobility impairments in particular are at risk for obesity and resultant late-onset insulin resistance or Type 2 diabetes. In my nutrition consultations with people with mobility impairments, I see a common issue contributing to this risk.
In addition to poor dietary choice, the impact of nutritional value on weight management is a concept people generally don’t understand. We need to look at the relationship between two factors. The first we call “energy in” – this is the total amount of energy we receive from the food we consume on a daily basis.
Then there is “energy out”, which is the energy the body uses to function on a daily basis. This is also called the total daily energy expenditure (TDEE). A simple starting point in understanding personal weight management is to understand how your “energy in” values versus your “energy out” values affect weight loss, weight gain and the increased risk of lifestyle diseases.
Each person’s TDEE is different and based on a variety of metrics. It is vital then to find the correct values for each person. Why is this so important? It has been calculated that a daily excess of only 10 percent in kilojoule intake can lead to a weight gain of up to nine kilograms a year. The concept of “energy in” vs “energy out” will be familiar to many people.
What is not understood by many in the disability community is that another factor needs to be considered – one that is critical in terms of calculating your actual “energy in” requirement in order to manage weight. To illustrate this, let us use the example of an above-the-knee amputee.
The amputee’s body systems may present similar to those of an able-bodied person. However, as one of his legs is missing, the body mass is lower. Thus we need to reduce the required “energy in” by about 20 percent versus the TDEE to maintain a healthy weight. This applies even though an above-the-knee amputee uses 50 percent more energy to walk compared to an able-bodied person.
Wheelchair users might have all their limbs but no mobility. As such, the same principle applies: a reduced daily kilojoule intake is required to lose weight or maintain a healthy weight. On average, we look at reducing the “energy in” by a further 15 percent per immobile limb. So a 30 percent reduction of “energy in” is required after a typical SCI.
A healthy diet is vital. Of critical importance to people with limited mobility is to ensure correct protein intake as this helps ensure skin integrity, which is an important factor in preventing pressure sores. Remember, meat is not the only source of protein and simply contains it.
It is recommended that an individual consumes a minimum of 0,8 grams of protein per kilogram of body weight per day. This applies to actual body weight, not desired body weight.
Each person is different; not one person’s physiology is the same as another’s. The key for people with mobility impairments is to balance quality nutrition with a significantly reduced daily kilojoule allowance. This can be quite challenging to set up and maintain on your own.
I specialise in creating customised nutritional programmes for people with mobility impairments. Contact me with any queries at guy@accessameal.com or on 079 228 5608.
