Energy Balance

Energy
Status
Energy Balance
Energi
Energy intake
Requirement
Khairun Nisa Berawi

ENERGY BALANCE
Key Term:
Energy intake
Energy expenditure
Energy requirement
Energy balance
Energy intake
 Food composition  Bomb calorimeter
 Food intake:
 Hunger
 Appetite
 Satiation
 Satiety
 Overriding hunger and satiety

Equilibrium of energy intake and energy
expenditure determine the energy status.
ENERGY STATUS
Energy st. assessment for children  weight for

age.
Energy st. assessment for adults  weight for
height: Body Mass Index (BMI).
Balanced energy: if energy intake
sufficient with the energy
expenditure.
Surplus of energy: if energy intake
larger than energy expenditure 
energy storage increase:
 CH  stored as glycogen (limited) and
as lipid (abundance).
 Fatty acids  stored as lipid.
 Protein  stored as lipid.
Energy deficit = if energy intake
insufficient for energy expenditure.
Storage molecules will be used.
7 Kkal of energy similar to 1 gram of

body tissue.
Loss of energy: 500 Kkal/day or 3500

Kkal/week  catabolism of body
tissue: 3500 : 7 = 500 g body
tissue/week.
Energy intake  obtain from the
food.
Various amount of energy in the food,
depends on the composition of the
foods.
1 gram CH  4 Kkal
1 gram Protein  4 Kkal
1 gram fatty acid  9 Kkal
Vitamin, mineral and water do not
provide adequate energy.
Daily amount of energy intake depends on:
food class, quantity per portion, and
frequency of food intake per day.
Nutrient composition & amount of energy

per 100 gram food stuff are available in
Food Composition List. Food stuff weight
comes from Household measurement.
Total Energy Expenditure = TEE : sum of
Basal Energy Expenditure (BEE), Physical
Activity (PA) and Spesific Dynamic Action
of food (SDA) or Thermic Effect of Food
(TEF).
The calculation:
TEE = BEE + PA + SDA (TEF)
BEE is energy expenditure in basal
condition , the ongoing activity while
the body rest: heart beat, peristaltic,
hormone secretion, enzyme
secretion, muscle contraction, etc.
Basal condition:
 12 – 16 hours after the last meal
 Lying position
 No physical activity an hour before the
test
 Relax
 Normal body temperature
 Room temperature should be 21-25oC
 Normal humidity
Harris & Benedict calculation for BEE:
Men : 66 + (13,7 x BW kg) + (5 x BH cm) – (6,8 x age)

Women: 665 + (9,6 x BW kg) + (1,7 x BH cm) – (4,7 x age)
Simple calculation for BEE:
Men : 1 Kkal / BW Kg / h = 24 Kkal / BW Kg / d

Women: 0,9 Kkal / BW Kg / h = 21,6 Kkal / BW Kg/ d
Factors that influence BEE
Body weight, height, age, gender,

growth, temperature, muscle mass,
sleep, endocrine activity, nutrition
status.
Age : above 20  BEE will decrease 2%
every 10 y.
Gender : BEE in men > women (at age >10 y)
Growth: highest for baby and adolescence.
Height: the taller the higher BEE
Muscle mass : the greater the higher BEE
Temperature : every 1oC elevation of body
temperature (body temp above 37oC) 
BEE will increase 13%
Sleep : BEE decrease 10%
Endocrine:- hiperthyroid: BEE increase
75-100%
- hipothyroid : BEE decrease
30-40%
- right before menstruation BEE
slightly increase and during
menstruation BEE decrease
Nutrition status: BEE decrease in PEM
Pregnancy : BEE increase 15-25%
Physical Activity (PA)
 PA very light = 10-30% BEE
 PA light = 30-50% BEE
 PA moderate = 50-80% BEE
 PA heavy = 80-100% BEE
 AF very heavy = > 100% BEE
Level of Activity
 Very light: - Activity in sitting position
- Bedrest
 Light: Teacher, lecturer, general
practitioner, housewife.
 Moderate: Farmer, student(+ sport),
office worker
 Heavy : Athlete during TC, unskilled
worker, manual laborer,
army during training
 Very heavy : Sawyer of wood,blacksmith,
ricksaw carrier, becak
driver.
SDA or TEF
SDA /TEF is the amount of energy used
for digestion, absorption and utilization of
food consumed.
- SDA of protein 30% BEE
- SDA of carbohydrate < protein
- SDA of fat  the lowest
SDA of Indonesian food on the average is
10% of BEE + AF
TEE for hypermetabolism
 TEE = BEE x SF x PA
 Simple calculation:
“The rule thumb”  25-30 of kkal/kg BW
Stress Factor (SF)
 Postoperative (without comp.)1.00-1.10
 Fracture of long bone 1.15-1.30
 Cancer 1.10-1.30
 Peritonitis/sepsis 1.10-1.30
 Serious infection/mult. Trauma1.20-1.40
 Multiple organ failure syndr. 1.20-1.40
 Burn 1.20-2.00
Physical activity (PA)
 Bedridden  1.1
 Ambulatory  1.2
 Start low, increase gradually
 Use ideal body weight for underweight
patient
 Use adjusted body weight for overweight
patient
 Ideal body weight = ((Body height cm)-
100) – (10%x (Body height-100))
 Adjusted body weight = Actual body
weight (ABW) – (25% x (Actual Body
Weight- Ideal Body Weight))

Energy Balance

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Energy

Khairun Nisa Berawi

 Overriding hunger and satiety

Energy st. assessment for children  weight for

7 Kkal of energy similar to 1 gram of

Loss of energy: 500 Kkal/day or 3500

Nutrient composition & amount of energy

Men : 66 + (13,7 x BW kg) + (5 x BH cm) – (6,8 x age)

Simple calculation for BEE:

Men : 1 Kkal / BW Kg / h = 24 Kkal / BW Kg / d

Body weight, height, age, gender,

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