Breezing Co., Tempe, Arizona 1
The Motivation 2.1 billion people, 30% of the world population, were overweight or obese in 2013 People spend ~$600 billion per year, yet most are frustrated with the results Most people know weight management requires balanced diet and exercise. 2 out 3 Americans are overweight or Obese 2
The Problem How much should I eat? How much should I exercise? Why is my weight is like yo- yo? 3
The need. Total energy expenditure (TEE) Weight Caloric Intake = + + - Resting (REE) ~ 80% Thermogenesis ~ 10 % Physical Activity < 10 % (sedentary) (sedentary) Affordable & Mobile Technologies Affordable & Mobile Technologies 4
History of Measuring Energy Expenditure 1770 s 1890 s 1900 s 1940 1980 2000 2010 2014 Lavoisier & Laplace Law of the conservation of energy à First Human Calorimetry Other Direct Calorimetry Efforts: Airflow, water flow, water storage, and gradient layer calorimeter Indirect Calorimetry: Open circuit spirometry O 2 CO 2 Portable Breath-by- Breath Instrumentation First Mobile Metabolism Tracker $350 Atwater & Rosa Wesleyan Univ.: First important work of Direct Calorimetry + Analyzers Claude Douglas: Gold Standard Indirect Calorimetry Method O 2 CO 2 + Analyzers Indirect calorimetry: Computer-based Instrumentation (Breath-bybreath) O 2 CO 2 $(10-35)K 5
The need. Total energy expenditure (TEE) Weight Caloric Intake = + + - Resting (REE) ~ 80% Thermogenesis ~ 10 % Physical Activity < 10 % (sedentary) (sedentary) Affordable & Mobile Technologies Affordable & Mobile Technologies 6
Resting Energy Expenditure (REE) Resting Metabolic Rate (RMR) Food + Oxygen O2 VO2 consumed oxygen rate Carbon + ATP (heat), storage Dioxide CO2 VCO2 produced carbon dioxide rate Resting Metabolism: Sustains life Majority of our daily total energy expenditure How does it work? Indirect calorimetry (Breezing measures consumed oxygen rate and produced carbon dioxide rate) Recommended by AND, WHO, ACSM, ADA 7
Energy management: Cardio- Pulmonary System VO2 consumed oxygen rate CO2 O2 Lungs VCO2 produced carbon dioxide rate CO2 O2 CaO2 - CvO2 = 5 ml O2 per 100 ml Right Side of Heart CO2 Muscle and Tissues Energy (ATP) O2 Left Side of Heart O2 8
Resting Energy Expenditure: Indirect Calorimetry Principle Weir Equation: REE (kcal/day) = [3.9 (VO 2 ) + 1.1 (VCO 2 )] x 1.44 VO 2 : consumed oxygen rate (ml/min) VCO 2 : produced carbon dioxide rate (ml/min) Weir, J. B. D. (1949). "New Methods For Calculating Metabolic Rate With Special Reference To Protein Metabolism." Journal Of Physiology-London 109(1-2): 1-9. Weir, J. B. D. (1990). "Nutrition Metabolism Classic - New Methods For Calculating Metabolic-Rate With Special Reference To Protein- Metabolism." Nutrition 6(3): 213-221. 9
Direct Calorimetry vs. Indirect Calorimetry Direct Heat Measurement Indirect Heat Measurement CO 2 O 2 10
Direct Calorimetry vs. Indirect Calorimetry Direct Heat Measurement Indirect Heat Measurement 1900 - Atwater & Rosa research: Energy expenditure of 3 men who lived in the calorimeter for 40 days CO 2 O 2 2717 kcal/day 2723 kcal/day Error: +/- 0.2 % * Other researchers experiments: Error = +/- 1% Science demonstrated that direct calorimetry is equivalent to indirect calorimetry 11
Why track metabolism? 1200 kcal/day 1700 kcal/day Oxygen Carbon Dioxide Oxygen Weight: 112 lbs Height: 5 6 Age: 29 years Carbon Dioxide Your metabolism = Your energy = Your Fire Different people have different metabolisms 12
Why track metabolism? Different factors can affect metabolism Genetics Hormones Diet Exercise Drugs, substances Pregnancy Informacion from S port Nutrition for Health and Performance, M. Manore, N. Mayer, J. Thompson - 2009 13
Tracking Metabolism for Better Health Diet Changes in diet can significantly change metabolism. For example, a crash diet can cause drastic reduction in metabolic rate, leading to a weight loss plateau. See slides 23-24, and Case Studies Case #8. Exercise Exercise can affect metabolism. For example, muscle- building increases metabolism and High Intensity Intermittent Training (HIIT) creates an afterburn effect. See slides 27-28, and Case Studies Cases #6 and #7. Hormones/medication Hormonal changes and medications can change metabolism. Monitoring metabolism helps screen for potential hyper- or hypo- thyroidism. See Case Studies Case #5. Pregnancy Metabolism changes significantly throughout pregnancy and after giving birth. Tracking metabolism helps the mother maintain and achieve the proper weight for the baby s healthy growth. See Case Studies Case #3. 14
Tracker for Resting Energy Expenditure (REE) or Resting Metabolic Rate GJODMS, March, 2015 15
The Tracker for Energy Expenditure (EE) demonstrated ~100% accuracy GJODMS, March, 2015 16
Other independent validations (case #1) Moscow Hospital - 2014 Link a video: hups://yadi.sk/i/as_kzzkddy3da Professionals in Moscow s Hospital have probed that Breezing functions at the same level of expensive metabolic carts (100 times more expensive than Breezing) 17
Other independent validations (case #2) Grupo GAYTA/COINCIDEgroup, México - 2014 Atlas soccer team s Sports Nutrition Team (COINCIDE) has demonstrated the importance of measuring metabolism in Sports Nutrition 18
Other independent validations (case #3) Comparison with Fitmate (Cosmed) - 2014 Difference between Breezing and Fitmate of 4 kcal/day 19
Other groups/institutions using Breezing Vincennes University British Columbia 20
Importance of Metabolism for Weight Management Resting Metabolic Rate (RMR) = Metabolism = Resting Energy Expenditure (REE) 21
Energy Balance and Weight Loss Food Total Energy Expenditure (TEE) = Calories burned Calorie Intake PA REE Physical Activity Food- induced Thermogenesis Metabolism (>75%) 22
Unsustainable Weight Loss Problem Weight 1 2 3 Target Weight Time Metabolism can drop! 1 2 3 Weight maintenance Weight loss 1 REE Drop = No weight loss 2 1- Seagle, H. M., G. W. Strain, et al. (2009). "Position of the America Dietetic Association: Weight Management." Journal Of The American Dietetic Association 109(2): 330-346. 2 - Elliot, D. L., L. Goldberg, et al. (1989). "SUSTAINED DEPRESSION OF THE RESTING METABOLIC- RATE AFTER MASSIVE WEIGHT- LOSS." American Journal Of Clinical Nutrition 49(1): 93-96. - Heshka, S., M. U. Yang, et al. (1990). "WEIGHT- LOSS AND CHANGE IN RESTING METABOLIC- RATE." American Journal Of Clinical Nutrition 52(6): 981-986. - Leibel, R. L., M. Rosenbaum, et al. (1995). "CHANGES IN ENERGY- EXPENDITURE RESULTING FROM ALTERED BODY- WEIGHT." New England Journal of Medicine 332(10): 621-628. 23
Sustainable Weight Loss Weight 1 2 3 Target Weight Time 1 2 3 Weight maintenance Weight loss REE Increase = Weight loss Monitoring Resting Energy Expenditure 24
Daily Activity (hs) REE / TEE (%) 24 20 16 12 8 4 0 100 80 60 40 20 Leisure 1 2 3 4 5 6 7 Subject (#) Mean: 85.1% Standard Deviation: 2.9% How Sedentary Are We? Driving Bench Lab Work Work Watching TV Walking Office Work Sleeping Physical Activity Total Energy Expenditure* ~10 % 15 % Thermogenesis 75 % Resting Energy Expenditure (REE) 0 1 2 3 4 5 6 Subject (#) Most of daily total energy expenditure (TEE) is spent to maintain basic body functions (energy expenditure at resting state, EER or REE) *McArdle, Katch & Katch, Ex. Physiology, 2009 Work from Arizona State University, 2013
Daily Activity (hs) REE / TEE (%) 24 20 16 12 8 4 0 100 80 60 40 20 Driving Leisure 1 2 3 4 5 6 7 Subject (#) Mean: 85.1% Standard Deviation: 2.9% How Sedentary Are We? Bench Work Watching TV Walking Office Work Sleeping Physical Activity 15% à 5% 75% à >80% Total Energy Expenditure* < 5 % ~10 % Thermogenesis > 80 % Resting Energy Expenditure (REE) 0 1 2 3 4 5 6 Subject (#) Most of daily total energy expenditure (TEE) is spent to maintain basic body functions (energy expenditure at resting state, REE) Work from Arizona State University, 2013 *Exercise Physiology, McArdle, Katch & Katch
Energy Balance How we can modify it? Food Total Energy Expenditure (TEE) = Calories burned Calorie Intake PA REE Physical Activity Food- induced Thermogenesis Metabolism (>75%) (80-90 % in sedentary persons) 27
Metabolism (RMR) and Physical Activity* Physical Activity Food- induced Thermogenesis Metabolism Total Energy Expenditure (TEE) Exercise P A REE P A REE P A REE Total Effect of Sustained Exercise *Speakman et.al., Proceeding of the nutrition society, 2003, 62, 621-634 (Fig.2 reproduction) 28
How we can increase metabolism and reverse sedentary lifestyles without drastically altering our schedules? High Intensity Intermittent Training (HIIT) Work from Arizona State University, 2013 29
Real User Stories Jessica and Andrew Troy, Personal Trainer Gabriel Fang, pregnant mom (episode 1, episode II) Olympic Diver, Mexico Dr. Sabagh