EXERCISE NO.

ESTIMATING DAILY TOTAL ENERGY REQUIREMENT (TER) FOR ADULTS

WILMAR JUN O. ELOPRE, RND

INTRODUCTION

The total energy requirement (TER) is the total amount of energy or calories an
individual needs to consume per day in order to maintain his/her healthy weight. It is composed
of basal metabolic rate (BMR) or basal energy expenditure (BEE), physical activity (PA) and
thermogenic effect of foods (TEF). In clinical cases, an additional stress/injury factor is added
to the formula. There are different methods and formulas used in the estimation of TER but
their results do not significantly differ. Generally, the use of Harris-Benedict formula is used in
clients under critical care. The quick methods are preferable to eliminate time constrains and
when conditions warrant convenience.

OBJECTIVES: At the end of the exercise the students should be able to:

1. identify the different methods and formulas used in the estimation of TER for adults;
2. use the different methods and formulas in the estimation of TER for adults;
3. analyze the different components of TER for adults; and
4. apply the concepts of TER to practical conditions.

PROCEDURE:

1. TER can be computed using the following methods: the factorial method, the quick
method and through the use of Recommended Energy Intake (REI) of the Philippine
Dietary Reference Intake (PDRI).
2. There are two ways of using the factorial method, namely: the Method I and the Krause
and Mahan method.
3. The Method I use the Harris-Benedict formula in determining the Basal Metabolic Rate
(BMR) or Basal Energy Expenditure (BEE). The BMR is computed first and then it is
multiplied by physical activity factor (PA) and stress of injury factor.

TER (kcal) = BMR (kcal) x PA x stress/injury factor

I. Method I

A. Determine BMR using the Harris-Benedict formula as indicated below:

For males:
BMR (kcal) = 66.5 + [13.75 x wt (kg)] + [5 x ht (cm)] – [6.75 x age (yr)]
For females:
BMR (kcal) = 655.1 + [9.56 x wt (kg)]+[1.85 x ht (cm)]- [4.68 x age (yr)]
For obese, the weight to be used in Harris-Benedict formula must be adjusted. Do this by determining
first the Ideal Body Weight (IBW) and then adjust the weight using this formula (where ABW is actual
body weight):
(ABW – IBW) x 0.25 + DBW = adjusted W in kilograms
B. Determine the cost for PA. Determine the factor for PA by referring to the table below
(note: resting is synonymous with bed rest as sedentary is to very light):

Table 1. Table of activity levels for determining the PA factor

c. Determine the stress or injury factor by referring to the table below:

d. Once the PA factor and stress/injury factor are determined, compute the TER using
the formula indicated in procedure in number 3.

4. The next factorial method that can be used is the Krause and Mahan method. This is
done by taking into consideration the PA as well as the Thermogenic Effect of Food
(TEF), both of which are derived from the BMR/BEE. In this method, the formula used
for the determination of BMR/BEE can be different from that of the Method I but both
can yield similar (or slightly different) results. The TER is then determined by using this
formula
 TER (kcal) = BMR (kcal) + PA (kcal) + TEF (kcal)

I. Krause and Mahan Method

A. Determine first the IBW using one of the formulas previously indicated.
B. Determine next the BMR/BEE using the following formulas:

For males:
BMR (kcal) = 1 kcal x IBW (kg) x 24
For females:
BMR (kcal) = 1 kcal x IBW (kg) x 24

C. Adjust the BMR/BEE for number of hours slept. This is determined by using this formula
first:

Adjustment for sleep (kcal) = 0.1 x IBW x number of hours slept

D. Then this is subtracted from the BMR computed. To put in a formula, finally adjust the
BMR using this:

Adjusted BMR (kcal) = BMR – adjustment for sleep

E. Determine the cost for PA by referring to the table below (refer to table number 1 to know
exactly the nature of the activity levels indicated in this table):

Activity level
Bed rest 10% of BMR
Sedentary 30% of BMR
Light 50% of BMR
Moderately Active 75% of BMR
Very Active 100% of BMR

For example, if the adjusted BMR is 1500 kcal and the activity level is sedentary, the
cost for PA is:

1500 kcal (adjusted BMR) x 30% = 450 kcal (So 450 kcal is the cost for PA in this
case)

F. Determine the cost for TEF by multiplying the sum of adjusted BMR and PA by 10%. For
example, if the BMR computed is 1500 kcal and the PA is 450 kcal, the sum of which is
multiplied by 10%, therefore in that case the TEF is 195 kcal (1500 + 450 x 10%).
G. To finally determine the TER (kcal), total the adjusted BMR, PA and TEF using the formula
indicated in procedure number 4.

5. Note that the Harris-Benedict formula can also be used in the determination of BMR in the
Krause and Mahan method.
6. There are two (2) quick methods that can be used to estimate the TER; these are the following:
Quick Method I and through the use of the NDAP formula.
7. In the Quick Method I, the IBW is multiplied with the amount of kcal/kgIBW that corresponds
to the activity level.

A. Determine first the IBW using one of the formulas previously indicated.
B. Refer to the following table to check for the activity level (refer to table
number 1 to know exactly the nature of the activity levels indicated in this
table):

Activity level Kcal/kgIBW

Bed rest 25
Very light activity 30
Light activity 35
Moderate activity 40
Heavy activity 45
Strenuous activity 50

C. To compute for the TER, just multiply the IBW with the amount of kcal per
IBW corresponding to the selected activity level. For instance, if the IBW is
50 kg then the identified activity level is light activity (~35 kcal/kgIBW),
therefore 50 x 35 = 1750 kcal).

8. For the NDAP method, the way of determining the TER is the same with that of the Quick
Method I, except for a slightly different table of activity levels used (refer to the following table
below):

Activity level Male (kcal/kgIBW) Female (kcal/kgIBW) Examples

In bed but mobile 35 30 Secretary, clerk, typist,

administrator, cashier,
bank teller

Light 40 35 Teacher, nurse, student,

lab technician, housewife
with maids

Moderate 45 40 Housewife without maids,

vendor, mechanic,
jeepney and car driver

Heavy 50 - Farmer, laborer, cargador,

coal miner, fishermen,
heavy equipment
operators

A. For instance, the IBW is 50 and the client is female and her activity level is
light because she is a teacher, so her TER is 50 x 35 = 1750 kcal

9. Using the REI in the PDRI, find for the client’s amount of calories or energy that corresponds
to the age of the client. By then, you will be able to easily determine the client’s TER.
 Name: Marjourie F. Cadampog BSN1-A

COMPUTATION:

1. Compute the TER of a client who is a 50-year old male farmer. His height is 5’4”. He sleeps 7
hours per day.

A. Determine his IBW using the Tanhausser’s method.

➢ 5’4(60=4) =64(2.45) =162.6cm
➢ 162.6-100=62.6
➢ 10% of 62.6=6.26
➢ 62.6-6.26=56.34kg

B. Determine his TER using the following:

I. Method I
A. BRM formula male: BMR (kcal) = 66.5 + [13.75 x wt (kg)] + [5 x ht (cm)] – [6.75 x age (yr)]
➢ BMR (kcal) = 66.5 + [13.75 x 56.34 (kg)] + [5 x 162.6(cm)] – [6.75 x 50(yr)]
➢ 66.5+774.68=813-337.5
➢ 1316.7kcal

B. Determining PA: Agricultural worker=2.1

C. Stress injury: none= 1.0
D. Solving for TER: TER (kcal) = BMR (kcal) x PA x stress/injury factor
➢ 1316.7x2.1x1.0=2765.07/2750

II. Krause and Mahan

A.Determine his IBW using the Tanhausser’s method.
➢ 5’4(60=4) =64(2.45) =162.6cm
➢ 162.6-100=62.6
➢ 10% of 62.6=6.26
➢ 62.6-6.26=56.34kg
B.Determining BMR/BEE For males: BMR (kcal) = 1 kcal x IBW (kg) x 24
➢ BMR (kcal) = 1 kcal x 56.34(kg) x 24=1352.16/1352.2kcal
C.Adjustment for sleep (kcal) = 0.1 x IBW x number of hours slept
➢ 0.1 x 56.34 kg x 7hrs=39.44kcal
D,Adjusted BMR (kcal) = BMR – adjustment for sleep
➢ 1352.16-39.44kcal=1312.72
E.Determine the cost for PA:Very active 100%
➢ 1312.72x 100%=1312.72
F.Determine the cost for TEF
➢ 1352.16kcal+1312.72kcalx10%=1483.43kcal
G.To finally determine the TER (kcal) TER (kcal) = BMR (kcal) + PA (kcal) + TEF (kcal)
➢ 1352.16kcal+1312.72kcal+1483.43kcal=4148.31/4150kcal

III. Quick Method I

A.Determine his IBW using the Tanhausser’s method.
➢ 5’4(60=4) =64(2.45) =162.6cm
➢ 162.6-100=62.6
➢ 10% of 62.6=6.26
➢ 62.6-6.26=56.34kg
 B.Identify activity level
➢ Agricultural worker, heavy activity=45
C. Compute for the TER
➢ 56.34x45=2535.3/2550kcal

IV. NDAP Method

A.Compute for NDAP TER-heavy
➢ 56.34x50=2817/2800kcal

2. Compute the TER of a 24-year-old female nurse with a height of 5’2”. She sleeps 5 hours per
day.

A. Determine her TER using the Hamwi method.

For females = 100 pounds for 5 feet plus 5 pounds per inch over 5 feet
➢ Given: Height:5’2ft. (100+10lbs=110lbs)
➢ Small frame=subtract 10% of 110=11
➢ =99lbs/45kgs.

B. Determine her TER using the following:

I. Krause and Mahan (but use the Harris-Benedict formula for BMR)
A.Solving for BMR
➢ Females: BMR (kcal) = 655.1 + [9.56 x wt (kg)]+[1.85 x ht (cm)]- [4.68 x age (yr)]
➢ 655.1 + [9.56 x 45(kg)] + [1.85 x 157.5(cm)]- [4.68 x 24(yr)]
➢ 665.1+430kg+291.38cm-112.32
➢ 1274.16kcal
B.Adjustment for sleep: 0.1 x IBW x number of hours slept
➢ 0.1x45kg x 5hr=25
C.Adjusted BMR (kcal) = BMR – adjustment for sleep
➢ 1274.16kcal-25kcal=1249.16kcal
D.Determine the cost for PA: Light 50%
➢ 1249.16kcal x 50%= 624.58kcal
E.Determine the cost for TEF
➢ 1249.16kcal+624.58kcal x 10%=187.37kcal
F.To finally determine the TER (kcal) TER (kcal) = BMR (kcal) + PA (kcal) + TEF (kcal)
➢ 1274.16kcal+624.58kcal+187.37kcal=2086.11/2100kcal

II. Quick Method I

Determine her TER using the Hamwi method.
A.For females = 100 pounds for 5 feet plus 5 pounds per inch over 5 feet
➢ Given: Height:5’2ft. (100+10lbs=110lbs)
➢ Small frame=subtract 10% of 110=11
➢ =99lbs/45kgs

B. Activity level: Light, Nurse=35

➢ IBW x Level= 45kgsx35=1575/1550kcal

III. NDAP Method: Activity level-Light

➢ IBW x Level= 45kgsx35=1575/1550kcal
3. Compute the TER of a 36-year old with COPD with a height of 5’10”. He is already bed-ridden
(immobile). Compute his IBW using the Tanhausser’s method and TER using Method I.
A.Determine his IBW using the Tanhausser’s method.
➢ 5’10(60=10) =70(2.45) =171.5cm
➢ 171.5-100=71.5
➢ 10% of 71.5=7.15
➢ 71.5-7.15=64.35kg
B. BRM formula male: BMR (kcal) = 66.5 + [13.75 x wt (kg)] + [5 x ht (cm)] – [6.75 x age (yr)]
➢ BMR (kcal) = 66.5 + [13.75 x 64.35(kg)] + [5 x 171.5(cm)] – [6.75 x 36(yr)]
➢ 66.5+884.81+857.5-243
➢ 1565.81/1550kcal
C. Identify Level: Bed rest=25
D. Solving for TER: IBW x Level= 64.35kg x 25=1608.75kcal

4. Using the REI-PDRI, determine the TER of the following: I. Male (18 y/o), Female (35 y/o) and
Male (56 y/o). (As instructed, this question can’t be answered)

(Insert your computations after this page)

Pardon Ma’am, but my computations were directly written in the questionnaire part. Thank
you.
 QUESTIONS:

1. Elaborate the definition of Basal Metabolic Rate (BMR) by pointing out the different
physiological processes it is used for.

Basal Metabolic Rate can be defined as the rate at which the body uses energy even when
it is resting. It constantly burns calories by performing basic functions to sustain life, such as
our breathing, body circulation, nutrient processing and cell production. Basal metabolic rate
is the number of calories your body needs to accomplish its most basic (basal) life-sustaining
functions.

2. State the difference between BMR/BEE from Resting Metabolic Rate (RMR) or Resting
Energy Expenditure (REE).

BMR and RMR are different from each other, as the BMR is the minimal energy
expenditure needed for survival, or the number of calories we burn in order for our body to
perform minimal survival functions, whereas our RMR is the energy required to maintain bodily
functions at rest. Aside from that, the Nasal metabolic rate (BMR) is often used
interchangeably with resting metabolic rate (RMR). While BMR is a minimum number of
calories required for basic functions at rest, RMR also called resting energy expenditure (REE)
is the number of calories that your body burns while it’s at rest.

3. How important is physical activity in the determination of the TER? How can it affect
one’s weight maintenance?

Engagement of physical activity increases the number of calories our body uses for
energy or “burns off.” The burning of calories through physical activity, combined with reducing
the number of calories that was eaten and creates a “calorie deficit” that results in weight loss.
Constant engagement of physical activity of a person based on its level affects its Total Energy
Requirements as a person who engage more in physical activity requires a lot of calorie to
sustain the body’s energy needs. But if a person failed to sustain the body with its caloric
needs, then a possibility of weight loss could occur as there was no enough calorie to be burns
off and converted to energy.

4. What is thermogenic effect of food? State its importance in the determination of one’s
TER

The thermic effect of food (TEF), is defined as the increase in metabolic rate after
ingestion of a meal. It is also the energy required for digestion, absorption, and disposal of
ingested nutrients. Its magnitude depends on the composition of the food consume. For
example, Protein-rich foods, such as meat, fish, eggs, dairy, legumes, nuts and seeds, could
help increase your metabolism for a few hours. They do so by requiring your body to use more
energy to digest them.
 REFERRENCES

Frothingham, S. (2018, November 12). What Is Basal Metabolic Rate? Healthline.

https://www.healthline.com/health/what-is-basal-metabolic-rate

The 12 Best Foods to Boost Your Metabolism. (n.d.). Healthline.

https://www.healthline.com/nutrition/metabolism-boosting-foods