NFSC 403 - Advanced Nutrition and Physical Fitness Instructor: Tracy Berman

Fall 2012 Case Study/Final (50 pts)

Nutrition, Exercise, & Body Building Vladamir is a 22 year old male college student who spends most of his free time at a health club working out with free weights. His ambition is to compete in body building at the local and state levels and to one day be state champion. He will be competing in his first contest in a year. He is 61 inches and weighs 218#. A body fat test at the fitness club indicated that Vladamir had 10% body fat. He was disappointed with this and states that he wants to get his body fat down to 5% so hell be closer to his competition value. Vladimirs goal is to gain 15 pounds of muscle while reducing his body fat to 5%. Toward this goal, he is taking several different nutritional supplements. He tells you that he is on a high protein, low fat diet. He uses a calorie counter book to determine the amounts of CHO, fat, protein and calories he ingests. He explains that he takes in about 20% of his total kcals from fat. He tries to eat 350 g of protein and 3500 calories daily. Vladamir knows that the highest quality protein is contained in eggs, so his protein intake includes 2 eggs and 2 egg whites per day. In addition, he drinks a protein shake after working out and again in the evening that contains 25 grams of protein per shake (this is part of his total intake) just to make sure he gets enough protein. Vladimir is very rigid with his diet. He tends to eat the same foods daily for several weeks and then he will tweak it a bit for the next several weeks. He does this about every 4-6 weeks. His diet has very little variety, he sticks with oatmeal, yams and white rice as his primary source of starch, and he eats green vegetables like broccoli, asparagus, and salad greens because they are easy. He will occasionally eat bananas and apples but consumes very little fruit at all. His meat mainly consists of flank steak, chicken breasts and occasionally tuna and he does not consume milk because he is lactose intolerant. He wont drink soy milk because he heard that it contains estrogen and he is worried that he will become more feminine. Vladamir says that it seems that everyone at the gym is taking creatine monohydrate to help them bulk up so he bought some. The directions indicate a loading dose of 15 to 20 g for 5 days and then a maintenance dose of 5 per day. Vladamir has decided that twice that amount will help him twice as much. He works out 6 days per week in the weight room for 2 hours at a time. In addition, he runs 3-4 miles 4-5 days per week, at a high intensity, to burn fat. He has one day each week of complete rest. He recently had his blood cholesterol checked and the doctor said it was high for his age. Vladimir was concerned because his dad also had high cholesterol at a young age. He also has a family history of hypertension and kidney disease. The reason he has come to you is because he is having trouble gaining weight and has actually been losing some in recent weeks. He is also having trouble recovering from workouts, especially the heavier ones. His workouts feel OK but he doesnt feel as strong as he was before he started training heavily. He has also been sick with several colds the past couple months and is frustrated because it interferes with his workouts.

QUESTIONS: 1. Using the Cunningham equation calculate Vladimirs RMR, then use an activity factor and calculate and his total calorie needs based on his current activity patterns (its ok to round off). Is his caloric intake adequate?(4pts) Cunningham Equation: RMR = 500+ 22(FFM) RMR = 500 + 22(89kg) = 2458 kcals 218 x (.10) = 22 lbs 2458 kcals x 1.6 = 3932 kcals 218lbs 22lbs = 196lbs / 2.2kg = 89kg His caloric intake of 3500kcals a day is not adequate enough to meet his needs given his activity factor. 2. What caloric intake would you recommend for him in order to achieve his goal of gaining 15 pounds of muscle? What rate of weight gain do you recommend and approximately how long should it take for him to achieve his goal? (3 pts) In order to gain weight, its recommended to increase caloric intake above what is calculated. I would recommend increasing his calories by 250-500 cals per day, which would cause him to gain .5-1lb per week. This should take him about 15-30 weeks depending on the amount increased calorie consumption. After gaining the weight he would need to lean down and trim down the fat. 3. Using the Target Body weight formula for gaining mass, figure out what he would weigh, with the extra muscle, at his desired body fat percentage.( 3 pts) Target Body Weight = Current FFM + Desired FFM Increase/ 1- Desired % BF FFM = 218 x (.90) = 196lbs 196lbs+15lbs/1-(.05) = 211/.95 = 222lbs He would weight 222lbs at his desired body fat percentage of 5%. 4. How many grams of protein per kg is he consuming? Is his current protein intake considered excessive? If so, how much protein do you recommend he eat per kg of body weight? (3 pts) 218lbs/2.2kg = 99kg 350g Protein/99kg = 3.53 g/kg Protein Yes, his current intake of 3.53 g/kg is considered excessive. I would recommend he consume 1.6-2.0 g/kg of protein. 5. Calculate his recommended protein intake in grams per day if it is different than what he is currently doing. (2 pts) Protein Needs: 99kg x 1.6g/kg = 158.4 g/day 99kg x 2.0g/kg = 198 g/day Given the range of 158.4 g/day to 198 g/day I would recommend cutting it right down the middle and consuming 178g of protein per day.

6. Make a recommendation for his carbohydrate intake in grams/kg and then calculate total recommended grams per day. Look at the recommendations from the power point, but be realistic as to what you think he might actually do based on his current eating pattern and ideas. (2 pts) 6g/kg of CHO: 99kg x 6g/kg = 594g of CHO I would recommend that he consume 594g of CHO per day for his weight gain plan and his current physical activities. Due to his idea of only consuming a high protein, low carbohydrate diet I would educate him on the benefits of consuming carbohydrates in order to gain weight. Since gaining 15 pounds is his primary goal, I think he would realize that increasing his carbohydrate intake to 594g per day would benefit him in accomplishing that goal. 7. Finish and summarize your dietary recommendations for CHO, Protein and fat. Use your recommendations from previous questions to calculate his recommended intake of fat. Make sure your recommendations are realistic for his goals, you may have to go back and make revisions. (5 pts) Calories= 4100 Fat: 2376 CHO + 712 Protein= 3088cals CHO grams= 594g = 2376cals 4100cals-3088cals = 1012cals left for fat Protein grams= 178g = 712cals 1012cals/9 = 112g of fat Fat grams= 112g = 1012cals 8. Vladimir did a sweat trial to determine his fluid needs. Calculate his fluid requirements per hour based on the results of his sweat trial. (5 pts) Sweat trial results: Pre exercise weight 219 pounds Post exercise weight 216.5 pounds Fluid consumed during 30 ounces Duration of workout 2.5 hours Weight loss: 219lbs 216.5lbs = 2.5lbs Additional Fluids needed: 2.5lbs x 16-24oz = 40-60oz Total: 30oz (consumed) + 40-60oz = 70-90oz Fluid needs per hour: 70-90oz/2.5hr = 28-36oz per hour 10. What are your thoughts about his exercise regimen? Could this have anything to do with how he is feeling and why he is not gaining weight? (2pts) His exercise regime is very intense considering he wants to gain 15lbs. His weight lifting with his high intensity cardio is whats making it hard for him to gain that extra weight and actually lose it instead. His lack of adequate carbohydrate in his diet is another reason why hes not gaining weight along with why he doesnt feel good after working out. Carbohydrates are the energy that is needed to work out and increase calories, without them then he will continue to lose weight and not be fueled enough to exercise. In 3-4, well organized, paragraphs address what you believe to be the main concerns regarding his diet, training and health. What changes do you think he should make to improve his ability to achieve his goals and to protect his long term health? Be sure to address any and all pertinent topics discussed in the case study. There are several things

11.

that need to be addressed and part of your grade is based on your ability to recognize them. (15 pts) Vladimirs diet is a major concern in his effort to increase his weight by 15lbs and decrease his body weight to 5 percent. His biggest concern should be consuming enough adequate calories to meet his needs, which is something he is currently not doing. His current protein intake of 350g per day is too excessive and needs to be decreased down to 178g per day so that its equal to 712cals per day. Hes not consuming enough carbohydrates to provide enough energy to work out and go through his daily life. Without adequate carbohydrates hes going to continue to feel weak after working out and not gain the amount of weight that he wants. His carbohydrate intake should be his highest intake of food being 2376cals per day. This will provide him the energy he needs to work out and contribute to him gaining weight. His current food choices need to be altered in order for his goal to be reached. He needs to add more calorie dense foods into his diet such as brown rice instead of white rice, nuts and seeds, legumes, avocados, and whole wheat bread. All of these foods will increase his caloric intake and provide him with the extra calories he needs to gain weight. In order to gain weight he must eat regularly with 3 meals and 3 snacks, eat until hes full and then eat some more, avoid carbonation with meals and have no beverages before his meals. All of these modifications will increase his caloric intake and make it easier for him to gain weight. His health is a very big concern when trying to modify his diet and increase calories. The need for decreasing protein is crucial as long-term effects of high protein consumption can cause kidney disease and increased calcium excretion. A high-protein diet can also be linked to an increased risk for heart disease as most high-protein foods are rich in saturated fats and cholesterol. Since his family history includes kidney disease and hypertension and that he has high cholesterol, it would be best to decrease protein consumption. The amount of eggs and meat consumption contribute to the high cholesterol and should be decreased. Instead of consuming meat often, he could replace it with fish and increase the consumption of tune instead. The fish will provide little cholesterol and essential fatty acids of omega-3 and omega-6 and the tuna has little cholesterol that contribute to a healthy body. He could also decrease cholesterol by consuming foods high in fiber like beans, nuts, and soy. His idea of soy milk containing estrogen is accurate in that it contains plant estrogen however, not the estrogen hormone found in women so it will not make him more feminine. It would be beneficial for him to consume soy milk as it has no cholesterol, fiber, and monounsaturated and polyunsaturated fats that decrease the risk for heart disease. He needs to increase his consumption of fruits and consume fruits that are rich in carbohydrates which can help him gain weight. Fruits like bananas, pears, mangoes, and pineapples all have adequate carbohydrates and can help him increase caloric intake to meet his needs. His current training level is not adequate enough to see changes in weight gain. He needs to decrease his intensity of cardio to decrease fat loss. He will see increases in both muscle and fat in doing this. His goal then should be to minimize fat and to maximize the muscle. He will have to lean down later to increase muscle and decrease fat. He can stop taking the protein shake as hes getting enough protein from his diet and possibly substitute it for a weight gain supplement instead. His other supplements do not need to be taken as he wants to take creatine also. If hes going to decrease his protein intake then creatine can be taken, otherwise it may overwhelm the kidneys. The extra creatine however that he wants to consume will not make the

affect any larger. The body can only handle so much creatine and the excess amount will be excreted by the kidney as creatinine. By taking into consideration all of these modifications to his health, training, and diet Vladimir can see changes to his weight and how he feels. He will see an increase in both fat and muscle and feel much better while he works out and after he works out. He will be able to decrease his cholesterol and protein intake which will decrease his risks for heart disease and kidney disease. All of these modifications will have a positive effect on his goal of gaining 15 pounds and decreasing his body fat to 5 percent. Instead of being so strict with his diet he can eat a wide range of different foods that will contribute to his weight gain that will be healthy and beneficial to him. After taking all of this into consideration he will understand that muscle and fat will both need to gained together, then fat will be trimmed away as muscle will get leaner.