Asked by Louise, Sacramento, California
I'm a 58-year-old diabetic whose A1C is less than 6. I would like to lose about 25 more pounds. I watch what I eat and walk about 2.5 miles a day but my weight stays around 158. Would having a resting metabolism rate test help with the weight loss?
Diet and Fitness Expert
Dr. Melina Jampolis
Physician Nutrition Specialist
Hi Louise -- While I do perform resting metabolic rate tests in my office, I do not feel that they are essential in most of my patients, although they do provide interesting information and can be very helpful in some cases. The tests, which historically have been done only in a hospital, measure the amount of oxygen that your body consumes as a measure of your resting metabolic rate. There are office-based systems available that can do the same thing in a shorter time with far less expensive equipment. They are not quite as accurate as the hospital-based tests but again, they can be useful in some people, particularly if the causes of a slower metabolism can be addressed, such as medication, low thyroid function or low levels of muscle mass.
Resting metabolic rate that is measured accounts for approximately 60-70 percent of your total metabolic rate (total daily calories burned). Most of your resting metabolic rate is beyond your control and is dictated by age, height, sex, weight, genetics, organ function and hormones. The only aspect of your resting metabolic rate that you really have control over, unless you have a hormonal or medication problem, is your muscle mass. The remainder of your total metabolic rate is composed of exercise, which accounts for about 20-25 percent depending on how active you are, and eating (also called the thermic effect of feeding), which accounts for about 10 percent of your total daily calories burned.
When you test your resting metabolic rate, you must then multiply that number by an activity factor that usually ranges from 1.3 to 1.9, depending on how physically active you are every day in your job and also during exercise. Resting metabolic rate can also be estimated using a mathematical equation and can be calculated by some of the more sophisticated body fat scales that measure age, height, sex, weight, fat mass and lean body mass to come up with a fairly accurate estimate.
If you think you would find it helpful to know more precisely how many calories you should be consuming daily, you might want to consider testing your resting metabolic rate or getting a body composition analysis. Once you know this number, it is critical to pay close attention to the number of calories you consume to lose weight, since most people who are overweight underestimate caloric intake by up to 30 percent.
In addition, I would highly recommend adding strength training to your exercise regimen to give yourself a metabolic boost. Also, if possible, you should increase the intensity or duration of your cardiovascular activity. Finally, because you are diabetic, you might want to try cutting back somewhat on your carbohydrate intake, particularly refined, processed carbohydrates, and increasing your intake of lean protein slightly to lose weight. Slightly higher amounts of lean protein have been shown to help middle-aged women with belly fat and high triglycerides, which often accompany diabetes, lose more weight and keep the weight off more effectively.
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