Take a breath: Dieting gets easier

Monday, January 30, 2006
Dr. Muhannad Al-Kilani, endocronologist, demonstrates how the indirect calorimeter is used.

SIKESTON -- Dr. Muhannad Al-Kilani is taking some of the guesswork out of weight loss for area residents.

A new program offered by Al-Kilani more accurately tailors weight loss plans for patients by using a more accurate number for a person's metabolism derived from an indirect calorimeter for resting metabolic rate instead of calculations.

"It's primarily an educational tool to help patients lose weight," Al-Kilani said. "The machine provides an objective measurement of base metabolic rate which will help guide a custom-made recommendation for weight loss."

A frequently-heard excuse among those who are overweight or trying to lose weight is that they have a slow metabolism.

Al-Kilani, an endocrinologist, confirmed a person's base metabolic rate, which is how much energy a body burns while at rest, is an important factor in weight management.

Before the technology for indirect calorimeters was made affordable, "we used to use estimations of metabolic rate based on calculations," Al-Kilani said. These calculations are based on formulas from 1919 which use age, height, weight, and sex to predict a patient's metabolic rate.

"What this machine does is it measures how much oxygen you burn," Al-

Kilani explained. By determining how much oxygen is used, a very accurate, objective figure for a person's basal metabolic rate can be determined: "It's the gold standard."

To get a reading from the machine, the patient's nose is pinched shut while they breathe through a tube into the machine for 10 minutes.

To demonstrate just how far off calculations using the old formulas can be in determining a person's metabolism, Al-Kilani used the formula on a six-foot tall, 38 year old male weighing 212 pounds.

According to the calculations, this person should burn about 2,047 calories in a day without any activity.

After testing the person with the indirect calorimeter it was determined the man actually burns 2,851 calories per day while at rest.

The metabolic rate is then used with special software to come up with a custom-made diet.

For most people, cutting 500 calories per day will result in the loss of 1 pound of fat per week, according to Al-Kilani, although initial weight loss may exceed that due to the loss of water weight and perhaps even some muscle mass.

"If you exercise, you will keep the muscle and lose the fat more," Al-Kilani said.

Having developed several dietary templates in advance, Al-Kilani can quickly personalize a seven-day meal planner to help a patient meet their weight-

loss goal.

Only seven days are mapped out but there is enough variation among those meals to give patients a good idea of how much they should be eating to achieve their targeted weight loss.

"It's a guidance," he said. "This is an educational dietary plan, but they don't necessarily have to stick to this. We instruct people to read food labels."

For example, bagels vary in size - along with their calorie content, Al-Kilani said.

"I've seen bread as low as 50 calories per slice to as high as 120," he said.

The program also includes taking measurements at the waist and hip and recording blood pressure, blood sugar and a lipid profile.

A recommendation for exercise is also given along with the dietary recommendation.

Al-Kilani noted that while results for the test are very accurate, a person's metabolism does change over time and with changes in diet and activity. For example, Al-Kilani noted that the amount people eat can change their metabolism.

"If you eat more than you should, your metabolism creeps up," he said. This also works the other way: those who cut back on how much they eat will find their body compensates by reducing their base metabolism.

Al-Kilani received the machine near the end of last year but only started offering the customized weight-control program since the first of the year to coordinate with New Year's resolutions many people make to work toward a better health profile.

The American Medical Association recently recognized Al-Kilani for accumulating over 270 hours of continuing medical education credit hours during a three-year period. "I charted 294 but I actually did more than that," he said. A minimum of 25 hours per year are required in the state of Missouri.

For more information regarding the weight control program, contact Al-

Kilani's office at 471-4417.

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