So the diet plan is take what you would burn sitting around awake doing nothing, just like in the test, all day, and subtract 500 to actually eat?
Then you create more deficit by actually getting up and moving around, and some hoped for walking as exercise?
Well, that should lead to more than 1 lb weekly, since I doubt you sit around 24 hrs daily like during the test.
But I could also see that deficit becoming unreasonable very fast. What if you did walk around and exercise too and burned 3000 in the day (only 1000 more than RMR, not hard at all). You'd be eating at 50% deficit - that's huge, eating half of what the body wants. And bad idea for reaching goal and maintaining.
Did they recommend using the Fitbit? Was it supposed to be 500 less than you burned all the time, not 500 less than a specific number?
Because frankly, with a disease, you don't have a healthy body, so you can't expect it not to be stressed taking a deficit that might be reasonable for others.
I hope you are eating more often than 72 hrs - that's how long it would take for body to think it was going to starve. Not skipping a meal - that's a myth. Eat your meals for whatever works for you and the diabetes, but don't be forcing it worse by thinking you have to eat frequently and always be spiking blood sugar and need a shot.
Starvation mode is brought on by taking too big a deficit for what the body wants, so it becomes more metabolically efficient to get closer to what you eat. Meaning what once was a 3000 calorie burn day becomes 2400 because it slows down by upwards of 20-25%.
When that happens you usually lose muscle mass too because just not eating enough.
http://www.youtube.com/watch?v=2i_cmltmQ6A
If you are not doing some resistance training - you are losing muscle right now anyway - not good at all. Because studies have shown it's the resistantance training and usage of muscular carb stores that helps insulin sensitivy.
Can you do some resistance training with heal spur? Machines at the least. The best thing is not always going to be walking steps, actually rarely is it the best thing possible. It is a thing that is possible for vast majority to improve on though, but that doesn't mean it's best.
And you can cause your RMR to go down by the amount you eat. You could keep chasing it down to that 20% suppression if eating level is always based on it, rather than what potential of the body could be. That would be a Bodpod or DEXA or hydrostatic measurement for bodyfat.
Just a thought. Because without that BF%, you don't know if measured RMR is actually correct for amount of BF or perhaps it is lower than expected.
Here's a case study showing just what one lady did to herself. I'll mention her weight gain in there was likely from binges, every binge was in excess to her reduced metabolism and daily burn, causing fat gain. It's not because of starvation mode, but that sure is made easier to accomplish eating in surplus when dealing with it. Every sick week, every binge meal or day, was all in excess and would have been stored as fat.
A similar case study was published by Jampolis (2004).
A 51 year old patient complained of a 15 lb weight gain over the last year, despite beginning a strenuous triathlon and marathon training program (2 hours per day, 5-6 days per week).
A 3 day diet analysis estimated a daily intake of only 1000-1200 Calories.
An indirect calorimetry revealed a resting metabolic rate of 950 Calories (28% below predicted for age, height, weight, and gender).
After medications and medical conditions such as hypothyroidism and diabetes were ruled out, the final diagnosis was over-training and undereating. The following treatment was recommended:
- Increase daily dietary intake by approximately 100 Calories per week to a goal of 1500 calories
- 32% protein; 35% carbohydrates; 33% fat
- Consume 5-6 small meals per day
- Small amounts of protein with each meal or snack
- Choose high fiber starches
- Select mono- and poly- unsaturated fats
- Restrict consumption of starch with evening meals unless focused around training
- Take daily multi-vitamin and mineral supplement
- Perform whole body isometric resistance training 2 times per week
After 6 weeks, the patient's resting metabolism increased 35% to 1282 Calories per day (only 2% below predicted).
The patient also decreases percent fat from 37% to 34%, a loss of 5 lbs of body fat.
Jampolis MB (2004) Weight Gain - Marathon Runner / Triathlete. Medicine & Science in Sports & Exercise, 36(5) S148.
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