The B vitamin, which can prevent birth defects, will not harm the general public, a study says.

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Kilojoules are those little units of energy we consume whenever we eat, well, anything. And they are arguably the most talked about part of any weight-loss journey.

The general rule is that if you eat more kilojoules than you use, you’ll gain weight. And if you take in fewer kilojoules than you use, you’ll lose weight. And if those numbers are more or less even, your weight will stay about the same.

It seems simple, but the number of kilojoules you need to lose weight, maintain weight or gain weight from lean muscle depends on your activity levels, body size, hormones, sleep and more, explains registered dietitian Wesley Delbridge, a spokesman for the Academy of Nutrition & Dietetics.

So figuring out how many kilojoules you need per day can be complicated.

And, it’s also important to remember that, when it comes to cutting kilojoules for weight loss, lower is not always better.

According to the American College of Sports Medicine, your kilojoules should never dip below 5 020.

That’s because most women, unless they are very small, will burn more kilojoules than that doing literally nothing, says registered dietitian nutritionist Jonathan Valdez, owner of Genki Nutrition and a spokesperson for the New York State Academy of Nutrition and Dietetics.

“Less than that and you could shock your body into starvation mode, which will slow your metabolism, decrease your muscle mass, and likely keep you from getting the nutrients you need to sustain daily activity,” Delbridge explains.

Read more: Your guide to carb cycling for weight loss

So, if you’re asking yourself, “How many kilojoules do I need a day?” read on as experts explain what you need to know to get your kilojoule intake just right.

How to determine your base kilojoule needs

In order to figure out how many kilojoules you need to lose or gain weight, you first need to determine how many you need to maintain.

Guidelines say young women should aim for 7 531 to 10 041 daily kilojoules, depending on age and activity level, but that range isn’t necessarily tailored to your specific needs – so it’s not as precise as it could be.

For a more exact number, start by finding your basal metabolic rate (BMR), which is the minimum number of kilojoules your body burns at rest, suggests physical therapist Grayson Wickham, founder of Movement Vault.

Your BMR accounts for 60 to 75% of your total daily kilojoule burn, according to a review in Medicine and Science in Sports and Exercise.

“To most accurately calculate your BMR, you’d need to go to a lab to have your carbon dioxide and oxygen analysed after having fasted for 12 hours and slept for eight. But, that can be a little pricey and a rough estimation of your BMR can be found using a few different equations,” says Wickham.

One study published by the Journal of the Academy of Nutrition and Dietetics found the Mifflin-St. Jeor equation to be highly accurate, so it is now considered the gold standard when it comes to calculating BMR.

For comparison’s sake, however, some experts prefer the Harris Benedict equation for determining BMR.

Read more: Are you making this huge weight loss mistake?

For women, the Mifflin-St. Jeor equation is: BMR = (10 x weight in kg) + (6.25 x height in cm) – (5 x age in years) – 161.

For women, the Harris Benedict equation is: BMR = 655.1 + (9.563 x weight in kg ) + (1.850 x height in cm) – ( 4.676 x age in years).

The results for both will be slightly different, but they’re pretty darn close, says Wickham. When you find your BMR on your own, consider it a really good estimate, not a hard-and-fast rule, he adds.

For both equations, finding your BMR requires your weight, height, age and gender (yes, guys have their own equation). Wondering why? “The more you weigh and the more mass you have, the more fuel you need to sustain your organs,” explains Valdez. That’s why people who weigh more have heavier BMRs.

Age is a factor in the equations because, as you get older, muscle mass declines by five or so percent each decade after the age of 30, Wickham explains. This might change as more women start strength training, but as a general rule, that’s fair, he says.

And if you’re wondering why the formula is different for men and women, it’s because research published in The Journal of Clinical Investigation shows that a woman’s BMR is typically around 5 to 10% lower than a man’s.

Now what? Once you know your BMR, you know the bare minimum number of kilojoules you would need to keep your body alive if you were going to lay in bed all day, says Wickham.

But you need to take into account everything else you do that burns kilojoules (walking the dog, folding laundry, climbing five floors of stairs to your apartment, bi-weekly CrossFit class, Thursday evening yoga…).

To do that, multiply your BMR by the factor that best represents your activity level.

Read more: What’s the best way to track weight loss: a measuring tape or scale?

If you are sedentary = BMR x 1.2

If you do light exercise 1-3 days a week = BMR x 1.375

If you exercise at a moderate intensity 3-5 days a week= BMR x 1.55

If you are exercise at a high intensity 6-7 days a week = BMR x 1.725

If you are into two-a-days or have a physically demanding job = BMR x 1.9

How many kilojoules you need to lose weight

Okay, so how many kilojoules do I need a day to lose weight? Once you know how many kilojoules you need to maintain your weight, you simply subtract some kilojoules to put yourself into a deficit.

How many kilojoules? Well, to lose roughly half a kilo of fat per week (a healthy goal) you need a 2 092kJ per day deficit, he explains. In other words, just delete 2 092 kilojoules from the number you found above.

But a kilojoule deficit doesn’t have to (and, in reality, shouldn’t) come solely from eating less, says Valdez. Exercise can help, too.

If you are game for taking your workouts to the next level, Valdez recommends decreasing your kilojoules from food by 1 046 per day, and increasing the intensity or duration of your workouts so that you are burning an additional 2 092 kilojoules two to three times a week through exercise.

That means if you already take a cycling class three days a week, add in a 30-minute walk two days per week to keep the kilojoule burn going. Or, if you currently live a lightly active life, consider incorporating a yoga class, strength-training class or a hike into your routine.

However, that does mean that on the days you don’t do any physical activity at all, you should decrease your kilojoule intake by closer to 2 092kJ, he says.

Your goal is to burn about 2 092 fewer kilojoules than you take in per day, through diet, exercise, or both. You do the math.

Read more: 5 weight-loss rules from nutritionists that you should break

How many kilojoules you need to gain weight from muscle

Not everyone who counts kilojoules wants to lose weight. Some want to gain it from lean, powerful muscle. Gaining weight from muscle is a great way to improve your health and even decrease your body-fat percentage.

Bonus: Since muscle is metabolically active, it can also help you shed fat without cutting kilojoules, says Wickham. When you start to gain muscle, your BMR will increase, which means that your body needs more kilojoules just to go about its daily function, he explains.

“If you want to gain weight, the simple trick is to tack on 1 046 to 2 092 extra kilojoules in healthy, whole foods per day. Every one to two weeks, you’ll have added half a kilo safely,” says New York City nutritionist Brittany Kohn.

To gain muscle without also gaining fat, you need to increase your protein to 1.8 to 2g per kilogram of body weight every day, so the majority of these additional kilojoules should come from protein, says Valdez.

And the rest should come from carbs like whole grains, fresh fruits, and vegetables, which will help power your workouts.

^{This article was originally published on www.womenshealthmag.com}

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Gabrielle Kessel

Ever had to answer the question, “Which famous person would you love to have dinner with?”

Think carefully before you choose your ideal dinner partner – turns out your companion is just as important as the food on your plate when it comes to weight management. 

When eating out, helpful tricks like sharing an entrée or ordering an appetiser instead of a main dish can curb calories. But your choice of dining companions may factor into the equation, too.

What the study entailed

An experiment done at the Cornell University Food and Brand Lab confirmed the theory that people are less likely to stick to their own diet rules when eating with or near someone who is overweight. The researchers found that diners at a buffet ate larger portions of unhealthy foods – and smaller portions of healthy food – even when the overweight person ate less.

One possible explanation for this behaviour is that people become less in tune with their goals when they see others who are overweight.

Studies have also found that diners can be influenced by being near anyone who’s overeating, even when that person is slim. Their overeating can encourage your overeating.

Your strategy

No, we are not suggesting that you get rid of friends or family members and eat in solitude. Avoiding overeating takes planning and knowing your weaknesses.

1. Know your enemy

Identify when you are triggered to eat more, and practice self-control in those situations.

2. Avoid the pitfalls

Stay out of harm’s way by avoiding all-you-can-eat restaurants or buffet options. If, however, you find yourself in such a situation, take control by having small portions of the foods you absolutely love and loading the rest of your plate with vegetables.

3. Tell it to the world

Tell your dining companions about your diet goals so they won’t unintentionally tempt you to overeat; also remind yourself of your goals before you enter any restaurant.

4. Plan, plan, plan

When possible, decide in advance what you’re going to order by reading menus on restaurant websites. This makes it less likely that you’ll be influenced by your environment.

For those times when you do find yourself facing a buffet, take a full tour of the table before you make any selections. Other research from Cornell found that people load up on the foods placed at the beginning of a buffet and that they take even larger helpings when the dishes are unhealthy. So, be sure to identify the location of the healthiest choices before you reach for a serving spoon and start filling your plate.

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The audit will reveal how many women have suffered ill consequences from the controversial treatment.

A judicial review is granted over government health policy plans.

Although there are no official statistics, last year was probably the most fatal in history for South African university students in terms of mental health.

According to reports, six students at the University of Cape Town died by suicide, and at Stellenbosch University there were three. On other campuses, suicide probably claimed just as high a toll.

Breaking the silence

With the academic year that has just begun, it is imperative that notice – and action – be taken of these silent tragedies that are playing themselves out on our campuses. Apart from the individual tragedies and human lives that have been destroyed forever, these are scary statistics.

Last year, there was a public outcry after the senseless murder of Matie student Hannah Cornelius. That is the way it should be. A young person, on the threshold of their dreams, should not be robbed of their life in such an indescribably cruel way.

Yet, the death by suicide of three other Matie students last year did not also elicit nearly such an outcry – there was no similar upheaval of emotion or outrage over three beautiful young people who also lost their lives. This is not right, and it is our moral duty to break the silence and the stigma around mental health – and to raise public awareness.

A study last year in Britain showed that suicide among UK students reached a record level, doubling over the past decade. The prevalence of mental health problems such as depression and anxiety disorder among British first-year students has also increased fivefold over the last ten years.

It is described as a crisis, and the British government and universities need to do much more to prevent treatable diseases from developing into fatalities. The study also showed much higher numbers of female first-year students seeking help for mental health problems – indicating just how big the pressure on student support services is, and what their shortcomings are.

Students under extreme pressure

Although there are no similar university-wide statistics available on the situation in South Africa, we can conclude that the same phenomenon plays itself out on South African campuses.    

For a variety of reasons, students are under extreme pressure. The “always on” culture of social media is a major contributing factor. There are also many more first-generation students, something that places a unique burden on them. No-one in their immediate family circle knows what their stressors are, and therefore cannot give them the necessary support.

In South Africa, the additional stress factors of study fees and campuses often under siege because of protests, add to the negative effect on students’ well-being.

A Matie student leader and mental health activist, Cally Ballack, thinks the stress and anxiety of academic life is often a tipping point. “The negative connotations and stereotypes attached to such illnesses often prohibit us from speaking, as one is embarrassed to do so, or  simply not aware of the facilities available on campus to assist students, as they are not advertised adequately or spoken about frequently.”

She says speaking about mental illness is imperative to one’s treatment and recovery. “We’re rushed to Campus Health when we sustain a physical injury or illness; the time is now to start taking mental illnesses just as seriously.”

Raising awareness

That is precisely why one welcomes Varsity Sports’ SpeakUp campaign for 2018. The sports codes played under the Varsity Sports banner on participating campuses across South Africa want students to realise that without mental health there is no health. The sports that are played in the name of awareness raising of the importance of mental health, are athletics, cricket, hockey, netball, soccer, sevens rugby and mountain biking.

The campaign was initiated by the Ithemba Foundation, a non-profit enterprise that aims to raise awareness of depression and related diseases as clinical, biological diseases, and to support research.

In our modern society, especially with the new kind of pressure associated with our digital lifestyle, we must also develop a new perspective on mental health. The campaign aims to improve young people’s mental health literacy by empowering them with the necessary knowledge. Mental “fitness” on and off the sports field is the basis of a healthy lifestyle.

As Cameron Peverett of Varsity Sports and former rugby player emphasises: “When I was playing rugby, the maxims ‘If the mind is willing, the body will go’ and ‘mind over matter’ were used to get us through difficult times. All teams and individuals do their best, and the difference in winning and losing comes down to the quality of the decisions you make long before you set foot on the field.

The well-being of your mental state therefore is the foundation of any success. This is as true in life after sport as it was when I was playing, and the importance of seeking out the right support structure/team is fundamental in keeping a positive state of mind.”

Clinical diseases

Our society has a duty to break down centuries of stigma surrounding mental health.  Mental ill-health has biological, clinical causes, causing our most important organ, our brain, to malfunction. Something – an external factor such as stress, or an endogenous factor such as heredity – causes the non-secretion of vital neurotransmitters which can lead to abnormal reactions, which in turn can spiral out of control if not treated.

If the symptoms are not recognised and treated, they can develop into clinical diseases that may be fatal to some, even with the best treatment. Therefore, we need to be pro-active and seek treatment, either from a clinical psychologist through behavioural therapy, or with the help of a psychiatrist who may also prescribe medication.

All students experience extraordinary stress factors, but it is also known that especially medical students are under great pressure. I was at a student meeting last year where the student leader of a medical campus spoke bravely about the mental health challenges on his medical campus – where it is a taboo subject despite it being a medical campus. The problem was expressed in a touching piece by an American medical student who wrote how she was caught in a vicious circle.

‘Already dead’

The author cannot ask for help, because she would be discriminated against. She writes that the stigma is sometimes palpable. On hospital rounds diagnoses of mental health are often discussed in whispers. On one patient’s discharge, it was written: “He is not sick. He just has depression.” As if depression weren’t a real disease…

On her psychiatry rotation, the medical student wrote how another student, after looking at a depressed young man admitted after a suicide attempt, declared his admission pointless as he was “already dead”.

The author concludes: “I write this because we would never look at a patient with cancer and say that person is already dead … I write this because I hope for a future in which a medical student fighting mental illness will be seen as someone strong and not as someone ‘dying’. I write this because I dream of a future where I would not have to be afraid to write this.”               

Hopefully, the SpeakUp campaign will give a voice to all students across all our campuses to not be afraid to say, “I need help!” As the campaign’s slogan states: “Speak Up!” Please, dear student, speak up! It can save your life!

Where to find help:

Lifeline 24-hour helpline: 0861 322 322

SADAG helpline: 0800 567 567 / or SMS 31393.

For information:

WHO’s website on mental health: http://www.who.int/features/factfiles/mental_health/en/

SA Federation for Mental Health:  www.safmh.org.za

South African Depression and Anxiety Group: www.sadag.org.

Lizette Rabe is a professor of journalism at Stellenbosch University and founder of the Ithemba Foundation. On 24 February 24, a panel discussion will take place in the Breytenbach-Sentrum in Wellington with Rabe, who lost a son who was a medical student to depression, as panel leader. Participants are author Dana Snyman, who lost his fiancé, Dr Cobus McCallachan, a psychiatrist, who lost his daughter, and Dr Gerrit de Villiers, a paediatrician, who lost his son. For more information, contact info@breytenbachsentrum.co.za.

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Lizette Rabe

We’re often told that our doctors have seen everything, and that we shouldn’t feel awkward asking them about things we find embarrassing. 

And on the other side of the spectrum, a problem might seem so insignificant that you’re not sure whether it’s serious enough to warrant a trip to the doctor.

The answers to the following common questions may help. 

1. Sometimes my poop is green. Why?

It’s easy to be alarmed when your stool looks unusual. It’s completely normal for the colour of your stools to be varying shades of brown – and even green at times. Green stools can occur because of the chlorophyll in green, leafy vegetables or supplements. Some colourants and dyes in food may also cause green stools.

Sometimes a yellow-green colour indicates the presence of bile. When you have an upset stomach, bile is not broken down normally and may appear in your stools.

According to our liver expert, dark green stools may also be caused by stress. If this persists, see your doctor.

2. I’m farting more than usual. Should I be worried?

Have you changed your diet recently? Are you eating more fibre or legumes? Did you perhaps overdo it on onion rings or a greasy meal? If so, this could explain your increased wind.

If your farts, however, are coupled with other unpleasant symptoms such as diarrhoea, constipation or cramps over a period of time, it might signify other digestive problems such as IBS.

3. There was a little bit of blood when I wiped. Is this an intestinal problem or could it be something else?

Seeing blood on toilet paper after a bowel movement can be scary, but is not always a reason for panic. There are a number of factors that can cause rectal bleeding, such as ulcers, haemorrhoids or polyps. The cause of bleeding may not be serious, but locating the source of bleeding is important.

The source of the bleeding is not always from the intestines, and contrary to popular belief doesn’t always signify cancer. How regularly does it happen? What is the amount of blood? If it’s a frequent occurrence, you need to see your doctor as a colonoscopy might be needed to find the cause.

4. Sometimes it’s sore when I orgasm. Is there a reason?

Painful orgasms can make sex unpleasant, but research suggests that it’s more frequent than we may think. The condition is called dysorgasmia and causes cramps in the lower abdomen and pelvic region as women orgasm. This condition is more frequent in older women nearing menopause.

5. I always have ingrown, fungal toenails. They’re unsightly. How can I fix them?

Ingrown toenails are already sore and prone to cause infection – add a fungal infection to the mix and it can be an unpleasant double whammy. Fungal infections in the toenails are common, but can be stubborn to treat and often reoccur. An antifungal tablet or oral antibiotic can be taken to treat of the fungal infection, while proper footcare such as trimming the nails straight across will help remedy the ingrown toenail. If the problem persists, you will need to visit a podiatrist, especially if you’re a diabetic.

6. My breasts feel lumpy and sore when I menstruate. How will I know if it’s cancer?

During your period your breasts retain extra fluid, causing the natural tissue to feel a bit lumpier. This is completely normal and no treatment is needed. You can also experience a lumpy, tender feeling in your breasts when you are on birth control, due to the hormonal changes.

Learn how to self-examine your breasts to distinguish unusual, solid lumps and always consult your doctor if you are worried. Here’s a guide on how to do a breast examination. 

7. I keep getting yeast infections. Is it my underwear, or is there a problem with my immune system?

Vaginal yeast infections occur when the natural yeast in the vagina starts to multiply, leading to uncomfortable itching, redness and discharge. There are several factors that could aggravate a yeast infection, including wearing sweaty gym clothes and tight shapewear, especially in summer.

While it’s not specifically the clothing that causes the condition, clothing can trap bacteria and accelerate the growth of yeast, leading to an uncomfortable infection. Stick to cotton underwear, especially during the warmer months. If this doesn’t get rid of your yeast infections, your doctor can help you investigate other underlying causes.

Readers, don’t hesitate to ask our panel of experts if you have any embarrassing questions of your own. Or you can share with us at healthnews@health24.com. 

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