Z.I.A.D. Healthcare for the Underserved Inc. is a 501c3 Non Profit organization that came to be in 2002 when four individuals sat down and looked for ways to help provide access to the uninsured. Specifically they looked at those that fall through cracks, some 46,000,000 people in the United States. These are the people that work part time jobs (making them unqualified for governmental assistance), and receive no coverage from their employers, and cannot afford the premiums of health insurance.
Z.I.A.D. derives its name from the names of its founders Ray Zak, Iqbal Nasser MD, Ibraham Ahmed ND, Theodore Densley MD. Z.I.A.D. primarily works with private doctors to find a primary care home for the uninsured on a sliding scale program where they receive reduced office costs based on federal poverty guidelines.
If you are a primary care office and would like to participate in the program please call 313-815-8767.
Resting metabolic rate reflects the energy your body uses while at rest. Learn what affects RMR, how it differs from BMR, and how to interpret a test or estimate.
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On August 9, 2022 Ray Zak the president of the board of ZIAD received a prestigious award from the Wayne County Health Authority for the work done by him in leadership of ZIAD Healthcare for the Underserved.
The plaque was awarded and titled “The Best Safety Net Award” with the following inscription:
“On The ninth day of August , 2022, in recognition for extraordinary commitment and service to community health care, we recognize Ray Zak.” The plaque was signed by Gail Warden and Chris Allen of the Wayne County Health Authority. Congratulations to Ray Zak on his devoted leadership of Z.I.A.D.
ZIAD Health Care for the Underserved participated in a health and community fair at Resurrection Lutheran Church Kelly Rd., Detroit, MI.. ZIAD provided the community with information on services that are available for the uninsured, and also provided Free Blood Pressure screening.The event was a cooperative program of three Lutheran churches in the Detroit area. Many residents turned out for the free information, screening, community togetherness, and some free hot dogs. Click here to see pictures from the event.
As always for information on health care call ZIAD at 313-815-8767
A Letter from the HeartDear Friends of ZIAD,
I have been blessed my entire life with the luxury of health insurance. My Father provided for me when I was a child, and I have been fortunate enough in my adult life to provide coverage for myself and my family. Recently, however, my son was stricken with a very rare blood disorder, and we were forced to live in a children’s hospital in Los Angeles for many weeks. I was able to see, first hand, how such a tragedy can financially ruin a family.
The bill for merely the first two weeks in the hospital came to just over $99,000 dollars. One bag of transfusable blood alone cost over $700 dollars. Our son faces a minimum of another 12 to 18 months of treatment. Without insurance, we would have been forced to declare bankruptcy, at the very least. There are thousands of families seeking care for loved ones with life-threatening and chronic afflictions every day. Sadly, the truth is there are many, many families that are turned away from facilities in this great country, only because they do not have enough medical insurance. Please help the gracious people of ZIAD provide care for the underinsured. If you have ever had a loved one need medical attention, you know the urgency of their mission.
Thank you, and may God bless your family with perfect health,
Paul Ganus
Nearly 46 million Americans, including more than 8 million children, are living without health insurance – forced to gamble every day that they won’t get sick or injured. That’s a risk no one should have to take. Uninsured Americans live sick and die younger than those with health insurance. Just one serious illness or injury can wipe out an uninsured family’s bank account, and the problem is getting worse.
To provide health care, health education, physical fitness and other programs to uninsured, under insured, poor, working poor families, and individuals. To provide access to health care in underserved areas, and to the frail elderly.
1) Expand the network of Private doctors offices, and services working with Z.I.A.D. Healthcare for the Underserved that provide primary healthcare as well as other services to underserved, poor, and working poor, and on a sliding scale basis to other geographical areas.
2) Expand services and assistance to the frail elderly.
3) To participate and collaborate with other organizations helping the uninsured or underinsured.
3) To participate and collaborate with Specialty, Pharmacy, Hospital, Dental and other programs to help the uninsured.
4) To identify, apply for and obtain grants that provide screening and outreach to identify disease early up.
Affiliates:
Donations: ZIAD Health Care for the Underserved Inc. is open to all donations public and private and has received Tax Exempt Status with the IRS (#75-3080830).
Donations can be made to ZIAD Health Care via PayPal. Below are buttons that you can use to donate now. We appreciate your donations very much.
Resting metabolic rate is the energy your body uses to maintain essential functions while you are resting. It accounts for a substantial part of daily energy use, but it is not your entire metabolism or an exact calorie target. Body size, body composition, organ and tissue demands, physiological state and recent weight change can all affect it. A laboratory test using indirect calorimetry can estimate resting energy expenditure from respiratory gases; online calculators provide less individualized estimates.
The simplest way to understand resting metabolic rate explained in practical terms is to picture the body continuing its essential work even when you are physically inactive. Your brain remains active, your heart pumps, your lungs exchange gases, your kidneys and liver perform ongoing tasks, and your cells maintain and repair tissues. All of that requires energy.
RMR is useful for understanding energy expenditure and planning nutrition, but it should not be treated as a score of health, discipline or effort. Two people of the same weight can have different resting energy needs, and neither a measured nor predicted result can fully explain weight change on its own.
Resting metabolic rate, or RMR, describes the energy a person expends while resting under defined conditions. Researchers and clinicians also use the term resting energy expenditure, abbreviated REE. Although “rate” and “expenditure” are not technically identical concepts, RMR and REE are commonly used to describe the same practical measurement.
The result is usually expressed as an estimated amount of energy used over a day. It represents the combined resting demands of many organs and tissues rather than energy used by one body system. It does not mean the body has literally been monitored for an entire day; a shorter measurement or an equation may be used to produce a daily estimate.
RMR is only one part of total daily energy expenditure. The body also uses energy to digest and process food and to support physical activity, from deliberate exercise to ordinary movement. The National Academies overview of energy requirements explains these components in the broader context of human energy expenditure.
Resting metabolic rate and basal metabolic rate are closely related, but they are not perfectly interchangeable. Basal metabolic rate, or BMR, is measured under stricter basal conditions. These typically require a highly controlled environment and a longer period without food or activity. RMR is measured under less restrictive resting conditions and is therefore more practical in many clinical and research settings.
| Term | What it represents | How to interpret it |
|---|---|---|
| BMR | Energy used under strict basal conditions | A tightly controlled measure of minimum ongoing energy needs |
| RMR or REE | Energy used during quiet rest under standardized conditions | A practical estimate of resting energy expenditure |
| Thermic effect of food | Energy used to digest, absorb and process food | A separate component of daily expenditure |
| Activity expenditure | Energy used for exercise and other movement | Highly variable between people and from day to day |
| Total daily energy expenditure | Resting expenditure plus food processing and activity | A broader estimate of total energy use over a day |
This distinction matters when comparing numbers. A BMR calculator, an RMR equation and a laboratory RMR test may not produce identical results. Before interpreting a value, check what the number claims to represent and how it was obtained.
No single factor controls RMR. Body size and body composition are important, but two people with similar measurements may still differ because their tissues, organs and physiological circumstances are not identical.
A larger body generally requires more energy to maintain than a smaller one, but total weight is an incomplete explanation. Fat-free mass—including muscle, organs, bone and other nonfat tissues—is strongly related to resting expenditure. Fat mass also has metabolic costs, although they differ from those of fat-free tissues.
Fat-free mass should not be treated as one metabolically uniform compartment. The brain, liver, heart, kidneys, skeletal muscle and other tissues have different resting energy demands. The amount and distribution of these tissues help explain why people with similar body weight or even similar amounts of fat-free mass can have different RMRs.
Body-composition figures also need context. Just as waist circumference is a metabolic-health marker rather than a diagnosis, an RMR or body-composition result is one piece of information rather than a complete health assessment.
RMR often differs across age groups, but age alone is not a complete explanation. Changes in body size, tissue composition, health, hormones, activity and other physiological factors may accompany aging. Research examining variation among adults supports interpreting RMR as a multifactorial measure rather than assuming that age determines it by itself.
Growth, pregnancy, illness, recovery and other physiological states may also alter energy demands. Some medications and medical conditions can influence energy expenditure or body weight, but an RMR result by itself cannot identify their cause.
Skeletal muscle uses energy at rest, so muscle contributes to RMR. However, the popular claim that a small amount of added muscle will cause a dramatic increase in daily calorie expenditure oversimplifies the physiology.
Muscle is one part of fat-free mass, and whole-body RMR reflects the combined activity of organs and tissues. Some relatively small organs have high metabolic demands per unit of mass, while skeletal muscle has a lower resting demand per unit of mass but occupies much more of the body.
Resistance training can still be valuable for strength, physical function, bone health and preservation or development of lean tissue. Its benefits do not depend on promising a large permanent rise in RMR. A realistic interpretation is that muscle affects resting expenditure, but the size of the effect depends on how much tissue changes and what else changes with it.
Indirect calorimetry is the main practical method used to measure resting energy expenditure. The person breathes through a hood, mask or mouthpiece while the equipment measures oxygen consumption and carbon dioxide production. Those respiratory gases are used to estimate energy expenditure.
Testing conditions matter because the goal is to capture a stable resting state. Protocols may control recent food intake, exercise, caffeine or other stimulants, the amount of rest before measurement, room conditions and body position. Talking, moving, anxiety or arriving soon after strenuous activity can make the result less representative of quiet rest. Best-practice guidance therefore emphasizes standardized preparation, adequate rest and appropriate measurement procedures.
If you are booking a test, ask for the preparation instructions in advance and follow them closely. Also ask whether the report represents RMR or another form of energy-expenditure measurement. A repeat test is most useful when preparation and measurement conditions are reasonably consistent.
An online calculator can provide a useful starting estimate. Prediction equations commonly use variables such as age, sex, height and weight; some also use body composition. Apps and smart scales may display a similar estimate even when they do not directly measure respiratory gas exchange.
The important word is estimate. Equations are developed from group data, so their average performance does not guarantee precision for a particular individual. A systematic review and meta-analysis involving adults with overweight or obesity found substantial variation in estimates from resting- and total-energy-expenditure equations. No equation should therefore be treated as an exact personal measurement in every population.
Use a calculator as a planning baseline rather than a rigid prescription. If the estimate informs a nutrition plan, observe longer-term patterns in body weight, appetite, performance and wellbeing, then adjust thoughtfully. Day-to-day scale changes are often noisy, so a single morning measurement should not be used to decide that an energy estimate is wrong.
Some reduction in resting expenditure after weight loss is expected because a smaller body generally requires less energy to maintain. Changes in fat mass and fat-free mass can both contribute. This expected size-related change is distinct from adaptive thermogenesis.
Adaptive thermogenesis describes a possible reduction in energy expenditure beyond what would be predicted from changes in body size and composition. It is often presented online as a fixed metabolic penalty, but the evidence is more nuanced. A systematic review found that estimates were affected by study methods; higher-quality studies often reported smaller or nonsignificant effects, and the effect may lessen after weight stabilizes.
This does not mean weight-loss plateaus are imaginary. Energy needs can change as body size changes, while appetite, movement and adherence may also shift. The practical response is to reassess the whole pattern rather than attributing every plateau to permanent “metabolic damage.” There is no single adaptive-thermogenesis figure that can responsibly be applied to everyone.
RMR can answer a narrow question about resting energy use. It cannot independently provide a complete explanation of metabolism, health or body-weight change.
Total daily expenditure can differ from RMR because physical activity and food intake introduce additional variables. Sleep, symptoms, medication use, health conditions and changes in routine may also matter when a clinician evaluates unexplained weight change, even though they are not all captured by an RMR number.
Consider speaking with a qualified healthcare professional if you have substantial or unexplained weight change, persistent fatigue, new heat or cold intolerance, a racing or unusually slow heartbeat, significant changes in appetite, digestive symptoms, menstrual changes or other concerning symptoms. Seek urgent care for severe or rapidly worsening symptoms.
A clinician can consider your history, symptoms, examination, medications and appropriate laboratory testing. An RMR measurement may sometimes add useful information, but it should not replace a medical evaluation or be used to self-diagnose an endocrine condition.
They describe closely related concepts, but BMR requires stricter basal testing conditions. RMR is a more practical resting measurement and may be slightly different from BMR because its conditions are less restrictive.
Their height, fat mass, fat-free mass, organ and tissue composition, age-related physiology and other individual factors may differ. Even fat-free mass is made up of tissues with different energy demands, so total body weight cannot fully predict resting expenditure.
Usually, a displayed RMR or BMR figure is an estimate generated from an equation and user data. Unless a specific device has validated respiratory measurement capabilities, do not assume it directly measures resting energy expenditure. Check the product's documentation to learn how the number is calculated.
Body composition and physiological circumstances can change resting expenditure, but claims of a dramatic permanent “metabolism boost” deserve skepticism. Exercise and balanced nutrition can support health, strength and weight management without needing to produce a large increase in RMR. The available evidence does not establish that a supplement, peptide, special food or single workout method reliably creates a dramatic permanent rise in resting expenditure.
Resting metabolic rate is the energy required to support the body's ongoing work during rest. It is influenced by body size, body composition and the differing demands of organs and tissues, along with broader physiological circumstances. It is important, but it is not the whole of metabolism.
If you use an RMR number, first identify whether it came from indirect calorimetry or a prediction equation. Treat a calculator as a starting estimate, follow standardized preparation for a laboratory test, and interpret either result alongside activity, nutrition, weight trends and health context. For unexplained changes or concerning symptoms, the next step is a clinical evaluation—not an attempt to diagnose the problem from RMR alone.