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Diet vs. Exercise: What’s More Important?

January 17, 2013 by Michael Greger M.D. in News with 12 Comments

When trying to lose weight, which is most important: diet or exercise? The vast majority of those surveyed believe that both monitoring food and beverage consumption and physical activity are equally important in weight maintenance and weight loss. After equally important, people go with exercise, and then diet. As you can see in my 2-min. video Diet vs. Exercise for Weight Loss, most people get it wrong.

Note the caloric expenditure equivalencies I present in the video are assuming no dietary compensation–something seen quite dramatically, for example, with nut consumption. Given how hard it is to work off food, let’s make our calories count by choosing the most nutrient dense foods, as detailed in my 4-min. video Calculate Your Healthy Eating Score.

Another misconception is that weight alone is a good predictor of disease risk. Body mass index is better since it takes height into account, but it doesn’t describe what or where that mass is. Body-builders can have huge BMIs (especially since muscle is heavier than fat), but that doesn’t mean they’re obese.

As I document in my 2-min. video Keep Your Waist Circumference to Less Than Half Your Height, it is now accepted that health risks can be determined as much by the relative distribution of the excess fat as by its total amount. It’s not so much body fat, but visceral fat–abdominal fat, the fat around our internal organs–that most increases our risk of dying prematurely. Waist circumference takes care of both the “what” and “where” of the weight, so the best metric may be waist-to-height ratio. Move over BMI; we now have WHR.

The target is to keep our waist circumference to less than half our height. Take a cloth measuring tape and measure halfway between the top of your hipbones and the bottom of your ribcage. Stand up straight, breathe deep, exhale, let it all hang out and that measurement should be half our height. If it’s not, we should consider cutting down on our consumption of meat, as I cover in my video Meat and Weight Gain in the PANACEA Study. It may also help to cut back on refined plant foods, such as white flour products. Three servings a day of whole grains, however, was recently associated with a slimmer waist in the Framingham Heart Study.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my full 2012 presentation Uprooting the Leading Causes of Death.

Image credit: Helga Weber / Flickr

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Dr. Michael Greger

About Michael Greger M.D.

Michael Greger, M.D., is a physician, author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial. Currently Dr. Greger proudly serves as the Director of Public Health and Animal Agriculture at the Humane Society of the United States.

View all videos by Michael Greger M.D.

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  • Nooch

    Check out “saggital abdominal diameter” as a measure of diabetes risk.

  • AmazinglyWell

    I know you don’t mean it this way, but the phrase “muscle is heavier than fat” causes confusion. Muscle is NOT heavier than fat, it is more dense than fat. A pound of muscle and a pound of fat weigh the same…. 1 pound! But the muscle takes up less space. Love your blog though! As a health coach I visit your site multiple times a day and refer everyone I know to this resource!!!

    • Kartoffelmao

      Well, its an expression. When people say it, they mean that muscle weigh more than fat per volumetric unit.

    • Christallin

      Thanks for making that correction. I don’t know why people still promote this fallacy and I was disappointed to see a doctor stating this hooey.

  • rjs

    Based on my own experience, and I realize it’s only anecdotal, cutting my whole grain consumption to one serving per day caused me to lose 7-8 pounds. I replaced the whole grains, however, with more vegetables, legumes and fruits, not with refined grains, meats or oils.

    • stacy

      Sounds similar to the fuhrman diet!

    • Kartoffelmao

      Off course you did. You exchanged calorie dense grains for lower dense calorie foods like vegetables, legumes and fruits, hence you ate less calories and got in a negative calorie balance that made you lose weight.

  • http://www.facebook.com/kathi.richards.5 Kathi Richards

    My waist is a bit wider than my height and I have been vegan for 13 years. Where do I go wrong? Not enough exercise and eating while I am driving, and I drive a lot. I have started to change my snacking habits to carrots and raisins. We shall see what this year brings.

    • http://www.DonForresterMD.com/ Don Forrester MD

      The exercise is an important component but the nutritional is much more important. The important concepts are explained well by Dr. Doug Lisle in his video, How to Lose Weight Without Losing your Mind, view for free at http://www.youtube.com/watch?v=xAdqLB6bTuQ. For a more in-depth explanation you should order and view Jeff Novick’s DVD, Calorie Density Eat More Weigh Less and Live Longer. Order off his or Dr. McDougall’s website. So you want to eat foods that are lower in calorie density. To check out calorie density you can log onto the website, CRON-O-METER, find a food and enter 454 grams(the number of grams in a pound) and check out the calories. You will see that the carrots are 186 kcal/pound and raisins are 1357 kcal/pound. Take home message more vegetables… generally around 100 cal/pound and be very cautious with dried fruit. However avoiding things with labels is a good idea since processed foods often contain alot of sugars and fats. For help reading labels you might enjoy Jeff Novicks DVD, Should I Eat This. You will be more successful if you understand the important concepts and their application. Good luck.

  • http://www.facebook.com/lauren.r.ard Lauren Rae Layton Ard

    Now that we’ve figured this out, I’d like to know just *how much* more risk a person like me has, who is two inches off of her ideal waist measurement, but eating healthy and exercising often. I mean, surely there are some biological outliers where someone’s waist is normal and healthy without it being less than half their height?

  • Judy

    I’m new to your blog. So far, I like the information, but I do not like being referred to videos. I’d much more like to see the information in print.

  • Joe Pyle

    Dr., I recently started to become vegan and am wondering what to eat for breakfast. I was eating a bowl of oatmeal with rolled oats, and bran, but then heard about the benefits of not eating grains. Can you please point me in the right direction for a tasty breakfast that’s filling? BTW, I am now training for a marathon. thank you so much, you’re my “go to site” for health!

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