Have you ever wondered if there’s a natural way to lower your high blood pressure, guard against Alzheimer's, lose weight, and feel better? Well as it turns out there is. Michael Greger, M.D. FACLM, founder of NutritionFacts.org, and author of the instant New York Times bestseller “How Not to Die” celebrates evidence-based nutrition to add years to our life and life to our years.

Exercise and Weight Loss

How much exercise do we need to lose weight? What kind of exercise is best? This episode features audio from:

  • https://nutritionfacts.org/video/is-swimming-good-for-weight-loss/
  • https://nutritionfacts.org/video/how-much-exercise-to-sustain-weight-loss/
  • https://nutritionfacts.org/video/diet-or-exercise-whats-more-important-for-weight-loss/

Visit the video pages for all sources and doctor’s notes related to this podcast.


Today, we look at the relationship between exercise and weight loss. And, we start with the question: Can exercising in cool water lead to an increase in post-workout calorie intake?


Swimming and aquatic exercise in general are popular alternatives to land-based activities such as walking or biking. The buoyancy helps take some of the weight-bearing stress off of joints, but swimming appears to be less effective for weight loss. Obese women were randomized into an hour a day of walking, cycling, or swimming. Six months later, the walkers lost an average of 17 pounds, the cyclists lost an average of 19 pounds, and the swimmers didn’t lose an ounce (in fact, they actually gained 5 pounds). Gauging skin folds to estimate body fat, the measurements slimmed more than 40 percent in the walking and cycling groups, but there was no change at all in the swimming group. What’s going on? And check this out. The more the women walked, the more they lost weight. The more the women biked, the more they lost weight. But the more laps they did didn’t seem to matter. Even an hour a day. No weight loss. What is going on?

Well, it turns out that some exercise boosts appetite more than others. While land-based exercise does not stimulate a compensatory increase in appetite and calorie intake, the same cannot be said of water-based exercise. In contrast to walking, in contrast to running, and in contrast to cycling, swimming can significantly heighten hunger within hours. This may explain why swimmers tend to have more body fat than runners of equal caliber, even though they may be actually expending more calories during training. If anything, you’d think swimming might lead to even greater weight loss since you’re losing heat to the water. But swimming didn’t seem to work at all. The cold, it turns out, may actually be the culprit.

If you exercise in warm water (about 90º F), it does not boost your appetite more than exercising on land. After the same workout in cool water (about 70ª F), people can end up eating more than twice as much at a meal an hour later. Maybe they’re just burning off extra calories to stay warm? No, even at the same number of calories expended, people eat hundreds of calories more after exercising in cold water. Offered a buffet after burning off about 500 calories in cool water, people eat nearly 900 calories, hundreds more than after exercising in warm water or just staying dry. So, they ended up taking in about twice as many calories as they exercised off. No wonder swimming doesn’t appear useful for weight loss.

Would the same thing happen under different temperatures on land? A team of British researchers sought to find out, randomizing people to briskly walk for 45 minutes on a treadmill in the cold (about 46º F) or at closer to room temperature (about 68º F). Participants were then presented with a buffet meal in which their eating was covertly recorded. And calorie intake was significantly greater after exercising in the cold. Though walking is often prescribed for overweight individuals, the researchers conclude, “if walking was to take place in a cold environment, such as in winter, then this may stimulate food intake.” In the warmer months, though, obesity researchers suggest exercising outdoors may be preferable to an air-conditioned gym. 

All studies to date on the effects of hot and cold environments have found that exercising in cool water or under cool conditions on land led to an increase in post-workout calorie intake. What about a quick dip in the pool after you exercise? Australian researchers found that immersion in water for 15 minutes—cool or warm—after a running session resulted in increased calorie intake. What is it about getting wet that whets your appetite? Maybe they got a chill after getting out before they could change into dry clothes? This suggests that though a cool shower after a workout may be invigorating, it might be better to stick to hot.


Next up, we look at what role inactivity has played in the obesity epidemic.


Right now, “[a]lmost two thirds of Americans are overweight.” And by 2030, more than half our population may be clinically obese. “[C]hildhood obesity has tripled,” and most of them will grow up to be overweight as well. “The United States may be in the midst of raising the first generation since [our] nation’s founding that will have a shorter predicted life span than that of the previous generation.”

The food industry blames inactivity; we just need to move more. But, what is “the role of exercise in the treatment of obesity”?

“There is considerable debate in the medical literature today about whether physical activity has any role whatsoever in the epidemic of obesity that has swept the globe since the [19]80s.” The increase in calories per person is “more than sufficient to explain the US epidemic of obesity.” In fact, if anything, the level of physical activity over the last few decades has actually gone up in both Europe and North America.

“This…has important policy implications.” Yes, we still need to exercise more, but “the priorities for reversing the obesity epidemic should focus on…the…overconsumption” of calories. To work off the increased calorie intake—which, for kids, is like an extra can of soda and small fries, compared to what they were eating back in the 70s, and, for adults, about an extra Big Mac a day. To work that off, we’d have to walk, like, two hours a day, seven days a week. So, exercise can prevent weight gain, but “the amount required to prevent weight gain may be closer to twice” the current recommendations.

Public health advocates have been experimenting with including this kind of information. The fast food menu labeled with calories, and the number of miles to walk to burn those calories, appeared to be “most effective in influencing the selection of lower-calorie meals.”

Now, exercise alone may have a small effect, and that small effect can make a big difference on a population scale. A one percent decrease in BMI nationwide might prevent millions of cases of diabetes and heart disease, thousands of cases of cancer.

But, why don’t we lose more weight from exercise? It may be because we’re just not doing it enough. “[T]he small magnitude of weight loss observed from the majority of…exercise interventions” (you know, where they make people exercise) “may be primarily due to [how] low [the] doses [are] of prescribed exercise…”

People tend to overestimate how many calories are burned by physical activity. For example, there’s this myth that “[a] bout of sexual activity burns a few hundred calories.” So, hey, you could get a side of fries with that. But, if you actually hook people up, and measure energy expenditure during the act (and your study subjects don’t get too tangled up with all the wires and hoses), though it may be nearly the metabolic equivalent of calisthenics, “[g]iven that the average bout of sexual activity only lasts about six minutes, a [young] man…might expend approximately 21 [calories] during sexual intercourse.” Of course, he would have spent roughly one-third of that just lying around watching TV, just basal metabolism. So, “the incremental benefit is plausibly on the order of 14 [calories].” So, maybe we could have, like, one fry with that.

Finally today, what’s more important – diet or exercise, when it comes to weight loss? You may be surprised at the answer.

When trying to lose weight, which is most important: diet or exercise? This is what a survey found recently: “The vast majority of those trying to lose or maintain weight believe that both monitoring food and beverage consumption and physical activity are equally important in weight maintenance and weight loss.” Most people go with equally important, and then exercise, and then diet. And, most people are wrong.

Identified as one of the most common misconceptions about obesity in this recent review, the “Confusion about the leverage of exercise on body weight.” “Unfortunately, the energy balance equation [you know, calories in have to equal calories out] suggests that energy intake and energy expenditure occupy equivalent roles in determining energy balance, when in fact the factors governing energy intakes influence the energy balance far more powerfully than the factors determining resting energy expenditure.” 

What we put in our mouths is most important. For example, to walk off the calories found in single pat of butter, you’d have to add an extra 700 yards to your stroll that evening. A quarter-mile jog for each sardine we put in our mouth—and that’s just the edible part. And those who choose to eat two chicken legs better get out on their own two legs, and run an extra three miles that day to outrun weight gain. And that’s for steamed chicken, skin removed.

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