So, what about exercise, the activity that Lustig calls the second half of the antidote
to fructose toxicity? According to him, a fat but physically fit person is healthier
than a normal-weight person with insulin resistance and the metabolic syndrome.
Exercise has a variety of beneficial health effects: 1) it activates the sympathetic
nervous system, increases muscle mass and insulin sensitivity so you burn more
calories at rest and 24/7; 2) it improves liver metabolism, so it decreases the amount
and negative effects of visceral fat—it improves insulin sensitivity, lowers insulin
levels, and improves leptin signaling; 3) it improves many of the metabolic biomarkers
associated with the metabolic syndrome and other chronic diseases and
improves health; and 4) it heightens endorphins and reduces stress, so you feel better and have less cortisol
that makes you hungry and drives obesity.

At a high level of physical activity, we expend more calories than our appetite tells
us to eat, and we lose weight. At a lower level of physical activity, one that is typical
for Americans, we lose the ability to sufficiently down-regulate our appetites, and
we gain weight. One estimate is that when we walk about 7100 steps a day (about
3.5 miles), our calorie expenditure and appetite are in balance. With less exercise,
our appetites do not down-regulate enough, so we are likely to gain weight.

Non-exercise activity thermogenesis (NEAT) is an important component of daily
energy expenditure. It represents the energy expenditure of common daily activities,
such as fidgeting, walking, and standing. The benefits of NEAT include not
only the extra calories expended, but also the reduced occurrence of the metabolic
syndrome, cardiovascular events, and all-cause mortality. All physical activity contributes
to health, even if it is gentle or of short duration.

However, exercise is an inefficient way to lose weight because most energy is consumed by
resting (basal) metabolism, and it is a rare person who boosts their calorie expenditure
with physical activity by more than an extra 500 calories per day. I alternate a daily 16-mile ride on a bike that barely uses an extra 400 calories with a four-mile walk that burns only 200 extra calories. Although cutting intake of
calories is more efficient, by expending additional calories through increased exercise,
you can reduce the calorie restriction needed to lose weight. For example,
to reduce caloric intake by 500 calories a day, enough to lose a pound a week, an
addition of enough moderate to vigorous exercise each day to burn an extra 250
calories would reduce the needed restriction of food to only 250 calories a day.

This blog presents opinions and ideas and is intended to provide helpful general information. I am not engaged in rendering advice or services to the individual reader. The ideas, procedures and suggestions in that are presented are not in any way a substitute for the advice and care of the reader’s own physician or other medical professional based on the reader’s own individual conditions, symptoms or concerns. If the reader needs personal medical, health, dietary, exercise or other assistance or advice the reader should consult a physician and/or other qualified health professionals. The author specifically disclaims all responsibility for any injury, damage or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this blog or participating in any programs described in this blog or in the book, The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist (available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere). Copyright 2021 by J. Joseph Speidel.