The Magic of NON-Exercise
We've all heard advice like “take the stairs" or "park in the furthest spot," but can this stuff actually make a difference? What's the point of movement if it's not leaving you out of breath, dripping in sweat, and sore the next day? This week, we talk to Dr. James Levine about the powerful health (and non-health) benefits of non-exercise. Get ready to bust out the bike desk.
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Guests
James A. Levine MD PhD is President of Foundation Ipsen. He is Director of the Rare Disease Institute at Fondation Ipsen.
Terms
Exercise - Purposeful activity for the sake of health. Think Pilates, gym, yoga, a run and so on.
Non-Exercise - Daily activity not necessarily performed for health, the movement that naturally happens from just living your life. Think walking around the grocery store, standing, fidgeting, housework and so on.
Studies
Non-Exercise Activity Thermogenesis: Liberating the Life-Force
The Effects of Overfeeding on Spontaneous Physical Activity in Obesity Prone and Obesity Resistant Humans - Different NEAT responses to overeating
The response to long-term overfeeding in identical twins - Different people gain different amounts of weight even after the same amount of overfeeding
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Juna Hey, guys, it's Juna, and I have a favor to ask you if you're enjoying this show, if we're bringing you any sort of value, it would just be super awesome if you could help us out and go to wherever you get your podcast to give us a five star rating and review. Basically, this tells the algorithm that the show is good and it helps other people find us. Thank you so much in advance. And now to the show. Food We Need to Talk is funded by a grant from the Ardmore Institute of Health, home of Full Plate Living. Eddie and I are going to let you guys in on a little behind the scenes action here. Okay. So the way that we basically pick out shows is we think of a topic or a guest that we're really interested in we think is really cool. And then we reach out.
Eddie Right. It could be by email or it could be like someone that I've met at a conference. I'll give them a call. Or it could be someone Juna contacts through Instagram.
Juna While when I was reading papers on Human Metabolism for some of our other shows, there was one name that kept popping up over and over and over again, and that was Jay Levine. And I decided, we got to get this guy on the pod. He sounds awesome. The only problem was we could not find him anywhere. No email, no way to contact crickets, guys. Crickets. Everywhere we looked, he was a mystery man.
Eddie Is this the guy behind the treadmill desk Boom?
Juna Yes. Dr. James Levine studies something called non exercise activity, thermogenesis or NEAT.
Eddie If you've been listening, you've heard us mention NEAT in the last few episodes.
Juna These are the calories you burn of doing all your movement that isn't exercise.
Eddie So walking around doing the dishes, cooking stuff like that.
Juna Yes, Eddie, this man is single handedly okay. Maybe not single handedly, but he had a big part in popularizing the standing desk and the bike desk.
Eddie You know, I love my bike desk. I use it all the time.
Juna Guys, and all our meetings. Eddie's head is just bopping up and down, up and down because he's on his bike the entire meeting.
Eddie Oh, so you're not after one hospital zoom meeting, one of my neurology colleagues actually reached out to me privately to see if he could be of assistance with my apparent movement disorder. So I explained about the bike test and suggested that I really didn't have a movement disorder. But maybe everyone else on the call could be diagnosed with a lack of movement disorder.
Juna So back to Dr. Levine. We emailed and we searched and we got in touch with publishers and the man was nowhere to be found. Guys, I'd let go of hope, okay? I just said, You know what? We have to let this go. He's moved to France or something. He's disappeared. And then my producer, Morgan, texted me and she said, We found James Levine. He's interested in doing the podcast.
Eddie I guess he's, like, particularly good at keeping in motion, huh? Yes. Yes. So what exactly we're going to talk to Dr. Levine about today?
Juna Well, you know how we're always hearing things like, oh, take the stairs or park far away from the grocery store?
Eddie Yeah, I tried to do that. Sure.
Juna I have to admit, I always thought to myself, could these things actually be making a difference if you're not even burning that many calories by walking an extra 40 feet or something, why even bother? So that is what we're going to be talking about today. Does your non exercise activity thermogenesis actually matter? And if so, why?
Eddie I'm Juna Gjata, and I'm Dr. Eddie Phillips.
Juna And this is Food, We Need to Talk. The only podcast that you should be listening to on your extra 40 feet walk from your far away parking spot to the grocery store. So let's meet the man, the myth, the legend. Dr. James Levine.
James Levine My name is James Levine, M.D., Ph.D. and all that. And I'm president of Foundation Ipsen in Paris, France and Washington, D.C..
Eddie Well, he's English. You didn't mention that.
Juna Yeah, guys, Dr. Levine is indeed English, so he's quite a joy to listen to. The first thing he's going to tell us is what is the difference between activities that count as exercise and activities that count as NEAT?
James Levine When you look at exercise, which is purposeful activity for the sake of health and the way I think about that with a patient is somebody comes to me wearing Lycra spandex, Nike running shoes and a heart rate monitor. I'm thinking, this person's just come from the exercise I'm going to apply to his class. That's exercise. I'm going shopping with my daughter and we're going to go to the mall rather than do Amazon. That's NEAT. That's daily activity just for the sake of having fun.
Eddie You know, in the recording, it sounds like he's on a walk outside. This guy is just unstoppable.
Juna He's just taking his interview walking outside. No, guys, I can confirm he was at a standing desk during the interview. If there is one thing that this man wants to make clear about exercise and NEAT, it's that one is not more important than the other.
James Levine What is extremely important to emphasize, and again is often mismanaged in the media, is that both are good. Well, let's put it differently. Both are great. If you love to exercise, keep on doing it. If you love to go for walks with a friend, if you love to take a walk in your lunch time, if you like to do walk and talk meetings, keep on doing them. They're both great.
Juna But why? Why is NEAT so great? If you never get more than a light intensity going and you're likely burning way less calories than formal exercise?
Eddie So one answer may be the thing we've been talking about for a long time now, which is it's not just about the calories.
James Levine So, for example, if I have a big meal and as is so often the case, I'm eating my pizza, watching a movie on TV, and then I move from one episode to another episode. And by the time I've eaten my pizza, 4 hours later, I've covered, you know, five episodes of whatever my favorite show may or may not be, Law and Order. And if, on the other hand, I'd eat my pizza in the same way, switched on to Netflix, but after the first one done a 15 minute walk, I could have actually lowered the impact of that pizza on my blood glucose. Now, that's not burning many calories at all. A 15 minute walk 20 minutes after eating pizza. What's the big deal? But that little walk massively affected my what's called postprandial glucose, the sugar elevation that occurs after eating a meal that is very important in understanding type two diabetes, for example.
Eddie See. Isn't that such an amazing effect of exercise? Just moving a little bit after the meal? That's the postprandial part changes the way it affects your body.
Juna That is an amazing effect of exercise. But can we go back to the fact that Dr. Levine loves law and order? Like, you know.
Eddie He may or may not?
Juna The mystery continues. One of my favorite habits that I've picked up over the past few years is taking a big, long walk after my big meal. So lunch and dinner specifically, and I have no idea what it's doing to my blood glucose, but I just feel like it makes the food sit so much better in my stomach, you know? So back to the benefits of NEAT, Eddie. You and I are quite the exercise fiends.
Eddie Oh, yeah, I love it. My wife and I are currently gearing up for bicycle season.
Juna Haha, guys. Did you get it? He said he's gearing up for bicycle season. Now, if you have a patient coming into the office and they're going to start exercising, how often are they actually going to exercise?
Eddie Well, going at all is a victory, but I would say like 2 to 3 times a week. That would be stellar.
Juna Exactly. Most people don't exercise, but even those that do go 2 to 3 times a week. What does that actually mean, though?
James Levine Well, first of all, you've got to get to the gym and many people would use a taxi or they'll drive there. That takes 20 minutes. Then you've got to change. That takes 10 minutes. And then there may be a class 30 minutes. And of course, there's a chat and a warmup. Okay. After the 30 minutes, what do you then do? Hopefully shower. And then the big problem actually when you when you actually ask people about gym membership and you'll be listening to the podcast, but you will not see my own hairstyle. And I'm bald, by the way. But a big problem after the gym is redoing your hair. That takes a lot of time and then of course you have to transport back. So yes, I've gone to the gym for one hour, 45 minutes, but actually I've only done a 30 minute class. The amount of time doing that exercise isn't actually very much. Ergo, therefore it can't be that many calories. However exertional I am.
Eddie Wow. An advantage to having so little hair. Okay, so we all know exercise is important and great for your health, but yeah, it definitely takes some pre-planning and some extra time and effort out of your day.
Juna It's true, guys. The gym takes about 3 hours out of my day, but my actual workout is only like an hour to an hour and a half. NEAT, though, is different.
James Levine Many of your people, particularly in the COVID era, will recognize that. Now, we have so many meetings all day long and we're sitting all day long. Now, if I convert and this isn't a ridiculous thing, two of my one hour meetings to walk and talk meetings, and that could be strolling around my room, walking down a corridor with a colleague or even I did this during COVID socially distancing in the park. That's two one hour slots. Right. And for somebody of my size, that would be about 250, 300 calories. But think about it now, that's 300 calories five times a week without breaking a sweat, without leaving work, what? Five times 300 is 1500 calories boom right there for doing. Absolutely no. And I haven't even got to the weekend yet. And so you can see the power because you can do it for longer. You can do it in a more sustained fashion. And hopefully it's great fun.
Eddie Yes. The rise of the bike desk.
Juna Eddie, you smart, smart man. Here I am sitting in our Zoom meetings like a log. Okay, just working my little fingers away typing while Eddie is just on his bike. Does getting in all his neat guys? Why didn't you tell me you got a bike desk?
Eddie Oh, I thought I did. You and I'm sorry. How about a birthday present for you?
Juna Okay, but if I'm not getting a bike desk on August 18th, I will be very, very upset with you. Okay. Just like most things that turn out to be good for our body, there's probably a pretty good evolutionary explanation as to why.
James Levine The human species did evolve on foot. It moved on foot across Africa and then populated the entire world on foot. The human being did learn to build shelters and protect his and her young, manually and physically. The early human being did acquire all of her and his food manually, either in agriculture, chasing animals and so on and so forth. And so the human being, if you like, in an evolutionary context, was designed as a moving entity.
Eddie Unfortunately, if we think about urbanization happened actually pretty fast, maybe the last few hundred years. Right. And here's a little biology lesson for everyone. That's not nearly enough time for our DNA to adapt. So it's actually quite unnatural for us to be sitting all day long and not moving. It makes sense that our bodies don't respond well.
Juna So I asked Dr. Levine, I said, Esteemed Jay Levine. What are your go to strategies for incorporating movement? And do you know what he said? What? Think.
Eddie Think.
James Levine I would say I think. I would say the data are in there, about 50 to 90000 scientific publications. The gist of a caucus of publications that large is that excess sitting is bad for you. Getting up and moving is good for you. And in addition, other healthy behaviors such as good sleep are in addition good for you as well. So therefore, the first solution to finding ways to put movement into my life is to think, how can I take my life, not Dr. Levine's life, but my life, and inject movement into it. If I have a job that does involve ten Zoom meetings a day, will my boss allow me to purchase the secondhand treadmill for the sake of argument for 300 bucks and do two of my meetings a day strolling at one mile an hour because that makes no difference to your meeting.
Eddie So I want to just like point out here that you could get a treadmill often for free because so many purchases are just regretted. So put up an ad on what are we going to do, Facebook marketplace or something. Just ask for equipment. And the people will say, like, as soon as I move my laundry, you can have the frickin treadmill.
Juna Guys, I just want to I just want to shout out my mom. There is an erg in her bedroom that has not been touched. It's gathering dust.
Eddie Make an offer. Make it, offer it.
James Levine But the absolute trick is what works for me? What is fun? What is sustainable? Now, can I keep a chart of that? And can I, you know, make a record of how successful I've been? Yes, you can do all of that. But step one is to think how to inject movement into my life, not in a way that makes my life worse because then you won't keep doing it. But to find a way that makes my life better.
Eddie Juna, I get it. NEAT is important because it's more easily integrated into our lives, like me using my bike desk and I don't have to redo my hair. But do we know how much difference need is actually making on people's metabolisms?
Juna That's a great question. And it turns out. Yes, yes, we do.
James Levine The data actually originally gathered from Cambridge using again sophisticated technology called doubly labeled water showed that two people of similar size living in a high income economy, high income country can have two fold, 100% variation in the total calories they burn. So you could have one person of my size. I weigh about 70 kilos, 150 lbs or thereabouts on a good day, and one person of that size could burn 2500 calories. Another person of exactly the same size could burn 3500 calories.
Eddie Wow. Imagine having that extra thousand calories a day. That's amazing.
Juna And this has nothing to do with formal exercise because, again, the majority of people are not doing exercise. This has simply to do with the way people's lives are set up.
James Levine Some people and don't we know these people spend all their day in a chair, often not by choice. It's their job. They have no choice but to do their job. And and 100% respect is difficult to keep a job at the moment is really tough. But a lot of our jobs compel us to be seated all day long. And then in the evening we're so exhausted from work. Often will come home and we'll plop down and read a book, watch TV, Internet shopping and so on. So you can imagine a person literally sleeping, what, 7 hours and then sitting basically the remaining hours of the whole 24 hour cycle? That's entirely possible. But you can also imagine somebody like we spoke before who converts two of their meetings to walk and talk meetings. You can imagine that same person saying, you know what, it's not green to drive to work every day. I'm going to make the sacrifice. It will take longer, but I'm going to walk halfway to work and catch the bus the other half of the walk. I'm going to commit nothing wrong with online shopping, but I'm also going to commit to mall shopping or walking through the grocery store. And all of a sudden, as you and I are talking without burning a single drop of sweat, we've actually burnt 500 to 700 more calories a day. And so you therefore can get the sense by two people living in a high income economy. One can live their entire day while seated. Another can be quite committed to moving more throughout their day and burning 700 calories to 1000 calories more. It's possible.
Eddie So you and I both have jobs that really just require us to be sitting, which is why we are both really intentional about how we incorporate movement into our days. Even outside of the gym. Something listeners may or may not know is that while we're recording this podcast, we choose to do it while standing.
Juna Yeah, guys, I was tempted today. I was a little tired. I was tempted. I said, I'm going to do this one sitting. And then I said, no, it would be antithetical to the subject of this episode. We have to do it standing. And if you've ever lived in any of my neighborhoods, I am a crazy person that like paces around at like 10 p.m. or 10:30 p.m. just to finish my 10,000 steps. Whereas someone like my dad, he is on his feet all day long doing physical activity as part of his work. So he really doesn't have to make this intentional, you know, effort to try to incorporate a walk into his day because that's literally just his day. Something we haven't talked about yet is the way that NEAT to potentially interact with food and specifically overfeeding. Dr. Levine ran some studies on this at the Mayo Clinic.
James Levine And what we did is we took a group of healthy folk in Minnesota, and we worked out how many calories each person required to keep their body weight stable. Now, the way we did that was we brought them on to a metabolic kitchen. And every single food item that went into their mouths, we measured and chemically analyzed using chemical analysis. And not only did we do that, I'll tell you, we also collected all their we and all their poo and measured that again.
Eddie The glamorous world of research.
Juna Doesn't it make you just want to get into science, guys?
James Levine We then took this group of volunteers because they were total volunteers and we then gave them the calories they needed and we added a thousand.
Eddie Well, a thousand extra calories a day where people getting sick from all the extra food?
Juna Eddie No, it turns out it's really, really easy to overeat a thousand calories.
James Levine An extra thousand calories is extremely well-tolerated. We found by normal people. It's just an extra Big Mac and a shake. And I don't mean that rudely. It just gives the audience an idea of what that means. So you can imagine nibbling a Big Mac on the way to work. You can imagine drinking a milkshake on the way home from work.
Eddie You don't have to imagine.
Juna Guys this is bringing me back to some horrible flash backs of like every single day freshman year of college getting a grind soy caramel macchiato, like just on the way to class every day.
Eddie And it's bringing me back to those years when I was chugging those sugar sweetened Snapple iced teas with lunch. It's really easy to do. So these people were overfed a thousand calories a day, which apparently it's not that hard to do. How long did they do it for?
Juna They did it for eight weeks, which I will save you some live math on air. That's 56,000 calories.
Eddie Wait a minute. But I did this math. That's about 15 lbs of extra fat. That's a lot. So what happened that everyone just gained £15?
Juna Oh, Eddie. Oh, Eddie. Of course, that's not what happened, because that would actually make sense.
James Levine What we found was that some people seemed to take every extra calorie and put it into their body fat stores. So they gained a lot of extra body fat. Fascinatingly, some people didn't seem to gain any weight at all. They literally got all these extra calories and we knew they got them because we literally fed them. We saw them going in and we were able to measure metabolically that they weren't disposed of in any other way. And we collected all the poo and we asked the question, how can somebody consume 56,000 calories and not gain any weight? This is absurd.
Eddie How can this be?
Juna We're going to find out right after this break.
Eddie Food We Need to talk is funded by a grant from the Ardmore Institute of Health, the home of Full Plate Living. Full plate living helps you add more whole plant based foods to meals you're already eating. These are foods you're already familiar with apples, beans, strawberries and avocados. It's a small step approach that can lead to big health outcomes. Full plate living includes weekly recipes and programs for weight loss, meal makeovers and better blood sugar management. Best of all, full plate living is a free service of the Ardmore Institute of Health. Sign up for free at fullplateliving.org. Okay. We're back where we left off. We had people being overfed a thousand calories a day for a whole eight weeks. And some of them, well, they gained tons of weight and some of them gained none. What is going on? You know, this reminds me of the obesity prone and the obesity resistant rats in Dr. McLain's lab from the last episode.
Juna Eddie, you did not want to let a single episode go by without talking about the rats, you know, bringing the rats.
James Levine What we found was that people were spontaneously in a slightly I wouldn't say weird fashion, but I'll tell you what I mean in a second, but subconsciously would be better getting up and moving around more and more and more that we overfed them. Other people were carrying on their normal behaviors and so absorbed all the extra calories.
Juna Because they were turning on their NEAT. Some people overeat and just all of a sudden became way more active and other people over ate and just continued whatever they were already doing.
Eddie Wow. This is incredible. That movement can make such a difference. But the really incredible part to me is that it's subconscious. People were moving that much more without even trying to burn off all those extra calories.
James Levine As an example, we interviewed somebody who burnt off an extra 750 calories a day without even noticing it. And we went up to him and we said, How did you do it? He said, I didn't do anything. I said, You must do something. You can't just vanish. He said, Well, it's funny you should ask. I'm a scoutmaster. He was in charge of scouts during the experiment. There was the Ethiopian crop crisis and I took my scouts and ironically yours here had them going around the local village, local town, Rochester, selling chocolate. And he said, Well, I had to go wherever there was a scout, I had to monitor these people. I said, I'm curious how many hours a day was that? He said, Oh, it's about three or 4 hours every night. And you see he's walking around Rochester through and rushing and probably shouting at the scouts and everything, you know, three or 4 hours, all subconsciously. But guess what? He burnt off an extra 700 calories a day. And you see what I mean by subconsciously? Weirdly, what's odd is those people have the capacity to eliminate hundreds of extra calories a day through non exercise activity. Don't go to the gym, but oddly enough, suddenly take up hobbies that are exothermic, that are calorie burning. Another person suddenly realized how much they like going to art galleries and became like an art gallery addict four hours wandering around an art gallery. 600 calories, you see. And all of a sudden it makes sense, right?
Eddie This is absolutely insane. Can you imagine overeating a thousand calories but picking up a hobby to go to the art galleries and unknowingly burning it off? The subconscious part is what's so crazy because people try so consciously to exercise. But if it's something that you like to do and you're interested in, it almost takes away all the work. But do we know why certain people were subconsciously increasing their NEAT and others didn't?
Juna Well, as with everything very complicated and cool, it turns out it has to do with the brain.
James Levine What appears to be the case is that at the center of the brain are a series of chemicals that are sort of pulsating against the hypothalamus, certain parts of the hypothalamus that are driving this type of activity. It is a bit weird that somehow subconsciously people are moving more, but what is absolutely intriguing is that it isn't random. There appears to be a really subtle neurochemical mechanism that's driving this.
Juna Specifically, we think that there are neurochemicals like orexin. Okay, that's some trivia for you in case that comes up next time that are actually influencing our non exercise movements.
Eddie Okay. But what controls the chemicals is that genetic or maybe environmental?
James Levine It stands to reason that possibly I get some genetic influence for my tendency to move from mom and dad. But that information isn't 100% locked in. There are a catalog of genes that can influence it, but there aren't necessarily genes I can point to and say, Oh, I've got that one switched on another person hasn't. That information, to my knowledge, doesn't exist.
Juna Of course, though, it's not that simple because beyond the genetics we have the epi genetics. Eddie, do you want to tell us what epigenetics are?
Eddie Oh, so epigenetics is how your environment affects the expression of your genes. Being in a certain environment may activate certain genes or shut off other ones. This is really neat. Even in the fetal environment, what the mom is doing when she's pregnant can change the baby's gene expression.
James Levine The data are basically starting to suggest that the active mom has the capacity to influence the fetus through her behavior. So as we think about the biological influences, there are definitely molecular mechanisms impacting who we are and how we behave.
Eddie You know, I think we need to take a second here just to focus on the environment. It can be so easily overlooked but your environment, which a lot of us have actually no choice in, especially when you're growing up, is actually super important when it comes to your health.
James Levine The data we have on movement, for example, looking at 110 million Americans, suggest that your zip code, your zip code is a major determinant of whether you are active or inactive. Your zip code is a major determinant of whether a person is likely or less likely to have obesity.
Eddie So in the medical literature now, there's an expression where they say that your zip code is probably more important than your genetic code on your health. When we talk about making conscious lifestyle changes, a lot of the time we're assuming that we have the ability to make those changes, which for a lot of people in this country and in this world, it's just not the case.
Juna So Dr. Levine used to actually work in inner city Cleveland, and that experience completely changed his view on health.
James Levine Imagine living in an environment that it is too dangerous to let your kid go out in the evening. Imagine an environment where you're at home and every 10 to 15 minutes there is a bang. And it's not a car backfiring. It is a gun being shot in your neighborhood. Imagine living in an area where there's no access to good quality health. Imagine living in an area where kids aren't going to school because they're either bullied or frightened. Imagine living in that area. And now you talk about healthy activities and now you immediately can appreciate that's not a struggle. That's an impossibility.
Eddie Such a good reminder that for those of us that live in an environment where we can easily increase our need, it's not something that we have to do. It's something we get to do.
Juna Guys, I cannot tell you how many times I've been doing my walks at night and I'm just like complaining, like, oh, I'm so annoyed that I have to walk these 10,000 steps.
Eddie You can do it, right?
Juna Exactly. But I can do it. And I don't ever worry about going out in my neighborhood at night, which is just a luxury I never even think about.
James Levine I think the biggest failure in the media is to understand how incredibly hard it is in modern society, with people fighting for their jobs, people fighting poverty, people fighting violence and difficulties, people fighting depression, people winning every single day in their own way. How difficult it is to be healthy in a modern society. And for everyone listening, if you could do me one favor, it would be to take a five minute walk at the end of this podcast.
Juna Okay, guys, you have your assignment. It's to be appreciative of what we do have and take a five minute walk after the podcast. And by the way, just in case it wasn't extremely clear, this does not mean stop going to the gym.
James Levine Do not stop going. It's fantastic for your health. It's fantastic for socializing. Not in my case, but others. It's fantastic for your hair, etc.. Right. It's very, very important.
Eddie Who I love his enthusiasm. I have an idea. You could combine the two and walk to the gym.
Juna Whoa, guys, the life hacks coming out of this man is amazing. That is going to be the end of today's episode. You can find us on Instagram @FoodWeNeedToTalk. You can find us on our Web site: foodweneedtotalk.com, that's where you can find all the show notes for today's episode. I am @theOfficialJuna on Instagram and Juna Gjata on YouTube and Tik Tok and you can find Eddie celebrating his new promotion to associate professor at Harvard Medical School. Everybody's clapping for you. You can hear them, but they're all clapping. If you find James Levine, please do not hesitate to let us know because we would love to know where he is as well. I'm just kidding, guys. You can find links to his books on our website as well. Food, We Need to Talk is a production of PRX.
Eddie Our producer is Morgan Flannery.
Juna Claire Carl Landau is our associate producer. Tommy Bazilian is our mix engineer.
Eddie Jocelyn Gonzales is executive producer for PRX Productions.
Juna Food, We Need to Talk was co-created by Kerry Goldberg, George Hicks, Eddie Phillips and me.
Eddie Always remember to consult with your health professional for your personal health questions. To find out more, go to foodweneedtotalk.com. Thanks for listening.
