Diet vs. Exercise: What’s More Important?

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’ll see when clicking on the above video, 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 covered in my video-of-the-day last Tuesday (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.

In health,
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

Burning Fat With Flavonoids
Nuts Don’t Cause Expected Weight Gain
Stomach Staples or Healthy Kitchen Staples?


Aldana W
Aldana W8 months ago


W. C
W. Cabout a year ago


William C
William Cabout a year ago

Thank you.

Summerannie Moon
Summerannie M4 years ago


Mrs M.
Linda M5 years ago

I really don't know the answer, but I'm certainly having an okay time with caloric input and outgo. Too many calories = trouble.

Carol P.
Carol P5 years ago

I'm not buying into this simplistic waist-measurement idea. I have a naturally skinny waist and could probably gain 30-50 pounds of before I broke this "rule". Meanwhile, my sister who is the same height but weighs less and exercises more, would have difficulty staying under this measurement guideline.

Add on that basing your health on BMI completely overlooks a major health problem related to muscle mass. Your heart doesn't care one iota if your overall size is increased due to fat or muscle. It has to work harder to pump blood in either case.

Remember that recent study that determined that marathon runners are actually damaging their hearts, or the rash of deaths among marathon runners (during their races) this summer and you have to take exercise in a different light as well.

Gergen is dangerous because he oversimplifies in absolutely everything that he writes, and does so in a way to try to prove his personal opinions, that people shouldn't eat meat at all. Even if he only uses the term "plant-based diet", he's still just a vegan propagandist.

Any extreme is going to be bad for your body, and that includes excluding food groups from your diet completely.

a             y m.
g d c5 years ago


a             y m.
g d c5 years ago


Heather M
Heather Marvin5 years ago

I think so many of us are taught to eat breakfast, lunch and tea whether we are hungry or not. I think we all need to listen more to our body about when it needs to eat.

Nicole Gorman
Nicole Gorman5 years ago

Wow!!! Thanks for the information.