What recommendations would you give about the use of diet alone verses a combination of diet and exercise in the development and maintenance of a healthy lifestyle.

 Nick Sherriff



“The populations of industrialised nations are becoming steadily more overweight as a result of changes in physical activity and diet. In recent years, concern about health and appearance has led ever-increasing numbers of people to use a wide variety of diets, dietary aids, and exercise regimens to lose weight.”

(New England Journal of Medicine)(2)



In order to answer the question clearly it is necessary to understand that all answers are relative to the lifestyle in which you live or want to live.   A healthy lifestyle could be considered as sitting on a continuum with varying degrees of health transcending ones lifestyle.   Although the most important consideration is probably that of balancing lifestyle in relation to diet and exercise.   This essay does accept that there are considerable issues outside diet and exercise that affect one’s lifestyle such as stress, smoking, drinking alcohol and avoiding too much sun but focus will be given to diet and exercise relationships to lifestyle.  The development and maintenance of such a lifestyle suggests a certain structure or order that this essay will suggest is the crux for the degree of success achieved.


The word diet could be easily misconstrued as weight loss when in fact a healthy diet may require the individual to increase their weight rather than lose it. During this essay diet will be considered as the balancing of nutrients in the form of foodstuffs and fluids to meet the requirements of the body.   Due to the essay constraints focus will be given to fat consumption.   Evidence and advice will be presented from various sources such as the World Health Organisation (WHO), the Gatorade Sports Science Institute (GSSI), The UK Health Education Authority (HEA) and the citing of medical journals such as  the New England Medical Journal (NEJM) and Lancet.  During the many stages in an individual’s life their dietary needs change, focus will be given to people within the age bracket of 19 -50 years of age.


The term exercise will be considered as more than just physical activity, encompassing a planned and structured activity with an objective.   Furthermore exercise will be examined in terms of  excess energy burn off.   Whilst it is agreed that not everyone has aspirations to be Linford Christie, a general compliance could probably be found for the decreasing one’s chance of contracting  heart related illnesses.  This essay will examine the relationship between exercise and a healthy lifestyle.


A plethora of recommendations regarding diet and healthy eating can be found in the everyday lives of almost everyone.   The media, especially television, is paramount with various advertisements for healthy eating from both the private and public sector. With such a variety of so-called diets ranging from low fat to high fibre it is easy to see where confusion and myth could flourish.   Basically the body requires a set amount of nutrients in order to function correctly.   The degree of function is affected by the amount of nutrients consumed.    The body requires six main classes of nutrients; minerals, vitamins water, fats, carbohydrates and proteins.  The latter three being sources of energy.  (Beashel and Taylor. p179) The recommended ratios of these energy sources are 12% protein, 30% fats and 58% carbohydrates. (NACNE.1989)  This allows the body to maintain cellular activity both at rest and during exercise. (Le Fanu.1987)


Arguably the main area for concern within a western diet is the high degree of fat consumed. Fat contains twice as much energy as both protein and carbohydrate.   If unused these sources of energy will be laid down in the body as fat.   This notion is further given credence by the governments state run television, the BBC, who has its own campaign called ‘Fighting fat, fighting fit.’ Although, there could be the suggestion that if government really wanted to cut the amount of fat consumed then fat could  be made less palatable.

This coincides with the World Health Organisation who in 1982 suggested that saturated fat caused the early death of males in the western world and therefore consumption would have to be cut by a third.


The Multiple Risk Factor Intervention Trial (MRFIT) was set up to provide information to substantiate these claims. Six thousand men were monitored over ten years. Half had their diets changed and stopped smoking, the other half were not so coerced.  The findings showed that the rate of heart disease was the same in both the groups.  A similar experiment in 1983 of five European countries and forty thousand men came to a similar conclusion. ( Le Fanu.1987,p16)


“Dietary recommendations are unwise, impractical and unlikely to lead to a reduced incidence of heart disease.”

(Prof.E.H.Ahrens.1979. cited in Le Fanu. Eat Your Heart Out. P17)


In 1994, the Committee on Medical Aspects of Food and Nutrition Policy (COMA) published a report on the Nutritional Aspects of Cardiovascular Disease.  In this report it was recommended fat should be no more than 35% of the total diet and of this no more than 10% should be saturated fatty acids, 12% monounsaturated fatty acids, 6% poly-unsaturated, 2% trans fatty acids. (British Nutritional Foundation)


In the light of previous evidence from the MRFIT these recommendations may seem rather odd but it has been proven that even if fat intake is not related to high blood cholesterol or blood pressure , the fattest people do not live as long.  


“The risk of death from all cases, cardiovascular disease, cancer, or other diseases increases throughout the range of moderate and severe overweight for both men and women in all age groups.”

(Dept of Epidemiology and Surveillance Research.NEJM.1999)(1)


One other point that is worth noting is that even a low fat diet if taken in excess will lead to obesity and therefore again the importance of balancing ones intake is paramount.


“Balance the food you eat with physical activity - maintain or improve your weight.”

(Dietary Guidelines for Americans.USDA.1995)


It is generally accepted that energy levels have become progressively less overtime. Coupled with advancement in technologies and computers the average worker probably spends much more time at a desk than their predecessors.  This suggests that the main problem may not be energy intake but energy output.  The HEA (2) suggest that six out of ten men are unfit. This lack of activity is often considered to be an important factor in the increasing incidence of obesity.  Obesity could be considered as having an energy excess in terms of body fat, therefore increasing energy expenditure should decrease the excess energy resulting in fewer health related problems.  


The largest variable in terms of energy expenditure is exercise many top class athletes can double their energy output training three to four hours per day. (Beashel & Taylor. P193)   Exercise stimulates the resting metabolic rate and keeps it elevated for up to 24 hours after.   Thus more energy is burnt and less fat is deposited around the body.   It is important to understand that the duration and intensity of exercise is a predeterminant as to whether fat oxidation or carbohydrate consumption is used (GSSI) .   The general acceptance is that low intensity exercise is better for weight regulation as it has a greater fat oxidation.  However, (Phelan.1997. cited in GSSI) suggests that the post exercise period after high intensity exercise produces 23% higher fat oxidation.   GSSI further suggest that dieting produces greater weight loss than does exercise. (GSSI)  Clearly an obese, sedentary person is unlikely to exercise with enough intensity or duration to effect a greater energy deficit than a low energy diet.  However, the combination of initial dieting to reach a weight that facilitates a more efficient form of exercise is arguably the best solution.



Exercise has another major health benefit in that it increases the number of high-density lipoproteins (HDL) and decreases the number of low-density lipoproteins (LDL). (Beashel & Taylor. P193)  LDLs are rich in cholesterol and travel the veins and arteries depositing cholesterol. HDLs have the opposite effect and act like cholesterol Hoovers removing cholesterol from the arteries.   On the surface this sounds fantastical but this is a long-term investment.  Beashel and Taylor further suggest that it would take about six months of regular anaerobic activity, covering around 10 miles a week in order to see a marked increase in HDLs.   The down side sees the levels returning to pre-exercise value after less than 10 – 14 days of inactivity. Whilst this does appear to be a great plus for advocating an increase in physical activity the crux does seem to be that of consistency.  Therefore balance may initially take a back seat in favour of what could be called goal setting realism. Using the rationale of something rather than nothing. In terms of health regular exercise has been linked to a reduction in CHD.  


“Just under a third of all cases of CHD and a quarter of strokes could be avoided by men if they were regularly active at a moderate level”

(Health Education Authority.p9-11)(2)


 In 1993 the National Task Force for Physical Activity was set up to produce a national strategy to promote physical activity. (HEA)(1)  In order to minimise mortality the HEA recommends at least 30 minutes of moderate intensity on at least five days a week . An increase in anaerobic fitness requires 20 minutes of vigorous intensity on three or more days a week.   This does not mean individuals should purchase expensive memberships of gyms and health clubs. Rather, encompass an increase in general activity into ones lifestyle and therefore achieving a balance. For instance a window cleaner that is constantly up and down ladders will require a different exercise pattern than a console operator.   Achieving this increase in activity may require walking the dog or to work and  using stairs instead of lifts. All of which must make the individual breathe harder and faster thus raising the pulse rate.



The evidence shows that increases in fat intake and therefore weight have additional consequences.  Whether that is in the form of CHD or obesity  is actually not the point.   After all, who really cares what they might die of, the issue still remains that they will die.   The western diet has a problem with fat but ultimately it is a question of excess.  Eating less and following the recommended guidelines in terms of ratio will help reduce an individual’s health risk.   This should have the knock on effect of lowering obesity and the mortality rate.  However the management of  excess may be easier  tackled from the combined diet and exercise perspectives.  A balance still needs to be struck between intake and output, therefore, the less active will need to employ some form exercise or physical activity  to effect an equilibrium.   The main problem is that society has become less active with the onset of technology causing children to become accustom to more sedentary way of life.  Again, the individual nature of people means that  suggested activities other than the average are unwise.  Low impact activities not only burn fat but also are easier for the less active individuals to get started with.   All of which comes under the umbrella of lifestyle.   Rather than an addition to one’s lifestyle diet and exercise should  become an integral concept.   Unless your diet and exercise become habitual then it will always feel unwelcome.  















Beashel and Taylor.1996.Physical Education and Sport. Nelson, Spain.



James Le Fanu.1987.Eat Your Heart Out. Macmillan, London



Scott, K, Powers. Edward, T, Howely. 1994. Exercise Physiology – Theory and Application to Fitness and Performance. (2nd) Brown and Benchmark, USA.




Health Education Authority


(1)   Health Education Authority. 1999 . Frequently Asked Questions. [online]. HEA. Available from : www.hea.org.uk/hpic/gnvq [Accessed 02 November 1999].



(2)   HEA.1998. Healthy Living For Men. HEA. London



New England Journal of Medicine



(1)   New England Journal of Medicine. 1999. Body-Mass Index and Mortality in a Prospective Cohort of U.S. Adults . [online]. Massachusetts Medical Society. Available from: www.nejm.org/content/1999/0341/0015/1097.asp [Accessed 03 November 1999].



(2)   New England Journal of Medicine. 1998. Apetite Surppressants and Valvular Heart Disease . [online]. Massachusetts Medical Society. Available from: www.nejm.org/content/1998/0339/0011/0765.asp [Accessed 03 November 1999].





The British Nutrition Foundation. 1998. Facts about fat. [online]. Royballam. Available from: www.nutrition.org.uk [Accessed 02 November 1999].




BBC Education.1999. Fighting fit, fighting fat. [online]. BBC. Available from: www.bbc.co.uk/education/health/fightingfat/eatwell.shtml [Accessed 30 October 1999].



Gatorade Sports Science Institute. 1999. Exercise, Macronutrient Balance and Weight Regulation. [online]. SGS Net, Inc. Available from: www.gssiweb.com/references/ [Accessed 28 October 1999].







US Dept of Agriculture. 1995. Dietary Guidelines for Americans .[online]. USDA. Available from: www.nalusda.gov/fnic/dga/dga95.html [Accessed 10 November 1999].








































HEA.1995. Enjoy Healthy Eating. A.R.T. Creative publishing. London



HEA. 1997. The Health Guide. HEA. London



HEA. 1991. Beating Heart Disease. HEA. London



National Coaching Foundation. 1999. The Body in Action. GKK. Leeds

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