NEAT: IF you programme in walks to up your NEAT is still NEAT?
There has been a trend over recent years of trainers and health professionals prescribing daily step goals or other tasks to increase the individual’s NEAT output. This raises the question whether it is still NEAT, or does it now fall into exercise prescription? Let us define some terms, NEAT stands for non-exercise activity thermogenesis which is the energy consumed by the body performing daily tasks like housework, going to the shops, working, gardening and generally going about an individual’s daily life. EAT is exercise activity thermogenesis which is the energy expended doing exercise and fitness related activities such as lifting weights, running, cycling, rock climbing, playing a team sport etc. TDEE is total daily energy expenditure, this refers to the amount of energy expended in total in a day and is made up of BMR (Basal Metabolic Rate), NEAT, TEF (Thermogenic Effect of Food) and EAT. Exercise prescription is like a medical prescription from a doctor but is normally prescribed from a physiotherapist or a fitness professional and will include a sequence of movements designed to enhance a person’s physical wellbeing. It has become increasingly popular to increase an individual’s TDEE through the prescription of increased NEAT, more often by setting a daily step goal. Although increasing NEAT isn’t a new concept, trainers have been doing this for years as after BMR, NEAT is the next biggest contributor to an individual’s TDEE. This is only a concerning concept as trainers are now starting to prescribe exactly what they want an individual to achieve in their day. This is where NEAT becomes exercise prescription as it is not being naturally achieved and an individual is having to set aside time in their day to perform the prescribed “NEAT” activity. Most NEAT prescription comes in the form of step goals specifically ten thousand steps per day, but where does this idea originate? In 1964 when preparing to host the Olympic games in Tokyo the Japanese government noticed that they had an obesity epidemic on their hands, the easiest way for them to combat this was to get people walking. Walking required no equipment and almost everyone could do it and Dr Iwao Ohya, head of one of Tokyo’s largest clinics, suggested that the solution was for everyone to walk ten thousand steps per day. After a few years of development along came the pedometer Manpo-Kei which literally translates as ten thousand step meter, and a worldwide health claim was made from a great marketing idea (Tudor-Locke, 2003). Although, this was a good simple exercise prescription it does not seem to be based on scientific evidence and is now being portrayed as the benchmark for all health and fitness. This benchmark for fitness is even overshadowing the world health organisation’s guidelines for one-hundred and fifty minutes of intense exercise (Bull et al., 2020). The ten-thousand steps a day subject has since been researched by various institutes and individuals presenting surprising results.
The most recent large-scale study (Paluch et al., 2021) into the ten thousand step debate was carried out over ten years with more than two thousand participants by The University of Massachusetts who concluded that seven thousand steps a day was enough to significantly decrease risk of death, but walking more than ten thousand steps or walking faster did not further reduce this risk. Although the study was performed over a ten-year period, the actual monitoring of step was only carried out once over three days and it was assumed that the number of steps would not drastically change per individual in the subsequent years. Another study by (Lee et al., 2019) found that four thousand four hundred steps per day was enough to reduce the risk of death in older women. Again, the intensity of steps performed had no significant correlation to the all-cause mortality rate. (Colley et al., 2010) examined the effects of time-based walking prescription and found that there was not a linear progression to the time spent walking to the number of steps achieved by the individual. They prescribed walking in ascending thirty-minute increments and discovered that there was a negative correlation to time prescribed and the number of steps achieved, between thirty minutes walking and sixty minutes ten thousand and fourteen thousand respectively where achieved. The longer the walking prescription was the less compliant the group became. (Schutz et al., 2014) advised that if the walking prescription was to be time based then an additional objective of pace should be considered and to maintain the moderate intensity activity level necessary to achieve the current recommendation, individuals should use a pedometer/ accelerometer to count 100 steps/min. In a study into the effect of exercise-induced energy expenditure (Colley et al., 2010) prescribed kilocalorie weekly walking in various increments and monitored participants only in the first half of the study. Adherence to the programme was good in whilst participants were monitored, but compliance dropped off once monitoring stopped, and significantly dropped after four weeks. This would indicate that individuals need continuous encouragement to achieve the stated kilocalorie goal long term or fatigue of the programme may have set in. Interestingly the study demonstrated that with prescribed walking targets the individual’s NEAT expenditure decreased once on the programme. Sedentary and moderate activity levels increased, and light activity levels decreased which may have led to the resulting decrease in NEAT. Although researchers were expecting to see an increase in TDEE with the addition of prescribed walking, the significant reduction in NEAT meant that there was no appreciable increase in TDEE from baseline measurements. With the prescription of walking, participants were compensating through the remainder of their day leading to a reduction in NEAT. The more walking an individual was prescribed, the greater the drop off in NEAT, this was exacerbated in less fit individuals. Other studies by (Goran & Poehlman, 1992; Kempen et al., 1995; Ludo, 1997) found similar outcomes within their populations evaluated.
These studies would suggest that although NEAT makes the second largest contribution to TDEE we should not be prescribing an arbitrary number of steps to increase energy burn as most individuals will compensate for this throughout the day, and the prescription of steps to increase NEAT will actually have the opposite effect. The problem seems to arise from the increased duration of training, when programming an individual to perform certain exercises in a day, they will perform these exercises, couple this with a diet plan and a step goal and all of a sudden, the majority of their free time is taken up. The individual has done their training, hit their macro targets, and hit their step goal; they are tired so now they will decrease their overall activity (NEAT) as they have reached the targets set for their day and there is no reason for them to do any further activity. Careful exercise prescription, gradually increased over a period of time could be a much smarter choice. Programming the individual to perform certain movement patterns in a controlled manner and at a given intensity allows you as a coach a greater ability to improve an individual’s fitness without too much undue stress or additional time commitment.
Should we be encouraging individuals to increase their NEAT? Or will this naturally occur as an individual’s personal fitness levels increase through exercise prescription? For example, as an individual becomes fitter will they choose to take the stairs rather than the lift? Maybe they will park at the other side of the car park at the supermarket? These could also be great suggestions to increase an individual’s NEAT as they are not time consuming, they are low intensity, and they are essentially, small unnoticeable changes so will not have an adverse effect on the individual’s mentality towards activity levels for the rest of the day. From these studies we can see that the prescription of walking has a cascading negative effect into the amount of energy an individual expends throughout their day or week. It is undeniable that there are health benefits to walking a certain number of steps each day but the prescription of this said activity seems to have negative correlation with TDEE when prescribed via the means of steps or time. The use of walking in exercise prescription alongside other movement interventions could work well but will have to be accounted for in the total volume of exercise in the week to not effect an individual’s NEAT and may ultimately reduce the TDEE.
Bull, F. C., Al-Ansari, S. S., Biddle, S., Borodulin, K., Buman, M. P., Cardon, G., Carty, C., Chaput, J.-P., Chastin, S., Chou, R., Dempsey, P. C., DiPietro, L., Ekelund, U., Firth, J., Friedenreich, C. M., Garcia, L., Gichu, M., Jago, R., Katzmarzyk, P. T., … Willumsen, J. F. (2020). World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine, 54(24), 1451–1462. https://doi.org/10.1136/bjsports-2020-102955
Colley, R., Hills, A., King, N., & Byrne, N. (2010). Exercise-induced energy expenditure: Implications for exercise prescription and obesity | Elsevier Enhanced Reader. https://doi.org/10.1016/j.pec.2010.03.001
Goran, M. I., & Poehlman, E. T. (1992). Endurance training does not enhance total energy expenditure in healthy elderly persons. American Journal of Physiology-Endocrinology and Metabolism. https://doi.org/10.1152/ajpendo.1992.263.5.E950
Kempen, K. P., Saris, W. H., & Westerterp, K. R. (1995). Energy balance during an 8-wk energy-restricted diet with and without exercise in obese women. The American Journal of Clinical Nutrition, 62(4), 722–729. https://doi.org/10.1093/ajcn/62.4.722
Lee, I.-M., Shiroma, E. J., Kamada, M., Bassett, D. R., Matthews, C. E., & Buring, J. E. (2019). Association of Step Volume and Intensity With All-Cause Mortality in Older Women. JAMA Internal Medicine, 179(8), 1105–1112. https://doi.org/10.1001/jamainternmed.2019.0899
Ludo, M. (1997). Effect of an 18-wk weight-training program on energy expenditure and physical activity. https://doi.org/10.1152/jappl.19220.127.116.118
Paluch, A. E., Gabriel, K. P., Fulton, J. E., Lewis, C. E., Schreiner, P. J., Sternfeld, B., Sidney, S., Siddique, J., Whitaker, K. M., & Carnethon, M. R. (2021). Steps per Day and All-Cause Mortality in Middle-aged Adults in the Coronary Artery Risk Development in Young Adults Study. JAMA Network Open, 4(9), e2124516. https://doi.org/10.1001/jamanetworkopen.2021.24516
Schutz, Y., Nguyen, D. M. T., Byrne, N. M., & Hills, A. P. (2014). Effectiveness of Three Different Walking Prescription Durations on Total Physical Activity in Normal- and Overweight Women. Obesity Facts, 7(4), 264–273. https://doi.org/10.1159/000365833
Tudor-Locke, C. (2003). Manpo-Kei: The Art and Science of Step Counting: How to Be Naturally Active and Lose Weight. Trafford Publishing.