Saturday, January 17, 2015

Alternate Day Fasting is an Effective Technique for Reducing Excessive Fat Stores

Alternate Day Fasting is an Effective Technique for Reducing Excessive Fat Stores

Where are the upper and lower limits of calorie restriction for effective weight loss?

The upper limit is the calorie reduction level at which weight loss stops and metabolic rate diminishes to match the metabolic needs for DIET supplied energy and building blocks.

The lower limit is the calorie reduction level at which weight loss is not solely stored fat but lean body mass loss or STARVATION when DIET supplied energy and building blocks are not adequate to maintain lean body mass and energy exceeds fat mobilization.

The upper limit is 70% of normal calories.
The lower limit is 50% of normal calories.

ALTERNATE DAY FASTING

Method:  Alternate 100% of normal calories on day 1 and 25% of calories on day 2.  The moving average becomes 62.5% of normal calories.  This results in the following:

1.  Intermittent depletion of liver glycogen and triglyceride.
2.  Increased insulin sensitivity.
3.  Preservation of lean body mass.
4.  Mobilization of visceral body fat stores.
5.  Call up of peripheral body fat to replace visceral body fat losses.
6.  Reduction of waist line circumference.

Alternate day fasting is Phase 2 of IMPROVING METABOLIC HEALTH.
Phase 1 is optimizing LEAN BODY MASS, AEROBIC FITNESS, INSULIN SENSITIVITY and CELLULAR HEALTH.

7.  Cellular health is improved by weekly intermittent fasting.  Alternate day fasting is not inferior to weekly intermittent fasting.
8.  Intermittent fasting is associated with low insulin and low insulin growth factor 1 which signals the cell nucleus to turn on longevity and repair genes which optimizes cell health and function.

A story about intermittent fasting restoring heart health follows.
Rodents with heart failure or pump failure with 40% ejection fraction are fasted once a week for 8 weeks.  At the end of 8 weeks, the rodent no longer have heart failure with the normal 60% ejection fraction and restored exercise capacity.  Further examination confirmed that every heart myocardial cell was restored to "good as new" status.
The good news is that every cell nucleus contains the blueprint to make an entirely new copy of the person in the DNA code.
It follows that every cell nucleus contains the genes to transform the cell into "good as new" status.
The signal to activate the relevant genes is the threat of NUTRIENT DEPRIVATION.
Early starvation leads to gene activation that results in 1. biogenesis of needed proteins, 2. refolding of abnormally folded and  poorly functioning cellular proteins by cellular chaperone proteins and 3. recycling of abnormal proteins that cannot be restored to normal function.

The IMPROVING METABOLIC HEALTH plan modestly loses fat and increases lean muscle mass.  For EXCESSIVE FAT STORES, alternate day fasting is one way to achieve the safe weight loss.

The other safe weight loss diet is CHRONIC CALORIE RESTRICTION of 30-50 % or normal daily intake or 50-70% of normal daily calorie intake.

Why, How and What of Improving Metabolic Health and Reducing Fat Storage.

Why, How and What of Improving Metabolic Health and Reducing Fat Storage.



Deconditioning.

The metabolically normal lean individual becomes metabolically abnormal lean becomes metabolically abnormal overweight becomes metabolically obese becomes comorbidly diseased obese.

Reconditioning

Reverses the above steps.

The above graphic indicates Inside Out Approach that achieves remarkable results.

For Metabolic Health;

Why. Increase the optimum lean body mass with optimum aerobic fitness indicated by VO2 max, the 6 minute run time or the mitochondrial number or mass of energy factories in the slow twitch fibers of the muscles.  The lean body mass is in relationship to bone in a 4/1 weight ratio.  Make more muscle, build more bone, increase resting metabolic rate.

How. The visceral body fat stores, the liver glycogen and triglyceride stores represent the TARGET of the Improving Metabolic Health and Reducing Fat Storage.  When one reduces the TARGET energy stores via DIET and EXERCISE that reduces glycogen repletion and depletes liver glycogen and triglyceride and visceral fat stores by increased production of norepinephrine or adrenergic stimulation.

What.  The subcutaneous fat stores are not reduced by adrenergic stimulation by norepinephrine.  Subcutaneous fat stores mobilize slowly in response to reduced visceral fat stores.  The long term fat storage, subcutaneous fat, is like the army reserves which is called to duty when the short term fat storage depot is depleted and forward deployed to the front lines of visceral fat.

When one make the JUST RIGHT STORAGE of liver glycogen and triglyceride the target of DIET and EXERCISE one increases the PULL EFFECT of peripheral fat mobilization and reduction.  If one increases the WHY, decreases the HOW, reduction of the WHAT follows.
In other words increasing muscle mass, increasing resting metabolism, reducing visceral body fat results in declining peripheral fat.

REMARKABLE CHANGE occurs from the INSIDE OUT!

Preventing Atherosclerosis the Source of Heart Attacks and Strokes Part 2

Preventing Atherosclerosis the Source of Heart Attacks and Strokes Part 2

HOW DOES THE WAY WE IMPROVE OUR METABOLIC HEALTH AFFECT THE POTENTIAL MORBIDITY OF ATHEROSCLEROSIS?

Consider a story about an experiment comparing high intensity interval exercise by rodents and sedentary non-exercising rodents who have a major induced heart attack.  What happened to each group?
The sedentary group has 2 out of every 3 rodents die from their induced heart attack.
The high intensity interval exercise group has 1 out of every 3 rodents die from their induced heart attack.
The survivors are rehabilitated and then the size of the heart damage was compared.
The sedentary group had a 4 times larger scar than the high intensity interval group.

In summary the high intensity interval exercise group had 66% survival compared to 33% and their scar was 75% smaller.  Prognosis is determined by the amount of surviving heart or ejection fracture and the number of vessels with significant plaques which are subject to rupture/clot/heart attacks in the future.
Strokes caused by ruptured atheromatous plaques should have similar smaller areas of damage to the brain.

Another benefit of high intensity interval exercise is the production of inducible hypoxic factor.  This chemical is responsible for protecting the heart muscle and brain cells when blood, the source of oxygen, is interrupted.

A common cause of plaque rupture is inflammation.  The strongest predictor of heart attack risk and inflammation is a quantitative CRP or C reactive protein.  When the liver glycogen is intermittently exhausted or decreased, inflammatory chemicals and chemokines are reduced including CRP level.

When one intermittently fasts, consumes a low glycemic diet, performs daily high intensity interval exercise and weekly resistance training, supplements with Vitamin D3 and Vitamin K2 the following is true.

1.  Matrix GLA/K2 removes calcium from the arterial plaques and sequesters it safely in the bones preventing osteoporosis and ruptured plaques.

2.  HDL is elevated for increased reversed cholesterol transport of oxidized LDL in the atheromatous plaque.

3.  LDL bad cholesterol is reduced in amount and qualitatively changed to large and fluffy LDL with reduced particle count making it less atherogenic, less oxidizable which is an important first step for cholesterol to enter the arterial wall.

4.  Inflammatory chemicals, chemokines and CRP production by the liver is reduced and the plaques are less likely to ruptured.

5.  Increased inducible hypoxic factor is produced by the high intensity interval exercise and protects the heart and brain should an ischemic event ever occur.

6.  Metabolic health is associated with lower insulin levels, increased insulin sensitivity and prevents diabetes which results in lower blood pressure.

7.  Lower blood pressure reduces a major risk factor for atherosclerosis, heart failure and stroke.


Preventing Atherosclerosis the Source of Heart Attacks and Strokes Part 1.

Preventing Atherosclerosis, the Source of Heart Attacks and Stroke.


Atherosclerosis is the build up of LDL bad cholesterol AND Calcium which causes hardening of the arteries and blockage to flow.  Heart attacks and strokes occur when the plaque ruptures like a pimple and a clot forms changing an artery narrowing into a blocked artery.

Three ways to significantly reduce heart attacks and strokes are as follows.

1.  Prevent or remove LDL cholesterol from making or maintaining plaques.
2.  Prevent or remove Calcium from making or maintaining plaques.
3.  Stabilize the harmless plaque narrowing from rupturing by reducing inflammation in the plaque.

1.

LDL is more or less plaque forming based on the size and number of the particles.
Large fluffy particles are best and have lower particle counts per mg of LDL cholesterol.
HDL removes LDL cholesterol from plaques by reverse cholesterol transport to the liver.
Metabolically healthy diet and exercise depletes liver glycogen stores and calories are converted into glycogen and healthy fat.
Healthy fat has 8% higher HDL good cholesterol, 7% lower LDL bad cholesterol made up of large fluffy particles having a lower particle count per mg of LDL cholesterol.

Metabolically unhealthy high glycemic diets and low intensity steady state exercise maintains full liver glycogen stores and calories are converted into unhealthy fat.
Small dense particles are worse and have higher particle counts per mg of LDL cholesterol.
Unhealthy fat has 8% lower HDL good cholesterol, 7% higher LDL bad cholesterol made up of small dense particles having higher particle count per mg of LDL cholesterol.

2.

Calcium makes up 18% of the plaque by weight.
High coronary artery calcium scores predict earlier heart attacks in men.
Women have 1/10 the rate of atherosclerosis in men at age 50 and equal rates at age 60.
The rapid build up of atherosclerosis coincides with the loss of bone calcium in menopause.
The combination of Vitamin D3 and Vitamin K2 removes calcium from soft tissues by "reverse calcium transport" to the bones.
This occurs because Vitamin D3 makes a Vitamin K2 dependent protein, Matrix GLA protein which joins Vitamin K2 and removes calcium from the plaques and sequesters the calcium in stronger and fracture resistant bones. I recommend D3 5,000 IU and K2 5 msg daily. Avoid if on warfarin/coumadin.

3.  HDL and Matix GLA protein/K2 remove LDL cholesterol and calcium respectfully from arteries preventing blockages and the INFLAMMATION that leads to rupture, heart attacks and strokes.

Saturday, January 10, 2015

Great Health Part 7

Improving Your Metabolic Health.

Great health requires resilience in the following 4 domains:
1.  Physical
2.  Social
3.  Mental
4.  Emotional

How can mental and emotional resilience be increased?
What is the evidence that mental and emotional resilience matters?

First, the second question explored through a story about a recent experiment.  English soldiers were divided into two groups.  Both groups performed high intensity interval exercise on exercise bicycles to increase physical resilience and aerobic capacity.  One of the groups added computer assisted brain training to also increase mental resilience.
After 6 weeks, both groups achieved identical levels of increased aerobic capacity.
On an exercise to exhaustion test, the exercise only group pedaled 42% longer and the brain trained group pedaled 115% longer.  Identical peak aerobic capacity gains but vastly different endurance and resilience.  Training the brain increased mental (and likely emotional) resilience.  The work or play to exhaustion duration should be increased by combining HIIE and brain training.

The HIIE and BRAIN TRAINING NEXUS is as interesting as the DIET and EXERCISE NEXUS for promoting health and resilience.
Both are elegantly simple and economical.
Both increase BDNF or brain derived neurotrophic factor also known as the memory chemical.   BDNF is also an apparent metabolic turbocharger engaging when needed during high energy demands or low energy supply conditions. (HIIE, Brain training high energy mental processing and intermittent fasting)

Emotional resilience is directly explored through a story about another recent experiment.  Elderly depressed patients with cognitive slowing were randomized to receive either of two treatments; computer assisted brain training OR antidepressant medication.  The brain training resolved both the cognitive slowing and depression within 4 weeks while the antidepressant medication resolved both the cognitive slowing and depression at 12 weeks.  Therefore, brain training was superior in treating emotional or affective illness achieving remission in 4 weeks instead of 12 weeks.

Depression is associated with low energy low BDNF.  Emotional resilience is associated with high energy high BDNF.  Therefore metabolically healthy promoting activities increase BDNF, that acts in the brain and in the body.  Healthy brain, healthy body.

Secondly, the long version of how is answered in the first post of my blog, Livermanlearningtolearn.blogs

PRESCRIPTION for increasing MENTAL and EMOTIONAL resilience.

Positscience.com or BrainHQ.com

Train for 20 minutes regularly until completing 40 hours or achieving 90 percentile brain speed score.



Great Health Part 6

Improving Your Metabolic Health.

Great health requires resilience in the following 4 domains:
1.  Physical
2.  Social
3.  Mental
4.  Emotional

Why, How and What can improve our social resilience?

In Malcolm Gladwell's Outliers he tells the story of a community of especially long lived persons that moved from the mountain region of Italy to the mountain region of America and continued to enjoy excellent health and longevity.  Medical researchers were perplexed because this population defied the predictions of morbidity and mortality based on traditional predictors of diabetes, cholesterol and smoking.  Tellingly, the excellent health and longevity evaporated as persons left the community to dwell elsewhere.  The confounding variable was proved to be the caring social community or the excellent social connections of their community.

Did you know that the full name of Family Medicine is Family and Community Medicine?

Your personal family physician wants to individually treat you in the context of your family, faith, vocation, avocations and community.

Speaking of community and family, Charles Murray studied success and happiness in America.  He defined success as high education and high income through data mining comparing the 7th percentile with the 93rd percentile zip code communities.
He discovered that the relative success and happiness were determined by 4 measures, 2 personal characteristics and 2 institutions as follows:

1.  Industriousness.
2.  Honesty
3.  Marriage.
4.  Religiosity.

Happiness was determined by a good job, a good marriage, personal faith and living in community where people care about one another.

Paraphrasing a secular and universal summary of Jewish and Christian scriptures;  Love the good with all your heart, soul and mind and your neighbor as yourself.  This means to love yourself a little less and others a little more for mutual benefit; so love yourself 150% and others 150% to promote social resilience, improve health and increase longevity.

Consider that all work is honorable and deserves your best efforts performed with honesty and integrity.  Consider marriage and family as economic and corporate growth.  Poverty is decreased to single digits by completing three tasks; graduating from high school, marrying after age 20 and delaying children until after marriage.  Violating one of these tasks results in a substantial increase in poverty up to 88%.  Also, consider the context of your spiritual life and develop an ecumenical respect for the faith of others.

Cultivate your social and community relationships and roles.


Great Health Part 5

Improving Your Metabolic Health.

Great health requires resilience in the following 4 domains:
1.  Physical
2.  Social
3.  Mental
4.  Emotional

Promoting healthy energy utilization and storage by understanding the NEXUS of intermittent exhaustion of stored liver glycogen through a healthy DIET and EXERCISE is the JUST RIGHT STORAGE or optimum condition to live a healthy life.

High intensity interval exercise of 4 minutes increased energy expenditure equal to 50 minutes of steady state exercise and increased aerobic capacity to exercise (or burn more calories per unit time) by 150% more.

The target of effective exercise is the type 2 or fast twitch muscle fibers because they exhaust quickly and cause type 1 or slow twitch muscles to adapt to exercise by increasing mitochondria or energy factories.

Intensity of exercise recruits type 2 or fast twitch muscle fibers.  One can produce intensity for muscle work in two ways, speed and load.  Load is essentially resistance exercise.

Calorie restriction is a similar stressor for cells as high intensity exercise.  High intensity exercise exceeds demand and requires the cell to become efficient by making more energy factories or mitochondria.  Intermittent fasting requires cells to become efficient for lack of abundant energy or supply.  Increased demand and decreased supply both require LEAN efficient cells.  Weekly fasting produces gene expression changes or epidemic changes that create metabolically efficient cell through expression of longevity and repair or regenerative gene action.

PRESCRIPTION FOR DIET AND EXERCISE that intermittently depletes liver glycogen (and triglyceride) while promoting increased aerobic capacity/resilience, increased muscle mass and strength.  Increased aerobic capacity or horsepower includes stronger heart and lungs.

1.  Weekly intermittent fasting of 24 hours without carbohydrate or protein.
2.  Low glycemic daily diet.
           1. limit 1 fist sized starch per meal or snack.
           2. eat 1 oz of healthy fats or nuts daily.
3.  4 minutes of high intensity interval aerobic exercise daily.
            1.  Tabata smart phone timing app.
            2.  8 cycles of 20 secs of speed and 10 secs of stop.
4.  10 minutes of weekly resistance exercise.
            1.  perform 7 reps of each exercise with 5 count positive and 5 count negative.
                  1.  Seated bench press.
                  2.  Seated chest pull.
                  3.  Seated military press.
                  4.  Seated overhead pull down.
                  5.  Quadriceps anterior thigh exercise, squat or extension.

OR CHOOSE a less efficient, less effective prescription without synergy.

1.  Chronic calorie restricted diet to deplete liver glycogen.
2.  Exhaustive steady state exercise to deplete liver glycogen.

This combination sounds logical but does not work well because appetite is stimulated by chronic calorie restriction AND steady state exercise.  Moreover this combination reduces basal metabolism by promoting loss of muscle (and mitochondrial) mass instead of muscle (and mitochondrial) mass building.  Would you prefer to look like a healthy marathon runner or a healthy decathlete?



Great Health Part 4

Improving Your Metabolic Health.

Great health requires resilience in the following 4 domains:
1.  Physical
2.  Social
3.  Mental
4.  Emotional

Promoting healthy energy utilization and storage by understanding the NEXUS of intermittent exhaustion of stored liver glycogen through a healthy DIET and EXERCISE is the JUST RIGHT STORAGE or optimum condition to live a healthy life.

What is the optimum exercise for metabolic health?

Exercise that depletes stored liver glycogen and builds metabolically healthy heart, lungs and muscles.

Steady state exercise that is prolonged and exhausting will deplete glycogen stores and improve muscle endurance.  It also increases appetite.

High intensity interval exercise rapidly depletes liver glycogen storage and also triglycerides because it increases adrenalin levels to 17 times baseline which slowly declines to baseline after 22 minutes.  Adrenalin stimulates adrenergic receptors in the liver which cause glycogen to release glucose to the body and also triglycerides to the body for energy.

Intense exercise recruits greater numbers of muscle fibers per unit time including fast twitch type 2 muscle fibers which are powerful but fatigue quickly.  After brief bouts of high intensity interval exercise the liver glycogen is partially depleted and the fast twitch muscles are also exhausted.  High intensity interval exercise also results in the production of lactic acid caused by the high metabolic demand and inadequate numbers of mitochondria, the energy factory within the cell, to process the supplied energy which therefore becomes lactic acid that causes the burn and fatigue of intense exercise.

After the intense exercise is over, the lactic acid released from the muscle is metabolized in the liver to pyruvate, an energy byproduct of glucose metabolism.  Unlike glucose which requires active transport into cells, pyruvate passes into cells and into the energy furnace of the mitochondria where ATP, a chemically useable form of energy is made.  Because the ATP made is unstable, like the manna from heaven, it rapidly breaks down into heat,

That essentially means that intense stop and go exercise depletes liver glycogen powering rapid movement initially and producing heat afterwards.  Moreover the overloaded muscles and their mitochondria respond to the stress to make greater numbers of energy factories or mitochondria.  The result is a higher capacity for aerobic steady state exercise, an increased VO2 max which measures the maximum distance one can cover in 6 minutes or alternatively the time to run a 10K race.

Intense stop and go or interval exercise is 150% superior to moderate steady state or aerobic exercise in increasing aerobic fitness.

Moreover, in a 15 week study of individuals on an eat what you want diet comparing no exercise, with 50 minutes of steady state exercise and 4 minutes of high intensity interval exercise only the later group reduced their weight by 6.5 lbs.  Steady state exercise increases energy expenditure and appetite.  High intensity interval exercise increased energy expenditure the same with a decreased appetite due to adrenalin.

Great Health Part 3

Improving Your Metabolic Health.

Great health requires resilience in the following 4 domains:
1.  Physical
2.  Social
3.  Mental
4.  Emotional

Promoting healthy energy utilization and storage by understanding the NEXUS of intermittent exhaustion of stored liver glycogen through a healthy DIET and EXERCISE is the JUST RIGHT STORAGE or optimum condition to live a healthy life.

Stages of health deconditioning.

Optimum >  metabolically healthy, overweight > metabolically healthy, obese > metabolic syndrome, obese > Co-morbid disease, obese (diabetes, hypertension, atherosclerosis, heart attacks, strokes.)

Caveat:  some persons cannot gain weight but develop metabolic syndrome and co-morbid diseases without obesity.  NOMS = non obese metabolic syndrome.

Stages of health reconditioning.

Co-morbid disease control > metabolic syndrome, obese > metabolically healthy, obese > metabolically healthy, overweight > optimum.

What is the optimum diet?
What diet is associated with lowering of blood pressure by 11-14 points, lowering fasting insulin levels,  lowering blood lipids, lowering triglycerides and lowering LDL numbers and improving their lipoprotein particle counts and number?
What diet lowered all cause mortality by 0.3% over a 5 year period?

The DASH diet and the closely related MEDITERRANEAN diet.

What is the simplest way to choose this diet?

By following 2 rules.
1.  Limit starch to less than one fist sized serving per meal or snack.
2.  Eat an ounce of nuts or other healthy fat daily.

Notice that the high starch diet is to be avoided.
Notice that adding healthy fat daily changes the ratio of good fats to neutral fats.  Bad fats such as trans fat should be avoided.

When to fuel up with the MEDITERRANEAN  diet?

When the glycogen tank has been exhausted and the fuel light would come on if humans had a fuel indicator light.

The secret of metabolic health is to DIET and EXERCISE in a way that empties the glycogen tank intermittently between meals and snacks to keep the JUST RIGHT STORAGE of liver glycogen.

Great Health Part 2.

Improving Your Metabolic Health.

Great health requires resilience in the following 4 domains:
1.  Physical
2.  Social
3.  Mental
4.  Emotional

THE LIVER STORES GLYCOGEN, glucose in chains, for energy use.
THE LIVER STORES TRIGLYCERIDES,  a form of fat which stores the most energy per gram.

DIET and EXERCISE affect the amount of GLYCOGEN and TRIGLYCERIDE and the amount of GLYCOGEN and TRIGLYCERIDE affect the health of the liver and the body parts downstream.
Here is the NEXUS of DIET and EXERCISE!

The liver stores glucose and triglycerides when fed and releases them to the body parts downstream when fasting.
TOO MUCH STORAGE causes liver dysfunction.
TOO LITTLE STORAGE causes starvation.
JUST RIGHT STORAGE allows optimum liver function and optimum body function.

The healthy liver also removes toxins and drugs and synthesizes proteins, fats and other nutrients for a healthy body.

How does one create a JUST RIGHT STORAGE of glycogen?

When the liver glycogen is low but not empty, like a car in motion with a falling fuel indicator but without a refuel light on, the liver interestingly intakes DIET and makes glycogen and healthy fats.

But when the liver glycogen is full, like a car with a full tank of fuel, the liver cannot make glycogen and converts DIET into unhealthy fats which the body stores in the fatty liver and stored fat in fat cells.  Body fat is stored in 2 separate "tanks" the VISCERAL FAT tank and the PERIPHERAL FAT tank.

Does visceral and body fat excess indicate metabolic syndrome, a disorder of energy utilization and storage diagnosed by a co-occurrence of three out of five of the following criteria below:

1. Increased waist circumference, > 40 in for men and > 35 in for women.
2.  Increased systolic blood pressure, >140.
3.  Increased diastolic blood pressure, > 90.
4.  Increased fasting glucose, >100.
5.  Increaed Triglyceride, >250.

Approximately 25% of Americans have metabolic syndrome and climbing.  Metabolic Syndrome leads to diabetes, hypertension, atherosclerosis, heart attacks and strokes.  Diabetic patients for any given age relative to non diabetic patient have three times the rates of dementia, heart attacks and osteoporosis.  Metabolic syndrome leads, in effect, to the ravages of advanced degenerative diseases usually associated with very advanced aging.

Promoting healthy energy utilization and storage by understanding the NEXUS of intermittent exhaustion of stored liver glycogen through a healthy DIET and EXERCISE is the JUST RIGHT STORAGE or optimum condition to live a healthy life.

Great Health Part 1.

Improving Your Metabolic Health.

Great health requires resilience in the following 4 domains:
1.  Physical
2.  Social
3.  Mental
4.  Emotional

The following TED talk by Jane McGonigal inspirationally points the way to health and resilience

Jane McGonigal: The game that can give you 10 ... - TED.com

I will discuss each of these domains along with my recommendations to improve each as the beginning of great health.

1.  PHYSICAL.

The physical health of a person is strongly related to DIET and EXERCISE.

But specifically what diet and what exercise?
Based on what criteria?

As always based on efficacy, safety and costs; in effect, the return on investment.
The greatest and most powerful tool for continuous quality improvement is the first of the three tools of quality improvement which are as follows:
1.  Reduce COMPLEXITY.
2.  Make the process LEAN.
3.  Use statistical tools of SIX SIGMA to solve a quality problem.

How does one reduce COMPLEXITY for diet and exercise?
By identifying where diet and exercise have a common result or a common goal and then making that process LEAN.

The body is organized like a 2 cycle engine.
Lungs actively inhale and passively exhale.  Think In, and Out.
Hearts passively fill and actively pump.  Think In, and Out.
All biologic processes require energy for action and building blocks for biosynthesis.
Energy may be simply thought of as diet.
Building blocks may be simply thought of as diet.
The Alimentary system is the start of our process of ENERGY In, ACTION and BIOSYNTHESIS Out.
Livers In diet and Ex building blocks for energy and biosynthesis.

What happens in the liver that is common to both diet and exercise?
Does that affect the health of the liver?
Does that affect the output of the liver?

THE LIVER STORES GLYCOGEN, glucose in chains, for energy use.
THE LIVER STORES TRIGLYCERIDES,  a form of fat which stores the most energy per gram.

DIET and EXERCISE affect the amount of GLYCOGEN and TRIGLYCERIDE and the amount of GLYCOGEN and TRIGLYCERIDE affect the health of the liver and the body parts downstream.
Here is the NEXUS of DIET and EXERCISE!