1. Nonexercise Activity Thermogenesis in Obesity Management
Pedro A. Villablanca, MD, MSc, Jorge R. Alegria, MD, Farouk Mookadam, MBChB, MSc, David R. Holmes, MD, R. Scott Wright, MD, James A. Levine, MD, PhD 
Mayo Clinic Proceedings 
Volume 90, Issue 4, Pages (April 2015)
DOI: /j.mayocp
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2. Figure 1
Components of total energy expenditure (TEE). The left column shows the 3 components of TEE: basal metabolic rate, thermic effect of food, and extent of physical activity.18 In the right column, physical activity is further divided into nonexercise activity thermogenesis (NEAT) and exercise activity thermogenesis.21 The right column also illustrates the theoretical difference in NEAT between sedentary and active individuals and the significant amount of extra calories that could be expended.
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3. Figure 2
Factors involved in the level of nonexercise activity thermogenesis (NEAT). The interindividual variability predisposing to a higher or lower level of NEAT is driven by genetic and acquired factors. The genetic regulation of NEAT is possibly influenced by multiple neuromediators located in the hypothalamus, including orexin, neuromedin U, ghrelin, and the agouti gene–related protein. This, plus the conditioning of the environment to different levels of physical activity and the behavioral factors that we learned from our main educators, will determine an individual to be a NEAT activator or a NEAT conserver, predisposing us to spend more time either sitting or moving. Educators at all levels (family, teachers, and health care providers) should encourage NEAT in multiple settings, ie, the workplace, health care facilities, schools, or any institutions in the community where we spend considerable time. NEAT implementation strategies are particularly critical for overweight and obesity to prevent the health consequences associated with this epidemic. Patients should stand up from their desktops, work in a standing position, climb the stairs, and keep moving to increase the level of NEAT. BMI = body mass index.
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4. Figure 3
Nonexercise activity thermogenesis (NEAT) opportunities to intervene. From awakening to bedtime, most persons have numerous opportunities to increase their NEAT.
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5. Figure 4
Implementing nonexercise activity thermogenesis (NEAT): a theoretical model. With increased NEAT at work and during leisure time, a 45-year-old female office worker who is 5 feet 3 inches tall, weighs 180 lb, and has a body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 32 could, in theory, reduce weight and BMI over 3 months to healthier levels. She expends 400 kcal while sitting for 8 hours. By progressively increasing standing and walking and adding other NEAT activities during work and leisure time, she can theoretically decrease her BMI from 32 to 27 in 3 months. The dotted line represents the obesity threshold.
Mayo Clinic Proceedings  , DOI: ( /j.mayocp )
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