A locally coherent exact category is a finitely accessible additive category endowed with an exact structure in which the admissible short exact sequences are the directed colimits of admissible short exact sequences of finitely presentable objects. We show that any exact structure on a small idempotent-complete additive category extends uniquely to a locally coherent exact structure on the category of ind-objects; in particular, any finitely accessible category has the unique maximal and the unique minimal locally coherent exact category structures. All locally coherent exact categories are of Grothendieck type in the sense of Št’ovíček. We also discuss the canonical embedding of a small exact category into the abelian category of additive sheaves in connection with the locally coherent exact structure on the ind-objects, and deduce two periodicity theorems as applications.