Weight Loss: Popular Diets and Techniques

Obesity is a risk factor for OA

Being overweight or obese is a known risk factor for osteoarthritis (OA). Extra weight puts more stress on weight-bearing joints and increases the rate of joint degeneration (11). This results in an increased risk of joint replacement surgery and operative complications (22). Fat tissue also produces proteins that can cause harmful inflammation in and around the joints (21).


At Surecell, our doctors often stress the importance of weight management to reduce the risk of OA, delay the progression of joint damage and alleviate joint pain. Patients who are overweight or obese are strongly encouraged to lose weight.


Benefits of weight loss

Weight loss is responsible for increasing insulin activity and improved hypertension levels, therefore limiting the adverse health effects related to being obese or overweight (4, 16).


There are two important factors in managing weight loss: participation in physical activity to promote energy expenditure and modifying energy intake via various diets (12, 16).

Low-calorie diet

A low-calorie diet involves imposing a restriction on the number of calories a person consumes daily (5). Reducing the number of calories consumed assists with losing weight when combined with a higher energy output, such as exercising (5).


Components of a low-calorie diet include:

  • High levels of Carbohydrates, total daily energy intake of 50-55% (1).

Carbohydrates are broken down into glucose within the digestive tract, which provides a source of energy (17). Extra glucose is stored in the liver and muscle tissue, readily available to provide energy when required (17). Carbohydrates also assist in controlling blood glucose levels and insulin metabolism (17).

  • Low levels of fats, composed of 20-35% daily intake and saturated fats restricted (1).

Overconsumption of saturated fats are considered to increase levels of low-density lipoprotein (bad cholesterol) in the bloodstream (1).


Effects of a low-calorie diet

A low-calorie diet promotes metabolic fitness and disease prevention when combined with essential micronutrient supplements, with the potential to lose 8% of total body weight (1).


Long-term effects of a low-calorie diet may lead to detrimental adverse clinical effects (1). Therefore, it is important to monitor the body’s response to the adaptation of consuming a lower number of calories per day (1). To minimise the risks of adverse effects, it is advisable not to undergo a low-calorie diet for more than 16 weeks (1).

Ketogenic diet

A Ketogenic diet centres around consuming a diet that is very low in carbohydrate (<20 grams per day) and high levels of unsaturated fat and protein, limiting the catabolic effect occurring at the muscles (6, 18).


Effects of a ketogenic diet

A low intake of carbohydrate results in an increased production of Ketone bodies from fat reserves, assisting in keeping the body in a ketogenic state (2). This state the body enters helps suppress appetite, ultimately depleting glycogen stores and leading to significant weight loss (6).


A ketogenic diet leads to a rise in low density lipoprotein cholesterol levels and therefore may not be favoured, as an increase in low density lipoprotein cholesterol may place a person at a greater risk for cardiovascular disease (3).


When implementing a ketogenic diet, it is advisable to ensure sufficient intake of fluid and electrolytes, as this will assist in reducing the minor side effects associated with initial incorporation of the diet. Minor side effects may include nausea, fatigue, insomnia and headache (4).

High Protein Diet

Protein is one of the most important macronutrients for the human body. It provides a source of energy and promotes growth and development (15). A protein contains 20 different amino acids that are linked via peptide bonds (15). Amino acids are vital to the human body as they provide nitrogen, sulfur and hydrocarbon skeletons, all of which primarily come from protein. For a healthy adult, it is suggested to consume a minimum of 0.8 grams of protein per kg body weight (15).


Effects of a high protein diet

The effects of consuming a diet high in protein leads to an increased secretion of satiety hormones, reduced orexigenic hormone secretion and improves glucose homeostasis (13). This type of diet assists in preserving lean body mass during a weight loss phase (13). This is due to the fact that higher protein meals have the ability to suppress hunger (14). However, a diet too high in protein may result in the kidneys experiencing an acid load (13).


Protein can be found in a variety of plant and animal sources such as meat and fish, eggs, dairy products, seeds and nuts, and legumes like beans and lentils. While red meats, eggs and dairy products are rich sources of protein, they contain a high level of saturated fats and cholesterol. Overconsumption of these protein sources may put a person at a greater risk of heart disease (13).


Intermittent fasting

Intermittent fasting is a process in which an individual alters their eating patterns, resulting in a time frame whereby no food is consumed (typically 16 hours), paired with periods of eating (typically 8 hours) (7, 19). This pattern and time frames are completed on a consistent and recurring basis (7).


Effects of intermittent fasting

This method may assist in weight loss as it reduces the ability and time frame available to over consume foods. Intermittent fasting may be an effective option for an individual living a sedentary lifestyle because overconsuming foods, along with little or no energy expenditure (exercise), may result in metabolic morbidities, including insulin resistance and excessive accumulation of visceral fat (7).


However, intermittent fasting has potential disadvantages. If an individual has a diet that is lacking in vitamins and protein, intermittent fasting may potentially lead to a deficiency in essential nutrients (malnourishment), and therefore a reduction in muscle mass (8).

High intensity training

High intensity training is a short duration exercise style that increases energy expenditure as it is performed above the lactate threshold, accompanied by periods of short rest that provide time to recover between exercise bouts (10, 20).


Effects of high intensity training

This style of training utilises fat and carbohydrate stores in the body. Therefore, it is considered an effective intervention to assist with weight loss, improving cardiorespiratory fitness and metabolic outcomes (10, 20).


Recommendations

Overall, it is important to ensure that when implementing a diet or new exercise regime, you seek professional guidance. To seek advice, visit your local GP. Individualised education and support programs covering both nutrition and exercise are also available at Surecell.


Support available at Surecell

If you are interested in being prescribed a tailored exercise program, we offer exercise physiology, personal training and gym facilities, as well as medical treatments like platelet-rich plasma injections to manage the symptoms of OA. Feel free to contact our friendly staff on 03 9822 9996 or submit an enquiry here.


References:

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  2. Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE. Effects of a high-protein ketogenic diet on hunger, appetite and weight loss in obese men feeding as libitum. The American journal of clinical nutrition. 2008;87(1):44-45.

  3. O’Neil B, Raggi P. The ketogenic diet: Pros and cons Atherosclerosis. 2020; 292:119-26.

  4. Marcel CB. Diets for Weight Loss. Pravikoff D RPF, editor. CINAHL Nursing Guide [Internet]. 2019 [cited 2022 March 9] Available from: https://eds.s.ebscohost.com/eds/detail/detail?vid=7&sid=b6bb4de9-d2a1-4a78-96e2-b32684de5b05%40redis&bdata=JkF1dGhUeXBlPXNzbyZhdXRodHlwZT1zc28mY3VzdGlkPWRlYWtpbiZzaXRlPWVkcy1saXZlJnNjb3BlPXNpdGU%3d#AN=T706837&db=nup

  5. Benton, D., Young H.A. Reducing Calorie Intake May Not Help You Lose Weight. Perspectives on Psychological Science, 12(5), 703-714. 2017. [cited 2022 March 5]. Available from: https://journals.sagepub.com/doi/full/10.1177/1745691617690878

  6. Miller WC. How effective are traditional dietary and exercise interventions for weight loss? Medicine and science in sports and exercise. 1999;1;31:1129-34.

  7. Mattson MP, Longo VD, Harvie M. Impact of intermittent fasting on health and disease processes. Ageing research reviews. 2017;1;39:46-58.

  8. Collier R. Intermittent fasting: the next big weight loss fad.

  9. Andrikopoulos S. The Paleo diet and diabetes. The medical journal of Australia. 2016;205(4): 151-2.

  10. Alahmadi MA. High-intensity interval training and obesity. J Nov Physiother. 2014;4(3):211.

  11. Ellulu MS, Patimah I, Khaza'ai H, Rahmat A & Abed Y. Obesity and inflammation: the linking mechanism and the complications. Archives of medical science. 2017; 13(4): 851–63

  12. Strychar I. Diet in the management of weight loss. Cmaj. 2006; 174(1):56-63.

  13. Pesta DH, Samuel VT. A high-protein diet for reducing body fat: mechanisms and possible caveats. Nutrition & metabolism. 2014;11(1):1-8.

  14. EisenteinJ, Roberts SB, Dallal G, Saltzman E. High-protein weight loss diets: are they safe and do they work? A review of the experimental and epidemiologic data. Nutrition reviews. 2002;60(7): 189-200.

  15. Wu G. Dietary protein intake and human health. Food & function. 2016;7(3):1251-65

  16. Johns DJ, Hartmann-Boyce J, Jebb SA, Aveyard P, Group BW. Diet or exercise interventions vs combined behavioural weight management programs: a systematic review and met analysis of direct comparisons. Journal of the Academy of Nutrition and Dietetics. 2014;114(10):1557-68.

  17. Holesh JE, Aslam S, Martin A. Physiology, Carbohydrates. 2017.

  18. Maswood W, Annamaraju P, Uppaluri KR. Ketogenic diet. Statpearls [Internet]. 2020 Dec 4.

  19. Mallinowski B, Zalewska K, Wesierska A, Sokolowska MM, Socha M, Liczner G, Pawlak-Osinska K, Wicinski M. Intermittent fasting in cardiovascular disorders – an overview Nutrients. 2019; 11(3):673

  20. Shiraev T, Barclay G. Evidence based exercise: Clinical benefits of high intensity interval training. Australian family physician. 2012; 41912:960-2.

  21. King LK, March L & Anandacoomarasamy A. Obesity & osteoarthritis. The Indian journal of medical research. 2013; 138(2): 185–93.

  22. Leyland KM, Judge A, Javaid MK, Diez-Perez A, Carr A, Cooper C, Arden NK, Prieto-Alhambra D. Obesity and the Relative Risk of Knee Replacement Surgery in Patients With Knee Osteoarthritis: A Prospective Cohort Study. Arthritis Rheumatol. 2016 Apr; 68(4):817-25.