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.
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