Korean J Gastroenterol.  2024 Mar;83(3):87-93. 10.4166/kjg.2024.004.

Dietary Management of Obesity

Affiliations
  • 1Department of Internal Medicine, Kangwon National University College of Medicine, Chuncheon, Korea

Abstract

Obesity is defined as a condition characterized by the abnormal accumulation of fat cells, which results in increased body weight. Worldwide, obesity is progressively on the rise, leading to an increased prevalence of chronic conditions such as cardiovascular disease, type 2 diabetes, and hyperlipidemia. Obesity is a result of the interplay between genetic, metabolic, social, behavioral, and cultural factors, necessitating an interdisciplinary and multimodal management approach. Diet therapy, which includes dietary modifications and nutritional interventions, is a fundamental component of the multifaceted approach to managing obesity. The principle of diet therapy is based on achieving weight loss through a negative energy balance and maintaining weight through an equilibrium of energy intake and expenditure. Strategies for weight loss and control rely on caloric restriction, macronutrient distribution, and dietary patterns such as the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets. Recently, studies have been conducted on weight control using information and communication technology-based interventions, as well as interventions based on intestinal microorganisms which consider inter-individual variability and long-term adherence. In conclusion, diet therapy stands as a pivotal element in the management of obesity, providing a personalized and comprehensive approach to weight control. By combining evidence-based dietary strategies with behavioral modifications and consistent support, healthcare professionals can enable individuals to attain and sustain a healthier weight, thereby reducing related health risks.

Keyword

Obesity; Diet therapy; Weight loss

Reference

1. Lean ME, Han TS, Morrison CE. 1995; Waist circumference as a measure for indicating need for weight management. BMJ. 311:158–161. DOI: 10.1136/bmj.311.6998.158. PMID: 7613427. PMCID: PMC2550221.
Article
2. Apovian CM. 2016; Obesity: definition, comorbidities, causes, and burden. Am J Manag Care. 22(7 Suppl):s176–s185.
3. Ortega FB, Lavie CJ, Blair SN. 2016; Obesity and cardiovascular disease. Circ Res. 118:1752–1770. DOI: 10.1161/CIRCRESAHA.115.306883. PMID: 27230640.
Article
4. Jensen MD, Ryan DH, Apovian CM, et al. 2014; 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 63(25 Part B):2985–3023. DOI: 10.1161/01.cir.0000437739.71477.ee. PMID: 24222017. PMCID: PMC5819889.
5. Haslam DW, James WP. 2005; Obesity. Lancet. 366:1197–1209. DOI: 10.1016/S0140-6736(05)67483-1. PMID: 16198769.
Article
6. Blüher M. 2019; Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol. 15:288–298. DOI: 10.1038/s41574-019-0176-8. PMID: 30814686.
Article
7. Huang Y, Lu Y, Huang YM, et al. 2020; Obesity in patients with COVID-19: a systematic review and meta-analysis. Metabolism. 113:154378. DOI: 10.1016/j.metabol.2020.154378. PMID: 33002478. PMCID: PMC7521361.
Article
8. Stelmach-Mardas M, Rodacki T, Dobrowolska-Iwanek J, et al. 2016; Link between food energy density and body weight changes in obese adults. Nutrients. 8:229. DOI: 10.3390/nu8040229. PMID: 27104562. PMCID: PMC4848697.
Article
9. Kolotkin RL, Meter K, Williams GR. 2001; Quality of life and obesity. Obes Rev. 2:219–229. DOI: 10.1046/j.1467-789X.2001.00040.x. PMID: 12119993.
Article
10. Wang L, Wang H, Zhang B, Popkin BM, Du S. 2020; Elevated fat intake increases body weight and the risk of overweight and obesity among Chinese adults: 1991-2015 trends. Nutrients. 12:3272. DOI: 10.3390/nu12113272. PMID: 33114561. PMCID: PMC7694029.
Article
11. Lee SI. 2010; Metabolism & nutritional support in obesity. Surg Metab Nutr. 1:12–16.
12. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015-2020 dietary guidelines for Americans, 8th ed. Washington, D.C: U.S. Department of Health and Human Services;2015.
13. Sacks FM, Bray GA, Carey VJ, et al. 2009; Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 360:859–873. DOI: 10.1056/NEJMoa0804748. PMID: 19246357. PMCID: PMC2763382.
Article
14. Bray GA, Siri-Tarino PW. 2016; The role of macronutrient content in the diet for weight management. Endocrinol Metab Clin North Am. 45:581–604. DOI: 10.1016/j.ecl.2016.04.009. PMID: 27519132.
Article
15. Lee SH. Metabolism, Obesity, and Nutrition Research Group of The Korean College of Helicobacter and Upper Gastrointestinal Research. 2023. Dietary Management of Obesity. 1st ed. Nutritional management of upper gastrointestinal diseases. Daehanuihak;Seoul: p. 160–170.
16. Howell S, Kones R. 2017; "Calories in, calories out" and macronutrient intake: the hope, hype, and science of calories. Am J Physiol Endocrinol Metab. 313:E608–E612. DOI: 10.1152/ajpendo.00156.2017. PMID: 28765272.
Article
17. Bischoff SC, Schweinlin A. 2020; Obesity therapy. Clin Nutr ESPEN. 38:9–18. DOI: 10.1016/j.clnesp.2020.04.013. PMID: 32690184.
Article
18. Korean Society for the Study of Obesity. 2022. Clinical practice guidelines for obesity 2022. 8th ed. Korean Society for the Study of Obesity;Seoul:
19. Di Angelantonio E, Bhupathiraju ShN, et al. Global BMI Mortality Collaboration. 2016; Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 388:776–786. DOI: 10.1016/S0140-6736(16)30175-1. PMID: 27423262.
Article
20. Beechy L, Galpern J, Petrone A, Das SK. 2012; Assessment tools in obesity-psychological measures, diet, activity, and body composition. Physiol Behav. 107:154–171. DOI: 10.1016/j.physbeh.2012.04.013. PMID: 22548766. PMCID: PMC7174029.
Article
21. Słowik J, Grochowska-Niedworok E, Maciejewska-Paszek I, et al. 2019; Nutritional status assessment in children and adolescents with various levels of physical activity in aspect of obesity. Obes Facts. 12:554–563. DOI: 10.1159/000502698. PMID: 31639803. PMCID: PMC6876601.
Article
22. Huang K, Zhao L, Fang H, et al. 2022; A preliminary study on a form of the 24-h recall that balances survey cost and accuracy, based on the NCI Method. Nutrients. 14:2740. DOI: 10.3390/nu14132740. PMID: 35807917. PMCID: PMC9269212.
Article
23. Kirkpatrick SI, Reedy J, Butler EN, et al. 2014; Dietary assessment in food environment research: a systematic review. Am J Prev Med. 46:94–102. DOI: 10.1016/j.amepre.2013.08.015. PMID: 24355678. PMCID: PMC4558887.
24. Ham SJ, Kim DW. 2021; Estimation of the usual food intake distribution reflecting the consumption frequency and a comparison of the proportion of non-consumers: based on the KNHANES 2009. Korean J Community Nutr. 26:296–306. DOI: 10.5720/kjcn.2021.26.4.296.
Article
25. Wadden TA, Foster GD. 2000; Behavioral treatment of obesity. Med Clin North Am. 84:441–461. viiDOI: 10.1016/S0025-7125(05)70230-3. PMID: 10793651.
Article
26. American College of Cardiology/American Heart Association Task Force on Practice Guidelines, Obesity Expert Panel, 2013. 2014; Expert panel report: guidelines (2013) for the management of overweight and obesity in adults. Obesity (Silver Spring). 22 Suppl 2:S41–S410. DOI: 10.1002/oby.20660.
27. Muscogiuri G, El Ghoch M, Colao A, et al. 2021; European guidelines for obesity management in adults with a very low-calorie ketogenic diet: a systematic review and meta-analysis. Obes Facts. 14:222–245. DOI: 10.1159/000515381. PMID: 33882506. PMCID: PMC8138199.
Article
28. Patterson RE, Sears DD. 2017; Metabolic effects of intermittent fasting. Annu Rev Nutr. 37:371–393. DOI: 10.1146/annurev-nutr-071816-064634. PMID: 28715993.
Article
29. Franz MJ, VanWormer JJ, Crain AL, et al. 2007; Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc. 107:1755–1767. DOI: 10.1016/j.jada.2007.07.017. PMID: 17904936.
Article
30. Rynders CA, Thomas EA, Zaman A, Pan Z, Catenacci VA, Melanson EL. 2019; Effectiveness of intermittent fasting and time-restricted feeding compared to continuous energy restriction for weight loss. Nutrients. 11:2442. DOI: 10.3390/nu11102442. PMID: 31614992. PMCID: PMC6836017.
Article
31. Schwingshackl L, Zähringer J, Nitschke K, et al. 2021; Impact of intermittent energy restriction on anthropometric outcomes and intermediate disease markers in patients with overweight and obesity: systematic review and meta-analyses. Crit Rev Food Sci Nutr. 61:1293–1304. DOI: 10.1080/10408398.2020.1757616. PMID: 32363896.
Article
32. Rolls BJ. 2009; The relationship between dietary energy density and energy intake. Physiol Behav. 97:609–615. DOI: 10.1016/j.physbeh.2009.03.011. PMID: 19303887. PMCID: PMC4182946.
Article
33. Smethers AD, Rolls BJ. 2018; Dietary management of obesity: cornerstones of healthy eating patterns. Med Clin North Am. 102:107–124. DOI: 10.1016/j.mcna.2017.08.009. PMID: 29156179. PMCID: PMC5726407.
34. Rolls BJ, Roe LS, Beach AM, Kris-Etherton PM. 2005; Provision of foods differing in energy density affects long-term weight loss. Obes Res. 13:1052–1060. DOI: 10.1038/oby.2005.123. PMID: 15976148.
Article
35. Rolls BJ. 2017; Dietary energy density: applying behavioural science to weight management. Nutr Bull. 42:246–253. DOI: 10.1111/nbu.12280. PMID: 29151813. PMCID: PMC5687574.
Article
36. Rho MR. 2015; Dietary intervention strategies to reduce energy intake in diabetes. J Korean Diabetes. 16:43–48. DOI: 10.4093/jkd.2015.16.1.43.
Article
37. Fogelholm M, Anderssen S, Gunnarsdottir I, Lahti-Koski M. 2012; Dietary macronutrients and food consumption as determinants of long-term weight change in adult populations: a systematic literature review. Food Nutr Res. 56:19103. DOI: 10.3402/fnr.v56i0.19103. PMID: 22893781. PMCID: PMC3418611.
Article
38. Fechner E, Smeets ETHC, Schrauwen P, Mensink RP. 2020; the effects of different degrees of carbohydrate restriction and carbohydrate replacement on cardiometabolic risk markers in humans-A systematic review and meta-analysis. Nutrients. 12:991. DOI: 10.3390/nu12040991. PMID: 32252374. PMCID: PMC7230871.
Article
39. Phillips SA, Jurva JW, Syed AQ, et al. 2008; Benefit of low-fat over low-carbohydrate diet on endothelial health in obesity. Hypertension. 51:376–382. DOI: 10.1161/HYPERTENSIONAHA.107.101824. PMID: 18195164. PMCID: PMC2702133.
Article
40. Leidy HJ, Clifton PM, Astrup A, et al. 2015; The role of protein in weight loss and maintenance. Am J Clin Nutr. 101:1320S–1329S. DOI: 10.3945/ajcn.114.084038. PMID: 25926512.
Article
41. Frost GS, Brynes AE, Bovill-Taylor C, Dornhorst A. 2004; A prospective randomised trial to determine the efficacy of a low glycaemic index diet given in addition to healthy eating and weight loss advice in patients with coronary heart disease. Eur J Clin Nutr. 58:121–127. DOI: 10.1038/sj.ejcn.1601758. PMID: 14679377.
Article
42. Ko GJ, Rhee CM, Kalantar-Zadeh K, Joshi S. 2020; The effects of high-protein diets on kidney health and longevity. J Am Soc Nephrol. 31:1667–1679. DOI: 10.1681/ASN.2020010028. PMID: 32669325. PMCID: PMC7460905.
Article
43. Zafar MI, Mills KE, Zheng J, et al. 2019; Low-glycemic index diets as an intervention for diabetes: a systematic review and meta-analysis. Am J Clin Nutr. 110:891–902. DOI: 10.1093/ajcn/nqz149. PMID: 31374573.
Article
44. Zambrano AK, Cadena-Ullauri S, Guevara-Ramírez P, et al. 2023; The impact of a very-low-calorie ketogenic diet in the gut microbiota composition in obesity. Nutrients. 15:2728. DOI: 10.3390/nu15122728. PMID: 37375632. PMCID: PMC10305724.
Article
45. Guarnotta V, Emanuele F, Amodei R, Giordano C. 2022; Very low-calorie ketogenic diet: a potential application in the treatment of hypercortisolism comorbidities. Nutrients. 14:2388. DOI: 10.3390/nu14122388. PMID: 35745118. PMCID: PMC9228456.
Article
46. Takahara S, Soni S, Maayah ZH, Ferdaoussi M, Dyck JRB. 2022; Ketone therapy for heart failure: current evidence for clinical use. Cardiovasc Res. 118:977–987. DOI: 10.1093/cvr/cvab068. PMID: 33705533.
Article
47. Storoni M, Plant GT. 2015; The therapeutic potential of the ketogenic diet in treating progressive multiple sclerosis. Mult Scler Int. 2015:681289. DOI: 10.1155/2015/681289. PMID: 26839705. PMCID: PMC4709725.
Article
48. Grochowska K, Przeliorz A. 2022; The effect of the ketogenic diet on the therapy of neurodegenerative diseases and its impact on improving cognitive functions. Dement Geriatr Cogn Dis Extra. 12:100–106. DOI: 10.1159/000524331. PMID: 35950150. PMCID: PMC9247494.
Article
49. Muscogiuri G, Barrea L, Laudisio D, et al. 2019; The management of very low-calorie ketogenic diet in obesity outpatient clinic: a practical guide. J Transl Med. 17:356. DOI: 10.1186/s12967-019-2104-z. PMID: 31665015. PMCID: PMC6820992.
Article
50. Goossens C, Weckx R, Derde S, et al. 2021; Altered cholesterol homeostasis in critical illness-induced muscle weakness: effect of exogenous 3-hydroxybutyrate. Crit Care. 25:252. DOI: 10.1186/s13054-021-03688-1. PMID: 34274000. PMCID: PMC8285799.
Article
51. Caprio M, Infante M, Moriconi E, et al. 2019; Very-low-calorie ketogenic diet (VLCKD) in the management of metabolic diseases: systematic review and consensus statement from the Italian Society of Endocrinology (SIE). J Endocrinol Invest. 42:1365–1386. DOI: 10.1007/s40618-019-01061-2. PMID: 31111407.
Article
52. Padma V. 2014; DASH diet in preventing hypertension. Adv Biol Res. 8:94–96.
53. Svetkey LP, Sacks FM, Obarzanek E, et al. 1999; The DASH Diet, Sodium Intake and Blood Pressure Trial (DASH-sodium): rationale and design. DASH-Sodium Collaborative Research Group. J Am Diet Assoc. 99(8 Suppl):S96–S104. DOI: 10.1016/S0002-8223(99)00423-X. PMID: 10450301.
54. Konikowska K, Bombała W, Szuba A, Różańska D, Regulska-Ilow B. 2023; A high-quality diet, as measured by the DASH score, is associated with a lower risk of metabolic syndrome and visceral obesity. Biomedicines. 11:317. DOI: 10.3390/biomedicines11020317. PMID: 36830853. PMCID: PMC9953672.
Article
55. Davis C, Bryan J, Hodgson J, Murphy K. 2015; Definition of the mediterranean diet; a literature review. Nutrients. 7:9139–9153. DOI: 10.3390/nu7115459. PMID: 26556369. PMCID: PMC4663587.
Article
56. Jeong EH, Kim E, Hong CH, et al. 2019; Practicability of six weeks of Korean-style Mediterranean diet for elderly Koreans with high risk for dementia. J Korean Diet Assoc. 25:237–256.
57. Goldstein SP, Zhang F, Forman E, Evans BC. 2016; Using Machine learning to predict dietary lapses from a weight loss program. Ann Behav Med. 50:S23.
58. Goldstein SP. 2018. Comparing effectiveness and user behaviors of two versions of a just-in-time adaptive weight loss smartphone app. Drexel University;Philadelphia:
59. Rabbi M, Pfammatter A, Zhang M, Spring B, Choudhury T. 2015; Automated personalized feedback for physical activity and dietary behavior change with mobile phones: a randomized controlled trial on adults. JMIR Mhealth Uhealth. 3:e42. DOI: 10.2196/mhealth.4160. PMID: 25977197. PMCID: PMC4812832.
Article
60. Stein N, Brooks K. 2017; A fully automated conversational artificial intelligence for weight loss: longitudinal observational study among overweight and obese adults. JMIR Diabetes. 2:e20. DOI: 10.2196/diabetes.8590. PMID: 30291087. PMCID: PMC6238835.
Article
61. Zhou M, Fukuoka Y, Mintz Y, et al. 2018; Evaluating Machine learning-based automated personalized daily step goals delivered through a mobile phone app: randomized controlled trial. JMIR Mhealth Uhealth. 6:e28. DOI: 10.2196/mhealth.9117. PMID: 29371177. PMCID: PMC5806006.
Article
62. Chew HSJ, Ang WHD, Lau Y. 2021; The potential of artificial intelligence in enhancing adult weight loss: a scoping review. Public Health Nutr. 24:1993–2020. DOI: 10.1017/S1368980021000598. PMID: 33592164. PMCID: PMC8145469.
Article
63. Kolodziejczyk AA, Zheng D, Elinav E. 2019; Diet-microbiota interactions and personalized nutrition. Nat Rev Microbiol. 17:742–753. DOI: 10.1038/s41579-019-0256-8. PMID: 31541197.
Article
64. Walker AW, Parkhill J. 2013; Microbiology. Fighting obesity with bacteria. Science. 341:1069–1070. DOI: 10.1126/science.1243787. PMID: 24009379.
65. Ridaura VK, Faith JJ, Rey FE, et al. 2013; Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science. 341:1241214. DOI: 10.1126/science.1241214. PMID: 24009397. PMCID: PMC3829625.
66. Rudolph A, Hilbert A. 2013; Post-operative behavioural management in bariatric surgery: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 14:292–302. DOI: 10.1111/obr.12013. PMID: 23294936.
Article
67. Seo MH, Lee WY, Kim SS, et al. 2019; 2018 Korean society for the study of obesity guideline for the management of obesity in Korea. J Obes Metab Syndr. 28:40–45. DOI: 10.7570/jomes.2019.28.1.40. PMID: 31089578. PMCID: PMC6484940.
Article
Full Text Links
  • KJG
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr