Preface

We wrote this book for people with lymphedema and lipedema because we believe nutrition is one of the most important aspects of self-care and treatment for these conditions.

Care providers have long recognized the importance of nutrition but been frustrated by a lack of specific guidelines and the difficulty of changing eating patterns. This guide addresses both issues based on our experience and the latest research.

Our team provides a variety of backgrounds and perspectives:

• Chuck Ehrlich is a medical researcher and writer for Lymph Notes, as well as a lymphedema caregiver.
• Emily Iker, MD, specializes in treating lymphedema and lipedema at the Lymphedema Center in Santa Monica and has lower-extremity lymphedema.
• Karen Louise Herbst, PhD, MD, treats people with lymphatic issues including lymphedema and lipedema, and leads the Treatment, Research and Education of Adipose Tissue (TREAT) Program, at the University of Arizona College of Medicine.
• Linda-Anne Kahn. CMT, NCTMB, CLT-LANA, CCN, is a lymphedema therapist, nutritional consultant and integrative health coach at Beauty Kliniek Day Spa and Wellness Center in San Diego, and has lipedema.
• Dorothy D. Sears, PhD, researches diet and behavior patterns for reducing disease risk at the University of California San Diego School of Medicine.
• Mandy Kenyon, MS, RD, CSSD, is a consulting dietitian and research leader for Salk Institute and Veteran’s Medical Research Foundation.
• Elizabeth McMahon, PhD, is a clinical psychologist specializing in health-related behavior change and the author of several lymphedema books including Overcoming the Emotional Challenges of Lymphedema.

Emily Iker

I developed secondary lymphedema of the right leg following treatment for lymphoma, which interrupted my surgical residency. Consequently, I continued my studies in physical medicine and rehabilitation. After completing my residency at New York Medical College, I moved to Los Angeles and assisted an orthopedic surgeon for several years before opening my own practice.

Frustrated by the lack of lymphedema treatment options, I started the Lymphedema Center in Santa Monica in 1994. In 1995, I received my Certification of Lymphedema Management from Prof. Albert Leduc, the world-renowned lymphologist. My center is dedicated to diagnosing and managing lymphedema and lipedema. I am actively involved in patient education, research, and raising awareness of these conditions through organizations such as LE&RN. I lecture and teach on national and international level.

For me, lymphedema self-care is both routine and a challenge, especially when I am travelling. I am very careful to maintain my daily routine including skin care, self-massage, exercises, and compression, as well as maintaining healthy organic diet.

Linda-Anne Kahn

Growing up in South Africa, I was very active in sports including field hockey, swim team (I trained and swam 6 miles daily), exercise classes, and trampoline. I rode my bicycle to school every day.

I noticed that I didn't have ankles like the other girls. I hated my "thick" ankles especially in my school uniform with socks and laced shoes, which made my ankles look even worse. As I became a teenager, my legs became larger and I became so self-conscious. I had a small waist and flat stomach and larger legs. One day my aunt remarked that I had the family thighs and I never wore shorts again. My grandmother and two aunts had “heavy legs” and we just thought that was how we were in my family.

In my teens, I began dieting and jogging daily, weighing my food, and sometimes not eating properly for days in an attempt to reduce my legs. My waist got smaller and my arms became skinny but my legs stayed the same. I began yo-yo dieting, which lasted for years. In college, I put on 20 pounds and felt awful. When I was in my 20’s I was almost anorexic, took diet pills, and tried hard not to eat too much. Prior to my menstrual period, my legs would ache. I hated my legs!

I began noticing that certain foods, like bread and cheese, made me bloat terribly so I eliminated those foods. During my first pregnancy, I was very careful and I only put on 18 pounds. Two years later, I became pregnant again and put on 40 pounds, which was very difficult to get rid of.

When I was 30 years old, I immigrated to the United States. It was a very stressful time and I began eating Baskin Robbins ice cream, cream cheese, bagels, pasta, chocolate, and processed foods and I put on 25 pounds. It was a struggle and my weight fluctuated daily. I could put on 5 pounds overnight. I was bloated, tired, constipated, uncomfortable and not happy with my body. My stomach looked as though I was 3 month pregnant after eating. I then became vegan for 12 years, but ate so much brown rice, beans and starchy items that I put on weight.

Then I began studying nutrition and realized that I could not eat any bread or pasta. I finally settled on a diet with some fish, vegetable juices, some fruit, moderate grains (wild rice, brown rice), and legumes and my weight began stabilizing. I tried the raw food diet and cleansing and could lose 8 pounds in a week, but it would come back within a few weeks, once going back to regular eating.

In 1991 at the Dr. Vodder School in Austria, my beloved lymphedema therapy teacher Hildegard Wittlinger diagnosed me with stage 1 lipedema. With new knowledge of my condition, I began searching for the missing link and putting together an anti-inflammatory diet.

Hildegard told us about small chain fatty acids being important for lipedema, as these fats bypass the small intestine and can be helpful to lipedema patients. I discovered coconut oil and began incorporating that into my diet. I went on a three week cleanse every year, began eliminating the inflammatory foods and for the first time in my life I enjoyed my food. I became a wonderful cook! I incorporated dry brushing, lymphatic massage, and deep breathing exercises into my daily routine.

My present exercise routine is Pilates twice a week, yoga once a week and walking every day. I am 3 pants sizes smaller than I was 25 years ago. I am dairy free, gluten free, sugar free and do not eat red meat, chicken or turkey. In recent months, I have incorporated goat kefir onto my diet. I eat fermented foods, vegetables, and low glycemic fruits daily, as well as eggs, quinoa, brown rice, and wild salmon, when available. I avoid GMO foods and only eat organic foods at home.

At 66 years old, I am more energetic and vital than ever before. For the first time in my life, I am not unhappy with my body. My stomach is flat most of the time and I do not bloat after meals. I did not progress to stage 2 lipedema and I continue to feel better, with high energy and acceptance of my “lippy” legs, which look much better than they did before. Recently I was so excited to fit into my favorite tight jeans that I had saved for over 25 years.

Lipedema is treatable and I love sharing and coaching my patients on a path to optimal health.

Adapted from the Lymphedema and Lipedema Nutrition Guide by Chuck Ehrlich, Emily Iker, MD, Karen Louise Herbst, PhD, MD, Linda-Anne Kahn, CMT, CLT-LANA, Dorothy D. Sears, PhD, Mandy Kenyon, MS, RD, CSSD, and Elizabeth McMahon, PhD. ©2015, 2016 by Lymph Notes, all rights reserved.

Order paper books from your favorite bookstore, Amazon.com, Amazon Canada, Amazon UK, or Barnes and Noble (ISBN 978-0976480686). E-books are available from Amazon.com, Amazon Australia, Amazon Canada, Amazon UK, or Apple iBooks (ISBN 978-0976480693).

Got a question or comment? Post it in the Lymphedema and Lipedema Nutrition Guide, the book forum.

Publication: Lymphedema and Lipedema Nutrition Guide
Updated: 2016-07-02