Introduction

Eating to Starve Lymphedema and Lipedema

You can starve lymphedema and lipedema by eating foods that fight these conditions and avoiding foods that make them worse. Benefits of better food choices include:

• Improving your symptoms, overall health, and quality of life.
• Delaying changes associated with progression to more advanced stages.
• Reducing your risk of developing symptoms, for those at risk.

Starving these conditions does not mean that you go hungry. We recommend a wide variety of tasty and satisfying foods, without limiting portions.

‘Eating to starve’ comes from a TED Talk by William Li on dietary cancer prevention. His research into foods that fight tumor growth validated our thinking about using foods to combat disease and supports our recommended ‘fighting foods.’ Eating to starve cancer overlaps with our work because cancer causes lymphedema and shares many underlying mechanisms. We also looked at food for fighting other conditions that contribute to lymphedema or lipedema–such as liver disease, cardiovascular disease, and diabetes–and incorporated them into our recommendations.

Our goal is to help you feel better and improve your health by changing what you eat. This guide is also for health care professionals, family, and friends who want to learn more about lymphedema, lipedema, and the latest nutrition research.

We view nutrition as an essential part of treatment for lymphedema and lipedema, with the same importance as the traditional pillars of Complex Decongestive Therapy (CDT): skin care, compression, lymphatic drainage, and exercise.

Nutrition alone is not adequate treatment, but many people will gain little benefit from CDT without changing their eating pattern. Lymphedema caused by obesity can be improved or even reversed with better nutrition. Although much of what we think about the influence of nutrition on disease is based on inference (in the absence of objective data), this information is still useful and important.

Proper nutrition is a life-long concern and should start with prenatal nutrition and continue through infancy and childhood. Childhood obesity has many undesirable effects including abnormally elevated levels of undesirable estrogen metabolites in girls, prior to starting puberty [i] and significantly increased risk of liver disease in both sexes [ii].

How to Use This Book

Use this guide to understand what foods to eat, why, and how to prepare them:

• Chapter 1 will help you understand lymphedema and lipedema in more detail including signs and symptoms and how these conditions change at different stages.
• Chapter 2 summarizes the research supporting our food recommendations in terms of relevant physical processes (physiology) and the ways in which food choices affect these processes.
• Chapter 3 summarizes our recommended eating pattern in terms of foods to eat routinely and foods to avoid or eat infrequently.
• Chapters 4 and 5 explain important nutrients and nutritional factors in foods including nutrients identified on food labels and other important nutritional factors.
• Chapter 6 covers vitamins, minerals and supplements, including some that anyone with lymphedema or lipedema should consider taking.
• Chapter 7 guides you through the process of changing your eating pattern by providing tools for decision making, helping you build support, identifying and obtaining missing skills, sustaining change, coping with emotional issues, dealing with difficult situations, etc.
• Chapter 8 provides example meal plans and menus, as well as suggestions for menu planning and changing tastes.
• Chapter 9 includes a variety of healthy recipes for all occasions.
• Chapter 10 provides instructions on preparing different vegetables and fruits.
• Chapter 11 contains practical tips for including healthier alternatives to favorite foods and tips for eating away from home.
• Chapter 12 covers record keeping in support of change and problem solving.
• Appendix A is our suggested shopping guide.
• Appendix B is the list of ingredients to avoid.
• Appendix C includes risk factors for developing lymphedema or lipedema, factors that distinguish between these conditions, and information on treatment and other health care considerations.
• Appendix D has photos of people with lymphedema and lipedema in all stages of each condition and combinations of lymphedema and lipedema.
• Appendix E contains a list of resources and sources of additional information.

Is Lipedema Lymphedema?

Lipedema, or painful fat syndrome, is an inherited chronic disease condition, as explained later. We consider lipedema to be a form of lymphedema and a vascular disorder as well as a fat disorder. Although we use both terms, almost everything we say about lymphedema applies to lipedema.

Previous thinking was that lipedema caused lymphedema only in the later stages of the condition when visible swelling develops, especially in the feet. We now know that abnormal increased tissue fluid from leaky blood and lymphatic vessels contributes to abnormal fat accumulation in early stage lipedema, even though swelling (edema) is not apparent.

Your Mileage May Vary

We know from experience that people can respond differently to foods or supplements and many factors influence how foods make you feel and support your health. Certain factors are fixed (like genetics), some factors change over time (like your age), some can be changed intentionally (such as your eating pattern), and some unexpected events have effects (like infections requiring antibiotics).

Please use our recommendations as guidelines and work with your health care team to discover an eating pattern that works for you, at this time in your life. We provide tools to help you find the eating pattern that supports your health and fits your lifestyle.

Focus on moving to a healthy eating pattern that you can enjoy and sustain. Avoid major short-term changes in your eating pattern, unless there is a medical reason.

Adapt our food recommendations to your own tastes and food preferences. Skip any foods or supplements that may trigger food allergies, food sensitivities, digestive disorders, histamine intolerance, etc.

If you are being treated for cancer, or have recently completed treatment, ask your care team about consulting a registered dietitian for nutritional recommendations tailored to your condition and treatment. The American Cancer Society also provides information on nutrition during and after treatment; see www.cancer.org.

If you have had weight loss surgery, gastric bypass surgery, other gastrointestinal surgery, or if you have a medical condition of the gastrointestinal tract or metabolism (such as diabetes), please coordinate changing your eating pattern with your health care team.

Let Us Know What Works

Please keep in touch to let us know what works for you and how we can improve this book. E-mail is best: [email protected]. Errata and lessons learned will be shared on the book website (www.lymphnotes.com/nutrition.php).

Never Say Diet

You may notice that we generally avoid the term ‘diet.’ This is because we want to help you to find an eating pattern that helps you feel better and you can enjoy for the foreseeable future. Consistently following a healthy eating pattern is better for you physically and emotionally than bouncing between diets that you cannot sustain long term.

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).

[i] Mauras N, et al. Estrogens and their genotoxic metabolites are increased in obese prepubertal girls. J Clin Endocrinol Metab. 2015 Apr 9:jc20151495. www.ncbi.nlm.nih.gov/pubmed/25856214

[ii] Anderson EL, et al. The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis. PLoS One. 2015 Oct 29;10(10):e0140908. www.ncbi.nlm.nih.gov/pubmed/26512983

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