Lymphedema and Diet

January 8, 2021

Lymphedema and Diet

Is there an ideal diet that can help alleviate swelling due to lymphedema or reduce the severity of symptoms? Unfortunately, there are not any good studies that definitively have the answer to this question, but there is evidence that certain lifestyle changes can be beneficial to overall health and may help to alleviate some symptoms associated with lymphedema.

Maintain a Healthy Weight

There is a proven link between maintaining a healthy weight and positive outcomes when it comes to lymphedema symptoms. Studies dating back as far as 1957 have noted that the greater the weight of the patient, the greater the risk of lymphedema onset after breast cancer treatment [1]. In one study, the 5-year incidence of lymphedema in women after breast cancer treatment with a high BMI (>29) was 36% versus 12% for those that had a lower BMI (<29) [2]. Obesity itself impairs lymphatic transport capacity and can cause the development of lymphedema independent of other risk factors, pair that with an already impaired lymphatic system and it’s a recipe for lymphedema.

If you’ve struggled with your weight before or are currently overweight, you know that getting to and maintaining a healthy weight can be a lifelong struggle. There are a number of approaches to losing weight. However, if you plan to embark on a weight loss journey, be sure to discuss any changes you make to your diet or exercise regimen with your doctor.

Weight Reduction Strategies

  1. Work with your doctor to make a plan to lose weight.
  2. Ask for a referral to see a nutritionist or dietician that can help you.
  3. Discuss any weight-loss strategies and restrictive eating habits with your doctor. Dieting strategies such as keto or intermittent fasting may not be appropriate for everyone.
  4. Use a reputable weight loss solution such as WW (Weight Watchers) or Noom. Move away from dietary approaches that focus on quick, unsustainable results. Use an app such as MyFitnessPal or LoseIt! to track your weight and caloric intake.
  5. Build your plate around nutrient-dense foods such as fruits, vegetables, whole grains, and healthy fats.
  6. Eat fewer processed foods. Processed foods are loaded with sugar and salt which can cause inflammation and fluid retention. More on that below.
  7. Move your body. Be sure that you’re approved by your doctor or lymphedema therapist to exercise, determine the level and intensity of exercise that is appropriate for you.
  8. Stay hydrated. Determine the amount of water that is best for you and try to meet your goal regularly. Sometimes hunger is just thirst in disguise, drinking a small amount of water before a meal or regularly incorporating herbal teas and soups into your diet can be a great way to stay hydrated and satiated.
  9. Share your goals with your friends and family. Making lifestyle changes can be difficult. Share your goals and dreams with your family and friends so they can make necessary adjustments and offer you support during your journey.
  10. Get support. Whether in-person (although admittedly this can be difficult now) or digitally, joining a support group of others going on this journey can be helpful and make the loss process feel less lonely.

Be sure to focus on healthy weight loss strategies that are sustainable long term. When it comes to food philosophy, journalist Michael Pollan has said it best: "Eat food, not too much, mostly plants."

Lymphedema and Sugar

At this point, you probably already know that there is a relationship between added sugar and inflammation. Articles have suggested that limiting added sugars can greatly reduce inflammation and lymphedema symptoms, among other health benefits such as weight loss, stable blood sugar levels, and decreased mood fluctuation. The USDA dietary guidelines for sugar intake is no more than 10 teaspoons (42 grams) of sugar a day for adults. If you’re at risk for lymphedema, staying below that number can be beneficial to reduce the severity and onset of swelling.

Reducing Sugar Intake

  1. Read your labels. Reducing sugar intake can be easier said than done, unfortunately, sugar is added to many conveniences and processed foods to extend shelf life. The first task in reducing sugar intake is to read nutrition labels on packaged foods and look for the “added sugar” value. Sugar is often snuck into seemingly healthy foods, for example, two slices of Wonder bread has more sugar (4 grams) than a Dum Dum Lollipop (3.7 grams).
  2. Don’t drink your sugar. It goes without saying that eliminating soda is a great thing to do for your health. Other sugary beverages to consider reducing or eliminating are sweetened coffee drinks (sorry, Frappuccinos!), sweet teas, and juices with added sugar.
  3. Eat fruit as dessert. Natural sugars occurring within fruits are paired with healthy fiber and make them a great option when feeling like you need a little something sweet. Due to the fiber content, fruit will also fill you up quicker than an equivalent amount of candy or baked goods.

Lymphedema and Salt

It’s no secret that salt causes fluid retention. And although there are no studies about lymphedema and salt, there has been a lot of anecdotal evidence to suggest that excessive salt intake does exacerbate lymphedema. So while reducing salt intake won’t reverse lymphedema, it may reduce the onset of swelling and duration. USDA dietary guidelines recommend that adults consume no more than 2,300 milligrams (~1/2 teaspoon) of sodium per day. However, many processed foods are loaded with sodium and makes it difficult to adhere to the guidelines. Seemingly healthy Arnold 12-grain bread has 360 milligrams per 2 slices, which is 15% of the recommended daily intake.

Lymphedema and the Keto Diet

At this point, you’d be hard-pressed to find someone who hasn’t heard of the popular Keto diet. Can adhering to the keto diet benefit lymphedema? The science isn’t clear on this. There are no human studies that compare the Ketogenic diet to other diets in terms of outcomes for lymphedema, however, studies using mice did have promising results. Mice that were fed a Ketogenic diet saw reduced edema of the mice tail and enhanced lymphatic transport. Overall, switching from the SAD (Standard American Diet) to the Keto diet can have positive effects due to weight loss and emphasis on reduced sugar intake, which we already know is tied to better lymphedema management. However, the Keto diet isn’t for everyone and it hasn’t been studied in relation to lymphedema in trials using humans. If you plan on changing your diet to the Ketogenic diet, be sure to discuss this with your medical team.

Lymphedema and Gluten

The link between eliminating gluten and improvement of lymphedema symptoms isn’t there. However, there are individual accounts that have had positive experiences with eliminating gluten and reduced lymphedema symptoms. Those individuals may have had an existing gluten intolerance, which was causing them to experience inflammation and edema, and when it was paired with lymphedema risk or onset of swelling, consuming gluten exacerbated those symptoms. It is estimated that between 6-7% of the American population is sensitive to gluten, if you think you may have a gluten intolerance, speak with your medical team about doing a temporary elimination to see if it improves your symptoms.

Lymphedema is such an individual disease, the best advice is to speak with your medical team about which, if any, of these diet strategies may benefit your lymphedema. Evidence suggests that leading a healthy lifestyle: eat whole, unprocessed foods, watching your sugar and salt intake, and moving more can improve lymphedema symptoms.

If you’re interested to learn more about diet and lymphedema check out The Complete Lymphedema Management and Nutrition Guide by registered dietitian Jean LaMantia and physiotherapist Ann DiMenna.

  1. Treves N. An evaluation of the etiological factors of lymphedema following radical mastectomy; an analysis of 1,007 cases. Cancer. 1957;10:444–459. [PubMed]
  2. Werner RS, McCormick B, Petrek J, et al. Arm edema in conservatively managed breast cancer: Obesity is a major predictive factor. Radiology. 1991;180:177–184. [PubMed]

The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding lymphedema. Never disregard professional medical advice or delay in seeking it because of something you have read on the internet.