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THE LYMPHEDEMA DIET

DIET AND LYMPHEDEMA

NUTRITION AND LYMPHEDEMA

IS THERE A LYMPHEDEMA DIET?

There is no “special” diet that lymphedema patients must follow, just because they have lymphedema. If you have no other medical conditions involved, your diet will be fairly normal (healthy diet of course).

The rules on foods to avoid or consume in moderation are much like the guidelines given for non-lymphedema people.

1. Restrict high fat foods or high cholesterol foods.

2. Limit sodium intake as it causes fluid retention.

3. Limit or avoid caffeine as it is a natural diuretic

4. Limit or avoid alcohol

Having said that however, I have always been a proponent of vitamins, supplements, good nutrition an, exercise and weight control. It just makes sense whether or not you have lymphedema.

It becomes even more important if you do.

It is well established that stress depletes your body of vitamins and nutrients as it tries to cope with whatever threat you are under, physically and mentally. Once these reserves are depleted, it becomes even more difficult for your “system” to take care of and rejuvenate itself.

These supplements will help give it that extra boost.

I am also a proponent of the concept that it is up to the patient to take the responsibility for taking care of themselves. This is especially true in lymphedema.

You can not expect doctors too, most of them have no clue anyway about this condition. Therapists are our best friends and do more for lymphedema patients that anyone else in the medical world, but you shouldn't expect this from them either.

At some point, you must care enough about yourself and your life to step forward. You must understand no one else can take care of you, but you.

Special Dietary Considerations

It is essential to understand as well, that if you other medical conditions that require a special diet, you must follow that dietary regime.

For example If you have a diabetes and lymphedema, then you must ad here to the special dietary rules for diabetes. The same is true should you have coronary problems and lymphedema.

A Healthy Eating Plan

The best way to help lower your blood cholesterol level is to eat less saturated fat and cholesterol, control your weight and walk or do another physical activity for at least 30 minutes each day. Our plan is based on these simple steps:

Use up at least as many calories as you take in. Be physically active. Aim for at least 30 minutes of physical activity on most days of the week, if not all. Eat a variety of nutrient-rich foods. Eat a diet rich in vegetables and fruits. Choose whole-grain, high-fiber foods. Eat fish at least twice a week. Eat less of the nutrient-poor foods. Limit how much saturated fat, trans fat and cholesterol you eat. Choose lean meats and poultry without skin and prepare them without added saturated and trans fat. Select fat-free, 1 percent fat, and low-fat dairy products. Cut back on foods containing partially hydrogenated vegetable oils to reduce trans fat in your diet. Cut back on foods high in dietary cholesterol. Cut back on beverages and foods with added sugars. Choose and prepare foods with little or no salt. If you drink alcohol, drink in moderation. Follow the American Heart Association recommendations when you eat out. Read the nutrition facts label and ingredients list. Avoid use of and exposure to tobacco products.

According to the United States Department of Agriculture, a healthy diet also includes whole grains, low-fat dairy products and lean proteins. Foods high in fat and added sugar should be limited because they are high in calories and can contribute to weight gain and obesity.

The Important of Weight in the Management of Lymphedema

The importance of weight control in the management of lymphedema cannot be stressed enough. Obesity or morbid obesity can actually cause a secondary form of lymphedema. While it may start as a “temporary” lymphedema the lymphatics can be so damaged that if the weight were lost, the lymphedema would remain. The weight actually crushes and overloads the lymphatics. When this occurs you will also begin experiencing further damaged caused by lymphedema complications, such as infections, weeping wounds and fibrosis.

Also, some of the complications involved in obesity lead to edema.

These edema causing complications are congestive heart failure, diabetes, hypertension, kidney disease, stroke and liver disease.

Other reasons for weight control when you have lymphedema is simple mobility and the ability to continue to function and do activities you really enjoy. It is difficult enough with just lymphedema and is profoundly affected by morbid obesity.

For information on obesity and lymphedema. Below are articles that will help in understand what a healhy diet is and the basic foods groups that contribute to that diet.

NUTRITION AND LYMPHEDEMA

UNDERSTANDING CARBOHYDRATES AND THEIR ROLE IN NUTRITION

Carbohydrate Addicts' Official Frequently Asked Questions and Answers on Carbohydrates

http://www.carbohydrateaddicts.com/kinds.html


Carbohydrates in Nutrition

by Ron Kennedy, M.D., Santa Rosa, California

http://www.medical-library.net/sites/carbohydrates_in_nutrition.html

Carbohydrate Addiction

What causes carbohydrate and other food cravings?

We don't really know enough about all the factors that cause specific food cravings. More research is needed to help understand appetite. Many studies suggest that a decrease in blood sugar stimulates hunger. This might help explain a craving for foods high in carbohydrates, which are a quick energy source.

Other studies suggest that the “mind-mood-food connection” may be explained by decreases in the brain chemical serotonin (sair-oh-TO'nin). Serotonin helps you feel less pain, less anxiety and less stress, so it improves mood by increasing relaxation. Some experts think that people who crave carbohydrates have low serotonin levels. Others caution that these cravings may just be a learned response.

What is “carbohydrate craving” or “carbohydrate addiction?”

These terms are used in a theory about the relationship between carbohydrate, insulin and appetite. (The body uses the hormone insulin to convert sugar, starch and other foods into energy.) We know that eating carbohydrate raises insulin, which then lowers blood sugar. This causes a desire (or craving) for more food and, in some people, carbohydrate.

Some people advocate severely reducing carbohydrate intake to reduce the insulin response and cravings. Others suggest that choosing carbohydrate-containing foods with a lower glycemic (gli-SE'mik) index also can lower insulin response and appetite. There isn’t enough research in this area for us to know what’s right. Also, individual responses may vary considerably.

What are the potential problems of severely reducing carbohydrate intake?

Diets low in carbohydrate are likely to lack sufficient amounts of essential nutrients found in plant foods that promote good health. People following these diets may not get enough vitamins, minerals and fiber to avoid blood chemistry imbalances, constipation and other health problems.

What's missing if carbohydrate-containing foods are severely restricted?

The American Heart Association recommends choosing a wide variety of foods low in saturated fat and cholesterol. While people need to watch their calorie intake to prevent obesity, they should consume a diet rich in grains (6 or more servings of breads, cereals, rice, pasta and beans) and at least five servings of fruits and vegetables daily. Combined with 2–4 servings of fat-free or low-fat dairy products, most healthy diets will contain at least 50–55 percent of calories from carbohydrates. Diets severely restricted in carbohydrate may be low in components that we need. For instance,

Diets low in grain products are likely to be low in B vitamins and minerals. Whole grains are also rich sources of potassium and fiber.

Low-fat or fat-free milk and yogurt are excellent sources of calcium, protein and riboflavin.

Vegetables and fruits are rich sources of vitamins, minerals and fiber. They may also have other components with health benefits that are still being discovered.

Some experts stress the importance of eating breakfast and at least two other meals a day to help control hunger. People with insulin resistance or diabetes may need to spread their calories out over a whole day by having small meals and 2–3 small snacks. (This can also help reduce hunger.) Related AHA publications:

An Eating Plan for Healthy Americans

Easy Food Tips for Heart-Healthy Eating

Reading Food Labels: A Handbook for People with Diabetes, order from American Diabetes Association (1-800-232-3472) Detailed Research

AHA Scientific Statement: AHA Dietary Guidelines: Revision 2000, #71-0193 Circulation. 2000;102:2284-2299; Stroke. 2000;31:2751-2766

See also:

Carbohydrates and Sugars Whole Grains and Fiber American Heart Assoc. - Nutrition Center Healthier Kids Fiber and Children's Diet Phytochemicals and Cardiovascular Disease Triglycerides Vegetables and Fruits Vegetarian Diets Carbohydrate Addiction Diet and Lifestyle Recommendations

Protein

Protein: Moving Closer to Center Stage

Harvard School of Public Health

When it comes to nutrients, protein hasn't gotten much attention. Like a quiet child in a classroom of rowdies, it's often been overshadowed by fat, carbohydrates, and vitamins. That's changing.

Surprisingly little is known about protein and health. We know that adults need a minimum of 1 gram of protein for every kilogram of body weight per day to keep from slowly breaking down their own tissues. That's about 9 grams of protein for every 20 pounds. Beyond that, there's relatively little solid information on the ideal amount of protein in the diet, a healthy target for calories contributed by protein, or the best kinds of protein.

Around the world, millions of people don't get enough protein. This protein malnutrition leads to the condition known as kwashiorkor. Lack of protein can cause growth failure, loss of muscle mass, decreased immunity, weakening of the heart and respiratory system, and death.

In the United States and other developed countries, it's easy to get the minimum daily requirement of protein. Cereal with milk for breakfast, a peanut butter and jelly sandwich for lunch, and a piece of fish with a side of beans for dinner adds up to about 70 grams of protein, plenty for the average adult.

Too little protein is clearly a problem. What about too much? The digestion of protein releases acids that the body usually neutralizes with calcium and other buffering agents in the blood. Eating lots of protein, such as the amounts recommended in the so-called no-carb diets, requires lots of calcium. Some of this may be pulled from bone. Following a high-protein diet for a few weeks probably won't have much effect on bone strength. Doing it for a long time, though, could weaken bone. In the Nurses' Health Study, for example, women who ate more than 95 grams of protein a day were 20 percent more likely to have broken a wrist over a 12-year period when compared to those who ate an average amount of protein (less than 68 grams a day).(2) While more research is clearly needed to define the optimal amount of daily protein, these results suggest that high-protein diets should be used with caution, if at all.

All protein isn't alike

Some of the protein you eat contains all the amino acids needed to construct new proteins. This kind is called complete protein. Animal sources of protein tend to be complete. Other protein lacks one or more amino acids that the body can't make from scratch or create by modifying another amino acid. Called incomplete proteins, these usually come from fruits, vegetables, grains, and nuts.

Vegetarians need to be aware of this difference. To get all the amino acids needed to make new protein–and thus to keep the body's systems in good shape–people who don't eat meat, fish, poultry, eggs, or dairy products should eat a variety of protein-containing foods each day.

The protein package

Animal protein and vegetable protein probably have the same effects on health. It's the protein package that is likely to make a difference. A 6-ounce broiled Porterhouse steak is a great source of complete protein–38 grams worth. But it also delivers 44 grams of fat, 16 of them saturated. (3) That's almost three-fourths of the recommended daily intake for saturated fat. The same amount of salmon gives you 34 grams of protein and 18 grams of fat, 4 of them saturated. (3) A cup of cooked lentils has 18 grams of protein, but under 1 gram of fat.(3) The bottom line is that it's important to pay attention to what comes along with the protein in your food choices. If you are partial to beef, stick with the leanest cuts. Fish or poultry are excellent alternatives. Even better options are vegetable sources of protein, such as beans, nuts, and whole grains.

Protein and chronic disease

The most solid connection between proteins and health has to do with a common disorder of the immune system. Proteins in food and the environment are responsible for a variety of allergies. These are basically overreactions of the immune system to what should be harmless proteins. Beyond that, relatively little evidence has been gathered regarding the effect of protein on the development of chronic diseases.

Cardiovascular disease: Cardiovascular disease: To date, only one large, prospective study has investigated the association between dietary protein and heart disease or stroke. In the Nurses' Health Study, women who ate the most protein (about 110 grams per day) were 25 percent less likely to have had a heart attack or to have died of heart disease than the women who ate the least protein (about 68 grams per day) over a 14-year period. (4) Whether the protein came from animals or vegetables–or whether it was part of low-fat or higher-fat diets–didn't seem to matter. These results offer reassurance that eating a lot of protein doesn't harm the heart. In fact, it is possible that eating more protein while cutting back on easily digested carbohydrates may be benefit the heart.

Diabetes: Diabetes Proteins found in cow's milk may play a role in the development of type 1 diabetes (formerly called juvenile or insulin-dependent diabetes). That's one reason why cow's milk isn't recommended for infants.(5) Later in life, the amount of protein in the diet doesn't seem to adversely affect the development of type 2 (adult-onset) diabetes, although research in this area is ongoing.

Weight control: Weight control: In short-term studies, a lower-calorie diet that includes more protein and less carbohydrate is more effective for losing weight or keeping weight steady than a lower-calorie, high-carbohydrate diet.

Eating high-protein foods such as beef, chicken, fish, or beans makes you feel full longer because they slow the movement of food from the stomach to the intestine. This strategy may also delay hunger signals. The digestion of protein, when compared to that of carbohydrates, results in smaller, steadier increases in blood sugar. This helps avoid the steep climbs and drops in blood sugar–which trigger hunger pangs and occur after eating rapidly digested carbohydrates. Unfortunately, few data have been collected on the long-term effects of a high-protein diet on weight control.

Cancer: There's no good evidence that eating a little protein or a lot of it influences cancer risk.

Straight talk about soy

The U.S. Food and Drug Administration now allows food makers to claim on the label of low-fat foods containing at least 6.25 grams of soy protein that soy can help reduce the risk of heart disease. (1) The U.S. Food and Drug Administration now allows food makers to claim on the labels of low-fat foods containing at least 6.25 grams of soy protein that soy can help reduce the risk of heart disease. (1) One protein source that has been getting a lot of attention is soybeans. Some research suggests that regularly soy-based foods lower cholesterol, chill hot flashes, prevent breast and prostate cancer, aid weight loss, and ward off osteoporosis.(6) These effects may be due to a unique characteristic of soybeans–their high concentrations of isoflavones, a type of plant-made estrogen.

This research has prompted scads of media reports touting the joys of soy. It also has food makers churning out new soy products that are beginning to move into the mainstream. In Boston, for example, soymilk is now advertised on the radio during Boston Red Sox games, alongside donuts, oil additives, and beer.

As is so often the case, though, many of the claims made for soy go far beyond the available evidence.

Heart disease: There's decent evidence that soy lowers cholesterol levels. A 1995 meta-analysis of 38 controlled clinical trials showed that eating approximately 50 grams of soy protein a day in place of animal protein reduced total cholesterol levels by 9.3 percent, LDL cholesterol by 12.9 percent, and triglycerides by 10.5 percent.(7) Such reductions, if sustained over time, could mean a 20 percent reduction in the risk of myocardial infarction or other forms of cardiovascular disease. Individuals with very high cholesterol levels, in the vicinity of 300 mg/dL, appeared to benefit most from eating soy-based foods. Keep in mind that 50 grams of soy protein is the equivalent of 1½ pounds of tofu or eight 8 ounce glasses of soymilk a day. The American Heart Association now recommends including soy-based foods as part of a heart-healthy diet.(8)

Flashes: Soy has also been investigated as a treatment for hot flashes and other problems that often accompany menopause. In theory, this makes sense. Soybeans are rich in plant estrogens, also called phytoestrogens. In some tissues, these substances mimic the action of estrogen. So they could cool hot flashes by giving a woman an estrogen-like boost during a time of dwindling estrogen levels. Yet carefully controlled studies haven't found this to be the case.(9)

Breast cancer: Breast cancer: In some tissues, phytoestrogens block the action of estrogen. If this occurs in breast tissue, for example, then eating soy could reduce the risk of breast cancer because estrogen stimulates the growth and multiplication of breast and breast cancer cells. However, studies to date haven't provided a clear answer, with some showing a benefit and others showing no association between soy consumption and breast cancer. (6) Large prospective studies now underway should offer better information regarding soy and breast cancer risk. So the news for soy isn't all rosy. Unsettling reports suggest that concentrated supplements of soy proteins may stimulate the growth of breast cancer cells.(10, 11) Too much soy could also lead to memory problems. Among older women of Japanese ancestry living in Hawaii, those who relied on the traditional soy-based diet were more likely to have cognitive problems than those who switched to a more Western diet.(12) These preliminary findings suggest that too much anti-estrogen in the wrong place at the wrong time could be harmful.

The Bottom Line-Recommendations for Protein Intake:

Get a good mix of proteins. Almost any reasonable diet will give you enough protein each day. Eating a variety of foods will ensure that you get all of the amino acids you need.

Pay attention to the protein package. You rarely eat straight protein. Some comes packaged with lots of unhealthy fat, like when you eat marbled beef or drink whole milk. If you eat meat, steer yourself toward the leanest cuts. If you like dairy products, skim or low-fat versions are healthier choices. Beans, soy, nuts, and whole grains offer protein without much saturated fat and with plenty of healthful fiber and micronutrients.

Balance carbohydrates and protein. Cutting back on highly processed carbohydrates and increasing protein improves levels of blood triglycerides and HDL, and so may reduce your chances of having a heart attack, stroke, or other form of cardiovascular disease. It may also make you feel full longer, and stave off hunger pangs. Too much protein, though, could weaken bones.

Eat soy in moderation. Soybeans, tofu, and other soy-based foods are an excellent alternative to red meat. But don't go overboard. Two to four servings a week is a good target. And stay away from supplements that contain concentrated soy protein or soy extracts, such as isoflavones. Larger amounts of soy may soothe hot flashes and other menopause-associated problems, but the evidence for this is weak.

Dietary Sources of Protein

Food Serving - Weight in grams - Protein grams - % Daily Value

  • Hamburger, extra lean - 6 ounces 170 - 48.6 - 97
  • Chicken, roasted - 6 ounces 170 - 42.5 - 85
  • Fish - 6 ounces 170 - 41.2 - 82
  • Tuna, water packed - 6 ounces 170 - 40.1 - 80
  • Beefsteak, broiled - 6 ounces 170 - 38.6 - 77
  • Cottage cheese - 1 cup 225 - 28.1 - 56
  • Cheese pizza - 2 slices 128 - 15.4 - 31
  • Yogurt, low fat - 8 ounces 227 - 11.9 - 24
  • Tofu - 1/2 cup 126 - 10.1 - 20
  • Lentils, cooked - 1/2 cup 99 - 9 - 18
  • Skim milk - 1 cup 245 - 8.4 - 17
  • Split peas, cooked - 1/2 cup 98 - 8.1 - 16
  • Whole milk - 1 cup 244 - 8 - 16
  • Lentil soup - 1 cup 242 - 7.8 - 16
  • Kidney beans, cooked - 1/2 cup 87 - 7.6 - 15
  • Cheddar cheese - 1 ounce 28 - 7.1 - 14
  • Macaroni, cooked - 1 cup 140 - 6.8 - 14
  • Soymilk - 1 cup 245 - 6.7 - 13
  • Egg - 1 large 50 - 6.3 - 13
  • Whole wheat bread - 2 slices 56 - 5.4 - 11
  • White bread - 2 slices 60 - 4.9 - 10
  • Rice, cooked - 1 cup 158 - 4.3 - 9
  • Broccoli, cooked - 5 inch piece 140 - 4.2 - 8
  • Baked potato - 2 x5 inches 156 - 3 - 6
  • Corn, cooked - 1 ear 77 - 2.6 - 5

Nutritive Value of Foods, USDA

Harvard

Nutrition

During wound healing, as during all illnesses, it is important to provide the body with adequate nutrients and calories. It is suggested that a person needs 30-35 calories/kg/day, 1.25-2 grams protein/kg/day and vitamins. (12) These include a multi-vitamin, vitamin C for collagen (a component of skin) formation, vitamin A for increased cell development, and zinc for wound healing. (12) Zinc will also correct yellow nail syndrome associated with chronic lymphedema.

It should be noted that patients with lymphedema are encouraged to eat enough food and supplemental protein. While the thought may be that decreasing protein intake will decrease the high protein levels in lymph fluid, and thus decrease lymphedema, this is not true. Rather, too little protein may weaken connective tissue and worsen the lymphedema condition. Easily digestible protein, such as chicken, fish and tofu, is advised. (11)

A balanced healthy diet that includes whole grains, fruits and vegetables and fish not only promotes optimal weight, but makes you feel good. Furthermore, a healthy diet can maintain the body's immune system, which will help prevent and treat infections. It is advised to restrict fatty foods or those with high cholesterol, to increase low sodium/high fiber foods, to avoid excessive alcohol and to avoid smoking.

In her article, Living with Lymphedema, Dr. Sabrina S. Selim presents a paragraph on nutrition.

“During wound healing, as during all illnesses, it is important to provide the body with adequate nutrients and calories. It is suggested that a person needs 30-35 calories/kg/day, 1.25-2 grams protein/kg/day and vitamins. (12) These include a multi-vitamin, vitamin C for collagen (a component of skin) formation, vitamin A for increased cell development, and zinc for wound healing. (12) Zinc will also correct yellow nail syndrome associated with chronic lymphedema.

It should be noted that patients with lymphedema are encouraged to eat enough food and supplemental protein. While the thought may be that decreasing protein intake will decrease the high protein levels in lymph fluid, and thus decrease lymphedema, this is not true. Rather, too little protein may weaken connective tissue and worsen the lymphedema condition. Easily digestible protein, such as chicken, fish and tofu, is advised. (11)

A balanced healthy diet that includes whole grains, fruits and vegetables and fish not only promotes optimal weight, but makes you feel good. Furthermore, a healthy diet can maintain the body's immune system, which will help prevent and treat infections. It is advised to restrict fatty foods or those with high cholesterol, to increase low sodium/high fiber foods, to avoid excessive alcohol and to avoid smoking.” See: Living with Lymphedema

Vitamins

Vitamins for Lymphedema - Vitamins for Life

Vitamins are a part of the crucial nutrition circle for a healthy life. Vitamins deficiency causes many diseases and medical conditions, or contributes to them.

I am a proponent of vitamins supplement for two reasons:

1. Stress, whether if be mental or physical depletes your bodies reserves. A body with a depeleted vitamin reserve is less likely to heal from wounds, and infections, is less likely to cope with stress, and is much more vunerable to further illnesses.

2. In our modern world of processed, bleached, regurgitated and fast food products, much of the nutrient is gone before it reaches you table. Therefore, it is necessary to help in our vitamin requirements by taking supplements.

3. Lymphedema and the constant battle with infections and usage of antibiotics changes our vitamin requirements. Infections and antibiotics both can depelete vitamin reserves and it is necessary to take supplements.

Numbers, Types and Functions of Vitamins

There are 13 known vitamins and these are divided into two types.

Fat soluble - Vitamins that are absorbed and stored within our fat cells. It is importantto remember that you can overdose on these vitamins and the results can lead so serious toxic poisonings and conditions. In the case of fat soluble vitamins, more is not better.

Water soluble - Vitamins wherein your body uses what it needs for the moment and then flushes the remaining ones from your system via the urine. Inadequate intake of these also leads to complications and conditions.

Because of the above, I always recommend chelated or time-released vitamins. That way, your body is constantly getting the required vitamins throughout your day and you don't have to worry about to much or to little.

EXTERNAL LINKS FOR DIETS, WEIGHT AND NUTRITION

Lymphedema People pages on Vitamins, Nutrition

Articles from our Lymphedema Lifestyles Forum

Lymphedema People Pages on Exercises

Lymphedema Exercise Links

Beneficial Exercises for Lymphedema Lymphedema Today

Exercise, Lymphedema, and the Limb at Risk Bonnie B. Laninski, MA, PT, CLT-LANA

The Role of Exercise in Treating Lymphedema Rehab Management

Arm Elevation and Exercise Breast Cancer.org

Getting (and Staying) Aerobically Fit through Swimming! - Dr. Susan Harris, Phd. PT, School of Rehabilitation Sciences – UBC

Challenging the Myth of Exercise-Induced Lymphedema Dr. Susan R. Harris, PhD, PT, School of Rehabilitation Sciences - UBC /Abreast in the West

Light Arm Exercises That Can Help Prevent/Manage Lymphedema Imaginis

Exercise Links

the_lymphedema_diet.txt · Last modified: 2012/10/16 14:40 (external edit)