Lymphedema and Nutrition: Interview with Dr. Letizia Astrologo
When the lymphatic system malfunctions, the lymphatic circulation is impaired and lymph is no longer drained, accumulating in the tissues and limbs. This causes swelling, heaviness, persistent itching, oedema, pain, difficulty in movement and, in the most severe conditions, can cause recurrent infections. We are dealing with lymphedema, a very common condition that particularly affects women between the ages of 30 and 40. This pathological condition can be of a primary type and have congenital causes, or of a secondary type, due to pre-existing pathologies (cardiovascular, hepatic, diabetes) or to oncological treatment, particularly following the removal of lymph nodes or the treatment of breast cancer.
Nutrition can be a fundamental support in the course of treatment, whether conservative or surgical. We talked about this with Dr. Letizia Astrologo, nutrition biologist at UPMC Salvator Mundi International Hospital.
Dr. Astrologo, how does nutrition affect lymphedema?
Nutrition plays a crucial role in both the prevention and therapeutic management of lymphedema. Maintaining an adequate body weight is essential, as being overweight and obesity can slow down lymphatic circulation due to fat accumulation.
What kind of diet is recommended for lymphedema sufferers?
For those who suffer from lymphedema, it is essential to adopt a dietary regime aimed at avoiding excessive accumulation of lymphatic fluid and reducing the chronic inflammatory state of the cells. The diet should also help maintain stable blood sugar levels by acting on the patient's hormonal state.
A balanced diet, favouring fruit, vegetables and whole grains, but avoiding excess fibre that could inflame the colon. It is important to integrate proteins of high biological value, which help counteract tissue tearing. So white meat such as turkey, veal, rabbit and chicken, as well as fish, eggs and pulses. Fats should not be eliminated, but it is essential to balance them correctly. I am referring to the 'good' fats, the omega 3 and 6. It may also be advisable to supplement the diet with minerals and vitamins that promote cell development and collagen formation, such as vitamin A, vitamin C, vitamin D and zinc. Proper hydration should not be lacking, taking in at least 1.5-2 litres of water a day.
How do you recommend adjusting your carbohydrate consumption?
In order to maintain a proper balance of the hormones insulin and glucagon, which is essential to prevent lymph accumulation, it is crucial to regulate carbohydrate consumption. Carbohydrates can raise blood sugar and provoke an insulin response, it is important for lymphedema sufferers to moderate their intake. This does not mean that they should be eliminated from the diet, but they should be introduced in moderation and by selecting the most appropriate type, favouring complex and low-glycaemic-index carbohydrates. It is advisable to avoid sugary drinks, industrial foods, refined flours and sweets, while whole-grain pasta and rice as well as drinks and sweets without added sugar are welcome on the table.
Are there, on the other hand, foods that should absolutely be avoided?
It is good to limit salt consumption as it contributes to swelling in the limbs. Therefore, be careful with salt added for seasoning, but also with salt contained in certain foods such as sausages, snacks and packaged foods. As we have seen, it is best to avoid carbohydrates with a high glycaemic index, as well as to moderate consumption of red meat, sugary drinks and alcohol. Consumption of foods rich in histamine, such as canned fish and alcohol, should also be reduced in order to keep the intestinal barrier intact.
Dr. Astrologo, do you have any other advice for those suffering from this condition?
The first piece of advice is to consult a specialist to draw up a targeted diet plan that will help achieve and maintain an adequate body weight. A balanced diet with the characteristics already mentioned is certainly a great help for patients with lymphedema, which will improve not only the quality of the food, but also the overall dietary intake, which will also promote weight loss beneficial to lymphatic fluid stagnation.
One of the most effective diets in the treatment of lymphedema is the ketogenic diet, as it affects not only weight loss, but also the patient's inflammatory state and the maintenance of stable blood glucose levels, which are essential in the proper drainage of fluids. It should be emphasised that this diet is administered under the supervision of an expert nutritionist in order to avoid worsening of the clinical state and rebound of the weight lost.
Finally, regular physical activity, possibly monitored by an expert, can also contribute to the effectiveness of the treatment.