What is Lymphedema?
Lymphedema is a dysfunction of the lymphatic system that causes the accumulation of lymph fluid in tissues, causing body parts to swell and increase in size.
Lymphedema swelling comes in all kinds of shapes and sizes and in the most severe cases, it can be debilitating. Add to that, there are TWO types of lymphedema—as if one wasn’t sufficient. Patients can have primary, i.e., congenital, or be born with it. The disease can also be acquired after cancer treatment (radiation therapy). The latter is commonly referred to as secondary or acquired lymphedema.
There is yet another category: obesity-related lymphedema. Excess weight exerts pressure on lymphatic vessels and can cause them to atrophy. Lymph fluid will build up and spill into tissues, causing further damage. Inflammation caused by obesity also affects the fragile lymphatic cells. The patient may not notice the swelling in the leg until they experience pain, oozing, and reduced mobility.
In this article, I will not discuss the treatment modalities or how to manage the disease (compression, bandaging, surgery, etc). The purpose of this post is to discuss what else you can do to help your body evacuate the lymph more efficiently in the hope of reducing swelling or toxicity to your tissues. We will look at nutrition, hydration, and exercise. These three components can assist you in the management of the disease from the inside. You will still need to continue with compression and other tools recommended by your healthcare professional—if you’re lucky enough to have one.
As it’s true for everyone, it’s even more crucial for lymphedema patients to maintain a healthy body weight. If you are overweight, lymphedema is much harder to manage and treat. It’s essential that you make weight loss your top priority.
Tip ONE: Lymphedema and Nutrition.
Nutrition plays a significant role in overall health for everyone. Observing an anti-inflammatory diet, eating enough of the right protein (plant-based vs. animal protein sources), lowering saturated fat intake, and avoiding UPF (see my previous post about ultra-processed food), will not only help you manage this disease but will also enhance your wellness and prevent other health complications that will make lymphedema even more difficult to manage.
- Portions. Let’s start with portion control. If you have to worry about portions when eating, that’s a sign you are eating the wrong foods. Proper nutrition is not about portion control, calorie counting, or eliminating carbs. Nourishment is a result of a balance between micronutrients and macronutrients. Your meals should have one macronutrient, either a carbohydrate or a protein, and several parts of non-starchy vegetables. These are sources of micronutrients and fiber and are very low in calories. You may download my MicroRiche-Diet, which explains in detail how to compose a balanced meal rich in nutrients and anti-inflammatory ingredients. Once you understand how to compose a healthy meal, you can eat as much as you want while being well nourished, lose weight, and the best part of all, keep joy in eating. Eating without pleasure will not lead to a healthy lifestyle.
- Inflammation. I have read many online posts of people proudly listing the ingredients in their anti-inflammatory diet. They include eggs, chicken, low-fat meat, and low-fat dairy. But they have eliminated all carbs and sugar. So instead of telling you about the components of an anti-inflammatory diet, I want to make sure we’re clear on what foods cause inflammation.
- Eggs. are an inflammatory food. They are a source of cholesterol and saturated fat. This information is accurate and has never changed. But the FDA, influenced by food industry lobbyists, is constantly trying to change that information and spread confusion in consumers’ minds. Just look at the nutritional content of an egg: protein, saturated fat, and cholesterol. That is all you need to know.
- Chicken is high in arachidonic acid. A type of fat that makes your cell membranes rigid, leading to inflammation. Chicken is also high in cholesterol.
- UPF. Another cause of inflammation is highly processed food, otherwise known as UPF. These foods are energy-dense but nutrient-poor. The additives are toxic. They not only cause inflammation but also interfere with the functions of your glands, leading to insulin resistance, thyroid disruption, and digestive problems, followed by weight gain.
- Dairy. I could talk about the myths and misconceptions of dairy products for days. To make matters worse, the USDA food pyramid (created with the input of the dairy industry) includes a glass of milk. Many people purposely add so-called low-fat cheese to their diet for fear of missing out on calcium or protein. There is no such thing as low-fat cheese. Fat content of cheese varies from one cheese to another. But all cheese is made with saturated fat. That’s a fact and cannot be changed, regardless of how much pseudoscience lobbyists try to inject into people’s consciousness. You see, they don’t have to be right. All they need to do is plant a seed of doubt and keep people confused. What about probiotics and calcium, you may ask?
- Yogurt. As a nutritionist, I hear this almost from every patient: “I eat yogurt to get the probiotics.” The dairy industry will have you believe, through many ad campaigns, that yogurt has calcium and probiotics. Doctors, due to misleading, outdated education, also recommend yogurt for probiotics. Who can argue with the almighty doctor! However, science is now clear and definite. Recommending yogurt for probiotics is misleading, wrong, and harmful to the consumer. But if you insist, we can look at the probiotics in yogurt. There is one or two strains of probiotics in yogurt, lactobacillus and sometimes bifidus, which is always added. Lactobacillus is found abundantly in the digestive tract. Consuming more will increase this population and create a gut flora imbalance. But this never happens, even when people consume yogurt regularly. This is because many of these bacteria die before they reach your fridge, and the remaining die during digestion. So the amount you get is too small to cause any trouble or make a difference in your digestive health. A more serious issue with yogurt is the milk protein, casein, present in all cow milk products. Dairy consumption can trigger an allergic reaction that will release mucus in the throat, cause constipation, diarrhea, bloating, and abdominal discomfort.
- Calcium. Another misconception is that dairy is a source of calcium. While it’s true that cow milk has calcium, it doesn’t benefit humans because we don’t process it the same way as a baby animal. One of my patients is from France and has eaten cheese and yogurt all her life. She suffers from bloating and constipation, and at the age of 55, she was diagnosed with advanced osteoporosis.
- Refined Sugar. Finally, we need to discuss refined sugar. If you are new to this term, this is highly processed flour and sugar in desserts, crackers, candy bars, snack foods such as chips, flavored popcorn, sugary beverages, salad dressings, Asian-style dressings, and Starbucks special coffees. A These beverages are addictive due to their high sugar and dairy content. A regular Caramel Frappuccino packs 380 calories. A Chipotle vegan bowl: rice, beans, fajita veggies, lettuce, and salsa amounts to around 530 calories. Another source of refined sugar is cereal. I was surprised to find that a lot of adults still eat the cereal they ate as children: frosted corn flakes, honey-sweetened Cheerios, and other sweetened varieties. When buying cereal, choose a whole grain one that has no sugar and no additives. Vitamin E should be the only preservative. Refined sugar contributes to weight gain, increases triglycerides, and most refined sugar treats contain additives that are toxic to the digestive system and, in accumulation, can cause hormone disruption (insulin resistance, thyroid problems, appetite regulation hormones, etc.)
Tip TWO: Hydration
I talk extensively about hydration because water is essential to all our bodily functions. Poor hydration leads to joint pain, shoulder pain, dry eyes, dry skin, and can trigger other health problems. For lymphedema patients, dehydration can be disastrous. Lymph fluid is 95% water. During dehydration, all fluids in the body decrease, reducing the amount of water available to the lymphatic system. The lymph fluid will then thicken, creating congestion. Proteins, fats, and toxic waste products cannot be transported and instead form into a hardened mass called fibrosis. Fibrosis damages tissues and helps further disease progression.
It is recommended that we drink 2 liters of water a day. Drinking more than that is unnecessary. Drinking excessively can have adverse effects. Too much water dilutes the electrolytes, leading to lightheadedness, dizziness, vomiting, and muscular cramps. At the risk of sounding trite, please drink responsibly.
Tip THREE: Movement
Exercise is one of your best tools when dealing with lymphedema. Swelling reduces flexibility and decreases movement, leading to muscle atrophy. Moving and keeping the muscle challenged will preserve and increase strength. The Memorial Sloan Kettering Cancer Institute recommends decongestive exercises for those who are very swollen. There are countless YouTube videos presented by physical therapists and fitness trainers that can assist you in everyday exercises. If you are very stiff, you may consult a physical therapist to get you started safely.
For those who are not very swollen, walking, swimming, yoga, and any low-impact exercises can be therapeutic in the management of lymphedema. But please do not neglect exercise, it’s the only way to preserve function, mobility, and keep you independent without having to rely on tools (walker, cane, wheelchair) or another person.
Here are a few resources you can use to get you started with gentle exercise at home and if you need further guidance, give me a holler. Would love to hear from you.