Providing Lymphedema Care
General Nutrition Guidelines for the Patient with Lymphedema
Good nutrition is important for overall health, weight management, and in the prevention of chronic diseases. Nutrition is also equally important for people who suffer from lymphedema, the primary symptoms include swelling, tenderness, excessive dryness and staining of the skin, all of which can be reduced through proper nutrition and exercise.
Eating Right: Where to Start
A healthy diet and weight for those with lymphedema begins with eating right. This includes consuming well-balanced meals consisting of lean meats, beans, lower fat dairy, fruit, vegetables, and whole grains. Each of these is important in providing adequate nutrition and balance. It is also important to consume the right amount of calories and incorporating a variety of whole foods, rather than highly processed foods which tend to contain less healthy ingredients and higher calories. Portion control is also critical in achieving and maintaining a healthy weight. The average adult portion size found in most restaurants is 2-3 times the amount that it should be. If hunger is a problem, aim to consume frequent low calorie, filling snacks throughout the day, such as a few almonds or a piece of low-fat cheese, and drink a tall glass of water before meals in order to fill up and avoid overeating. Although there is no recommended diet for lymphedema, making nutritional choices that maintain the body’s overall fluid balance may help.
Surprisingly, there is not much research that directly links sodium to lymphedema, however, we do know that in the human body, water tends to follow salt. Thus, excess salt intake can cause water to be drawn into the blood vessels, increasing pressure on arterial walls therefore, increasing filtration through the blood capillaries which worsens swelling (edema). In addition, high sodium foods are generally more processed, devoid of nutrients, and less healthy. The following are just a few common foods naturally high in sodium:
- Sauces / Salad Dressings
- Deli Meats, Shellfish
- Canned Entrees
- Strategies to Decrease Sodium Intake
Dramatically cutting out salt in the diet will generally result in less palatable foods. However, taste buds adapt to the taste of less salt over time. To increase compliance, it is recommended to reduce total daily salt intake by 1/4 tsp or 600mg at a time until optimal daily intake levels are reached.
The following are a few ways to help reduce sodium intake:
- Eat more fresh, single ingredient foods
- Eat more homemade foods
- Buy fresh/frozen meat with no added sodium
- Buy whole grain rice/pasta plain without seasonings and add your own
- Make soups on your own; use extra onion, carrot, and celery for flavor
- Replace salt in recipes with other herbs and spices
- Rinse canned foods
Lymph fluid contains a large amount of protein in the form of albumin, so it is not surprising that people assume REDUCING protein intake may DECREASE lymph fluid. However, this is NOT the case. In fact, optimal protein intake is necessary to help repair skin and keep connective tissue strong. Moreover, it is important to replenish protein stores since some protein is lost in the fluid.
The following are just a few common foods naturally high in protein:
- Lean Chicken
- Low Fat Cheese
- Lean Beef and Veal (low fat)
When Protein Needs Increased
- Sores, Wounds
- During active treatment
- Increased activity level from moderate to vigorous
- Muscle Wasting
There is no direct correlation between fluid intake and fluid retention. However, adequate fluid intake is critical for overall health and wellness. Fluids play a role in detoxification, helping with bowel movement, urination, maintaining temperature via perspiration, etc. The National Cancer Institute suggests consuming 8-12 cups of fluid per day. Avoid alcoholic beverages
One function of the lymphatic system is to absorb fat. Some studies show that limiting calories from fat 15%-20% of our overall intake may improve lymphedema symptoms. In addition, certain kinds of fat are not primarily transported through the lymphatic system and aid in the actual digestion of fat. These fats are called Medium Chain Triglycerides (MCTs) that are partially man made. Studies have shown that consuming these kinds of fats may decrease lymphedema symptoms. Coconut oil and palm kernel oil are examples of a fat that contains a large percentage of MCTs.