Nutrition and Diet Page

Just a quickie note to pass on a link to another nutritional information page for lymphedema:

Nutrition and Diet

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Lymphedema and vitamins

Lymphedema and vitamins

**Editor's note: This is an interesting article, even though it dates back to 1971.  Written by the Földi clinic, so thought it worth sharing.** 

Ethel Földi-Borcsok and M. Földi - Lymphödem

In 1971, the unexpected fact has been described (1) that surgically induced acute experimental lymphedema in the rat flourished with the usual laboratory diet rich in
vitamins, can be treated successfully by the administration of various vitamins, e.g., pyndoxine, pantothenic acid, and particularly, a highly active representative of the vitamin P family,2 coumarin (5 , 6-benzo-a-pyron). These data, obtained by means of plethysmographic assessment of the volume of lymphedema, were confirmed by histology.

Based on these results, the question has to be raised whether an inadequate supplying of the organism with vitamins would aggravate lymphedema. After having obtained an affirmative answer to this question, therapeutic trials were performed in avitaminotic
lymphedematous animals. 

Material and methods

Experiments were performed in 150 male Wistar rats (body weights given in Fig. 1). The animals were divided into three groups.

Group 1

Group 1 comprised rats fed ad libitum an artificial diet rich in vitamins (Table 1). On the 56th day, these animals were divided into five subgroups. 

Subgroup 1.1 (n = 10). From the 56th to the 63rd day, the rats were given daily ip injections of saline, 10 mI/kg body wt. On the 60th day, the rats were anesthetized with nembutal (50 mg/kg ip). Preoperative volume of the neck and head was measured by electronic plethysmography by means of the apparatus constructed by Bundschuh (Griesheim, W. Germany). This was followed by a radical cervical lymphatic blockage. From a midline incision reaching from the mandibula to the sternum, lymph nodes were carefully prepared and
ligated. Plethysmographic measurements were repeated on the 63rd day.

Subgroup 1.2 (n = 10). In this subgroup, the procedure was the same as in subgroup 1.1, with
just one difference. Instead of saline, the rats were treated with the following vitamins in milligrams per kilogram body weight: vitamin B1, 40; lactoflavin, 23; niamid, 160; pyridoxine, 16; pantothenic acid, 240; biotin, 2 and cyanocobalamin, 80 pg/kg body weight.

Subgroup 1.3 (n 10). Procedure was the same as in subgroups 1.1 and 1.2 with one difference; i.e., the animals were treated with 25 mg/kg coumarin
(5 , 6-benzo-alpha-pyron). Subgroup 1.4 (,z 10). Procedure differed from that used in subgroups 1.1, 1.2, and 1.3 in one respect; the rats were treated with 500 mg/kg tnhydroxy-ethyl-rutin. Subgroup 1.5 (n 10). In this subgroup, the same procedure was followed as with subgroup 1.1 except that instead of a cervical lymphatic blockage, only a sham operation was performed.

Group 2

Rats were fed a diet (ad libitum) that was poor in B-complex vitamins (Table 1). On the 35th day, the rats were divided into five subgroups. (This day was chosen instead of the 56th because vitamin B deficiency was already marked and the state of the rats deteriorated rapidly.)

Subgroup 2.1 (n 10). From the 35th to the 42nd day, the rats were given daily ip injections of saline. On the 39th day, they were treated as those in subgroup 1 . 1 . Plethysmographic measurements were repeated on the 42nd day. Subgroup 2.2 (n 10). In this subgroup, procedure was the same as in subgroup 2.1, with one exception. Instead of saline, the rats were treated with the same vitamins as those in subgroup 1.2. Subgroup 2.3 (n 10). The rats in this group were treated with coumarin; otherwise the procedure was the same as in subgroup 2.1 and 2.2.

Subgroup 2.4 (n = 10). Our procedure differed from that used in subgroups 2.1, 2.2, and 2.3 in one respect, these rats were treated with trihydroxyethyl-rutin. Subgroup 2.5 (n = 10). In this subgroup, the procedure was the same as in subgroup 2.1 except that instead of a lymphatic blockage, only a sham operation was performed.

Group 3

Rats in this group were fed the Sherman-LaMerCampbell diet (4), free of vitamin P but supplemented with ascorbic acid (Table 1). This group..... 

Complete Text with charts:

American Journal of Clinical Nutrition

Nutrition and Lymphedema

Nutrition and Lymphedema

Patients affected by lymphedema should try their best to achieve and maintain a reasonable weight in order to reduce the risk factors associated with obesity. 

Is there a Lymphedema Diet?

No, there is no special diet for lymphedema. Patients affected by lymphedema, just like everybody else, should trust their own judgment when it comes to the selection of of a proper diet. If there are no other medical conditions present, such as diabetes or heart disease, a healthy and balanced diet should be the goal.

An accepted approach in lymphedema management is to follow a low-salt and low-fat diet, which also positively contributes to weight management. A balanced healthy diet including whole grains, fish, fruits and vegetables and avoiding fatty foods, or those with high cholesterol will greatly reduce risk factors associated with lymphedema.

Many patients are under the impression that lymphedema may be positively affected by limiting the protein intake. This is not the case – although lymphedema is defined as an accumulation of water and protein in the tissues, it is essential to understand that lymphedema cannot be reduced by the limitation of protein ingestion. It is also important not to limit fluid intake in an attempt to reduce the swelling. Good hydration (water) is essential for basic cell function and especially important before and after lymphedema treatment to assist the body in eliminating waste products.

Read the full text of this excellent article:

Lymphedema Today

A randomized controlled trial of weight reduction as a treatment for breast cancer-related lymphedema.

2007

Shaw C, Mortimer P, Judd PA.

Source

Department of Nutrition and Dietetics, Royal Marsden National Health Service Foundation Trust, London, United Kingdom. clare.shaw@rhs.uk

Abstract

BACKGROUND:

Obesity is considered a risk factor for the development of breast cancer-related lymphedema of the arm and as a poor prognostic factor in response to lymphedema treatment. The objective of this study was to examine weight reduction as a treatment for breast cancer-related lymphedema.

METHODS:

Twenty-one women with breast cancer-related lymphedema were randomized either to receive dietary advice for weight reduction or to receive a booklet on general healthy eating. They were monitored for 12 weeks.

RESULTS:

The primary outcome measure was arm volume at 12 weeks. The results indicated a significant reduction in swollen arm volume at the end of the 12-week period (P = .003) in the intervention weight-reduction group. There was a significant reduction in body weight (P = .02) and body mass index (P = .016) in the weight-reduction group at the end of the 12-week study period.

CONCLUSIONS:

Weight loss achieved by dietary advice to reduce energy intake can reduce breast cancer-relatedlymphedema significantly.

Wiley OnLine

National Nutrition Month

National Nutrition Month: All About Eating Healthy

March 12

March is National Nutrition Month, and all Americans are encouraged to take a look at

their eating habits and make any changes necessary in order to ensure that one is eating healthy. The theme of the observance encourages everyone to eat the recommended amounts of fruits, vegetables, grains, protein foods, and dairy.

One thing that National Nutrition Month may address is childhood obesity, something that has been described countless times as an epidemic in the United States.

Information and awareness on proper nutrition and eating habits may help today’s kids eat healthy while they are still young, a thought that Linda Minges, a North Carolina Cooperative Extension Service Family and Consumer Science Agent, advocates.

Minges shared: “Develop healthy habits at an early age when children are a sponge… that prevention can go a long way with overall health.” She teaches a program to 4- and 5-year-old children called “Color Me Healthy,” which teaches children about healthy eating and being active through sight, touch, and sound.

Among its activities is getting to children to try new foods, one of the steps that they have to take in their journey towards a healthier lifestyle. Minges shares the following tips with parents who would like to get their children to eat healthy but still unfamiliar foods: start with smaller portion sizes, and add more fun to fruit and vegetable servings by adding herbs and spices. Minges also suggests encouraging children to engage in outside play, in order to stay active.

Testcountry.com

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.

A Diet for Lymphedema

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.

The Importance 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. Our following articles that will help in understanding what a healhy diet is and the basic foods groups that contribute to that diet and help in managing lymhpedema.