Lipedema, a chronic condition primarily affecting women, is characterized by the abnormal buildup of fat cells in the legs and arms. Often misdiagnosed as obesity or lymphedema, lipedema requires a multifaceted approach to management, with nutrition playing a pivotal role. While there is no consensus on the most effective nutritional approach, adopting specific dietary strategies can significantly alleviate symptoms, reduce inflammation, and improve overall quality of life.
Understanding Lipedema
Lipedema is a genetic disorder affecting adipose tissue mass and distribution. It is often inherited through X-linked dominant or autosomal dominant patterns. While hormonal factors, particularly elevated estrogen levels, may play a role in its onset, lipedema in males is rare but has been reported in individuals with liver disease or low testosterone levels.
The condition is characterized by symmetrical fat tissue deposition in the arms and legs, often with a clear demarcation line between the hands and feet (the cuff sign). Other common clinical features include pain, easy bruising, and orthostatic edema. Lipedema progresses through four stages, each with distinct structural skin changes and symptoms:
- Stage I: Smooth skin with small nodules and occasional pain.
- Stage II: Uneven skin with walnut-sized nodules, reversible or irreversible edema, and thickened perilobar fascia.
- Stage III: Thickened and indurated skin with disfiguring fat deposits and accompanying lymphedema.
- Stage IV: Lipedema acts in synergy with lymphedema, featuring large protruding portions of fat tissue on the legs and arms.
The Role of Nutrition in Lipedema Management
Nutrition is an essential part of lipedema self-care and treatment. While diet alone cannot cure lipedema, making informed dietary choices can have a substantial impact on general health and symptom management. The best diet for women with lipedema focuses on reducing swelling and inflammation, maintaining low insulin levels, and adhering to a low glycemic index.
Recommended Eating Pattern
The recommended eating pattern for individuals with lipedema involves consuming whole foods, mostly plants, including a wide variety of rainbow-colored vegetables and fruits, as well as fermented foods. It is crucial to avoid added sugars, refined grains, and chemically modified fats while limiting animal products and high-salt foods. Avoiding dairy (other than kefir and yogurt) appears to help with lipedema.
Read also: The Hoxsey Diet
Whole foods are best because most prepared foods contain added sugar, salt, soy, unhealthy fats, or undesirable additives. Juicing (other than green vegetable juices) is only recommended for those who cannot eat solid food because juicing breaks down fiber, removing an important nutritional and digestive health benefit. Fruit juices should be minimized because they raise blood glucose more rapidly than whole fruit.
Modify this eating pattern if you are vegetarian, vegan, gluten intolerant, have food allergies, diabetes, or other dietary concerns.
Foods to Include in Your Lipedema Diet
- Vegetables: Brightly colored vegetables such as dark green leafy vegetables, beets, corn, squash, peppers, onions, garlic, mushrooms, and herbs.
- Beans, Legumes, or Pulses: Adzuki beans, black beans, butter beans, cannellini beans, chickpeas, fava beans, great northern beans, kidney beans, lentils, lima beans, peas, navy beans, pinto beans, etc.
- Berries: Fresh or frozen blackberries, blueberries, cranberries, raspberries, strawberries, etc.
- Citrus Fruits: Grapefruit, orange, etc.
- Fruits: Apples, apricots, bananas, cherries, grapes, kiwi fruit, mangoes, melons, papaya, peaches, pears, pineapple, plums, etc.
- Potatoes: Smaller waxy potatoes such as new, red, purple, etc. Not starchy Russet or Idaho potatoes.
- Sweet Potatoes or Yams
- Grains (whole grains not containing gluten): Amaranth, brown rice, buckwheat, millet, oats, quinoa, sorghum, teff, and wild rice.
- Fermented Foods: Kefir and yogurt with active cultures, sauerkraut, dill or sour pickles (subject to salt limits), kimchi, etc.
- Soy: Minimally processed or fermented soybeans/edamame), tofu, miso, natto, tempeh.
- Milks: Unsweetened non-dairy milk drinks such as almond milk, coconut milk, or hemp milk.
- Coffee, tea: Black, green, herbal, red, white, unsweetened cocoa or cacao.
- Omega-3 Rich Foods: Omega-3 fatty acids are anti-inflammatory, which may help with lipedema symptoms. Include fish like tuna, wild salmon, mackerel, herring, sardines, and anchovies.
Foods to Limit
- Brazil nuts: Limit to 1 ounce or 6 nuts purchased shelled, or 3 nuts purchased unshelled per day, OR take a selenium supplement, not both.
- Chocolate: Dark chocolate with 70% or more cacao.
- Dairy: Preferably organic, not recommended for lipedema: butter or ghee, cheeses (not processed cheeses or cheese spreads), goat’s milk cheese goat cheese), sheep’s milk cheese, milk.
- Eggs: Including yolks, preferably organic, pastured or free-range
- Meats: Preferably organic grass-fed beef, buffalo, lamb, pork, wild game.
- Poultry: Preferably organic chicken (without skin), turkey, duck including dark meat.
- Nuts and seeds: Raw and unsalted almonds, cashews, hazelnuts, macadamia nuts, pecans, pistachios, pumpkin seeds, sesame seeds, sunflower seeds, walnuts.
- Oils: Extra-virgin olive, avocado, walnut, coconut, cocoa butter, flaxseed, macadamia, sesame oil.
- Salad dressing: Products containing healthy fats and modest amounts of sodium or sweeteners.
- Sugar and real maple syrup
- Condiments: Chili, hot sauce, or pepper sauce, horseradish, mustard, salsa, tamari soy sauce, tapenade, vinegar (white, red wine, apple cider, balsamic), Worcestershire sauce, etc.
- Dried fruits: Cranberries (low sugar), currants, dates, figs, prunes, raisins.
- Wine: Preferably red, no more than 3 servings (5 ounces or 150 ml)/week.
Foods to Avoid or Eat Rarely
- Grain products containing gluten: Wheat, barley or rye: breads, breakfast cereals, bulgur, cakes, cookies, couscous, crackers, cupcakes, kamut, noodles, pancakes, pasta, pies, pita, pizza, triticale, waffles, etc.
- Gluten-free food substitutes: Breads, pasta, pizza, baked goods, etc. made with cornstarch, potato starch, rice starch, tapioca starch, etc.
- Fried foods and food products: Chips, crisps, fries, etc.
- Meat: Processed or preserved using nitrates, nitrites, or salt (such as hot dogs or lunch meats), cooked at high temperatures, or over a flame.
- Meat substitutes: Made from gluten, seitan, or highly processed soy.
- Soy-based processed foods: Infant formula, soymilk, etc.
- Sugary snacks: Candies, energy bars, fruit roll-ups, ice cream, sherbet, etc.
- Sugary sweeteners: Agave syrup or nectar, high-fructose corn syrup, honey, and artificial sweeteners.
- Sweet condiments: Chutney, jams, jellies, preserves, sauces, syrups, etc.
- Sweet drinks: Sugar sweetened and diet (artificially sweetened): sodas, soft drinks, teas and tea-based beverages, coffee and coffee-based beverages, energy drinks, fruit drinks (especially 100% fruit drinks), etc.
- Unhealthy fats: Hydrogenated oils (palm, palm kernel), polyunsaturated oils (corn, cottonseed, grape seed, safflower, soybean, sunflower), trans-fats, and chemically modified fats.
- High-Sodium Foods: Excess salt can cause water retention, aggravating the swelling in lipedema.
- Alcohol: Drinking too much alcohol can dehydrate the body, increase inflammation, and affect the lymphatic system.
- Processed and refined foods: Consuming refined sugars, white flour, and unhealthy fats can cause inflammation and weight gain.
Specific Dietary Approaches for Lipedema
The Rare Adipose Disorder (RAD) Diet
The Rare Adipose Disorder (RAD) diet is a modification to a standard Mediterranean diet that helps maintain a low glycemic index to limit blood sugar spikes. This diet emphasizes avoiding refined or processed starches and sugars, commonly found in pasta, rice, bread, corn, and potatoes.
Anti-Inflammatory Diet
Given that lipedema can coexist with chronic low-grade inflammation, adopting an anti-inflammatory diet can be beneficial. This involves consuming foods that combat inflammation, such as omega-3 fatty acids, colorful fruits and vegetables, and anti-inflammatory spices like turmeric, ginger, and garlic.
Ketogenic Diet (KD)
Scientific evidence supports the use of a ketogenic diet for managing lipedema. A ketogenic diet involves limiting carbohydrate intake to less than 25 grams per day, maintaining an even ratio of proteins to fats, having a high intake of vegetables, and minimizing sugar intake. VLCKD has been shown to reduce inflammation more significantly than the others.
Read also: Walnut Keto Guide
Low-Carbohydrate Diet (LCD)
A study published in Obesity evaluated the effects of a low-carbohydrate diet (LCD) on pain and quality of life in women with lipedema. The results showed that the LCD group experienced greater weight loss and reduced pain, though there was no direct link between pain reduction and weight loss.
The Mind-Body Connection
Living with lipedema involves more than just dietary changes. The mind-body connection is a crucial part of symptom management. Consider the impact of your mental outlook, physical status, and overall well-being.
Additional Supplements
Alongside dietary modifications, certain vitamin supplements may be beneficial for individuals with lipedema:
- Vitamin D3: Lipedema patients are often deficient in Vitamin D, an essential supplement that plays a critical role in the immune system and helps with bone, muscle, and nervous system health.
- Selenium: A supplement that can aid with daily metabolism and help reduce lipedema swelling.
- Diosmin: A bioflavonoid commonly found in citrus fruits that has been shown to improve leg edema or swelling and decrease leg circumference.
Monitoring Progress and Seeking Professional Guidance
During nutritional treatment, it is essential to monitor anthropometric parameters such as weight and circumferences, as well as derived indices and ratios such as BMI and WHR. A complete nutritional follow-up includes the combination of anthropometric measurements with other techniques licensed for the assessment of body composition, including dual-energy x-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA).
It is crucial to work with a doctor or nutritionist to choose a dietary pattern that fits your needs and preferences. Always contact a healthcare expert before making large dietary changes, especially if you have any underlying health concerns.
Read also: Weight Loss with Low-FODMAP
Sample Meal Ideas
Breakfast
- Add something different to a slice of toasted, whole-wheat bread each day, so you’re following the plan but mixing it up enough that it doesn’t get boring!
- Oatmeal with berries and nuts
- Kefir or yogurt with fruit and a sprinkle of seeds
Lunch
- Try keeping lunch to different versions of a salad. The more colorful, the better!
- Salad with grilled chicken or fish
- Lentil soup with a side of vegetables
Dinner
- Baked salmon with roasted vegetables
- Chicken stir-fry with brown rice and plenty of vegetables
- Tofu and vegetable curry with quinoa