The benefits of a balanced diet
Nutrition and health typically go hand in hand. This article is an overview
of how to maintain good health and how diet can impact lymphedema.
As an oncology dietitian, I often see how a water tends to follow salt. Thus, excess salt Learn how much sodium is in the
cancer diagnosis leaves people with a lost
intake can cause water to be drawn into blood
sense of control. The risk, development and
vessels increasing pressure on arterial walls,
progression of lymphedema can also leave
worsening swelling. In addition, high sodium
those afflicted feeling helpless. The good news
foods are generally more processed, devoid of
is that there are several researched dietary
nutrients and less healthy.
factors that may modify the risk and progres-
sion of lymphedema, such as fluid, protein and Sodium requirements
sodium intake, anti-inflammatory dietary pat-
terns, immune boosting foods, weight history
How much salt should
and current body mass index (BMI).
we be eating?
Assuming we are not losing excess
How does lymphedema manifest?
salt through sweating, vomiting,
Lymphedema manifests in many ways that
can affect a person's nutrition and overall health. Some symptoms of lymphedema may
Pick the foods that are naturally
impact one's ability to carry out tasks related
2 In tablespoons?
high in sodium
(choose all that apply):
to food preparation. For example, pain may
limit the ability to independently shop for gro-
ANSWER: Health Canada recommends
ceries or carry and unpack bulky food items.
eating between 1500 and 2300mg of
Leg lymphedema may be made worse by
salt daily. Canadians eat an estimated
standing in one place for long periods of time
3400mg daily. Sodium intake above
to chop and prepare food or upper extremity
2300 mg per day is likely to pose a
compression garments such as gloves or
health risk. 1500 mg salt is ¾ teaspoon
gauntlets may interfere with food preparation.
and 2300 is 1 teaspoon. Studies show that most sodium intake is through the
Nutritional interventions: sodium
salt in processed foods as opposed to
ANSWER: all of the above!
added table salt.
Surprisingly, there is not much research that
directly links sodium to lymphedema. How-
ever, we do know that in the human body,
Strategies to decreasing
Dramatically cutting out salt in the diet will
Hillary Sachs MS, RD, CSO, CDN
is a board certified oncology dietitian
generally result in less palatable foods.
working in an outpatient chemotherapy center and as an oncology nutrition
However, taste buds adapt to the taste of less
education consultant for Meals to Heal, a USA-based company dedicated to
salt over time. To increase compliance, it is
providing healthy meals, trusted information and access to oncology nutrition
recommended to reduce total daily salt intake
professionals. She uses evidenced based information to help patients minimize
by ¼ tsp or 600mg at a time until optimal
treatment related side effects and to guide survivors towards health and wellness.
daily intake levels are reached.
should be consuming (EXAMPLE – a 120
Strategies to help reduce sodium intake
pound woman would need 60 ounces (7.5 glasses) of water per day
3 Eat more fresh, single ingredient foods
Provide 1 mL of fluid for every calorie
3 Eat more homemade foods
3 Buy fresh/frozen meat with no added sodium
Provide 25mL of water for every kg of
3 Buy whole grain rice/pasta without seasonings; add your own3 Make your own soups; use onion, carrots and celery for flavor
What counts as fluids?
3 Replace salt in recipes with other herbs and spices
3 Rinse canned foods
Apple 84Banana 74
Fluid needs and frequently
Lymph fluid contains a large amount of
Do caffeinated beverages count towards
protein in the form of albumin so it is not
surprising that people assume that REDUCING
Drinking caffeine has a mild diuretic effect
protein intake may DECREASE lymph fluid.
(may cause the need to urinate), but studies
However, this is NOT the case. In fact, optimal show that caffeine does NOT cause excessive
protein intake is necessary to help repair skin
fluid losses or dehydration. Nevertheless,
and keep connective tissue strong. Moreover,
it is important to balance caffeinated and
it is important to replenish protein stores
non-caffeinated drinks throughout the day.
since some protein is lost in the fluid.
What are my fluid needs?
Jell-O 93Broccoli 91
Protein needs in lymphedema
In general, fluid requirements are based
Protein requirements for the average, healthy
upon a person's weight. Assuming that a
person with lymphedema are generally:
person is not losing excess fluids (through
100 lb person needs about 45-55 grams sweat, vomiting, diarrhea, etc.), fluid needs
of protein per day
can be calculated as such:
125 lb person needs about 57-68 grams •
The National Cancer Institute suggests
150 lb person needs 68-82 grams
consuming 8–12, 8 oz cups of fluids
175 lb person needs about 80-95 grams
Divide a person's pound weight in half:
Protein needs increase with:
that is how many ounces per day they
increased activity level from moderate
Protein content of foods
o open sores/pressure ulcers
One function of the lymph system is to circu-
o during active treatment
late dietary fat. Some studies show that limit-
ing calories from fat to 15-20% of our overall
Beans, cooked ½ cup
intake (rather than the typical 25-35%), may
improve lymphedema symptoms. In addition,
There is no direct correlation between fluid
certain kinds of fats are not primarily trans-
intake and fluid retention. However, adequate
ported through the lymph system. These fats
fluid intake is critical for overall health and
are called medium chain triglycerides (MCTs).
wellness. Fluids play a role in detoxification,
Studies have shown that consuming these
both in helping with bowel movements,
kinds of fats may decrease lymphedema
urination, maintaining temperature via
symptoms. Coconut oil is one example of a
fat that contains a large percentage of MCTs.
Obesity and lymphedema
weight loss. This approach helps to maintain
Most studies show there is a direct relation-
the emphasis on nutrient rich, anti-inflam-
Immune boosting foods
ship between people who are overweight
matory dietary patterns. Working with a
or obese and incidence of lymphedema.
registered dietitian can also help efforts.
Fermented foods (yoghurt, kefir, etc.)
While the exact mechanism is not fully
Zinc rich foods (wheat germ, spinach)
understood, excess weight creates more
Selenium rich foods
work for the lymphatic system. The
Anti-inflammatory foods, immune
(sunflower seeds, brazil nuts)
additional fat deposition creates deeper
boosting foods, dietary supplements
Ginger, garlic, onions
separations in the lymphatic channels.
Currently there are no direct studies linking
• Researchers have learned that adipose
specific dietary patterns to lymphedema.
Broad spectrum of phytonutrients
(fat) tissue is not inactive. It is constantly
However, with the understanding that there
from fruits and vegetables
secreting hormones and markers of
is a relationship between lymphedema,
inflammation. This inflammation can
the immune system and inflammation,
worsen lymphedema symptoms.
future studies may find that key foods will
Overall, most evidence supports the following
• In addition, excess weight leads to
help patients to decrease edema volume,
decreased mobility, likely decreasing
reduce abnormal blood vessel growth
having no more than 2300 mg salt daily
the ability to exercise.
and improve immunity (see chart for a
consuming appropriate intake of
There are several strategies for weight
list of foods). It is essential to evaluate
management. Focusing on less processed
patients for adequate intakes of key
whole foods with simple and recognizable
nutrients, especially those that promote
ingredient lists is a healthy way to approach
tissue healing like zinc and vitamin C.
n 45-55% carbohydrate
Striving towards and/or maintaining a normal body weight by following Canada's Food
Guide and eating a broad spectrum of fruits
and vegetables will benefit not only people
living with lymphedema, but everyone. LP
References are available at www.lymphedemapathways.ca.
Calgary • October 23 - 24, 2015
Co-hosted by the
Canadian Lymphedema Framework and the
Alberta Lymphedema Association in collaboration with the
University of Calgary.
Abstract Early-bird Hotel
Abstract Early-bird Hotel
The Mouse, Rat and Guinea-Pig Rodents are a very successful order of placental mammals which colonise almost all habitats. All members of the order are small, the largest member, the Capybara, being about the size of a small pig. Rodents have a number of distinguishing features: they have open rooted sharp teeth, hindgut microbial fermentation chambers, and are coprophagic. Rodents can be divided into three suborders, the Myomorpha, Hystricomorpha and Sciuromorpha. Most laboratory rodents are Myomorphs or Hystricomorphs.
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