Ial.org.il

Nutrition Considerations
in Lymphedema
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.
Sodium Detector
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 Source: http://hc-sc.gc.ca/fn-an/nutrition/ directly links sodium to lymphedema. How- ever, we do know that in the human body, Strategies to decreasing
sodium intake
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 Nutritional interventions:
Fluid needs and frequently
protein intake
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
Lettuce (Iceberg) • 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
Nutritional interventions:
o open sores/pressure ulcers dietary fats
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 Nutritional interventions:
Beans, cooked ½ cup intake (rather than the typical 25-35%), may fluid intake
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 perspiration, etc. 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, nutritional recommendations: 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 macronutrients, approximately: 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.
National L
Calgary • October 23 - 24, 2015
Co-hosted by the Canadian Lymphedema Framework and the Alberta Lymphedema Association in collaboration with the University of Calgary.
Conference
Abstract Early-bird Hotel Deadlines:
September 21
Conference
Abstract Early-bird Hotel Deadlines:
September 21

Source: http://www.ial.org.il/asp/documents/Nutrition%20Considerations%20in%20Lymphedema%20-%20H.Sachs.pdf