Some notes on Diet and Lymphoedema
Why is diet important?
There is an old saying 'You are what you eat' and to a certain
extent that is true. It should perhaps be extended to include the
effect that the food you eat can influence the way in which the body
works. Food provides the body with nutrients that have various
functions, for example:
• Protein for muscles and tissue function
• Energy for providing warmth and for activity
• Minerals for structure such as calcium and phosphate for bones
• Vitamins for chemical reactions within the body
There has also been a lot of interest more recently about compounds
in foods that are not vitamins or minerals but may influence the way
in which cells in the body work. For example, these may be called
bioactive compounds and include substances, particularly in fruit
and vegetables, that may help protect the body against some
diseases.
Does weight have links with Lymphoedema?
Being overweight has been identified as a possible risk factor for
the development of lymphoedema with most of the studies that
indicate this being in breast cancer patients. There are fewer
studies that mention weight and leg lymphoedema but it is possible
that body weight may also affect this in a similar way. This
possible rela¬tionship does not of course apply to everyone - you do
not have to be overweight to have lymphoedema.
How would body weight influence lymphoedema?
The answer is that we are not completely sure. It may be that extra
fat holds water under the skin, but it may also be that extra weight
may act in another way such as affecting the flow of lymph through
the lymphatics.
Would altering diet help lymphoedema?
A number of years ago we undertook two studies here at The Royal
Marsden Hospital in overweight breast cancer patients with arm
lymphoedema. In fact some of you reading this article may have been
kind enough to volunteer to take part in the study. The first study
looked at allocating breast cancer patients with lymphoe¬dema into
one of three groups. One group of patients were asked not to change
their diet and were therefore the control group. One group were put
on a weight reducing diet and the other group were asked to follow a
low fat diet. The low fat diet was chosen because a couple of
previous studies had mentioned that this was helpful. The results of
this study indicated that the low fat diet did not specifically help
lymphoedema unless weight was lost. Overall it was losing weight
that was important not how you lost it. The second study which
looked much more closely at weight reduction showed that this did
help reduce the size of a swollen arm with lymphoedema.
What can we conclude from these studies?
It seems that changing the foods that you eat does not necessarily
help lymphoedema unless you lose weight. However, if you are
overweight and have lymphoedema then this could perhaps make a
difference to the swelling. It is important that any hosiery is
rechecked after weight loss to make sure that it fits and still
applies the correct pressure.
Basic principles.
There are basic principles to a healthy eating diet and these may
not be new to many people. They can be summarised as follows:
• Base your meals on starchy foods such as potatoes, pasta,
rice, noodles, plantain and try to choose wholegrain varieties
where possible.
• Eat lots of fruit and vegetables. Try to eat at least 5 portions
each day.
• Eat more fish and include at least one portion of oily fish each
week such as sardines, mackerel, pilchards.
• Cut down on saturated fat and sugar.
• Try to eat less salt.
• Get active and try to be a healthy weight.
• Drink plenty of water (at least 6-8 glasses daily).
This has been adapted from the Food Standards Agency. More
information is available at www.eatwell.gov.uk/healthydie