Lifestyle Tips for Managing Lymphedema

Lymphedema is a common side effect that may affect a cancer survivor months or even years after treatments such as surgery or radiation therapy. As part of the circulatory system, the lymph organs play many roles in the body including fluid balance and immunity.

Lymph fluid is a lipid- and protein-rich fluid found within the lymphatic system that contains white blood cells and helps remove waste. When lymph nodes don’t filter and drain lymph fluid appropriately, the fluid will accumulate and lead to fluid retention and abnormal swelling around the extremities. Lymphedema can also affect other body parts such as the face, neck and abdomen.

Some typical signs and symptoms of lymphedema include a tight or heavy feeling in your arms or legs, limited range of motion from swelling in extremities, pain or discomfort and hardening of skin.

There is no specific medical nutrition therapy to cure lymphedema, but here are some tips to help manage symptoms, and possibly prevent lymphedema onset.

1. Maintain a healthy weight. There is an association between a high body mass index (BMI), or obesity, and an increased risk for lymphedema. The more adipose tissue or fat one has, the more the lymphatic system will struggle to pass fluid. Excessive fat also promotes more inflammation. To successfully manage weight, balance meals with low-fat, nutrient-dense foods. Include lean protein, whole grains, fruits, vegetables and dairy in daily meals and snacks. It is important not to follow fad diets that restrict any food group. Eating foods from each food group guarantees that the body receives all its vital nutrients for survival. Monitor daily caloric intake. Phone apps like MyFitnessPal and Lose It! make tracking food consumption easy. Each person has their own unique circumstances, so it would be best to consult a dietitian for guidance.
2. Exercise. Exercises that promote joint motion, stretching and strength training will help with circulation and improve lymph vessel activity. Consult a medical specialist such as a physical therapist or certified lymphedema therapist to safely execute any exercise program.
3. Avoid diuretics (“water pills”), alcohol and caffeine. While diuretic medications generally work well with fluid retention associated with venous insufficiency (such as conditions like congestive heart failure), they do not work well with excess lymph fluid-associated lymphedema. Alcohol and caffeine could also function like diuretics. They both could dilate the lymph tissue and cause more swelling, and as a result, exacerbate the lymphedema.
4. Don’t adopt a low-protein diet. Consumed protein has no connection with the protein in the lymph fluid. Low-protein diets may actually be harmful, as proteins contain essential amino acids that the body requires. Insufficient protein intake could result in malnutrition and muscle wasting. Each meal should include at least three ounces of lean protein such as eggs, fish, chicken, turkey and lean beef.
5. Reduce salt intake. Salt promotes fluid retention. There are no official guidelines for avoiding salt for lymphedema, however people who are sensitive to salt might exacerbate their symptoms if they eat high-sodium foods. Current recommendations for salt intake are less than 2,300 mg for healthy individuals and less than 1,500 mg for people who have cardiac disease, diabetes and kidney disease.

In addition to good nutrition and exercise, there are many other strategies like compression therapy, massage therapy and proper skin care that can aid in the treatment of lymphedema. Talk to your doctor first if you would like to explore these options.

Simone Gampel, RD, CDE, is a Registered Dietitian with Summit Medical Group in Berkeley Heights, NJ. She has worked in private practice, home care and large university hospitals. She currently works with diabetic, bariatric, gastric and surgical oncology patients.