The lymphedema diet

Discussed with Jean LaMantia

Jean LaMantia is a registered dietitian, cancer survivor, and professional speaker. After being diagnosed with Hodgkin’s Lymphoma at age 27, Jean dedicated herself to collect, analyze, and distill an incredible amount of information about nutrition and cancer. In 2017, she was contacted by physiotherapist Ann DiMenna from the Markham Lymphatic Centre. Ann was convinced that nutrition could make a difference for her clients living with lymphedema and wanted to work with a registered dietitian who knew about working with cancer survivors, as many of her clients with lymphedema had developed the condition as a result of their cancer treatment.

As a registered dietician, Jean looks at available research and decides what will make for an adequate diet for her client(s) based on their circumstances and health conditions. However, when confronted with cases of lymphedema, Jean could not find information on the condition from either of the two large databases for nutrition professionals. So, Jean dug into primary research herself and found loads of information behind lymphedema. (She found so much that she decided that in addition to incorporating the information into nutritional counselling, she would put the information into a book, the Complete Lymphedema Management and Nutrition Guide!)

“Meet Jean LaMantia – Registered Dietitian in Toronto, ON.” Jean LaMantia – Registered Dietitian in Toronto, ON, https://jeanlamantia.com/meet-jean/.

In a conversation over the phone, Jean and I discussed the lymphedema diet.

The lymphedema diet

As a registered dietitian that works with people with lymphedema, Jean has seen first hand how diet can help clients manage their lymphedema. It just makes sense. If more than 50% of lymphatic fluid is formed in your GI tract, why wouldn’t what you eat have an influence on lymphatics?

LaMantia, Jean, and Jean LaMantia. “Lymphedema Diet.” Jean LaMantia – Registered Dietitian in Toronto, ON, 4 Nov. 2019, https://jeanlamantia.com/cancer-bites-diet-blog/lymphedema-diet/.

Management vs. prevention

The lymphedema diet is mostly for managing lymphedema. Once you have lymphedema, there are things you can do as part of the diet to manage it.
However, if someone is at high risk for lymphedema after cancer treatment, they can be put on the lymphedema diet in an effort to prevent lymphedema. Weight loss in general can also be used to lower the risk of developing lymphedema after cancer.

Basics of the lymphedema diet

1) Try to get close to ideal body weight; even small amounts of weight loss are beneficial
2) Low salt diet (around 2300 milligrams of sodium a day); limit processed or prepared/restaurant food
3) Drink enough fluid
*This may be counter intuitive, because oftentimes, the recommendation for swelling conditions is to restrict fluid. There is something unique about lymphedema fluid; it’s high in protein. Protein wants to dilute itself. If you have a lot of concentrated protein, it’s gonna pull more fluid through different membranes to help dilute it. If you’re dehydrated and the protein in the lymphatic area is very concentrated, it is gonna pull more fluid towards it. Therefore, you must keep hydrated.
4) Anti-inflammatory diet
*Cellular Inflammation is common in lymphedema, which can be dangerous, because inflammation is associated with heart and joint disease, cancer, metabolic syndrome, etc.
5) Low-fat diet with inclusion of MCT oil
6) Keep regular bowel movements
*Lymph is formed in the GI tract. If you’re constipated, this will create problems for the lymphatic system.
7) Restrict eating window (make it smaller than fasting window)
8) Measure and track your lymphedema (use a tape measure and be exact)

And remember:
Everyone is different in their journey with nutrition.

Everyone is different in their journey with nutrition.

There is almost exclusively anecdotal evidence available as a basis for the lymphedema diet.

Diet in relation to multidisciplinary lymphedema treatment

Diet is the new kid on the block in terms of lymphedema treatment.

Diet is the new kid on the block in terms of lymphedema treatment.

Traditionally, dietitians were not part of the multidisciplinary team that was treating lymphedema. It’s been physical and occupational therapists, nurses, and doctors. Diet and nutrition have been left behind in the discussion.
Jean thinks diet is a part of lymph management, but technically speaking, it’s not part of complete decongestive therapy. Nutrition, hopefully, is growing in its role in lymphedema treatment. Patients, especially, are interested in the lymphedema diet as they are looking for what more they can do to aid their condition after trying everything else available.

The issue in bringing nutrition into the conversation is that if you’re in a certain profession looking at a patient, you don’t know what you don’t know.

The issue in bringing nutrition into the conversation is that if you’re in a certain profession looking at a patient, you don’t know what you don’t know.

Physiotherapists don’t necessarily know that nutrition or a certain diet could help lymphedema; it’s not a part of their profession. In addition, there aren’t many dietitians speaking up about how nutrition can, in fact, aid lymphedema. It’s a problem on both sides (the nutrition community and Jean’s dietitian colleagues).
But Jean reminds us that lymphedema, in general, has suffered from a lack of attention and proper care.

Jean’s Work

Jean has written books on cancer risk reduction, the lymphedema diet, and more, which you can find here. Her recent book, The Complete Lymphedema Management and Nutrition Guide, is a big way to say “Listen! Nutrition can be a part of lymphedema care.” (I will be reviewing the book and posting a review shortly.)

Jean also recently presented a webinar to dietitians in Canada and is applying to speak at more nutrition conferences in the future.

She is planning to launch a lymphedema nutrition school in an online program to work through different components of the lymphedema diet each week with her students.

Find more about the lymphedema diet here.