Numerous scientific studies have been carried out over the past 100 years on the Ketogenic Diet, exploring how this way of eating can benefit patients who suffer from various medical conditions. This extremely low carbohydrate, high-fat regime is a powerful tool for treating a wide range of medical conditions (epilepsy, cardiovascular disease and neurological conditions) and when executed properly, can correct metabolic functions at the cellular level.
More recently, researchers have started to explore if this way of eating can also be beneficial for chronic inflammation diseases, such as Lymphedema. Leslie Keith, a Certified Lymphedema Therapist, is at the forefront of this preliminary research and recently conducted a study using 12 obese lymphedema patients from her clinic, to see if the Ketogenic way of eating was beneficial in reducing their swelling and promoting a healthy lymphatic system. Half the group ate a strict Ketogenic diet and the other half ate a normal, non-Ketogenic diet. At the end of three months, 4 out of 6 patients had a significant reduction in limb volumes, whereas the Non-Ketogenic diet group had very little changes to limb volume- some patients actually increased in volume. All six members reported a decrease in the impact that Lymphedema had in their life.
The Ketogenic way of eating: what is it and how does it work?
“A Keto diet is a low carbohydrate, moderate protein, high-fat way of eating. It changes our primary fuel source to fat instead of glucose or carbohydrates and is the best way to have weight loss without any muscle wastage,” explains Keith. Nutrient intake is generally around 70% fats, 25% protein, and 5% carbohydrates.
A Ketogenic diet involves eating real foods that contain natural fats and protein (such as meat, poultry and fish) and significantly low amounts of carbohydrates. Other diets which consist of high carbohydrate intake make the body’s blood sugar levels rise and make you feel constantly hungry and gain weight faster. A low carbohydrate diet lowers blood sugar and insulin levels, making you feel fuller for longer and most importantly, stimulates a powerful metabolic effect on the body. The primary fuel source is changed from glucose to dietary fat and some of this is converted into ketone bodies.
As explained by Ellen Davis, a Clinical Nutritionist, “When blood glucose and insulin levels drop and ketone levels rise, muscle tissue, including the heart, use the available fatty acids in the bloodstream as fuel and the brain begins using ketones as an energy source. Being in this metabolic state of ‘nutritional ketosis‘ (blood sugar is low and ketone levels are moderate) has some powerful benefits.”
Eating more dietary fat can positively affect lymphatic health
The Ketogenic way of eating provides more dietary fats to the body’s cells which can be beneficial on many levels. Perhaps the most important benefit for Lymphedema patients is that it helps reduce natural body fat, which in turn reduces inflammation.
The National Lymphedema Network explains that “Inflammation plays an important part in the development of obesity-related lymphedema. Fat tissue produces many metabolically active substances, that produce inflammation, damage lymphatic vessels, and diminish lymphatic vessel contractility. In addition, pressure from large, heavy fatty deposits and associated folds of skin and tissue may obstruct lymphatics and impede lymphatic drainage.”
The longer someone lives with Lymphedema, they will experience a higher than average accumulation of adipose tissue (or simply speaking, fat) in their affected limb. This is due to the continuous deposition of excess protein that accumulates in the body’s tissues. Lymph fluid is lipophilic, meaning that it naturally attracts fat and uses it as energy to fuel lymphatic processes.¹ The proteins in lymph attract water and fats because they need these elements to survive and function. Excess fluid and protein start to accumulate, so the body reacts with inflammation to try and protect itself which causes the skin to become hard and firm. The combination of these two factors- a lymphatic system that depends on fat as energy and a chronic inflammatory condition that stimulates fat growth- builds up excess fat that does not normally belong in the tissues.
Eating in the Ketogenic way helps to reduce natural body fat (as it is burnt as fuel instead of stored), which means there is overall less fat for proteins and liquid to be attracted to. The build-up of fat is slowed down and reduced, leading to lower levels of excess protein build-up and inflammation.
What if I am not overweight, but still have Lymphedema?
The good news is that patients with Lymphedema who are not overweight can also benefit from a Ketogenic diet. The same principals still apply when it comes to helping reduce excess fat and inflammation in the lymphie limb, as it does in obese patients. Other benefits for making the switch to a Ketogenic diet include improvements in immune functions (faster wound healing, improved skin condition, fewer infections) and more stable energy levels throughout the day.
 Harvey NL. The link between lymphatic function and adipose biology.: https://www.ncbi.nlm.nih.gov/pubmed/18519961
Ellen Davis, 2017. Ketogenic Diet Resource
National Lymphedema Network: Ask an obesity expert
Download a food log app to help Cronometer.com (30 days for free) to help track your eating.
Consult with your primary care physician before making any changes to your diet. It’s best to be medically supervised for any weight loss program, particularly if you are taking medications.