Lymphedema is a condition that causes swelling in the arms or legs due to a build-up of lymph fluid. It often occurs after lymph nodes have been removed or damaged during cancer treatment. There has been some speculation that consuming too much sugar may worsen lymphedema symptoms. In this article, we will examine the evidence on whether sugar intake affects lymphedema.
What is lymphedema?
The lymphatic system is a network of vessels and nodes that carry lymph fluid throughout the body. Lymph fluid contains white blood cells that help fight infection and other waste products. Normally, lymph fluid flows through lymph nodes where it is filtered. However, when lymph nodes are removed or damaged, lymph fluid can build up and cause swelling known as lymphedema.[1]
Lymphedema usually affects an arm or leg on the side of the body where lymph nodes were removed. For example, breast cancer surgery often involves removal of lymph nodes under the arm, which can lead to lymphedema in that arm. The swelling caused by lymphedema ranges from mild to severe. While it is not life-threatening, lymphedema can cause significant discomfort, tightness, heaviness, and impaired limb mobility.[2]
Treatments for lymphedema include compression garments, massage, exercise, and elevating the affected limb. Losing weight and maintaining good skin care may also help reduce swelling. However, there is no cure and lymphedema is a lifelong condition requiring management.[3]
Does sugar intake affect lymphedema?
There are a few theories about why sugar may potentially impact lymphedema:
Sugar causes inflammation
Eating too much added sugar causes inflammation in the body. Chronic, low-grade inflammation is linked to various health conditions. Some experts theorize that inflammation from excess sugar could worsen lymphedema swelling.[4] However, there is no direct evidence proving sugar-induced inflammation exacerbates lymphedema specifically.
Sugar leads to weight gain
A diet high in added sugars often leads to obesity. Carrying excess body fat puts pressure on the lymphatic system and can cause swelling. For those with lymphedema, maintaining a healthy body weight is recommended to avoid additional swelling from fat accumulation.[5]
Sugar affects circulation
One small study found that consuming 75 grams of sugar negatively impacted circulation in healthy adults for several hours. Poor circulation could potentially hinder lymph fluid drainage, causing more swelling in those with lymphedema.[6] However, more research is needed to know if sugar intake directly worsens circulation in lymphedema patients.
Does cutting out sugar improve lymphedema?
There is limited evidence that lowering sugar intake reduces existing lymphedema swelling.
One small study had 10 women with breast cancer-related lymphedema follow a low-sugar diet for 4 weeks. They were allowed no more than 15g of fructose per day from fruits/vegetables and avoided all other added sugars. At the end, the women showed a 31% reduction in lymphedema swelling and improvements in symptoms like tightness and heaviness.[7]
While interesting, this study had a very small sample size. Participants also reduced calories and lost weight during the 4 weeks, which could have contributed to the improvement. Larger scale studies are still needed.
Overall, there is currently no strong research proving sugar directly worsens or improves lymphedema swelling. However, maintaining a healthy body weight is important for managing lymphedema.
Recommendations for sugar intake with lymphedema
Based on the limited evidence available, here are some recommendations on sugar intake for those with lymphedema:
– Avoid added sugars like soda, candy, baked goods, and sugary cereals. These provide excess calories without nutrition.
– Limit naturally occurring sugars from fruits/vegetables to no more than 15g per day. Spread fruit consumption throughout the day rather than all at once.
– Sweeten foods with small amounts of maple syrup, honey, or stevia instead of refined sugar. But still aim to minimize sweeteners.
– Focus on getting daily sugar from healthy carb sources like whole grains, legumes, vegetables, and a little fruit.
– Stay well hydrated by drinking water throughout the day. Dehydration may worsen lymphedema swelling.
– Maintain a healthy body weight through diet and exercise. Ask your doctor what weight range is ideal for you.
The bottom line
There is limited evidence that sugar worsens existing lymphedema. However, a diet high in added sugars can lead to weight gain, inflammation, and poor circulation – all factors that may impact lymphedema. To manage swelling, it is reasonable to limit added sugars and stick to natural sources like fruit in moderation. Staying hydrated and maintaining a healthy weight through diet and exercise are also important. More research is still needed on how sugar intake may directly affect lymphedema. Those with lymphedema should discuss diet recommendations with their doctor.
References
1. Lymphedema. (2018). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/lymphedema/symptoms-causes/syc-20374682
2. What Is Lymphedema? (n.d.). National Lymphedema Network. https://lymphnet.org/le-faqs/what-is-lymphedema
3. Lymphedema Treatment. (2020). American Cancer Society. https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/lymphedema/lymphedema-treatment.html
4. Inflammation. (2021). Harvard T.H. Chan School of Public Health. https://www.hsph.harvard.edu/nutritionsource/disease-prevention/inflammation/
5. 10 Reasons Why Excess Weight Causes Lymphedema & What You Can Do. (2019). LympheDIVAs. https://lymphedivas.com/blogs/news/10-reasons-why-excess-weight-causes-lymphedema-what-you-can-do
6. Aeberli, I., Gerber, P. A., Hochuli, M., Kohler, S., Haile, S. R., Gouni-Berthold, I., Berthold, H. K., Spinas, G. A., & Berneis, K. (2011). Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial. The American journal of clinical nutrition, 94(2), 479–485. https://doi.org/10.3945/ajcn.111.013540
7. Katz, S. (2020). Dietary carbohydrate restriction for treatment and management of lymphedema. Nutrition and Healthy Aging, 5(4), 293-300. https://doi.org/10.3233/NHA-20016