Easing lipedema with a ketogenic diet

How can a ketogenic diet help me with lipedema? What does nutrition have to do with it at all? And what exactly are the connections between lipedema and a ketogenic diet? If you have asked yourself these questions more than once, you are in exactly the right place, because alongside a well-functioning metabolism a ketogenic diet can help you reduce the water retention caused by lipedema and also the pain that goes with it. We will now explain how and why that works.

Lipedema is a disorder of fat distribution in which the fat cells in the body change in a pathological way. As a result they multiply uncontrollably and cannot be reduced through nutrition or exercise. The condition occurs (under natural circumstances) exclusively in women. First symptoms are usually noticed between the ages of 20 and 30, often in connection with hormonal changes such as puberty, a pregnancy or the menopause. It is also suspected that the condition can be inherited, since several cases within one family are common.

Symptoms are:

• strikingly rapid weight gain despite unchanged habits
• symmetrical distribution of this gain, usually either on the lower half of the body such as legs, hips and buttocks, or on the upper half such as arms, neck and upper back
• the trunk, hands and feet remain untouched by the gain
• water retention and the pressure pain that comes with it
• orange-peel skin, or wavy skin with the formation of small nodules under the skin
• a tendency to bruise
• as it progresses: the formation of bulges, above all on the inner thighs

First of all it has to be said: the additional volume with lipedema does not come from substantial fat, as it does with overeating. That is why you cannot “remove” lipedema with a diet either. Researchers assume that the fat cells fill up with fluid, which then settles between the cells. You can see this in the cellulite, often very pronounced even at a young age. The fat cells, now filled to bursting, press on lymph vessels and veins in the tissue. The pressure stimulates them to release more water, which can then gather again in the spaces between the fat cells. It is like a vicious circle. Over the course of the day the tissue fills with more and more water, until as someone affected by lipedema you feel as if your skin is about to burst.

The background to inflammatory factors really is a science of its own. With a ketogenic diet the transcription factor NF-κB is particularly important. It regulates genes that determine the extent to which the immune system reacts. If NF-κB is actively at work, more messenger substances such as prostaglandin E2 are formed. This causes swelling of the tissue and an increased perception of pain. It has been observed that when the transcription factor NF-κB is inhibited, the inflammation can be eased as well. Sounds easy, doesn’t it? So why not simply do that? The problem: so many receptors and messenger substances are involved in this inhibition that you could stop or activate a factor at practically every fork in the signal’s path. In short: the solution is not yet known.

A reduced intake of carbohydrates, as with a ketogenic diet, can block the formation of NF-κB. The key element here is the lower intake of glucose. If glucose is missing, the signalling pathway of NF-κB is disturbed, which means less inflammation. If you take in a lot of glucose instead, you encourage inflammation in the body.

So why not just go on a diet? Why a ketogenic diet?

Thanks to the high fat intake with a ketogenic diet, if it is put together correctly, an increased amount of anti-inflammatory polyunsaturated fatty acids (omega-3) is taken in as well. By binding to special receptors (PPARs), these can reduce inflammatory reactions.

At first glance: low carb, high fat. Of course there is a little more to it than that. A ketogenic diet is characterised by the fact that the amount and the choice of ingredients lead to the formation of ketone bodies. It is “ketogenic”, that is “ketone body generating”.

What are these ketone bodies? Special molecules that are formed in the liver from fatty acids. As carriers of energy they supply the brain, the muscles and other body tissue with the energy they need in order to function. When an increased number of ketone bodies is present in the blood, this state is called ketosis: a raised state of fat burning which, as we remember, at the same time breaks down glycogen and reduces water retention.

In order to reach the state of ketosis, you should put your nutrition together in the following order:

• Very few carbohydrates
• Moderate protein consumption
• Main source of energy: fat

With a healthy ketogenic diet, vegetables are your best friend. Green vegetables in particular contain so few carbohydrates that you can eat large amounts without affecting your ketosis. But careful: root vegetables have a high carbohydrate content and are better avoided on a ketogenic diet. Red and yellow vegetables such as peppers and carrots can be enjoyed in moderation.

Alongside vegetables, proteins are important for your body. They fill you up and maintain your muscles. High-quality protein from animal sources is ideal: eggs, fish, meat. Since fat is your main source of energy, you can happily go for the fatty version here, such as salmon. High-quality fatty acids from coconut oil, avocado, olive oil or nuts (macadamias especially) are also good.

You still have a million questions about how exactly to put all this into practice in your case? Do not worry, we have the solution. In cooperation with Lipocura, Foodpunk has developed a lipedema programme. There it is worked out individually for you how much and what you should eat in order to get into the state of ketosis and thereby reduce water retention and pressure pain. Our nutrition expert draws up an individual plan for you and discusses any questions with you in a personal phone call, for a more liveable life with lipedema.