Effect of a ketogenic diet on pain and quality of life in patients with lipedema: The LIPODIET pilot study

Vilde Sørlie; Ann Kristin De Soysa; Åsne Ask Hyldmo; Kjetil Retterstøl; Catia Martins; Siren Nymo

doi:10.1002/osp4.580

Effect of a ketogenic diet on pain and quality of life in patients with lipedema: The LIPODIET pilot study

Obes Sci Pract. 2022 Apr 21;8(4):483-493. doi: 10.1002/osp4.580. eCollection 2022 Aug.

Authors

Vilde Sørlie¹, Ann Kristin De Soysa², Åsne Ask Hyldmo³, Kjetil Retterstøl¹, Catia Martins^{3

4}, Siren Nymo^{3

4

5}

Affiliations

¹ Department of Nutrition Institute of Basic Medical Sciences Faculty of Medicine University of Oslo Oslo Norway.
² Department of Clinical Nutrition and Speech Pathology Clinic of Clinical Services St. Olav Hospital-Trondheim University Hospital Trondheim Norway.
³ Centre of Obesity Research and Innovation Clinic of Surgery St. Olav Hospital -Trondheim University Hospital Trondheim Norway.
⁴ Department of Clinical and Molecular Medicine Centre for Obesity Research Faculty of Medicine Norwegian of Science and Technology Trondheim Norway.
⁵ Namsos Hospital Clinic of Surgery Nord-Trondelag Hospital Trust Namsos Norway.

Abstract

Background: Lipedema is an underdiagnosed condition in women, characterized by a symmetrical increase in subcutaneous adipose tissue (SAT) in the lower extremities, sparing the trunk. The lipedema SAT has been found to be resistant to diet, exercise and bariatric surgery, in regard to both weight loss (WL) and symptom relief. Current experience indicates that a low carbohydrate and high fat (LCHF-diet) might have a beneficial effect on weight and symptom management in lipedema.

Objective: To assess the impact of an eucaloric low carbohydrate, high fat (LCHF)-diet on pain and quality of life (QoL) in patients with lipedema.

Methods: Women diagnosed with lipedema, including all types and stages affecting the legs, (age 18-75 years, BMI 30-45 kg/m²) underwent 7 weeks of LCHF-diet and, thereafter 6 weeks of a diet following the Nordic nutrition recommendations. Pain (visual analog scale) and QoL (questionnaire for lymphedema of the limbs), weight and body composition were measured at baseline, week seven and 13.

Results: Nine women (BMI: 36.7 ± 4.5 kg/m² and age: 46.9 ± 7 years) were recruited. The LCHF diet induced a significant WL -4.6 ± 0.7 kg (-4.5 ± 2.4%), p < 0.001 for both, and reduction in pain (-2.3 ± 0.4 cm, p = 0.020). No correlation was found between WL and changes in pain at week seven (r = 0.283, p = 0.460). WL was maintained between week seven and 13 (0.3 ± 0.7 kg, p = 0.430), but pain returned to baseline levels at week 13 (4.2 ± 0.7 cm, p = 0.690). A significant increase in general QoL was found between baseline and week seven (1.0 (95% CI (2.0, 0.001)), p = 0.050) and 13 (1.0 95% CI (2.0, 0.001) p = 0.050), respectively.

Conclusion: A LCHF-diet is associated with reduction in perceived pain and improvement in QoL, in patients with lipedema. Larger randomized clinical trials are needed to confirm these findings.

Keywords: bodyfat distribution; ketogenic diet; obesity; obesity phenotype; quality of life.