The Effect of a Low-Carbohydrate, High-Fat Diet versus Moderate-Carbohydrate and Fat Diet on Body Composition in Patients with Lipedema

Abstract

Introduction: Lipedema is a disorder characterized by an excessive accumulation of subcutaneous body fat, mainly bilateral and symmetrical accumulation of fat deposits, particularly in the lower extremities excluding feet. Pain (spontaneous or with palpation) and increased capillary fragility with bruising are also part of clinical presentation. It is estimated to occur in approximately 11.0% of women worldwide. Management of obesity among patients with lipedema is a key component in its treatment.

Purpose: The aim of this study was to compare effectiveness of two diets: low-carbohydrate-high-fat diet (LCHF) and medium-fat-medium-carbohydrate diet (MFMC) in body weight, body fat and limb circumference reduction in patients with lipedema.

Material and methods: The studied women (n = 91) were divided into 2 groups and submitted to 1 of the 2 diets for 16 weeks. Anthropometric measurements such as body height [cm], body weight [kg], body fat percentage [%], body fat [kg], lean body mass [kg], and visceral fat level were collected at the beginning and end of the study.

Results: We have not found any significant differences in anthropometric measurements at the baseline between groups. Body weight and all anthropometric parameters decreased significantly in both groups after 16 weeks of diets, excluding the circumference above the right ankle for the MFMC diet which did not change. The LCHF diet contributed to reduction of body weight (-8.2 ± 4.1 kg vs -2.1 ± 1.0 kg; p < 0.0001), body fat (-6.4 ± 3.2 kg vs 1.6 ± 0.8 kg; p < 0.0001), waist (-7.8 ± 3.9 cm vs -2.3 ± 1.1 cm; p < 0.0001), hips (-7.4 ± 3.7 cm vs -2.5 ± 1.3 cm; p < 0.0001), thighs and calves' circumferences compared with the MFMC diet. We observed reduction of pain in the extremities and mobility improvement in LCHF group (data not shown).

Conclusion: The LCHF diet was more effective than MFMC in body weight, body fat and lower limb circumferences reduction.

Keywords: anti-inflammatory diet; body composition; lipedema; low carbohydrate high fat diet; low-glycemic index diet.

Figure 1

Lipedema staging. (A) Stage 1 - skin appears smooth, but the thickened subcutaneous tissue contains small nodules. (B) Stage 2 - skin has an irregular texture, subcutaneous nodules occur that vary from the size of walnut to that of an apple in size. (C) Stage 3 - deformed lobular fat deposits form, especially around thighs and knees, and may cause considerable distortion of limb profile. (D) Stage 4 - lipedema with lymphoedema (lipolymphoedema).

Figure 2

Lower limb photos of two patients (no. 1 and no. 2) with lipedema before and after the LCHF diet. Patient 1 and 2: (A) - photo before intervention; (B) - photo after intervention (own documentation).

Figure 3

Lower limb photos of patient (no. 3) with lipedema before and after the LCHF diet. (A and C) - photos before intervention; (B and D) - photos after intervention (own documentation).

Figure 4

Lower limb photos of two patients (no. 4 and no. 5) with lipedema before and after the MCMF diet. Patient 4 and 5: (A) - photo before intervention; (B) - photo after intervention (own documentation).