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Lipedema is a pathology of the adipose tissue, in evident female prevalence, diagnosed clinically and still of not well-defined etiopathogenesis. Indeed, an estrogen-related component is present, and an inflammatory state and a condition of edema are present in most cases; even pain seems to be a recurring feature, and insulin resistance is also often associated with lipedema. The therapeutic approach is finally becoming holistic. Therefore, with surgery, physiotherapy, and elastic compression therapy, the nutritional aspect of food supplementation is gaining much value. The objective of the present work is to consider the nutritional supplements that could be useful to manage this condition, underlining that, at the moment, the specific literature is practically non-existent. The most promising supplements seem to be omega 3 fish oil, polyphenols, and vitamin C, but the need for studies in this sector is urgent.
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Background: Edema is highly prevalent in patients with cardiovascular disease and is associated with various underlying pathologic conditions, making it challenging for physicians to diagnose and manage. Methods: We report on presentations from a virtual symposium at the Annual Meeting of the European Venous Forum (25 June 2021), which examined edema classification within clinical practice, provided guidance on making differential diagnoses and reviewed evidence for the use of the treatment combination of Ruscus extract, hesperidin methyl chalcone and vitamin C. Results: The understanding of the pathophysiologic mechanisms underlying fluid build-up in chronic venous disease (CVD) is limited. Despite amendments to the classic Starling Principle, discrepancies exist between the theories proposed and real-world evidence. Given the varied disease presentations seen in edema patients, thorough clinical examinations are recommended in order to make a differential diagnosis. The recent CEAP classification update states that edema should be considered a sign of CVD. The combination of Ruscus extract, hesperidin methyl chalcone and vitamin C improves venous tone and lymph contractility and reduces macromolecule permeability and inflammation. Conclusions: Data from randomized controlled trials support guideline recommendations for the use of Ruscus extract, hesperidin methyl chalcone and vitamin C to relieve major CVD-related symptoms and edema.
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Abstract Objectives Lipoedema is a chronic fat disorder involving an excessive abnormal deposition of subcutaneous fat in the thighs, legs, hips and buttocks mainly (Wounds UK, 2017). The importance of healthy eating in lipoedema management has been recognised (Wounds UK, 2017), yet dietary guidelines specific for lipoedema are lacking (Bertsch et al., 2020). The study aimed to investigate the self-reported dietary and lifestyle impact on lipoedema management among a representative lipoedema population in the UK. Methods The study used an online questionnaire that consisted of multiple-choice and open-response questions to collect data on symptoms and diagnostic status of lipoedema and self-reported dietary and lifestyle impact on lipoedema management among participants. The questionnaire was constructed using the Survey Monkey software. The active online survey link was sent to Lipoedema UK's members and contacts via e-mail and also made accessible via the study flyer advertised on Lipoedema UK's website and newsletters. Ethical approval was obtained from the De Montfort University Faculty Research Ethics Committee of Health and Life Sciences prior to the study. Participants had given their consents before starting the survey. Data collection was anonymous. Data were analysed using SPSS v26.0. Results The results showed that 165 out of 257 participants (66.3%) had tried diet as a mean to improve their lipoedema symptoms in the past. Anti-inflammatory diet was reported to be one of the three most effective diets that improved their symptoms (either single or multiple). The other two diets were ketogenic diet and rare adipose disorder diet. Noticeably, 95% of the 257 participants were classified as either overweight or obese based on their Body Mass Index (BMI) measure. And 20% of the participants who tried weight loss diets had found improvements in their lipoedema conditions. Conclusions The study results will help inform the development of future research on finding a dietary solution to effective lipoedema management for the UK lipoedema population. Funding Sources De Montfort University funded the recruitment of a Research Assistant to support part of the data analysis work.
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Lipedema is a chronic disease that mostly manifests in females as the abnormal distribution of subcutaneous adipose connective tissue, usually coupled with bruising, pain, and edema. Lipedema molecular pathophysiology is currently not clear, but several studies suggest that genetics and hormonal imbalance participate in lipedema pathogenesis. Women with lipedema present in some cases with elevated body mass index, and the appearance of obesity in addition to lipedema, where the obesity can cause serious health issues as in lipedema-free individuals with obesity, such as diabetes and cardiovascular disorders. Unlike obesity, lipedema tissue does not respond well to diet or physical exercise alone. Therefore, in this review we discuss the effect of various dietary supplements that, along with diet and physical exercise, cause fat burning and weight loss, and which could potentially be important in the treatment of lipedema. Indeed, an effective fat burner should convert stored fats into energy, mobilize and break down triglycerides in adipocytes, boost metabolism and inhibit lipogenesis. Common ingredients of fat burning supplements are green tea, caffeine, chromium, carnitine, and conjugated linoleic acid. The use of fat burners could act synergistically with a healthy diet and physical exercise for decreasing adipose tissue deposition in patients with lipedema and resolve related health issues. The effects of fat burners in human studies are sometimes contradictory, and further studies should test their effectiveness in treating lipedema.
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Tarlov Cysts is a pathological condition, with low incidence, characterized by a painful component with a strong impact on quality of life. The therapeutic options are surgery or analgesics and/or anti-inflammatory medications; however, the condition is still without resolution. Herein, we are reporting a case of a woman who expressly followed a low-calorie ketogenic diet program for 3 months. In addition to the change in diet, an appreciable decrease of weight (−5 kg) and body circumferences were recorded; there was also a marked improvement (evident from the questionnaires administered) in the quality of life, of sleep, and in the perception of pain. It is interesting to note how, in conjunction with the Christmas period, upon leaving the ketogenic regime, there was a recurrence of symptoms, confirming the beneficial effect of the low-caloric ketogenic diet at least on the management of pain and, very likely, on inflammation.
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Background: An adequate dietary energy supply is particularly important in patients with lipedema as it promotes weight and fat loss. Accurate estimation of resting metabolic rate (RMR) allows implementing a proper calorie restriction diet in patients with lipedema. Therefore, an accurate assessment of energy demand in patients with lipedema is crucial in clinical practice. Our study aimed to compare actual resting metabolic rate (aRMR) with predicted resting metabolic rate (pRMR) in women with lipedema and to determine the association between individual anthropometric measurements and aRMR.Methods: A total of 108 women diagnosed with lipedema were enrolled in the study. aRMR was measured by indirect calorimetry (IC) using FitMate WM metabolic system (Cosmed, Rome, Italy). pRMR was estimated with predictive equations and BIA. All anthropometric measurements were based on BIA (bioelectric impedance analysis).Results: The mean aRMR in the study group was 1705.2 ± 320.7 kcal/day. Most methods of predicted RMR measurement used in our study significantly underpredicted aRMR in patients with lipedema. We reported statistically significant high correlations between all anthropometric measurements and aRMR/pRMR and a moderate correlation between visceral fat level (VFL) and aRMR. Conclusions: aRMR in patients with lipedema calculated with predictive equations was significantly lower than aRMR measured with other methods. This study found the agreement of predictive equations compared to IC is low (<60%). Fat-free mass (FFM) is a stronger determinant of RMR in patients with lipedema than fat mass.
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