Nutritional Approaches and Supplementation in Lipedema Management: A Narrative Review of Current Evidence.

purpose of reviewLipedema is a painful chronic disease characterized by symmetric fat tissue accumulation in the lower extremities. Inflammation of the subcutaneous adipose tissue causes pain, edema, and various functional limitations, making daily activities difficult and affecting quality of life. RECENT

findingsAlthough the pathogenesis of lipedema is not fully known, it is a disease that is associated with the interaction of genetic predisposition, hormonal factors, stressful lifestyle and inflammatory processes. Lipedema, which can often be confused with obesity and lymphedema, causes patients to undergo unnecessary examinations and treatments, while the disease can also create an additional burden on the health system through psychosocial problems. Chronic inflammation of subcutaneous adipose tissue is resistant to weight loss. Since there is no definitively proven treatment method in the literature for the treatment of lipedema, the primary goal is to alleviate the symptoms associated with the disease with a multidisciplinary team. At this point, increasing misinformation content on social networks or difficulties in accessing accurate information emphasize the importance of evidence-based practices and guidelines in the nutritional treatment of lipedema. Ketogenic diet and Mediterranean diet are prominent dietary models in the nutritional treatment of lipedema, as they overlap with the pathophysiology of lipedema with their insulin sensitivity-enhancing and anti-inflammatory effects. The Mediterranean diet, rich in antioxidants, acts by reducing the production of proinflammatory cytokines in the body, while the ketogenic diet with its low carbohydrate content improves the blood glucose profile and insulin resistance, preventing hyperglycemia-induced inflammation supported by lipedema. On the other hand, serum levels of vitamins and minerals, which play important roles in ensuring the physiological functioning of the body, are also important in order not to worsen the clinical picture and reduce inflammation. There is limited data in the literature on the long-term applicability, safety and therapeutic effects of these dietary models. Therefore, more research is needed to expand clinical applications.