Ketojenik Beslenmenin Lipödem Üzerindeki Etkilerinin Detaylı İncelenmesi

Kaynakça

1. 1
   Amato ACM, Amato JLS, Benitti DA (2024). The Efficacy of Ketogenic Diets (Low Carbohydrate; High Fat) as a Potential Nutritional Intervention for Lipedema: A Systematic Review and Meta-Analysis.. Nutrients. PubMed.https://doi.org/10.3390/nu16193276
2. 2
   de Oliveira J, de Paula ACP, Guimarães VHD (2025). Clinical or cultural? Dietary interventions for lipedema: a systematic review.. Maturitas. PubMed.https://doi.org/10.1016/j.maturitas.2025.108716
3. 3
   Lundanes J, Sandnes F, Gjeilo KH, Hansson P, Salater S, Martins C, Nymo S (2024). Effect of a low-carbohydrate diet on pain and quality of life in female patients with lipedema: a randomized controlled trial.. Obesity (Silver Spring, Md.). PubMed.https://doi.org/10.1002/oby.24026
4. 4
   Jeziorek M, Chachaj A, Sowicz M, Adaszyńska A, Truszyński A, Putek J, Kujawa K, Szuba A (2023). The Benefits of Low-Carbohydrate, High-Fat (LCHF) Diet on Body Composition, Leg Volume, and Pain in Women with Lipedema.. Journal of obesity. PubMed.https://doi.org/10.1155/2023/5826630
5. 5
   Lundanes J, Storliløkken GE, Solem MS, Dankel SN, Tangvik RJ, Ødegård R, Holst JJ, Rehfeld JF, Martins C, Nymo S (2025). Gastrointestinal hormones and subjective ratings of appetite after low-carbohydrate vs low-fat low-energy diets in females with lipedema - A randomized controlled trial.. Clinical nutrition ESPEN. PubMed.https://doi.org/10.1016/j.clnesp.2024.11.018
6. 6
   Lundanes J, Naustvoll TG, Tangvik RJ, Martins C, Nymo S. (2025). Hedonic hunger and eating behavior after low-carbohydrate versus low-fat diets in females with lipedema and obesity.. Europe PMC.https://doi.org/10.3389/fnut.2025.1716592

   ▼Abstract

   <h4>Introduction</h4>Lipedema is a chronic female disease, characterized by an excessive accumulation of subcutaneous adipose tissue in the limbs and is commonly mistaken for obesity, although the two conditions often coexist. Obesity is associated with increased hedonic hunger and dysfunctional eating behavior. However, these aspects have not been investigated in females with lipedema and obesity.<h4>Objectives</h4>The objective of this secondary analysis from a randomized controlled trial was to compare changes in hedonic hunger and eating behavior following two different low-energy diets, low-carbohydrate (CHO) or low-fat, in females with lipedema and obesity.<h4>Methods</h4>Females with lipedema and obesity (body mass index (BMI) 30-45 kg/m²) were randomized to two different low-energy diets (1,200 kcal), low-CHO diet (LCD) (75 g CHO) or low-fat diet (180 g CHO) for 8 weeks. Hedonic hunger was assessed using the power of food scale (PFS) and eating behavior was assessed using the Dutch Eating Behavior Questionnaire (DEBQ) pre- and post-intervention.<h4>Results</h4>A total of 70 females were included with a mean age of 47 years, and a BMI of 37 kg/m². The LCD group reported a reduction in Food Present (<i>p</i> < 0.001) and in Aggregated Score (<i>p</i> = 0.035) from the PFS, while no changes were seen in the low-fat diet group, with changes in Food Present over time being significantly different between groups (<i>p</i> = 0.050). The low-fat diet group reported increases in Restrained Eating from the DEBQ (<i>p</i> = 0.036) while only the LCD group reported decreases in Diffuse Emotions (<i>p</i> = 0.040), however, no differences between groups were found.<h4>Conclusion</h4>A LCD may induce more favorable changes in hedonic hunger and eating behavior than an isocaloric low-fat diet in females with lipedema, which may be related to altered metabolic signaling pathways related to satiety and reward.
7. 7
   Lundanes J, Nes VF, Aakervik O, Ryan L, Hansson P, Rokstad AM, Martins C, Nymo S (2025). Changes in Cytokines and Fibrotic Growth Factors after Low-Carbohydrate or Low-Fat Low-Energy Diets in Females with Lipedema.. Current developments in nutrition. PubMed.https://doi.org/10.1016/j.cdnut.2025.104571
8. 8
   Amato AC. (2025). The Evolutionary Theory of Lipedema: A Perspective on Energy Storage and Chronic Inflammation.. Europe PMC.https://doi.org/10.7759/cureus.88809

   ▼Abstract

   Lipedema, characterized by the disproportionate accumulation of fat in the lower extremities, pain, and tenderness, is frequently misdiagnosed and underestimated. This evolutionary perspective reframes lipedema as an ancestral adaptive mechanism for energy storage, crucial in prehistory for female survival during periods of food scarcity. Subcutaneous fat, predominant in lipedema, conferred energetic, thermoregulatory, and cardioprotective advantages - especially for women during pregnancy and lactation - unlike men's visceral fat, which is geared toward rapid mobilization. In the modern context, inflammatory triggers such as pollution, stress, and gluten-rich diets exacerbate chronic inflammation, turning lipedema into a clinical challenge. Inflammation acts as a warning signal, and its management - rather than indiscriminate surgical removal of adipose tissue, an essential endocrine organ - is fundamental. Extensive liposuction may lead to postoperative adipose endocrine insufficiency, with metabolic and hormonal imbalances. Conservative strategies, such as ketogenic or gluten-free diets, moderate exercise, and stress management, foster a favorable metabolic environment, allowing mobilization of stored fat. This editorial advocates for a holistic and individualized approach, highlighting the connection between lipedema and conditions such as attention-deficit/hyperactivity disorder (ADHD), calls for further research into the interaction between genetics, inflammation, and environmental factors, and urges increased awareness of lipedema as a legitimate medical condition.
9. 9
   Lundanes J, Nes VF, Hansson P, Fristedt R, Landberg R, Martins C, Nymo S. (2026). Changes in plasma fatty acid composition in females with lipedema following low-carbohydrate vs low-fat diets and associations with pain reduction.. Europe PMC.https://doi.org/10.1186/s12937-026-01304-y
10. 10
    Amato AC, Amato JS, Benitti D, Santos KD. (2025). Lipedema in Men: A Retrospective Case Series of Five Patients From a Brazilian Referral Center.. Europe PMC.https://doi.org/10.7759/cureus.87332

    ▼Abstract

    Lipedema is a chronic adipose tissue disorder traditionally considered to affect almost exclusively women, with recent estimates suggesting approximately 0.2% prevalence in men worldwide; the condition remains underdiagnosed in males due to limited awareness and scarce literature. This retrospective case series from the Amato Institute of Advanced Medicine in São Paulo, Brazil, describes clinical characteristics, diagnostic findings, and treatment outcomes of five male patients diagnosed with lipedema between January 2022 and December 2024. The patients, aged 31-58 years (mean, 42.6 ± 9.7), with a BMI of 29-42.4 kg/m², all presented bilateral, symmetrical lower extremity fat accumulation, sparing the feet, with endocrine comorbidities present in 80% of cases and one participant testing positive for HLA-DQ2/DQ8. Diagnosis was based on clinical criteria requiring bilateral symmetrical fat accumulation, disproportionate fat distribution, negative Stemmer's sign, sparing of feet, and at least two minor criteria. Conservative management, including dietary interventions over four to eight weeks, resulted in mean weight reduction of 7.0 ± 2.2 kg and lower limb volume reduction of 2.5 ± 1.1 L. These findings demonstrate that lipedema occurs in men with classical phenotypic features, and the presence of HLA-DQ2/DQ8 markers in some cases suggests potential autoimmune components and opportunities for targeted dietary interventions. Conservative management yields significant short-term improvements, warranting larger prospective studies to establish prevalence, investigate HLA associations, and optimize management strategies for male lipedema.
11. 11
    Kuttiatt VS, Anandan M, Elangovan N, Sadhasivam A. (2026). Report of two cases of lipedema: An under-recognized, misdiagnosed, and under-reported disorder in India.. Europe PMC.https://doi.org/10.4103/jpgm.jpgm_273_25

    ▼Abstract

    <h4>Abstract</h4>Lipedema is a chronic adipose tissue disorder primarily affecting women, marked by abnormal, symmetrical, and disproportionate accumulation of subcutaneous fat in the lower limbs and sometimes in the arms, with hands and feet typically spared. Frequently misdiagnosed as lymphedema or obesity, lipedema presents with pain, easy bruising, bilateral nonpitting edema, and swelling that worsens throughout the day. We present two cases: Two middle-aged women reported longstanding bilateral lower limb swelling, pain, and varicose veins, without significant comorbidities. Clinical examination revealed characteristic disproportionate fat distribution and negative Stemmer's sign. Laboratory investigations and lymphoscintigraphy excluded other causes of edema. Imaging confirmed subcutaneous thickening, fat stranding, and varicosities. Both patients were advised to have conservative management including compression therapy, limb elevation, physiotherapy and dietary counseling; one patient had significant limb volume reduction. Our report underscores the importance of recognizing lipedema for early diagnosis and effective management to prevent progression and complications.
12. 12
    Giovanna, Pitotti (2024). Lipedema and Nutrition: High Fat Ketogenic Diet as Treatment of Choice. Journal of Gastroenterology &amp; Hepatology Reports. Crossref.https://doi.org/10.47363/jghr/2024(5)163

    ▼Abstract

    Crossref indexed source