Is a high protein diet adding to lymph problems?

By Tatjana van der Krabben
In our efforts to manage our weight, we eventually leaned towards high-protein, low-carb. We are also picky about the protein: low in or, if possible, free of toxins and from organically raised and/or grass-fed animals. Polluted foods only lead to inflammation. But sometimes we also hear advice against a high-protein diet. It supposedly adds to the buildup of protein in the lymph fluid, further hindering the lymph flow.

I had to expand my search a little and found more information through lymphedema. We do have a thing or two in common, like lymph fluid high in protein.

Dr. Vodder’s Manual Lymph Drainage: A Practical Guide by H. Wittlinger, D. Wittlinger, A. Wittlinger and M. Wittlinger (2011) talks elaborately about nutrients being stored in our connective tissue. The short version, as quoted from Vodder (2005) is this: “All protein molecules leave the bloodstream within 24-48 hours, enter the connective tissue, and most of them are returned to the bloodstream via the lymphathic vascular system, so the term “protein circulation” is justified.”

Wittlinger et al continue to explain the problem with high levels of protein: “..the protein circulation needs a properly functioning lymphatic vascular system: otherwise there will be blockages and build-ups in the connective tissue, that is, the concentration of protein in the tissue will rise. This will lead to chronic inflammation, which in its turn will result in cell proliferation (fibrosis).”

Protein in your diet is blamed as a contributing factor: “If the blood protein concentration is too high, e.g., due to a protein-rich meal, various mechanisms of the endothelial cells of the blood capillaries will cause the protein to be released into the tissue in order to maintain homeostasis.”

By implying that molecules of the protein you digest go to the connective tissue via the bloodstream and are next absorbed by the lymphatic system, I get that some warn against high-protein diets.

There are two sides here. The other side being that the protein you digest does not become part of your lymphatic fluid:

Ray (2004) says this on the subject: “Although lymph fluid is high in protein, the protein is derived from the blood, not directly from the diet. Consuming less protein does not affect lymphedema and can have serious health consequences.” (http://www.amylhwilliams.com/Lymphedema.pdf)

Cornely (2006) quoting Földi and Földi says: “Lymphatic edema is rich in protein and arises from the reduced transport capacity of the lymphatic system despite normal protein load.” And: “Lymph transported from the periphery to the center in this semicircular system essentially consists of products which cannot be transported via the venous system. Among these products plasma proteins represent the main protein load.” (http://link.springer.com/content/pdf/10.1007/3-540-28043-X_3.pdf#page-1)

Two views and a need for useful advice on protein-intake
The Recommended Dietary Allowance (RDA) for protein for the average, sedentary adult is at 0.8 grams per kilogram of body weight. Recommended amounts found online vary greatly. Depending on age, gender and lifestyle (bodybuilding, attempting weight loss, Paleo, food pyramid etc.). So, your recommended protein-intake, when assuming this element of your diet does not interfere with your lymphatic system, depends on the health or diet guru of your choice.

When assuming dr. Vodder and those who follow his teachings, Wittlinger et al, are correct, this does have potential implications for your protein-intake. When you look at what the Wittlinger Lymphedema Clinic does recommend, you find a food pyramid style plan: http://www.lymphedema-clinic.com/oedemarten/5-saeulen-der-behandlung/ernaehrung.html
The base is fruit and veg and second are sources of protein. Yes, second. The single largest source of nutrition would have to be protein-based.

The Wittlinger Lymphedema Clinic even speaks of a minimum protein demand of 0,6 grams per kilogram of body weight. Their example of a 65 kilogram or 143,3 pound woman states she should have 39 grams of protein minimum. Since weighing 143 pounds would be something many of us can’t image ever weighing (again) and the sum of 0,6 grams per kilogram would add up unrealistically for many, I’ve contacted the Wittlinger Lymphedema Clinic to elaborate on their recommended diet.

Dr. Christine Heim, Director of the Dr. Vodder Akademie Walchsee, was kind enough to explain in more detail.

The 0,6 grams of protein per kilogram is related to a normal body weight. For your point of reference it is best to calculate from a normal height: you don’t add up 0,6 grams per kilogram indefinitely. That would imply that if you are a bit taller than average you would need more than the 39 grams from the example.

To my question what the maximum protein-intake should be, she replied that would be 1 gram per kilogram of body weight, related to a normal body weight. This allows for a substantial protein-intake.

So, whether you do or do not believe your diet contributes to your blood protein levels, it takes a lot before your protein intake is too high. It also doesn’t hurt to take a peek at the base of their pyramid: fresh veggies and fruit. Fruit has issues with (blood) sugar, but it’s also the thought that counts here. Grains and even more really starchy foods and sweets should be consumed in smallest quantities in comparison. First and foremost you need to work on your veg (and fruit) and protein intake. A modern perspective that doesn’t clash with the average dietary recommendations going round among lipedema patients. That’s reassuring.

Some have translated the potential impact of protein-intake into a low-protein recommendation. As you can read above, this is not what those following Vodder imply.  A word of caution: Dawson and Pillar (2011) state that low-protein diets are dangerous and quote Mahan and Escott-Stump (2007): “Proteinaceous foods are high in amino acids that are essential for the body. If protein is not acquired in the diet, the body begins to catabolise its own protein stores, resulting in muscle wastage and malnourishment.”