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DAY ONE

LIPEDEMA STRONG START

Welcome! I’m so glad you’re here. Watch the day one video below.

cravenourishment_thelippyrd

Lipedema Nutrition RD
Board-Certified in Obesity Care
170-lb Loss • Stage 2
The Lipedema Method™| Precision | Data-Driven | Root Cause
👇 Start Here

Boston Lymphatic Symposium, research by Andrzej Sz

Boston Lymphatic Symposium, research by Andrzej Szuba, PhD. from Poland.

A new 2025 study explored a Mediterranean-style ketogenic diet in women with lipedema, and the findings are important.

After 7 months:

• CRP decreased
• IL-6 decreased
• Dietary Inflammatory Index (DII) significantly improved

Even though the diet was high in fat, inflammation markers dropped. Why?

Because fat quality and nutrient density matter.

This version of keto emphasized:
✔️ Olive oil and omega-3 fats
✔️ Vegetables and herbs
✔️ Antioxidant nutrients
✔️ Anti-inflammatory food compounds

Researchers concluded that the reduction in systemic inflammation was linked to nutrient composition, not calorie restriction alone

nutrients-17-03014
Link: https://www.mdpi.com/2072-6643/17/18/3014

For women with lipedema, this reinforces something critical:

Inflammation modulation through strategic nutrition is possible.

And diet quality always matters more than the diet label. There is no one-size-fits-all. Nutrition matters, food quality matters, and not all calories are the same.

Healthful eating rich in fiber, protein, and healthy fats lowers inflammation.

#LipedemaResearch #AntiInflammatoryNutrition #LipedemaCare
#NoOneSizeFitsAllNutrition #EvidenceBasedNutrition

Lisa is our Featured Guest Speaker, and she is tru

Lisa is our Featured Guest Speaker, and she is truly exceptional.

A nationally recognized leader in Public Speaking, Burnout Prevention, Organizational Development, Executive Coaching, and Leadership Development, Lisa works with high-performing executives and organizations to create sustainable success.

She is also a podcast voice on CTRL, ALT, DELETE, where she speaks about leadership, resilience, and navigating complex careers with clarity and strength.

What makes this even more powerful for our community is that Lisa is also a successful woman living with lipedema, balancing the demands of a high-level career while managing her health with intention.

In our session, she will guide us through how to Pause, Notice, and Choose, teaching us how to re-architect our internal leadership so we can manage, live, and truly thrive with lipedema instead of feeling controlled by it.

She embodies what is possible: high achievement, grounded self-awareness, and sustainable success, all while navigating lipedema.

This is a rare opportunity to learn from someone who understands both executive-level performance and the lived experience of this condition.

This will be a very special conversation.

Need a great speaker, find on LinkedIn at: https://www.linkedin.com/in/lisaduerre/

#LipedemaLeadership
#ThrivingWithLipedema
#WomenWhoLead
#LipedemaStrong
#HighAchievingWomen

Do you struggle with acid reflux, or GERD, as a Li

Do you struggle with acid reflux, or GERD, as a Lippy Lady? This is so common! Many of the women in my practice are medicating this with a Proton Pump Inhibitor (PPI) and still experiencing uncomfortable episodes of reflux. Here’s why this could be happening. . .

💡 Research shows that 85-98% of reflux episodes in patients with reflux esophagitis contain both acid and bile. Most reflux is actually mixed reflux.

Bile acids act synergistically with acid and pepsin to cause more severe mucosal injury than acid alone. Even brief exposure to bile acids in acidic conditions can disrupt esophageal integrity and activate pain pathways.

Secondary bile acids (like deoxycholic acid) are particularly toxic and are found in higher proportions in erosive esophagitis and Barrett’s esophagus.

Here’s what that means for symptoms:

✅ Some reflux persists despite PPI therapy
✅ Symptoms can occur even with weakly acidic reflux
✅ Nighttime symptoms are common

In Lipedema, we often see these things, which may contribute to reflux physiology:

✅ Insulin resistance
✅ Estrogen dominance
✅ Dysbiosis
✅ Altered bile metabolism
✅ Connective tissue laxity

💡 So, what’s the solution? Great question!

Clinically, I often incorporate soluble fiber (psyllium husk or beta-glucan) as a gentle bile-binding strategy. Research supports the use of fiber supplementation to reduce reflux episodes and improve lower esophageal sphincter tone.

Here’s how this will help you. These fibers:

✅ Bind bile acids
✅ Increase fecal excretion of bile
✅ Support microbiome balance
✅ Improve metabolic regulation
✅ Reduce inflammatory signaling

⭐️ The big takeaway here?

Reflux isn’t always just excess acid. Sometimes it’s bile dysregulation layered onto metabolic dysfunction. And when we address root physiology, symptoms often improve.

#LipedemaDietitian #CraveNourishment_TheLippyRD #GERDEducation #AntiInflammatoryLiving #EvidenceBasedNutrition

It’s National Protein Day! Are you prioritizing

It’s National Protein Day! Are you prioritizing protein on your plate?! 🤔⁣
⁣
I know this can feel daunting at times, so I’m here with some simple ideas you can try to up your protein intake. ⁣
⁣
⭐ As a general rule of thumb, I encourage my clients to focus on whole food sources of protein over things like bars, shakes, and protein powders. ⁣
⁣
Our bodies respond so much better to whole foods, and you’ll notice a wide variety of positive effects when making this switch! From better digestion to increased feelings of satiety, whole food sources will have a big impact! ✅⁣
⁣
Some of my favorite protein sources include:⁣
✅ Eggs⁣
✅ Yogurt⁣
✅ Chicken⁣
✅ Shrimp⁣
✅ Fish⁣
✅ Ground Turkey ⁣
✅ Tempeh⁣
✅ Tofu⁣
✅ Edamame⁣
✅ Beans⁣
✅ Lentils ⁣
⁣
👉 SWIPE to see some mix-and-match meals you can make for breakfast, lunch or dinner that prioritize BOTH protein and fiber! ⁣
⁣
What are some of your favorite, go-to protein sources? Share in the comments below! ⁣
⁣
#cravenourishment #lipedemadietitian #thelippyrd #LipedemaSupport #LipedemaNutrition #highprotein #protein

Lipedema is biologically distinct. New research f

Lipedema is biologically distinct.

New research from over 10 years of lipedema analysis by Sara Al-Ghadban, PhD. (University of Virginia) reinforce something many of us already suspected:

• Inflammation is inherent to lipedema tissue; elevated macrophages are present even in non-obese women.

• Adipose-derived stem cells (ASCs) may help drive abnormal fat expansion.

• Lipedema tissue is highly adipogenic (builds fat) compared to non-lipedema tissue.

• Inflammatory gene expression is elevated.

• Matrix protein gene expression is reduced, suggesting structural extracellular collagen matrix (ECM) remodeling.

• High estrogen increases PPARγ, promoting fat cell differentiation and accumulation. PPARy is a nuclear receptor that turns on genes that promote fat cell formation.

Taken together, this supports that lipedema is a chronic inflammatory syndrome with unique molecular and hormonal drivers.

This shifts the clinical lens:

Not “eat less.”
Not “try harder.”

But regulate inflammation.
Support hormone balance.
Improve metabolic flexibility.
Protect extracellular matrix health.

When the tissue behaves differently, the strategy must be different.

Please share if this was helpful. 😊

#LipedemaResearch
#Cravenourishment_thelippyRD #ChronicInflammation #PrecisionNutrition
#RegisteredDietitian

Histamine + Lipedema: Is It a DAO Issue… or a Me

Histamine + Lipedema: Is It a DAO Issue… or a Methylation Issue?

I am helping a client navigate this path, and I wanted to share what I think you should know.

If you’re navigating histamine symptoms with lipedema, jumping straight to a supplement may not always be the first step.

Histamine is broken down through two different pathways in the body, and which one is impaired matters.

1️⃣ The DAO Pathway (Gut-Based)

Enzyme: Diamine oxidase (DAO)
Location: Intestinal lining
Handles: Histamine from food

When DAO is low, you may see:

* High plasma histamine on a lab test (in a flare up)
* Symptoms triggered by high-histamine foods
* GI-dominant symptoms (bloating, flushing, headaches after meals)

👉 In this case, DAO supplementation may help.

2️⃣ The HNMT Pathway (Intracellular / Methylation-Dependent)

Enzyme: Histamine N-methyltransferase (HNMT)
Location: Inside cells (liver, kidneys, CNS, bronchial tissue)
Requires: Adequate methylation support

HNMT converts histamine → N-methylhistamine (NMH), which is then excreted in urine.

If urinary NMH is low, this may suggest:

* Reduced HNMT activity
* Impaired intracellular histamine breakdown
* Methylation insufficiency
* Genetic variants (COMT or HNMT SNPs)

If plasma histamine is elevated AND NMH is low, this pattern suggests:
✔ Histamine is being produced
✖ But intracellular breakdown is impaired

That’s not a gut DAO issue.
That’s a methylation issue.

So What Do We Do?

Instead of automatically adding DAO, we ask:

* What do labs show? (plasma histamine + urinary NMH)
* What does DNA testing reveal? (COMT, HNMT variants)
* Are methyl donors adequate?

In a methylation-driven pattern, we may consider:

* A methylated B complex
* Phosphatidylcholine support
* Targeted methylation support

Precision matters, especially in lipedema, where inflammation, mast cell activity, and tissue remodeling already complicate the picture.

Testing guides strategy. Guessing creates noise.

If this resonates, save this post and share.

#LipedemaSupport #HistamineIntolerance ##PrecisionNutrition #Cravenourishment_theLippyRD

Lipedema is NOT just “stubborn fat.” The biol

Lipedema is NOT just “stubborn fat.”

The biology tells a much deeper story.

Research from Dr. Tara Karnezis shows that lipedema involves dysregulated extracellular matrix (ECM) organization, progressive interstitial fibrosis, and increased collagen accumulation in affected tissue.

In a 2022 study published in the International Journal of Obesity, she uncovered transcriptional profiling of adipose-derived stem cells revealed 3,400+ differentially expressed genes, with ECM signaling pathways prominently disrupted.

Here’s where it gets even more compelling:

**GPC4 (Glypican-4), found on the X chromosome, has been identified as altered in lipedema.

GPC4 plays a role in cell growth signaling and adipocyte regulation. Because it’s X-linked, this may help explain the overwhelming female predominance of lipedema. Changes in GPC4 expression may influence how fat tissue develops, communicates, and remodels.

** FBLN7 (Fibulin-7), a protein important for the structural integrity of the extracellular matrix, has been found to be reduced in lipedema tissue. Lower FBLN7 may impair normal ECM stability and organization, contributing to abnormal collagen deposition and fibrosis as lipedema progresses.
In addition, lipedema tissue shows:

• Stage-dependent increases in interstitial collagen as lipedema progresses

• Dysregulation of matrix metalloproteinase pathways (including the MMP14–caveolin axis)

• Immune involvement, particularly M2 macrophages influencing ECM remodeling

Translation?

This is a connective tissue remodeling issue with immune and genetic influences, not a failure of willpower.

Understanding ECM disruption, fibrosis progression, and X-linked signaling pathways shifts the narrative from blame to biology.

#LipedemaResearch
#CraveNourishment_TheLippyRD #LipedemaAwareness #EvidenceBasedNutrition #LipedemaDietitian

I left the Boston Lymphatic Conference energized a

I left the Boston Lymphatic Conference energized and deeply reflective.

It was an honor to listen, to learn, and to challenge my own biases in how I deliver care. Growth requires humility. It asks us to stay open. To stay curious. To question what we think we know.

Advancing care for lipedema isn’t about defending positions, it’s about bringing rigorous science forward, collaborating across disciplines, and continually refining how we serve.

The goal is simple: better outcomes, better conversations, and a better quality of life for those living with lipedema.

Forever a student. Always evolving.

#LipedemaCare #LymphaticHealth #EvidenceBasedNutrition #ScienceForward #HealthcareLeadership

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