The Effect of Mediterranean Diet on Pain Level and Biochemical Parameters in Women With Lipedema

Objective: To evaluate the effects of a 3-month Mediterranean diet-based intervention on anthropometric and metabolic outcomes, pain and central sensitisation-related symptoms in women with lipedema. Methods: In this non-randomised controlled intervention study, 86 women with lipedema were enrolled and 67 completed the study (intervention, n 33; control, n 34). Participants were allocated alternately according to enrolment order. The intervention group received an individualised energy-restricted Mediterranean diet (1300-1500 kcal/d) for 3 months, whereas controls received no dietary intervention. MEDAS, CSI and VAS scores, anthropometric measurements, and biochemical and inflammatory parameters were assessed. Results: After 3 months, the intervention group showed improvements in anthropometric measures and lipid profile, whereas changes in inflammatory markers were limited. MEDAS scores increased from 4.8 to 10.7, CSI scores decreased from 40.2 to 16.3 and VAS scores decreased from 4.1 to 0.9; corresponding changes in controls were 4.1 to 2.7, 41.2 to 43.4 and 3.7 to 5.0, respectively (all between-group changes, p \< 0.001). In the intervention group, higher MEDAS scores remained significantly associated with lower pain after accounting for body-weight change (β = -0.471, p= 0.005), whereas body-weight change was not significantly associated with final VAS score (β = 0.201, p= 0.208). Conclusions: A 3-month Mediterranean diet-based intervention was associated with improvements in pain, central sensitisation-related symptoms and anthropometric and metabolic outcomes in women with lipedema. Larger randomised controlled trials with longer follow-up are warranted.