Abstract
Lymphedema is a chronic and often irreversible complication of cancer treatment, marked by persistent tissue swelling, fibrosis, and adipose deposition in the affected body region. Although several risk factors have been identified, predicting which patients will develop lymphedema remains a significant clinical challenge. Growing evidence links poor metabolic health and insulin resistance to increased susceptibility to lymphedema, while interventions that improve metabolic function, including glucagon-like peptide-1 (GLP-1) receptor agonists and diabetes medications, have shown symptom-reducing effects. Notably, the ketogenic diet (KD), known for reversing insulin resistance and enhancing metabolic health, has demonstrated promise in managing lymphedema. A KD may confer additional advantages through ketone exposure. This paper explores the hypothesis that proactively improving metabolic and lymphatic health, specifically through ketogenic dietary strategies, could offer a novel means of preventing lymphedema in individuals undergoing cancer treatment. By examining the metabolic underpinnings of lymphedema and the beneficial targets of ketone exposure, we advocate for a paradigm shift: from managing lymphedema as a secondary complication to preventing it through early ketogenic dietary intervention.