Insights into diet, psychological distress, and personality traits among patients with lower-extremity lymphedema and overweight/obesity in comparison to patients with lifestyle-induced overweight/obesity and patients with normal body weight

Obesity is a leading cause of cardiovascular diseases. There are significant and mutual associations between lymphatic dysfunction and obesity. This case-control study aimed to compare nutrient intake, depressive symptoms, and Eysenck's personality traits in patients with lower extremity lymphedema and overweight/obesity (n = 34) in comparison to patients with lifestyle-induced overweight/obesity (n = 30) and patients with normal body weight (n = 30). The study groups were evaluated using the Food Frequency Questionnaire (FFQ), Beck Depression Inventory-II, and Eysenck Personality Questionnaire-Revised (EPQ-R). Surprisingly, the study groups did not differ in any item in the FFQ, including total daily energy value and total intake of macronutrients, vitamins, or minerals. The group with lymphedema and overweight/obesity had higher scores on the depression scale, and the groups with lymphedema and overweight/obesity and lifestyle-induced overweight/obesity differed from the control group in Eysenck's psychoticism score; however, in all study groups, the scores of this trait were within the normal range. In conclusion, our study suggests that when FFQ is used, the problem of under-reporting of usual dietary intake among patients with lower extremity lymphedema and overweight/obesity, and lifestyle-induced overweight/obesity should be considered.