Exploring the Anti-Inflammatory Potential of a Mediterranean-Style Ketogenic Diet in Women with Lipedema

<b>Background/Objectives:</b> Lipedema is a chronic adipose tissue disorder characterized by disproportionate fat accumulation and inflammation, predominantly affecting women. While recent evidence suggests a systemic pro-inflammatory state in lipedema, the role of diet in modulating inflammation remains underexplored. This study assessed the anti-inflammatory potential of a Mediterranean-style ketogenic diet and its effects after 7 months of adherence on systemic inflammation markers (CRP and IL-6) in women with lipedema (n = 24) and a control group with overweight/obesity (n = 24). <b>Methods:</b> The Dietary Inflammatory Index (DII) was used to characterize the inflammatory potential of the diet throughout the intervention. Dietary intake was analyzed pre- and post-intervention, and anthropometric, body composition, and biochemical parameters were measured. <b>Results:</b> Beyond its beneficial effects on body composition (significant reductions in body weight, fat, leg circumferences, and visceral fat), the intervention diet also demonstrated anti-inflammatory potential. In lipedema, baseline diet showed a pro-inflammatory DII profile (DII/day = 3.04), which was reduced by about 1.5 points after the intervention (<i>p</i> = 0.008). When expressed per 1000 kcal, the DII values were markedly lower for both baseline (DII = 0.22) and intervention diet (DII = ~0.01). Following the intervention diet, reduction in CRP (-0.39, <i>p</i> = 0.016) and IL-6 levels (-0.33, <i>p</i> = 0.034) in lipedema were observed. A significant positive association was observed between the intervention diet's DII and CRP (r = 0.55, <i>p</i> = 0.005), and between the baseline diet's DII and IL-6 (r = 0.50, <i>p</i> = 0.013) in lipedema group. <b>Conclusions:</b> These findings suggest that ketogenic diet rich in anti-inflammatory and antioxidant nutrients can reduce systemic inflammation in lipedema patients, independently of caloric restriction.