Venous Insufficiency and Varicose Veins: Nutritional Considerations

Chronic venous insufficiency and varicose veins appear to be related to an obesity–promoting Western lifestyle that is low in dietary fiber and physical activity. Evidence suggests that avoidance of these risk factors may reduce the incidence of venous disorders.

In observational studies, the following factors are associated with reduced risk of venous disorders:

• High–fiber diets: Studies of large populations support a relationship between low dietary fiber intake and the prevalence of varicose veins. The presence of varicose veins in some developing areas is associated with increases in refined (fiber–poor) carbohydrates. However, additional studies are needed to investigate whether a high–fiber diet will prevent varicose veins.
• Maintenance of a healthy weight: Many studies have shown that overweight and obese women are more likely to develop varicose veins. Women who are moderately overweight (BMI = 25.0–29.9 kg/m2) have a 50 percent increased risk, compared with nonoverweight women. Women with a BMI > 30 have three times the risk
• Moderate physical activity: Regular physical activity is associated with lower risk for chronic venous insufficiency and varicose veins. Occupations that require prolonged standing are associated with a greater risk.
• Herbal treatments: Certain herbal treatments have been effective for treating chronic venous insufficiency and varicose veins. Although controversial, the following preparations have been shown in clinical trials to be effective:
• Horse chestnut seed: Systematic reviews have concluded that extracts of horse chestnut seed (Aesculus Hippocastanum, 50 milligrams twice daily) reduce leg pain, leg volume, edema, and itching. 
• Diosmin–hesperidin combination: (Daflon 500 milligrams, given twice daily). Long–term controlled clinical trials have revealed that this combination of flavonoids increases venous tone, improves lymphatic drainage, and reduces capillary leakage. These improvements resulted in significant decreases in ankle and calf swelling, discomfort, nighttime cramps, and laboratory measurements.
  
  A recent meta–analysis of controlled clinical trials indicated that adding Daflon to conventional medical therapy increased the likelihood of healing of leg ulcers, compared with conventional therapy alone.
• Butcher’s broom: Extracts of Ruscus Aculaetus (150 milligrams, two to three times daily) improve venous insufficiency. Benefits include redd the likelihood of healing venous leg ulcers by 32 percent, comuction of pain, leg cramps, leg heaviness, and swelling. It is particularly effective when combined with another flavonoid (e.g., hesperidin) and vitamin C.