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Endometriosis Nutritionist
IS THERE A UNIVERSAL DIET TO TACKLE ENDOMETRIOSIS?
If we were to answer this question, the answer would simply be no . However, there is nothing that can be called simple about endometriosis. It is a very complex pathology where many factors must be taken into consideration; when we talk about diet and endometriosis, even in this case simplicity is not a word that we can consider.
Endometriosis is a female disease caused by the abnormal accumulation of endometrial cells outside the uterus . Usually the endometrial cells should be inside it. This anomaly causes chronic inflammation in the body, harmful to the female system, which manifests itself through severe pain and intestinal suffering.
About 176 million women worldwide are affected (1). Symptoms can range from very intense pain during the menstrual period, chronic pelvic pain , to infertility - these and other symptoms can vary from person to person. Furthermore, the intensity of the pain does not always reflect the severity of the disease (2).
When we talk about diet and endometriosis there are two areas on which we must focus: prevention and the application of nutrition for therapeutic purposes.
Endometriosis diet
PREVENTION
Carrying out research aimed at obtaining meaningful data regarding a preventive diet can present numerous obstacles.
To demonstrate with certainty that certain foods can reduce the risk of developing this disease, the researchers, as a control group, would need a population without endometriosis. As there are currently no reliable blood tests to diagnose it, it would mean that all individuals considered for the study should undergo a laparoscopy to make sure they do not have this pathology; which is not very feasible, being a very invasive and expensive exam.
Alternatively, it could be possible to monitor the progress of the disease in a group of women who have already been diagnosed with endometriosis while following a specific diet, however even this method could prove to be unsuccessful since asking patients to remember or monitor everything they have. eaten over a relatively long period may be hardly achievable.
Having said that, when we talk about prevention, as a qualified nutrition biologist and researcher I can only say that there are still no tangible and reliable data and that there is no clear correlation between the intake of certain foods and the risk of developing endometriosis. On this topic, research has yet to give many answers.
Endometriosis diet
THERAPEUTIC USE
What research can show us with greater certainty regarding the correlation between endometriosis and diet, is how certain symptoms can improve or reduce their intensity by adding or removing certain key foods in our diet.
The two main diets to consider in relation to endometriosis:
FODMAP : The term collects fermentable oligosaccharides, disaccharides, monosaccharides and polyols. These are carbohydrates present in a large amount of different foods such as dairy and starchy products, or in certain fruits or vegetables such as apple, peach, watermelon, onion, garlic, mushrooms etc. When these molecules are removed or introduced to a limited extent, they promote some improvements in women with irritable bowel syndrome (IBS) in conjunction with endometriosis (3). However, eliminating so many types of foods and consequently so many important nutrients in the long term can be very risky for your health, which is why it is always good to contact a specialized professional such as Dr. D'Imperio.
Anti-inflammatory : I want to emphasize that there is no universal anti-inflammatory diet for endometriosis. That said, women with endometriosis have a state of chronic inflammation - building a diet based on reducing the intake of pro-inflammatory foods and increasing anti-inflammatory foods could mitigate the risk or severity of endometriosis.
Endometriosi cibi si cibi no
PROTEIN
Fish : Omega 3s found in fish, seafood and some seeds appear to reduce inflammation and also hinder the synthesis of prostaglandins (4). Some prostaglandins can be elevated in women with endometriosis and contribute to pain (5).
Few studies have looked at the direct effect of fish on endometriosis symptoms, however, some researchers suggest that women with endometriosis consume lower amounts of Omega 3 (6) and those with higher levels of Omega 3 in their blood have a reduced risk. to develop endometriosis (7,8).
Other studies suggest that what is most important is the ratio of Omega 3 to Omega 6 for reducing inflammation (9).
If you want to achieve your goals, "do it yourself diets" don't work. Trust a true professional and make an appointment for a nutritional consultation now.
Red Meat : Maintaining a low-red meat diet has been recommended for many chronic conditions such as cardiovascular disease and colon cancer (10,11).
Research on endometriosis is still in its infancy, although some research shows that reducing the consumption of red and processed meats (<2 servings per week) may be useful not only to mitigate the pain of endometriosis by reducing inflammation but also to reduce the risk of developing it (11,12).
All this must be balanced with the awareness that many women with endometriosis can have periods with heavy blood loss, and therefore need a higher iron requirement . To overcome this problem, a selection of iron-rich plant foods such as dark green leafy vegetables, fruits, nuts and seeds can prove beneficial.
When general health conditions are complicated by various diseases, the best thing is to contact an expert nutritionist such as Dr. D'Imperio who will be able to recommend the most suitable foods for a healthy and correct diet.
Vegetables : The intake of certain vegetables is also a matter of debate when endometriosis studies are conducted. While we know that for overall health, components contained in fruits and vegetables such as flavonoids and polyphenols have been shown to have substantial anti-inflammatory and antioxidant effects, (13,14) when we examine them in relation to endometriosis the result is not so clear.
Some small studies show that these compounds are useful specifically for reducing the inflammation of endometriosis (13), however for some women, eating more than one serving per day of vegetables from the brassicacea family (cauliflower, broccoli, cabbage, etc.) may increase the risk of endometriosis (25). Researchers suggest that this may indicate a role for gastrointestinal symptoms in both the presentation and exacerbation of endometriosis-related pain (25).
This indicates not to stop this group of nutritious foods, but to include a serving and then for larger quantities, evaluate the symptoms. It is also worth remembering that the limitations of dietary studies conducted over long periods of time, as previously mentioned, require careful memory recall, often from many years ago.
Having said that, pay attention to do-it-yourself diets. It is always better to contact an expert such as Dr. D'Imperio before venturing into home diets and risking nutritional imbalances or pathologies.
Fats: Hydrogenated fats are often found in confectionery products, baked foods, frozen foods, and freeze-dried foods. Generally hydrogenated fats are present in spreads, crackers, snacks, puddings and mousses, ice creams, fillings and have been implicated in the origin of chronic health conditions such as diabetes and cardiovascular disease (16).
Several studies (7) have suggested that the risk of endometriosis increases when larger amounts of hydrogenated fats are consumed in the diet or when hydrogenated fats are substituted for carbohydrates. They have also been shown to negatively impact menstrual pain for endometriosis sufferers (17).
In line with general health recommendations, it is best to remove or minimize dietary hydrogenated fats to below 1% (7,16).
GLUTINE ENDOMETRIOSI
Gluten free : Gluten is a protein found primarily in wheat, barley, rye, and oat grains, although it is commonly found in other foods such as beer, ready-made condiments, sausages, and is present as a thickener in many store-bought sauces. . Celiac disease is a chronic autoimmune disease that causes the body's immune reaction to gluten intake. People with celiac disease need to eliminate all sources of gluten from their diets in order for their digestive system to function optimally.
Some studies have shown an overlap between celiac disease and endometriosis . The relationship has yet to be clarified overall, but it has been thought that the inflammation of the intestine caused by celiac disease may trigger the onset (or worsen) of the symptoms of endometriosis (18); there are also case studies in which women have had both diseases at the same time (19).
Most people are not celiac, but many report having some type of non-celiac gluten sensitivity (NCGS) (20) with symptoms such as flatulence, bloating, and disturbed bowel function, similar to some of the intestinal symptoms of endometriosis.
However, only one study has been conducted so far examining the benefits of a gluten-free diet on endometriosis symptoms (21). This was done over a 12-month period, mainly examining its effect on pain as a symptom of endometriosis: generalized pelvic pain, particularly painful menstrual cycles, and improved quality of life.
The results were positive, recording that 75% of people showed a lower presence of pain in all areas and an improvement in the quality of life; the remaining 25% had pain the same as before without any worsening.
However, the study was retrospective, making it more difficult to be certain of the results. In general, if you remove gluten from our diet and feel better, then this is a good result. If this reduces your symptoms, you can try this route.
The important thing is to always make use of specialized advice, avoiding diets done independently without having any knowledge of nutrition
Contact Dr. D'Imperio now for a specialized visit. Thanks to his academic studies, his doctorate in biochemistry and two masters in nutrition he will be able to provide you with a highly personalized nutritional plan keeping in mind your preferences, recent and past eating habits, diseases and allergies.
Diet for endometriosis
FINAL CONSIDERATIONS
In light of the conflicting scientific evidence regarding the benefits and correlation between edometriosis and diet, many professionals such as nutrition biologist Sara D'Imperio may decide to opt for a rather practical approach called RA-RA (remove, asses, reintroduce asses ) which translated literally means remove, evaluate, reintroduce, evaluate.
For this type of approach it is essential to contact an expert nutritionist before venturing into home diets and risking nutritional imbalances, the development of pathologies or worsening existing ones.
Until there is scientific evidence to support one particular nutritional therapy rather than another, this appears to be the best option.
What is certain is that as more research is carried out on the subject, the more we will know about endometriosis and consequently we will be able to refine the use of diet as a therapeutic tool to combat this pathology.
Dr. Sara D'Imperio
Sara D'Imperio as a qualified nutritionist biologist helps clients in the Novara, Borgomanero and province areas to live life in a healthier way. In addition to his doctorate in biochemistry, he obtained two masters in nutrition.
Provides nutritional advice for:
Children
Families
Adults
To make an appointment with Sara, contact her online or call her +393457404660
1) http://endometriosis.org/resources/articles/facts-about-endometriosis/ accessed 23.4.20
2) Szendei G et al 2005 : Is there any correlation between stages of endometriosis and severity of chronic pelvic pain? Possibilities of treatment . Gynecol Endocrinol. 21 (2): 93-100.
3) Moore J et Al 2017 : “ Endometriosis in patients with IBS: Specific symptomatic & demographic profile and response to the low FODMAP diet. "ANZJOG; 57, (2): 201-205).
4) Fereidoon S et al 2018 : Omega-3 Polyunsaturated Fatty Acids and Their Health Benefits
Annual Review of Food Science and Technology 9: 1, 345-381
5) Arosh JA et al 2015 : Molecular and preclinical basis to inhibit PGE2 receptors EP2 and EP4 as a novel nonsteroidal therapy for endometriosis . Proc Natl Acad Sci USA; 112 (31): 9716–9721.
6) Parazzini F et al 2013 : “ Diet and endometriosis risk: A literature review”: Reproductive BioMedicine Online ; 26, 323–336
7) Missmer SA, et al 2010 : A prospective study of dietary fat consumption and endometriosis risk . Hum Reprod. Jun; 25 (6): 1528-35.
8) Hopeman MM et al 2015 : Serum Polyunsaturated Fatty Acids and Endometriosis . Reprod Sci; 22 (9): 1083-1087.
9) Gazvani MR et al 2001:. High omega-3: omega-6 fatty acid ratios in culture medium reduce endometrial-cell survival in combined endometrial gland and stromal cell cultures from women with and without endometriosis . Fertil Steril; 76 (4): 717-722.
10) Czerwonka M, Tokarz 2017 : Iron in red meat-friend or foe. Meat sci; 123: 157–165.
11) Simmen RCM, Kelley AS. 2018 : Seeing red: diet and endometriosis risk . Ann Transl Med.; 6 (Suppl 2): S119
12) Yamamoto A et al 2018 : A prospective cohort study of meat and fish consumption and endometriosis risk . Am J Obstet Gynecol. Aug; 219 (2): 178.e1-178.e10.
13) González R et al 2011 : Effects of Flavonoids and other Polyphenols on Inflammation, Critical Reviews in Food Science and Nutrition , 51: 4, 331-362.
14) Dull AM et al 2019 : Therapeutic Approaches of Resveratrol on Endometriosis via Anti-Inflammatory and Anti-Angiogenic Pathways . Molecules. 24 (4): 667.
15) Harris HR et al 2018 : Fruit and vegetable consumption and risk of endometriosis . Hum Reprod; 33 (4): 715–727.
16) Wanders AJ, et al 2017:. Trans Fat Intake and Its Dietary Sources in General Populations Worldwide: A Systematic Review . Nutrients; 9 (8): 840. Published 2017 Au
17) Hansen SO, Knudsen UB 2013 : Endometriosis, dysmenorrhoea and diet . Eur J Obstet Gynecol Reprod Biol; 169 (2): 162–171.
18) Caserta D et al 2014 : Celiac disease and endometriosis: an insidious and worrisome association hard to diagnose: a case report . Clin Exp Obstet Gynecol; 41 (3): 346–348.
19) Stephansson O et al 2011 : Risk of endometriosis in 11 000 women with celiac disease , Human Reproduction, Volume 26, Issue 10, October, Pages 2896–2901,
20) Biesiekierski JR et al 2015:. Non-coeliac gluten sensitivity: piecing the puzzle together . United European Gastroenterol J; 3 (2): 160–165.
21) Martial M et al 2012:. Gluten-free diet: a new strategy for management of painful endometriosis related symptoms? Minerva Chir; 67 (6): 499-504
22) Kobayashi H et al 2009 : The role of iron in the pathogenesis of endometriosis. Gynecol Endocrinol ; 25 (1): 39–52.
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