Endometriosis diet: Food to eat and food to avoid

 Key takeaways

• Consuming foods that reduce estrogen levels and inflammation can help alleviate endometriosis symptoms, as inflammation and increased estrogen level are the key things that cause endometriosis symptoms. 
• Foods that may be great for people with endometriosis include foods that are rich in antioxidants, omega-3 fatty acids, and fiber. Gluten-free diets can also be helpful.
• People with endometriosis may want to avoid high intake of red meat, alcohol, and caffeine, as these can aggravate endometriosis symptoms.

Endometriosis is an estrogen-dependent disease characterized by the growth of tissues similar to endometrium (tissues lining the inner layer of the uterus) outside the uterine cavity. Being estrogen-dependent means they rely on estrogen to develop. 

Endometriosis typically causes symptoms like painful menstruation, painful sexual intercourse, and gastrointestinal distress like nausea, diarrhea, and constipation. 

Healthcare professionals don’t know the exact cause of endometriosis. But, they believe the following can contribute to its development and progression: 

• Increased level of estrogen hormone
• Inflammation
• oxidative stress (a process that develops from an imbalance between free radicals and antioxidants resulting in scar tissue formation and inflammation)

Therefore, targeting these in the treatment of endometriosis can help relieve its symptoms and prevent its progression. Certain foods have been shown to increase or decrease the above factors linked to endometriosis, thereby improving or worsening endometriosis symptoms.

If you have endometriosis, understanding the role of diet in endometriosis treatment is crucial to the development of effective dietary patterns. Below are foods you should eat and those you should avoid to help alleviate your symptoms.

 Endometriosis friendly meals

Foods that can help alleviate endometriosis symptoms include the following.

 1. Fruits and vegetables

A higher intake of fruits and vegetables is associated with a lower risk of endometriosis. These foods are also good sources of vitamins.

Vitamins are rich in antioxidants which fight off the free radicals involved in oxidative stress, thereby reducing adhesion formation (thick bands of scar tissues that cause internal organs to be stuck together) and inflammation. This helps relieve endometriosis symptoms. 

 2. Fish oils

Fish oils are rich in omega-3 fatty acids, which are known for their anti-inflammatory effects. Omega-3 is an 'essential nutrient' meaning that your body doesn't produce it, and if you don't eat it, you won't have any in your body.

Salmon, sardines, herring, trout, mackerel, tuna, and anchovies are some examples of foods classified as fish oils. 

 3. Dairy products

Most dairy products are rich in calcium, magnesium, and vitamin D, which play important roles in reducing inflammation and oxidative stress. Some examples are whole milk, skimmed milk, ice cream, yogurt, cheese, and butter. 

While some studies have linked sufficient intake of dairy products to reduced endometriosis symptoms and lower risk of developing endometriosis, other contradictory studies have also been recorded.

The contradictory studies highlighted the possibility of dairy products causing lactose intolerance (the inability of your digestive system to properly digest milk-containing foods) in some individuals and the presence of growth hormones and antibiotics, which can worsen endometriosis symptoms. 

If you're lactose intolerant or allergic to dairy products like milk, you might want to minimize or avoid the intake of dairy products, as taking them might aggravate your symptoms. 

 4. Legumes

Legumes are plant-based foods rich in vitamins B and C, magnesium, and calcium which are known to reduce inflammatory factors seen in endometriosis. They also contain iron which is essential in the production of red blood cells. This is important to prevent anemia related to excess blood loss. Some examples of legumes are beans, lentils, chickpeas, soybeans, and clover.

 5. Eggs

An egg is an animal-derived protein rich in omega-3 fatty acids which plays a good role in reducing inflammation. 

Unless your body reacts to eggs, you may benefit from including eggs in your diet. 

 6. Fibers

Increased intake of dietary fiber has been linked to reduced circulatory estrogen levels in the body, lowering the progression of endometriosis. Fiber does this by altering the gut microbiota (microorganisms found in the intestine that help digest foods), thereby decreasing the reactivation of secreted inactive estrogen and its reabsorption into the body.

Whole grains, legumes, iron-rich foods, fruits, and vegetables fall into this category of food.

 7. Turmeric

Turmeric contains curcumin, a natural anti-inflammatory compound. According to an older 2013 study, it may be said that curcumin suppresses the proliferation of endometriotic cells by decreasing the estrogen level. Using turmeric in preparing your meals is advisable in the dietary management of endometriosis.

 Key nutrients to focus on when sourcing foods for endometriosis

Some key nutrients that should be focused on while trying out some foods for endometriosis are: 

• Omega-3 fatty acids: This is a type of polyunsaturated fatty acid known for its anti-inflammatory effects. It's mostly found in fish and other seafood; nuts and seeds, e.g., flaxseed and walnuts; plant oils, e.g., flaxseed oil, soybean oil, avocado oil, and eggs.
• Fiber: fibers are very good for gut health. They help maintain normal bowel movements. In people with endometriosis, it may also help reduce the level of circulatory estrogen. 
• Vitamins: Vitamins B, C, and D are rich in antioxidants which help reduce oxidative stress and inflammation. Fruits and vegetables are good sources of vitamins.
• Iron: Iron is very important in the production of red blood cells. It is the main part of hemoglobin (a protein in the red blood cells that carries oxygen). To prevent anemia that might result from excess blood loss, it's important you include iron-rich foods in your diet. Some sources are green leafy vegetables, legumes, fish, and poultry.
• Antioxidants: These are molecules that fight the oxidative stress causing adhesions and inflammation in endometriosis. Plant-based foods are rich sources of antioxidants. They're most abundant in fruits, vegetables, nuts, whole grains, fish, and poultry.
• Micronutrients like calcium, magnesium, and zinc: These elements are very potent in anti-inflammation and strengthening the immune system. Some sources include dark green leafy vegetables, nuts, legumes, dairy products, seafood, e.g., oysters and fish, fruits, and vegetables.
• Mono- and poly-unsaturated fatty acids (MUFAs and PUFAs): These are considered the 'healthy fats'. They're known to reduce inflammatory factors and bad cholesterol in the body. Some sources include nuts, e.g., almonds, hazelnut, walnuts, fish oils, olive, vegetable oil, and seeds, e.g., pumpkin. 

 Foods to avoid if you have endometriosis

Certain foods may aggravate the symptoms of endometriosis. They include: 

 1. Red meat

Red meat has been associated with an increased risk of endometriosis. It increases estrogen levels and inflammatory factors, which are involved in the development and progression of endometriosis.

This may be linked to the presence of heme iron which is abundant in red meat. A 2018 study showed that women who consumed ≥2 servings of red meat per day had increased endometriosis symptoms.

In as much as iron is important in replacing blood loss, red meat should be consumed in minimal quantities. Red meat can be replaced with fish, poultry-derived meat, and plant-based foods, which are also sources of iron. 

 2. Trans and saturated fatty acids

These fats are considered the 'unhealthy fats'. They stimulate the production of inflammatory factors and increase inflammation. Studies suggest that diets rich in these fats have negative effects on endometriosis, hence worsening the symptoms. Trans and saturated fats can be found in fried foods, baked foods, margarine and other spreads, and red meat.

 3. Caffeine

Too much caffeine can create an inflammatory reaction in the body, worsening endometriosis symptoms. A study found that high caffeine intake (>300 mg per day) among people with endometriosis significantly increased the risk of endometriosis compared to little or no caffeine (<100 mg per day).

 4. Alcohol

Alcohol raises estrogen levels resulting in inflammation, thereby worsening endometriosis pains. Limiting alcohol intake to one glass once in a while is advised in the dietary management of endometriosis.

 5. Processed foods

It is best to avoid eating processed foods as most of them contain artificial sugar and sweeteners, trans, and saturated fatty acids, which create room for inflammation. Feeding on fresh foods is often the best when it comes to alleviating endometriosis symptoms.

 Symptoms of endometriosis that can be impacted by food

Certain foods can improve or worsen endometriosis symptoms. Below are some symptoms that can be impacted by food:

• Dysmenorrhea (painful menstruation): Consuming foods that increase inflammation, as listed above, can worsen pains during periods. Therefore, it is advisable to eat foods with anti-inflammatory effects.
• Painful sexual intercourse: Pain during intercourse results from adhesions and inflammation present in endometriosis. Consuming foods that reduce estrogen levels which will, in turn, reduce inflammation and adhesions, will improve the pain experienced during intercourse.
• Gastrointestinal distress: This includes diarrhea, constipation, bloating, nausea, and vomiting: Some individuals are allergic to gluten and some dairy products, and these mostly affect the digestive tract. Hence, avoiding these can help improve symptoms. Sufficient intake of fiber can also help improve gastrointestinal discomfort. 
• Anemia: Including iron-rich foods in your diet can help prevent anemia resulting from excess blood loss.

 Can supplements help with endometriosis?

Supplements may be needed in cases where a person with endometriosis does not get enough nutrients through foods. Also, patients with severe endometriosis might benefit from supplementation as a complementary treatment. Some dietary supplements that can help include omega-3 fatty acids, vitamins B, C, D, and E. 

 Can gluten-free diets help with endometriosis?

Glutens cause hormonal imbalances and inflammation which can worsen endometriosis symptoms. Research indicates that gluten-free diets may improve symptoms of endometriosis . Going on gluten-free diets can help relieve endometriosis symptoms.

 Wrap-up

Dietary management of endometriosis is very beneficial in the management of endometriosis as food influences the state of health. Certain nutrients like vitamins, omega-3 fatty acids, antioxidants, and iron-rich foods have been proven to improve endometriosis symptoms and lower its risk, while trans fat, alcohol, and caffeine have been shown to worsen the symptoms. 

Eliminating some foods from your dietary options is not always easy. Still, it's important you pay attention to what you eat. You can speak with a registered dietitian to use available food options and help you draw up a 7-days meal plan. This will help you manage your condition better. References