Nutrition guidelines for Endometriosis
A nutritional approach to endometriosis is aimed at reducing inflammation.
A nutritional approach to endometriosis is aimed at reducing inflammation. The primary food that drives inflammation in the body is sugar. An enhanced desire for sugar may be caused by an emotional element such as not feeling loved or pathological such as overgrowth of Candida albicans. Eliminating sugar therefore is a primary consideration in addressing diet.
Processed foods, and refined-grain based foods, are not only nutrient deficient but may contain many undesirable and possibly endocrine disrupting additives. These ought to be avoided by everyone, independent of a disease diagnosis. The processing itself renders the original food stuffs indigestible by denaturing the very building blocks of the food, especially proteins and fats. Proteins subjected to high heat and pressure such as in the extrusion process of manufacturing different shapes (e.g. crackers, dried pasta, breakfast cereals, etc) change their molecular shape due to unfolding of the tertiary and quadernary structures. These are then harder for the body to digest and use in the synthesis of body tissues as the enzyme “keys” don’t fit the shape of the molecules. The hydrogenation of poly-unsaturated fats breaks molecular bonds within the fat molecule, changing its shape into a trans-fat, which is no longer able to be used by the body. It is uplifting to hear that the USFDA (USA Food and Drug Authority) has recently removed trans-fats from the GRAS (generally recognized as safe) list and has deemed them not fit for human consumption.46
Grains are considered to be inflammatory in nature. Modern agricultural methods and processing of the grains are the main reasons behind this. The extensive use of glyphosphate on most grain crops causes extra phosphate groups to bind to gluten making this protein unavailable to the body’s digestive enzymes. In cases of compromised intestinal lining, this large molecule is able to pass through into the body and create inflammation. Manufactured foods from grains rarely pass through traditional fermentation processes meaning that phytates present in grains are not neutralised, phytates then bind to minerals in the body, especially calcium, and excrete them, resulting in nutrient deficiencies.
Although a Paleo-type diet (primarily meat and vegetables) may not suit everyone long-term, it would be prudent to adopt this type of diet while attempting to overcome endometriosis. Once health has been regained, limiting the amount of grains to a maximum of four serves per day, preferably prepared by traditional fermentation techniques (e.g. sour dough bread), will aid the body in maintaining an adequate response to inflammation.
A diet that is high in fresh, organic vegetables, including lots of green leafy vegetables is the most desirable. Fresh meat is also an important element to include in the diet with organic pasture raised meat the gold standard. Animals raised in such a manner not only have a healthier nutrient profile, they are free from endocrine disrupting chemicals or drugs that may be used in the production of meat as a result of intensive commercial animal husbandry practices. The portion size need not be large, the size and thickness of the palm of the hand will suffice.
The types of fats to include in the diet include animal fats from pasture raised animals as they contain fat soluble vitamins (A, D3, K2) in their most bioavailable form. Butter, ghee, coconut oil and extra virgin olive oil are other top contenders. Vegetable oils may be used but only in their virgin cold pressed form and only used in salad dressings i.e. they should not be heated and used for cooking. Trans-fats should be completely eliminated from the diet as they are highly inflammatory. This therefore, includes all processed and take away foods which currently always contain these harmful fats.
Pure, clean water, free of chemical additives is important in any health regime. It is important here to consider plastic bottles as they have the propensity to leach endocrine disrupting substances into the food or fluid contained within them. BPA (bisphenol-a) is a molecule that mimics oestrogen, while BPA free plastics are available these are made with other analogues of bisphenol (BPB, BPC, etc) it is not the letter on the end that it is problem, it is the bisphenol that has the ability to disrupt steroid hormones within the body. As far as is possible in these modern times, plastic ought to be avoided and never, ever, microwave food in a plastic container. Buying food from bulk co-ops to reduce packaging, buying from farmer’s markets and preparing meals from scratch using fresh ingredients helps to reduce the plastic in your life.
Dietary Supplements
Dietary supplementation may be of benefit to women during the initial stages of treatment to help the body to detoxify excess oestrogen and other toxins in the body. Dietary supplementation for 6 months after conservative laparoscopy showed a better HRQoL improvement than did surgery alone.6
Excess oestrogen is metabolised in the liver. Oestrogen, being a steroid hormone is fat soluble, the liver metabolises the excess oestrogen into a water soluble molecule that can be excreted from the body. Nutrients that help the liver to detoxify include amino acids – Glutamine, Cysteine and Taurine; the B vitamins (Thiamine, riboflavin, nicotinamide, pantothenic acid, pyridoxine, folic acid, cobalamin), vitamin C, D and E and the minerals Magnesium, Selenium and Zinc.
As mentioned previously, endometriosis is associated with under methylation. Nutrients that support the methylation process include activated B vitamins, B6 as pyridoxal 5-phosphate, and B9 in the form of folinic acid which is a metabolised form of folic acid. By using activated forms of these nutrients, the efficiency of the methylation cycle is increased. This is because in conditions of undermethylation, there may possibly be a deficiency in the enzyme methylene tertahydrofolate reductase (MTHFR) which impairs the metabolism of supplemental folic acid, obtaining folates in whole foods (e.g. green leafy vegetables) is not so affected. Cobalamin (B12) is also a requirement to aid in mitochondrial function. Vitamin C and E are synergistic with each other and help to combat oxidative stress which is increased in endometriosis. Magnesium is found to be deficient in a large portion of the population, especially in women who experience dysmenorrhoea, supplementation may help with cramping pains. Zinc is a mineral known to be involved in many enzyme reactions within the body, it is especially important for combating oxidative stress and inhibiting pro-inflammatory cytokines. Iodine is an important trace element for the production of thyroid hormones which in turn influence the levels of other hormones in the body including oestrogen, it also has anti-oxidant effects. As copper levels have been found to be high in women with endometriosis,23 molybdenum is a trace mineral that helps to antagonise copper by interfering with its intestinal absorption. Chromium is a trace mineral that aids the body in metabolising sugar. Hair Tissue Mineral Analysis may be useful in identifying imbalances in minerals.
Suggested minimum doses per day
50 – 100mg B6 (as pyridoxal 5-phosphate)
400mg folic acid or folinic acid
500µg B12
15-30mg Zinc
100µg Molybdenum
200µg Potassium iodide
600mg Magnesium
400µg Chromium picolinate
Omega-3 essential fatty acids from fish oil are known for their ability to dampen inflammation in the body. Dosages of 3 grams per day in divided doses would be a starting point in supplementation along with the inclusion of cold water oily fish at least once per week. In some women, omega-3 supplementation may not bring about the desired relief and supplementation with omega-6 oils such as borage, blackcurrant or evening primrose oil is required to activate the appropriate anti-inflammatory pathways in the body.
It is important for women to maintain a healthy weight as fat cells have the ability to produce oestrogen which drives inflammation. Maintaining a healthy weight therefore contributes to the reduction of inflammation in the body and helps regulate oestrogen production and detoxification.
A minimum daily exercise regime including 30 minutes of gentle walking is beneficial to lift mood, improve circulation and oxygenation of body tissues and therefore help with detoxification.
This article is part of a 4 part series
This is taken from my thesis written in 2016. References are available on request. Next post will cover the homeopathic recommendation for endometriosis.
Great Jayne ! Useful info thank you so much !