Anti-Inflammatory Diet for Endometriosis: Fact or Fad?
Endometriosis is a condition that affects approximately 1 in 10 women of reproductive age and may have serious impacts on one’s quality of life (1). Currently, there is no known cure for endometriosis and treatment is based on managing symptoms (1).
Because of this, there has been increasing research into diet and lifestyle with evidence suggesting that focusing on foods that help reduce inflammation (anti-inflammatory foods) may help relieve endometriosis symptoms (2). But which foods are considered anti-inflammatory? And do they really make a difference? If you would like to learn more about inflammatory foods and their association with endometriosis, then this is the post for you.
What is inflammation?
Inflammation is the body’s natural response to illness or infection. If you have ever had a cut or a bacterial infection, you have likely experienced acute inflammation which usually resolves on its own (3). This is perfectly normal and nothing to be alarmed about as it helps you heal and makes you feel better!
However, inflammation when there is no injury or invader is called systemic inflammation or low grade inflammation (3). This kind of inflammation affects the whole body, builds up over months and years and can cause a range of conditions including obesity, inflammatory bowel disease and endometriosis (3).
What causes inflammation in Endometriosis?
The chronic inflammation associated with endometriosis is driven by the hormones oestrogen and progesterone (4). In women with endometriosis, cells like those of the lining of the womb (also called the endometrium) attach themselves to other parts of the body, commonly in and around the pelvis (4).
These cells undergo changes related to the activity of the menstrual cycle. This causes patches of endometrial tissue to thicken and shed. As these cells cannot leave the body, scar tissue is formed and inflammation is initiated, presenting as pain and discomfort in women suffering with this condition (4).
What foods cause inflammation?
Inflammation may result from a range of factors including exposure to environmental toxins and chronic stress; however, the diet also plays a contributing role towards the persistence of inflammation.
Certain foods have been associated with causing inflammation and therefore reducing your intake may offer some benefit. These foods include:
Red and processed meat e.g., cold cuts and sausages
Deep fried foods e.g., chips, fried chicken, and onion rings etc
Foods high in added sugar e.g., sweets, cakes and biscuits
Sugar sweetened beverages e.g., fizzy drinks
Trans fats, including those found in margarine and biscuits
Cooking and processing methods may also impact the body’s response to various foods. Deep frying or grilling foods (especially red meat) can exacerbate inflammatory processes within the body. Therefore, it is recommended to preferably stick to baking or steaming foods when trying to reduce inflammation (5).
Ultra-processed foods may also contribute to inflammation. These are pre-packaged products that tend to be high in added sugar, trans fat and sodium. Reading and understanding food labels in grocery stores can be really useful when deciding which foods to purchase as they can help identify certain ingredients that should be limited. Look out for sugar (listed as fructose, corn syrup, glucose or other names ending in -ose) and trans fats (listed as partially hydrogenated oils) (5).
Additionally, alcohol and caffeine may negatively affect people with endometriosis due their influence on hormonal regulation and inflammation. Therefore, it may be best to limit, avoid or at least be mindful of your intake of alcohol or caffeine containing drinks (6).
What foods help reduce inflammation?
There isn’t one specific miracle food or diet that can help combat inflammation, however, evidence suggests that healthy eating patterns with a focus on certain food groups and nutrients may help relieve systemic inflammation. These include:
Omega 3 Fatty Acids
Foods rich in vitamin C and other antioxidants
Polyphenols (type of plant compound that can help fight inflammation)
High fibre and fermented foods (these foods can help promote a healthy gut microbiome to support the immune system) (5)
One dietary pattern that has been specifically studied due to its anti-inflammatory nature is the Mediterranean diet. This way of eating has shown potential to reduce systemic inflammation and overall chronic disease risk due to its ability to beneficially alter the gut microbiota and immune system (7).
Given the anti-inflammatory properties of this diet, it could be especially beneficial for people with endometriosis, due to the inflammatory nature of this condition. Check out our post, for more on the Mediterranean diet and its benefits including improving mental health symptoms.
Despite being equipped with this information, it can still be quite challenging to figure out what foods to purchase and consume on a regular basis. To simplify this, we have created a non-exhaustive list of foods rich in these important compounds and nutrients (6) which we recommend to eat frequently.
Fruit, especially berries and citrus fruits: these fruits are rich sources of anthocyanins, a type of antioxidant known for its powerful anti-inflammatory effects. Aiming for a variety of colours will allow you to get the widest range of nutrients
Vegetables: cruciferous veg (e.g., broccoli and cabbage) and dark leafy greens (e.g., kale and spinach) are packed with the antioxidant sulforaphane, which has been shown to help fight inflammation. Again, aiming for variety will help maximise nutritional value
Nuts and seeds: these foods are rich in inflammation fighting omega-3 fats as well as phytonutrients which are beneficial plant compounds
Fish and seafood, especially oily fish such as salmon and mackerel: again, rich in omega-3 fats
Green tea: this is rich in a polyphenol compound called EGGC, which has been shown to have anti-inflammatory properties
Dark chocolate: this is packed with flavanol which is another antioxidant known to help with inflammation (the darker the better!)
Whole grains, including oats, quinoa and brown rice: these foods are rich in fibre which can improve your gut health and help combat inflammation
Can an anti-inflammatory diet help with endometriosis?
Reducing endometriosis risk
Much of the evidence related to the impact of diet on endometriosis looks at the risk of developing endometriosis and not specifically at the role of diet in the treatment and management of the condition. One key factor highlighted is dietary fats, with a study from 2010 showing that intake of saturated and fatty acids was associated with increased risk of endometriosis (8). Interestingly, total fat consumption did not show the same results with another study actually demonstrating that consuming omega-3 fatty acids may help prevent endometriosis (8). This suggests that including healthy fats is an important part of a healthy diet.
Red meat consumption has also been linked with endometriosis risk in some studies (9, 10). The intake of these products has been associated with higher levels of oestradiol which may promote inflammation and the development of endometriosis, seeing as these two factors are closely linked (11).
Given the key role of inflammation in endometriosis, the effects of plant-based diets on reducing inflammation have been of interest. In some studies, increased fruit fibre intake has been shown to reduce endometriosis risk (9,12). This may be due to the fact that plant-based foods have higher amounts of polyphenols, which are broken down by the body into beneficial bioactive compounds that can help combat inflammation (12).
Reducing Endometriosis Symptoms
As endometriosis is an inflammatory condition, aiming to reduce inflammation may act as the key mechanism to aid with symptom management. From the evidence discussed, it can be extrapolated that trying to increase the intake of anti-inflammatory foods and consume less inflammatory foods may also help treat women with endometriosis. Although less attention has been given to examining the use of diet in the treatment of endometriosis, some studies have provided some promising results.
Reducing dietary fat intake while increasing fibre has been shown to reduce levels of oestrogen in the blood, which may be beneficial for women with endometriosis as it is an oestrogen dependent disease (2). Additionally, the anti-inflammatory properties of plant based diets, such as the Mediterranean diet may be of great benefit to women with endometriosis, seeing their ability to reduce systemic inflammation related to the disease (2).
The symptoms related to endometriosis can have a severe impact on the quality of life of women with the condition and interestingly, one study has shown that diet may help directly modulate these symptoms. Consumption of vitamin D, alongside vitamins C and E was shown to significantly reduce endometriosis symptoms, including pelvic pain in comparison to those who did not consume these nutrients (13). Consuming a diet rich in omega-3’s and plant based foods can help you obtain all these beneficial nutrients and help manage your endometriosis symptoms.
Although the evidence of anti-inflammatory diets and endometriosis symptoms is limited, it does show promising results. Furthermore studies showing improvements in inflammation with anti-inflammatory foods provide additional support in this inflammatory condition. Anti-inflammatory foods not only contain these active ingredients to reduce inflammation, they also contain a variety of other nutrients providing further health benefits. Incorporating these foods into your diet can therefore be an easy way for you to potentially help manage your symptoms, as well as enjoy some new delicious foods!
If you would like to read more about endometriosis flares and diet, check out this blog post.