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Tuesday, 5 March 2013

Endometriosis Awareness Month 2013 – Part II



Dietary advice is everywhere these days and the number of myriad ways in which people can shove or not shove foodstuffs down their gob seems to be steadily growing every year. For example Wikipedia lists some of the many, many diets you could go on for various reasons. Being bombarded with so much information regarding what we stuff in our mouths does create a lot of confusion though. Sometimes we will hear that a certain food is good for us, whilst simultaneously being told that same food is bad for us, usually by people with different agendas to push.

If all the general advice we get isn’t confusing enough, we also get regular updates about what foods are supposedly good for certain medical conditions (regardless of whether it is true or not). Endometriosis is no exception to this and there are a number of ‘endo diets’ out there you can follow. Some women find adhering to these diets helps their symptoms, which is fantastic news, however some women find it makes no difference. So it seems to be the case that there isn’t a ‘quick fix’ diet solution that will suit the needs of all endo sufferers and it may be a case of trying lots of things before you find something that works for you. But if you do find something that works, it will definitely be worth it.

One of the problems that compounds the issue of diet and endometriosis is that there has been very little proper, scientific research done examining the effect of different foodstuffs on endometriosis. That said, there have been a few articles published recently examining the role diet plays in endometriosis.

Firstly, there was a study from Italy looking at the effect of a gluten-free diet on the pain symptoms of women with endometriosis. I know some women with endo find that reducing or eliminating gluten from their diet helps relieve their pain symptoms. This study seems to very much confirm this as 75% of patients reported a significant change for the better in their pain symptoms - very encouraging results. However I can’t get full access to the paper so I can’t see whether this study was properly controlled. What do I mean by controlled? Well, in order to eliminate false conclusions from being drawn, studies like this have to take into account any factors that could swing the results away from the true values. Let’s consider the study above, what are the factors that could possibly interfere with the results? Were the women also taking any kind of medical therapy that may also change their pain levels? Did any of the women have surgery during the time of the study? Did any of the women have a gluten intolerance that they either did or didn’t know of or other conditions like IBS or Crohns?  How was the patient’s diet monitored to ensure it was definitely gluten free over the 12 months?

Like I said, I don’t have access to the full version of this article so the authors may well have taken all the above factors into consideration and if you want to try a gluten free diet for yourself, by all means give it a try. However, next time you read a magazine or newspaper article giving details about a supposed ‘miracle diet’, think about how well the study was conducted and whether the people conducting the study did it right.

Next up is a study from the US looking at dietary and health records of 70,556 US women over a 14 year period, so it was quite a large study. What they found was that women who developed endometriosis consumed less dairy products than other women. This finding was in agreement with another, smaller US study published in 2011 which had a similar result. However, these two studies are in conflict with an Italian study in 2004 that found dairy product consumption didn’t significantly vary between women with and without endometriosis. Remember when I said it can get very confusing. And again we have issue with what conclusions can be drawn from these results. Some might claim this information shows dairy products are protective against endo, because women who don’t have endo consume more dairy products. Of course another way of looking at it could be that women with endo may be more likely to have a dairy (or lactose) intolerance, which there is some circumstantial evidence to support, hence why they consume less dairy products. 

"well do you want the milk or not, I've got stuff to do y'know" Image courtesy of FreeDigitalPhotos.net

What we really could do with is a review of all the information published on the relationship between diet and endometriosis, which then gives the results from a pool of data. Conveniently that is the final study I’ll be looking at in this blog post. So this review examined the results of eleven different studies into the connection between dietary factors and endometriosis. What they concluded, from all the information that is worth examining, was that women with endometriosis may benefit from eating more vegetables and less red meat and trans fats. Oh, not exactly a radical breakthrough in our dietary intake paradigm, its good advice for, well, anyone really but not exactly giving us anything concrete and specific about endometriosis.

But that, in effect was the other conclusion of the review. There simply isn’t enough robust evidence at the moment to support a link between any specific dietary component and the risk of endometriosis. This isn’t surprising either when you think about it; every woman’s disease is different and every woman’s dietary needs are different, some may have tolerances and intolerances that others don’t, so trying to say one thing with make a difference across the board just isn’t going to be true.

Fortunately a lot of women with endometriosis do find modifying their diet can help reduce their symptoms, unfortunately though it may involve a bit of a trial and error.  Just don’t try anything extreme, for example the Breatharian diet (in fact a good rule is, if a diet has a silly sounding name, just avoid it) and if in doubt consult a doctor or dietician. 

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