Endometriosis affects 1 in 10 women, and is characterised by the endometrial-like tissue from the uterus growing outside of the uterus itself, often causing chronic pelvic pain, inflammation and other complications. Endometriosis is commonly associated with infertility, though in reality only 30-50% of endo warriors will experience impacts to their fertility (Bulleti et. al, 2010).
Given endometriosis is an inflammatory condition, using an anti-inflammatory diet and lifestyle to treat or manage the condition is an area of interest. Particularly given that women with endometriosis are at greater risk of obstetric complications such as preterm birth and low birth weight than those without endo (Kyozuka et. al, 2021), the potential of an anti-inflammatory diet to reduce these risks is an area of increasing interest and research.
So, how does endometriosis impact pregnancy and obstetric outcomes?
Being a chronic inflammatory condition, endometriosis increases the risk of preterm birth before 34 weeks, and low birth weight of below 1.5 kg in pregnant women – both of which can cause further health complications and neurological defects in children later in life (Kyozuka et. al, 2021). A recent large-scale study conducted on Japanese women addressed whether an anti-inflammatory diet could reduce these risks for women with endometriosis (Kyozuka et. al, 2021).
Given that your diet influences inflammation in the body, eating patterns such as a Western diet (high in energy, processed foods and trans fats) promotes inflammation in the body (Simmen & Kelley, 2018), potentially worsening obstetric complications for women with endo (Kyozuka et. al, 2021). This way of eating can also increase the risk of inflammatory-related health conditions, including cardiovascular disease, diabetes, asthma and depression (Kyozuka et. al, 2021).
On the other hand, an anti-inflammatory diet, such as the Mediterranean diet, promotes a greater intake of vegetables, mineral-rich foods, healthy fats and lean proteins, and can have strong health benefits (Kyozuka et. al, 2021). The study analysed whether these anti-inflammatory eating patterns could have similar health benefits for pregnant women with endo, by reducing the overall inflammation in their bodies, therefore reducing risk of obstetric complications and health concerns in their unborn children.
What did they find?
They found that preconception was a critical time for improving both pregnancy outcomes and the health of both mother and child, as well as reducing the risk of pregnancy complications (Kyozuka et. al, 2021).
By introducing preconception diet counseling to promote long-term changes to food behaviour and dietary patterns such as the implementation of an anti-inflammatory diet, this improved the success rates of implantation and pregnancy in women with endometriosis, as well as enhancing their long-term health outcomes (Kyozuka et. al, 2021).
The study identified preconception as a “window of opportunity”, owing to the increased willingness of women to change their previous dietary habits and make healthy lifestyle changes during this time (Kyozuka et. al, 2021). As a result, the study promoted this period as a critical time to reduce obstetric complications and improve health outcomes for women with endometriosis, particularly by introducing and advocating for an anti-inflammatory diet pattern.
So let’s crunch the numbers…
Overall, the study found that following an anti-inflammatory diet during preconception significantly reduced the risk of both preterm birth and low birth weight for women with endometriosis (Kyozuka et. al, 2021). Preconception lifestyle and dietary choices improved perinatal mortality and morbidity among this group. So changing your dietary habits prior to conception can have a huge impact on the health of your future baby.
Women with endometriosis who followed the most anti-inflammatory dietary pattern in the study experienced a decreased risk of preterm birth (less than 37 weeks) from 6.2% risk (in those eating an inflammatory diet) to 5.5% risk (Kyozuka et. al, 2021).
They also saw a decreased risk of low birth weight (below 2.5kg) by 2% compared to those following the most pro-inflammatory diets (Kyozuka et. al, 2021).
In women with endometriosis who followed an anti-inflammatory diet, the incidence of low birth weight decreased, and preterm birth rates significantly decreased (Kyozuka et. al, 2021).
These figures show that an anti-inflammatory diet is a potential management strategy for endometriosis, and also an effective risk-reduction strategy for pregnancy complications when adopted prior to conception.
So there we have it – an anti-inflammatory diet adopted during preconception and maintained during pregnancy can significantly improve pregnancy and health outcomes in women with endo!
So how do we put this into practice?
An anti-inflammatory diet can look very different according to different people. However, there are a few things to keep in mind if you’re aiming to reduce inflammation in your body and improve health and pregnancy outcomes – whether you have endo or not!
- Prioritising whole foods, such as vegetables, fruit, legumes and beans, healthy fats and whole grains
- Reducing your intake of processed (and especially ultra-processed!) foods
- Increasing your intake of omega-3 fatty acids, found in oily fish like salmon and sardines, nuts and seeds, and extra virgin olive oil
- Limiting processed meats
- Including red meat, poultry and dairy in smaller amounts. Important to not completely avoid these foods as they contain important micronutrients for pregnancy health including iron, calcium and zinc!
Research suggests anti-inflammatory dietary patterns like the Mediterranean diet can really reduce endo-related pain – not to mention helping prevent heart disease and supporting fertility (Simmen & Kelley, 2018)!
Need help with building an anti-inflammatory diet that suits your needs for endometriosis to support conception and throughout pregnancy? Check out Get Pregnant with Endo and get your name on the waitlist for the next enrolment!