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Omega 3 fats linked to a lower risk of endometriosis

AniKowal — Mon, 26 Apr 2010 05:00:50 +0000

In October 2008 I wrote a piece which looked at how nutrition may be able to help women suffering with endometriosis. A newly published study (1) has found that eating a diet rich in omega 3 fats seems to reduced the risk of developing endometriosis, whereas eating a diet containing trans-fats may actually increase the risk.

Endometriosis is a painful disease that affects women during their reproductive years and is caused when the tissue lining the uterus starts to grow in other parts of the abdomen, outside of the uterus, such as the ovaries. The tissue behaves in the same way as it does in the uterus, growing during the menstrual cycle in response to oestrogen in anticipation of an egg being fertilized and shedding blood when there’s no pregnancy. For some women the pain can be excruciating. Endometriosis can sometimes lead to infertility. The precise mechanism for the development of endometriosis in the pelvis and abdominal cavity has not been full uncovered. There is currently no cure and symptoms are usually treated with pain medication, hormone medication or surgery.

Previously I wrote about fish oils being useful due to their anti-inflammatory effects in the body and also wrote about anti-oxidants and how they may be useful to women suffering from the condition. Please read the post for more detailed information

This most recently published study (1) is interesting as it deals with risk reduction. The study scientists wanted to investigate the relation between the type of dietary fat consumed in the diet and the risk of endometriosis. They analysed 12 years of data from a very large study called ‘the Nurses’ Health Study II’ which began in 1989. The intake of dietary fat was assessed via specialised questionnaires at various intervals over the 12 year period. Over the study period over 1000 cases of confirmed endometriosis were recorded. The study authors found that total fat consumption was not associated with endometriosis risk but that women with the highest long chain omega 3 fatty acid consumption were 22% less likely to be diagnosed with endometriosis compared with those women with the lowest intakes. In addition to this the study scientists found that women with the highest consumption of trans-fat intake were 48% more likely to be diagnosed with endometriosis (for more on trans fats please see my previous post).

This is the largest study to have investigated the link between diet and endometriosis risk and the first study to identify a risk factor that may be modifiable for the condition. Again it is important to note that total fat was not associated, it was the type of fat that mattered. Individuals who eat ultra-low fat diets may actually be putting themselves at risk for a number of conditions.

Long chain omega 3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), are found in oily fish such as trout, salmon, mackerel and sardines. Eating at least 2 portions a week will go far in providing the body with these fats which seem crucial for disease prevention and maintenance of optimal health. The short chain omega 3 fat, alpha linolenic acid, can be found in walnuts and flaxseeds/linseeds. The body can convert the short chain version to the long chain but the process is very inefficient.

Trans fats are artificially produced through a process known as hydrogenation, which turns liquid vegetable oil into solid fat. These kinds of fats are used in many processed foods, from snacks to ready-meals, they have been strongly linked to an increased heart disease risk. Some countries have banned their use. The major sources of trans fats in this study were from fried restaurant foods, margarine and crackers. Trans fats are known to increase levels of inflammation in the body and inflammatory factors have been associated with endometriosis. It may be that trans fats are increasing the risk of endometriosis development through chronic inflammation. Further studies would be needed to confirm this.

The authors conclude that “These data suggest that specific types of dietary fat are associated with the incidence of laparoscopically confirmed endometriosis, and that these relations may indicate modifiable risk. This evidence additionally provides another disease association that supports efforts to remove trans fat from hydrogenated oils from the food supply”.

Dr. Stacey Missmer, an assistant professor of obstetrics, gynaecology and reproductive biology at Brigham and Women’s Hospital and Harvard Medical School in Boston, Massachusetts, USA said in a press release (2) “Millions of women worldwide suffer from endometriosis. Many women have been searching for something they can actually do for themselves, or their daughters, to reduce the risk of developing the disease, and these findings suggest that dietary changes may be something they can do. The results need to be confirmed by further research, but this study gives us a strong indication that we’re on the right track in identifying food rich in Omega-3 oils as protective for endometriosis and trans fats as detrimental,”

Further studies are needed to confirm the link and it would be very interesting to see intervention studies were women with endometriosis were supplemented with omega 3 oils to see if this could reduce their symptoms.

As you will see from reading my blog posts, Omega 3 fatty acids are beneficial to health for so many reasons and are essential to the body. If you do not regularly eat oily fish, at least twice per week, I would suggest that you seriously consider taking an omega 3 supplement. Fish oil supplements provide the long chain EPA and DHA fatty acids that seem to be vital for health. For vegetarians and vegans linseed/flaxseed oil supplements will provide the shorter chain omega-3 fat alpha-linolenic acid, unfortunately the body finds it quite difficult to bioconvert this to the longer chain forms but it is still an important source. Vegan EPA/DHA supplements made from algae are now becoming increasingly available and are certainly worth considering.

For more information on endometriosis please contact Endometriosis UK www.endometriosis-uk.org, a charity dedicated to supporting women with the condition, or www.endometriosis.org a global forum for information about endometriosis.

(1)Missmer SA et al. 2010. A prospective study of dietary fat consumption and endometriosis risk. Human Reproduction. E-pub prior to print. March 23, 2010 DOI: 10.1093/humrep/deq044

(2)Press release. European Society of Human Reproduction and Embryology (2010, March 23). Trans fats linked to increased endometriosis risk and omega-3-rich food linked to lower risk. ScienceDaily. Retrieved March 24, 2010, from http://www.sciencedaily.com¬ /releases/2010/03/100323212146.htm

Written by Ani Kowal

Can nutrition help women suffering with endometriosis?

admin — Wed, 01 Oct 2008 07:07:20 +0000

Earlier this year a study was published(1) highlighting the fact that local removal of endometriosis, via key-hole surgery, was associated with good short-term outcomes but, on long-term follow-up, such procedures were often unsuccessful and there was a need for further surgeries later on. The study authors concluded that better treatment is needed for those suffering from endometriosis. Reading the paper led me to have a look and see if there were any natural remedies associated with an improvement in the condition.

Endometriosis is a painful disease that affects women during their reproductive years and is caused when the tissue lining the uterus starts to grow in other parts of the abdomen, outside of the uterus, such as the ovaries. The precise mechanism for the development of endometriosis in the pelvis and abdominal cavity has not been elucidated.

Evidence is accumulating to suggest a role for fish oils (long chain omega 3 fatty acids) in the management of endometriosis (2,3,4). Fish oils appear to reduce the inflammation associated with endometriosis. Inflammation is mediated by a group of chemical substances in the body known as eicosanoids. Synthesis of these inflammatory mediators can be influenced by the dietary ratio of omega-3 and omega-6 polyunsaturated fatty acids. The eicosanoids derived from omega-3 fatty acids are far less potent inflammatory agents, hence it would seem sensible for women who suffer from endometriosis to increase their consumption of omega 3 fatty acids, found in oily fish e.g. mackerel, salmon, trout and sardines or consider taking a supplemet to provide around 250mg of EPA and 250mg DHA daily. Studies do suggest that women afflicted with endometriosis generally have elevated levels of Leukotriene B4, a potent inflammatory chemical (5).

Very recent preliminary evidence(6) suggests that endometriosis is linked to excessive oxidative stress, and a lower level of vitamin E, an antioxidant. This was just a small pilot study which needs follow up with larger trials. However, another small study(7) published in March this year which found that supplementation with the antioxidant vitamins C and E was associated with a decrease in the concentration of oxidative stress markers in women with endometriosis. The women involved were given 343mg vitamin C and 84mg vitamin E daily or a placebo. After 4 months the supplemental group had lower levels of oxidative stress markers.

Antioxidants protect our cells from the damaging effects of highly reactive molecules called free radicals, which cause oxidative stress in the body. There is mounting evidence that these destructive molecules, together with lowered antioxidant defences, play a significant role in the development and aggravation of many diseases. The body does produce its own antioxidants but also relies on vitamins, mineral and phytochemicals (bioactive plant chemical) from the diet, especially from colourful vegetables and fruits, for additional valuable supplies.

Antioxidants are important for many health reasons (which I have written about in previous posts) and eating plenty of colourful fruits and vegetables daily will provide the body with many antioxidant nutrients. A healthy diet may well be particularly important to those suffering with endometriosis. In 2004 a study (8) was carried out in order to investigate the relationship between diet and endometriosis. The investigation involved 504 women with confirmed endometriosis and 504 women without endometriosis. Dietary analysis suggested that a high intake of green vegetables and fresh fruit was associated with a significantly reduced risk of endometriosis whereas a high intake of red meat and ham (processed meat) was associated with a significantly increased risk. Such associations do not show cause but studies like this do help to highlight the importance of a healthy diet, especially the real benefits of fruits and vegetables for disease prevention. Taking a broad-spectrum antioxidant (or multi nutrient) supplement, in addition to a healthy diet, is also an option in order to ensure good intake levels are constantly achieved.

For more information on endometriosis please contact Endometriosis UK, a charity dedicated to supporting women with the condition, or endometriosis.org a global forum for information about endometriosis.

(1) Shakiba K et al. 2008. Surgical Treatment of Endometriosis: A 7-Year Follow-up on the Requirement for Further Surgery. Obstet. Gynecol. 111:1285 -1292.
(2)Covens AL et al. 1988. The effect of dietary supplementation with fish oil fatty acids on surgically induced endometriosis in the rabbit. Fertil Steril. 49(4):698-703.
(3)Gazvani MR et al. 2001. High omega-3:omega-6 fatty acids in culture medium reduce endometrial gland and stromal cell cultures from women with and without endometriosis. Fertil Steril. 76:717-722
(4)Yano, Y. 1992. Effect of dietary supplementation with eicosapentaenoic acid on surgically induced endometriosis in the rabbit. Nippon Sanka Fujinka Gakkai Zasshi. 44(3):282-288.
(5)Pungetti D et al. 1987. Prostanoids in peritoneal fluid of infertile women with pelvic endometriosis and PID. Acta Eur Fertil. 18(3):189-192.
(6)Campos Petean C et al. 2008. Lipid peroxidation and vitamin E in serum and follicular fluid of infertile women with peritoneal endometriosis submitted to controlled ovarian hyperstimulation: a pilot study. Fertil Steril. 2008 Feb 2. [Epub ahead of print]
(7) Mier-Cabrera J et al. 2008 Effect of vitamins C and E supplementation on peripheral oxidative stress markers and pregnancy rate in women with endometriosis. Int J Gynaecol Obstet. 100:252-256
(8) Parazzini F et al. 2004. Selected food intake and risk of endometriosis. Hum Reprod. 19:1755-1759.

Written by Ani Kowal