Dian Shepperson Mills, MA, is a British nutritionist who pioneered a dietary program for endometriosis and has spoken around the world on the subject of endometriosis and diet. She is director of the Endometriosis and Fertility Clinic in London and Sussex, England; chair of the Nutrition Special Interest Group at the American Society for Reproductive Medicine; and author of Endometriosis: A Key to Healing and Fertility through Nutrition.
The theory behind her endometriosis diet: “The diet aims to reduce internal inflammation within the body, improve pain responses, and support estrogen excretion from the body,” Shepperson Mills explains. She says that 20,000 women have tried the diet and many reported improvement in pain levels and fertility.
How Diet May Affect Endometriosis
“Women with endometriosis should avoid fatty foods, such as red meat and [high-fat] dairy foods that may be high in PCBs and dioxins, to reduce their exposure to these estrogenic pesticides,” she suggests. Use organic food whenever feasible, or peel fruits and vegetables, she recommends. Some research suggests a link between dioxins in the environment and increased levels of estrogen.
Shepperson Mills also cites studies that found an association between oxidative stress — which includes the formation of cell-damaging substances called free radicals — and endometriosis. Additional research found that a lack of antioxidants may contribute to endometriosis, while absorbing key antioxidant nutrients like selenium and vitamins A, C, and E may help keep it under control.
What to Eat for Endometriosis
The core of Shepperson Mills’ diet for endometriosis includes these hallmarks of healthy nutrition:
- Freshness. Buy the freshest food you can find and eat it while it’s fresh. Avoid highly processed foods full of additives. Cook with fresh foods, but also eat some raw vegetables and fruit every day. To minimize exposure to pesticides, eat organically grown produce whenever possible.
- Variety. Eat a wide variety of foods every day. “Make it fun to try new dishes on weekends and expand your horizons,” says Shepperson Mills.
Specific Nutrients at Work
Certain foods rich in key nutrients contribute direct effects to a diet for endometriosis:
- Vegetables with B vitamins. “A healthy liver with a plentiful supply of B vitamins can degrade estradiol to estriol,” Shepperson Mills says. “Estriol is the form in which estrogen can be bound to fiber and excreted. The diet needs to have sufficient fiber and B vitamins from green vegetables to help the body deal with the constant breakdown of circulating estrogens. Green, leafy vegetables can also help the nervous and immune systems, and magnesium relaxes smooth muscles found in the intestines and uterus.”. The best vegetables: those in the cruciferous family, such as cabbage, sprouts, broccoli, cauliflower, kale, turnips, radishes, horseradish, and watercress.
- Iron-rich foods. “With endometriosis you may experience heavy bleeding, so replacing lost iron is important,” she says. Two types of iron are available in the foods we eat, heme iron from protein sources and non-heme iron from plant sources. Non-heme iron is available in green, leafy vegetables, beetroot, dried apricots, and plain chocolate. Heme iron comes from red meat, eggs, and fish.
- Omega fatty acids. Include 1 tablespoon of cold-pressed vegetable oil in your meals daily. Avoid trans fats, and keep saturated fats low. Sources of omega fatty acids include oily fish such as wild Alaskan salmon and Pacific halibut, and tree nuts, seeds, and extra virgin cold-pressed olive oil.
- Fiber. Shepperson Mills suggests getting 30 grams of fiber from fruits, vegetables, nuts, seeds, legumes, and whole grains including rye, oats, rice, corn, millet, and buckwheat to keep your intestinal tract healthy and promote the excretion of excess estrogens.
- Water. Drink four to six 8-ounce glasses of water a day. Avoid caffeine, refined sugars, sweeteners, soda (including diet), and alcohol when struggling with endometriosis or trying to get pregnant.
The Role of Supplements in an Endometriosis Diet
“Obtaining nutrients from food sources is obviously best,” says Shepperson Mills. “The judicious use of nutritional supplements may also improve reproductive health. Use only good quality supplements, free from yeast, gluten, wheat, dairy, and sugars, and stick to the dose on the carton or bottle.”