Cardiovascular disease is the leading cause of death in women, and up to 11% of women in the United States have endometriosis, a condition that affects reproductive organs. A relationship between the two conditions has been discovered, showing that women with endometriosis may also have a higher risk of cardiovascular disease. This connection is attributed to chronic inflammation, physiological and psychological stressors, and side effects related to treatments of the disease, which can result in high blood pressure and cholesterol.
​
Certain dietary changes can decrease inflammation, cholesterol, and blood pressure and thus decrease the risk of heart disease. Similar changes may also positively impact the symptoms of endometriosis.
 
EATING PLANT-BASED
 
It has been shown that increasing fiber from plant foods can decrease the risk of stroke and may also decrease inflammation in those with endometriosis.

Sources of fiber include:

• Beans and legumes
• Whole grains
• Leafy green vegetables
• Fruits with edible skin and berries

  
HEART HEALTHY FATS
 
Replacing high sources of saturated fat, like red meat, and refined carbohydrates, like white bread, with unsaturated (healthy) fats may similarly decrease the risk of cardiovascular disease and improve symptoms of endometriosis. 

Sources of healthy fats include:

• Nuts and seeds such as flaxseeds, walnuts, almonds, and pecans.
• Olive oil, canola oil, and avocado oil
• Fatty fish, such as salmon
• Avocado

 
Swaps to consider:

• Swapping butter for olive oil in cooking
• Building meals around beans and fish instead of red meat (e.g. try a bean-based chili instead of beef chili)
• Adding one or two colorful fruits or vegetables to each meal (like peppers, berries, or spinach)
• Snacking on nuts instead of chips 

 
Endometriosis cannot be prevented, but dietary management may improve symptoms and decrease the risk of developing chronic diseases, like heart disease.

REFERENCES:
Barnard ND, Holtz DN, Schmidt N, et al. Nutrition in the prevention and treatment of endometriosis: A review. Front Nutr. 2023;10:1089891. 
Diab A, Dastmalchi LN, Gulati M, Michos ED. A Heart-healthy diet for cardiovascular disease prevention: where are we now?. Vasc Health Risk Manag. 2023;19:237-253. 
Li Y, Hruby A, Bernstein AM, et al. Saturated fats compared with unsaturated fats and sources of carbohydrates in relation to risk of coronary heart disease: a prospective cohort study. J Am Coll Cardiol. 2015;66(14):1538-1548. 
Marchandot B, Curtiaud A, Matsushita K, et al. Endometriosis and cardiovascular disease. Eur Heart J Open. 2022;2:oeac001. 
Marcinkowska A, Górnicka M. The role of dietary fats in the development and treatment of endometriosis. Life (Basel). 2023;13(3):654. 
Missmer SA, Chavarro JE, Malspeis S, et al. A prospective study of dietary fat consumption and endometriosis risk. Hum Reprod. 2010;25(6):1528-1535. 
Mu F, Rich-Edwards J, Rimm EB, Spiegelman D, Missmer SA. Endometriosis and risk of coronary heart disease. Circ Cardiovasc Qual Outcomes. 2016;9(3):257-264. 
Preventing heart disease. Harvard T.H. Chan: The Nutrition Source. Last reviewed August 2022.
Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42:3227–3337.
Yu E, Malik VS, Hu FB. Cardiovascular disease prevention by diet modification: JACC health promotion series. J Am Coll Cardiol. 2018;72(8):914-926.

By Morgan Fries, MS, DTR
MGH Dietetic Intern

Research has shown that plant-based diets can help reduce the risk of diseases such as diabetes and heart disease. A plant-based diet does not mean you have to be vegetarian or vegan. It means choosing more fruits, vegetables, grains, nuts, seeds and beans in your diet instead of foods from animals (like red meat and poultry).

Plants contain fiber (fruits and vegetables), healthy fats (avocados, nuts and seeds), proteins and carbohydrates (beans, lentils, quinoa, tofu, chickpeas, veggie burgers, nuts and seeds) which can help manage blood sugar, cholesterol, blood pressure and weight.
 
Studies have also shown that consuming more plant than animal proteins is beneficial for the environment. Raising animals for food typically requires more land, water and fuel to produce the amount of meat expected from the population. This usage contributes to the emission of greenhouse gasses (e.g. methane from cow manure) and this negatively affects the climate by raising the temperature of the earth.
 
What can you do to help the environment and your health? Incorporate more plants into your diet. Cut down on your portion of meat and add more produce to your meals. Here are some tips to get started:

START WITH A PLANT-BASED BREAKFAST:

• Have a plant-based protein smoothie: blend frozen mixed berries and spinach with nut butter and soy or almond milk
• Swap in avocado: use this healthy fat instead of bacon with your morning eggs

 
REDUCE THE MEAT IN CLASSIC DISHES: ​

• For example, in chicken broccoli ziti reduce the portion of chicken by ¼ or ⅓ and replace what was reduced with extra frozen broccoli

Tip: frozen vegetables (and fruit) contain just as many vitamins and minerals as fresh ones. Also, frozen can often be less expensive than fresh produce.

USE MEALS THAT NATURALLY FEATURE BEANS:

• Go simple with rice and beans: rice options include white, brown and wild varieties. Pair with your choice of beans (e.g. black beans, kidney beans, white beans) with veggies.
• Try pasta fazool (a meatless pasta dish with beans) 

REFERENCES:
Bačėninaitė D, Džermeikaitė K, Antanaitis R. Global warming and dairy cattle: how to control and reduce methane emission. Animals (Basel). 2022;12(19):2687. 
Bouzari A, Holstege D, Barrett DM. Vitamin retention in eight fruits and vegetables: a comparison of refrigerated and frozen storage. J Agric Food Chem. 2015; 63(3):957-62. 
Jain R, Goomer S. Nutritional and health benefits of plant proteins: a review. Plant Archives. 2020; 20:160-162. 
Kahleova, H, Fleeman, R, Hiozkova, A et al. A plant-based diet in overweight individuals in a 16-week randomized clinical trial: metabolic benefits of plant protein. Nutr Diabetes. 2018; 8(1): 58. 
Sabaté J, Sranacharoenpong K, Harwatt H, Wien M, Soret S. The environmental cost of protein food choices. Public Health Nutrition. 2015;18(11):2067-2073. 
Stehfest, E, Bouwman, L, van Vuuren, DP et al. Climate benefits of changing diet. Climatic Change. 2009; 95: 83–102. 

By Celine Delaronde, MS
MGH Dietetic Intern

With summer approaching you might be thinking more about your hydration, but do you need a special hydration product?
 
The short answer – it depends.  
 
What are hydration products?
 
Hydration products are often found in powder forms and contain electrolytes. Electrolytes, like sodium, potassium, and chloride, are lost in sweat. Electrolytes help control muscle function, hydrate, and balance your blood. Electrolyte losses vary by person.
 
Who should use hydration products?
 
People who exercise, sweat excessively, or have digestive problems like diarrhea or vomiting may benefit.
 
Research suggests that for every 1 hour of moderate to intense exercise (brisk walking, biking, running, or high-intensity interval training), two cups (or 16 ounces) of fluid, 300 to 600 mg sodium, and some carbohydrates should be consumed to assist with rehydration. Carbohydrates can help with electrolyte absorption. 
 
What’s the difference? We reviewed some popular brands:

• Liquid IV (1 stick in 16 ounces water): 500 mg sodium, 380 mg potassium, 11 g carbohydrates (11 g added sugar)
• Pedialyte Powder Packet (1 packet in 16 ounces water): 490 mg sodium, 370 mg potassium, 12 g carbohydrate (12 g added sugar)
• DripDrop (1 stick in 8 ounces water):  330 mg sodium, 185 mg potassium, 9 g carbohydrates (7 g added sugar) - doubling the dose and increasing to 16 ounces of fluid may be more appropriate in certain situations
• Nuun (1 tablet in 16 ounces water): 300 mg sodium, 150 mg potassium, 4 g carbohydrates (1 g added sugar) - this may be inadequate in carbohydrate for certain types of rehydration 

 
​Final answer?
 
Certain products may aid in rehydration after intense exercise, periods of excessive sweating, or fluid lost through vomiting and diarrhea. For most people who exercise less than 1 hour, and are not excessively sweating or having digestive issues, plain water and food is usually enough to support hydration. 
 
If you are wondering if you may benefit from regularly consuming these products talk with your doctor or dietitian.
 
REFERENCES:
Aghsaeifard Z, Heidari G, Alizadeh R. Understanding the use of oral rehydration therapy: A narrative review from clinical practice to main recommendations. Health Sci Rep. 2022;5(5):e827
Kerksick, C.M., Wilborn, C.D., Roberts, M.D. et al. ISSN exercise & sports nutrition review update: research & recommendations. J Int Soc Sports Nutr. 2018;15(1): 38. 
McDermott BP, Anderson SA, Armstrong LE, et al. National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active. J Athl Train. 2017;52(9):877-895.
Sawka MN, Burke LM, et al. American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc. 2007;39(2):377-390.  
?June 2022 Parrish
 
By Emily Kolasheski
MGH Dietetic Intern 

Budget friendly healthy eating can seem like an impossible task, especially with rising food costs. Here are some tips on achieving healthy eating without breaking the bank.

BEFORE SHOPPING

• Look at what is already at home.

Check the fridge, pantry, and cabinets for items to use in meals.

• Use store circulars, coupons, sales, and specials to help plan weekly meals and snacks.

 

• ​Plan recipes with common ingredients.

​For instance, a bag of brown rice and frozen vegetables can be used to prepare a stir-fry with eggs. Leftover rice and vegetables can get added to lettuce, cheese, beans, and salsa for a taco bowl at lunch or dinner.

• Consider buying produce in season.

It is generally more abundant and often sold at a lower price.  Here is a resource for month-by-month seasonal produce.

• Make a list before shopping for an easier and faster process in the grocery store.

​

• Eat before shopping to stay on track and decrease impulse buying.

DURING SHOPPING

• Look for store brands.

​Sometimes they are the exact same as name brands but cost less.

• Opt for frozen or canned fruits and vegetables.

​They have a longer shelf life which can lead to less waste. Select options stored in water or 100% juice, not syrup, and without added sugar, sauces, or salt.

• Check the unit price (found on the shelf tag next to the price of the item).

Lower unit prices indicate a lower price per serving. Unit prices use a standard measure (for example, per pound), so you can easily compare similar products that are different sizes. Here is an example. 

Make sure to check the size of the whole package to determine if you can use it before it may spoil. Purchasing by unit price can often lead to purchasing a larger amount of an item, so ask yourself: “Can I use this before the expiration date?”

• Choose whole grains.

​They tend to be inexpensive and offer a lot of nutrition for the price. Look for options like brown rice, quinoa, farro, oats, and barley.

• Use Shop Simple with MyPlate.

This is an app from the United States Department of Agriculture designed to assist in making affordable healthy choices and offers ways to prepare budget friendly foods.

Can't get the app? Check out their website for tips instead. 

REFERENCES
6 Tips for Eating Healthy on a Budget. Centers for Disease Control and Prevention. Published December 2021. Accessed October 2024.
Academy of Nutrition and Dietetics Offers Tips for Healthful Eating as Consumer Food Spending Increases. Eat Right PRO: Academy of Nutrition and Dietetics. Published November 2023. Accessed March 2024.
Arky, J. How Much Cheaper Are Store-Brand Groceries Than Name Brands? Nasdaq.com. Published 2022. Accessed March 2024. 
Cox J. Shop Healthy on a Budget. Academy of Nutrition and Dietetics. Published March 2022. Accessed March 2024. 
Smart Shopping | SNAP-Ed. New York State Office of Temporary and Disability Assistance. Published June 2015. Accessed March  2024.

By Halle Derouin, MS
MGH Dietetic Intern