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Endometriosis May Increase Your Risk of Heart Disease: Diet Can Help

1/6/2025

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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


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Pomegranates: A Delicious Way to Boost Your Fiber Intake This Season

12/9/2024

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Fruit is important to eat year-round.  It is a good source of fiber, an indigestible carbohydrate found in plants that is associated with decreased risk of chronic diseases, like cardiovascular disease and type 2 diabetes. The United States Department of Agriculture recommends adults eat about 2 cups of fruit per day. Pomegranates are a seasonal fruit with an excellent amount of fiber and can help you hit your daily goal in the colder months.

Pomegranates are sweet, tart, and contain hundreds of edible seeds called arils, encompassed by a bitter white pith. They can be purchased whole, in juice form, or with just the seeds.

The seeds from one pomegranate will provide 10 grams of fiber and over 30% of the recommended daily goal. Most people need at least 25 grams of fiber per day.  The juice is not a good source of fiber, so opt for the seeds instead.

Pomegranates are typically available in the United States until January. Here are some festive ways to use pomegranate seeds this holiday season:

  • Eggplant, Pistachio, and Pomegranate Pizza 
  • Roasted Squash, Pecan, and Pomegranate Salad
  • Pomegranate Cinnamon Overnight Oats

New to the fruit?  Here is how to remove pomegranate seeds.

REFERENCES:
Definition of Fiber. National Institutes of Health: NCI Dictionary of Cancer Terms. Published February 2, 2011. Accessed November 2024. 

Fatima I, Gamage I, Almeida RJRD, Cabandugama P, Kamath G. Current Understanding of Dietary Fiber and Its Role in Chronic Diseases. Missouri Medicine. 2023;120(5):381.
Pomegranate. FoodPrint: Real Food Encyclopedia. Accessed November 2024. 
Pomegranates, Raw. US Department of Agriculture FoodData Central Food Details. Accessed November 2024. 

Reynolds A, Mann J, Cummings J, Winter N, Mete E, Morenga LT. Carbohydrate Quality and Human Health: A Series of Systematic Reviews and Meta-analyses. The Lancet. 2019;393(10170):434-445. 
U.S. Department of Agriculture and U.S. Department of Health of Human Services. Dietary Guidelines for Americans, 2025. 9th Edition. December 2020.


By Jill Laudone, MS, RYT 200
​MGH Dietetic Intern 


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Immune-Supporting Foods During Cold and Flu Season

11/7/2024

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With cold and flu season in full swing, it is important to incorporate foods with nutrients that may provide benefits for immune support. The foods listed below are important year-round and are especially timely during the winter months.
 
CITRUS FRUITS
 
Fruits such as oranges, grapefruits, lemons, and limes contain vitamin C and flavonoids. Both of these protective plant components target compounds in the body called free-radicals, which can damage our cells and make us more susceptible to viral infections such as the flu or COVID-19. Citrus fruits reach their peak season during the fall and winter months, making them a great option during cold and flu season.
 
Try this recipe: Citrus Salad
 
GARLIC 
 
Garlic contains alliin, which forms compounds in the body that can protect against free radical damage. Due to this, garlic is currently being studied for its potential to protect against viral infections. Though research is not yet conclusive, garlic is a flavorful addition to soups, stews, and other warm dishes during the winter months.
 
Pro tip: crush or chop garlic instead of adding it whole when cooking. This may help generate some of the protective components found in garlic. (Eating garlic raw is another option.)
 
Try this recipe: Garlic Mushroom Stir Fry
 
MUSHROOMS
 
Mushrooms contain selenium, which plays a key role in the body’s response to infection. One serving of mushrooms (½ cup cooked) provides over 10% of the recommended daily intake of the mineral. Research suggests that getting enough selenium can help fight viruses from replicating in the body.

 
Try this recipe: Stuffed Mushrooms

REFERENCES:

Barchielli G, Capperucci A, Tanini D. The role of selenium in pathologies: an updated review. Antioxidants. 2022;11(2):251.
Damle VG, Wu K, Arouri DJ, Schirhagl R. Detecting free radicals post viral infections. Free Radical Biology and Medicine. 2022;191:8-23.
Garlic and Organosulfur Compounds. Linus Pauling Institute. Updated September 2016. Accessed October 2024.
Guillin OM, Vindry C, Ohlmann T, Chavatte L. Selenium, selenoproteins and viral infection. Nutrients. 2019;11(9).
Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. The Cochrane Database of Systematic Reviews. 2013;2013(1):CD000980.
Liu W, Zheng W, Cheng L, et al. Citrus fruits are rich in flavonoids for immunoregulation and potential targeting ACE2. Nat Prod Bioprospect. 2022;12(1):4.
Lobo V, Patil A, Phatak A, Chandra N. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacognosy Reviews. 2010;4(8):118.
Mitra S, Paul S, Roy S, et al. Exploring the immune-boosting functions of vitamins and minerals as nutritional food bioactive compounds: a comprehensive review. Molecules. 2022;27(2).
Mushrooms, White, Stir-fried. U.S. Department of Agriculture: FoodData Central. Accessed October 2024.
Panche AN, Diwan AD, Chandra SR. Flavonoids: an overview. Journal of Nutritional Science. 2016;5:e47.
Rouf R, Uddin SJ, Sarker DK, et al. Antiviral potential of garlic (Allium sativum) and its organosulfur compounds: A systematic update of pre-clinical and clinical data. Trends Food Sci Technol. 2020;104.
Vishwakarma S, Panigrahi C, Barua S, Sahoo M, Mandliya S. Food nutrients as inherent sources of immunomodulation during COVID-19 pandemic. Lebensm Wiss Technol. 2022;158:113154. 


By Eva Pellerin, MS
MGH Dietetic Intern  


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Fall Flavor: Discover the Health Benefits of Pumpkin

10/17/2024

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Fall is finally here, and so is pumpkin season! From pumpkin-spiced lattes to pumpkin pie, this ingredient finds its way into many of our favorite foods.
 
Not only is pumpkin delicious and versatile, but it also provides various health benefits. This winter squash supports vision, boosts immune function, and promotes healthy digestion.
 
Pumpkin is a great source of both vitamin A and fiber. Vitamin A is a fat-soluble vitamin that plays an important role supporting eye health and immune function. Fiber is a type of carbohydrate found in plant sources that helps you feel full, improves digestion, and maintains blood sugar levels.
 
Even adding a small amount of pumpkin can offer benefits.  ¼ cup of canned pumpkin puree provides over half of your recommended daily goal of vitamin A plus 2 grams of fiber.
 
There are many ways to incorporate pumpkin into your diet. Try some of these creative recipes to add sweetness to your meals and boost your vitamin A and fiber intake.
 
  • Pumpkin Risotto with Goat Cheese
  • Pumpkin Overnight Oats
  • Pumpkin Zucchini Bread

REFERENCES:
Calcium I of M (US) C to RDRI for VD and, Ross AC, Taylor CL, Yaktine AL, Valle HBD. Dietary Reference Intakes (DRIs): Recommended Dietary Allowances and Adequate Intakes, Vitamins. 2011. Accessed September 20, 2024. 
FoodData Central. Accessed September 20, 2024. 
Ioniță-Mîndrican CB, Ziani K, Mititelu M, Oprea E, Neacșu SM, Moroșan E, Dumitrescu DE, Roșca AC, Drăgănescu D, Negrei C. Therapeutic Benefits and Dietary Restrictions of Fiber Intake: A State of the Art Review. Nutrients. 2022; 14(13):2641.
Office of Dietary Supplements - Vitamin A and Carotenoids. Accessed September 20, 2024. 

​By Peyton Walker, MS
MGH Dietetic Intern 
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Plant-Based Foods: Good for Your Health and the Environment

9/9/2024

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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
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Fall Produce in New England

9/15/2023

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According to the CDC, only 10% of adults in the US are consuming adequate vegetables and only 12% are consuming adequate fruits. Shopping at a farmers market is a great way to get fresh tasting produce and mix up your fruit and vegetable routine. 

Why Eat Seasonally?  
One of the best things about getting produce from the farmers market is the great taste. There is nothing like the taste of a crisp apple in the fall. Beyond the flavor, shopping at a farmers market is a great way to engage with your community and try new foods. 

Research shows affordability of fruits and vegetables can be a barrier to eating them regularly. If you are worried about the cost of foods at a farmers market, remember that you can use SNAP benefits there. The Healthy Incentives Program (HIP) even gives you cash back on your EBT card if you purchase produce. You may also be eligible for the farmers market coupon program in Boston. 

What is in Season in New England During Early Fall? 
  • Apples
  • Broccoli 
  • Brussels sprouts
  • Cranberries
  • Pears
  • Peppers
  • Pumpkins 
  • Squashes

There are many health benefits of consuming fruits and vegetables. They are loaded with vitamins, minerals, and other antioxidants. For example, pumpkins contain vitamin C, copper, fiber, and beta-carotene. Beta-carotene is part of the carotenoid family, a group of antioxidants that may offer protection for your heart. 

Pumpkins can be delicious in both sweet and savory recipes. Try a savory pumpkin stuffed with your favorite vegetables, rice, and cheese if you want something hearty and savory. Follow along with this recipe here. 

REFERENCES: 
Lee SH, Moore LV, Park S, Harris DM, Blanck HM. Adults Meeting Fruit and Vegetable Intake Recommendations — United States, 2019. Morbidity and Mortality Weekly Report. 2022; 71:1–9.
Miller V, Yusuf S, Chow CK, Mente A. et al. Availability, Affordability, and Consumption of Fruits and Vegetables in 18 Countries Across Income Levels: Findings from the Prospective Urban Rural Epidemiology (PURE) Study. Lancet Glob Health. 2016; 4(10): e695-703. 
Xavier AA, Pérez-Gálvez A. Carotenoids as a Source of Antioxidants in the Diet. Subcell Biochem. 2016; 79:359-75. 

By Abigail Harrison, MS
MGH Dietetic Intern 


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Get Movin' with Magnesium

8/14/2023

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Magnesium, the fourth most abundant mineral in the body, can be found naturally in foods and is crucial to a variety of bodily functions.
 
Why is magnesium important?

The mineral plays a key role in bone mineralization and vitamin D synthesis, making adequate amounts of magnesium vital to building and maintaining healthy bones. It is also involved in energy production and regulation of blood sugar. Lastly, magnesium is critical to muscle and nerve function, acting as an electric conductor to contract muscles and help keep the heart beating steadily. 
 
What happens if you don't get enough?

Magnesium deficiency can result if your diet is too low in magnesium-rich foods. Other factors that influence magnesium intake include how food is grown and processed. Digestive disorders and chronic diseases, like diabetes, can also increase deficiency risk. Early signs of deficiency can include fatigue, loss of appetite, muscle spasms, nausea, and weakness. If the deficiency is left untreated, more severe symptoms, like abnormal heart rhythms and seizures, can occur.
 
Here are some tips to boost your intake:

Magnesium is found in a wide variety of plants.  To increase your intake, aim to include a handful (about ¼ cup) of nuts or seeds per day. Switching from refined grains (like pasta) to whole grains (like quinoa) helps too. Try to eat leafy greens as often as you can and consider adding beans to salads.

Some of our favorite magnesium-containing foods are:
  • Pumpkin seeds
  • Dark leafy greens, like spinach
  • Beans, like black beans or soybeans (edamame)
  • Nuts, like almonds, cashews, peanuts
  • Brown rice
  • Dark chocolate
 
RESOURCES:
25 Magnesium-Rich Foods You Should Be Eating. Cleveland Clinic. Published March 2023. Accessed June 2023. 

Magnesium. The Nutrition Source: Harvard T.H. Chan School of Public Health.  Last Reviewed March 2023. Accessed June 2023.
Magnesium: Fact Sheet for Health Professionals. National Institutes of Health: Office of Dietary Supplements. Last Updated June 2022. Accessed June 2023. 
Razzaque MS. Magnesium: Are We Consuming Enough?. 
Nutrients. 2018;10(12):1863.
Signs You May Have a Magnesium Deficiency Cleveland Clinic. Published October 2022. Accessed June 2023. 

Volpe SL. Magnesium in Disease Prevention and Overall Health. Advances in Nutrition. 2013;4(3):378S-83S. 

By Isabel Balady
MGH Dietetic Intern


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Seasonal Benefits of Apples to Enjoy All Year

11/10/2022

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Fall is the perfect time to enjoy apples, though their health benefits can be experienced throughout the year. Apples are source of fiber and contain protective plant compounds like quercetin and pectin.
 
Quercetin may help control blood sugar and eating foods containing this compound has been associated with decreased diabetes risk. It may also offer protection for your heart. Pectin may help to lower cholesterol though more research is needed.
 
Try adding more apples into your cooking this fall:


  • Toss apples into a salad with walnuts and crumbled feta cheese.
  • Bake whole apples for an easy seasonal dessert (try this).
  • Make squash soup and add apples for sweetness (here is a recipe).
  • Add chopped apples to oatmeal.
  • Mix diced apples into leftover wild rice or quinoa along with pumpkin seeds, dried cranberries, and your favorite vinaigrette dressing. 

Not a fan of apples? Quercetin can also be found in:
​
  • Oranges
  • Cranberries​
  • Sweet potatoes
  • Onions
  • Broccoli
  • Kale
  • Green and black tea

​REFERENCES:
Boyer J and RH Liu. Apple phytochemicals and their health benefits. Nutrition Journal. 2004; 3:5. 
Brouns F, et al. Cholesterol lowering properties of different pectin types in mildly hypercholesterolemic men and women. European Journal of Clinical Nutrition. 2012; 66: 591-599.
Dabeek, WM and MV Marra. Dietary quercetin and kaempferol: bioavailability and potential cardiovascular-related bioactivity in humans. Nutrients. 2019; 11(10):2288.
Dhanya R. Quercetin for managing type 2 diabetes and its complications, an insight into multitarget therapy. Biomedicine & Pharmacotherapy. 2022;146:112560. 
Gerhauser C. Cancer chemopreventive potential of apples, apple juice, and apple components. Planta Medica. 2008;74(13):1608-1624. 
Koutsos A, Tuohy KM, Lovegrove JA. Apples and cardiovascular health--is the gut microbiota a core consideration?. Nutrients. 2015;7(6):3959-3998. 
Wojdyło A, Oszmiański J, Laskowski P. Polyphenolic compounds and antioxidant activity of new and old apple varieties. Journal of Agricultural and Food Chemistry. 2008;56(15):6520-6530. 
Yao Z, Gu Y, Zhang Q, et al. Estimated daily quercetin intake and association with the prevalence of type 2 diabetes mellitus in Chinese adults. European Journal of Nutrition. 2019;58(2):819-830. 
Yi H, Peng H, Wu X, et al. The therapeutic effects and mechanisms of quercetin on metabolic diseases: Pharmacological Data and clinical evidence. Oxidative Medicine and Cellular Longevity. 2021; 6678662.

By Ummu D Erliana, PhD, CLC, MGH Dietetic Intern

​
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Once Again, It’s Pumpkin Season

10/13/2021

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There’s no denying it - pumpkin season is back! These days you can find pumpkin in everything from ice cream to alfredo sauce. But do these pumpkin options offer any benefit to our health?  
 
It depends.
 
Pumpkin, a type of winter squash, has an impressive nutrient profile, with benefits ranging from skin and eye health to immune support and heart benefits.
 
A 1-cup serving of pumpkin contributes several key nutrients:
  • Vitamin A - promotes eye and skin health and contributes to a strong immune system.
  • Carotenoids - antioxidants that may reduce risk of heart disease and cancer.
  • Fiber – assists in both weight loss and heart health by helping to keep you full and lowering cholesterol.
 
When evaluating festive fall foods, look for pumpkin as one of the first few ingredients listed on a food label. (Sadly, pumpkin ice cream usually has more cream and sugar than pumpkin.)
 
Or try this creamy pasta fettuccini as a comforting way to celebrate the health benefits of pumpkin.

REFERENCES:
Pumpkin, cooked, boiled, drained, without salt. Cronometer. 2021.

Soliman GA. Dietary Fiber, Atherosclerosis, and Cardiovascular Disease. Nutrients. 2019;11(5):1155.
Vitamin A: Fact Sheet for Consumers. National Institutes of Health: Office of Dietary Supplements. 2021.
Young AJ and Lowe GL. Carotenoids-Antioxidant Properties. Antioxidants. 2018;7(2):28.


By Deanna Nappi, MS, MGH Dietetic Intern  
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The Bolts on Nuts

2/5/2021

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Nuts are a fantastic source of healthy fats, vitamins, and minerals. There’s a variety out there and each type offers slightly different nutrients, so aim to eat an assortment. 
 
A little goes a long way: 1 ounce (roughly one handful) of … 

  • ALMONDS provides 6% of the recommended daily dose of calcium, a mineral necessary for healthy bones and teeth, and 48% of vitamin E, an antioxidant that helps protect against damaging compounds, like smoke and ultraviolet sunlight 
 
  • WALNUTS supplies over 100% of the recommended amount of plant-based omega-3 fats, which support a healthy heart and immune system
 
  • BRAZIL NUTS yields 25% of the recommended amount of magnesium, a nutrient necessary for muscle function and blood pressure regulation (just 1 Brazil nut satisfies daily need for selenium –another beneficial antioxidant – but high doses can cause health problems, so eat Brazil nuts in moderation)
 
  • PEANUTS offers over 100% of the recommended dose of niacin, a nutrient that’s necessary for converting food into energy

References:
FoodData Central. USDA: Agricultural Research Service. Accessed January 2021.
Nutrition Facts Labeling Requirements. FDA. Accessed January 2021.
Omega-3 Fatty Acids. NIH: Office of Dietary Supplements. Updated October 1, 2020. Accessed January 2021.
Vitamin and Mineral Supplement Fact Sheets. NIH: Office of Dietary Supplements. Accessed January 2021.
By Rebecca Joy Thompson, MGH Dietetic Intern
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