Endometriosis 101: Signs, Symptoms, & Support

Transcript:

Kara: Welcome to Dishing Up Nutrition. This is brought to you by Nutritional Weight & Wellness, and today's episode is all about endometriosis. It might be surprising to learn that one in 10 women is affected by endometriosis. So whether you've been diagnosed, you suspect you might have it, or you just want to understand your body better, we're going to walk you through what it is, what causes it, and how diet and some key supplements can play a supportive role.

So I'll just start by introducing myself. I'm Kara Carper. I'm a Licensed Nutritionist and Certified Nutrition Specialist here at Nutritional Weight & Wellness. And I'm here with my cohost today, Brandy Buro. She is a Registered and Licensed Dietitian.

Brandy: That's right. Thanks for having me, Kara.

Kara: Yeah, good to be with you again.

What is endometriosis?

Brandy: Well, let's get started with our topic today. Let's start by describing what is endometriosis? Endometriosis is a condition where the tissue that's similar to the lining of the uterus, which is called the endometrium, it starts growing outside of the uterus.

And this tissue can show up in places like the ovaries, fallopian tubes, the outside lining of the uterus. And if it's a more advanced case, it could even travel to the bladder and the intestines.

So it's just like the body is perceiving that as foreign tissue, right? It's growing in places that it doesn't natural naturally grow.

Brandy: Exactly.

Kara: And during a normal menstrual cycle, the endometrial tissue of the uterus, it thickens in preparation for a potential pregnancy. But the key issue in endometriosis is that the tissue tends to spread outside the uterus, like Brandy mentioned, but it's still behaving as though it's a uterine lining.

So just like the uterine lining does every month, this tissue will thicken regardless of where it's located in the body. It thickens and then it breaks down and it tries to shed. But unlike your menstrual cycle, there's nowhere for that tissue to go when it sheds, so it gets trapped. That can lead to really intense pain for women, inflammation, often scar tissue and then the scar tissue creates adhesions and organs actually can stick together and so you can imagine the pain that that would result in.

Brandy: Absolutely. So how would you even know if this is affecting you? I think one of the biggest challenges in, you know, getting a diagnosis of endometriosis is that the symptoms can vary so drastically, person to person, and an actual diagnosis requires surgical intervention.

So they actually have to look at, you know, the, the tissue and get a biopsy and confirm that that's what it is. Many people don't get that surgical diagnosis right away, so we're just kind of looking at symptoms. And like I said, they can vary quite a bit person to person, but some of the more common symptoms that you might experience would be painful and heavy periods. They may get worse over time.

You could have chronic pelvic pain, pain during or after intercourse, even pain when you have a bowel movement or urinate. Some of those symptoms could even mimic other digestive issues like excessive bloating. They actually call that endo belly or you may have constipation or diarrhea.

Fertility challenges are also very common, so as you can see, there's just a whole spectrum of different symptoms. And it's easy to see how this condition can really negatively impact somebody's quality of life, which is why we're here to kind of outline all that you have control over, at least from a dietary standpoint to help reduce some of that pain, calm the inflammation. There's a lot we can do through food to support hormone balance, which can help slow the progression of the disease as well.

Kara: Yeah. And as you were listing those symptoms, Brandy, the first thing that popped into my mind is every single one of those could be attributed to something else.

Brandy: Right.

Kara: You know, like irritable bowel syndrome or it might be easy to explain away what they all are and hence, you know, the difficulty in getting that actual diagnosis.

Brandy: Right. You could be chasing, you know, other diagnoses or treatment plans, not never really finding relief and just kind of like cycling through different possible conditions until you do have that, maybe one day you do have that medical procedure to actually confirm what it is.

Kara: Or potentially hospitalized because of such severe pain or bleeding.

Brandy: Right.

Kara: So one of the challenges with endometriosis is that it often takes seven to 10 years on average to get diagnosed, and that delay happens because sometimes symptoms are dismissed as, oh, it's just a bad menstrual cycle. It's a bad period. That's what the cramps and the heavy bleeding are from.

Brandy: Mm-hmm.

Kara: Also, diagnosing is not a simple test. The only way to definitively diagnose endometriosis, it's through laparoscopic surgery. They actually look inside the pelvis. They take a sample of the tissue, they get a biopsy. That's part of why diagnosing can be delayed. You know, it's just not always visible on imaging like MRIs or even ultrasounds. All right, so let's shift, Brandy, to talking about what can women control?

What can women control when it comes to managing endometriosis?

Brandy: Right?

Kara: Because so far a lot of what we've been talking about might seem a little negative, you know? But we do have some positive solutions as well.

Brandy: Absolutely.

Kara: And I want to start by saying diet and what we're putting in our mouths can't necessarily cure endometriosis.

Brandy: Right.

Kara: But really the goal is to reduce inflammation, support hormone balance, improve intestinal health, and help to manage those debilitating symptoms.

Brandy: Yeah.

Kara: So one key point is that endometriosis, it is an inflammatory condition. So foods that either increase or decrease inflammation can impact symptoms either for the good or the bad.

Brandy: Mm-hmm.

Kara: So you want to think of everything you put in your mouth as adding fuel to that fire, making symptoms worse or helping to dampen and put out the fire.

Brandy: Mm-hmm.

Kara: And mitigate those symptoms.

Eat anti-inflammatory foods

Brandy: That's right. We have so much control over inflammation based on what we eat. Some foods are inflammatory, some foods are anti-inflammatory, so, so when you think of anti-inflammatory foods, what comes to mind? For me, I'm thinking colorful plants, colorful fruits and vegetables. We know they are rich in antioxidants. That helps fight inflammation, but also fatty fish.

Things like salmon, sardines, mackerel. Those are rich in anti-inflammatory omega-3 fatty acids. We can also get omega-threes from walnuts, flax seeds, chia seeds; smaller amounts than fatty fish, but it all counts. These are all great foods to regularly include in an anti-inflammatory diet.

I think another key point is making an effort to include lots of fiber rich foods. Again, we're thinking about vegetables, we're thinking about fruits, legumes, whole grains, like quinoa. Fiber helps the body eliminate excess estrogen. So fiber is going to play a role in hormone balance, and we know that excess estrogen can contribute to endometriosis.

Kara: Mm-hmm. And we'll talk more about that as the show goes on and how we can potentially stop that excess estrogen.

Brandy: Yeah, yeah. Definitely more nutrition solutions to look at that specifically. And controlling inflammation can help with that. So again, antioxidants from colorful fruits and vegetables that help combat that oxidative stress. Healthy fats can also support hormone balance and it helps support blood sugar control. So healthy fats, I'm thinking olive oil, avocados, nuts and seeds. So plants, healthy fats, are sort of the base of your anti-inflammatory diet.

Kara: And so like Brandy said, the goal is to lower inflammation as much as possible if you've received that diagnosis of endometriosis and you're wondering where to start. Reducing inflammatory foods or eliminating. But you know, there are foods that are equally as important to avoid, and that's because they're very inflammatory.

Brandy: Mm-hmm.

Kara: And I always think about processed foods, especially what we call ultra processed foods.

Brandy: Right.

Kara: Those are made in factories. They don't come from nature, and they're typically in a box. Maybe it's a frozen meal.

Brandy: Mm-hmm.

Kara: Certainly fast food would be considered ultra processed. So if you have foods in your cabinet that have been there for a couple of years, and I'm thinking about like certain brands of peanut butter that you can just kind of leave in your cabinet and from year to year, they don't seem to change. There's often like hydrogenated oils, trans fats.

Brandy: Added sugar.

Kara: Mm-hmm. So that, you know, these are ultra processed foods.

Brandy: Yeah, it could even be the box of mac and cheese or the cans of soup. Looking in your freezer, there could be like TV dinners. It could be French fries that you get at even a nice restaurant. You know, those would all be examples of ultra processed foods.

Kara: And they usually have a long list of ingredients, don't they Brandy? I think, you know, some of the fast food restaurants that provide chicken nuggets on their menu, you know, there could be 30 to 40 ingredients.

Brandy: Exactly.

Kara: Very little actual chicken. So, so those are just, they create more inflammation throughout the body. And we want to be reducing inflammation with endometriosis.

More on foods to avoid: alcohol & sugar sweetened beverages

Brandy: That's right. I'm also thinking other substances that can be inflammatory: alcohol. That's a big one. And sugar sweetened beverages. So thinking about what are you drinking and how could that be adding to the inflammation.

Kara: Yeah. Sugar can really sneak in to some of those beverages, whether it's a sweet coffee drink, soda. Even some of those smoothie places, it's really just a hundred grams of sugar.

Brandy: Right. That puts it into perspective.

Kara: And so it's worth it though to look at your food and your beverages and start cutting out some of those high sugar, ultra processed foods and drinks because it could reduce some of that heavy bleeding, the excessive bloating, and of course, that debilitating pain, that pelvic pain that so many women experience.

Brandy: And it's going to benefit other areas of your health, you know? So even if it doesn't completely eliminate the pain or turn those symptoms around a hundred percent, you're still doing your body good in other ways.

Kara: Yeah. Yeah. Maybe it's getting your glucose out of the prediabetic range or improving your lipids.

Brandy: Right.

Kara: So there's only going to be a benefit from eating to reduce inflammation.

Brandy: Right. So I think we can agree eliminating or drastically reducing ultra processed foods is only going to help reduce inflammation, benefit other areas of your health. Like I said, it may not completely eliminate your symptoms, but it is, it's definitely not going to make it worse.

Consider eliminating dairy & gluten to reduce inflammation

For some people we do need, you know, take that meal plan a step further to really try to make an impact in those symptoms. For some people, dairy and gluten can also be quite inflammatory. So those would be other foods that we're thinking about when we're putting together an anti-inflammatory meal plan.

So if I am working with somebody that's in a lot of discomfort from endometriosis, maybe the condition is quite advanced, we may do a dairy-free or a gluten-free trial for a few weeks just to see if it does help drive down inflammation and improve their symptoms.

For many people, gluten and dairy are inflammatory and many people don't realize the inflammation that they are causing until they remove it completely for three weeks, four weeks. I encourage six weeks to really give it a good shot. That connection isn't always obvious until you do that trial, and for some people doing the trial and even reintroducing it for a week or two, that's really kind of what gives you the comparison and helps you understand the inflammation that it has been causing.

Kara: Yeah. I think three to four weeks. That's an important timeframe. And most people, I mean, let's just say anybody can do that for three to four weeks.

Brandy: Yeah. Right. It's a drop in the bucket in the grand scheme of things. Worth the effort if it means you're going to feel better.

The gut health connection to endometriosis

Kara: Absolutely. So we also want to talk about gut health or intestinal health.

Brandy: Mm-hmm.

Kara: Because gluten and dairy are very common triggers when it comes to inflammation of the gut.

Brandy: Right.

Kara: And we can't talk about endometriosis without discussing intestinal health. You know, and we'll interchange those terms, gut and intestinal health, but the gut plays a major role in metabolizing the hormone, estrogen; plays a major role in immune function. In fact, most of our immune system begins in the gut.

Brandy: Mm-hmm. That's right.

Kara: And so here on Dishing Up Nutrition, you probably have heard us if you've tuned in before you've heard us talk about the importance of gut health. It really lays the foundation for so many areas of overall health, and we know for sure hormones are deeply connected to the health of our gut. As we mentioned earlier, Brandy had said, you know, it's important to include fiber with each meal and each snack. Foods that contain fiber will feed the good bugs, that good bacteria. We all have several pounds of bacteria in our gut.

Brandy: That's amazing.

Kara: So, and that's good. We want bacteria, trillions of bacteria. We just want most of them to be beneficial.

Brandy: That's right.

Kara: So we want to feed the good guys to keep them populated.

Brandy: And they love fiber.

Kara: They do, they thrive on fiber. Another way to support gut health is to look for foods that are naturally fermented: sauerkraut and pickles. It is important that they're naturally fermented with just salt. Yep. And so like for the sauerkraut, you would just look for cabbage and salt.

Brandy: Right; as the ingredients. And it's probably going to be in the refrigerator section, right?

Kara: Correct.

Brandy: Not from the can in the aisle.

Kara: Yeah. One brand is Bubbie’s. It really just depends on if your grocery store carries that or not. But that's a good one, that they carry the natural pickles and sauerkraut.

Brandy: Great. So those would be sources, those fermented foods are sources of the good bacteria.

Kara: Kimchi is another one that's a spicy Korean cabbage dish.

Brandy: Love kimchi.

Kara: I do too. And Brandy, you had mentioned a good suggestion: looking for a kombucha, which is a fermented beverage. But looking for one that is low in sugar.

Brandy: Right.

Kara: Because many of them can get pretty high in sugar.

Brandy: Definitely. So reading labels and just finding one where the sugar content should be a single digit.

Kara: Oh, that's perfect.

Brandy: Right. That's kind of my…

Kara: Under 10. Under 10 grams of sugar is a good goal.

Brandy: Right.

Kara: Now, if bloating and other digestive issues like constipation or diarrhea are some of your main symptoms, it wouldn't hurt to add in a probiotic supplement. It's you're just able to get a higher strength of the good bacteria by taking a supplement. We really like the Biotic 7. It's got seven strains. It's a multi strain. It includes bifidobacterium and the lactobacillus strains. So those both help with reducing inflammation and repairing the gut.

Brandy: That's right. It's easy to take one, one capsule a day. Some people may do two capsules a day, but pretty easy to wrap into your supplement routine. Well, it is time for our first break. Kara and I are discussing endometriosis 101, signs, symptoms, and support. When we get back, we'll continue our discussion on how we can reduce inflammation by supporting the gut. We'll be right back.

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Kara: Welcome back. You're listening to Dishing Up Nutrition. I am Kara Carper, a Licensed Nutritionist here with Brandy Buro, Licensed and Registered Dietitian. Our topic today is endometriosis, and we are giving tips on how to support the imbalances, the symptoms that come along with endometriosis naturally with nutrition.

Brandy: That's right. Before we went on break, we were discussing how important gut health is to reducing inflammation. You know, it can kind of make or break systemic inflammation in your body. If your gut is struggling, it's likely you'll experience a lot of inflammation.

So we're talking about ways to help support a healthy gut and unfortunately there are a lot of symptoms with endometriosis that mimic digestive issues or can contribute or worsen digestive issues like bloating, constipation, diarrhea; those are all quite common with endometriosis. A probiotic can help. We talked about the Biotic 7 being a multi-strain that's very easy to take.

A low FODMAP diet may benefit some with endometriosis

In some cases there are particular diets that can help manage some of those digestive issues. There's a diet called the low FODMAP diet that some, some women do very well with. And what this diet is, is basically removing certain groups of carbohydrates that are easily fermentable.

Fermentable carbohydrates can cause more bloating and fust add to that discomfort. I will say that this particular diet is not all that intuitive. It's pretty difficult to follow on your own. So I do suggest working with a dietitian if you are somebody struggling with these symptoms and you're just wanting to give the low FODMAP diet a try to see if you can get some relief;

Not recommended to follow a strict low FODMAP diet  long term because it is quite restrictive. But if you're willing to, you know, experiment with it, see if it helps you feel better, then what we do is we move on to the reintroduction phase where we, we sort of test those specific groups of carbohydrates to see what are the main contributors of your digestive issues.

Then we can liberalize the diet, and really just focus on the, the few groups of carbohydrates that are more problematic for you and your symptoms. So highly recommend getting the support of a dietitian to go through that process.

Key supplements that can help reduce inflammation for endometriosis

Kara: We've talked about the importance of reducing inflammation when it comes to endometriosis and some key supplements help with that process of reducing inflammation. There was a study published by the Journal of Environmental Research and Public Health.

The study found positive results from supplementing NAC. Some people call it NAC for short. It's N-Acetyl-Cysteine. N-Acetyl Cysteine acts as a powerful antioxidant, and of course that is going to help to reduce inflammation and oxidative stress. NAC is also a precursor to something called glutathione, which is the body's master antioxidant. So think of it as turning down the volume on inflammation throughout the body.

Brandy: That's great. We like the sound of that, right?

Kara: We do. Yes. And in the study, women took 600 milligrams of NAC three times per day, and it helped to reduce their pelvic pain and some of the formation of that scar tissue that occurs.

Brandy: That makes sense.

Kara: So the dose really is important.

Brandy: Yeah.

Kara: I think it's common to see NAC in the dose of 600 milligrams, but in the study it was successful when the women were taking that three times per day.

Brandy: Okay. Yeah. You, you do want that therapeutic dose to get similar benefits as these research participants. Another supplement that I think of when I think of reducing inflammation is curcumin, and there has been some research around curcumin and endometriosis.

It's been shown to reduce pain associated with endometriosis because of its anti-inflammatory effects, and it's been shown to directly prevent endometrial lesions from spreading, at least in a lab setting. So I think that's very promising. Curcumin is one of my supplements that I have in my daily regimen to help reduce inflammation. We have a product called Curcumin 400 that is very well absorbed. So I, I do like that product. Turmeric is also a natural food source of curcumin, so in integrating that into your cooking can be another way to get those anti-inflammatory benefits.  

Kara: Yeah. Great suggestion to actually, you know, use the real herb. Use the real spice whenever possible. Yeah. So since we're on the topic of supplements and nutrients that can reduce inflammation, we would be remiss if we did not talk about omega-3 fish oil.

Brandy: That's right.

Kara: And folks have probably heard discussion about taking omega-threes to reduce inflammation.

Brandy: Yeah. And I think a supplement is always a great option if you're somebody that doesn't really enjoy those fatty fish that we talked about, the salmon, the mackerel, the sardines, or if it's just not something that's very accessible to you, a supplement is just kind of an easy way to engineer that anti-inflammatory support in your day.

Kara: Great point. Because it can be challenging to get enough omega-threes to actually reduce that inflammation from eating fish, and that's one of the main sources when it comes to food, is the cold water fatty fish.

Brandy: That's right.

Kara: And so if somebody is experiencing painful or heavy periods, we first of all check with your doctor. Check with your provider. Because if you are on something like a blood thinner, yeah, it could be contraindicated or you may not want to be taking a lot of fish oil.

Brandy: Mm-hmm. True. Good point.

Kara: So just always double check on that. But if you're not on a blood thinner, there's nothing contraindicated. More is going to work better.

Brandy: Mm-hmm.

Kara: And so four to 6,000 milligrams per day is what we would recommend. You can certainly split that up. It is absorbed best with food, though.

Brandy: That's right.

Kara: Because it's a fatty acid, an essential fatty acid. And studies have found that young women who supplemented with omega-3 fish oil did have a reduction in pain. So that's huge. And research has shown that in animal studies, fish oil helped reduce the size of endometrial lesions. So omega-3 fish oil is really one of our foundational supplements.

Brandy: That's true. Yeah. Yeah. Omega-3 certainly is a foundational supplement. I, I think the same about magnesium. I think magnesium plays a role in endometriosis here, so let's talk a little bit more about that. When I think magnesium, I think relaxation. Magnesium helps relax our muscles, especially our smooth muscles.

In the context of endometriosis, it may prevent something called retrograde menstruation, and that is when menstrual blood flows back through the fallopian tubes and into the pelvic cavity instead of out the body through the vagina. And some people think that this may be the cause of endometriosis.

So if we have a easy way to help relax those muscles so that blood is flowing out of the body and not back flowing, I think that's something worth considering. So magnesium is something that will help relax those smooth muscles and making that exit a little easier. Magnesium is something that we do get from food.

You know, it is found in leafy greens. There's higher amounts in pumpkin seeds and nuts. I think avocados are also a really great source. The fact is though that magnesium in our plant sources are not as concentrated as they once were because our soil has been depleted of magnesium. So it is a little more challenging to get all of our magnesium from food. That's why magnesium as a supplement is often one of those foundational supplements for overall health, similar to omega-3. And there's a lot of other health benefits. It can help with lowering blood pressure. It can help with better sleep. All good things.

Kara: Magnesium is, it's a miracle mineral. I think it's involved in 300 processes, enzymatic processes in the body. So you know, it's important for heart health, sleep, digestion, Charlie horses, leg cramps. I mean, we could go on and on.

Brandy: Migraines.

Kara: Anything constricted though, magnesium, the mineral magnesium will help to relax.

Brandy: Mm-hmm.

Kara: And because of that, I often recommend magnesium in a supplement form, because that's, that's how you get that therapeutic dose. That's going to relax muscles. I recommend it for women dealing with menstrual cramps. Because think about it. That's just constricted pelvic muscles or abdominal muscles.

Brandy: Definitely.

Kara: And you had said it's beneficial for overall health. It can really, you know, when we are stressed out, we are depleted of more magnesium.

Brandy: Yeah.

Kara: We lose magnesium through urine, through sweat, so it's one of those minerals that's very easily excreted and three, either two out of three or three out of four people are deficient in magnesium.

Brandy: Yeah, I would agree with that. I think many people just feel better when they bring their magnesium levels up to par.

Kara: Yeah. So, start with the food sources and consider supplements if symptoms are more severe. There's also supplement called Estro-I-3-C. What that stands for is indole-three-carbinol.

Brandy: Mm-hmm.

Kara: Now we do have that in supplement form, but you can also get the same components by eating cruciferous vegetables.

Brandy: Yes, my favorite.

Kara: Kale, broccoli, cauliflower.

Brandy: Bok choy.

Kara: I always forget about that one. So eat those cruciferous veggies. They're helpful in metabolizing negative or excess estrogen. So we need, you know, they're great for detoxing estrogens. Brandy had mentioned earlier that the endometrial tissue that tends to overgrow with endometriosis produces estrogen. So it's kind of a vicious cycle. So if we can get in there and detoxify and excrete some of those excess estrogens that could lead to less pelvic pain, less bleeding, less cramping.

Brandy: And slowing the progression of the growth of those lesions, right?

Kara: Mm-hmm.

Brandy: So cruciferous vegetables a great way to just support your body's natural detoxification processes and help metabolize that excess estrogen. So we've gone over what endometriosis is. And the basics of that anti-inflammatory diet and a few key supplements that can further help reduce inflammation in the body.

Sample day of meals & snacks to support someone with endometriosis

Now, I just want to make this really practical and think about what is a whole day's worth of meals and snacks that's going to help reduce inflammation and support somebody with endometriosis. So in my mind we have to think protein, healthy fat, and plant-based carbs to support good blood sugar control.

We're also incorporating lots of colorful fruits and vegetables for antioxidants and fiber and key healthy fats for that blood sugar control and hormone balance. Okay. So with that in mind, let's just think through a day's worth of meals. We can kind of bounce back and think about what we've been eating lately that could match this picture. Right?

Kara: Yeah. Sounds great.

Brandy: Okay. So let's think about breakfast first. My favorite breakfast is some type of veggie scramble with eggs. I really like to do some kale. Maybe some bell pepper for color with a little bit of mushroom, garlic, onion, and a few scrambled eggs. Maybe a little bit of ham.

That way I'm getting my protein, I'm getting some cruciferous vegetables from the egg. And I might cook all of that in some avocado oil for some healthy fat. On the side maybe some avocado for a little extra boost of fiber and magnesium.

Kara: Fabulous. I love avocado, because it's just got everything, all the good parts: healthy, fat, the minerals, the fiber.

Brandy: Yeah. It's the complete package.

Kara: Yeah.

Brandy: If I could mention just one more recipe that is on our website that I've been experimenting with lately for a good, like, dose of fiber; we have something called “Noats”, which is kind of like oatmeal, but it doesn't contain oats.

Instead it uses chia seeds, flax seed, hemp hearts, and it's kind of like an overnight oat situation, but we are using those high fiber seeds instead. So you get that oatmeal experience without all of those excess carbohydrates, and you get some of those healthy omega-3 fats and a good dose of fiber. So I, I like that. It could even be like a little compliment to what we just talked about, like with the egg and avocado combination.

Kara: Yeah. And I think people appreciate a recipe like that. That's a make ahead recipe.

Brandy: Mm-hmm.

Kara: You know, especially for those rushed mornings. But just a really an upgrade from a regular oatmeal that's solely grain and carbohydrate based. This has some healthy fats and quite a bit of fiber, so, and it is gluten-free as well.

Brandy: Good point.

Kara: I'll give an example of a lunch. I probably have this once a week just because it's so simple.

Brandy: Mm-hmm.

Kara: So it's a can of wild caught salmon. Most salmon at the grocery stores will be wild caught.

Brandy: Oh, that's good to know.

Kara: So, but always look for that. But that I've only ever seen wild caught in the canned. So just drain that. I like to use a high quality avocado oil based mayonnaise. There's a couple out there: Primal Kitchen.

Brandy: Mm-hmm.

Kara: Chosen Foods, are two brands. Mix that in with a little celery, a little onion. And I just put that on a bed of greens.

Brandy: Oh, nice.

Kara: And actually, the recipe on our website, which is weightandwellness.com, it calls for a little starch. I like to put frozen peas, half cup of frozen peas. And it's crunchy. And I just like the flavor profile. So that's just simple and it can be tossed together in just a few minutes.

Brandy: And I bet you could even make a larger batch so you could have a few meals out of it.

Kara: Yes, I have done that before where I'll take like three cans of salmon and then just make it last.

Brandy: Mm-hmm. And that's kind of a built-in way to get that fatty fish two or three times a week. That's great. Well, let's think about snacks. I think many people really need an afternoon snack or somewhere in their day just to keep their blood sugar stable. A really popular recipe on our website, weightandwellness.com, are the peanut butter protein balls.

So that's basically kind of like, I like to describe it as like a DIY protein bar or a no bake cookie, but it's actually really nutritious. It's just a mix of protein powder, some peanut butter or sun butter, and there's a couple different versions of it, but the one that I really like is the carbohydrate is chickpeas.

Just mix it in a blender, form it into little balls, and that's a great balanced snack. Or you could even do like some nitrate free deli meat with a vegetable, like sliced cucumber or bell pepper and some guacamole. You know, that would be very easy to whip up. Almost no prep. Very balanced.

Kara: And some people like those roll-ups that are often served at parties.

Brandy: Yeah.

Kara: Ham, you know, nitrate free ham with some full fat cream cheese. Maybe put a pickle in there. Get fermented Bubbie’s pickle.

Brandy: That's great.

Kara: And you're good to go.

Brandy: AKA Minnesota sushi.

Kara: Yes. I was going to say that.

Brandy: Great idea and we are onto dinner then. So let's think through some good anti-inflammatory balanced meals. I can share what I have for tonight; something I intend to make. I've got all the ingredients. I make this turkey stew with kale and cannellini beans; really simple. You just kind of brown the ground turkey in some olive oil with ginger, garlic.

Add in some bone broth for extra protein, some canned beans, and a ton of kale. So we're getting those cruciferous veggies. I just add a bunch of fresh herbs, a little lemon. It's really delicious. It lasts all week.

Kara: That’s a great one pot meal, Brandy.

Brandy: Mm-hmm. Yeah, I, that's what I like about it.

Kara: Kind of one and done, right?

Brandy: One and done. Another, like one pot dish that I really like on our website is the egg roll in a bowl. Super fast, has a lot of cabbage, really flavorful. It has kind of all the components of a balanced meal in one dish.

Kara: Mm-hmm. Yeah, and I was also thinking along those lines. I like our white chicken chili recipe and the hamburger soup recipe.

Brandy: Oh yeah.

Kara: There's something about just having something made that has the protein, the vegetables, the carbohydrate, the healthy fat.

Brandy: Mm-hmm.

Kara: And you come home from work and it's ready or you just heat it up.

Brandy: Yeah. Reduces a lot of the, the stress of planning and making a whole meal from scratch again. So, good tip.

Lifestyle factors that can improve symptoms of endometriosis

Kara: So we've been talking about lowering inflammation and the importance of that, and we know that what we're eating is a really big piece of the puzzle that we have control over, but there are other lifestyle factors that can also improve symptoms of endometriosis.

Stress management is really important. Figuring out a way, we know that we can't avoid stress, but if we can manage it, and part of that is getting a good night's sleep.

Brandy: Absolutely.

Kara: Sleep goes hand in hand with managing stress. And so Brandy and I, you know, when we meet with clients, we can tailor a plan and work with people's individual needs.

Brandy: That's right.

Kara: Whether that's looking for support when it comes to sleep, or what they’re eating during the day. We get that it's not just about focusing on one area, while ignoring other areas of life.

Brandy: Right. We really have to support all pillars of health for any one pillar to be effective, I think. So taking the holistic approach with our nutrition support. Right?

Key takeaways

Let's talk about the key takeaways from our discussion today. Endometriosis is a chronic inflammatory condition that affects about one in 10 women, so it is very common and symptoms vary widely. Diagnosis, and getting a diagnosis can take years. So it's really important to do what you can to manage those symptoms with or without that diagnosis, and diet is just one of those tools that we have control over, that we have the ability to support and manage our symptoms.

Kara: And when it comes to what we're eating and how that can affect our hormones and the symptoms of endometriosis, we want to focus on real foods, those foods that will reduce inflammation. So that means cutting out processed and ultra processed foods, high sugar foods, high sugar beverages, because we know those are inflammatory.

Brandy: Mm-hmm.

Kara: So sticking with real proteins coming from clean, high quality animal sources if possible; real healthy fats coming from nature, olives, olive oil.

Brandy: Avocados.

Kara: Coconut, avocados, nuts and seeds, butter. And real carbohydrates. The best forms of carbohydrates for reducing inflammation will come from vegetables and then smaller quantities of fruit are fine as well. Carbohydrates coming from whole food sources. Usually they're single ingredients.

Brandy: That's right. You know, the, the plant or the tree that it came from. Plus those real food carbohydrates are also going to be much higher in fiber. And we know that we need fiber not only to support our gut, but also to support hormone balance.

So that is one of the ways that we can eliminate some of that excess estrogen through our gut. And of course, working with a dietitian to help identify if you do have any individual food triggers, any other foods that could be contributing to that inflammation; gluten and dairy being very common, inflammatory foods.

Kara: Mm-hmm. Well, Brandy and I want to thank you for listening to Dishing Up Nutrition. If you found this episode helpful, please share it with someone who might benefit from the information. And if you feel the need, you can consider meeting with Brandy or myself or any of the other licensed and registered dietitians here at Nutritional Weight & Wellness, and we can really create a good individualized plan for you.

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We're here to help, so don't hesitate to reach out. You can go to our website. It's chock-full of a lot of great free resources, information: weightandwellness.com.

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And our goal at Nutritional Weight & Wellness is to help each and every person experience better health through eating real food. It's a simple, yet powerful message, so thank you for listening and have a good day.