The Association Between Daily Intake of Dietary Supplements and Self-Reported Endometriosis: A NHANES-Based Study

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Higher dietary fiber and protein intake were associated with reduced endometriosis risk, particularly in normal-weight women.

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This NHANES-based cross-sectional study examined whether daily dietary supplement intake is associated with self-reported endometriosis initiation/progression using 3,950 U.S. participants from 1999–2006, with infertility assessed via a question about year-long attempts to become pregnant and associations tested using weighted multivariate logistic regression plus BMI-stratified subgroup analyses. Higher dietary fiber content and density were associated with lower endometriosis risk (e.g., Q4 vs Q1 OR ~0.56 for content and ~0.55 for density), and protein content and density also showed negative associations in the overall analysis. These associations appeared more pronounced in normal-weight women, while they were not evident in overweight/obese participants, and protein-related effects were not significant across subpopulations. The paper emphasizes that findings require future research to validate and establish a causal link; relevance to endometriosis: the study directly targets endometriosis risk with dietary supplement nutrient measures in a NHANES cohort, making it centrally applicable to endometriosis research. This paper is centrally about endometriosis — it analyzes how daily supplement nutrient intake is associated with self-reported endometriosis risk in NHANES.

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Abstract

Dietary supplements are gaining recognition as potential influencers of female reproductive health, but their connection to endometriosis risk remains underexplored. This study addressed this gap, examining the impact of daily dietary supplement intake on the initiation and progression of endometriosis. To explore this, a cross-sectional study was conducted involving 3950 participants representative of the US population from the 1999-2006 National Health and Nutrition Examination Survey (NHANES). Infertility was determined by a question on year-long attempts to become pregnant. Unweighted and weighted multivariate logistic regression analyses assessed the association between dietary supplements and endometriosis risk. Subgroup analysis was conducted based on the participants' body mass index (BMI). The results revealed intriguing patterns. Specifically, higher dietary fiber content (Q4 vs Q1: OR = 0.56, 95% CI = (0.37,0.84), P = 0.0062) and density (Q4 vs Q1: OR = 0.55, 95% CI = (0.38,0.81), P = 0.0035) were linked to reduced risk of endometriosis. Protein content (Q4 vs Q1: OR = 0.47, 95% CI = (0.31,0.74), P = 0.0011) and density (Q4 vs Q1: OR = 0.63, 95% CI = (0.45,0.88), P = 0.0096) similarly exhibited a negative association with endometriosis risk. Interestingly, when stratified by BMI, these effects were pronounced in normal-weight women, whereas they were not evident in the overweight and obese subgroup. Protein content and density showed no significant associations across subpopulations. In conclusion, this study established a negative relationship between dietary fiber and endometriosis, particularly notable in normal-weight women. Future research is essential to validate these findings and establish a causal link between dietary fiber and endometriosis.
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Abstract

Dietary supplements are gaining recognition as potential influencers of female reproductive health, but their connection to endometriosis risk remains underexplored. This study addressed this gap, examining the impact of daily dietary supplement intake on the initiation and progression of endometriosis. To explore this, a cross-sectional study was conducted involving 3950 participants representative of the US population from the 1999–2006 National Health and Nutrition Examination Survey (NHANES). Infertility was determined by a question on year-long attempts to become pregnant. Unweighted and weighted multivariate logistic regression analyses assessed the association between dietary supplements and endometriosis risk. Subgroup analysis was conducted based on the participants’ body mass index (BMI). The results revealed intriguing patterns. Specifically, higher dietary fiber content (Q4 vs Q1: OR = 0.56, 95% CI = (0.37,0.84), P = 0.0062) and density (Q4 vs Q1: OR = 0.55, 95% CI = (0.38,0.81), P = 0.0035) were linked to reduced risk of endometriosis. Protein content (Q4 vs Q1: OR = 0.47, 95% CI = (0.31,0.74), P = 0.0011) and density (Q4 vs Q1: OR = 0.63, 95% CI = (0.45,0.88), P = 0.0096) similarly exhibited a negative association with endometriosis risk. Interestingly, when stratified by BMI, these effects were pronounced in normal-weight women, whereas they were not evident in the overweight and obese subgroup. Protein content and density showed no significant associations across subpopulations. In conclusion, this study established a negative relationship between dietary fiber and endometriosis, particularly notable in normal-weight women. Future research is essential to validate these findings and establish a causal link between dietary fiber and endometriosis. Similar content being viewed by others Data Availability The datasets used in the current study are publicly available, which can be accessed at https://wwwn.cdc.gov/Nchs/Nhanes/. Code Availability Not applicable.

References

Giudice LC, Kao LC. Endometriosis. Lancet. 2004;364(9447):1789–99. Carter JE. Combined hysteroscopic and laparoscopic findings in patients with chronic pelvic pain. J Am Assoc Gynecol Laparosc. 1994;2:43–7. Sourial S, Tempest N, Hapangama DK. Theories on the pathogenesis of endometriosis. Int J Reprod Med. 2014;2014:179515. https://doi.org/10.1155/2014/179515. Sampson JA. Peritoneal endometriosis due to menstrual dissemination of endometrial tissue into the peritoneal cavity. Am J Obstet Gynecol. 1927;14:422–9. Yalçın Bahat P, Ayhan I, Üreyen Özdemir E, İnceboz Ü, Oral E. Dietary supplements for treatment of endometriosis: a review. Acta Biomed. 2022;93(1):e2022159. https://doi.org/10.23750/abm.v93i1.11237. Arab A, Karimi E, Vingrys K, Kelishadi MR, Mehrabani S, Askari G. Food groups and nutrients consumption and risk of endometriosis: a systematic review and meta-analysis of observational studies. Nutr J. 2022;21(1):58. https://doi.org/10.1186/s12937-022-00812-x. Missmer SA, Chavarro JE, Malspeis S, et al. A prospective study of dietary fat consumption and endometriosis risk. Hum Reprod. 2010;25(6):1528–35. https://doi.org/10.1093/humrep/deq044. Parazzini F, Chiaffarino F, Surace M, et al. Selected food intake and risk of endometriosis. Hum Reprod. 2004;19(8):1755–9. https://doi.org/10.1093/humrep/deh395. Shafrir AL, Farland LV, Shah DK, Harris HR, Kvaskoff M, Zondervan K. Risk for and consequences of endometriosis: a critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol. 2018;51:1–15. Sowers MR, Crawford S, McConnell DS, Randolph JF Jr, Gold EB, Wilkin MK, et al. Selected diet and lifestyle factors are associated with estrogen metabolites in a multiracial/ethnic population of women. J Nutr. 2006;136(6):1588–95. Kaneda N, Nagata C, Kabuto M, Shimizu H. Fat and fiber intakes in relation to serum estrogen concentration in premenopausal Japanese women. Nutr Cancer. 1997;27(3):279–83. Qi L, Rimm E, Liu S, Rifai N, Hu FB. Dietary glycemic index, glycemic load, cereal fiber, and plasma adiponectin concentration in diabetic men. Diabetes Care. 2005;28(5):1022–8. King DE, Egan BM, Geesey ME. Relation of dietary fat and fiber to elevation of C-reactive protein. Am J Cardiol. 2003;92(11):1335–9. Ajani UA, Ford ES, Mokdad AH. Dietary fiber and C-reactive protein: findings from National Health and Nutrition Examination Survey data. J Nutr. 2004;134(5):1181–5. Centers for Disease Control and Prevention. NHANES - IRBA 98. National Center for Health Statistics. 1998. https://www.cdc.gov/nchs/nhanes/irba98.htm. Centers for Disease Control and Prevention. NHANES 2001-2002: Dietary Interview - Individual Foods. National Center for Health Statistics. 2001-2002. https://wwwn.cdc.gov/nchs/data/nhanes/2001-2002/manuals/dietary_year_3.pdf. Centers for Disease Control and Prevention. NHANES 2013-2014: Reproductive Health Questionnaire I. National Center for Health Statistics. 2013-2014. https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/RHQ_I.htm. Akaike H, Petrov BN, Czaki F. Information theory and an extension of the maximum likelihood principle. In: 2nd Int. Sympo. on information theory. New York, NY: Springer. 1973;267–81. https://doi.org/10.1007/978-1-4612-0919-5_38. Schwartz NRM, Afeiche MC, Terry KL, Farland LV, Chavarro JE, Missmer SA, Harris HR. Glycemic index, glycemic load, fiber, and gluten intake and risk of laparoscopically confirmed endometriosis in premenopausal women. J Nutr. 2022;152(9):2088–96. https://doi.org/10.1093/jn/nxac107. Samaneh Y, ShahidehJahanian S, Azadeh M, Anoshirvan K. The association of food consumption and nutrient intake with endometriosis risk in Iranian women: a case-control study. Int J Reprod Biomed. 2019;17(9):661–70. https://doi.org/10.18502/ijrm.v17i9.5102. 10.18502/ijrm.v20i11.12366. eCollection 2022 Nov. Cronin P, Joyce SA, O’Toole PW, O’Connor EM. Dietary fibre modulates the gut microbiota. Nutrients. 2021;13(5):1655. https://doi.org/10.3390/nu13051655. Kolanska K, Alijotas-Reig J, Cohen J, Cheloufi M, Selleret L, d’Argent E, Kayem G, Valverde EE, Fain O, Bornes M, Darai E, Mekinian A. Endometriosis with infertility: a comprehensive review on the role of immune deregulation and immunomodulation therapy. Am J Reprod Immunol. 2021;85(3):e13384. https://doi.org/10.1111/aji.13384. Symons LK, Miller JE, Kay VR, Marks RM, Liblik K, Koti M, Tayade C. The immunopathophysiology of endometriosis. Trends Mol Med. 2018;24(9):748–62. https://doi.org/10.1016/j.molmed.2018.07.004. Mair KM, Gaw R, MacLean MR. Obesity, estrogens and adipose tissue dysfunction - implications for pulmonary arterial hypertension. Pulm Circ. 2020;10(3):2045894020952019. https://doi.org/10.1177/2045894020952023. Hildebrandt X, Ibrahim M, Peltzer N. Cell death and inflammation during obesity: “know my methods, WAT(son).” Cell Death Differ. 2023;30(2):279–92. https://doi.org/10.1038/s41418-022-01062-4. Davoodi SH, Shahbazi R, Esmaeili S, Sohrabvandi S, Mortazavian A, Jazayeri S, et al. Health-related aspects of milk proteins. Iran J Pharm Res. 2016;15:573–91. Majumder K, Chakrabarti S, Davidge ST, Wu J. Structure and activity study of egg protein ovotransferrin derived peptides (IRW and IQW) on endothelial inflammatory response and oxidative stress. J Agric Food Chem. 2013;61:2120–9. Missmer SA, Chavarro JE, Malspeis S, Bertone-Johnson ER, Hornstein MD, Spiegelman D, et al. A prospective study of dietary fat consumption and endometriosis risk. Hum Reprod. 2010;25:1528–35. https://doi.org/10.1093/humrep/deq044. Author information Authors and Affiliations Contributions Conceptualization, WZ; formal analysis, KL, WZ; methodology, WZ; software, WZ; writing—original draft, review and editing, KL, WZ. Corresponding author Ethics declarations Ethics Approval All survey procedures are supervised and approved by the NCHS Ethics Review Board, and each survey respondent provides written consent. These publicly available data are de-identified, so further institutional review committee approval is exempted. Consent to Participate Informed consent was obtained from all individual participants included in the study. Consent for Publication The participant has consented to the submission of the research article to the journal. Competing Interests The authors declare no competing interests. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary Information Below is the link to the electronic supplementary material. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Li, K., Zhang, W. The Association Between Daily Intake of Dietary Supplements and Self-Reported Endometriosis: A NHANES-Based Study. Reprod. Sci. 31, 1936–1947 (2024). https://doi.org/10.1007/s43032-024-01464-4 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-024-01464-4

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Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements Dietary Supplements

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