Atherosclerosis and Endometriosis: The Role of Diet and Oxidative Stress in a Gender-Specific Disorder

Michela Cirillo, Flavia Rita Argento, Monica Attanasio, Matteo Becatti, Irene Ladisa, Claudia Fiorillo, Maria Elisabetta Coccia, Cinzia Fatini
Biomedicines · 2023 · vol. 11(2) , pp. 450 · doi:10.3390/biomedicines11020450 · PMID:36830986 · W4319298188
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

A 6-month Mediterranean diet intervention in women with endometriosis reduced LDL cholesterol, improved vitamin and antioxidant levels, decreased homocysteine, and lowered oxidative stress markers.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This prospective study followed 35 reproductive-age Caucasian women with confirmed endometriosis (with major cardiovascular comorbidities and recent weight-loss programs excluded) to assess cardiometabolic, endothelial, oxidative stress, and inflammatory markers associated with atherosclerotic processes, including lipid/glucose profiles, homocysteine and Lp(a), hs-CRP, and blood redox measures. Women completed dietary questionnaires and diaries to characterize baseline Mediterranean-diet adherence, then received individualized Mediterranean Diet plans and were reassessed at baseline, 3 months, and 6 months for marker changes and diet adherence using validated scores. The paper emphasizes limitations in the literature about diet and endometriosis, but the study itself is limited by its relatively small sample and lack of reported long-term cardiovascular outcome endpoints. Relevance to endometriosis: this work is explicitly motivated by female-specific cardiovascular risk and examines how Mediterranean Diet intervention affects oxidative stress, endothelial and inflammatory markers in women with endometriosis, directly linking diet/oxidative stress to atherosclerosis-related biomarkers. This paper is centrally about endometriosis — a Mediterranean Diet intervention study measuring cardio-metabolic, endothelial, oxidative stress, and inflammatory markers in endometriosis patients.

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Abstract

Background: Accelerated atherosclerosis in patients with endometriosis has been hypothesised, and lifestyle improvement might control cardiovascular risk. We explored cardiometabolic markers and oxidative stress and evaluated the effects of the Mediterranean Diet (MD) in modulating these markers. Methods: In this prospective study, we included 35 women with endometriosis. At baseline (T0) and after 3 (T1) and 6 (T2) months from the start of the diet, we investigated cardiometabolic parameters, lifestyle and oxidative stress. Results: After a 3-month intervention with MD, we observed a significant reduction in total cholesterol (p = 0.01) and LDL-c (p = 0.003). We observed at T1 an increase in B12 and E vitamins, folate and zinc. After 6 months, zinc (p = 0.04) and folate (p = 0.08) increased in comparison to T0. A reduction in homocysteine from T0 to T1 (p = 0.01) was found. After 3 months, an increase in Rapid Assessment of Physical Activity tool 1 (RAPA) (p < 0.001) and RAPA 2 was observed (p = 0.009). We observed high levels of oxidative stress markers at baseline. After 6 months of MD, a significant improvement in lymphocyte Reactive Oxygen Species (ROS) (p < 0.001) and total antioxidant capacity was observed (p = 0.02). Conclusions: The improvement of lifestyle, and in particular the Mediterranean dietary intervention, allowed the improvement of the metabolic and oxidative profile and overall health-related quality of life.

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endometriosis

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