Evaluation of the role of dietary flavonoid intake in the risk of endometriosis among Iranian women

Document Type : Original Article

Authors

1 Assistant Professor, Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

2 Assistant Professor, Department of Nutrition, Research Center for Prevention of Cardiovascular Diseases, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.

3 Professor, Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

4 Professor, Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

Abstract

Introduction: Flavonoids include a large number of plant-based polyphenolic compounds with antioxidant, anti-estrogenic, anti-mutation, and anti-proliferative effects. This study was conducted to evaluate the relationship between endometriosis and dietary flavonoid intake among Iranian women referring to Arash Hospital, Tehran, Iran,from May 2016 to February 2017.
Methods: This case-control study was conducted on 156 women (78 women diagnosed with endometriosis after laparoscopy and 78 healthy women) in Arash Hospital. The dietary data of the subjects were obtained using a 147-item semi-quantitative Food Frequency Questionnaire a year before the interview. The USDA tables were used to determine the type and amount of flavonoids per 100 g of each food item. Data were analyzed using the Chi-square، t-tests, and logistic regression model.
Result: After the adjustments of the confounding variable, it was revealed that individuals who had a higher intake of total flavonoids ‎(P=0.001)‎ were less likely to have endometriosis‎. Among the subgroups of flavonoids, the only intake of flavanone ‎(P=0.04)‎ was significantly associated with ‎endometriosis risk. Regarding different food groups, flavonoid was significantly lower in the dairy product ‎(P=0.02), adviser ‎(P=0.001), and fruit ‎(P=0.03), compared to that of the control group.
Conclusion: Regarding the influence of flavonoid intake on endometriosis pathogenesis, it can be concluded that a higher intake of flavonoids can contribute to the prevention and control of endometriosis. Therefore, it is recommended to conduct counseling sessions about the benefits of flavonoid intake for such patients.

Keywords

References

  1. Duckitt K. Infertility and subfertility. Clin Evid. 2003(9):2044-73.
  2. Ashrafi M, Sadatmahalleh SJ, Akhoond MR, Talebi M. Evaluation of risk factors associated with endometriosis in infertile women. International journal of fertility & sterility. 2016 Apr;10(1):11.
  3. Taylor H, Johnson N, Carr B, Leyland N, Rechberger T, Duan W, et al. Maintenance of endometriosis-associated pain reduction and quality of life improvement in phase 3 extension studies with elagolix. Fertility and Sterility. 2017;108(3):e96-e7.
  4. Viganò P, Parazzini F, Somigliana E, Vercellini P. Endometriosis: epidemiology and aetiological factors. Best practice & research Clinical obstetrics & gynaecology. 2004;18(2):177-200.
  5. Biberoglu EH, Biberoglu KO. Prevention of Endometriosis.  Endometriosis: Springer; 2014. p. 277-310.
  6. Somigliana E, Busnelli A, Benaglia L, Viganò P, Leonardi M, Paffoni A, et al. Postoperative hormonal therapy after surgical excision of deep endometriosis. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2017;209:77-80.
  7. Heinrichs WL. Prevention of endometriosis signs or symptons. Google Patents; 2001.
  8. Harris HR, Chavarro JE, Malspeis S, Willett WC, Missmer SA. Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study. American journal of epidemiology. 2013;177(5):420-30.
  9. Parazzini F, Chiaffarino F, Surace M, Chatenoud L, Cipriani S, Chiantera V, et al. Selected food intake and risk of endometriosis. Human Reproduction. 2004;19(8):1755-9.
  10. Trabert B, Peters U, De Roos AJ, Scholes D, Holt VL. Diet and risk of endometriosis in a population-based case–control study. British Journal of Nutrition. 2011;105(3):459-67.
  11. Bhagwat S, Haytowitz DB, Holden JM. USDA database for the flavonoid content of selected foods, Release 3.1. US Department of Agriculture: Beltsville, MD, USA. 2014.
  12. Chuwa AH, Sone K, Oda K, Tanikawa M, Kukita A, Kojima M, et al. Kaempferol, a natural dietary flavonoid, suppresses 17β‑estradiol‑induced survivin expression and causes apoptotic cell death in endometrial cancer. Oncology letters. 2018;16(5):6195-201.
  13. Skibola CF, Smith MT. Potential health impacts of excessive flavonoid intake. Free radical biology and medicine. 2000;29(3-4):375-83.
  14. Gohiya A. Isoflavonoids. Orthopaedic Journal of MP Chapter. 2017;23(1).
  15. Sadatmahalleh SJ, Mottaghi A. Dietary phytoestrogen intake and the Risk of Endometriosis in Iranian Women: A case-control study. Int J Fertil Steril. 2019;13(4).
  16. Bosetti C, Rossi M, McLaughlin JK, Negri E, Talamini R, Lagiou P, et al. Flavonoids and the risk of renal cell carcinoma. Cancer Epidemiology and Prevention Biomarkers. 2007;16(1):98-101.
  17. González-Gallego J, García-Mediavilla MV, Sánchez-Campos S, Tuñón MJ. Anti-inflammatory and immunomodulatory properties of dietary flavonoids.  Polyphenols in Human Health and Disease: Elsevier; 2014. p. 435-52.
  18. Kawai M, Hirano T, Higa S, Arimitsu J, Maruta M, Kuwahara Y, et al. Flavonoids and related compounds as anti-allergic substances. Allergology International. 2007;56(2):113-23.
  19. Goto S, Handa S. Antithrombotic effects of flavonoid. Circulation. 2001;103(4):E23.
  20. Mirmiran P, Esfahani FH, Mehrabi Y, Hedayati M, Azizi F. Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study. Public health nutrition. 2010;13(5):654-62.
  21. Calado JCP, Albertão PA, de Oliveira EA, Letra MHS, Sawaya ACHF, Marcucci MC. Flavonoid contents and antioxidant activity in fruit, vegetables and other types of food. Agricultural Sciences. 2015;6(04):426.
  22. Vigano P, Parazzini F, Somigliana E, Vercellini P. Endometriosis: epidemiology and aetiological factors. Best Pract Res Clin Obstet Gynaecol. 2004;18(2):177-200.
  23. Zand RSR, Jenkins DJ, Diamandis EP. Steroid hormone activity of flavonoids and related compounds. Breast cancer research and treatment. 2000;62(1):35-49.
  24. Le Bail J, Laroche T, Marre-Fournier F, Habrioux G. Aromatase and 17β-hydroxysteroid dehydrogenase inhibition by flavonoids. Cancer Letters. 1998 Nov 13;133(1):101-6.
  25. Ribeiro D, Freitas M, Tomé SM, Silva AM, Laufer S, Lima JL, et al. Flavonoids inhibit COX-1 and COX-2 enzymes and cytokine/chemokine production in human whole blood. Inflammation. 2015;38(2):858-70.
  26. Han SJ, Jung SY, Wu S-P, Hawkins SM, Park MJ, Kyo S, et al. Estrogen receptor β modulates apoptosis complexes and the inflammasome to drive the pathogenesis of endometriosis. Cell. 2015;163(4):960-74.
  27. Chan FL, Choi H, Chen Z, Chan PS, Huang Y. Induction of apoptosis in prostate cancer cell lines by a flavonoid, baicalin. Cancer Letters. 2000;160(2):219-28.
  28. Riccio LdGC, Santulli P, Marcellin L, Abrão MS, Batteux F, Chapron C. Immunology of endometriosis. Best Practice & Research Clinical Obstetrics & Gynaecology. 2018.
  29. Wu M-H, Hsiao K-Y, Tsai S-J. Endometriosis and possible inflammation markers. Gynecology and Minimally Invasive Therapy. 2015;4(3):61-7.
  30. Landberg R, Sun Q, Rimm EB, Cassidy A, Scalbert A, Mantzoros CS, et al. Selected Dietary Flavonoids Are Associated with Markers of Inflammation and Endothelial Dysfunction in US Women, 2. The Journal of nutrition. 2011;141(4):618-25.
  31. Cassidy A, Rogers G, Peterson JJ, Dwyer JT, Lin H, Jacques PF. Higher dietary anthocyanin and flavonol intakes are associated with anti-inflammatory effects in a population of US adults. The American journal of clinical nutrition. 2015;102(1):172-81.
  32. García-Lafuente A, Guillamón E, Villares A, Rostagno MA, Martínez JA. Flavonoids as anti-inflammatory agents: implications in cancer and cardiovascular disease. Inflammation Research. 2009;58(9):537-52.
  33. Garcia V, Arts I, Sterne J, Thompson R, Shaheen SO. Dietary intake of flavonoids and asthma in adults. European Respiratory Journal. 2005;26(3):449-52.
  34. Zamora‐Ros R, Barupal DK, Rothwell JA, Jenab M, Fedirko V, Romieu I, et al. Dietary flavonoid intake and colorectal cancer risk in the European prospective investigation into cancer and nutrition (EPIC) cohort. International journal of cancer. 2017;140(8):1836-44.
  35. Sun L, Subar AF, Bosire C, Dawsey SM, Kahle LL, Zimmerman TP, et al. Dietary flavonoid intake reduces the risk of head and neck but not esophageal or gastric cancer in us men and women. The Journal of nutrition. 2017;147(9):1729-38.
  36. Ribas-Agustí A, Martín-Belloso O, Soliva-Fortuny R, Elez-Martínez P. Food processing strategies to enhance phenolic compounds bioaccessibility and bioavailability in plant-based foods. Critical reviews in food science and nutrition. 2017:1-18.

The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 22, Issue 3
May 2019
Pages 68-75

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