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Uterine Fibroids: Nutritional Considerations

Evidence for a direct effect of diet on fibroid risk or progression is very limited. However, the production of certain growth factors (insulin–like growth factor I, epidermal growth factor) is a risk factor for fibroid growth,6 and evidence indicates that these may be the effectors of estrogen– and progesterone–mediated fibroid growth.7 Diets low in fat and high in fiber (eg, vegetarian diets) have the ability to modulate blood hormone concentration and activity8 and reduce levels of growth factors.9 These effects may underlie the results of studies that have found higher risk for fibroids in women who eat red meat more often than do others, and who are overweight, as described below. However, this does not necessarily mean that a diet change, even if effective, will alleviate symptoms rapidly enough to obviate the need for other treatments.

Epidemiologic studies indicate that the following factors are associated with increased risk of fibroids:

Red meat consumption. Available evidence suggests that women who eat more than one serving per day of red meat have a 70% greater risk for uterine myoma, compared with women who eat the least. Women who eat more than one serving per day of green vegetables have a 50% lower risk.10 However, this study should be repeated by other independent investigators before diet is assumed to be effective for preventing or treating fibroids.

Weight gain. A greater number of women with fibroids are obese, compared with the general population.11 In the Black Women’s Health Study, the relationship between fibroids and obesity appeared to be “J–shaped.” Compared with the thinnest women (body mass index [BMI] <20 kg/m2), risk appears to increase gradually in women with a BMI of 20 to 22.4 (34% increased risk), to a maximum risk in women with a BMI of 27.5 to 29.9 (47% increased risk), before falling in the most obese group (20% increased risk).12

Alcohol. Alcohol appears to increase the risk for fibroids. This risk is positively correlated with the number of years of alcohol intake and specifically with beer consumption. Compared with women who abstained from alcohol, those who had one or more drinks of beer per day had more than a 50% increased risk for leiomyomata.13

Orders

See Basic Diet Orders chapter.

Avoid alcohol.

What to Tell the Family

Uterine fibroids are benign growths that, while bothersome, are rarely life–threatening. In women who do not get relief from medications or diet changes, surgical options are available, depending on whether future pregnancy is desired.

 

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