Specific dietary components and nutritional factors may be associated with various hormonal diseases, including uterine leiomyomas, or fibroids, the most common benign tumors of the female reproductive tract. Many studies have shown a protective effect of fruit and vegetable intake, particularly with citrus fruits, apples, cabbage, broccoli, and tomatoes. It has been suggested that plant-based diets may reduce bioavailable estrogen levels and increase estrogen excretion, thereby decreasing the risk of disease.
Laboratory studies highlight how phytonutrients in vegetables and fruits may protect against leiomyoma by inhibiting inflammation and fibrosis, inducing apoptosis, and inactivating hormone- or growth factor-related pathways, thus providing a plausible biological basis for the final effect.
Studies investigating the relationship between individual vitamins and leiomyoma risk are based on data collected in the Black women’s health study, in which no correlation was found between disease and intake of carotenoids, including lycopene. Similar results were obtained in the Nurses’ health study II: β-carotene intake even slightly increased the risk of leiomyoma, but only in smokers. Studies in recent years do not reveal a significant association between vitamin C, E intake and leiomyoma incidence. Several studies have examined the role of vitamin D and concluded that the incidence of the disease is inversely associated with its serum levels. The effects of vitamin D are extensively documented, and it may be considered a potential pharmacologic agent for the prevention and treatment of these cancers.
The dietary fat/leiomyoma association still requires further investigation, but some indications suggesting a protective effect of statins are interesting, proposing a possible correlation between myomas and lipid metabolism.
Data on the effect of meat and fish consumption are conflicting. The results of an Italian case-control study revealed that significant consumption of meat, such as beef or ham, is associated with an increased risk of leiomyoma, but this association is not confirmed by studies in Chinese populations.
Among beverages, there are no definitive data on whether caffeine consumption increases risk, except among younger women for high consumption (500 mg/day).
In the case of green tea, a randomized, double-blind study examined the efficacy of the extract in treating women with uterine leiomyoma and improving quality of life compared with placebo, demonstrating a significant decrease in leiomyoma volume and symptom severity and an improvement in health-related quality of life scores.
Several studies of whole-grain food intake in Chinese and Italian populations have indicated no significant relationship between whole-grain intake and leiomyoma prevalence. Similarly, there would be no significant link between fiber-rich diets and disease development, as found in the Black women’s health cohort study and in a Japanese study.
Bibliography
Review: diet and nutrition in gynecological disorders: a focus on clinical studies. Nutrients 2021, 13(6), 1747
Evaluation of 25-hydroxy vitamin D3 levels in patients with a fibroid uterus. J. Obstet. Gynaecol. 2020, 40, 710–714.
Use of dietary phytochemicals to target inflammation, fibrosis, proliferation, and angiogenesis in uterine tissues: promising options for prevention and treatment of uterine fibroids? Mol. Nutr. Food Res. 2014, 58, 1667–1684.
Intake of fruit, vegetables, and carotenoids in relation to risk of uterine leiomyomata. Am. J. Clin. Nutr. 2011, 94, 1620–1631.
Association of intakes of fat, dietary fibre, soya isoflavones and alcohol with uterine fibroids in Japanese women. Br. J. Nutr. 2009, 101, 1427–1431.
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