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Basta dolore. È questo il desiderio di almeno 3 milioni di donne con diagnosi conclamata di endometriosi, infiammazione cronica benigna che può essere contenuta con i giusti cibi, previlegiando quelli benefici ed eliminando quelli che rafforzano lo stato infiammatorio. una patologia invalidante di cui finalmente si parla, tanto che è stata istituita la giornata mondiale dell'endometriosi che ricorre il 28 marzo. Dopo anni di silenzio la malattia ha smesso di essere invisibile, grazie a una maggiore informazione, divulgazione e visibilità e grazie al maggior numero di ginecologi esperti in endometriosi. Oltre ai trattamenti farmacologici e chirurgici, aiutano anche i giusti cibi: via libera agli alimenti ricchi fibre e di omega 3, no invece ai preparati industriali, alla farina 00, agli zuccheri raffinati, agli alcolici, alla soia e non solo.
Cosa è l’endometriosi
L’endometriosi è un’infiammazione cronica benigna che possono sviluppare le donne in età fertile e deriva da un’anomalia delle cellule della cavità uterina, le cosiddette cellule endometriali, che migrano verso sedi extra-uterine, di solito ovaie o peritoneo pelvico. Ne sono affette circa tre milioni di donne, anche se questa patologia tarda a essere diagnosticata o viene individuata spesso per caso, durante visite ginecologiche di controllo o esami diagnosi svolti per altri disturbi. Un campanello d’allarme è un forte dolore durante il ciclo mestruale, che non si calma neppure ricorrendo ad antidolorifici, inoltre spesso ci sono dolori durante i rapporti sessuali e la defecazione. A volte compaiano anche problemi gastrointestinali soprattutto durante il ciclo mestruale, come gonfiore addominale, intestino irritabile, nausea o stitichezza. L’attenzione nel seguire una dieta adeguata aiuta a contrastare l’infiammazione e quindi a migliorare la qualità della vita, purché associata a trattamenti medico-chirurgici indispensabili per il trattamento della patologia stessa.
La dieta antinfiammatoria per le persone con endometriosi
Gli studi scientifici ad oggi disponibili sulla correlazione tra endometriosi e alimentazione suggeriscono che la dieta e lo stile di vita possono influenzare gli stati infiammatori. “Il termine dieta non equivale a privazione o penitenza, seguire un’alimentazione sana ed equilibrata non significa solo soddisfare le esigenze fisiologiche dell’organismo, ma anche gli aspetti psicologici e relazionali. È quindi importante non essere troppo rigide con sé stesse: quel che conta è mantenere un stile di vita sano nel tempo”, si legge sulle linee guida di A.P.E. ODV, Associazione progetto endometriosi, sviluppate con il contributo di professionisti della nutrizione.
Cibi da preferire
Il consumo di omega-3 è stato associato a una riduzione del rischio di endometriosi e dell’abbassamento della risposta infiammatoria. Via libera al pesce pescato, soprattutto il pesce azzurro, alle noci, ai semi di lino. “È utile aumentare il consumo di frutta e verdura facendo attenzione alla stagionalità e al tipo di coltivazione, ossia le coltivazioni non devono essere trattate con pesticidi. Frutta e verdura sono importanti per il loro apporto di vitamine, minerali e molecole bioattive dall’effetto antinfiammatorio, in particolar modo gli alimenti ricchi di vitamine A, C, E ed acido folico hanno un ruolo nella riduzione del rischio di endometriosi grazie alla loro azione antiossidante. Inoltre, la fibra presente negli alimenti vegetali, grazie all’azione prebiotica, è fondamentale per la salute intestinale e per mantenere uno stato di equilibrio tra tutti i microrganismi presenti nel nostro intestino”, si legge su apendometriosi.it. Passando ai cereali, quelli integrali sono da preferire rispetto ai raffinati in cui il chicco risulta impoverito di preziosi nutrienti, in particolar modo della fibra. Quest’ultima riduce i livelli di estrogeni circolanti e diminuisce il carico glicemico/insulinico del pasto. Tuttavia, occorre fare attenzione alla scelta dei cereali perché qualora vi siano sintomi da colon irritabile l’eccesso di fibra, potrebbe peggiorare la sintomatologia.
Cosa diminuire drasticamente
Gli zuccheri sono da limitare al massimo perché aumentano lo stato infiammatorio. “Attenzione anche a estratti o spremute nelle quali gli zuccheri, sebbene non siano stati aggiunti, vengono comunque liberati dalla frutta che, privata della parte di fibra, ha un impatto glicemico e insulinico assai maggiore. È importante comporre dei pasti bilanciati che garantiscano un’adeguata stabilità insulinica considerato che l’iperinsulinemia aumenta le concentrazioni di estrogeni e di IGF-1 (insulin-like growth factor 1) e questi sono in grado di stimolare la proliferazione delle cellule dell’endometrio”, raccomandano da A.P.E. ODV.
Passando alla carne, più di una porzione a settimana di quella rossa è stato associata a un aumentato rischio di endometriosi. La carne rossa diminuisce le globuline leganti gli ormoni sessuali aumentando le concentrazioni di estradiolo, uno degli ormoni che regola il ciclo mestruale nelle donne. Meglio ridurre il consumo di carne rossa e salumi, preferendo la carne bianca da allevamenti biologici. Un altro alimento da evitare o comunque da ridurre è la soia, che veicola fitoestrogeni. Il consiglio è di consumare saltuariamente prodotti derivati dalla soia “giovane” (edamame) o a lunga fermentazione (ad esempio tempeh, natto e salsa di soia). Si consiglia anche di limitare il consumo di alcol e caffeina, sostanze che possono indirettamente mantenere alti i livelli di estrogeni in circolo, nonostante per la caffeina, le evidenze scientifiche siano ancora limitate.
Pillole di consigli utili su alimentazione ed endometriosi
Sulle linee guida stilate dall’Associazione progetto endometriosi spiccano dei consigli per alimentarsi in modo tale da contrastare gli stati infiammatori dell’endometriosi.
In generale sono da preferire gli alimenti biologici, grass fed, latte fieno, senza conservanti e coloranti, preferibilmente non in scatola per ridurre l’esposizione ai pesticidi, mentre sono da evitare i cibi ricchi di grassi conservati in pellicola o contenitori di plastica, preferendo l’utilizzo del vetro.
Cereali: preferire i cereali in chicco e biologici, alternando prodotti senza glutine (riso integrale, quinoa, miglio, grano saraceno, amaranto, chia, teff, e così via) a prodotti con glutine (farro, orzo, grano e così via). Evitare sia gli alimenti addizionati di glutine (come il seitan, mopur o prodotti da forno confezionati tipo pane in cassetta) sia gli alimenti raffinati e ricchi di zuccheri.
Legumi: meglio secchi e biologici, da mettere in ammollo (per 48 ore con bicarbonato) e poi cuocere in acqua non salata e alloro. In alternativa, vanno bene già cotti ma confezionati in vetro e sciacquati per bene sotto l’acqua prima di consumarli. Esistono anche legumi decorticati o spezzati (come lenticchie, piselli e così via).
Yogurt: rigorosamente bianco e biologico da latte fieno ossia prodotto da mucche che si nutrono principalmente di foraggi; ci sono anche delle alternative più proteiche come lo yogurt greco o lo skyr, e anche in questo caso è da preferire un prodotto biologico da latte fieno. Latte e latticini: anche in questo caso la scelta deve ricadere sui prodotti biologici e latte fieno.
Uova: biologiche e da galline libere di razzolare all’aperto.
Pesce: meglio fresco e pescato/selvaggio. È da preferire il pesce azzurro di piccola pezzatura, ricco di omega 3, come alici, aringhe, palamita, ricciola, sarde e sardine, sgombro. Il pesce allevato viene nutrito con mangimi e trattato con antibiotici ed altre sostanze, pertanto è meglio evitarne il consumo. Pesce conservato: rigorosamente in vetro, in filetti e in olio extravergine di oliva, da consumare massimo una volta a settimana.
Grassi: evitare i grassi saturi, trans e gli omega-6. I grassi saturi sono contenuti nei prodotti di origine animale e derivati (panna, burro, formaggi etc.). I grassi trans sono contenuti nei prodotti confezionati/industriali (es. grassi idrogenati e margarine). Gli omega-6 sono contenuti negli olii di semi (come ad esempio olio di girasole, di mais o di soia).
