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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition in Women".

Deadline for manuscript submissions: closed (31 July 2021) | Viewed by 124684

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Dr. Pasquapina Ciarmela

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Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
Interests: nutrition in women; reproductive medicine; obstetric delivery; reproductive biology; fetal growth restriction; prenatal diagnosis; screening; RNA; immunohistochemistry; gene expression; cells
Special Issues, Collections and Topics in MDPI journals

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Dear Colleagues,

The pathologies concerning the gynecological organs are very varied and range from tumoral pathologies to hormonal dysfunctions. The frequency of benign and malignant disease affecting women’s health is very high. These include ovarian, endometrial, and cervical cancer, as well as gynecological benign diseases such as PCOS, endometriosis, and uterine leiomyoma.

Epidemiological studies show that lifestyle can be an important risk factor for gynecological diseases. One such modifiable lifestyle factor is the diet. The father of medicine, Hippocrates, proclaimed “Let food be thy medicine and medicine be thy food” almost 25 centuries ago. The relationship between diet and health is yet to be fully explored. The human diet contains a wide variety of plant-based foods that provide essential nutrients for the body. Besides, plant-based foods possess a huge variety of non-nutritive components that offer beneficial health effects.

This Special Issue aims to bring together the latest knowledge regarding the nutrition therapy of gynecological diseases, which will offer valuable insight into how diet as a whole, nutraceuticals, nutrients, dietary patterns, phytochemicals, or other dietary components can serve as preventive and/or therapeutic compounds. Contributions regarding the utility of nutrients in the management of menopause, reproductive disfunction, and the obstetric outcomes are also welcome.

Prof. Dr. Pasquapina Ciarmela
Guest Editor

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Keywords

gynecologic disease
nutrients
uterus
ovary

Published Papers (12 papers)

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Editorial

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2 pages, 180 KiB

Open AccessEditorial

Nutrition in Gynecologic Disease

by Pasquapina Ciarmela

Nutrients 2022, 14(3), 707; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14030707 - 08 Feb 2022

Viewed by 1885

Abstract

The pathologies concerning the gynecological organs are very varied and range from tumoral pathologies to hormonal dysfunctions [...] Full article

(This article belongs to the Special Issue Nutrition in Gynecologic Disease)

Research

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14 pages, 1166 KiB

Open AccessArticle

Supplementation with Spirulina platensis Prevents Uterine Diseases Related to Muscle Reactivity and Oxidative Stress in Rats Undergoing Strength Training

by Paula Benvindo Ferreira, Anderson Fellyp Avelino Diniz, Francisco Fernandes Lacerda Júnior, Maria da Conceição Correia Silva, Glêbia Alexa Cardoso, Alexandre Sérgio Silva and Bagnólia Araújo da Silva

Nutrients 2021, 13(11), 3763; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13113763 - 24 Oct 2021

Cited by 8 | Viewed by 2450

Abstract

Strength training increases systemic oxygen consumption, causing the excessive generation of reactive oxygen species, which in turn, provokes oxidative stress reactions and cellular processes that induce uterine contraction. The aim of this study was to evaluate the possible protective effect of Spirulina platensis (SP), an antioxidant blue algae, on the contractile and relaxation reactivity of rat uterus and the balance of oxidative stress/antioxidant defenses. Female Wistar rats were divided into sedentary (CG), trained (TG), and T + supplemented (TG50, TG100) groups. Reactivity was analyzed by AQCAD, oxidative stress was evaluated by the malondialdehyde (MDA) formation, and the antioxidant capacity was measured by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method. Strength training increased contractile reactivity and decreased the pharmaco-mechanical component of relaxing reactivity in rat uterus. In addition, training decreased oxidation inhibition in the plasma and exercise increased oxidative stress in the uterine tissue; however, supplementation with algae prevented this effect and potentiated the increase in antioxidant capacity. Therefore, this study demonstrated that food supplementation prevents changes in reactivity and oxidative stress induced by strength training in a rat uterus, showing for the first time, that the uterus is a target for this exercise modality and antioxidant supplementation with S. platensis is an alternative means of preventing uterine dysfunction. Full article

(This article belongs to the Special Issue Nutrition in Gynecologic Disease)

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14 pages, 3606 KiB

Open AccessArticle

The Role of Cell Proliferation and Extracellular Matrix Accumulation Induced by Food Additive Butylated Hydroxytoluene in Uterine Leiomyoma

by Yi-Fen Chiang, Hsin-Yuan Chen, Mohamed Ali, Tzong-Ming Shieh, Yun-Ju Huang, Kai-Lee Wang, Hsin-Yi Chang, Tsui-Chin Huang, Yong-Han Hong and Shih-Min Hsia

Nutrients 2021, 13(9), 3074; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13093074 - 31 Aug 2021

Cited by 10 | Viewed by 2888

Abstract

Leiomyoma is the most common benign uterine tumor in reproductive-age women. Increasing numbers of studies are focusing on the effects of environmental exposure on the incidence and progression of tumors. One major step taken in the food industry is the addition of food preservatives to maintain freshness. Butylated hydroxytoluene (BHT) is a synthetic phenolic antioxidant, which is widely used as an additive to develop fat-soluble characteristics, as well as in cosmetics and rubber. Previous studies also highlighted that BHT may be related to increased fibrosis capacity and carcinogenic effects. In this study, we explored the effects of the commonly used food additive BHT on leiomyoma progression, and the related mechanism. The exposure of the ELT-3 leiomyoma cell line to BHT for 48 h increased the proliferative effect. Since leiomyoma progression is related to increases in extracellular matrix (ECM) accumulation and matrix metalloproteinase (MMP), BHT could effectively increase ECM-related protein expression, as well as MMP-2 and MMP-9 protein expression. This increase in ECM, in response to BHT, may be linked to the activation of the phosphoinositide 3-kinase (PI3K)/Akt and mitogen-activated protein kinase (MAPK) signaling pathway. Through PI3K inhibition, BHT’s effect on leiomyoma progression could be partially modulated. These results suggest the harmful effect of BHT exposure on leiomyoma progression may relate to PI3K modulation. However, an in vivo study is necessary to confirm these findings. Full article

(This article belongs to the Special Issue Nutrition in Gynecologic Disease)

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18 pages, 3381 KiB

Open AccessArticle

Altered Umbilical Cord Blood Nutrient Levels, Placental Cell Turnover and Transporter Expression in Human Term Pregnancies Conceived by Intracytoplasmic Sperm Injection (ICSI)

by Enrrico Bloise, Jair R. S. Braga, Cherley B. V. Andrade, Guinever E. Imperio, Lilian M. Martinelli, Roberto A. Antunes, Karina R. Silva, Cristiana B. Nunes, Luigi Cobellis, Flavia F. Bloise, Stephen G. Matthews, Kristin L. Connor and Tania M. Ortiga-Carvalho

Nutrients 2021, 13(8), 2587; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13082587 - 28 Jul 2021

Cited by 5 | Viewed by 3113

Abstract

Assisted reproductive technologies (ART) may increase risk for abnormal placental development, preterm delivery and low birthweight. We investigated placental morphology, transporter expression and paired maternal/umbilical fasting blood nutrient levels in human term pregnancies conceived naturally (n = 10) or by intracytoplasmic sperm injection (ICSI; n = 11). Maternal and umbilical vein blood from singleton term (>37 weeks) C-section pregnancies were assessed for levels of free amino acids, glucose, free fatty acids (FFA), cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), very low-density lipoprotein (VLDL) and triglycerides. We quantified placental expression of GLUT1 (glucose), SNAT2 (amino acids), P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) (drug) transporters, and placental morphology and pathology. Following ICSI, placental SNAT2 protein expression was downregulated and umbilical cord blood levels of citrulline were increased, while FFA levels were decreased at term (p < 0.05). Placental proliferation and apoptotic rates were increased in ICSI placentae (p < 0.05). No changes in maternal blood nutrient levels, placental GLUT1, P-gp and BCRP expression, or placental histopathology were observed. In term pregnancies, ICSI impairs placental SNAT2 transporter expression and cell turnover, and alters umbilical vein levels of specific nutrients without changing placental morphology. These may represent mechanisms through which ICSI impacts pregnancy outcomes and programs disease risk trajectories in offspring across the life course. Full article

(This article belongs to the Special Issue Nutrition in Gynecologic Disease)

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14 pages, 2696 KiB

Open AccessArticle

Effects of Curcumin on Glycemic Control and Lipid Profile in Polycystic Ovary Syndrome: Systematic Review with Meta-Analysis and Trial Sequential Analysis

by Yung-Jiun Chien, Chun-Yu Chang, Meng-Yu Wu, Chih-Hao Chen, Yi-Shiung Horng and Hsin-Chi Wu

Nutrients 2021, 13(2), 684; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13020684 - 21 Feb 2021

Cited by 37 | Viewed by 9537

Abstract

The therapeutic effects of curcumin for polycystic ovary syndrome (PCOS) remain inconclusive. The present study aims to evaluate the effects of curcumin on glycemic control and lipid profile in patients with PCOS. PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched from the inception through 28 November 2020. Randomized control trials (RCTs), which enrolled adult patients with PCOS, compared curcumin with placebo regarding the glycemic control and lipid profile, and reported sufficient information for performing meta-analysis, were included. Three RCTs were included. Curcumin significantly improves fasting glucose (mean difference (MD): −2.77, 95% confidence interval (CI): −4.16 to −1.38), fasting insulin (MD: −1.33, 95% CI: −2.18 to −0.49), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) (MD: −0.32, 95% CI: −0.52 to −0.12), and quantitative insulin sensitivity check index (QUICKI) (MD: 0.010, 95% CI: 0.003–0.018). It also significantly improves high-density lipoprotein (MD: 1.92, 95% CI: 0.33–3.51) and total cholesterol (MD: −12.45, 95% CI: −22.05 to −2.85). In contrast, there is no statistically significant difference in the improvement in low-density lipoprotein (MD: −6.02, 95% CI: −26.66 to 14.62) and triglyceride (MD: 8.22, 95% CI: −26.10 to 42.53) between curcumin and placebo. The results of the fasting glucose, fasting insulin, HOMA-IR, QUICKI, and total cholesterol are conclusive as indicated by the trial sequential analysis. Curcumin may improve glycemic control and lipid metabolism in patients with PCOS and metabolic abnormality without significant adverse effects. Further studies are advocated to investigate the potential effects of curcumin on hyperandrogenism. Full article

(This article belongs to the Special Issue Nutrition in Gynecologic Disease)

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Review

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12 pages, 1640 KiB

Open AccessReview

Phytoprogestins: Unexplored Food Compounds with Potential Preventive and Therapeutic Effects in Female Diseases

by Stefania Greco, Pamela Pellegrino, Alessandro Zannotti, Giovanni Delli Carpini, Andrea Ciavattini, Fernando M. Reis and Pasquapina Ciarmela

Nutrients 2021, 13(12), 4326; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13124326 - 30 Nov 2021

Cited by 7 | Viewed by 3557

Abstract

In recent years, there has been an increasing interest in natural therapies to prevent or treat female diseases. In particular, many studies have focused on searching natural compounds with less side effects than standard hormonal therapies. While phytoestrogen-based therapies have been extensively studied, treatments with phytoprogestins reported in the literature are very rare. In this review, we focused on compounds of natural origin, which have progestin effects and that could be good candidates for preventing and treating female diseases. We identified the following phytoprogestins: kaempferol, apigenin, luteolin, and naringenin. In vitro studies showed promising results such as the antitumoral effects of kaempferol, apigenin and luteolin, and the anti-fibrotic effects of naringenin. Although limited data are available, it seems that phytoprogestins could be a promising tool for preventing and treating hormone-dependent diseases. Full article

(This article belongs to the Special Issue Nutrition in Gynecologic Disease)

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23 pages, 1597 KiB

Open AccessReview

Genistein: Dual Role in Women’s Health

by Linda Yu, Eddy Rios, Lysandra Castro, Jingli Liu, Yitang Yan and Darlene Dixon

Nutrients 2021, 13(9), 3048; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13093048 - 30 Aug 2021

Cited by 27 | Viewed by 5224

Abstract

Advanced research in recent years has revealed the important role of nutrients in the protection of women’s health and in the prevention of women’s diseases. Genistein is a phytoestrogen that belongs to a class of compounds known as isoflavones, which structurally resemble endogenous estrogen. Genistein is most often consumed by humans via soybeans or soya products and is, as an auxiliary medicinal, used to treat women’s diseases. In this review, we focused on analyzing the geographic distribution of soybean and soya product consumption, global serum concentrations of genistein, and its metabolism and bioactivity. We also explored genistein’s dual effects in women’s health through gathering, evaluating, and summarizing evidence from current in vivo and in vitro studies, clinical observations, and epidemiological surveys. The dose-dependent effects of genistein, especially when considering its metabolites and factors that vary by individuals, indicate that consumption of genistein may contribute to beneficial effects in women’s health and disease prevention and treatment. However, consumption and exposure levels are nuanced because adverse effects have been observed at lower concentrations in in vitro models. Therefore, this points to the duplicity of genistein as a possible therapeutic agent in some instances and as an endocrine disruptor in others. Full article

(This article belongs to the Special Issue Nutrition in Gynecologic Disease)

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16 pages, 1017 KiB

Open AccessReview

Has Menstruation Disappeared? Functional Hypothalamic Amenorrhea—What Is This Story about?

by Karina Ryterska, Agnieszka Kordek and Patrycja Załęska

Nutrients 2021, 13(8), 2827; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13082827 - 17 Aug 2021

Cited by 14 | Viewed by 15935

Abstract

Functional hypothalamic amenorrhea (FHA) is a very common condition affecting women of procreative age. There are many reasons for this disorder, including a low availability of energy in the diet, low micro- and macronutrient intake, overly intensive physical activity, disturbed regeneration processes, sleep disorders, stress, and psychological disorders. The main determinant is long-term stress and an inability to handle the effects of that stress. FHA is a very complex disorder and often goes undiagnosed. Moreover, therapeutic interventions do not address all the causes of the disorder, which could have implications for women’s health. As shown by scientific reports, this condition can be reversed by modifying its causes. This review of the literature aims to update the current knowledge of functional hypothalamic amenorrhea and underscores the complexity of the disorder, with particular emphasis on the nutritional aspects and potential interventions for restoring balance. Full article

(This article belongs to the Special Issue Nutrition in Gynecologic Disease)

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18 pages, 832 KiB

Open AccessFeature PaperReview

Nutrition Strategy and Life Style in Polycystic Ovary Syndrome—Narrative Review

by Małgorzata Szczuko, Justyna Kikut, Urszula Szczuko, Iwona Szydłowska, Jolanta Nawrocka-Rutkowska, Maciej Ziętek, Donatella Verbanac and Luciano Saso

Nutrients 2021, 13(7), 2452; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13072452 - 18 Jul 2021

Cited by 56 | Viewed by 34257

Abstract

Here we present an extensive narrative review of the broadly understood modifications to the lifestyles of women with polycystic ovary syndrome (PCOS). The PubMed database was analyzed, combining PCOS entries with causes, diseases, diet supplementation, lifestyle, physical activity, and use of herbs. The metabolic pathways leading to disturbances in lipid, carbohydrate, and hormonal metabolism in targeted patients are described. The article refers to sleep disorders, changes in mental health parameters, and causes of oxidative stress and inflammation. These conditions consistently lead to the occurrence of severe diseases in patients suffering from diabetes, the fatty degeneration of internal organs, infertility, atherosclerosis, cardiovascular diseases, dysbiosis, and cancer. The modification of lifestyles, diet patterns and proper selection of nutrients, pharmacological and natural supplementation in the form of herbs, and physical activity have been proposed. The progress and consequences of PCOS are largely modifiable and depend on the patient’s approach, although we have to take into account also the genetic determinants. Full article

(This article belongs to the Special Issue Nutrition in Gynecologic Disease)

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14 pages, 812 KiB

Open AccessReview

Nutrition in Menopausal Women: A Narrative Review

by Thais R. Silva, Karen Oppermann, Fernando M. Reis and Poli Mara Spritzer

Nutrients 2021, 13(7), 2149; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13072149 - 23 Jun 2021

Cited by 28 | Viewed by 19692

Abstract

Among the various aspects of health promotion and lifestyle adaptation to the postmenopausal period, nutritional habits are essential because they concern all women, can be modified, and impact both longevity and quality of life. In this narrative review, we discuss the current evidence on the association between dietary patterns and clinical endpoints in postmenopausal women, such as body composition, bone mass, and risk markers for cardiovascular disease. Current evidence suggests that low-fat, plant-based diets are associated with beneficial effects on body composition, but further studies are needed to confirm these results in postmenopausal women. The Mediterranean diet pattern along with other healthy habits may help the primary prevention of bone, metabolic, and cardiovascular diseases in the postmenopausal period. It consists on the use of healthy foods that have anti-inflammatory and antioxidant properties, and is associated with a small but significant decrease in blood pressure, reduction of fat mass, and improvement in cholesterol levels. These effects remain to be evaluated over a longer period of time, with the assessment of hard outcomes such as bone fractures, diabetes, and coronary ischemia. Full article

(This article belongs to the Special Issue Nutrition in Gynecologic Disease)

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33 pages, 1106 KiB

Open AccessReview

Nutrition in Gynecological Diseases: Current Perspectives

by Michał Ciebiera, Sahar Esfandyari, Hiba Siblini, Lillian Prince, Hoda Elkafas, Cezary Wojtyła, Ayman Al-Hendy and Mohamed Ali

Nutrients 2021, 13(4), 1178; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13041178 - 02 Apr 2021

Cited by 46 | Viewed by 16866

Abstract

Diet and nutrition are fundamental in maintaining the general health of populations, including women’s health. Health status can be affected by nutrient deficiency and vice versa. Gene–nutrient interactions are important contributors to health management and disease prevention. Nutrition can alter gene expression, as well as the susceptibility to diseases, including cancer, through several mechanisms. Gynecological diseases in general are diseases involving the female reproductive system and include benign and malignant tumors, infections, and endocrine diseases. Benign diseases such as uterine fibroids and endometriosis are common, with a negative impact on women’s quality of life, while malignant tumors are among the most common cause of death in the recent years. In this comprehensive review article, a bibliographic search was performed for retrieving information about nutrients and how their deficiencies can be associated with gynecological diseases, namely polycystic ovary syndrome, infertility, uterine fibroids, endometriosis, dysmenorrhea, and infections, as well as cervical, endometrial, and ovarian cancers. Moreover, we discussed the potential beneficial impact of promising natural compounds and dietary supplements on alleviating these significant diseases. Full article

(This article belongs to the Special Issue Nutrition in Gynecologic Disease)

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Other

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30 pages, 726 KiB

Open AccessSystematic Review

Endometriosis and Phytoestrogens: Friends or Foes? A Systematic Review

by Ludovica Bartiromo, Matteo Schimberni, Roberta Villanacci, Jessica Ottolina, Carolina Dolci, Noemi Salmeri, Paola Viganò and Massimo Candiani

Nutrients 2021, 13(8), 2532; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13082532 - 24 Jul 2021

Cited by 12 | Viewed by 7186

Abstract

The aim of this systematic review was to provide comprehensive and available data on the possible role of phytoestrogens (PE) for the treatment of endometriosis. We conducted an advanced, systematic search of online medical databases PubMed and Medline. Only full-length manuscripts written in English up to September 2020 were considered. A total of 60 studies were included in the systematic review. According to in vitro findings, 19 out of 22 studies reported the ability of PE in inducing anti-proliferative, anti-inflammatory and proapoptotic effects on cultured cells. Various mechanisms have been proposed to explain this in vitro action including the alteration of cell cycle proteins, the activation/inactivation of regulatory pathways, and modification of radical oxidative species levels. Thirty-eight articles on the effects of phytoestrogens on the development of endometriotic lesions in in vivo experimental animal models of endometriosis have been included. In line with in vitro findings, results also derived from animal models of endometriosis generally supported a beneficial effect of the compounds in reducing lesion growth and development. Finally, only seven studies investigated the effects of phytoestrogens intake on endometriosis in humans. The huge amount of in vitro and in vivo animal findings did not correspond to a consistent literature in the women affected. Therefore, whether the experimental findings can be translated in women is currently unknown. Full article

(This article belongs to the Special Issue Nutrition in Gynecologic Disease)

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