{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T02:03:17Z","timestamp":1788832997579,"version":"build-2803163510"},"reference-count":99,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:00:00Z","timestamp":1771632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Centre of Postgraduate Medical Education","award":["501-1-022-26-25"],"award-info":[{"award-number":["501-1-022-26-25"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Endometriosis is a chronic, estrogen-dependent inflammatory disorder. It is associated with hormonal dysregulation, pelvic pain, and a reduced quality of life. Dietary factors may influence disease development and symptom severity. Objective: This article aims to summarize current evidence on the role of dietary fiber in endometriosis and to discuss the underlying biological mechanisms and clinical implications. Methods: A narrative review of the literature was conducted using peer-reviewed original research articles and review papers published in English. Studies examining dietary fiber intake, fiber-rich dietary patterns, and their associations with endometriosis risk, symptoms, estrogen metabolism, gut microbiota, and inflammation. Results: Observational studies suggest that higher dietary fiber intake, particularly from fruits, vegetables, and whole grains, may be associated with a reduced risk of endometriosis. Interventional evidence remains limited. However, available studies indicate that fiber-rich dietary patterns may contribute to pain reduction and improvements in quality of life. Conclusions: Current evidence suggests that dietary fiber may play a supportive role in the prevention and management of endometriosis through multiple interconnected biological pathways. Nevertheless, the limited number of high-quality interventional studies highlights the need for further well-designed clinical trials to clarify the therapeutic potential of fiber-rich diets as an adjunct to standard endometriosis care.<\/jats:p>","DOI":"10.3390\/nu18040690","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T11:39:10Z","timestamp":1771846750000},"page":"690","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Dietary Fiber in Endometriosis: Mechanisms, Evidence, and Potential Clinical Benefits\u2014Up-to-Date Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1554-2219","authenticated-orcid":false,"given":"Justyna","family":"Czerniak","sequence":"first","affiliation":[{"name":"Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 166, 02-787 Warsaw, Poland"},{"name":"Warsaw Institute of Women\u2019s Health, 00-189 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5780-5983","authenticated-orcid":false,"given":"Micha\u0142","family":"Ciebiera","sequence":"additional","affiliation":[{"name":"Warsaw Institute of Women\u2019s Health, 00-189 Warsaw, Poland"},{"name":"Second Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Zeber-Lubecka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, 02-781 Warsaw, Poland"},{"name":"Department of Experimental Oncology, Laboratory of Cancer Metabolism, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0552-2855","authenticated-orcid":false,"given":"Piotr","family":"Olcha","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Gynecological Endocrinology, Medical University of Lublin, Aleje Rac\u0142awickie 23, 20-049 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.52054\/FVVO.13.4.036","article-title":"An International Terminology for Endometriosis, 2021","volume":"13","author":"Tomassetti","year":"2021","journal-title":"Facts Views Vis. ObGyn"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Abulughod, N., Valakas, S., and El-Assaad, F. (2024). Dietary and Nutritional Interventions for the Management of Endometriosis. Nutrients, 16.","DOI":"10.3390\/nu16233988"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Feduniw, S., \u017beber-Lubecka, N., W\u0142odarczyk, M., Abramiuk, M., Kacperczyk-Bartnik, J., Bartnik, P., and Ciebiera, M. (2025). Compromised Concept: Link between Endometriosis, Pregnancy Complications and Infertility. J. Endometr. Pelvic PainDisorders, 22840265251386969.","DOI":"10.1177\/22840265251386969"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/s10815-010-9436-1","article-title":"Endometriosis and Infertility","volume":"27","author":"Bulletti","year":"2010","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Harzif, A.K., Nurbaeti, P., Sayogo Putri, A., Silvana, V., Andyra, A.F., and Wiweko, B. (2024). Factors Associated with Delayed Diagnosis of Endometriosis: A Systematic Review. J. Endometr. Pelvic Pain Disord., 22840265241291120.","DOI":"10.1177\/22840265241291120"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-G\u00f3mez, E., V\u00e1zquez-Mart\u00ednez, E.R., Reyes-Mayoral, C., Cruz-Orozco, O.P., Camacho-Arroyo, I., and Cerb\u00f3n, M. (2020). Regulation of Inflammation Pathways and Inflammasome by Sex Steroid Hormones in Endometriosis. Front. Endocrinol., 10.","DOI":"10.3389\/fendo.2019.00935"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Koninckx, P.R., Fernandes, R., Ussia, A., Schindler, L., Wattiez, A., Al-Suwaidi, S., Amro, B., Al-Maamari, B., Hakim, Z., and Tahlak, M. (2021). Pathogenesis Based Diagnosis and Treatment of Endometriosis. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.745548"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1007\/s00204-012-0868-5","article-title":"Estrogen Receptors and Human Disease: An Update","volume":"86","author":"Burns","year":"2012","journal-title":"Arch. Toxicol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Martire, F.G., Costantini, E., d\u2019Abate, C., Capria, G., Piccione, E., and Andreoli, A. (2025). Endometriosis and Nutrition: Therapeutic Perspectives. J. Clin. Med., 14.","DOI":"10.3390\/jcm14113987"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1007\/s13679-025-00662-8","article-title":"Effectiveness of Medical Nutrition Therapy in the Management of Patients with Obesity and Endometriosis: From the Mediterranean Diet to the Ketogenic Diet, Through Supplementation. The Role of the Nutritionist in Clinical Management","volume":"14","author":"Barrea","year":"2025","journal-title":"Curr. Obes. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Barnard, N.D., Holtz, D.N., Schmidt, N., Kolipaka, S., Hata, E., Sutton, M., Znayenko-Miller, T., Hazen, N.D., Cobb, C., and Kahleova, H. (2023). Nutrition in the Prevention and Treatment of Endometriosis: A Review. Front. Nutr., 10.","DOI":"10.3389\/fnut.2023.1089891"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"28502","DOI":"10.1038\/s41598-024-79746-9","article-title":"A Cross-Sectional Study on the Relationship between Dietary Fiber and Endometriosis Risk Based on NHANES 1999\u20132006","volume":"14","author":"Zheng","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"9202","DOI":"10.1038\/s41598-025-92978-7","article-title":"Unveiling the Correlation between Dietary Fiber Intake and Endometriosis: A Cross-Sectional Analysis of NHANES Data","volume":"15","author":"Huang","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.3390\/nu2121266","article-title":"Effects of Dietary Fiber and Its Components on Metabolic Health","volume":"2","author":"Lattimer","year":"2010","journal-title":"Nutrients"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"191","DOI":"10.17306\/J.AFS.2014.2.8","article-title":"Health Effects of Dietary Fiber","volume":"13","author":"Ozgoz","year":"2014","journal-title":"Acta Sci. Pol. Technol. Aliment."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1111\/j.1753-4887.2009.00189.x","article-title":"Health Benefits of Dietary Fiber","volume":"67","author":"Anderson","year":"2009","journal-title":"Nutr. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.fshw.2021.07.001","article-title":"Effects of Dietary Fiber on Human Health","volume":"11","author":"He","year":"2022","journal-title":"Food Sci. Hum. Wellness"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1079\/PNS2002234","article-title":"On Defining Dietary Fibre","volume":"62","author":"DeVries","year":"2003","journal-title":"Proc. Nutr. Soc."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Barber, T.M., Kabisch, S., Pfeiffer, A.F.H., and Weickert, M.O. (2020). The Health Benefits of Dietary Fibre. Nutrients, 12.","DOI":"10.3390\/nu12103209"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1017\/S095442241700004X","article-title":"Dietary Fibre in Europe: Current State of Knowledge on Definitions, Sources, Recommendations, Intakes and Relationships to Health","volume":"30","author":"Stephen","year":"2017","journal-title":"Nutr. Res. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Rauber, F., Da Costa Louzada, M.L., Steele, E., Millett, C., Monteiro, C.A., and Levy, R.B. (2018). Ultra-Processed Food Consumption and Chronic Non-Communicable Diseases-Related Dietary Nutrient Profile in the UK (2008\u20132014). Nutrients, 10.","DOI":"10.3390\/nu10050587"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/S0271-5317(00)00149-4","article-title":"Dietary Fibre from Edible Seaweeds: Chemical Structure, Physicochemical Properties and Effects on Cholesterol Metabolism","volume":"20","year":"2000","journal-title":"Nutr. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/S0960-0760(03)00360-1","article-title":"Sources of Estrogen and Their Importance","volume":"86","author":"Simpson","year":"2003","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"105439","DOI":"10.1016\/j.jsbmb.2019.105439","article-title":"Human Steroid Biosynthesis, Metabolism and Excretion Are Differentially Reflected by Serum and Urine Steroid Metabolomes: A Comprehensive Review","volume":"194","author":"Schiffer","year":"2019","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Chantalat, E., Valera, M.-C., Vaysse, C., Noirrit, E., Rusidze, M., Weyl, A., Vergriete, K., Buscail, E., Lluel, P., and Fontaine, C. (2020). Estrogen Receptors and Endometriosis. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21082815"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1056\/NEJMra1810764","article-title":"Endometriosis","volume":"382","author":"Zondervan","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/s41572-018-0008-5","article-title":"Endometriosis","volume":"4","author":"Zondervan","year":"2018","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/0091-7435(87)90067-3","article-title":"Diet and the Excretion and Enterohepatic Cycling of Estrogens","volume":"16","author":"Gorbach","year":"1987","journal-title":"Prev. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.3945\/ajcn.2009.27990","article-title":"Effect of Daily Fiber Intake on Reproductive Function: The BioCycle Study","volume":"90","author":"Gaskins","year":"2009","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1002\/1097-0142(19940801)74:3+<1125::AID-CNCR2820741521>3.0.CO;2-5","article-title":"The Effect of Dietary Fat and Fiber on Serum Estrogen Concentrations in Premenopausal Women under Controlled Dietary Conditions","volume":"74","author":"Goldin","year":"1994","journal-title":"Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1002\/ijc.35427","article-title":"The Estrobolome: Estrogen-metabolizing Pathways of the Gut Microbiome and Their Relation to Breast Cancer","volume":"157","author":"Larnder","year":"2025","journal-title":"Int. J. Cancer"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2236749","DOI":"10.1080\/19490976.2023.2236749","article-title":"Gut Microbial Beta-Glucuronidase: A Vital Regulator in Female Estrogen Metabolism","volume":"15","author":"Hu","year":"2023","journal-title":"Gut Microbes"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"18586","DOI":"10.1074\/jbc.RA119.010950","article-title":"Gut Microbial \u03b2-Glucuronidases Reactivate Estrogens as Components of the Estrobolome That Reactivate Estrogens","volume":"294","author":"Ervin","year":"2019","journal-title":"J. Biol. Chem."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Nannini, G., Cei, F., and Amedei, A. (2025). Unraveling the Contribution of Estrobolome Alterations to Endometriosis Pathogenesis. Curr. Issues Mol. Biol., 47.","DOI":"10.3390\/cimb47070502"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Pai, A.H.-Y., Wang, Y.-W., Lu, P.-C., Wu, H.-M., Xu, J.-L., and Huang, H.-Y. (2023). Gut Microbiome\u2013Estrobolome Profile in Reproductive-Age Women with Endometriosis. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms242216301"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e00202-25","DOI":"10.1128\/msystems.00202-25","article-title":"The Inconsistent Pathogenesis of Endometriosis and Adenomyosis: Insights from Endometrial Metabolome and Microbiome","volume":"10","author":"Li","year":"2025","journal-title":"mSystems"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"hoaf061","DOI":"10.1093\/hropen\/hoaf061","article-title":"Microbiome Dysbiosis and Endometriosis: A Systematic Scoping Review of Current Literature and Knowledge Gaps","volume":"2025","author":"Facciotti","year":"2025","journal-title":"Hum. Reprod. Open"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1093\/humupd\/dmab035","article-title":"The Role of Gut and Genital Microbiota and the Estrobolome in Endometriosis, Infertility and Chronic Pelvic Pain","volume":"28","author":"Salliss","year":"2022","journal-title":"Hum. Reprod. Update"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Cronin, P., Joyce, S.A., O\u2019Toole, P.W., and O\u2019Connor, E.M. (2021). Dietary Fibre Modulates the Gut Microbiota. Nutrients, 13.","DOI":"10.3390\/nu13051655"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"6229","DOI":"10.1007\/s11033-020-05611-3","article-title":"Molecular Link between Dietary Fibre, Gut Microbiota and Health","volume":"47","author":"Kumar","year":"2020","journal-title":"Mol. Biol. Rep."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Maniangat Luke, A., Kumari, N.S., Hegde, M.N., and Hegde, N.N. (2025). Metabolic Interplay of SCFA\u2019s in the Gut and Oral Microbiome: A Link to Health and Disease. Front. Oral. Health, 6.","DOI":"10.3389\/froh.2025.1646382"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Escorcia Mora, P., Valbuena, D., and Diez-Juan, A. (2025). The Role of the Gut Microbiota in Female Reproductive and Gynecological Health: Insights into Endometrial Signaling Pathways. Life, 15.","DOI":"10.3390\/life15050762"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Pronina, V., Denisov, P., Muravieva, V., Skorobogatiy, A., Zhigalova, K., Chernukha, G., Sukhikh, G., and Priputnevich, T. (2025). Gut Microbial Composition on Dienogest Therapy in Patients with Endometriosis. Microbiol. Res., 16.","DOI":"10.3390\/microbiolres16080169"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e70202","DOI":"10.1111\/1751-7915.70202","article-title":"Gut Microbiota-Derived Acetate Ameliorates Endometriosis via JAK1\/STAT3-Mediated M1 Macrophage Polarisation","volume":"18","author":"Xu","year":"2025","journal-title":"Microb. Biotechnol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e14562","DOI":"10.1016\/j.heliyon.2023.e14562","article-title":"Microbiota Metabolites in the Female Reproductive System: Focused on the Short-Chain Fatty Acids","volume":"9","author":"Mirzaei","year":"2023","journal-title":"Heliyon"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1892441","DOI":"10.1080\/19490976.2021.1892441","article-title":"Mucin Degrader Akkermansia Muciniphila Accelerates Intestinal Stem Cell-Mediated Epithelial Development","volume":"13","author":"Kim","year":"2021","journal-title":"Gut Microbes"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Rondanelli, M., Borromeo, S., Cavioni, A., Gasparri, C., Gattone, I., Genovese, E., Lazzarotti, A., Minonne, L., Moroni, A., and Patelli, Z. (2025). Therapeutic Strategies to Modulate Gut Microbial Health: Approaches for Chronic Metabolic Disorder Management. Metabolites, 15.","DOI":"10.3390\/metabo15020127"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Shin, J., Noh, J.-R., Chang, D.-H., Kim, Y.-H., Kim, M.H., Lee, E.S., Cho, S., Ku, B.J., Rhee, M.-S., and Kim, B.-C. (2019). Elucidation of Akkermansia Muciniphila Probiotic Traits Driven by Mucin Depletion. Front. Microbiol., 10.","DOI":"10.3389\/fmicb.2019.01137"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2232","DOI":"10.1136\/gutjnl-2020-322260","article-title":"Mucus Barrier, Mucins and Gut Microbiota: The Expected Slimy Partners?","volume":"69","author":"Paone","year":"2020","journal-title":"Gut"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1097\/MOG.0000000000000156","article-title":"Bile Acids as Metabolic Regulators","volume":"31","author":"Li","year":"2015","journal-title":"Curr. Opin. Gastroenterol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.cmet.2016.05.005","article-title":"Intestinal Crosstalk between Bile Acids and Microbiota and Its Impact on Host Metabolism","volume":"24","author":"Sayin","year":"2016","journal-title":"Cell Metab."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2232143","DOI":"10.1080\/19490976.2023.2232143","article-title":"Gut Microbiota-Related Bile Acid Metabolism-FXR\/TGR5 Axis Impacts the Response to Anti-A4\u03b27-Integrin Therapy in Humanized Mice with Colitis","volume":"15","author":"Han","year":"2023","journal-title":"Gut Microbes"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2172671","DOI":"10.1080\/19490976.2023.2172671","article-title":"Bile Acids as Modulators of Gut Microbiota Composition and Function","volume":"15","author":"Larabi","year":"2023","journal-title":"Gut Microbes"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"108238","DOI":"10.1016\/j.pharmthera.2022.108238","article-title":"Bile Acid Metabolism and Signaling, the Microbiota, and Metabolic Disease","volume":"237","author":"Cai","year":"2022","journal-title":"Pharmacol. Ther."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"7659509","DOI":"10.1155\/2019\/7659509","article-title":"Role of Bile Acids in Dysbiosis and Treatment of Nonalcoholic Fatty Liver Disease","volume":"2019","author":"Wang","year":"2019","journal-title":"Mediat. Inflamm."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"(2025, December 16). From Dysbiosis to Diagnosis: The Role of Gut Microbiota in Breast Cancer Etiology and Management. Available online: https:\/\/www.mdpi.com\/2673-8007\/5\/4\/134.","DOI":"10.3390\/applmicrobiol5040134"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Wang, H., Shi, F., Zheng, L., Zhou, W., Mi, B., Wu, S., and Feng, X. (2025). Gut Microbiota Has the Potential to Improve Health of Menopausal Women by Regulating Estrogen. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1562332"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1016\/j.cell.2016.05.041","article-title":"From Dietary Fiber to Host Physiology: Short-Chain Fatty Acids as Key Bacterial Metabolites","volume":"165","author":"Koh","year":"2016","journal-title":"Cell"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s11914-024-00896-w","article-title":"Associations Among Estrogens, the Gut Microbiome and Osteoporosis","volume":"23","author":"Kverka","year":"2025","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"101190","DOI":"10.1016\/j.focha.2025.101190","article-title":"Mechanistic and Hormetic Insights into the Interaction between Dietary Bioactive Compounds and Gut Microbiota in Modulating Human Health","volume":"10","author":"Elumalai","year":"2026","journal-title":"Food Chem. Adv."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Ou, Y., Wang, H., Zhou, C., Chen, Y., Lyu, J., Feng, M., and Huang, X. (2025). Endometriosis-Associated Infertility: Multi-Omics Insights into Pathogenesis and Precision Therapeutics. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1613334"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Sobstyl, A., Cha\u0142upnik, A., Mertowska, P., and Grywalska, E. (2023). How Do Microorganisms Influence the Development of Endometriosis? Participation of Genital, Intestinal and Oral Microbiota in Metabolic Regulation and Immunopathogenesis of Endometriosis. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241310920"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"4137","DOI":"10.1016\/j.cell.2021.06.019","article-title":"Gut Microbiota-Targeted Diets Modulate Human Immune Status","volume":"184","author":"Wastyk","year":"2021","journal-title":"Cell"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"(2025, December 16). Beyond the Gut: Unveiling Butyrate\u2019s Global Health Impact Through Gut Health and Dysbiosis-Related Conditions: A Narrative Review. Available online: https:\/\/www.mdpi.com\/2072-6643\/17\/8\/1305.","DOI":"10.3390\/nu17081305"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Fusco, W., Lorenzo, M.B., Cintoni, M., Porcari, S., Rinninella, E., Kaitsas, F., Lener, E., Mele, M.C., Gasbarrini, A., and Collado, M.C. (2023). Short-Chain Fatty-Acid-Producing Bacteria: Key Components of the Human Gut Microbiota. Nutrients, 15.","DOI":"10.3390\/nu15092211"},{"key":"ref_66","first-page":"1","article-title":"Lactobacilli Biology, Applications and Host Interactions","volume":"24","author":"Marco","year":"2025","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Ruiz, L., Margolles, A., and S\u00e1nchez, B. (2013). Bile Resistance Mechanisms in Lactobacillus and Bifidobacterium. Front. Microbiol., 4.","DOI":"10.3389\/fmicb.2013.00396"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Doden, H.L., and Ridlon, J.M. (2021). Microbial Hydroxysteroid Dehydrogenases: From Alpha to Omega. Microorganisms, 9.","DOI":"10.3390\/microorganisms9030469"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e02475-17","DOI":"10.1128\/AEM.02475-17","article-title":"Targeted Synthesis and Characterization of a Gene Cluster Encoding NAD(P)H-Dependent 3\u03b1-, 3\u03b2-, and 12\u03b1-Hydroxysteroid Dehydrogenases from Eggerthella CAG:298, a Gut Metagenomic Sequence","volume":"84","author":"Mythen","year":"2018","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"24400","DOI":"10.1021\/acs.jafc.4c04456","article-title":"Butyrate Inhibits the HDAC8\/NF-\u03baB Pathway to Enhance Slc26a3 Expression and Improve the Intestinal Epithelial Barrier to Relieve Colitis","volume":"72","author":"Peng","year":"2024","journal-title":"J. Agric. Food Chem."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"You, H., Tan, Y., Yu, D., Qiu, S., Bai, Y., He, J., Cao, H., Che, Q., Guo, J., and Su, Z. (2022). The Therapeutic Effect of SCFA-Mediated Regulation of the Intestinal Environment on Obesity. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.886902"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"(2025, December 16). Modulation of the Bile Acid Enterohepatic Cycle by Intestinal Microbiota Alleviates Alcohol Liver Disease. Available online: https:\/\/www.mdpi.com\/2073-4409\/11\/6\/968?utm_source=researchgate.net&utm_medium=article.","DOI":"10.3390\/cells11060968"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"101392","DOI":"10.1016\/j.jcmgh.2024.101392","article-title":"Quantifying Forms and Functions of Enterohepatic Bile Acid Pools in Mice","volume":"18","author":"Sudo","year":"2024","journal-title":"Cell. Mol. Gastroenterol. Hepatol."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Parada Venegas, D., De la Fuente, M.K., Landskron, G., Gonz\u00e1lez, M.J., Quera, R., Dijkstra, G., Harmsen, H.J.M., Faber, K.N., and Hermoso, M.A. (2019). Short Chain Fatty Acids (SCFAs)-Mediated Gut Epithelial and Immune Regulation and Its Relevance for Inflammatory Bowel Diseases. Front. Immunol., 10.","DOI":"10.3389\/fimmu.2019.00277"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"e00236-25","DOI":"10.1128\/cmr.00236-25","article-title":"The Sex Hormone-Gut Microbiome Axis: Mechanistic Drivers of Sex-Disparate Bacterial Infection Outcomes and Precision Clinical Interventions","volume":"38","author":"Tang","year":"2025","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(04)17403-5","article-title":"Endometriosis","volume":"364","author":"Giudice","year":"2004","journal-title":"Lancet"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Neri, L.C.L., Quintiero, F., Fiorini, S., Guglielmetti, M., Ferraro, O.E., Tagliabue, A., Gardella, B., and Ferraris, C. (2025). Diet and Endometriosis: An Umbrella Review. Foods, 14.","DOI":"10.3390\/foods14122087"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Xholli, A., Cremonini, F., Perugi, I., Londero, A.P., and Cagnacci, A. (2023). Gut Microbiota and Endometriosis: Exploring the Relationship and Therapeutic Implications. Pharmaceuticals, 16.","DOI":"10.3390\/ph16121696"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Liu, M., Peng, R., Tian, C., Shi, J., Ma, J., Shi, R., Qi, X., Zhao, R., and Guan, H. (2024). Effects of the Gut Microbiota and Its Metabolite Short-Chain Fatty Acids on Endometriosis. Front. Cell. Infect. Microbiol., 14.","DOI":"10.3389\/fcimb.2024.1373004"},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Qin, R., Tian, G., Liu, J., and Cao, L. (2022). The Gut Microbiota and Endometriosis: From Pathogenesis to Diagnosis and Treatment. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.1069557"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"uqad032","DOI":"10.1093\/femsml\/uqad032","article-title":"Epigenetic Effects of Short-Chain Fatty Acids from the Large Intestine on Host Cells","volume":"4","author":"Stein","year":"2023","journal-title":"microLife"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.maturitas.2017.06.025","article-title":"Estrogen\u2013Gut Microbiome Axis: Physiological and Clinical Implications","volume":"103","author":"Baker","year":"2017","journal-title":"Maturitas"},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Zhou, L., Liu, B., Jian, X., Jiang, L., and Liu, K. (2025). Effect of Dietary Patterns and Nutritional Supplementation in the Management of Endometriosis: A Review. Front. Nutr., 12.","DOI":"10.3389\/fnut.2025.1539665"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s12986-025-00970-9","article-title":"Dietary Factors and Risk for Endometriosis: A Mendelian Randomization Analysis","volume":"22","author":"Zhang","year":"2025","journal-title":"Nutr. Metab."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"112846","DOI":"10.1016\/j.exger.2025.112846","article-title":"Association between Dietary Inflammatory Index and Endometriosis in the US Population: A Cross-Sectional Study","volume":"209","author":"Chen","year":"2025","journal-title":"Exp. Gerontol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1093\/humrep\/deh395","article-title":"Selected Food Intake and Risk of Endometriosis","volume":"19","author":"Parazzini","year":"2004","journal-title":"Hum. Reprod."},{"key":"ref_87","first-page":"661","article-title":"The Association of Food Consumption and Nutrient Intake with Endometriosis Risk in Iranian Women: A Case-Control Study","volume":"17","author":"Youseflu","year":"2019","journal-title":"Int. J. Reprod. Biomed."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1017\/S0007114510003661","article-title":"Diet and Risk of Endometriosis in a Population-Based Case\u2013Control Study","volume":"105","author":"Trabert","year":"2011","journal-title":"Br. J. Nutr."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.ejogrb.2011.05.014","article-title":"Nutrient Intake, Anthropometric Data and Correlations with the Systemic Antioxidant Capacity of Women with Pelvic Endometriosis","volume":"158","author":"Savaris","year":"2011","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1093\/humrep\/dey014","article-title":"Fruit and Vegetable Consumption and Risk of Endometriosis","volume":"33","author":"Harris","year":"2018","journal-title":"Hum. Reprod."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"2088","DOI":"10.1093\/jn\/nxac107","article-title":"Glycemic Index, Glycemic Load, Fiber, and Gluten Intake and Risk of Laparoscopically Confirmed Endometriosis in Premenopausal Women","volume":"152","author":"Schwartz","year":"2022","journal-title":"J. Nutr."},{"key":"ref_92","first-page":"162","article-title":"Endometriosis and Nutrition\u2014Recommending a Mediterranean Diet Decreases Endometriosis-Associated Pain: An Experimental Observational Study","volume":"1","author":"Ott","year":"2012","journal-title":"J. Aging Res. Clin. Pract."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Cirillo, M., Argento, F.R., Becatti, M., Fiorillo, C., Coccia, M.E., and Fatini, C. (2023). Mediterranean Diet and Oxidative Stress: A Relationship with Pain Perception in Endometriosis. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241914601"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"jhn.13411","DOI":"10.1111\/jhn.13411","article-title":"Nutrition Interventions in the Treatment of Endometriosis: A Scoping Review","volume":"38","author":"Varney","year":"2025","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1936","DOI":"10.1007\/s43032-024-01464-4","article-title":"The Association Between Daily Intake of Dietary Supplements and Self-Reported Endometriosis: A NHANES-Based Study","volume":"31","author":"Li","year":"2024","journal-title":"Reprod. Sci."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"536.e1","DOI":"10.1016\/j.ajog.2023.07.033","article-title":"Associations between Endometriosis and Common Symptoms: Findings from the Australian Longitudinal Study on Women\u2019s Health","volume":"229","author":"Gete","year":"2023","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/j.1479-828X.2009.01030.x","article-title":"Relevance of Gastrointestinal Symptoms in Endometriosis","volume":"49","author":"Maroun","year":"2009","journal-title":"Aust. N. Zealand J. Obstet. Gynaecol."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Ghasemisedaghat, S., Eslamian, G., Kazemi, S.N., Rashidkhani, B., and Taheripanah, R. (2023). Association of Fertility Diet Score with Endometriosis: A Case\u2013Control Study. Front. Nutr., 10.","DOI":"10.3389\/fnut.2023.1222018"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"20190084","DOI":"10.1515\/jcim-2019-0084","article-title":"Phytotherapy in Endometriosis: An up-to-Date Review","volume":"17","author":"Noventa","year":"2020","journal-title":"J. Complement. Integr. Med."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/4\/690\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T11:42:03Z","timestamp":1771846923000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/4\/690"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,21]]},"references-count":99,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["nu18040690"],"URL":"https:\/\/doi.org\/10.3390\/nu18040690","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,21]]}}}