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Table 1.

Methodological recommendations.

Study type Target population Dietary intake or intervention Endpoint
Risk of endometriosis
 Observational; cross-sectional or cohort study Girls and women before menopause Habitual intake assessed by FFQ (nutrients, foods) Presence (cross-sectional) or new cases (cohort) of endometriosis based on complaints (questionnaires: EHP-30) and clinical confirmation by ultrasound, MRI or surgery
Associations between severity of subjective and clinical endometriosis complaints and diet
 Cross-sectional study, observational or longitudinal study Women with clinically confirmed endometriosis Habitual intake of foods or nutrients by FFQ Subjective outcomes: pelvic pain, mood and quality of life
Clinical outcomes: subfertility; presence of endometriosis lesions on ultrasound, MRI or surgery and cyst size
Effect of diet on endometriosis-related complaints
 Intervention, one group design with measurements before and after start of diet Women with clinically confirmed endometriosis; subgroups based on type of endometriosis; use of oral contraceptives; past surgical treatment for endometriosis Whole diet: (e.g. Mediterranean, healthy eating); Elimination diet: (e.g. low FODMAP); specific foods: (e.g. fruits and vegetables) Subjective outcomes (e.g. pelvic pain, mood, quality of life) as assessed by questionnaires (EHP-30).
Clinical outcomes (e.g. Inflammation markers, presence of endometriosis lesions on ultrasound, MRI or surgery; cyst size)
 Intervention, parallel groups including placebo Women with clinically confirmed endometriosis; subgroups based on type of endometriosis; use of oral contraceptives; past surgical treatment for endometriosis Specific nutrients: (e.g. vitamin D or omega-6 fatty acids) Subjective outcomes (e.g. pelvic pain, mood, quality of life) as assessed by questionnaires (EHP-30).
Clinical outcomes (e.g. Inflammation markers, presence of endometriosis lesions on ultrasound, MRI or surgery, cyst size)
Mechanistic studies
 Observational or intervention study Women with clinically confirmed endometriosis Any dietary intervention Immune cells in peripheral blood and/or menstrual effluent: cytokines, neutrophils, granulocytes (including mast cells and macrophages), chemokines and different subsets of T-cells