• Introduction
• Physical factors
• Nutrient needs
• Dietary choices
• References

Introduction

During adulthood, a woman's body no longer needs to devote its energy and resources to support the rapid growth and development that characterizes infancy, childhood and adolescence. Nevertheless, good nutrition is still vitally important to promote long term health and vitality, prevent the development of chronic degenerative disease, and, for those women who wish to have children, to provide the nutritional resouces that will ensure a healthy pregnancy. Unfortunately, many American women have a poor diet and a sedentary lifestyle, which sets the stage for an inability to conceive or a higher risk for certain birth defects as well as the development of chronic degenerative diseases including heart disease, obesity, diabetes, and cancer. A diet centered around organic vegetables, fruits, whole grains, legumes (particularly soy products), nuts, seeds, and wild-caught cold-water fish provides all of the necessary nutrients for health and disease prevention.

Physical Factors

A defining aspect of a woman's early adult years is the ability to bear children, while her middle and older years are marked by the accumulation of wisdom and transition through menopause. The natural process of menopause typically occurs in women between the ages of 40 and 60 years, when the ovaries stop producing the hormones estrogen and progesterone. The decrease in circulating estrogen levels that accompanies menopause increases women's risk for osteoporosis and heart disease. In addition, the perimenopausal period, which occurs 1-5 years before actual menopause, may also be a period of uncomfortable side effects for many women. Approximately 80% of perimenopausal women in the United States experience hot flashes as a result of changes in hormone levels; 30% of these women have hot flashes that are severe or frequent enough to interfere with normal life. In other countries, Japan, for example, the incidence of symptoms, such as hot flashes, is much, much lower, and research suggests that this may be due in large part to the diet typically consumed by Asian women. Vegetables, soy foods, fruits, fish and rice are the dietary staples in Asia.

Over the last 100 years, the life expectancy of people living in the United States has increased substantially, from 47 years at the beginning of the 20th Century, to over 70 years by the end of this century. Unfortunately, this increase in life expectancy has been accompanied by an increase in the incidence of chronic and degenerative diseases including cancer, heart disease, osteoporosis, and diabetes. For many people, these diseases begin to develop during adulthood, and lead to pain, suffering, and a dramatic decrease in quality of life during the later years. Although some factors involved with chronic disease are not entirely within your control, for example, your genetic susceptibilities, your diet and lifestyle choices play a central role in determining whether or not you will develop certain diseases. So, if you haven't already developed good eating habits, started exercising, and quit smoking ' start taking care of yourself now! By taking charge of your diet and lifestyle choices now, you can help prevent the diseases listed below and remain healthy and vibrant well into your golden years.

• Obesity: As of December 2001, about 60% of American adults are overweight or obese. Carrying around excess body weight has severe health consequences, increasing your risk for heart disease, various types of cancer (including breast cancer) and diabetes.
• Heart disease: Heart disease is the leading cause of death in adults in the United States today, affecting 60 million Americans. An estimated 1,100,000 new or recurrent heart attacks occur annually, which translates into the grim statistic that every 20 seconds a person in the U.S. has a heart attack, and one-third of these attacks lead to death. The main underlying cause of heart disease is atherosclerosis, which is a build-up of fatty deposits in the walls of the arteries. Although women's estrogen offers some protection against the development of atherosclerosis, it cannot compensate for a diet that contains excessive total fat, saturated fat, refined sugar, and cholesterol and is low in dietary fiber, essential fatty acids, and the B-complex vitamins. And after estrogen levels drop during the transition through menopause, a woman eating an unhealthy diet has a similar risk for heart disease to that of men in the U.S., an unacceptable risk of a 50% chance of a heart attack.
• Breast cancer: This type of cancer affects 1 in 8 American women. Diets high in fat, saturated fat, refined sugar, caffeine, and alcohol increase your risk for breast cancer. Alternatively, a diet rich in soy products and cruciferous vegetables, such as cabbage, broccoli, and kale can help prevent breast cancer.
• Type 2 Diabetes Mellitus: Type 2 diabetes affects over 12 million people and causes more than 140,000 deaths in the United States each year. Type 2 diabetes significantly increases your risk for heart disease, kidney disease, blindness, and amputations. The primary cause of type 2 diabetes is the Standard American Diet (SAD), which is high in fat, saturated fat, sugar and refined foods and low in fruits, vegetables, legumes, fish, whole grains, nuts and seeds.
• Osteoporosis: An estimated 20 million Americans, mostly women, have osteoporosis, meaning 'porous" or soft bone, or are at significant risk for it. Osteoporosis causes at least 1.5 million fractures each year, including 250,000 hip fractures. Hip fractures are often devastating. Nearly one-third of all women and one-sixth of all men will fracture their hips in their lifetime. Hip fractures result in death 12-20% of the time and 50% of those who survive end up in long-term nursing home care. Excessive consumption of animal foods is a signficant contributing factor to osteoporosis.

Nutrient Needs

Good nutrition plays a fundamental role in preserving overall wellness, maintaining a healthy weight, and preventing the diseases associated with aging. The Dietary Reference Intakes (DRI) for adult women are listed in the table below. Several key nutrients specific to the needs of women are highlighted. A diet that is based on organic vegetables, fruits, whole grains, legumes (particularly soy products), nuts, seeds, and wild-caught cold-water fish provides all of the necessary nutrients for health. And, remember, eliminating unhealthy foods (such as highly processed snack foods and desserts that contain hydrogenated fat, sodium, refined sugar and saturated fat) and breaking unhealthy lifestyle habits (such as smoking and excessive alcohol consumption) can make a huge impact on how you feel.

• Dietary Fat: All adults should consume no more than 30% of total calories from fat (approximately 60 grams in a 2000 calorie diet) and a maximum of 10% of total calories as saturated fat (about 20 grams). Too much fat in your diet can increase your risk for cancer and heart disese. But, remember that 'low-fat' labeling does not always point to your best food choice. Food products that are advertised as 'low-fat' and 'fat-free' often contain high amounts of sodium and refined sugar, which are as detrimental to health as fat. Also, some nutrition experts now recommend consuming at least 4 grams of omega-3 fats every day.
• Calories: Each woman's calorie needs are different depending on her current body weight, body fat percentage, and level of physical activity. The bottom line, however, remains that if you take in more calories than you expend to fuel normal physiological functions and exercise, then you will store the excess as fat.
• Fiber: Increasing fiber in your diet is probably one of the most important things you can do for your health. A high dietary intake of fiber can lower your cholesterol levels, normalize your blood sugar levels, help you lose weight, and help prevent colon cancer. Nutrition experts recommend a fiber intake of a minimum of 25 grams per day. Many foods contain good amounts of fiber, including dark green leafy vegetables, celery, cauliflower, cabbage, raspberries, lentils and brown rice.
• Bone-building nutrients: Calcium is important for maintaining the strength and density of bones, and inadequate intake of calcium in women throughout their lifetime, but especially after menopause, leads to more rapid breakdown of bone, resulting in osteoporosis. Excellent food sources of calcium include tofu, collard greens, spinach, turnip greens, mustard greens, beet greens, and bok choy. Vitamin D plays an important role in the absorption and utilization of calcium. As a result, vitamin D deficiency negatively impacts calcium status and bone health. Take care to include foods that contain vitamin D (salmon, sardines, milk, tuna, eggs, and shiitake mushrooms) and be sure to get outside so that your skin is exposed to sunlight on a regular basis. Boron, a trace mineral that is also an important nutrient for bone health, is found in raisins, which are among the top 50 contributors in the U.S. diet of this important nutrient for bone health.
• Heart-healthy nutrients: High dietary intake of folic acid, vitamin B6, and vitamin B12 is known to lower blood levels of homocysteine, a by-product of metabolism that can cause damage to artery walls, setting the stage for the development of atherosclerosis. A high blood homocysteine level (called hyperhomocysteinemia) is associated with increased risk of cardiovascular disease, and low intake of folic acid, vitamin B6 and vitamin B12 are key risk factors for hyperhomocysteinemia. Excellent sources of folic acid include lentils, asparagus, spinach, broccoli, and beets. Excellent sources of B6 include tuna, spinach, cabbage, bell peppers, turnip greens, garlic, and cauliflower. Excellent sources of B12 include sardines, salmon, tuna, cod, lamb, scallops, shrimp, and beef.
• Antioxidant nutrients: To help prevent heart disease and cancer, focus on obtaining an abundance of the antioxidant nutrients, including vitamin E, vitamin C and the carotenoids, to protect your cells from free radical damage. Food sources of these nutrients include dark green leafy vegetables and a variety of fruits.
• Isoflavones: These hormone-like compounds are believed to play a role in the prevention of heart disease and breast cancer. Soy products are a good source of isoflavones.

Dietary Choices

Many women want to eat right and exercise, but they feel they can't find the time. Most of each day is spent taking care of kids, keeping the home in order, and staying caught up at work. At the end of the day, it's hard to find the energy to exercise and/or cook a good meal.

The dietary choices of women are also influenced by societal values that emphasize thinness at any cost. A fear of fatness drives many women to choose their foods simply by looking at the calories they contain rather than their nutrient-density. Research shows that maintaining lost weight merely by counting calories is very difficult, a fact that forces many women into a pattern of weight cycling, in which weight is gained and lost repeatedly over the years. Chronic dieting can lead to underconsumption of vitamins, minerals, fiber, and essential fats, ultimately producing severe nutrient deficiencies and setting the stage for the development of disease.

Finally, during the transition through menopause, some women experience a variety of uncomfortable symptoms, including hot flashes, depression, forgetfulness, and fatigue ' all of which can make it even more difficult to eat well.

The World's Healthiest Foods, however, offers women another dietary option, one that can help women stay healthy, vibrant and slender throughout their lives. The World's Healthiest Foods provide maximum nutrition for the lowest caloric cost, expanding your energy rather than your waistline. With the personalized information available on the World's Healthiest Foods website (Food Advisor), you can quickly determine which foods will best promote your health. Then take advantage of the wonderful recipes specially developed to fit your needs. All are so quick and easy, that even the busiest working mom can reap the many benefits of providing optimal nutrition for herself and her family.

References

• American Dietetic Association. Women's health and nutrition. Journal of the American Dietetic Association 1995; 95: 362. 1995.
• Brockie J. Dietary and lifestyle changes for menopausal women. Community Nurse 1999 Oct;5(9):13-4. 1999. PMID:19410.
• Faine MP. Dietary factors related to preservation of oral and skeletal bone mass in women. J Prosthet Dent 1995 Jan;73(1):65-72. 1995. PMID:19450.
• Finn SC. Women in midlife: a nutritional perspective. J Womens Health Gend Based Med 2000 May;9(4):351-6. 2000. PMID:19350.
• Hargreaves MK, Buchowski MS, Hardy RE, et al. Dietary factors and cancers of breast, endometrium, and ovary: strategies for modifying fat intake in African American women. Am J Obstet Gynecol 1997 Jun;176(6):S255-64. 1997. PMID:19440.
• Herrin M. Balancing the scales. Nutritional counseling for women with eating disorders. AWHONN Lifelines 1999 Aug-1999 Sep 30;3(4):26-34. 1999. PMID:19360.
• Kalkwarf HJ. Hormonal and dietary regulation of changes in bone density during lactation and after weaning in women. J Mammary Gland Biol Neoplasia 1999 Jul;4(3):319-29. 1999. PMID:19420.
• Lukmanji Z. Women's workload and its impact on their health and nutritional status. Prog Food Nutr Sci 1992;16(2):163-79. 1992. PMID:19400.
• Mahan K, Escott-Stump S. Krause's Food, Nutrition, and Diet Therapy. WB Saunders Company; Philadelphia, 1996. 1996.
• Morris VM, Rorie JA. Nutritional concerns in women's primary care. J Nurse Midwifery 1997 Nov-1997 Dec 31;42(6):509-20. 1997. PMID:19380.
• Seibel MM. The role of nutrition and nutritional supplements in women's health. Fertil Steril 1999 Oct;72(4):579-91. 1999. PMID:19370.
• Stephens FO. The rising incidence of breast cancer in women and prostate cancer in men. Dietary influences: a possible preventive role for nature's sex hormone modifiers - the phytoestrogens (review). Oncol Rep 1999 Jul-1999 Aug 31;6(4):865-70. 1999. PMID:19430.
• Walker SP. Nutritional issues for women in developing countries. Proc Nutr Soc 1997 Mar;56(1B):345-56. 1997. PMID:19390.