Women: Special Diets for Special Needs

Women: Special Diets For Special Needs

An estimated 143,000 women in the United States will have been diagnosed as having breast cancer in 1989, and approximately 43,000 of them will die. One American woman in 10 will develop a breast malignancy sometime during her life. These statistics provide a dramatic background for the news that cancer -- and many other disorders to which women are susceptible -- can now be prevented, ameliorated or even cured through modifications in nutrition and lifestyle.

Discouraging as the breast cancer statistics certainly are, research indicates that women can reduce their risk of breast cancer by cutting their intake of dietary fat. Experiments with animals show a relationship between dietary fats and the development of mammary cancer. The tumor-enhancing effects of saturated and polyunsaturated oils are similar when total fat content of the diet is high, but recent evidence indicates a diet higher in omega-3 oils, including fish, flax, canola and certain bean oils, may actually lower the risk of breast cancer in animals. Studies in humans also point to a close correlation between breast cancer incidence and total dietary fat consumption.

A high-fat diet can increase a woman's level of estrogenic hormones which, in turn, may stimulate breast tissue into a pre-cancerous state. High dietary fat intake may also alter the metabolism of estrogen or the quantity of estrogen in fatty tissues, which could increase the risk of breast cancer developing.( 1)

In light of this research, women whose families have a history of breast cancer, or who have hyperestrogenism (elevated estrogen levels) or the pre-malignant form of fibrocystic breast disease (cystic mastitis) may elect to follow a low-fat diet to reduce their risk of breast cancer. This means cutting down total fats in the diet to below 25 percent of the calories, a significant departure from the standard American diet, which derives nearly 40 percent of its calories from fats.

Other research supports the value of a low-fat diet in the prevention or retardation of breast cancer or in the reduction of the symptoms of cyclical mastopathy (breast tenderness associated with the onset of the menstrual period).( 2, 3)

Specific nutrients, too, can help modulate specific health problems in women. Vitamin E, for example, may be therapeutic for the treatment of fibrocystic disease of the breast.4

Nutrition and Anemia

Anemia in menstruating women is another condition which can be helped through a special diet. We usually think of anemia as an iron deficiency condition resulting from blood loss during menstruation, and iron is considered a "problem nutrient" in the standard American diet, according to such national food surveys as the Health and Nutrition Examination Surveys (HANES) I & II and the U.S. Department of Agriculture Ten-State Nutrition Studies.

In addition to ensuring they are getting adequate iron, however, women should also be aware that anemia can result from insufficiencies of other essential dietary nutrients, including copper, vitamin B( 12) and folic acid. In addition to preventing anemia, these nutrients also protect against urine cervical dysplasis (benign cysts of the uterine wall).( 5) Folic acid and vitamin C supplements (in amounts greater than those available in the standard American diet) may also help improve this condition. (Approximately 30 percent of U.S. women in their reproductive years consume less than 30 mg of vitamin C daily, and 68 percent consume less than 88 mg) A number of doctors, therefore, are beginning to recommend supplementary vitamin C for women at high risk of cervical cancer.6

Vitamin B( 12) also plays an important role in women's health. Vegetarian women whose diets are lacking in vitamin B( 12) may give birth to infants in whom a vitamin B( 12) deficiency may result in impairment of the nervous system, a condition which could be missed by a standard medical diagnosis. Evidence now suggests a pregnant woman needs vitamin B( 12), either from animal sources or supplements, to provide enough of this essential nutrient for her developing fetus.( 7)

Another disease for which women are uniquely at risk is osteoporosis, or thinning of the bones. Although women's need for 800 to 1,200 mg of calcium to help prevent bone demineralization is well known, it is less commonly understood that a magnesium deficiency, too, can increase the risk of bone loss. Magnesium, available in lean meats, green leafy vegetables and whole grains grown in mineral-rich soils, is essential for proper utilization of calcium and mineralization of bone.8

Another mineral which has recently been added to the list of nutrients essential for bone integrity is boron. Dr. Forest Nielsen, a researcher with the U.S. Department of Agriculture, found that boron may play a role in establishing proper estrogen levels and metabolism in post-menopausal women.

Boron supplementation at a level of 5 mg per day, a level that can be obtained in a diet rich in unprocessed foods, helped to establish higher estrogen levels and increase bone integrity in post-menopausal women.9 A diet containing beans, root vegetables and whole grains provides high levels of magnesium, boron and other bone-supportive trace elements. Dairy products are also rich sources of calcium. (One cup of nonfat milk provides about 300 mg of calcium, 38 percent of the Recommended Daily Allowance.)

Amenorrhea in heavily exercising young women can also lead to loss of skeletal mass. Some extremely active young women lose bone at the same rapid rate as post-menopausal women. Recent evidence indicates that amenorrhea in heavily exercising young women is due not to exercise but to undernourishment. Increasing the quality and number of calories in the diet brings about a return of menstruation and averts bone loss.1(0,11)

Another special diet may help prevent at-risk women from giving birth to babies with spina bifida or neural tube defects. Dr. R.W. Smithells in England reported in the Lancet that these birth defects may be related to insufficiencies of certain vitamins, particularly folic acid,( 12) and that taking a vitamin supplement before and during pregnancy could prevent neural tube defects in at-risk women.( 13)

In 1988, the results of an extensive study of multivitamin supplementation to reduce the occurrence of neural tube defects were reported in the Journal of the American Medical Association.( 14)

The study revealed that multivitamin supplementation during the years before a woman conceives can protect against these birth defects.

Protecting Smokers Through Diet

Consumption of orange-red vegetables, with their high levels of carotene, can help reduce the incidence of cleft lip and palate in the offspring of women who smoke.( 15)

By eating lots of carotene-containing vegetables, women who smoke can also lower their lung cancer risk.( 16)

Smoking interferes with the metabolism of estrogen and can contribute to increased bone loss in women who smoke, leading to possible spinal fractures and loss of jawbone integrity, the major risk factor for tooth loss in post-menopausal women.( 17)

Foods high in calcium, magnesium, vitamin C, vitamin E and carotene may help to prevent bone loss in women who smoke.

Guidelines for Dieters

Weight-loss diets are common among women today. The very low calorie diet (fewer than 300 calories per day, typical of most liquid protein diets) induces a starving physiology which may lower metabolic rate.( 18)

This lowered metabolism increases the risk of rebound or yoyoing with every repeated diet, making it harder to lose weight and easier to gain it back.

A special diet for women who want to lose weight effectively would be one which is low in calories (800-1,200per day), low in fat, rich in whole-grain complex carbohydrates and that contains 60 to 80 grams of daily protein.

(To be most effective in reversing depressed metabolism, this diet should be combined with an exercise program.)

Finally, digestive problems and disorders like Crohn's disease and irritable bowel syndrome, to which women are particularly susceptible, may have a dietary link. Dr. V. Allun Jones and his colleagues found a strong association between food intolerance or food allergy and irritable bowel syndrome.( 19)

Dairy products, wheat, corn, soy, yeast, citrus and shellfish may be major contributors to irritable bowel syndrome or Crohn's disease. By following a low-allergy diet, individuals have experienced significant improvement of these conditions without the necessity for medications to prevent inflammation.

Certain forms of arthritis may also be food allergy-induced. Dr. R.S. Panush reported a history of increased symptoms of inflammatory arthritis in patients who are sensitive to milk, wheat or other foods. When they rotated these foods or eliminated them from their diet, these patients noted considerable improvement in their conditions.

Dr. Joel Kremer, of Albany Medical College, also reported that lowering the total fat level and increasing the amount of fish oil in the diet of an arthritic patient can lead to significant reduction in pain and less need for anti-inflammatory medication.( 21)

By examining her diet, lifestyle and family history, and identifying her specific needs, a woman can design a therapeutic diet which may be able to alleviate not only the symptoms but the actual cause of a disorder as well.

From Medical Nutrition, Autumn, 1989. (C) 1989 Medical Nutrition. Reprinted with permission from Health Comm, Inc., 5800 Soundview Drive, P.O. Box 1729, Gig Harbor, WA 98335.

References
(1.) Schatzkin, A., Greenwald, P., Byar, D.P., and Clifford, C.K., "The Dietary Fat-Breast Cancer Hypothesis is Alive," Journal of the American Medical Association, Vol. 261, No. 22, p. 3284, 1989.

(2.) Greenwald, P., Clifford, C., Butrum, R.R., and Iverson, D.C., "Feasibility Studies of a Low-Fat Diet to Prevent or Retard Breast Cancer," American Journal of Clinical Nutrition, Vol. 45, pp. 347-353, 1987.

(3.) Boyd, N.F., et al., "Effect of a Low-Fat, High-Carbohydrate Diet on Symptoms of Cyclical Mastopathy," Lancet, p. 128, July 16, 1988.

(4.) Gonzalez, E. "Vitamin E Relieves Most Cystic Breast Disease; May Alter Lipids, Hormones," Journal of the American Medical Association, Vol. 244, p. 10, 1980.

(5.) Butterworth, C.E., and Noris, D., "Folic Acid and Vitamin C in Cervical Dysplasia," American Journal of Clinical Nutrition, Vol. 37, No. 2, p. 322, 1982.

(6.) Wassertheil-Smoller, S., et al., "Dietary Vitamin C and Uterine Cervical Dysplasia," American Journal of Epidemiology, Vol. 114, p. 5, 1981.

(7.) Specker, B.L., Miller, D., and Norman, E.J., "Increased Urinary Methylmalonic Acid Excretion in Breast-Fed Infants of Vegetarian Mothers and Identification of an Acceptable Dietary Source of Vitamin B(12)," American Journal of Clinical Nutrition, Vol. 47, pp. 89-92, 1988.

(8.) Ericsson, Y., Luoma, H., and Ekberg, O., "Effects of Calcium, Fluoride and Magnesium Supplementation on Tissue Mineralization in Calcium- and Magnesium-Deficient Rats," Journal of Nutrition, Vol. 116, p. 1018, 1986.

(9.) Neilson, F.H., Hunt, C.D., Mullen, L.M., and Hunt, J.R., "Effect of Dietary Boron on Mineral, Estrogen and Testosterone Metabolism in Post-menopausal Women," Applied Science of Experimental Biology, Vol. 1, pp. 394-97, 1987.

(10.) Brownell, K., Steen, S., and Wilmore, J., "Weight Regulation Practices in Athletes: Analysis of Metabolic and Health Effects," Medicine and Science in Sports and Exercise, Vol. 19, No. 6, pp. 546-556, 1987.

(11.) Nelson, M., et al., "Diet and Bone Status in Amenorrheic Runners," American Journal of Clinical Nutrition, Vol. 43, pp. 910-916, 1986.

(12.) Smithels, R.W., Sheppard, C., Schorah, C.J., et al., "Vitamin Supplementation and Neural Tube Defects, "Lancet, p. 339, Feb. 16, 1980.

(13.) Smithels, R.W., Sheppard, C., Schorah, C.J., et al., "Possible Prevention of Neural Tube Defects by Periconceptional Vitamin Supplementation," Lancet, p. 339,

(14.) Mulinare, J., Cordero, J., Erickson, D., et al., "Periconceptional Use of Multivitamins and the Occurrence of Neural Tube Defects, "Journal of the American Medical Association, Vol. 260, No. 21, pp. 3141-3145, 1988.

(15.) Ericson, A., Kallen, B., and Westerholm, P., "Cigarette Smoking -- An Etiologic Factor in Cleft Lip and Palate," American Journal of Obstetrics and Gynecology, Vol. 125, p. 348, 1979.

(16.) Ziegler, R., "A Review of Epidemiologic Evidence That Carotenoids Reduce the Risk of Cancer," Journal of Nutrition, Vol. 119, pp. 116-22, 1989.

(17.) Schectman, G., Byrd, J.C., and Gruchow, H.W., "Influence of Smoking on Vitamin C Status in Adults," American Journal of Public Health, Vol. 79, No. 2, pp. 158-62, 1989.

(18.) Wadden, T., Stunkard, A., and Brownell, K., "Very Low Calorie Diets: Their Efficacy, Safety and Future," Annals of Internal Medicine, Vol. 99, pp. 675

(19.) Jones, V.A., McLaughlin, P., Shorthouse, M., et al., "Food Intolerance: A Major Factor in the Pathogenesis of Irritable Bowel Syndrome," Lancet, p. 1115, Nov., 1982.

(20.) Panush, R.S., Stroud, R.M., and Webster, E.M., "Food-Induced (Allergic) Arthritis: Inflammatory Arthritis Exacerbated by Milk," Arthritis and Rheumatism Vol. 29, No. 2, p. 220, 1986.

(21.) Kremer, J.S., et al., "Fish-Oil Fatty Acid Supplementation in Active Rheumatoid Arthritis," Annals of Internal Medicine, Vol. 106, p. 497-503, 1987.

Life University.

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By Jeffrey S. Bland

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