EN’s Nutrition Advice for Women of “A Certain Age”

By the year 2010, women will break the 80-year old barrier; the average American woman will live to 81. As increasing numbers of female baby-boomers cross the 50 mark, preventive medicine and nutrition will become more important than ever.

As women age, they contend with concerns beyond the effects of menopause. They face increased risk of chronic diseases, such as osteoporosis, cancer, heart disease and cataracts. While no one doubts good nutrition can reduce these dangers, how much it can help is still a matter of debate.

Osteoporosis. By the time a woman reaches 80, she has a 40% chance of having at least one spinal fracture. Moreover, a woman’s risk of hip fracture is equal to her combined risk for breast, uterine and ovarian cancers. All this thanks to osteoporosis, a disease that affects more than 25 million Americans — 80% of them women.

Osteoporosis literally means “porous bone.” It is caused by insufficient bone mass and bone tissue that deteriorates structurally, leading to fragile bones and increased susceptibility to fractures of the hip, spine and wrist. The cornerstone of bone strength is calcium.

According to a 1994 National Institutes of Health (NIH) conference of calcium experts, women over age 50 who are currently on estrogen replacement therapy should strive for 1,000 milligrams of calcium a day. Women aged 50+ who are not taking estrogen — and all women over the age of 65 — should consume 1,500 milligrams of calcium a day. The NIH experts recommend calcium supplements for postmenopausal women if dietary intake is low.

Most women know they need calcium, but few realize the importance of magnesium. According to Mildred Seelig, M.D., M.P.H., adjunct professor at the University of North Carolina at Chapel Hill, magnesium aids the absorption of calcium, just as vitamin D does. But it does more.

“Calcium increases bone density, while magnesium is involved in the construction of the matrix — the flexible scaffold into which bone tissue is deposited,” explains Seelig. “The matrix is what allows the skeleton to absorb bone-fracturing shocks.”

Adequate magnesium intake is especially important after menopause. Estrogen maintains magnesium’s status in the body’s soft tissues and bones, so the danger of injury increases as the body’s supply of estrogen declines.

“Postmenopausal women who take high levels of calcium without raising their intake of magnesium will not utilize calcium properly,” warns Seelig.

The current recommended magnesium intake for women is 280 milligrams. But Seelig, for one, thinks this is too low. “Magnesium intake should be no less than one-third of calcium intake,” she contends. (Experts also recommend supplemental vitamin D for women who get little sun and drink little vitamin D-fortified milk.)

Breast Cancer. Another disease that targets primarily women is breast cancer. Researchers are now exploring the possible preventive action of plant phytoestrogens, natural chemicals that mimic estrogen’s protective effects.

“Preliminary studies in animals indicate that phytoestrogens from soy may actually suppress breast tumors,” says Claude L. Hughes, M.D., Ph.D., of the Bowman Gray School of Medicine in Winston-Salem, North Carolina.

Until more is known about soy’s effects in people, women should eat a low-fat diet with plenty of fruits, vegetables and whole grains. Though fat itself is no longer the leading suspect as a trigger for breast cancer, women who are overweight are at greater risk for breast cancer and other cancers, so aim to maintain a reasonable weight.

Heart Disease. This is the disease postmenopausal women should be most concerned about, because it kills 10 times more women than breast cancer.

Of course, if your cholesterol level is high, limit saturated fat and eat more soluble fiber. Keeping weight down is also a key defense.

New research has bolstered the growing belief that vitamin E protects against heart disease. (See feature story.) The other nutrient making waves in the fight against heart disease is the B vitamin folic acid. (See Just In.)

Research indicates a daily intake of at least 0.4 milligram (400 micrograms) of folic acid (also called folate) may protect the heart. Surveys suggest that 40% of Americans are not consuming enough of this vitamin. To help prevent birth defects, the government has ordered food manufacturers to begin fortifying breads, cereals, pasta and rice with folic acid by next year. We may all benefit from this fortification with lower heart disease risk.

Cataracts and Age-Related Macular Degeneration. Eye diseases are a leading public health problem for older people. Roughly 20% of Americans 65 to 74, and 45% of those 75+, have age-related cataracts, a common but treatable cause of vision loss. Less common, but more devastating, is age-related macular degeneration (AMD), the leading cause of blindness in people 65 and over. Unfortunately, there are limited treatment options for AMD once it develops. So prevention is the best hope. And nutrition may play a big role.

The exact causes of cataracts and AMD are unknown, but oxidation — the chemical reaction that produces damaging free radicals — may be central to both. Nutrients that are antioxidants, such as vitamins C, E and beta-carotene, may protect eyes.

In a study of more than 50,000 women, 45 to 67, those with the highest intakes of dietary carotenoids (of which beta-carotene is one) had a 40% lower risk of cataracts that needed extraction than those with the lowest intakes. Long-term vitamin C supplementation also decreased risk.

Another study found people with medium-to-high blood carotenoid levels had much less risk of AMD than those with low levels.

While much of this research is promising, most experts still feel they cannot yet make concrete nutrition recommendations for eye health.

Bottom-Line Advice for the 50+ Female. Though many avenues of research are still tentative, you may not want to wait until all the t’s are crossed and i’s are dotted before taking preventive action. Here’s what EN suggests the 50+ woman can do now:

  • Eat a varied diet with plenty of fruits and vegetables rich in antioxidents, such as broccoli, spinach, Brussels sprouts, carrots, tomatoes, cantaloupe, apricots, oranges, grapefruit, mango, papaya and strawberries.
  • Take a multi supplement with 100% of the Daily Value for most vitamins and minerals. While the jury is still out on the benefits of supplements for particular diseases, a multi can’t hurt and just might help.
  • Aim for a diet rich in calcium. Look to low-fat milk, yogurt and cheese, as well as calcium-fortified orange juice, dark green leafy vegetables, figs and canned salmon or sardines eaten with the bones.
  • If needed to reach a daily calcium total of 1,000 to 1,500 milligrams, take a calcium supplement — best absorbed when taken between meals in doses of 500 milligrams or less.
  • Eat foods rich in magnesium, such as wheat germ, spinach and tofu.
  • Search out foods rich in folate. Good sources include orange juice, dark green leafy vegetables and dried beans and peas.
  • Snack on small amounts of nuts and seeds for vitamin E. Consider a vitamin E supplement of 100 to 400 IU.
  • Limit fat in your diet to 20% to 30% of calories (about 50 to 60 grams for women of average weight). Especially limit saturated fat.
  • Gradually add fiber to your diet, to reach a goal of 20 to 35 grams a day.
  • Maintain a healthy weight. Be active every day; do aerobic exercise three or four times a week.
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