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Nutrition and Women's Health


We’ve become more aware of women’s heath in recent years, but there is still a long way to go. A recent survey found that 4 in 5 women “had at times felt that their healthcare professionals were not listening to them” (1). The Government developed the Women’s Health Strategy in 2022 (1), which outlines many of the health issues faced by women, and what can be done about them. Women’s bodies go through a lot in their life time - our health requirements are unique and unfortunately not always well understood from research (2). Outside health research, we see more often now the menopause being discussed openly by significant public figures and conditions like endometriosis being profiled throughout the media. This is both supportive and immensely empowering for women.

There are some health concerns which are more likely to affect women than men across the lifespan - these include heart disease and osteoporosis (3). In addition, health conditions affecting specifically women take many forms. At the centre of these are often difficult gut symptoms, fertility issues, inflammation and fatigue. Paired with often demanding social circumstances and roles of responsibility common for women, this can be a challenging scenario to live with.

Nutrition is a key component for optimising women’s health and can also help to address many of the symptoms faced through associated health conditions. Specific dietary approaches play a vital role in helping women to manage polycystic ovary syndrome, fertility issues, endometriosis and through the menopause. Knowing which changes to make and ensuring our diet stays balanced and adequate through these conditions can be difficult and may need additional support. We are all individual, however there are several dietary factors we can be aware of, to help optimise health for women. Here are a few key nutrients that as women we should be aware of:

Calcium & vitamin D
Due to the increased risk of osteoporosis and declining bone health in women owing to factors like pregnancy and menopause, it’s important to include enough calcium and vitamin D. This should be possible through diet, though sometimes additional supplements may be needed.
Calcium is vital for maintaining healthy bones and teeth, and also helps with nerve and muscle function. We should aim to have calcium rich foods 2-3 times a day – this includes cow’s milk, cheese, calcium enriched plant-based milks, yoghurt and other sources such as pilchards.
Vitamin D helps the body to absorb and retain calcium, it has also been found to have anti-inflammatory effects (4). As well as what we eat, the body makes vitamin D through being exposed to sunlight – though this depends on the strength of the sunlight. People who are not often exposed to sunlight, or live in areas where the sunlight is less strong and those over 65 years of age are more at risk of not getting enough vitamin D. In the UK, we are recommended to have 10ug (400IU) of vitamin D per day. For many, this may mean talking a supplement through the months of September to March. Foods high in vitamin D include oily fish, eggs, some mushrooms, liver and fortified foods.

Iron
Iron deficiency anaemia can be a significant concern for women, the risk is increased by abnormal uterine bleeding and pregnancy. This can lead to challenging symptoms like severe fatigue, reduced productivity and performance (6). Women pre menopause have the highest recommended daily intake for iron. It’s long been known that red meat is a good source of iron, however now we are encouraged to reduce our intake of red meat – so where else can we go for iron? Plant-based sources include pulses and legumes, dark green leafy vegetables, nuts and seeds. The body might need a bit of help absorbing iron from these foods (known as non-haem iron) so it is useful to have them alongside foods containing vitamin C (such as a small glass of fresh orange juice with a meal) and to avoid drinking tea or coffee directly with your meal, as this can inhibit iron absorption.

Folic acid
As well as helping the body to make red blood cells, folic acid is important before conception and during pregnancy. It is vital for foetal neural development and women through conception and to 12 weeks of pregnancy should take a supplement of 400ug per day in addition to the folic acid in their diet. Foods rich in folic acid include green leafy vegetables, sprouts, broccoli, legumes, yeast extracts, oranges, wheat bran and other whole grain foods, poultry, pork, shellfish and liver and fortified foods.

Fibre
Women are more likely to suffer from gut health issues than men (7). Having a diet rich in fibre is a good way to improve our gut health and increase the number of good bacteria in the bowel. In turn, this can support the immune system and help to reduce gut inflammation. A diet high in fibre is also associated with less risk of heart disease, type 2 diabetes and bowel cancer. Fibre has added benefits when it comes to managing energy levels, as it helps energy to be released more slowly from a meal or snack. There are different types of fibre, which play slightly different roles in the bowel, however we should aim to have an overall variety of each. Try to include a range of fruits and vegetables, oats, whole grains, nuts, seeds and legumes in your daily diet. A helpful approach can be to aim for thirty different plant-based foods each week – people eating this amount have been found to have the most diverse gut microbiome.

Omega 3
This is group of polyunsaturated fatty acids – heart healthy fats. Including omega 3 regularly in your diet can help to protect your heart and blood vessels through lowering the levels of undesirable fats circulating after a meal, improving circulation and lowering blood pressure. This, paired with anti-inflammatory benefits, reduces cardiovascular risk. Foods high in Omega 3 include oily fish, nuts (especially walnuts), seeds (flax, chia, pumpkin and hemp) and green leafy vegetables. We should try to eat fish twice weekly, one portion of which is oily fish.

We are all different, as are our needs and our priorities, but even small changes to the way we eat can have a positive impact on health. If you feel you would like discuss how diet can play a role in your health or conditions or for support in making these changes, please get in touch – I am passionate about improving women’s health through nutrition.

Useful resources –

References
(1) Dept of health and social care. Women’s health strategy for England (2022). Available at: https://www.gov.uk/government/publications/womens-health-strategy-for-england/womens-health-strategy-for-england#ministerial-foreword
(2) Hankivsky, O., Reid, C., Cormier, R. et al. Exploring the promises of intersectionality for advancing women's health research. Int J Equity Health 9, 5 (2010). https://doi.org/10.1186/1475-9276-9-5
(3) NICHD - Eunice Kennedy Shriver National Institute of Child Health and Human Development. What health issues or conditions affect women differently than men? (2016) Available at: https://www.nichd.nih.gov/health/topics/womenshealth/conditioninfo/howconditionsaffect
(4) Yin K, Agrawal DK. Vitamin D and inflammatory diseases. J Inflamm Res. 2014 May 29;7:69-87. doi: 10.2147/JIR.S63898.
(5) SACN. Vitamin D and Health (2016). Available at: https://www.gov.uk/government/groups/scientific-advisory-committee-on-nutrition
(6) Benson CS, Shah A, Stanworth SJ, Frise CJ, Spiby H, Lax SJ, Murray J, Klein AA. The effect of iron deficiency and anaemia on women's health. Anaesthesia. 2021 Apr;76 Suppl 4:84-95. doi: 10.1111/anae.15405. PMID: 33682105.
(7) Cain KC, Jarrett ME, Burr RL, Rosen S, Hertig VL, Heitkemper MM. Gender differences in gastrointestinal, psychological, and somatic symptoms in irritable bowel syndrome. Dig Dis Sci. 2009 Jul;54(7):1542-9. doi: 10.1007/s10620-008-0516-3. Epub 2008 Nov 1. PMID: 18979200; PMCID: PMC3569485.
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