Women face unique health challenges across their lifespan and nutrition plays a key role in meeting these health challenges. In a recent paper published by our founder Mike Wakeman, it identified the different associations between nutrition intakes and health in women in the UK aged between 11-65+.

This paper specifically looked at some of the less discussed health challenges women face and how supplementation could be used to help.

At Vitmedics, we believe strongly in scientific research supporting all recommendations which is why we want to share these scientific published research findings with you.

Specifically looking at health challenges and nutrition relating to:

• Oral contraceptives
• Fertility
• The Menstrual cycle & Pre-Menstrual syndrome
• Endometriosis

The majority of women actively care about being healthy and staying healthy throughout their life. But achieving this is not always easy given the myriad of complex health challenges from eating healthily in the context of a busy working lifestyle, pregnancy and raising children to just being sufficiently physically active.

Achieving and maintaining a healthy body weight, minimising stress, getting enough sleep, managing nutrition as well as ensuring sufficiency of micronutrients for bone health, brain health, cardiovascular health and digestive health at every stage of life can appear to be challenging.

Based on research few women actually achieve micronutrient sufficiency at any stage of life, which is serious given that vitamins and minerals in recommended amounts are essential for health.

Earlier reports from the UK National Diet and Nutrition Survey Rolling Programme (NDNS-RP), which began in 2008, have identified widespread shortfalls in micronutrient intake and status in females from the age of 11 through to adulthood [1].

1. Oral contraceptives

Oral contraceptives are a major class of prescription drug used by a large proportion of women from adolescence through to the end of the menopause. Data since the 1970s indicate that oral contraceptives induce depletions of nutrients including:

• folic acid, vitamins B2, B6, B12, vitamin C and E and the minerals magnesium, selenium and zinc.

Thus, the possibility to prevent vitamin and mineral deficiencies through the intake of appropriate dietary supplements should be considered as a first line approach. The ideal dietary supplement would contain vitamins of the B complex together with folic acid, vitamin E and C as well as minerals such as magnesium, zinc and selenium [2]. 

Combined Oral Contraceptives (COCs), to which adolescent exposure appears to be increasing, may interfere with Bone Mineral Density (BMD) accrual due to the presence of exogenous oestrogen in the pill.

(A meta-analysis of nine retrospective case control studies found evidence of impairment of peak BMD in the lumbar spine in adolescents using COCs compared with controls [3]). Controlled trials are needed to evaluate this potential public health problem, and whether increased calcium via supplements could play a role. Preliminary evidence also indicates that Omega 3 (LC-omega-3 PUFA) status may be altered in women taking oral contraceptives.

2. The Menstrual Cycle and Pre-Menstrual Syndrome

The menstrual cycle, particularly Pre-Menstrual Syndrome (PMS) appears to be related to several nutritional factors, including lower intakes of calcium, magnesium, vitamin B6 and dietary fibre, especially in young women [4, 5].

Multiple reviews have shown:

• Low serum levels of calcium and vitamin D during the luteal phase of the menstrual cycle caused or exacerbated the symptoms of PMS [6].
• Oral calcium supplementation has been demonstrated to reduce the symptoms of PMS in young women [7,8] and menstrual pain intensity [9].
• Vitamin D supplementation was effective in alleviating PMS symptoms based upon findings from interventional studies [10].
• Vitamin B1 (thiamine) has been found to reduce mental and physical symptoms of PMS possibly through affecting the performance of coenzymes in the metabolism of carbohydrates [11].
• Heavy menstrual bleeding is a common but often under recognised cause of iron deficiency anaemia and, indeed severe anaemia, in adolescent girls [12].

3. Endometriosis

Endometriosis is a hormone-dependent chronic inflammatory disease characterized by the presence of endometrium beyond the uterine cavity. The disease affects 5-15 per cent of women of childbearing age, 30-50 per cent of whom suffer from infertility. Existing studies concerning nutrition and endometriosis suggest that diet is a potentially modifiable risk factor for endometriosis.

• Fruits and vegetables, fish oils, dairy products rich in calcium and vitamin D, and omega-3 fatty acids are likely connected with a lower risk of developing endometriosis [13].
• A retrospective case-control study in 156 women with endometriosis and 50 controls found significantly lower intakes of vitamin C, B12 and magnesium in those with endometriosis [14].
• Although this is preliminary work the suggestion is made that nutritional intervention might reduce the burden of this disease [14].

4. Fertility

Nutrition is also linked to fertility in women.

• Intake of supplemental folic acid and long chain omega 3 fatty acids have been related to lower frequency of infertility [15].
• Higher intake of supplemental folic acid, vitamin B12, vitamin D, low- rather than high-pesticide residue produce, whole grains, dairy, soy foods, and seafood has been linked to improved outcomes in assisted reproduction [16].
• Some evidence suggests that vitamin D might influence reproductive processes.

A systematic review concludes that in women undergoing in-vitro fertilisation, a sufficient vitamin D level should be obtained [17]. Vitamin D might protect against two of the common causes of infertility in women endometriosis (see also above) and Polycystic Ovarian Syndrome (PCOS) [17]. Vitamin D supplementation might also improve metabolic parameters in women with Polycystic Ovary Syndrome (PCOS) [18].

In addition to these specific health challenges dietary patterns and eating habits have changed dramatically over the past 50 years. Women’s diets have been influenced by a range of factors, including urbanisation and the availability of different foods, busy lifestyles, more unpredictable working hours, increase in unstructured eating, more eating out and the rise in the number of women in the workforce.

Furthermore, food sensitivities such as gluten, wheat and dairy result in women cutting out whole food groups, whilst popular weight loss ‘diets’ can also reduce micronutrient intakes [19]. They tend to reduce red meat, other animal-based food and fish to become vegan or vegetarian can prejudice intakes of iron, zinc, calcium, iodine and vitamin B12. [20].

In addition, concerns about sustainability of fish stocks or dislike of oily fish may contribute to low intakes of long chain omega-3 polyunsaturated fatty acids (LC-omega-3 PUFAs). Consumption of food high in fat, sugar and salt at the expense of fruit and vegetables and a healthy overall diet can impact digestive health as plant-based foods provide prebiotic ingredients that can have a beneficial impact on the gut microbiome [21].

Given the low micronutrient intakes in a significant proportion of women across the lifespan in the UK, the essentiality of all micronutrients for health and the links between low intakes of several micronutrients and health issues, intakes of all nutrients should be at recommended levels. All women should ideally take a multivitamin and multimineral, a supplement providing 10 micrograms of vitamin D with the addition of omega-3 fatty acids as a routine part of their daily life.

At Vitmedics, we always recommend dietary improvements first, but in some cases of likely nutrient deficiency a supplement is essential. If we detect this, we will guide you on the supplements which are best suited for your needs.

Try our free and simply to use Vitcheck Assessment here and get your results of any nutrient deficiencies within minutes. If you would like to speak with one of our specialists you can book a free one-to-one consultancy here.

Please click here to read Mike's full research paper on 

'Women’s Health in the UK-Dietary and Health Challenges across the Life Cycle with a Focus on Micronutrients' 

References:

21. Public Health England, Food Standards Agency. National Diet and Nutrition Survey: Years 1 to 9 of the Rolling Programme (2008/2009 – 2016/2017): Time trend and income analyses. A survey carried out on behalf of Public Health England and the Food Standards Agency.
22. Palmery M, Saraceno A, Vaiarelli A, Carlomagno G (2013) Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci 17: 1804-1813.
23. Goshtasebi A, Subotic Brajic T, Scholes D, Beres Lederer Goldberg T, Berenson A, et al. (2019) Adolescent use of combined hormonal contraception and peak bone mineral density accrual: A meta-analysis of international prospective controlled studies. Clin Endocrinol (Oxf) 90: 517-524.
24. Bianco V, Cestari AM, Casati D, Cipriani S, Radici G, et al. (2014) Premenstrual syndrome and beyond: lifestyle, nutrition, and personal facts. Minerva Ginecol 66: 365-375.
25. Saeedian Kia A, Amani R, Cheraghian B (2015) The Association between the Risk of Premenstrual Syndrome and Vitamin D, Calcium, and Magnesium Status among University Students: A Case Control Study. Health Promot Perspect 5: 225-230.
26. Abdi F, Ozgoli G, Rahnemaie FS (2019) A systematic review of the role of vitamin D and calcium in premenstrual syndrome. Obstet Gynecol Sci 62: 73-86.
27. Bharati M (2016) Comparing the Effects of Yoga & Oral Calcium Administration in Alleviating Symptoms of Premenstrual Syndrome in Medical Undergraduates. J Caring Sci 5:179-85.
28. Shobeiri F, Araste FE, Ebrahimi R, Jenabi E, Nazari M (2017) Effect of calcium on premenstrual syndrome: A double-blind randomized clinical trial. Obstet Gynecol Sci 60: 100-105.
29. Zarei S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M, Javadzadeh Y, Effati-Daryani F (2017) Effects of Calcium-Vitamin D and Calcium-Alone on Pain Intensity and Menstrual Blood Loss in Women with Primary Dysmenorrhea: A Randomized Controlled Trial. Pain Med 18: 3-13.
30. Arab A, Golpour-Hamedani S, Rafie N (2019) The Association Between Vitamin D and Premenstrual Syndrome: A Systematic Review and Meta-Analysis of Current Literature. J Am Coll Nutr 38: 648-656.
31. Abdollahifard S, Rahmanian Koshkaki A, Moazamiyanfar R (2014) The effects of vitamin B1 on ameliorating the premenstrual syndrome symptoms. Glob J Health Sci 6:144-153.
32. Cooke AG, McCavit TL, Buchanan GR, Powers JM (2017) Iron Deficiency Anemia in Adolescents Who Present with Heavy Menstrual Bleeding. J Pediatr Adolesc Gynecol 30: 247-250.
33. Jurkiewicz-Przondziono J, Lemm M, Kwiatkowska-Pamula A, Ziolko E, Wojtowicz MK (2017) Influence of diet on the risk of developing endometriosis. Ginekol Pol 88: 96-102.
34. Schink M, Konturek PC, Herbert SL, Renner SP, Burghaus S, et al. (2019) Different nutrient intake and prevalence of gastrointestinal comorbidities in women with endometriosis. J Physiol Pharmacol 70 (2).
35. Gaskins AJ, Chavarro JE (2018) Diet and fertility: a review. Am J Obstet Gynecol 218: 379-89.
36. Gaskins AJ, Nassan FL, Chiu YH, Arvizu M, Williams PL, et al. (2019) Dietary patterns and outcomes of assisted reproduction. Am J Obstet Gynecol 220: 567.e1-e18.
37. Lerchbaum E, Rabe T(2014) Vitamin D and female fertility. Curr Opin Obstet Gynecol 26: 145-150.
38. Brzozowska M, Karowicz-Bilinska A (2013) [The role of vitamin D deficiency in the etiology of polycystic ovary syndrome disorders]. Ginekol Pol 84: 456-460.
39. Engel MG, Kern HJ, Brenna JT, Mitmesser SH (2018) Micronutrient Gaps in Three Commercial Weight-Loss Diet Plans. Nutrients 10: 108.
40. Elorinne AL, Alfthan G, Erlund I, Kivimaki H, Paju A, et al. (2016) Food and Nutrient Intake and Nutritional Status of Finnish Vegans and NonVegetarians. PloS one 11: e0148235.
41. Holscher HD (2017) Dietary fiber and prebiotics and the gastrointestinal microbiota. Gut Microbes 8: 172-184. 5.