What happened? I got older and discovered that my nutritional needs had changed (along with a few other things). And I’m wiser too, thanks to research that says that even the healthiest foods packed with vitamins, minerals, and phytochemicals might not be enough to deal with our busy schedules, personal health conditions, or the brand-new engagement ring we want to show off. So now, as I evaluate women’s diets, I find myself discussing their lifestyles and talking about the vitamins and minerals that come in the little brown bottles as well as the ones in food. Here’s some of the advice I’m doling out these days for women’s particular lifestyle needs. Problem: You love a hard workout at the gym, but it’s getting harder and harder. You’re eating well, losing weight, and working out like a champ. But your body feels so tired. “When women say they’re needlessly tired, I start looking at their iron intake,” says Nancy Clark, RD, author of Nancy Clark’s Sports Nutrition Guidebook. A diet with some lean red meat, chicken thighs, or iron-fortified energy bars or cereals, she says, usually pumps enough iron to deliver oxygen to exercising muscles and helps prevent unusual fatigue. But calorie cutting, heavy menstrual periods, vegetarian diets, or just nixing top iron sources such as red meat can leave you too pooped to participate. So have your doctor test hemoglobin, hematocrit, and serum ferritin, the storage form of iron. (Just be sure to buy grass-fed meat. Conventional is a lot dirtier than we once thought.) “Low storage iron impacts performance, even if you’re not anemic,” says Clark. A dietitian can recommend improvements, and your doctor may suggest a multivitamin with iron or even a higher-dose iron supplement to put that spring back into your step. Vegetarian? Plant sources of iron are poorly absorbed, so you’ll need to double your iron intake. Boost absorption by adding high-vitamin C foods such as broccoli, oranges, strawberries, or spinach to your meals. Have coffee or tea, which can interfere with iron absorption, only between meals. (Which tea is healthiest? The answer,here.) What you may need: Iron Usual dose: RDA for women ages 31 to 50, 18 mg/day; ages 51+, 8 mg/day; pregnant women, 27 mg/day; vegetarian women, 33 mg/day Tolerable upper limit: 45 mg/day from food and supplements unless prescribed by a doctor Food sources: Lean meat, poultry, fish, legumes, nuts and seeds, whole grains, dark molasses, fortified cereals such as Total or Cream of Wheat Best supplement: Daily multivitamin [pagebreak]
Pain That Won’t Quit
Problem: You get migraine headaches. You hurt, and want help. Amazing breakthroughs in prescription remedies have tamed migraines for millions of women, but if you’re not getting all the help you need, talk to your doctor about megadoses of riboflavin (vitamin B2). At the New England Center for Headache in Stamford, CT, patients who take 400 mg/day have a 50% decrease in either the frequency, duration, and/or severity of migraines, according to center director and neurologist Stewart Tepper, MD. Rewards come only if you’re patient and stick it out. “It takes 3 to 4 months of steady use to get results,” Dr. Tepper says. (Not sure why your head even hurts? Check out 7 Weird New Headache Causes.) What you may need: Vitamin B2 (Riboflavin) Usual dose: RDA for women ages 19+, 1.1 mg/day Tolerable upper limit: Unknown due to limited studies. Doses up to 400 mg/day for 3 months reported no side effects, but be careful because research is limited. Food sources: Milk and milk drinks, bread products, and fortified cereals, but the amounts are not great enough to get results. Best supplement: 400 mg/day over-the-counter or as recommended by your headache doctor
You Have a New Engagement Ring to Show Off
Problem: Your nails crack, peel, break, and split. Two carats or not, you’re not showing anybody those hands! Before adding insult to injury with acrylic or glue-on nails, ask your dermatologist about supplements of the B vitamin biotin. “About two-thirds of patients see improvement after about 3 months,” says Richard K. Scher, MD, a nail specialist and professor of clinical dermatology at Columbia University. Dr. Scher notes that, although you can buy biotin supplements over-the-counter in the same research megadoses he now recommends to his patients, caution is in order, since there have been no long-term placebo-controlled studies for possible side effects. Once you get your doctor’s okay, you can use it for about 3 months, then check back to evaluate results. “You can’t just go on at that dose indefinitely,” he says. If the treatment is successful, he often reduces the daily amount. If there is no improvement, he has patients stop the treatment. (Got the OK from doc? Paint on these three fortifying nail polishes.) What you may need: Biotin Usual dose for adults: 30 mcg/day Tolerable upper limit: Unknown Food sources: Small amounts are widespread in foods. Most concentrated sources include liver, kidney, egg yolk, soy flour, cereals, and yeast. Best supplement: 300 mcg/day over-the-counter or as recommended by your dermatologist More from Prevention: 7 Things Your Nails Say About Your Health [pagebreak]
D-Prived?
Problem: You’re sun-shy and living in a fluorescent world. Since you’ve ruled out the vampire thing, you may be risking soft bones. Imagine my surprise when I counted my daily moments in the winter sun and came up with zero! I rose at 5 am to run in the dark, drove to work, parked in a covered garage, worked inside all day long, then drove home as night was setting in. Why did I worry? I was pouring on the calcium, but without the sun’s vitamin D, my bones could go soft. Dietitian, heal thyself! Normally, sun hits our skin and creates one form of vitamin D that must be absorbed by the intestines, then worked over by the liver to create the kind our bones can actually use. Mess with any step, and we end up D-ficient. And without enough D, calcium heads for the sewer instead of our bones. Worse, the winter sun is weak, especially north of Omaha, and the sunscreen in makeup cancels even that out. Getting older means skin, gut, and liver all work less well, so vitamin D is often inadequate. Now here’s the good news: Supplements work great! That’s why the Institute of Medicine recommends a daily supplement for women over 50. But don’t overdo it. High doses can be toxic. (Find out the best type and dose of vitamin D.) What you may need: Vitamin D Usual dose: Ages 19 to 50, 200 IU/day; 51 to 70, 400 IU/day; over 70, 600 IU/day Tolerable upper limit: 2,000 IU/day Food sources: Pretty rare—fortified milk, fatty fish, cod liver oil Best supplements: Daily multivitamin with 400 IU vitamin D. After age 70, add another 400-IU individual supplement every other day. [pagebreak]
Asthma Leaves You Breathless
Problem: You depend on a steroid to clear your airways, which leaves you susceptible to weak bones. As a woman with asthma, you’re part of a rapidly growing crowd. Prevalence of this breathtaking disease among women skyrocketed by 97% from 1982 to 1996, compared with only a 22% increase among men. Among its most effective treatments: steroids, by mouth, injection, or inhaler. But they have a downside. High doses can cause cataracts and bone loss leading to osteoporosis. More from Prevention: Ashtma Control 101 “To protect bones, try to keep steroid doses below 800 mcg/day,” says Linda B. Ford, MD, medical director of the Asthma & Allergy Center in Papillion, NE. Then add weight bearing exercise three times a week. Strength training helps too. And pour on the calcium (1,500 mg/day for postmenopausal women, 1,000 mg/day for younger women) and vitamin D. “Calcium from food is the best absorbed, but calcium carbonate supplements such as Tums are easily absorbed too,” she adds. Three servings of dairy food plus two Tums E-X would get you to 1,500 mg. The DEXA bone test is a must to monitor bone density. If too much bone is lost, your doctor may need to add prescription Fosamax to rebuild bone. What you may need: Calcium and Vitamin D Calcium Usual dose: Ages 31 to 50, 1,000 mg/day; 51+, 1,500 mg/day Tolerable upper limit: 2,500 mg/day Food sources: Low-fat or fat-free milk, cheese, yogurt Best supplements: Calcium carbonate or calcium citrate in doses of 500 mg or less Vitamin D Usual dose: Ages 19 to 50, 200 IU/day; 51 to 70, 400 IU/day; over 70, 600 IU/day Tolerable upper limit: 2,000 IU/day Food sources: Pretty rare—fortified milk, fatty fish, cod liver oil Best supplements: Daily multivitamin with 400 IU vitamin D. After age 70, add another 400-IU individual supplement every other day. More from Prevention: Your Break-Proof Bone Plan [pagebreak]
Are You An Oenophile?
Problem: You think no dinner is complete without a glass of fine wine. But alcohol raises colon and breast cancer risks. A glass of red wine has so many pluses: It helps you relax, enhances the flavor of food, and even boosts your good HDL cholesterol. The drawback for women is that alcohol in any amount, even one drink a day, raises your breast and colon cancer risks, possibly because it limits your absorption of the B vitamin folate. (The synthetic form is folic acid.) (Do you drink too much? Six sneaky signs you do.) But research says that women who regularly drink alcohol but get more folate have cancer risks similar to the risks of nondrinkers. So do yourself a favor, and take your folic acid-laced multivitamin every day. It can also help fend off birth defects for younger women and control blood homocysteine to lower risk of heart disease. Limit your drinks to one a day. Heavier drinking can boost your chance of having a stroke or heart attack. (Not to mention an extra glass of vino is one of the nine habits that make seasonal allergies worse.) What you may need: Folate/Folic Acid Usual dose: RDA for adults 19 to 70 years, 400 mcg food folate/day. Women who could become pregnant need an additional 400 mcg folic acid/day. Tolerable upper limit: 1,000 mcg folic acid from supplements or fortified foods per day Food sources: Fortified cereals, breads, and pastas, dark green vegetables, liver, legumes, oranges, peanuts, sunflower seeds, whole grains Best supplement: Daily multivitamin containing 400 mcg folic acid, which is the kind that’s best absorbed. More from Prevention: 100 Best Supplements For Women
