These 7 Nutrients are Vital for Women Over 40
Here are 7 nutrients — and their food sources — that become even more important as women age.
Every woman over 40 benefits from understanding and meeting her unique nutrition needs.
That’s because nutrient needs change at midlife. That’s right, due to aging and hormonal shifts, women need to ensure their intake of key nutrients.
But before we get into all the details, let’s consider why we need to focus on nutrients as we get older.
The Triage Theory of Aging
Bruce Ames, from the Nutrition and Metabolism Center, Children’s Hospital Oakland Research Institute (CHORI), developed the “triage theory” of aging. His theory suggests that even modest vitamin and mineral shortfalls accelerate the aging process.
That’s because bodies respond to vitamin and mineral shortages by turning on proteins and enzymes that are essential for survival.
On the flip side, this turns off the proteins and enzymes needed for long-term health (preventing damage, etc.).
In this 2018 review Bruce Ames puts it this way:
A major aspect of degenerative aging is that the damage is insidious and clinically not obvious because it accumulates slowly over time and is apparent only later in life. The connection to V/M (vitamins and minerals) shortages is underappreciated.
Midlife is the ideal time to invest in nutrition, so as you get older, you have the reserves you need to support long-term health.
And for midlife women, these 7 nutrients are vitally important.
1. Nitrates = Nitric Oxide
Foods like spinach, kale, arugula, lettuce, and swiss chard contain high levels of nitrates. Although nitrates aren’t official nutrients (yet), they are vitally important as we age.
That’s because nitrates help generate nitric oxide, a vital signaling molecule responsible for vasodilation, increasing blood flow, and maintaining vascular function.
Most of the nitric oxide in our bodies comes from one of two ways. The first is via the cells that line blood vessels (endothelium) by a reaction combining L-arginine with the enzyme nitric oxide synthase (NOS). I’ll refer to this as “eNOS derived NO.”
The second way is by eating inorganic nitrate in leafy greens through the “nitrate-nitrite-nitric oxide” pathway. First, bacteria in the month reduce nitrate to the active form nitrite. Swallowing nitrite, and with help from stomach acid, the body produces nitric oxide.
For this process to work, you need nitrate-reducing bacteria in the mouth and stomach acid. So, avoid regular use of mouthwash because it kills bacteria and antacids decrease stomach acid.
What makes matters worse is when women go through menopause, they experience even lower levels of eNOS derived NO because estrogen and progesterone stimulate nitric oxide formation. Aging also decreases eNOS derived nitric oxide. It’s a double whammy!
A study with postmenopausal women had one group eating two high-nitrate salads per day for 10 days and another group consuming low-nitrate canned vegetables. Not only did women in the first group have higher nitrate concentrations, but they also had higher flow-mediated dilation (FMD), showing increased blood flow.
“What’s interesting about nitric oxide is you can produce it endogenously, which means your body will make it, with estrogen triggering it,” said Johston the lead researcher, in a press release. “But you can also provide your body with dietary nitrates that convert to nitric oxide, and leafy greens are full of nitrates.”
Bottom line: as we age, we benefit from eating greens that can generate nitric oxide and are have other established health benefits. Add arugula to any meal, spinach on sandwiches, and make tasty salads. Greens are an excellent source, but so are root vegetables like beets and celery.
Most days, I make a midlife power salad that includes many foods in this post.
2. Selenium
Selenium is a potent antioxidant through the formation of selenoproteins but it’s also vital for thyroid function. And because thyroid issues peak in women past 40, women should watch their selenium intake.
Research is unravelling the role selenium plays in thyroid health. In a study published in the Journal of Clinical Endocrinology, the risk of thyroid dysfunction was 69% higher in people living in a low-selenium county compared to those who lived in a selenium-sufficient area.
Even if you aren’t hypothyroid, having TSH levels in the high normal range has been associated with an increased risk of heart disease and metabolic syndrome, and reduced bone mineral density.
Selenium also plays a role in the prevention of cancer, boosting the immune system, and lessening anxiety and depression. The RDA is 55mcg although some studies show 100mcg may be optimal. We need more research to know for sure.
There is a narrow range for optimal intake of selenium, meaning taking too little or too much may have adverse effects. Blood levels between 90–120mcg/L are optimal and 85 or less are inadequate.
Because a variety of food contains selenium, getting it from the diet is a realistic goal, and food sources, RDA, and upper tolerable intake are listed below.
3. Vitamin E
Vitamin E is a fat-soluble antioxidant that helps tame free radicals that increase with age. Vitamin E also boosts immune function and helps regulate gene expression. According to one review, people who get more vitamin E from the diet are at a lower risk of getting lung cancer.
Vitamin E is also good for your heart. Getting more than 7mg/day can decrease death from heart disease by 35% according to two studies.
An ounce of sunflower seeds provides 7.4mg vitamin E, getting women to half of the recommended amount of 15mg. This is important because over 90% of Americans fall short on vitamin E.
Vegetable oils like sunflower and canola oil and nuts like almonds, hazelnuts, and peanuts/peanut butter are significant sources. I love adding sunflower seeds to my salads and eating nuts for a snack. See the chart below for more ideas.
What about supplements? In clinical trials, vitamin E supplements have been disappointing, and most benefits come from diets rich in vitamin E. Taking a multivitamin containing vitamin E and adding food sources make the most sense unless otherwise directed by a healthcare professional.
4. Magnesium
Magnesium is an abundant mineral involved in over 300 enzymatic reactions. It helps regulate protein synthesis, nerve and muscle function, blood pressure, and blood sugar.
Magnesium is necessary for energy production and aids in the in the structure of bone and helps convert vitamin D to its active form.
In a 2018 piece in Open Heart led by Dr. James DiNicolantonio from the Department of Preventative Cardiology, Saint Luke’s Mid America Heart Institute, the authors argue that magnesium deficiency is a key driver in heart disease:
The evidence in the literature suggests that subclinical magnesium deficiency is rampant and one of the leading causes of chronic diseases including cardiovascular disease and early mortality around the globe and should be considered a public health crisis.
Poor magnesium intake may also affect mood. One study using the 2007–2014 National Health and Nutrition Examination Survey data found that women with the lowest intake of magnesium were more vulnerable to depression. And there’s some evidence magnesium supplementation improves depressive symptoms and sleep, although we need more research.
Roughly half of adults aren’t getting the recommended amount of magnesium, which is 320mg for midlife women. One study with postmenopausal women showed 399mg of magnesium helped maintain positive magnesium balance while 100mg did not. We need more studies to know for sure.
Magnesium-rich foods include Brazil nuts, almonds, cereal, avocados, and chickpeas are good sources, as you can see below.
5. Iodine
Iodine intake has decreased by 50% between 1970 and 2000. Whether it’s due to the decrease in iodized salt, dairy products, or seafood, it’s a watch out for midlife women.
That’s because estrogen helps stimulate the uptake of iodine, which may be why thyroid issues peak after 40. So, a woman can be doing fine with the amount of iodine she gets, and then her hormones change, and Bam! She’s got some issues.
The body needs iodine to make thyroid hormone, but it also is important for heart and breast health. In fact, one study argues that the increase in breast cancer with distance involvement in younger women may be related to the reduction in iodine intake. And studies suggest people with lower urinary iodine are at increased risk of heart disease.
I found an interesting study showing that iodine status correlates with symptoms of perimenopause and menopause. I have a sneaking suspicion that iodine needs increase in women as we age, but we need more studies.
Iodine is controversial because a small portion of the population has trouble with it, meaning it can negatively affect the thyroid. Yet if you don’t get enough iodine, this can also cause thyroid issues. Confused yet?
Research is giving us clues on why iodine can help or cause thyroid problems. For example, having adequate selenium status may decrease the negative effect of iodine on the thyroid. Iron also plays a key role in thyroid health, so ensuring enough of these key nutrients — not just iodine — is important.
Read: Ferritin: The Blood Test Women Should Get at Every Doctor’s Visit
Dried seaweed is one of the best sources of iodine. Kelp contains very high levels of iodine, but Nori seaweed, which is most often used at Sushi places in the US, contains 232 mcg per 10g serving. That’s more than 100% of the RDA of 150mcg.
Women over 40 should ensure they at least get the RDA of 150mcg and no more than the tolerable upper intake of 1000mcg.
6. Omega-3 Fatty Acids
As we get older, omega-3 fatty acids (DHA and EPA) play a key role in a woman’s brain health. That’s because brain volume declines with age, and DHA levels decline as well.
For women, menopause exacerbates this, as estrogen enhances the conversion of alpha-linoleic acid (ALA) to EPA. After menopause, a woman’s risk for cognitive decline increases as estrogen receptors are found on the hippocampus, the part of the brain responsible for memory.
Even though our brains change with age and hormonal shifts, there’s so much we can do to boost brain health and DHA and EPA are part of that.
In the Framingham cohort, people in the top quartile for DHA experienced a 47% lower risk of dementia. And according to a study in Neurology, post-menopausal women with a higher omega-3 index had larger brain volume and hippocampal volume than those with lower omega-3 index. This difference in brain volume equated to about 2 years of brain aging.
According to a 2021 review in Aging Research Reviews, “The greatest bulk of evidence indicates that greater hippocampal volume is associated with higher levels of omega-3.” Overall, the evidence is still considered insufficient, and recommendations are lacking.
The bottom line: Eating fatty fish like salmon and other sources helps increase omega-3 index, which may positively affect brain health.
7. Choline
Choline is a nutrient most people don’t think about because the US declared it a nutrient not that long ago (1998). The recommended amount in adult women is 425mg/day and for men, 550mg.
Seventy-five percent of Americans consume inadequate choline. In a 14-year prospective study, middle-aged women on average consumed only 294mg of choline daily.
Choline helps make acetylcholine, a neurotransmitter involved in mood, memory, and muscle control. It also helps to build cell membranes and regulate gene expression. And estrogen also helps to stimulate acetylcholine, putting menopausal women at greater risk.
In the Framingham Cohort, they linked high choline intake to better cognitive performance and smaller white matter hyperintensities volume (WMHV), which is neuroprotective.
Research suggests adequate choline intake helps maintain the bioavailability of DHA. Without choline, the DHA we get through diets or supplements may not be as effective. That’s because phosphatidylcholine (PC), phospholipids that utilize choline, helps transport DHA throughout the body.
Eggs are an excellent source of choline, but so are soybeans, beef, and salmon as you can see below.
Nutrients Midlife Women Need
As midlife approaches, women need to be aware of their nutritional status because their bodies are changing.
Of course, it takes decades to see the effects of less-than-optimal vitamin and mineral intake. But by investing now, women over 40 can feel good that they are doing what they can to increase their health and quality of life.
What is your biggest midlife nutrition concern?
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Originally published at https://maryannjacobsen.com on November 23, 2021 and adapted for Medium.
