Wellness Essentials: The Role of Key Nutrients in Women's Health at Every Stage

Nutrition Notes

Wellness Essentials: The Role of Key Nutrients in Women's Health at Every Stage

Women's health and nutritional requirements are dynamically evolving throughout the different life stages. This may be driven by different biological and hormonal factors that occur during the reproductive years (e.g. menstruation, pregnancy, breastfeeding) and menopause. Finding the right balance of essential nutrients at every life stage plays an important role in supporting women’s physical and mental well-being and promoting overall health and longevity.

Adolescence and Reproductive Years

Adolescence and the reproductive years are periods characterized by rapid growth and development, hormonal changes, and building foundations that may increase the need for certain nutrients:

Iron may help address menstrual blood loss and support energy production, cellular and thyroid health, oxygen transport, DNA synthesis, and healthy immune responses. There are two main forms of iron: heme and nonheme. Heme iron has higher bioavailability than nonheme iron. The richest sources of heme iron are animal-based foods, such as lean meat and seafood, whereas nonheme iron sources are plant-based foods, including nuts, beans, and certain vegetables. Research indicates that up to one-third of women of reproductive age in the U.S. do not have enough iron in their bodies, and almost 40% of females aged 12 to 21 are iron deficient. The recommended dietary allowance for iron is 8 mg for females 9 to 13 years old, 15 mg for females 14 to 18 years old, and 18 mg for females 19 to 50 years old. The recommended dietary allowance for vegan or vegetarian women is 1.8 times higher than that for women who eat meat due to the poor bioavailability of nonheme iron. In cases of insufficient dietary intake or heavy blood loss, iron supplementation with a bioavailable form, such as ferrous bisglycinate, may be warranted.
Copper may also play an important role in adolescence and in women’s reproductive health. It is a cofactor for many enzymes supporting antioxidant status, energy production, iron metabolism, nervous system development and brain health, connective tissue synthesis and bone health, red blood cell production and angiogenesis, gene expression, and healthy immune responses. Dietary sources include organ meats, shellfish, dark chocolate, nuts, and seeds.
Calcium is essential for bone development, blood vessel contraction and dilation, muscle function, blood clotting, nerve transmission, and hormonal secretion. The RDA for calcium is 1,300 mg for females 9 to 18 years old and 1,000 mg for women 19 to 50 years old. The average intake of calcium in the U.S. has been estimated at 893 mg/day, which suggests that for some women supplementation may be recommended.
Magnesium may support muscle, bone, and cardiovascular health, normal energy production, nerve function, healthy insulin responses, and normal menstruation. The RDA is 360 mg for females 14 to 18 years old and 310 mg for females 19 to 30 years old, while the average daily intake in the U.S. has been estimated at 296 mg/day.
Vitamin D promotes brain, immune, and arterial health. It also facilitates calcium absorption to support healthy bones. With sun exposure, some of it can be endogenously synthesized in the body. Dietary sources include fatty fish, eggs, organ meats, and some mushrooms. The average daily intake in the U.S. has been estimated at 4.5 mcg/day, while the RDA for teenage and adult women is 15 mcg/day (600 IU/day).

Pregnancy

Pregnancy is a period with heightened nutritional needs, when adequate intake of essential nutrients supports both maternal health and optimal fetal development. The general nutritional guidelines during pregnancy include taking a prenatal vitamin with folate (400 to 600 mcg) starting before conception; eating a balanced diet rich in fruits and vegetables, lean proteins, whole grains, and healthy fats; and staying properly hydrated, while avoiding alcohol and excessive intake of refined sugar and unhealthy fats. Several nutrients are of particular importance during this period:

Folate (vitamin B9) supports normal DNA synthesis, cellular health, protein synthesis, and DNA repair and may reduce the risk of preeclampsia and neural tube defects, such as spina bifida and anencephaly. Methylated forms of folate, such as 5-methyl-tetrahydrofolate, may be superior to folic acid supplementation. 5-MTHF is well-absorbed even when gastrointestinal pH is altered and its bioavailability is not affected by genetic polymorphisms of folate metabolism. Use of 5-MTHF also mitigates the potential adverse effects of unmetabolized folic acid in the peripheral circulation.
Vitamin B2, vitamin B6, and vitamin B12, together with folate, support and maintain healthy methylation and homocysteine metabolism during pregnancy. Inadequate status of any one of these vitamins during pregnancy may lead to hyperhomocysteinemia, which has been associated with an increased risk of miscarriage, preeclampsia, placental abruption, and fetal growth restriction.
Calcium, magnesium, zinc, and choline all play important roles in prenatal health and proper fetal development. Calcium and magnesium support the development of the baby’s bones and teeth, while also maintaining maternal bone health. Choline promotes healthy fetal brain development and zinc is involved in multiple biochemical reactions supporting skin, gastrointestinal, immune, skeletal, reproductive, and brain health.
Chromium is a trace mineral involved in maintaining healthy blood sugar and lipid metabolism, which may be relevant in pregnancy to help mitigate the risk of developing gestational diabetes.
Iodine and selenium support normal thyroid hormone synthesis and conversion. Compromised maternal thyroid function may impact fetal neuropsychological development. Selenium also supports proper detoxification as a major constituent of glutathione enzyme activity and metabolism.
Iron may also be supportive during pregnancy to promote hemoglobin production and oxygen delivery to the baby and mitigate maternal anemia risk. The chelated form (such as ferrous bisglycinate) has higher bioavailability and tolerability — it increases absorption compared to ferrous sulfate due to its higher solubility in aqueous solutions and it has lower interactions with food inhibitors (such as phytates). The RDA for iron during pregnancy is 27 mg, while the average daily intake in the U.S. has been estimated to be about 13 mg/day.

Menstrual-Associated Complaints

Some women in reproductive age may experience premenstrual syndrome driven by hormonal fluctuations that may be accompanied by mood swings, irritability, fatigue, breast tenderness, bloating, or headaches. Certain nutrients and botanicals may help support hormonal balance, healthy estrogen metabolism, and healthy inflammatory responses:

Magnesium may play an important role in supporting those with PMS by promoting healthy mood and mitigating bloating and menstrual cramps by relaxing uterine muscles.
Diindolylmethane, derived from the primary plant indole found in cruciferous vegetables, indole‐3‐carbinol, supports healthy estrogen metabolism and inflammatory responses. By supporting menstrual cycle regularity, DIM may also be clinically relevant in mitigating certain adverse complaints associated with polycystic ovarian syndrome, such as hormonal imbalances, androgen excess, dysmenorrhea, insulin resistance, acne, and hirsutism.
Sulforaphane (e.g. from broccoli seed extract) may help promote healthy detoxification pathways and estrogen metabolism, antioxidant status, and overall cellular health.
Chaste tree extract (Vitex agnus castus) has a long history of use for promoting estrogen and progesterone balance to support PMS, fertility, menopause, PCOS, cystic mastalgia, and healthy inflammatory responses.
Calcium D-glucarate, a salt combining calcium and D-glucaric acid, may also support healthy inflammatory responses. By mitigating beta‐glucuronidase and promoting increased glucuronidation, calcium D-glucarate may support proper detoxification and excretion of potentially toxic compounds, including some estrogens.
Chrysin, an important bioactive flavonoid found in various plant foods, may also support hormonal balance, antioxidant status, and healthy inflammatory responses. It may play a role in estrogen balance by suppressing aromatase (a key enzyme for the conversion of androgen hormones into estrogens) and by competing with steroids that bind to this enzyme.
Black cohosh (Actaea racemosa) has a long history of medicinal use, especially for supporting women with certain PMS and menopausal complaints. Its actions may stem from constituents that support antioxidant status, promote healthy inflammatory responses, and mimic neurotransmitter effects.

Perimenopause and Menopause

As women transition into perimenopause and menopause, hormonal changes may influence bone density, mood, and metabolism, and trigger hot flashes. Nutritional demands may also shift during that time with the need for iron decreasing, while increasing the requirement for calcium, magnesium, omega-3, phytoestrogens, and vitamins D, E, K2, and B12.

Phytoestrogens, such as genistein and lignans, are plant substances that are structurally similar to estradiol, allowing them to bind to the estrogen receptors (ER) transcription factors in the body and modulate their activation. The estrogenic effects of phytoestrogens can be agonistic or antagonistic, depending on the target tissue, the type of ER (ERalpha or ERbeta), and the concentration of endogenous estrogen. During menopause, when estrogen levels fluctuate and eventually decline, phytoestrogens may help to promote estrogen homeostasis.
Vitamin E tocotrienols may support antioxidant status, hormonal health, neuronal health, and cellular health in the breast, ovaries, and uterus, which may promote menopausal comfort and healthy aging in women. They may also help mitigate hot flashes due to their affinity for the ER‑beta, as demonstrated in animal models.
Gammaoryzanol (GO) is a triterpene alcohol ester of ferulic acid extracted from rice bran oil that may help mitigate mild hot flashes and promote overall menopausal comfort. GO may also support healthy lipid metabolism and neurotransmitter health in menopausal women.
Taurine is synthesized endogenously in the body but additional supplementation may help promote menopausal comfort and support antioxidant status and metabolic, cardiovascular, cognitive, and cellular health.