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Preconception and menopause: Two transitional periods in women’s health

As we begin and move through life, there are clear transitional periods where our nutritional needs shift. The rapid growth of infancy and early childhood is one, adolescence and puberty is another. For women, those transitions also include pregnancy (including the time before conception) and menopause. In honor of Women’s Health Month, let’s look at the latter two.

It’s estimated that 50% of pregnancies are unplanned, and that includes women who are not actively preventing pregnancy but also not actively trying to conceive. Nutritionally, this isn’t ideal, because many women don’t know they’re pregnant until well into the first trimester, and it’s important for women to get adequate folic acid — the synthetic version of folate, a B vitamin found in dark green leafy vegetables, beans, whole grains and other foods — very early in pregnancy to help prevent birth defects, including neural tube defects. This process wraps up around day 21 of pregnancy, again, before most women know they are pregnant. Iodine, choline and vitamin B12 are also important.

Entering pregnancy with adequate iron levels is essential, as needs almost double during pregnancy (to 27 mg a day) in order to support rapidly expanding blood volume and tissue growth. Entering pregnancy with low iron will make it very difficult to get caught up, which can lead to iron-deficiency anemia — the most common nutrition-related complication of pregnancy — which increases the risk of preterm birth.

While getting folic acid, iron and often other nutrients in the form of dietary supplements is important, in addition to eating foods rich in those nutrients, it’s important to know that there’s little standardization in prenatal supplements, and more expensive supplements aren’t necessarily better quality.

If you are a woman who plans to have children, assess your nutrition status with your dietitian or doctor three to six months before trying to conceive so they can make personalized recommendations. In fact, any woman of reproductive age who plans to start a family someday — even if it’s a long way off — could benefit from talking to a knowledgeable health care provider about optimizing nutrition for fertility and preconception.

Now, flashing forward to when women’s potential reproductive years wrap up, the hormone shifts of menopause increase the risk of developing certain chronic health conditions, such as heart disease and osteoporosis.

Getting adequate protein is also important to protect bones and prevent muscle loss which can also accelerate around menopause. Current evidence recommends 1-1.2 grams of protein per kilogram of body weight for older adults. (For easier math, divide weight in pounds in half to hit the midpoint of the range, in this case, 100 grams of protein for a 200-pound woman.) Women should also include food sources of calcium, vitamin K and magnesium. After menopause or age 50, women need 1,200 milligrams of calcium from food and/or supplements each day. Food sources include dairy foods, canned salmon and sardines with bones, dark leafy greens and fortified foods and beverages. Depending on your vitamin D levels, you may need to add more from supplements, fortified foods or fatty fish.

For heart health, protect yourself by building a diet rich in vegetables and fruit, protein that comes at least partly from plants (soy, beans and lentils) and seafood, healthy fats (nuts, seeds, olive oil, avocados and fatty fish), and lower-fat milk, yogurt and other dairy. Keep alcohol intake moderate and intake of added sugar and salt low.

Source: The Seattle Times