Women face unique health challenges, especially when managing chronic conditions such as diabetes and celiac disease. Proper nutrition is crucial in managing these conditions, ensuring overall health, and preventing complications. This article explores essential nutritional tips for women with specific conditions, focusing on diabetes and celiac disease.
Diabetes Management Through Nutrition
A healthful eating pattern is one of the key components of diabetes management. For many individuals with diabetes, the most challenging part of the treatment plan is determining what to eat. It is the position of the American Diabetes Association (ADA) that there is no “one-size-fits-all” eating pattern for women with diabetes. The ADA also recognizes the integral role of nutrition therapy in overall diabetes management. It has historically recommended that each person with diabetes be actively engaged in self-management, education, and treatment planning with his or her healthcare provider, which includes the collaborative development of an individualized eating plan. Therefore, all healthcare team members must be knowledgeable about diabetes nutrition therapy and support its implementation. (Evert, A. B. et al., 2014)
Diabetes, characterized by high blood glucose levels, requires careful dietary management to maintain optimal blood sugar control and prevent complications. Women with diabetes, particularly type 2 diabetes, must be vigilant about their carbohydrate intake, meal timing, and overall nutritional balance. (Evert, A. B. et al., 2019), (Franz, M. J. 2016).
Carbohydrate Counting and Glycemic Index (GI) Awareness
Nutrition science dictates that carbohydrates are elements of a healthy diet. However, over the last decade, carbohydrates have been scrutinized by media and consumers as having the potential to negatively affect human health. The negative perceptions around dietary carbohydrates stem from multiple factors, which include a lack of understanding of the role carbohydrates play in a healthy diet, and the transfer of misinformation from scientifically unsubstantiated sources. For example, consumers have increasingly antagonistic feelings toward dietary carbohydrates as a cause of weight gain. Therefore, it is reasonable that the development of a credible and science-based communication tool could assist consumers in identifying foods of higher carbohydrate quality and provide assurances about the role of carbohydrates as part of a healthy dietary pattern. The glycemic index (GI) is such a tool that could be positioned as a consumer-facing symbol of carbohydrate quality.
Carbohydrate counting is a cornerstone of diabetes management. It involves tracking the number of carbohydrates consumed per meal to better manage blood glucose levels. The Glycemic Index (GI) of foods, which ranks carbohydrates based on their effect on blood sugar levels, is equally important. Low-GI foods (e.g., whole grains, legumes) cause slower, more stable increases in blood sugar, making them preferable for women with diabetes. (Marinangeli, C. P. et al., 2019)
Fiber-Rich Diet
Dietary fiber, particularly soluble fiber found in foods like oats, barley, and fruits, plays a significant role in blood sugar control. Fiber slows the absorption of sugar, leading to more stable blood glucose levels. Women with diabetes should aim for a minimum of 25 grams of fiber daily.
Low fiber intake is a major public health concern. Inadequate fiber intake is associated with an increased risk of weight gain and obesity, chronic disease, and premature aging and mortality.
Health effects associated with adequate fiber intake include slowing the eating process and reducing food metabolizable energy for better body weight regulation, stimulating laxation and healthy colonic microbiota including, attenuating elevated blood lipids and blood pressure for cardiometabolic health, and increasing insulin sensitivity and lowering systemic inflammation to reduce diabetes, colorectal cancer and premature aging risk (inflammaging).
Fiber-rich whole (or minimally processed) plant foods and healthy dietary patterns are generally lower in energy density, saturated and trans-fatty acids, sodium, and sugar and higher in essential nutrients and phytochemicals necessary to support optimal health and weight control compared to the usual low fiber Western diets.
The intake of fiber-rich foods during pregnancy also has several health benefits to the pregnant woman including lowering the risks of diabetes, preeclampsia, and constipation. (Dreher, M. L., & Dreher, M. L. 2018), (Zerfu, T. A., & Mekuria, A. 2019)
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Nutritional Management for Celiac Disease
Celiac disease (CD) is an autoimmune enteropathy, triggered by the consumption of gluten proteins in genetically prone individuals of all ages. Because nutrition is the most important effector of autoimmunity in susceptible patients, medical nutrition therapy (MNT) characterized by a lifelong adherence to a gluten-free diet (GFD) consists of the only effective treatment of CD. An early initiation and strict adherence to GFD does not only reverse villus atrophy triggered by exposure to gluten, but may also avert CD-related comorbidities, including osteoporosis, malignancies, and infertility, while simultaneously improving patients’ quality of life. For women with celiac disease, adhering to a gluten-free diet is the only effective treatment. (Theodoridis, X. et al., 2019)
Ensuring Nutritional Adequacy
A gluten-free diet can sometimes lead to nutritional deficiencies, particularly in fiber, iron, calcium, and B vitamins, which are commonly found in gluten-containing foods. Women with celiac disease should focus on naturally gluten-free, nutrient-dense foods like fruits, vegetables, lean proteins, and gluten-free whole grains. (Theodoridis, X. et al., 2019)
Nutrition for Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is the most common endocrine system disorder in women of reproductive age, which appears as a set of symptoms and disorders with mild to severe protests in the functioning of reproductive, hormonal, and metabolic systems.
This syndrome is characterized by irregular menstruation, polycystic ovaries and hyperandrogenism, insulin resistance, and obesity that is observed in 5–20 percent of women depending on the diagnostic criteria used.
Symptoms of this syndrome include the endocrine system and reproductive signs which occur in the shape of amenorrhea or oligomenorrhea, hirsutism, obesity, acne, male pattern hair loss, and reproductive disorders. This syndrome also increases the risk of diseases like type 2 diabetes, hypertension, lipid disorders, cardiovascular diseases, and malignancies, such as breast and endometrial cancer. (Faghfoori, Z. et al., 2017), (Szczuko, M. et al., 2016)
- Low-Glycemic Index Diet: A low-GI diet can help regulate blood sugar levels and improve insulin sensitivity in women with PCOS. Foods like whole grains, legumes, and non-starchy vegetables should be prioritized.
- Omega-3 Fatty Acids: Omega-3 fatty acids, found in fatty fish like salmon and flaxseeds, can help reduce inflammation and improve lipid profiles in women with PCOS.
- Regular, Balanced Meals: Similar to diabetes management, women with PCOS benefit from regular, balanced meals that include a mix of carbohydrates, protein, and healthy fats to stabilize blood sugar levels.
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Nutrition for Osteoporosis Prevention
Osteoporosis, a condition characterized by weak and brittle bones, is particularly common in postmenopausal women. Proper nutrition is critical for maintaining bone health and preventing fractures. Osteoporosis is a silent but progressive disease affecting the density and quality of bone while greatly increasing fracture risk. Globally, around one in three women are at risk of an osteoporotic fracture, with the most common fractures being at the hip, spine, or wrist. The pathogenesis of osteoporosis is multi-faceted, consisting of intricate interplay between physiological processes, including hormonal status, along with genetic and environmental factors. That said, the condition is regarded as being partly preventable using suitable nutrition and adequate mechanical influences (physical activity). (Higgs, J. et al., 2017)
The consumption of milk and dairy products reduces the risk of osteoporosis, a meta-analysis study confirmed that dairy consumption is not associated with the prevention of osteoporosis and fractures. However, protein and vitamin D supplementation in older people seems to prevent osteoporosis and fractures by increasing bone density.
Although the importance of proper nutrition in older women has long been recognized, research evaluating the effects of dietary habits on muscle and bone mass is relatively recent. As age increases, there is a decline in energy intake, which can reach as high as 16–20% in elder women >65 years. Dietary patterns such as the Mediterranean diet, i.e., rich in vegetables, fruits, fish, and good fats, enhance muscle strength and functionality. (Papadopoulou, S. K. et al., 2021)
- Calcium and Vitamin D: Adequate calcium and vitamin D intake is essential for bone health. Women should aim for 1,200 mg of calcium and 600-800 IU of vitamin D daily, through diet or supplements if necessary.
- Protein: Protein plays a vital role in maintaining bone density. Women should ensure they are consuming enough protein from sources like lean meats, dairy, and plant-based proteins.
- Limit Caffeine and Sodium: High caffeine and sodium intake can lead to increased calcium excretion, negatively impacting bone health. Women should moderate their intake of caffeinated beverages and processed foods.
Conclusion
Nutrition plays a vital role in managing chronic health conditions in women, such as diabetes, celiac disease, PCOS, osteoporosis, and cardiovascular disease. Tailored dietary strategies, including carbohydrate counting, gluten avoidance, and balanced nutrient intake, can significantly improve health outcomes. Women can enhance their well-being by focusing on meal planning, label reading, and seeking professional guidance. Staying informed and adopting mindful eating practices further empower women to manage their conditions effectively, leading to improved quality of life and reduced risk of complications. Proper nutrition is a powerful tool for long-term health and vitality.
References
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Evert, A. B., Dennison, M., Gardner, C. D., Garvey, W. T., Lau, K. H. K., MacLeod, J., ... & Yancy Jr, W. S. (2019). Nutrition therapy for adults with diabetes or prediabetes: a consensus report. Diabetes care, 42(5), 731.
Franz, M. J. (2016). Diabetes nutrition therapy: effectiveness, macronutrients, eating patterns and weight management. The American journal of the medical sciences, 351(4), 374-379.
Marinangeli, C. P., Castellano, J., Torrance, P., Lewis, J., Gall Casey, C., Tanuta, J., ... & Sievenpiper, J. L. (2019). Positioning the value of dietary carbohydrate, carbohydrate quality, glycemic index, and gi labelling to the canadian consumer for improving dietary patterns. Nutrients, 11(2), 457.
Dreher, M. L., & Dreher, M. L. (2018). Overview of the health benefits of adequate fiber intake. Dietary fiber in health and disease, 19-40.
Zerfu, T. A., & Mekuria, A. (2019). Pregnant women have inadequate fiber intake while consuming fiberârich diets in lowâincome rural setting: Evidences from Analysis of common “readyâtoâeat” stable foods. Food Science & Nutrition, 7(10), 3286-3292.
Theodoridis, X., Grammatikopoulou, M. G., Petalidou, A., Patelida, M., Gkiouras, K., Klonizakis, M., ... & Bogdanos, D. P. (2019). Dietary management of celiac disease: revisiting the guidelines. Nutrition, 66, 70-77.
Faghfoori, Z., Fazelian, S., Shadnoush, M., & Goodarzi, R. (2017). Nutritional management in women with polycystic ovary syndrome: A review study. Diabetes & metabolic syndrome: Clinical research & reviews, 11, S429-S432.
Szczuko, M., Skowronek, M., Zapalowska-Chwyc, M., & Starczewski, A. (2016). Quantitative assessment of nutrition in patients with polycystic ovary syndrome (PCOS). Roczniki paĆstwowego zakĆadu higieny, 67(4).
Higgs, J., Derbyshire, E., & Styles, K. (2017). Nutrition and osteoporosis prevention for the orthopaedic surgeon: A wholefoods approach. EFORT open reviews, 2(6), 300-308.
Papadopoulou, S. K., Papadimitriou, K., Voulgaridou, G., Georgaki, E., Tsotidou, E., Zantidou, O., & Papandreou, D. (2021). Exercise and nutrition impact on osteoporosis and sarcopenia—the incidence of osteosarcopenia: a narrative review. Nutrients, 13(12), 4499.
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