Women’s Nutrition Q & A

Thought I’d share a Q & A I recently put together for the upcoming issue of OASIS magazine about some common nutrition questions for women.  Enjoy!

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nutrition-for-womenIn honor of International Women’s Day on March 8th, I thought I’d use this month’s column to address some female-centric nutrition questions.

Does Soy Cause Breast Cancer?

The link between soy and breast cancer stems from the fact that some breast cancers are estrogen-sensitive.  Soy is rich in isoflavones, a class of compounds which are chemically similar to estrogen and actually have the ability to mimic estrogen’s action within the body.

The good news for soy lovers is that it doesn’t appear that a diet high in soy products increases the risk for developing breast cancer.  In fact, a recent study out of China showed that women with high soy intakes actually had lower rates of breast cancer.

That said, a potential area of concern may be soy protein supplements.  It was recently shown that a protein in soy called genistein may accelerate the growth of human breast cancer cells in vitro.   However it’s important to note that this has yet to be demonstrated at the population level.

Bottom line: If you enjoy soy as a regular part of your diet you can continue to do so, but speak with your doctor before you begin taking soy protein supplements to determine if the benefits outweigh the risks.

How Important Is Dietary Calcium After Menopause?

Fairly important.  After menopause women produce significantly less estrogen than they used to.  One of estrogen’s many functions is to help to maintain bone density (men actually have the same issue too with testosterone, but the decline in testosterone production occurs more gradually and at a later age).  Making sure you get enough calcium in your diet helps to minimize the amount of bone that you lose, decreasing your risk of developing osteoporosis.

The daily recommended amounts of calcium for women (>51 years) is 1200mg/day.  Some common calcium-rich foods include cow’s milk (1cup – 300mg), yogurt (3/4cup – 300mg), cooked spinach (½cup – 140mg), canned salmon with bones (2.5oz – 200mg), tahini (2 tbsp – 130mg) and semi-hard cheeses including cheddar and gouda (1.5oz – 300mg).  If you’re not eating many of these foods, a supplement may be warranted, however you should not exceed 2000mg/day from all sources.  Supplements should also contain vitamin D, which enhances calcium absorption.

Bottom line: After menopause it is especially important to consume adequate amounts of calcium in your diet to prevent bone loss.

 When You’re Pregnant Are You Really “Eating for Two”?

It’s actually more like eating for one plus a little bit extra.  During the 2nd and 3rd trimesters of pregnancy women should only be consuming an additional 300 calories/day.  The appropriate amount of weight gain during pregnancy is something to be discussed with your doctor, but generally speaking women who start their pregnancy at a healthy weight should gain on average 11-16kg over the course of their pregnancy.  Women who are underweight should aim for the high end of this range, whereas women who are overweight should aim for the low end.  Gaining much more than the recommended amount could put you at risk for certain pregnancy problems including gestational diabetes, high blood pressure, preeclampsia, pre-term birth and caesarian sections.  Also, babies born to overweight mothers are also at higher risk of childhood obesity.

Bottom Line: Yes, calorie requirements during the 2nd & 3rd trimesters are a little higher than normal, but it’s important not to go overboard by gaining an unhealthy amount of weight during pregnancy.

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Dietitians of Canada calls for “soda-tax”

sugary-drinks-soda-obesityEarlier this week Dietitians of Canada (DC) put out a press release calling for a 10-20% tax on sugar-sweetened beverages.  For those of you who complain that this would just be another example of the government sticking it’s nose where it doesn’t belong, here is my counterargument.

We eat too much sugar

The World Health Organization recommends that free sugars should not make up more than 10% of a person’s daily caloric intake.  As mentioned in the DC press release, Canadians are exceeding this by a fair margin (~15%).  Diets high in free sugars put individuals at risk for overweight and obesity, as well as dental caries. Given the fact that roughly 66% of Canadians are overweight or obese, the government needs to look for ways to reduce the amount of free sugars we consume.

A significant portion of free sugar in our diet comes from sugar-sweetened beverages

Are soft-drinks the only problem?  No, but they’re one of the biggest contributors to free sugars in our diets. It has been estimated that 7-8% of the daily caloric intake of Canadian adolescents is from sugar-sweetened beverages.  If we want to reduce the amount of free sugars we consume, sugar-sweetened beverages seems like a logical target.

Taxes have an impact on purchasing decisions

As someone who just got stuck with a bill from Egyptian Customs of 100 USD (a tax rate of nearly 200%!) on a recent purchase of running shoes I had shipped from the US, I understand as good as anyone that taxes affect purchasing decisions.  If something costs more, we buy less of it.  That’s economics 101.

We happen to have a real life example of a soda-tax working to reduce the public’s consumption of sugar-sweetened beverages. In 2014 Mexico implemented a 1 peso per litre tax, essentially raising the prices of sugar-sweetened beverages by 10%.  You know what happened?  In the first year, Mexican’s reduced their purchases of sugar-sweetened beverages by 6%. That may not sound like a lot, but as far as other health policy initiatives go, it’s significant. No one is arguing that this alone will solve the obesity epidemic, but it certainly appears to be part of the solution.

I have no doubt that the food industry will provide major push-back on such a tax, but I would hope that government could stand up to them in the interest of public health.

We already tax other products deemed unhealthy to deter use

It’s not like a tax on sugar-sweetened beverages would be unprecedented.  We already tax things like tobacco and alcohol.  The taxes are built into the price, just like they would be for sugar-sweetened beverages. One might debate the government’s motives for such taxes (revenue generation vs. public health), but I would argue, does it really matter? If you’re making certain unhealthy choices less desirable, regardless of the motivation, the outcome is still the same – less consumption.

Sugar-sweetened beverages won’t cease to exist

What annoys me most about this debate are those who cry that a soda-tax takes away our freedom of choice.  They make it seem as though under such a plan we would no longer have access to our beloved Coca Cola, etc.  Similar arguments were made years ago when New York passed legislation banning the use of large soda cup sizes (which have unfortunately since been repealed).  It’s an absurd position.  No one would be preventing you from purchasing your favorite sugar-sweetened beverage.  It just might mean that the next time you head to the convenient store, because of the added cost of sugar-sweetened beverages, perhaps you’ll chose them less often..  That’s all.

As far as public health initiatives go, a tax on sugar-sweetened beverages seems like no real no-brainer to me.  Have I convinced you?

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