Menopause

Note: The following abstracts are written in extremely technical language and include technical research and case studies. References are provided. For 'user-friendly' informative reading, check out the health topics presented by Dr. Martin and Dr. Davenport. Feel free to contact us for more information or if you have any questions.


Carotenoids, vitamin A, and estrogen receptor status in breast cancer

Among patients with breast cancer, tumors that contain estrogen receptors (ER) are associated with improved survival and better response to hormone therapy than those not expressing these receptors. The purpose of these case comparison studies was to examine the relationship between carotenoids, vitamin A, and the tumor ER status in women at diagnosis of primary breast cancer. The focus of the first study was the relationship between dietary intake and ER status, and the focus of the second study was the relationship between ER status and the plasma carotenoid, retinol, and tocopherol concentrations. We evaluated tumor ER status and self-reported dietary intake in 142 women and plasma concentrations of carotenoids, retinol, and tocopherols in 149 women, at diagnosis of breast cancer, before any medical or surgical treatment. In the first study the overall odds of ER-positive status were increased in relation to number of mammograms in the past five years, number of breast-fed babies, dietary carotenoid intake, and more frequent intake of yellow and green vegetables. Overall odds of ER-positive status were decreased in relation to years of oral contraceptive use and preformed vitamin A intake. In the second study older women, women with higher plasma lutein concentration, and women not using beta-carotene supplements were more likely to be ER positive, when data were adjusted for body mass index and factors that may influence breast cancer risk or hormonal status. Significant independent relationships between plasma retinol or tocopherol concentrations and ER status were not observed. The strong and independent relationships between carotenoid intake, plasma lutein concentration, and ER status may relate to observations linking a carotenoid-rich diet with improved prognosis after diagnosis of breast cancer.

Rock-CL; Saxe-GA; Ruffin-MT 4th; August-DA; Schottenfeld-D
Nutr-Cancer. 1996; 25(3): 281-96

Calcium and vitamin D nutritional needs of elderly women

Because osteoporosis is irreversible, the most effective approach to reduce morbidity and mortality from this disease is to maximize peak bone mass and minimize bone loss. This presentation reviews the evidence that calcium and vitamin D influence rates of bone loss in postmenopausal women. In the first five or more years after menopause, women lose bone very rapidly. During this period, high dose calcium supplementation modestly reduces cortical loss from long bones but has minimal effect on more trabecular sites such as the spine. In addition, vitamin D appears to enhance the effectiveness of supplemental calcium. Late postmenopausal women are generally more responsive to added calcium, and those with the lowest dietary calcium intakes benefit the most. In calcium-replete women, supplementation with vitamin D reduces bone loss and fracture incidence. Available evidence indicates that postmenopausal women should consume 1000-1500 mg of calcium and 400 to 800 IU of vitamin D per day to minimize bone loss.

Dawson-Hughes-B
J-Nutr. 1996 Apr; 126(4 Suppl): 1165S-7S

Cardiovascular disease and vitamins. Concurrent correction of 'suboptimal' plasma antioxidant levels may, as important part of 'optimal' nutrition, help to prevent early stages of cardiovascular disease and cancer, respectively

Epidemiological surveys provided abundant evidence that under steady-state conditions diets rich in antioxidants (from vegetables/fruits and suitable vegetable oils) reduce the relative risk of premature death from CVD and cancer. Material relative risks seem to disappear at 'optimal' antioxidant plasma levels in the order of > or = 50 micromol/l vitamin C, > or = 30 micromol/l lipid-standardized vitamin E (alpha-tocopherol/cholesterol ratio > or = 5.1-5.2), > or = 2.2 micromol/l vitamin A, and > or = 0.4 micromol/l beta-carotene or > or = 0.4-0.5 micromol/l alpha-plus beta-carotene. Levels 25-35% below these thresholds predict an at least 2-fold higher risk. 'Suboptimal' levels of any single antioxidant may increase the relative risk independently. Accordingly, 'suboptimal' levels of several antioxidants predict a further increase of risk. Data on habitual voluntary multivitamin supplements providing an adequate supply of either vitamins A, C or E, and of beta-carotene in smokers, indicates that steady-state 'optimization' reduces more or less regularly the relative risk of CVD and cancer respectively. Simple counting of multivitamins regardless of their composition did not reveal any risk reduction. The antioxidant-related health benefits seem to depend on an adequacy of all antioxidants, and possibly of nonantioxidant nutrients as well. Thereby, an overall 'optimal' antioxidant defense system may be more important than excess of any particular 'magic bullet' antioxidant. Although antioxidants may represent a crucially important fraction within a health-maintaining diet, any nonantioxidant co-nutrients remain to be identified which could condition the health benefits of antioxidants. In randomized antioxidant intervention trials during 5-6 years in middle-aged to elderly subjects in China and Finland, only earlier stages of CVD and cancer respectively were prevented by rectifying previously poor levels. Correspondingly, the incidence of prostate cancer (developing mostly not until the male menopause) was reduced by correction of a previously poor vitamin E status in Finland. In contrast, irreversible precancerous lesions (such as esophageal dysplasia), clonically established common cancers (highly probable for the lung of elderly heavy smokers) as well as (presumably advanced, complicated) vascular lesions of chronic smokers did not respond favorably. (ABSTRACT TRUNCATED)

Gey-KF
Bibl-Nutr-Dieta. 1995(52): 75-91

Magnitude and determinants of premenopausal bone loss

Bone loss prior to menopause may contribute to a woman's risk for fracture due to osteoporosis later in life. Most, but not all, longitudinal and cross-sectional studies suggest that bone mass decreases prior to menopause. This bone loss may be prevented by calcium supplementation. Heredity, exercise and menstrual status also have an impact on bone mass. Prevention of bone loss prior to menopause will allow women to enter menopause with a greater bone mass reducing their risk of subsequent fracture.

Baran-DT
Osteoporos-Int. 1994; 4 Suppl 1: 31-4

Calcium, phosphorus and magnesium intakes correlate with bone mineral content in postmenopausal women

Qualitative and quantitative differences in the dietary habits of postmenopausal women were studied to assess their influence on bone health and osteoporosis. A total of 194 postmenopausal women were studied with forearm DEXA densitometry. 70 were osteoporotic and 124 served as controls. Women had been menopausal for 5-7 years, and had never been treated with hormone replacement or drug therapy. A 3-day dietary recall was completed on Sunday, Monday and Tuesday after the examination: the results were processed by computer and daily calcium, phosphorus and magnesium intakes were related to bone mineral content (BMC). Data were compared with Student's t-test and significance was assessed at p < 0.05. Regression analysis was performed to correlate BMC and intake levels. The dietary intake of calcium, phosphorus and magnesium was significantly reduced in osteoporotic women and correlated with BMC. Calcium and magnesium intakes were lower than the recommended daily allowance even in normal women. The results suggest that nutritional factors are relevant to bone health in postmenopausal women, and dietary supplementation may be indicated for the prophylaxis of osteoporosis. Adequate nutritional recommendations and supplements should be given before the menopause, and dietary evaluation should be mandatory in treating postmenopausal osteoporosis.

Tranquilli-AL; Lucino-E; Garzetti-GG; Romanini-C
Gynecol-Endocrinol. 1994 Mar; 8(1): 55-8

Smoking and bone loss among postmenopausal women

We examined the effect of smoking on bone mineral density (BMD), rates of bone loss, and fractional whole-body retention of 47Ca in healthy postmenopausal women enrolled in a 2-year calcium supplementation trial. Bone density was measured by single- and dual-photon absorptiometry. BMD of the radius at the study baseline was inversely related to pack-years of exposure when controlled for body mass index and years since menopause (partial r = -0.18, p = 0.05, n = 125). The adjusted mean (+/- SD) annualized rate of bone change from the radius was greater among smokers than nonsmokers (-0.914 +/- 2.624%/year, n = 34, versus 0.004 +/- 2.568%/year, n = 278, respectively; p = 0.05). Similar trends were observed at the femoral neck, os calcis, and spine. Rates were were adjusted for caffeine intake, alcohol use, supplement type, and, at the spine only, menopausal status. At entry into the trial higher serum levels of alkaline phosphatase and lower levels of total and ionized calcium were found in smokers compared to nonsmokers. These differences did not persist with supplementation. In 44 women studied fractional 47Ca retention was lower in the 8 smokers than the 36 nonsmokers (16.6 versus 19.1%, respectively; p = 0.03). These results demonstrate an increased rate of bone loss at the radius after menopause and suggest that smoking is associated with decreased calcium absorption.

Krall-EA; Dawson-Hughes-B
J-Bone-Miner-Res. 1991 Apr; 6(4): 331-8

Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women

A study was done to examine the effects of aluminum, magnesium, and boron on major mineral metabolism in postmenopausal women. This communication describes some of the effects of dietary boron on 12 women between the ages of 48 and 82 housed in a metabolic unit. A boron supplement of 3 mg/day markedly affected several indices of mineral metabolism of seven women consuming a low-magnesium diet and five women consuming a diet adequate in magnesium; the women had consumed a conventional diet supplying about 0.25 mg boron/day for 119 days. Boron supplementation markedly reduced the urinary excretion of calcium and magnesium; the depression seemed more marked when dietary magnesium was low. Boron supplementation depressed the urinary excretion of phosphorus by the low-magnesium, but not by the adequate-magnesium, women. Boron supplementation markedly elevated the serum concentrations of 17 beta-estradiol and testosterone; the elevation seemed more marked when dietary magnesium was low. Neither high dietary aluminum (1000 mg/day) nor an interaction between boron and aluminum affected the variables presented. The findings suggest that supplementation of a low-boron diet with an amount of boron commonly found in diets high in fruits and vegetables induces changes in postmenopausal women consistent with the prevention of calcium loss and bone demineralization.

Nielsen-FH; Hunt-CD; Mullen-LM; Hunt-JR
FASEB-J. 1987 Nov; 1(5): 394-7



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