Micronutrients have a substantial impact on a woman’s health throughout her entire life. Every woman needs a constant, balanced, and adequate supply of all essential nutrients throughout her lifetime

Micronutrients have a substantial impact on a woman’s health throughout her entire life. Every woman needs a constant, balanced, and adequate supply of all essential nutrients throughout her lifetime.

Many women do not get enough of the micronutrients they need, however. Both in the U.S. and worldwide, inadequate intakes are far too common. Deficiencies of the following

nutrients are particularly common:
• Vitamin D • B vitamins • Calcium
• Zinc • Iron

In addition to low dietary intake, other factors can contribute to micronutrient deficiencies,

• genetic factors

• poor absorption

• drug-nutrient interactions

• acute and chronic health conditions

• stress

• normal processes of aging

The fact is that many women cannot get adequate amounts of some nutrients without supplementing their diets.

Research Shows the Importance of Micronutrients to Women’s Health
Breast Health

Breast health issues are one of the most common reasons why women consult their health care practitioners. Research suggests that several micronutrients play key roles in breast health, including iodine, B vitamins, vitamin D, calcium, and vitamin C.2–4 Uterine and Ovarian Health
Micronutrient status plays a major role in the overall health and function of the uterus and ovaries, which can be affected by a variety of health issues. Research suggests that supplementation with B vitamins, calcium, and vitamin D may support uterine and ovarian health.

Menstrual Cycle Health
Many women experience physical and emotional challenges relating to their menstrual cycle, and research suggests that several micronutrients support a healthy menstrual cycle—including increased B vitamins, vitamin C, magnesium, and zinc.7–9 Urinary Tract Health Women are at greater risk for urinary tract health issues than men. Statistically at least one-third of American women will develop urinary tract health issues, which also become more frequent with age. Recent research found that adequate vitamin D intake may protect against urinary health issues.

Anxiety and Mental Health

Mental health challenges are much more prevalent in women than men, and research continues to investigate the importance of vitamins and minerals for mental health. Higher intakes of vitamin D and magnesium have been associated with improved mental health and function.11,12

Birth Control / Contraceptives
Oral contraceptives have been shown to lower levels of B vitamins, vitamin C, and zinc in the body, causing researchers to recommend that women taking contraceptives should pay close attention to
their vitamin and mineral intake and consider supplementation.
Conception and Pregnancy Many women know the importance of vitamins and minerals during pregnancy, but recent research also emphasizes the importance of micronutrient status in the time period before conception. Micronutrient deficiencies can also negatively impact fertility. B vitamins, vitamin D, iodine, selenium, antioxidants, iron, and vitamin A have been shown to be key nutrients in fertility and maternal, fetal, and infant health.

Postpartum Mood

Postpartum mood challenges are common—affecting at least 12–16% of mothers. Studies have linked low intakes of micronutrients with increased incidence of mood issues, and have suggested that supplementation can help maintain healthy mood in postpartum women. B vitamins, selenium, vitamin D, and magnesium have been suggested to promote healthy mood. Menopausal and Bone Health
Menopause can affect women’s nutritional needs, and research has shown that B vitamins and vitamin D are particularly important. Minerals are also crucial after menopause, since one of the most significant changes associated with perimenopause and post menopause is a decrease in mineral
levels, which can negatively impact bone health in particular. Magnesium, zinc, and calcium are all important minerals to support postmenopausal bone health.

REFERENCES
1. Seibel M. Fertil Steril 1999;72(4).
2. Ghent W, et al. Can J Surg 1993; 35(5):453–60.
3. Zhang SM. Curr Opin Obstet Gynecol 2004;16(1):19–25.
4. Lazzeroni M, et al. Breast 2011;20(Suppl 3):S36–41.
5. Killicdag EB, et al. Hum Reprod 2005;20(6):1521–8.
6. Firouzabadi Rd, et al. Complement Ther Clin Pract 2012;18(2):85–8.
7. P.O. Chocano-Bedoya, et al. Am J Clin Nutr 2011 May;93(5):1080–6.
8. De Souza MC, et al. J Womens Health Gend Based Med
2000;9(2):131–9.
9. Abraham G. J Reprod Med 1983;28:446–64.
10. O Hertting, et al. PLoS One 2010;Dec 14;5(12):e15580.
11. Zender R, et al. Nurs Clin N Am 2009;44(3):355–364.
12. Murphy P, et al. J Midwifery Women’s Health 2008;53:440–446.
13. Veninga KS. J Nurse Midwifery 1984;29(6):386–90.

14. Webb JL. J Reprod Med 1980;25(4):150–6.

15. Allen LH. Am J Clin Nutr 2005;81(5):1206S–1212S.

16. Davison KM, et al. Can J Psychiatry 2012;57(2):85–92.
17. Leung BM, et al. J Am Diet Assoc 2009;109(9):1566–75.
18. Mokhber N, et al. J Matern Fetal Neonatal Med
2011;24(1):104–8.
19. Jacka FN, et al. J Affect Disord in press 2012.
20. Seibel MM. Fertil Steril 1999;72(4):579–91.
21. Grochans E, et al. Magnes Res 2011;24(4):209–14.
22. Chapuy M, et al. Br Med J 1994;308:1081–82.
23. Stendig-Lindberg G, et al. Magnes Res 1993;6:155–163.

Fighting Crime With Micronutrients

Diet and Violence

Does diet affect our criminal behavior?
Published on May 2, 2011 by Emily Deans, M.D. in Evolutionary Psychiatry 

What would you think if I told you that young people today likely committed violent, criminal acts in part due to poor nutrition.  What if they continued those violent acts in prison as the poor nutrition continued?  Reserve judgment for now.  This is science – let’s see what the data tells us.  My theory is that our relatively nutrient-poor modern diets contribute to a great deal of modern psychopathology.

Over the past decade or so, several groups of researchers have done some decent work in this area, and (for once in the nutritional-type psychiatry literature) I can look at a randomized controlled trial of good size and design that was actually replicated.

The modern era of good studies begins with Oxford nutrition and criminology researcher, Bernard Gesch. Back in 2002, he published a (full free text) study entitled “Influence of supplementary vitamins, minerals, and essential fatty acids on the antisocial behavior of young adult prisoners.” In this study, 231 (young, male, adult, prisoner) volunteers agreed to receive a daily vitamin, mineral, and essential fatty acid supplementation or placebo. The average length of the supplementation was about 142 days, and a number of measures were taken before and during the active phase, including psychological testing, reports of violent acts, and reports of disciplinary action. Prisoners were randomized in part based on baseline disciplinary status and their progress in the “prison regime.”

The results? The average number of “disciplinary incidents per 1000 person-days” dropped from 16 to 10.4 in the active group (p<0.001), which is a 35% reduction, whereas the placebo group only dropped by 6.7%. Especially violent incidents in the active group dropped by 37%, and in the placebo group only 10.1%. That’s a pretty impressive finding, really. Currently, Gesch is working on a study of 1000 prisoners in 3 different UK prisons for a 3 year trial, including blood chemistry analysis to see what the baseline levels of micronutrients are in the prisoners, and also more cognitive testing, designed to answer some questions the earlier study couldn’t answer.

However, luckily for us (as the newer Gesch results have yet to be published), a Dutch research team led by Zaalberg repeated the experiment (more or less) in “Effects of Nutritional Supplementation on Aggression, Rule-Breaking, and Psychopathology Among Young Adult Prisoners.” The researchers note that behavior issues have been linked to deficiencies in omega 3 fatty acids, and that low levels of magnesium and zinc are also associated with hyperactive behavior, impaired brain development, and cognitive dysfunction. Check out the quote from the study:

The mechanisms underlying potential associations between nutrition and behavior, however, are not yet clearly established. Although a clear comprehensive theory is lacking, several findings do offer some clues on the plausibility of dietary interventions. Epidemiological research, for instance, shows that major changes in dietary patterns over time have taken place, especially in industrialized world during the last century [Cordain et al., 2005; Crawford et al., 1999; Muskiet, 2005; Simopoulos, 1999]. These changes resulted in (micro)nutrient intakes that are significantly lower than in the ancient, Paleolithic diet. Indeed, some ecological studies show correlations between diet and behavioral outcomes [Christensen and Christensen, 1988; Hibbeln, 2001; Peet, 2004], including criminal behavior [Hibbeln, 2001]. A major limitation of epidemiological studies is, however, the impossibility of making causal inferences. For this reason, the findings mentioned above must be judged with caution and experimental confirmation is needed.

(I love these researchers already!) They did this trial specifically to see if they could replicate Gesch’s work. Only they made some modifications in their supplement – specifically leaving out linoleic acid “because of its abundance in the Dutch diet”, and using larger capsules that could include more bioavailable forms of minerals, so there was more magnesium (300mg of Mg citrate vs 30mg (of ?) in the Gesch trial). They also halved the amount of vitamin D (from 400 IU to 200 IU) in the supplement (but did not specify why). They also increased doses of omega 3 fatty acids compared to Gesch, inline with newer research on the effects of omega 3s on the brain. No one supplemented with micro doses of lithium, despite some interesting data on low doses of lithium and behavior.

In all, 221 young male prisoners completed the study. Many dropped out, often due to transfer to another prison or being released. Of the completers, numbers of violent events in the active group dropped 34%, whereas incidents in the control group increased 14%. The overall number of incidents was lower (11 per 1000 person-days) in the Dutch prison compated to the UK one, but the percentage change was still significant. There were no significant differences in any of the cognitive, personality, and behavioral testing measures used, just the actual incidents. Which is interesting. Because you can’t figure out, from this data, why the incidents decreased. If you could say – oh, look, impulsivity and attentional measures improved, then you could say that’s why the behavior is better. But they didn’t improve. Which means maybe the cognitive measures aren’t very good, or the effect was too subtle to catch. Well, I know a prison warden cares more about decreasing reported numbers of violent incidents in a prison compared than decreasing the psychologic testing measures of impulsivity.

One problem with this second study is that at the beginning, 51% of the prisoners guessed wrong as to whether they were receiving active vs. placebo pill. By the end, only 25% guessed wrong, suggesting the blind was somehow partially broken (perhaps by smell of the pills?). Violent incidents were measured by the prison staff, it is unknown whether the prisoners told the staff if they suspected active or placebo pills. So keep that in mind when interpreting the results.

Here is the Dutch researchers’ conclusion:

To summarize, the prospect of influencing aggression and rule-breaking behavior with nutrients in moderate doses is important enough to warrant further research. This is particularly true as adequate supplementation may also have beneficial effects on mental health and cognitive functioning. This study, however, did not confirm this association, except for some marginal trends in this direction. Yet, as the found decrease in the outcome measure-reported incidents and rule-breaking-is in line with the earlier British prison study of Gesch et al., we feel that further research on the association between dietary status and violent behavior is warranted.

What do I think?  Well, we now have evidence from two decently-sized randomized controlled trials of adding a multivitamin/multimineral/essential fatty acid supplement to normal prison fare. The trials were done about 8 years apart and in different countries, yet came out with a similar conclusion. Actual violent/discipline-requiring incidents committed by the prisoners who took the supplements was reduced by about 1/3 compared to pre-supplement days, and in one study the placebo-taking prisoners had an increase in violent events, whereas the other study showed not much change in the placebo group.

My conclusion – practically speaking, I hope that prisoners in the US get a supplement. I don’t care if it is the best pharmaceutical grade supplement on the planet, a month of supplementation can’t be more costly than a couple of days in prison. And total number of days in prison and parole and solitary and all those situations are in part determined by prisoner behavior, I imagine. I’m guessing that prisoners receive the most horrendous, cheap, grain-and-soy and margarine foods imaginable. We have to “get tough on crime” after all. Our tax dollars at work.

“Decades of studies by Schoenthaler and others have supported a connection between nutrition and violence, but for a variety of reasons-some scientific, others political-it hasn’t yet translated into policy.”

But let’s step back from pragmatism for a moment. Here’s the real issue with the science I pursue, at least in the eyes of the medical establishment (also from the Science article):

“This field has seen a lot of exaggerated claims and not enough solid placebo-controlled research,” says Eugene Arnold, a psychiatrist and former director of the Nisonger Center at Ohio State University, Columbus. Studies have shown that “there clearly is a connection” between nutrients and behavioral disorders-for example, between nutrition and depression- but rigorous research has been the exception, he says. Most studies of the effects of nutrition on antisocial behavior are dismissed because of poor experimental design. And Arnold notes that misleading claims by the booming nutrient supplement industry have brought the taint of pseudoscience to those studying diet and behavior. “Even good scientists in this field have been treated as guilty by association,” he says.

Gesch began working with young offenders in the 80s as a social worker. He would invite groups over for home-cooked meals, (the goal being that the atmosphere would help them open up and share their troubles) and Gesch noticed that after a while, the kids would be “transformed…

…becoming healthier and often abandoning the antisocial behaviors that had gotten them into trouble. He began to believe that shedding their scattershot diets of junk food was central to the behavioral shift, perhaps even more so than the family-like socializing. “

Finally he was able to obtain funding for his 2002 study, now replicated, and at the same time Gesch gathered data for a second paper on how food choices of prisoners affected actual daily intake of nutrients. He found (not surprisingly) that, when they got the chance, prisoners would buy food like peanuts, chips, candy and cookies from the prison store, which would add to their daily intake of omega-6 oils, trans fats, grains, and sugar. In addition, though the prison diets were designed by institutional dietitians, most had suboptimal amounts of vitamin D (even compared to the lowly 400 IU recommended for people with little sun) and selenium, and the vegetarian and Muslim menus often had some suboptimal B vitamins and total calories.

Just want to mention here Schoenthaler’s randomized controlled trial from 2000, of 80 six-twelve year old schoolchildren who had previously been disciplined at school in “working class” Hispanic neighborhoods of Phoenix – Schoenthaler notes that previous randomized controlled trials of supplementation of the RDA for prisoners resulted in a 40% decrease in number of violent acts – his results were a 47% decrease in violent acts among the supplemented kids compared to the placebo controls. I’d call that more replication. And a call for some serious multivitamin/multimineral/EFA supplementation action on a large scale in institutions such as prisons, especially where relatives are often not allowed to bring in outside food.

Of course, nutrition is only a part of the larger problem of violence and crime. But in institutions, it seems like a relatively 30-40% controllable part, if only common sense would prevail.

In the larger picture, yes, nutrition affects the brain.  We need to be eating nutrient-rich, wholesome, real food the vast majority of the time, and any government or economic intervention that affects our food will also affect our brains and behavior.  It behooves us all to consider carefully what we feed ourselves and our children.  Personally, I trust the track record of evolution more than the USDA, a government agency designed to promote the consumption of American-produced grains.  The stakes are high.  My only advice is – do your reading before you pass judgment.

Could Micronutrient Deficiency be a Missing Link in the Fight Against Overweight/ Obesity?

Could Micronutrient Deficiency be a Missing Link in the Fight Against Overweight/ Obesity?

By Jayson B. Calton Ph.D. Published in the Journal of the American Association of Integrative Medicine Summer 2010

Of all the debilitating health-related conditions and diseases in America today, perhaps none is as widespread and potentially devastating as overweight/obesity. According to Dr. Richard H. Carmona, M.D., a former surgeon general of the United States, “Obesity is the terror within; unless we do something about it, the magnitude of the dilemma will dwarf 9/11 or any other terrorist attempt.”1 The problem with America’s overweight/obesity epidemic is twofold: not only are the rates not declining, no one can seem to stop them from growing. According to Johns Hopkins researcher May Beydoun, “Obesity is likely to increase, and if nothing is done, it will soon become the leading preventable cause of death in the United States.2 While the media has focused largely on the rising number of overweight and obese adults, America’s youth may be the ones suffering the most, with the overweight prevalence for children and teens having tripled since 1980.3 It is hard to imagine that anyone living in America today has not been affected by the growing obesity pandemic in some way, whether personally, through family or friends, or by the rising costs of health care. While current research by Johns Hopkins Bloomberg School of Public Health shows that more than two-thirds (68%) of U.S. adults and one-third (33%) of U.S. children and adolescents are overweight or obese, the predictions concerning the future of obesity are even more sobering.4 According to the study’s lead author, Dr. Youfa Wang, estimates now predict that by 2015, 75% of all U.S. adults will be overweight or obese, by 2030 that number will be 86.3%, and by 2048 all American adults will overweight or obese.5

While nutritional and medical experts from around the world frantically try to understand the root causes of the obesity puzzle, the American people have tried just about everything they can to lose weight. Between the popular diet programs, gym memberships, hypnosis, acupuncture, cellulite creams, body wraps, infomercial contraptions, diet pills, prescription drugs, liposuction, aerobics classes, health spas, electronic abdominal stimulators, personal diet coaches, gastric bypass surgery, lap bands, fat-free foods, low-carbohydrate foods, foods whose macronutrient ratios add up the 40/30/30, vibration machines, yoga, saunas, appetite suppressants, diet drinks, exotic herbs, fasting, body cleansing, and pole dancing classes, Americans should be the skinniest people on the planet. But we’re not…why? While one of the major government objectives for 2010 was to reduce the number of obese people in America to 15%, the recently released results of that initiative show that not one state met that goal.6 In fact, a new report by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation shows that 28 states actually increased their obesity rates. Since 1991, a dramatic increase in obesity has occurred in the United States. The report shows that in 1991 no states were recorded as having an obesity rate greater than 20%. In contrast, the latest data from 2009 shows only one state as having a prevalence of obesity less than 20% (Colorado, 19.1%), 38 states have obesity rates greater than 25%, and currently nine states have obesity prevalence greater than 30% (Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee, and West Virginia.)7

While science seems to be missing an important piece of the puzzle when it comes to slowing, stopping, and eventually reversing obesity, one recent study found a connection between being deficient in essential vitamins, minerals, and vitamin-like substances, such as CoQ10 (micronutrients) and overweight/obesity that may be worth a closer look. Published in December 2007 in Economics and Human Biology, the study found a direct link between being micronutrient deficient and being overweight or obese.8 Keeping all variables constant, the researchers concluded that the odds of being overweight or obese were 80.8% higher for the study’s micronutrient-deficient participants when compared to the studies’ non-deficient participants. Other studies lend credibility to this theory. A group of researchers out of the Medical College of Georgia set out to determine if another essential micronutrient (vitamin D) played a role in childhood obesity. Their research, presented to the American Heart Association, showed that when 650 children between the ages of 14 and 19 were tested, the students with the lowest vitamin D intake had the highest percentages of both body fat and abdominal fat.9 In a related study published in the Journal of Clinical Endocrinology and Metabolism, researchers concluded that a deficiency in vitamin D was directly linked with increased body fat.10

While some may argue that micronutrient deficiency is too rare in America to be a probable cause for the obesity epidemic, recent statistics disagree. In a 2009 study published in the journal Pediatrics, American children were found to be a whopping 70% insufficient in vitamin D, and recent findings published in the Archives of Internal Medicine show three-quarters of U.S. teens and adults deficient in vitamin D.11,12 However, it is not just vitamin D Americans are deficient in—statistics from the USDA’s own Web site highlight just how widespread America’s micronutrient deficiency condition is. According to the USDA, 9 out of 10 Americans 2 years and older are deficient in potassium, 8 out of 10 are deficient in vitamin E, and more than 7 out of 10 Americans are deficient in calcium, and approximately 5 out of 10 are deficient in vitamin A, vitamin C and magnesium.13 In addition, in a recent study published in the Journal of the International Society of Sports Nutrition, the popular diet plans that millions of Americans are following each year to lose weight, such as the Atkins for Life diet, the DASH diet, The Best Life Diet, and the South Beach Diet, were found to be deficient at providing minimum Recommended Daily Intakes (RDI) of 27 essential micronutrients.14 The study determined that on average, these diets left their followers deficient in 15 vitamins and minerals, including vitamin B5, vitamin B7, vitamin D, vitamin E, choline, chromium, copper, iron, iodine, potassium, magnesium, sodium and zinc.

To add to America’s micronutrient deficiency epidemic, more U.S. adults are taking prescription drugs than ever before.15 Recent studies show that one of the major side effects of many of today’s most popular prescription drugs—including statins, analgesics, loop and thiazide diuretics, antacids and oral contraceptives—is vitamin and mineral depletion, which can eventually lead to micronutrient deficiency.16,17 Making matters worse, even those individuals who religiously take their daily multivitamin pill are not immune to becoming micronutrient deficient. It turns out that due to something called “micronutrient competition,” many of the vitamins and minerals found in the typical multivitamin may end up going right down the toilet. Research published in both the British Journal of Nutrition and Harvard Health Letter shows that natural competitions for absorption between many vitamins and minerals, including copper and zinc and calcium and iron, could make it so that unless a multivitamin is specially formulated to prevent micronutrient competition, many of the micronutrients in the multivitamin are simply not absorbed. 18,19

The fact is, new research is showing that micronutrient deficiency is much more of a widespread problem than previously thought. It has been proven to increase the risk factor for multiple heath conditions and diseases in both adults and children, including diabetes, high blood pressure, cardiovascular disease, and many cancers.20 In addition, kids who start out with micronutrient deficiencies and never correct them may be putting themselves at risk for developing all of these diseases at a much earlier age. With so many people worldwide affected by overweight/obesity, coupled with the recent research showing clear links between micronutrient deficiency and overweight/obesity, it seems prudent to further examine this potential connection. When all is said and done, a micronutrient rich diet, sunlight, and proper anti-competition supplementation could turn out to be our best defense against the potentially largest, most devastating health scourge of the 21st century—the obesity pandemic.