Natural health ingredients for women in their mid-life

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Wellness Foods Europe Women s health Photo : Shutterstock 14200444 Natural health ingredients for women in their mid-life Dr Karin Berger Büter, Christina Ehrhardt, Vital Solutions Swiss AG During

1 Wellness Foods Europe Women s health Photo : Shutterstock Natural health ingredients for women in their mid-life Dr Karin Berger Büter, Christina Ehrhardt, Vital Solutions Swiss AG During their life span women take on many roles and duties: as daughters, mothers, partners, employees, employers, caregivers and many others. They are confronted with manifold challenges and factors which might have an impact on their health and well-being. Although man and women share many similar health concerns, quite a number of health issues are more prevalent in women and some affect only women. Cardiovascular diseases such as strike and coronary heart disease are the leading cause of death and disability in women; risk factors and preventive strategies may differ in women, and women may experience different symptoms of an impending heart attack than men. Pain in the centre of the chest might not be the first sign of a heart attack in women; unusual tiredness, trouble sleeping, heart burn, cough or heart flutters might be symptoms signalling the imminent occurrence of a heart attack (World Health Organization 2009). Women in mid-life and their health > Women have specific health care needs during their life cycle. The most challenging health issues emerge in mid-life, where women are confronted with many changes in their body which are related to aging and particularly also to menopause. Women at mid-life not only are confronted with vasomotor symptoms, such as hot flashes 26 Wellness Foods Europe June 2014

Women s health Wellness Foods Europe and night sweats, they are also exposed to somatic symptoms including pain, shortness of breath, headaches, fatigue, musculoskeletal aches and joint stiffness.

2 Women s health Wellness Foods Europe and night sweats, they are also exposed to somatic symptoms including pain, shortness of breath, headaches, fatigue, musculoskeletal aches and joint stiffness. Menopause and midlife have various short-term and long-term health consequences among which cardiovascular disease, osteoporosis and mental health are of major implications (Santoro N et al., 2011). Risks for cardiovascular disease and metabolic syndrome In the study of Women s Health Across the Nation (SWAN), where more than 3000 women were monitored before and after menopausal transition over a period of 10 years it was shown that women experience a sharp rise in lipids at the time of their final menstrual period. Total cholesterol, LDL-cholesterol, and apolipoprotein-b demonstrated substantial increases within the one-year interval before and after the final menstrual period (Matthews KA, 2009). The most important indicator of the menopausal transition is the dramatic reduction in estradiol levels. With this reduction, there is a progressive shift toward androgen dominance in the hormonal milieu. Menopause-related testosterone predominance appears to be an evident hormonal change that is associated with the incidence of metabolic syndrome, such as insulin resistance, hyperinsulinemia, low HDL-cholesterol levels, high blood levels of glucose and triglycerides. Epidemiologic data show that androgens are also associated with haemostatic and inflammatory markers independent of aging and other standard cardiovascular disease risk factors. (Janssen I, 2008). particularly in gain of visceral fat, by e. g. higher androgen levels (Sutten-Tyrrell K et al., 2010). Visceral fat increase is associated with menopause due to higher availability of testosterone. Oestradiol stimulates the production of a protein which regulates reproductive hormones bioavailability by binding testosterone and oestrogen (SHBG, sex hormone-binding globu lin). Since oestradiol levels decline with menopause, SHBG level decrease and therefore the level of available testosterone increases (Janssen I et al., 2010). It has been shown that initial weight is the strongest predictor of for developing obesity and severe obesity in menopause so that, to be effective, attention to weight maintenance must begin prior to the menopausal transition (Santoro N et al., 2011). Bone health In post-menopausal women bones start naturally to lose more calcium than is incorporated due to lower oestrogen levels, which will result in lower bone strength. Many women suffer from a critical loss of bone mass substantially during the late peri- Body weight Weight gain and increases in central body fat occur in many women in menopausal transition. It was concluded that weight gain is driven primarily by aging. However, specific aspects of menopausal transitions have been identified which contribute to weight gain, Photo : Fotolia/roboriginal June 2014 Wellness Foods Europe 27

3 Wellness Foods Europe Women s health menopause, e. g. the stage before the menopause when the ovaries start to produce less oestrogen. Bone mass density continues to decline rapidly during the early postmenopausal years. Interestingly bone mass density decrease have been shown to be significantly faster in women with low body weight. The reasons why higher body weight is associated with slower rates of bone loss are unknown (Finkelstein JS, 2008). Strategies for staying healthy and relieving age related symptoms > During the whole life women and men are making health and medical decisions; e. g. what to eat, how long to sleep, when to exercise, what occasional medical screens and which supplements or medication to take to prevent illness and stay healthy. When reaching mid-life it would be a good occasion for reflection and to plan a strategy for the future for staying healthy or become healthier. Besides taking care of a balanced diet and adequate physical activities specific supplements can contribute to reduce menopausal symptoms and risk factors for developing agerelated diseases (See Tab. 1 Tab. 3). Ingredients with benefits for age-related diseases with focus on cardiovascular benefits, metabolic syndrome and body weight There are a lot of ingredients available in the market with cardiovascular health benefits (See Tab.1). blood Cholesterol Triglycerids oxidative Stress/ LDL oxidation inflammatory mediators Omega 3 FA Fibres Plant sterols/ stanols Grape seeds extract/resveratrol Cocoa flavanols Tomato extract Vitamin K (K2, menaquinone) Mango fruit powder (selected variety) X antiatherogenic antithrombotic and antiplatelet endothelial dysfunction (NO release) Normalisation of Blood pressure Reduced calcification of blood vessels X X Tab. 1: Ingredients for age-related diseases with focus on cardiovascular benefits, metabolic syndrome and body weight 28 Wellness Foods Europe June 2014

Women s health Wellness Foods Europe Supplements for maintenance of bone health With calcium rich diet and regular weightbearing exercise women can keep their bone strength and slow age-related bone

4 Women s health Wellness Foods Europe Supplements for maintenance of bone health With calcium rich diet and regular weightbearing exercise women can keep their bone strength and slow age-related bone loss. However, if regular exercise is not possible, supplementation with vitamins associated with bone formation, e. g. vitamin D and vitamin K2 might be necessary (Tab. 2). cial role in keeping the risk of calcification in blood vessels as low as possible. Ingredients and herbal preparations for relief of menopausal symptoms The main menopausal symptoms include hot flashes and night sweats. Since many women are looking for alternatives to hormone re- Increased bone mineralisation Reduced bone demineralisation Vitamin D + Calcium X Vitamin K2 + Calcium X X Tab. 2: Vitamins and ingredients for bone health The effect of vitamin D in combination with calcium on bone health in menopausal women was discussed controversial, how ever, the latest reanalysis of data obtained in The Women's Health Initiative (WHI) clinical trials, where randomly assigned 36,282 postmenopausal women in the U.S. got up to 1,000 mg elemental calcium carbonate plus 400 IU of vitamin D3 daily or placebo, with average intervention period of 7.0 years, it could be shown that long-term use of calcium and vitamin D appears to confer a reduction that may be substantial in the risk of hip fracture among postmenopausal women. Negative supplementation effects were not apparent on the risks of myocardial infarction (R. L. Prentic et al, (2013). Beside vitamin D, supplementation with vitamin K2 may help postmenopausal women to prevent bone loss. In a three-year lowdose menaquinone-7-supplementation (180 μg MK-7/day) study in healthy post-menopausal women an improved vitamin K status was obtained and the MK-7 supplementation significantly decreased the age-related decline in bone mineral density and bone strength (M. H. J. Knapen et al., 2013). Beside the positive effects of vitamin K on bone mineralisation it plays also a cruplacement therapy the use of a broad variety of supplements or herbal preparations has highly increased in the last decades. A selection of preparations is presented in Tab. 3. Ubiquinol: new generation Q10 Conventional Q10 Pioneer in Natural CoQ 10 KANEKA LAVONOID Patented extract for body reshaping TM Active form of Glucosamin - Q10@kaneka.be - June 2014 Wellness Foods Europe 29

5 Wellness Foods Europe Women s health Plant species Preparations Main constituents Effects Black cohosh Alcoholic Triterpenes Reduces hot flashes, extracts mood swings, night sweats Cimicifuga racemosa L. (Syn. Actea racemosa) Salvia officinalis L. (sage) Red clover (Trifolium pratense L.) Soy (Glycine max) Tinctures, alcoholic extracts Alcoholic extracts Organic solvent extracts Phenolic acids Phenolic acids (rosmarinic acid), flavonoids, triterpenes, Essential oil Isoflavones (Phytoestrogens) Isoflavones (Phytoestrogens) Efficacy proven in clinical trials (Drewe J et a., 2013) Reduces hot flushes and associated menopausal symptoms Efficacy proven in clinical trials (Bommer S et al., 2011) Relieve of general menopausal symptoms. Efficacy not clearly verified (Borelli F and Ernst E, 2010). Proven positive protective effect on bone mineral density loss, (Borelli Fand Ernst E, 2010) Dong quai (Angelica sinensis L.) Powdered root, tinctures volatile oil, phenolic acids, vitamins, minerals Relieve of general menopausal symptoms. Efficacy not clearly verified (Borelli F and Ernst E, 2010) Tab. 3: Products used for relief of menopausal symptoms (food supplements and traditional herbal preparations) Conclusions > Even when there are factors which cannot be controlled such as the gradual physical changes by age, there is a lot which affects health that can be controlled. With a healthful lifestyle and the benefit of health care products women (and men) can be supported to start healthier into the second part of their life. References > Bommer S et al. (2011) First time proof of sage's tolerability and efficacy in menopausal women with hot flushes. Adv Ther. 28(6): Borelli F and Ernst E (2010) Alternative and complementary therapies for the menopause. Maturitas 66: Drewe J et al. (2013) The effect of a Cimicifuga racemosa extracts Ze 450 in the treatment of climacteric complaints an observational study. Phytomedicine 20: Finkelstein JS (2008) Bone Mineral Density Changes during the Menopause Transition in a Multiethnic Cohort of Women. J Clin En- 30 Wellness Foods Europe June 2014

Women s health Wellness Foods Europe Photo : Fotolia/Martina Berg docrinol Metab. 93(3): 861 868 Janssen I (2008) Menopause and the Metabolic Syndrome: The Study of Women s Health Accross the Nation.

6 Women s health Wellness Foods Europe Photo : Fotolia/Martina Berg docrinol Metab. 93(3): Janssen I (2008) Menopause and the Metabolic Syndrome: The Study of Women s Health Accross the Nation. Arch Intern Med. 168(14): Janssen I et al. (2010) Testosterone and Visceral Fat in Midlife Women: The Study of Women s Health Accross the Nation (SWAN) Fat Patterning Study. Obesity (Silver Spring) 18(3): Knapen MHJ et al. (2013) MK-7 supplements decrease bone loss in healthy postmenopausal women. Osteoporos Int (2013) 24: Matthews K (2009) Are changes in cardiovascular disease risk factors in midlife women due to chronological aging or to the menopausal transition? J Am Coll Cardiol. 15; 54(25): Prentic RL et al. (2013) Health risks and bene fits from calcium and vitamin D Osteoporos Int 24: Santoro N et al. (2011) The SWAN Song: Study of Women s Health Across the Nation s. Gynecol Clin North Am. 38(3): Sutton-Tyrrell K (2010) Reproductive Hormones and Obesity: 9 Years of Observation From the Study of Women s Health Across the Nation. Am J Epidemiol 171: World Health Organization (2009) Women and health: today's evidence tomorrow's agenda. ISBN For more information, please contact: Vital Solutions Swiss AG Hauptstrasse 137C CH-8274 Tägerwilen Tel +41 (0) info@vitalsolutions.biz June 2014 Wellness Foods Europe 31

What is the menopause?

What is the menopause? Information for you Alternatives to hormone replacement therapy for symptoms of the menopause Published in December 2011 This information is for you if you are considering alternatives to hormone replacement