Nutrition for Women

Women with estrogen dominance as well as those who suffer from menopause problems whose diets are high in saturated fats, such as butter and dairy products (especially cheese and ice cream), often stimulate the growth of unhealthy, anaerobic bacteria in their intestinal tract. These bacteria chemically change the breakdown products of estrogen into forms that can be reabsorbed back into the body.

These bacteria split estrogen from the binding substances that inactivate it in your liver. This splitting process causes free estrogen to be reformed within your intestinal tract. As this free estrogen is reabsorbed into the circulation, it increases free estrogen levels within the blood.

To suppress the growth of these unhealthy bacteria, you should not only reduce your intake of saturated fat (which can lead to the problem in the first place), you need to increase your intake of probiotic-rich, fermented foods so you can recolonize your intestinal tract with healthy bacteria. These include yogurt (preferably goat- or coconut-based), kim chee, pickles, and sauerkraut.

Women with estrogen dominance or high estrogen levels need to eat a more acidic diet that can help to bring estrogen levels back into balance by interfering with estrogen’s ability to bind to tissue receptors, as well as support the breakdown, detoxification, and elimination of estrogen by the liver and intestinal tract.

The best foods for job include:

• High fiber foods such as buckwheat and flaxseed
• Citrus fruits
• All vegetables
• Free-range poultry and wild fish
• Soy and soy-based foods
• Vinegar
• Hot, spicy foods
• Nuts like almonds and walnuts
 

While this may seem like the title of a bad B-movie, it is actually a pretty accurate description of polycystic ovarian syndrome (PCOS). If you are like me and suffer from PCOS, you know how frustrating and difficult this condition can be. On one hand, you suffer with the effects of too much testosterone, including acne and increased growth of hair on the face, abdomen, upper thighs, chest, and back. Plus, you must contend with estrogen dominance issues, such as infertility and menstrual irregularities.

As if that weren’t bad enough, us PCOS women are also at risk for insulin resistance, which can cause many sufferers to become severely overweight, putting us at risk for diabetes and diabetic complications.

Part of the difficulty with PCOS is that it has multiple underlying causes, namely a number of different hormonal imbalances. Specifically, the production of the pituitary’s luteinizing hormone is significantly elevated in women with PCOS, while the production of the pituitary’s follicle-stimulating hormone is normal or slightly diminished. The imbalances in these female hormones upset the normal production of estrogen, progesterone, and testosterone by the ovaries and adrenal glands, disrupting the healthy balance between all three of these female sex hormones.

Fortunately, by following a particular diet (namely one geared toward women with estrogen dominance), and taking some targeted nutrients, you can find relief from PCOS. I know, because I have. And I’ll share the diet and nutrients with you in future postings.

When traveling, always keep your eye out for fresh, local fruits or vegetables. However, if you have menopause problems, you’ll want to avoid highly acidic fruits like oranges and grapefruit. Instead, stock up on high-enzyme foods like sprouts, carrots, celery, or papaya to snack on.

If you are eating in a restaurant, aim for salads, steamed vegetables, whole grains, legumes, fish, and poultry, especially if you suffer from hot flashes or night sweats. Be sure to order the less acidic, more alkaline fruits such as melons and papayas.

Conversely, if you have estrogen dominance, you should load up on spinach salads with vinegar- or lemon juice-based dressings, entrees with tomato sauce, spicy entrees, or healthy meat-based dishes.

If you are flying and your trip is an hour or more, try brown bagging it. That way, instead of raiding the frig or mini-bar, you can reach into your own store of energy-rich foods that you brought from home. These can include raw, fresh vegetables with a flavorful dressing or dip, whole-grain crackers with almond butter, and a piece of fruit. 

If you tend to eat out frequently, then you know that it is tough enough to make healthy choices, let alone having those choices reflect your particular hormonal makeup. To help you out, Dr. Lark and I created several tools in Hormone Revolution to make your food selections much easier when you are dining out.

Whether you tend to be overall acidic woman dealing with menopause problems or a more alkaline, woman with estrogen dominance or someone with low estrogen levels but excess yin, eating out can prove to be tricky since you are not the one preparing the food.

Traditionally, people have chosen mostly highly acidic dishes and entrées when eating in restaurants. Luckily, all-American, overly acidic fare such as the 16-ounce porterhouse steak, French fries, and rich, sugary deserts, and French cuisine with its heavy butter- and cream-based sauces have been replaced or supplemented in many restaurants by lighter, healthier, and less acidic, more alkaline dishes. This is true both in American restaurants and in those serving ethnic cuisines. The important thing is to know which dishes on the menu represent the less acidic, more alkaline options and to select a variety of these types of dishes when dining out.

International Cuisine

The following list can help you make healthy choices, particularly if you are working hard to balance your female hormones. In general, you will want to order salads, non-dairy soups, vegetable or bean appetizers and side dishes, and vegetarian or fish entrées. Remember, most restaurants are willing to make up vegetarian entrées and platters at your request, even if they are not on the menu.

• American cuisine: salad or salad bars, bean or vegetable soups, baked potatoes, rice, vegetable side dishes or platters, fish or shellfish entrées.
• Italian cuisine: escarole soup, bean or minestrone soup, white bean salad, Caesar salad, risotto, polenta (cornmeal) with a mushroom sauce, grilled eggplant entrée, fish or shellfish entrées.
• French cuisine: vegetable or seafood salads, nondairy soups, vegetable side dishes, stewed beans, fish or shellfish entrées.
• Indian cuisine: lentils, rice pilafs, cucumber salad, curried vegetable or shellfish dishes.
• Chinese cuisine: stir-fried vegetables, sizzling rice soup, tofu or bean curd dishes, steamed rice, shrimp and mixed vegetable entrées.
• Japanese cuisine: Japanese salads, miso soup, sticky rice, sushi, side dishes and soups made with vegetables and tofu.
• Mexican cuisine: mixed vegetable salads, tostada salad, bean and rice side dishes, bean or shrimp burritos, chicken or shrimp fajitas, bean or seafood tacos (skip the cheese and sour cream).

Now that you understand why you should be wheat-free, how can you actually do it? After all, wheat seems to be in everything!

I know exactly how you feel. That was my first thought when I started on this process. Thankfully, it isn’t nearly as complicated as you may think. Remember, wheat is an ingredient…not an entire food category. That means you can still have bread, pasta, pizza, baked goods, etc.—just choose ones made without wheat.

The most common wheat substitutes include oat, soy, corn, rice, millet, quinoa, and buckwheat breads, crackers, pizza crusts, bagels, and pasta. Great brands include Pamela’s, Gluten-Free Pantry, Namaste Foods, Foods by George, Glutino, and Bionaturae.

Below are the specific products from these brands that I like. If you cannot find these items in your local grocery store, Whole Foods Market, or specialty store, I’ve included a Web site for you so you can buy them online. You can also visit Miss Roben’s for many wheat-free (and sugar-free) products all in one place.

Breakfast

Lifestream Buckwheat or Flax Plus waffles
Glutino plain or sesame bagels (www.glutino.com)
Barbara’s Puffin cereals
Pamela’s pancake and baking mix (www.pamelasproducts.com)

Lunch/Dinner

Bionaturae pasta

The month of October is National Celiac Disease Awareness Month. As you likely know, celiac (also known as sprue) is an intolerance to the protein (gluten) found in wheat, rye, and barley. Current statistics show that about one in every 100 people is affected with celiac disease.

Symptoms range from mild to severe bloating, gas, diarrhea, constipation, cramps, fatigue, aches, flu-like symptoms, and/or mood swings. Any of these sound familiar? They should…they are similar symptoms to conditions as varied as irritable bowel syndrome, chronic fatigue, Crohn’s disease, and even fibromyalgia. No wonder so many people are either misdiagnosed or never even seen.

While celiac disease represents the extreme end of a gluten disorder, women with even a mild to moderate case of wheat or gluten intolerance (like me) can put their health at risk if they keep wheat on the menu. Some of the conditions that can be trigger by even a slight wheat intolerance include digestive inflammation, chronic fatigue, mood disorders, estrogen level imbalances, false fat-related weight issues, and migraine headaches.

In the case of digestive inflammation, wheat and other food allergies or intolerances can cause bloating and fluid retention in the abdomen. In addition to swelling and bloat (the “false fat”), wheat intolerance can cause intestinal gas and bowel changes.

Additionally, allergens such as wheat stress your adrenals, thereby triggering the release of anti-inflammatory hormones. Over time, these repeated allergic reactions can weaken your adrenals, greatly increasing your susceptibility to stress of all types and can lead to fatigue and low energy. Plus, recent studies indicate that an astounding 80 to 93 percent of women suffering from migraines also suffer from food allergies that trigger their headaches, and wheat is one of the most common allergens that triggers these incredibly painful headaches.

Finally, wheat can wreak havoc on your hormones. For women suffering from menopause problems, wheat can trigger mood shifts, due in part to your growing inability to produce enough enzymes that are needed to digest wheat properly and easily.  And for women like me who tend toward estrogen dominance, wheat can throw your estrogen levels even more out-of-whack, due in part to the high carb content, as well as the inflammation factor.

Clearly, wheat is one ingredient to keep off your plate. On Friday, I’ll give you a few tips and brands that make going wheat-free an easy and delicious choice for your health.

Since mammography became widely available in the early 1970s, physicians have mandated that women need annual mammograms in order to detect breast cancer at a much earlier stage, thereby allowing for more effective treatment and life-saving intervention. If you are like millions of other women, you have come to depend on this “gold standard” for the early detection of breast cancer.

However, over the years, a number of negative studies have cast doubt as to the true benefits of mammography in comparison to its many risks. Mammography has many flaws, including painful compression of the breasts, a high rate of false positive and false negative test results, and even increased risk of developing the very cancer you are trying to avoid.

Fortunately, an alternative method exists to help detect changes in a woman’s breasts—thermography. Thermography uses a heat-imaging screening technique that does not use radiation or breast compression to detect tumors.

I had thermography done a year or so ago. With this procedure, you undress down to your waist in a room that is keep at a fairly cool temperature. A qualified technician then uses a high-resolution camera to “read” the temperature of your body. The camera then converts it into an infrared heat image, records the images, and sends them to a computer where they are stored until a physician can perform a detailed exam to detect the exact differences in temperature that indicate whether or not cancer may be present.

It is very cool! Best of all, they can position you at the ideal angle for your particular breast contour to be examined simply by asking you to turn this way or that. This is very important, as the infrared “map” of each woman’s breast is as unique as her fingerprint.

Any change in this map over the course of months and years can signal an early indication of possible tumors or other abnormalities. In fact, studies have shown that an abnormal infrared image is the single most important indicator of high risk for developing breast cancer. Similarly, it has been found that a woman can increase her survival rate from breast cancer by 61 percent simply by including thermography as a part of her regular breast health checkups.

While thermography is still not as widely used and available as mammography, it is becoming more prevalent. Your best bet is to check with a complementary physician, osteopath, chiropractor, or naturopathic doctor in your area and ask them if there is anyone they recommend. 

Once you locate a physician and facility, be sure to ask who will be reading your exam and what qualifications they have. You’ll also want to ensure this doctor regularly tests, or at least participates in the quality control of the facility and equipment.

Final thought: The doctor I saw, Dr. Bruce Rind in Washington, DC, had the best comparison I’ve ever heard regarding thermography versus mammography. He said that thermography is like looking into the future, while mammography is like looking in a rearview mirror. In other words, mammography tells you what HAS happened while thermography tells you what MAY happen. Which would you rather have?

Performing a breast self-exam every month is one of the most important things you can do to promote breast health—and prevent cancer. Become familiar with your breasts, and how they look and feel. By doing so, you’ll be aware of any scar tissue or dents that are normal for you, and can work to develop your own intuition about the health of your breasts. You’ll also become more sensitive to any subtle changes in your breasts that might indicate the need to see your doctor.

Dr. Lark professes that there are three main components to a good breast self-exam. The first is the timing of the exam, the second entails a visual examination, and the third involves palpation (physical examination) of the breast tissue.

Step 1—Timing

Do your exam at the same time each month. If you are still menstruating, perform your exam after your period has ended. Your hormone levels are at their lowest during this time, and your breasts will tend to be less lumpy and swollen.

Step 2—Visual Examination

Take a good, long look in the mirror. While standing in front of a large mirror, hold your arms over your head, clasping your hands together. Look at your breasts for the following signs: an indentation in the breast that wasn’t there before; one nipple is inverted; eczema on either or both nipples; discoloration of nipple; and/or discharge from the nipple that is not a result of squeezing. Next, place your hands on your hips and gently bring both elbows forward in front of you. Look for the same signs listed above.

Step 3—Physical Examination

If your breasts are on the larger side, it may be best to do the manipulation part of the exam lying down. However, if you have small- to medium-sized breasts, you can perform the exam standing up. Just be sure to stand up straight. If you lean forward, glands and other benign nodules can feel like lumps and cause undue worry.

First, raise your left arm over your head and place it behind your head. Examine your left breast with your right hand. Picture your breast as a clock, with the nipple as the center. Moving clockwise, start in the 12:00 position, beginning at the nipple, and with firm but gentle pressure, press into your breast tissue with the pads of your fingertips, examining up as far as your collarbone, and as far to the sides as your armpits. Next, move to 1:00, 2:00, and so on, until you’ve examined the entire breast. Once you have finished examining your left breast, raise your right arm over your head, and repeat the procedure on your right breast.

Dr. Lark recommends that all women ages 20 and older perform monthly breast self-exams and have their physician do a clinical breast exam every year—at the same time they have their annual Pap smear. Starting good health practices early in life has been shown to increase compliance over time.

Women over 65 need to be especially vigilant with their screenings, as nearly 50 percent of all new cases occur in this small segment of the population (13 percent of all women), yet result in two-thirds of all breast cancer-related deaths.

Nothing says “breast health” like good nutrition. In addition to the benefits of DIM and Brassica vegetables, there are several other powerful nutrients that can promote not only healthy breasts, but overall health. Best of all, they include a supplement, food, and beverage, so it's a breeze to incorporate these changes into your life.

Bioflavonoids

Bioflavonoids, found in soy, buckwheat, alfalfa sprouts, the inner peel of citrus fruits, and many berries, are a natural source of plant estrogens that may help protect women from developing hormone-related cancers, strengthen blood vessels, and reduce inflammation.

Dr. Lark recommends 700–2,000 mg per day.

Flaxseed

This small, amazing seed benefits every cell, organ and system in the body. It helps maintain healthy cholesterol and blood sugar levels, supports healthy breast tissue, and even provides moisture to skin and joints. It’s easy to add flax to your diet. Just sprinkle two tablespoons of milled flaxseed over oatmeal or yogurt or blend into a smoothie once or twice a day.

Green Tea

Research continues to identify specific ways the polyphenols found in green tea fight cancer. The growing list already includes the following impressive actions:

• They prevent the formation of cancer-causing compounds, including nitrosamines (formed when the nitrites in cured foods bind with amino acids).
• They directly detoxify certain cancer-causing agents. 
• They block carcinogen activity by binding to tissue receptor sites. Polyphenols bind to receptor sites on breast tissue, preventing carcinogens (tumor promoters, hormones, and growth factors) from binding to and harming the cells. In essence, the polyphenols “seal off” the tissue from invasion by carcinogens.

Dr. Lark recommends drinking at least two to thee cups of green tea per day.

Increasing your consumption of Brassica vegetables is a great way to reduce your risk for breast cancer while also helping to offset elevated estrogen levels. Three of my favorite Brassica veggies include Brussels sprouts, broccoli, and cauliflower. Below are easy ways to prepare these vegetables and help offset your estrogen dominance, and hopefully decrease your risk for breast cancer.

Baked Brussels Sprouts

Trim Brussels sprouts and layer in a Pyrex baking dish. Drizzle with olive oil and sprinkle with a touch of sea salt and ground black pepper. Bake at 400ºF for 20 minutes. Some of the leaves with fall off and get deliciously crunchy. Enjoy!

Steamed Asian Broccoli

Cut flowerets from head of broccoli and steam until bright green and tender crisp. Place in bowl and mix with 1½  tablespoons sesame oil, 2 teaspoons tamari sauce, and 1 tablespoon sesame seeds. Blend well and serve.

Pureed Cauliflower

I don’t know about you, but I dream about mashed potatoes. They are definitely on my comfort food list. But, as a woman with estrogen dominance, I just can’t justify the carbs. Thankfully, pureed cauliflower is the perfect answer.

Trim cauliflower and place flowerets in a steamer. Steam until very soft. Place in a food processor and add a spoonful of ghee (clarified butter). Add ground pepper and puree until the consistency of mashed potatoes. Goes great with fish or veggie stuffed peppers.

As we reach a certain age, it seems that more and more of our friends are being diagnosed with breast cancer. This can be disheartening and frightening. While we know women who are estrogen dominant or those who have eleveated estrogen levels are at greater risk for breast cancer, women in premenopause or even those experiencing menopause symptoms can be diagnosed with this awful disease.

However, cancer is not an inevitable part of growing older! Arming yourself with the right information on how you can prevent breast cancer from happening in the first place can help lessen your fears and improve your overall health. And a key piece of that information is an amazing nutrient that has been shown to significantly lower your risk of breast cancer: DIM.

DIM and Breast Cancer

DIM (diindolylmethane) is a compound found in Brassica vegetables such as broccoli, bok choy, cauliflower, cabbage, and Brussels sprouts. When you eat these vegetables, the chewing process releases plant enzymes, which in turn create a phytochemical known as indole-3-carbinol (I3C). DIM is formed directly from I3C in the acidic environment of the stomach. Best of all, DIM has also been found to be highly stable, requires no conversion, and promotes beneficial estrogen metabolism.

When we talk about estrogen or estrogen levels, we are actually referring to three different compounds: estradiol, estrone, and estriol. During estrogen metabolism, estradiol (the most potent of the three) is converted into estrone. Estrone then becomes either 2-hydroxyestrone (a “good” estrone metabolite) or 16-alpha-hydroxyestrone (a “bad” estrogen metabolite). The good metabolite (2-hydroxyestrone) is then converted into 2-methoxyestrone and 2-methoxyestrodial. These two estrogen metabolites have been shown to inhibit the growth of malignant tumors. Conversely, 16-alpha-hydroxyestrone has been strongly associated with cancer growth.

This is where DIM comes in. Research has shown that when DIM is ingested, it not only encourages its own metabolism, but that of estrogen. While it is not an estrogen or even an estrogen-mimic, its metabolic pathway exactly coincides with the metabolic pathway of estrogen. When these pathways intersect, DIM favorably adjusts the estrogen metabolic pathways by simultaneously increasing the good estrogen metabolites and decreasing the bad estrogen metabolites.

After many studies confirmed that the 2-hydroxyestrone to 16-alpha-hydroxyestrone ratio was a good predictor of breast cancer risk, researchers set out to determine if consumption of Brassica vegetables could influence this ratio. In 2000, American researchers took urine samples from 34 healthy postmenopausal women. They then added 10 grams of broccoli a day to the women’s diets. After taking another urine sample, researchers found that this dietary change significantly increased the 2-hydroxyestrone to 16-alpha-hydroxyestrone ratio.

A similar study conducted in 2001 looked at the dietary habits of postmenopausal Swedish women aged 50 to 74. When asked how often, on average, they consumed a wide variety of foods, including 19 different commonly eaten fruits and vegetables, researchers found that those women who ate 1 to 2 servings of Brassica foods a day had a 20 to 40 percent lower risk of breast cancer than those women who ate virtually none.

What’s a Girl to Do?

Clearly, we all need to eat more Brassica vegetables. Aim for at least two servings a day to help keep estrogen levels of estrogen metabolites in the right balance. You can also augment your diet with a good, high-quality DIM supplement. Dr. Lark suggests taking 30 mg of DIM a day.

1. Preheat oven to 425°F.
2. Add all vegetables to roasting pan.
3. Top with basil and lemon pepper.
4. Drizzle with olive oil and bake for 45 minutes.
5. Serve warm.

Fall is my favorite time of the year. Not only does it mean snuggly sweaters and football, but it is also the time to pull out those soup and stew recipes. As you look through your favorites, keep your hormone type in mind.

If you have low estrogen levels and are experiencing menopause symptoms, you will want to lean toward recipes that are light on the spice and acid and high in vegetables, gluten-free grains, legumes, and seafood/fish.

If you have high estrogen levels and/or are estrogen dominant, then you’ll want to lean toward a diet rich in fruits and vegetables, poultry, fish, eggs, and more acidic condiments like vinegar and lemon juice. You will want to steer away from a grain-heavy diet.

In some cases, you’ll find that perfect recipe that pleases both estrogen profile. And here is just such a one for you!

Butternut Squash Soup
Serves 6

Butternut squash is rich in beta-carotene and vitamin C. Beta-carotene helps balance the estrogen excess in women with estrogen dominance, while vitamin C has many menopausal benefits, including the ability to fight heart disease by preventing the oxidation of LDL cholesterol.

Plus, the onions in the recipe provide the antioxidant power of quercetin. And with an antiseptic boost from sage, this soup is sure to keep your immune system strong during the cold winter months.

1 cup red onion, chopped
2 teaspoon olive oil
1 teaspoon ground sage
½ teaspoon sea salt
½ teaspoon cayenne pepper
3 cups vegetable broth
1 large butternut squash, peeled, seeded, and cubed
2 tablespoons soy or rice parmesan cheese (optional)

1. In a soup pot, sauté onion in olive oil over medium heat until soft
2. Add sage, salt, pepper, broth, and squash. Bring to a boil. 
3. Reduce heat and simmer for 25-30 minutes, or until squash is soft. 
4. Ladle ¾ of the soup in to a blender or food processor and purée. 
5. Pour back into pot and reheat for 5 minutes. 
6. Stir in parmesan cheese (if desired) and serve.

Marlene asked how you know if you are estrogen dominant. In our book Hormone Revolution, Dr. Lark and I give a couple of ways for you to determine your estrogen levels. While several doctors recommend blood testing, Dr. Lark prefers saliva testing, as it contains a particularly accurate indicator of free (unbound) hormone levels. This is the key, as only free hormones are active, meaning that they can affect the hormone-sensitive tissues in your breasts, brain, heart, and uterus. You can talk with your doctor about ordering a saliva hormone test.

For a non-testing a quick peek into your hormone balance, you can also use the following checklist to determine if you suffer from estrogen dominance and have high estrogen levels. What these symptoms have in common is that they are due to estrogen levels that are too high in relationship to progesterone.

• Are you over age 35?
• Do you suffer from PMS?
• Do you have heavy, irregular periods? 
• Do you suffer from anxiety, irritability, and/or mood swings?
• Have you gained more than 10 pounds over the past few years? 
• Do you have noticeable cellulite?
• Do you have puffiness around your eyes or face?
• Do you have a decreased interest in sex? 
• Are you experiencing sleep difficulties? 
• Are you retaining fluids? 
• Are you having headaches? 
• Do you have bouts of brain fog—forgetting your friend's first name, where you put your car keys, or the point of a text you recently studied? 
• Have you recently discovered cysts in your breasts? 
• Have you been told you have fibroid tumors? 
• Do you have symptoms of endometriosis? 
• Have you been diagnosed with either hyperplasia or endometrial cancer?
• Have you been diagnosed with ovarian cysts?

If you answered yes to three or more of these questions, you likely have estrogen dominance.

 

If you are have healthy estrogen levels or are in early menopause or premenopause, then you should quickly make lycopene your close and personal friend. A fascinating study from the International Journal of Cancer found that high carotene intake, especially a diet high in lycopene, significantly reduced the risk of ovarian cancer in premenopausal women. Investigators suggested that consumption of fruits, vegetables, and food items high in carotene and lycopene, particularly raw carrots and tomato sauce, may reduce the risk of ovarian cancer.

To reap these benefits, aim for 10 servings of cooked tomatoes or tomato products every week. Just be sure to mix the tomatoes in an oil base, such as olive oil, to enhance lycopene absorption.

If you do not want to eat this much tomato-based food, or you simply dislike their taste, then lycopene supplements are a good alternative. Dr. Lark recommends taking 5–10 mg per day. Lycopene is available in most health food stores.

Unfortunately, lycopene does not confer the same protection against ovarian cancer in postmenopausal women that it does in younger women. Luckily, foods high in alpha-carotene and alpha-carotene supplements have been found to significantly reduce the risk of the disease in postmenopausal women.

And, animal studies have shown alpha-carotene is 10 times more effective than beta-carotene in suppressing lung, liver, and skin cancer, while other research has found that the nutrient is 38 percent stronger in antioxidant activity than beta-carotene.

Foods highest in alpha-carotene are carrots, corn, squash, watermelons, green peppers, potatoes, apples, peaches, and leafy green vegetables. If you prefer a supplement, Dr. Lark suggests taking 25,000 IU of mixed carotenoids that contain a blend of both alpha- and beta-carotene.