Susan Calvert Finn

Nutrition Communiqué: Women in Midlife: A Nutritional Perspective

351 THIS YEAR , MORE THAN 31 MILLION WOMEN will reach the midlife transition known as menopause. Natural menopause occurs at a median age of 51 years, which has not changed much over the past few centuries. What has changed, however, is life expectancy. A century ago, most people died at about age 48. Now women generally live until almost 80. This increasing life span means that many women will spend a third (perhaps even a half) of their lives after menopause. According to a survey conducted by the North American Menopause Society (NAMS),1 more than three quarters of women aged 50–65 make some lifestyle changes at midlife, and the biggest area in which change occurs is diet and nutrition. That makes the midlife years an ideal time to use nutrition as a tool for health promotion.

Women and Chronic Conditions: A Double-Edged Sword

731 OVER THE LAST 50 YEARS, preventive hygiene, vaccines, antibiotic therapies, and various technologies have eliminated many of the diseases that killed people at an early age. Living longer, however, does not necessarily mean living better—especially for women, who not only suffer disproportionately from various chronic diseases but also do more than their fair share of caretaking for spouses, parents, and others with chronic conditions. To explore more about women and the doubleedged sword of chronic disease, we talked with Gerard F. Anderson, Ph.D., professor of public health at Johns Hopkins University, Baltimore, MD. Dr. Anderson is director of Partnership for Solutions: Better Lives for People with Chronic Conditions, a project of Johns Hopkins and The Robert Wood Johnson Foundation. A

Nutrition and Healthy Aging

7 million, 3-year national effort, Partnership for Solutions is aimed at raising awareness among the public, policymakers, and business leaders about the impact of chronic disease. The project combines research and communications initiatives to explore the impact of chronic disease on individuals, families, business, government, the healthcare system, and society and to discuss possible solutions.

Progress and promise in women's nutritional health.

711 MORE THAN 40 YEARS AGO, the Beatles captured our angst about aging when they sang, “Will you still need me, will you still feed me, when I’m 64?” Indeed, when the Fab Four wrote those lyrics, 64 probably seemed really old. Now, however, half a lifetime later, how old is old? Increasingly, getting old and being old are two distinct states. As the life span has increased, the criteria we used to define old have changed. A recent National Council on Aging (NCOA) survey, Myths and Realities of Aging 2000,1 reveals that a significant share of people in their 70s (44%) and 80s (33%) believe these are the best years of their lives. When asked what best defines the beginning of old age, most NCOA survey respondents said not candles on the birthday cake but rather a decline in physical ability and mental functioning.1 Today, we tend to think of the oldest old as people age 851. In 1998, there were 241 women for every 100 men in this age cohort. Because as a group women outlive men, far fewer older women than older men are likely to be married. In fact, in 1998, widows outnumbered widowers by 4 to 1.1 Meanwhile, the proportion of Americans age 60 with at least one parent alive has risen dramatically during this century—from 7% in 1900 to 44% in 2000. In 1960, 14% of Americans age 50 still had both parents living. That number has almost doubled, to 27%, today.1 The bottom line is this: Most people in the 851 cohort are women, and many are without husbands. More than ever before, these elderly people have adult children, many of whom become caregivers to one degree or another, and most of these caregivers are women. Of the estimated 7 million caregivers of aging parents or relatives, daughters outnumber sons by 4 to 1.2

Helping women find everyday solutions.

839 WITH THIS, THE LAST INSTALLMENT OF Nutrition Communique for the year 2001, we decided to take a look back and a look forward at progress and promise in the area of women’s nutritional health. Our expert panel is composed of some of my fellow members of the Council for Women’s Nutrition Solutions (CWNS), a group of professional women in the fields of nutrition, medicine, health research and education, and psychology— all of whom share a passion for promoting and protecting women’s health. (See Helping women find “everyday solutions.” Journal of Women’s Health & Gender-Based Medicine 2000;9(9):951.) Their replies to our two questions seem to echo a common theme: We are in an era of remarkable scientific discovery in many areas, including nutrition and health, but all the science in the world means nothing if people do not change their unhealthy behaviors. The real frontier in women’s nutritional health is motivating behavior change— communicating the power of setting attainable goals and making realistic changes.

Nutrition—The Best Opportunity for Improving the Health of Women

951 EARLIER THIS YEAR, I joined nine other health professionals—all women—on the newly formed Council for Women’s Nutrition Solutions (CWNS). My CWNS colleagues come from the fields of nutrition, medicine, health research and education, and psychology. All of us share a passion for promoting and protecting women’s health. The CWNS has a simple mission with profound implications. CWNS is dedicated to promoting a balanced lifestyle, championing good health, and supporting “everyday heroes”—that is, women just like your patients—in their everyday choices. Findings from the 1999 Wirthlin Women’s Health Issues Survey underscore the everyday hero’s need for this kind of support.1 For example, although 91% of women surveyed said they know that getting plenty of sleep is important for good health, only 46% felt they were getting enough sleep. Similarly, the vast majority of women surveyed said they know that regular exercise is important, but only a little over a third said they are regularly active. The survey also captured a snapshot of the physical and emotional drain many women experience as they juggle everyday demands. Eighty percent of respondents said there is just too much to get done during their day and reported feeling drained of energy by day’s end. Almost three quarters said they do not have enough time for themselves. Almost 9 in 10 women in the Wirthlin survey said they know that eating healthy, regular meals is important, but only about a quarter of respondents actually do so. Half acknowledged that when they do not eat right, they have less energy. But when time is tight—as it often is for these time-stacking women—cooking is often the first thing to go. The typical woman today does not have a large repertoire of recipes, and as far as ingredients and preparation time are concerned, less is better. In addition, eating on the run has become a way of life in 21st century America. From desktop to dashboard, virtually any flat surface can double as a dining table. As a result of this hectic lifestyle, many women are not meeting recommended dietary allowances (RDA) for many key nutrients essential for optimal health.2 For example: