A Woman's Way to Natural Health

The feminist movement, which spans the 18^th century through the 20^th century, has tackled many issues regarding womenfrom womans suffrage and equal pay to reproductive rights, domestic violence and maternity leave. Famous writers such as Virginia Woolf and Susan B. Anthony were influential advocates for womens rights and attempted to tackle these issues in their writings and speeches. Women have come a long way; but, regardless of the political progress theyve achieved, they still have unique and distinct needs, physically. Women exclusively experience menstrual cycles, pregnancy and menopause, just to name a few. The market for womens health covers many health issuesfrom menstruation and pregnancy to breast cancer, weight loss and menopause. And just as women fought for their political rights, women are now fighting for their physical rights and are advocating and actively seeking out natural alternatives to conventional mainstays such as hormone replacement therapy (HRT), antibiotics for urinary tract infections (UTIs), over-the-counter (OTC) medications for menstrual cramping and other pharmaceuticals designed for women.
The appeal of natural alternatives over synthetic pharmaceutical chemicals is extremely popular with women, especially since scientific studies have pointed out the adverse effects of HRT, said Ellen Kamhi, Ph.D., RN, professional herbalist/nutritionist, Bio-Botanica. Natural is perceived as safe. Women are much savvier than years ago and are carefully reading labels. They are looking for proof or studies that show a product works. Natural-based support for menopause and other female health issues such as infertility, premenstrual syndrome (PMS) and breast health has many short- and long-term issues to address.
Don Stanek, director of sales, Linnea Inc., echoed Kamhis comments, adding: As long as dietary supplements have good or adequate efficacy, consumers, especially women, are interested in natural products to stave off potential issues as women age. Maintenance of good memory, vision, cardiovascular, menopausal concerns and other age-related issues are all available through some types of supplementation. Women also may view pharmaceutical products as risky so they may gravitate to natural products as a way to obviate the need for prescription drugs.
But although women are interested in naturals, the number of menopausal women supplementing is still rather low. The Natural Marketing Institute (NMI) reported in its 2009 Supplements/Rx/OTC Database, 2 percent of women who indicated they use supplements indicated usage of supplements for menopause in the past 30 days.
But chin up; there are numbers in favor of womens reliance on supplements, too. The market for womens health products that incorporate natural ingredients is growing, said Bob Green, president, Nutratech. According to the National Institutes of Health (NIH), a nationwide government survey showed 42.8 percent of American women have used natural products, and the likelihood they will use natural products increases as they age, adopt active lifestyles, and achieve higher levels of income and education. The large population of aging female Baby Boomers and the general consumer trend toward all things natural bodes well for the womens natural health market.

Fruit First

As a womans body ages, her health needs change and evolve. Women have special dietary needs as they move through life, from adolescence, through their child-bearing years, to menopause and beyond, said Aparna Parikh, senior marketing manager, DSM Nutritional Products. Each lifecycle stage carries with it health concerns and so different nutrient requirements. From a fast physical and emotional growth stage during adolescence to pregnancy and lactation during child-bearing years, and later on menopause with an increase in age-related issues from declining estrogen levels, all require good nutritional support for optimal health.
As Parikh stated, starting in their teenage years, women confront numerous issues such as PMS or UTIs. According to Sherry Torkos, a holistic pharmacist and author, 80 percent of women will experience a UTI in their lifetimes, and approximately 20 percent of women will have a UTI each year. A total of 9.6 million U.S. doctor visits per year are attributed to UTIs, and they are the second leading cause of lost work days for women.
Based on our sales, as an ingredient supplier, I would say the UTI and menstrual sector of women's health is one of the most popular, said Steve Siegel, vice president, Ecuadorian Rainforest LLC. These ingredients include cranberry powders, for example. Cranberry has been shown to be effective in treating and preventing UTIs. It's known for its diuretic properties without depleting the body of important vitamins and minerals. In addition, maca is a root vegetable known for its effective relief of menopausal and PMS. I believe these two categories will continue to be very popular. UTIs can occur frequently in women, and well, that time of the month is made that much easier with some natural alternative help like maca.
As Siegel noted, the cranberry has gained popularity in the UTI category, due to research confirming the cranberrys role in urinary health.
Dean Mosca, president, Proprietary Nutritionals Inc., agreed, noting, There has been a significant increase in women consuming cranberry supplements to promote urinary tract and bladder health, as they also realize they are naturally susceptible to UTIs. In 2009, researchers found Trimethoprim, an antibiotic commonly prescribed for UTIs, had a very limited advantage over cranberry extract (as Cran-Max®, from Proprietary Nutritionals) in the prevention of recurrent UTIs in older women and had more adverse effects.¹ A total of 137 women with two or more antibiotic-treated UTIs in the previous 12 months were randomized to receive either 500 mg of cranberry extract or 100 mg of trimethoprim for six months. Thirty-nine of 137 participants (28 percent) had an antibiotic-treated UTI (25 in the cranberry group and 14 in the trimethoprim group). The time to first recurrence of UTI was not significantly different between the groups. The median time to recurrence of UTI was 84.5 days for the cranberry group and 91 days for the trimethoprim group.
Cranberry extract was also studied in patients with a spinal cord injury. A randomized, double blind, placebo-controlled trial with a crossover design gave a cranberry extract (as Cran-Max) or a placebo to subjects with a spinal cord injury and documentation of neurogenic bladder for six months, followed by the alternate preparation for an additional six months.² A reduction in the likelihood of UTI and symptoms for any month while receiving the cranberry tablet was observed. |
Another fruit thats plucked for its health benefits is the grape or, more specifically, resveratrol, which is found in the skins and seeds of grapes. In the summer of 2010, researchers investigated estrogen receptor-alpha (ER alpha)-positive and BRCA-1 wild-type MCF-7 breast cancer cells influence of aromatic hydrocarbon receptor (AhR) activation, which contributes to the etiology of various types of cancers, with the agonist 2,3,7,8 tetrachlorobenzo(p)dioxin (TCDD) on epigenetic regulation of the BRCA-1 gene, a tumor suppressor involved in repair of DNA damage, and the preventative effects of resveratrol.³ Researchers concluded epigenetic silencing of the BRCA-1 gene by the AhR is preventable with resveratrol and provide the molecular basis for the development of dietary strategies based on natural AhR antagonists.
And the purple tart juice from pomegranate seeds may also fight in breasts favor, as a study published in Cancer Prevention Research found pomegranates may prevent estrogen-responsive breast cancers.4 Phytochemicals ellagitannins (ET), found in pomegranates, inhibited aromatase, a key enzyme used by the body to make estrogen that also plays a key role in breast cancer growth.

So Soy

Soy receives mixed reviews in the womens health category. It carries a stigma with it since it was accused of causing breast cancer; but actually soy and other phytoestrogens play a positive role in breast health. JAMA reported women in China who had breast cancer and a higher intake of soy food had an associated lower risk of death and breast cancer recurrence.⁵ Patients in the group with the highest intake of soy protein had a 29-percent lower risk of death during the study period, and a 32-percent lower risk of breast cancer recurrence compared to patients with the lowest intake of soy protein. The American Journal of Clinical Nutrition also reported no association between phytoestrogen intake and breast cancer in women, or between phytoestrogen intake and colorectal cancer in men.⁶
According to findings presented at the Ninth Annual AACR Frontiers in Cancer Prevention Research Conference in November 2010, increased phytoestrogens commonly found in dietary soy may modify the risk of some types of breast cancer. Among premenopausal women, the highest intake of isoflavones had a 30-percent decreased risk of stage 1disease, a 70-percent decreased risk of having a tumor larger than 2 cm, and a 60-percent decreased risk of having stage 2 breast cancer. These connections were not seen among postmenopausal women.
A sister to soy is genistein, an isoflavone that serves as a very weak phytoestrogen and has shown promise in many peri- and postmenopausal women. Genistein is the primary isoflavone in soy foods, accounting for 50 to 55 percent of total isoflavone content, Parikh said. It is the main circulating isoflavone in humans and has been the most thoroughly researched of the three major soy isoflavones (genistein, daidzein and glycitein). genivida®, pure genistein, is an isoflavone that has been developed by DSM for use in dietary supplements and functional foods.  
A placebo-controlled, double blind study presented by James Elliott at the 9th International Symposium on the Role of Soy in Health Promotion and Chronic Disease Prevention and Treatment meeting in Washington, conducted in collaboration with KGK Synergize Inc., London, Ontario, randomized 84 healthy postmenopausal women to receive either geniVida (from DSM) or a placebo. After 12 weeks, the women on geniVida had a 51-percent reduction on hot flashes and night sweats compared to only 27 percent for the women in the placebo.
Separately, Italian researchers conducted a pilot study on the effects of the soy isoflavone genistein on the metabolic and hormonal disturbances of polycystic ovary syndrome (PCOS).⁷ Phytoestrogen supplementation significantly improved total cholesterol levels, reduced low-density lipoprotein (LDL) cholesterol and resulted in a decrease in LDL to high-density lipoprotein (HDL) ratio. Triglycerides showed a decrease; however no change was detected in very LDL-cholesterol plasma levels. This result suggests the advantages of phytoestrogens in PCOS may be limited to the improvement of the lipidic assessment.

Deep Rooted

Indigenous to Thailand, Pueraria mirifica (PM), a root belonging to the Papilionaceae (Leguminosae) family, has been used in Asian culture for many centuries. An in vitro study evaluated the possible role of PM (as Puresterol®, from Bio-Botanica) in the management of breast cancer.⁸ Cell growth studies over four days indicated low growth rates for the PM-treated cells with an increasing effect over time that appeared to reach significance by day three or four when compared with untreated cells. Additionally, a separate study published in Menopause found PM exhibited estrogenicity on vaginal tissue by alleviating vaginal dryness symptoms and dyspareunia, and improving signs of vaginal atrophy, and restoring the atrophic vaginal epithelium in healthy postmenopausal women.⁹
Similarly rooted, plant lignans are phytonutrients found in unrefined grain products; seeds such as sesame and flaxseed; and berries, fruits and vegetables. The body converts plant lignans into human lignansmainly enterolactonethat have a weak estrogen-like activity. Lignans are able to make up for deficiencies when estrogen levels are low in the body, and are able to reduce the activity of estrogens by occupying the cellular estrogen-binding sites where sufficient amounts are present.
Linnea manufactures and markets HMRlignan, which is metabolized directly into enterolacone. HMRlignan has been shown to decrease hot flashes by more than 50 percent, assist in breast health issues and perhaps weight management, Stanek said. In a recent Canadian study of women who were on a lignin-rich diet, and whose enterolactone levels increased, there was a weight loss and body mass loss that was significant.
High plasma levels of enterolactone are associated with breast cancer risk and whether the ERalpha status of the tumor influences this relation was investigated.¹⁰ The cohort study Diet, Cancer and Health included 29,785 women, ages 50 to 64 years, between 1993 and 1997. Researchers found a tendency toward a lower risk for breast cancer with higher concentrations of enterolactone, which was restricted almost entirely to ERalpha-negative breast cancer.
In a separate study, Finnish researchers examined the association between serum enterolactone and risk of breast cancer in Finnish women.¹¹ The study concluded, Serum enterolactone level was significantly inversely associated with risk of breast cancer.
Speaking of weight management, this is a concern for many women, as aging slows down the metabolic process, among other weighing factors. Originally, the womens health category was focused on female-specific health concerns like menopause and bone support, Green said. Nutratech, however, is a supplier of nutraceutical ingredients for weight management and sports nutrition. At first, that might appear unrelated to womens health; but, the American Obesity Association states prevention and early treatment of obesity are crucial to ensuring a healthy population of women of all ages because overweight and obesity are underlying risk factors in numerous womens health concerns.
Chase Hagerman, business development & marketing manager, Chemi Nutra, is also passionate about weight management in regards to womens health. In my opinion, weight management is the most popular sector of womens health, he said. Besides being the number one health concern for women, and having the largest basis of beneficiaries, consumers understand the health concern of weight management more than any other health concern.
And Mitch Skop, senior director of new product development, Pharmachem Laboratories Inc., echoed Green and Hagermans comments, adding: Weight management remains perennially top of mind and goal. Our scientists have created a three-part nutraceutical offering that addresses the three main causes of weight gain:  Phase 1 Hunger Controller, Phase 2 Carb Controller and Phase 3 Sugar Controller. These can be formulated in supplements and a wide variety of functional foods/beverages, as women are known to purchase foods and beverages based on functional/nutritional merit.
Nutratech developed a natural thermogenicAdvantra Z®from bitter orange. In a Canadian study, researchers boosted metabolism with a bitter orange extract. When given with a meal, a Citrus aurantium extract (as Advantra Z, from Nutratech Inc.) increased the thermic effect of food, although the effect was more pronounced in men than in women.¹² And, without adversely affecting blood pressure, Citrus aurantium (as Advantra Z) also increased epinephrine excretion by 2.4 times.¹³
Manufacturers and retailers who address the role obesity and overweight play in many of the health issues facing women are those that are going to see gains in sales, Green added.

Lipids

Caroline Brons, senior marketing manager, DSM Nutritional Products, agreed with Greens focus on weight control. The obesity problem lies in Closing the energy gap, suggesting it is not only how hard you work it off, but what you what you eat that matters when losing weight, she said. Therefore, weight management tools that address satiety, hunger control, portion control fit perfectly into today's consumer needs.
DSM tackles weight management with its lipid emulsion Fabuless® made of palm and oat oil. It creates satiety through the ileal brake, the body's natural appetite controller, Brons noted. This mechanism is triggered by the presence of lipids in the lower part of the small intestine (ileum). It sends a satiety signal to the brain that reduces appetite (telling the brain it is comfortably full) and helps individuals eat less to manage weight more effectively.
Another company interested in weight management via lipids is Lipid Nutrition. Weight management is a popular segment of womens health because its benefits of reducing body fat and increasing lean muscle appeal to womens desire to be more toned and have a shapely figure, said Patrick Luschsinger, Lipid Nutrition. A recent published clinical in the British Journal of Nutrition found conjugated linoleic acid (CLA; as Clarinol®, from Lipid Nutrition) reduced body fat in the region of the thighs and abdomen.¹⁴
In separate studies, CLA (as Tonalin®, from Cognis) significantly reduced body fat from 21.3 percent to 17 percent, and a small, but insignificant reduction in body weight (from 69.6 to 68.9 kg);¹⁵ and after seven weeks, CLA  increased lean tissue mass and reduced fat mass.¹⁶ No matter what issue a woman is dealing with, Luchsinger hit the nail on the head. I think a key driver is the womens health market is the concept of individualism: What works for you may not work for your friend, but the important thing is that you understand what works for you, he said.
And just as women fought for their individual political rights, they will continue to advocate an individualized natural approach to help manage their health issues.

References are on the next page...

References for "A Woman's Way to Natural Health"

1.       Marion E. T. McMurdo1 et al. Cranberry or trimethoprim for the prevention of recurrent urinary tract infections? A randomized controlled trial in older women J Antimicrob Chemo. 2009 63(2):389-395

2.       M J Hess et al. Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder Spinal Cord. 2009;46:622626

3.       Andreas J. Papoutsis et al. Resveratrol Prevents Epigenetic Silencing of BRCA-1 by the Aromatic Hydrocarbon Receptor in Human Breast Cancer Cells J Nutr. 2010;140(9):1607-14

4.       Lynn S. Adams, et al. Pomegranate EllagitanninDerived Compounds Exhibit Antiproliferative and Antiaromatase Activity in Breast Cancer Cells In vitro Cancer Prevent Res. (2009;3(1):10813)

5.       Xiao Ou Shu et al. Soy Food Intake and Breast Cancer Survival JAMA 2009;302(22):2483-2484

6.       Heather Ward et al. Breast, colorectal, and prostate cancer risk in the European Prospective Investigation into Cancer and NutritionNorfolk in relation to phytoestrogen intake derived from an improved database Am J Clin Nutr (Dec. 9, 2009). doi:10.3945/ajcn.2009.28282

7.       Romualdi D et al. Is there a role for soy isoflavones in the therapeutic approach to polycystic ovary syndrome? Results from a pilot study Fertil Steril. 2008 Nov;90(5):1826-33

8.       S. Ramnarine1, J. MacCallum2 and M. Ritchie Phyto-oestrogens: do they have a role in breast cancer therapy? Proceedings of the Nutrition Society 2009; DOI:10.1017/S0029665109990462

9.       Manonai, Jittima MD et al. Effect of Pueraria mirifica on vaginal health Menopause. 2007;14(5):919-924; DOI:10.1097/gme.0b013e3180399486

10.   Olsen A  et al. Plasma enterolactone and breast cancer incidence by estrogen receptor status, Cancer Epidemiol Biomarkers Prev. 2004 Dec;13(12):2084-9

11.   Pietinen P et al. Serum enterolactone and risk of breast cancer: a case-control study in eastern Finland Cancer Epidemiol Biomarkers Prev. 2001 Apr;10(4):339-44

12.   Gougeon R et al. Increase in the thermic effect of food in women by adrenergic amines extracted from citrus aurantium. Obes Res. 2005 Jul;13(7):1187-94.

13.   Haller CA, Benowitz NL, Jacob P 3^rd. Hemodynamic effects of ephedra-free weight-loss supplements in humans. Am J Med. 2005;8(9):998-1003.

14.   Gaullier JM, et al. Six months supplementation with conjugated linoleic acid induces regional-specific fat mass decreases in overweight and obese Brit J Nutr. 2007;97(3):550-560.

15.   Thom, E., Wadstein, J., and Gudmundsen O.: Conjugated linoleic acid reduces body fat in healthy exercising humans. J Int Med Res. 2001; 29, 392-396.

16.   Pinkoski, C.; Chilibeck, P.D.; Candow, D.G.; Esliger, D.; Ewaschuk, J.B.; Facci, M.; Farthing, J.P. and Zello, G.A. 2006: The effects of conjugated linoleic acid supplementation during resistance training. Med Sci Sports Exerc 38/2: 339-348.