Flourishing health is the new aspirational goal for women and as discerning self-care gurus, they are seeking out information from not only the doctor but also from fitness, beauty, naturopathic, and myriad other experts. With the sheer overload of information out there, natural health retailers remain a trusted source and have an incredible opportunity to help women make the right choices for themselves and their families.

Heart Health More women die from heart disease than any other disease. Period. Even more than all the cancers combined. Most women didn’t realize this before the last two decades as the vast majority of research and medical trials were performed exclusively on men. From an NIH report on cardiovascular health in women from 2016: “Women are less likely to receive preventive treatment or guidance, such as lipid-lowering therapy, aspirin, and therapeutic lifestyle changes, than are men…” The report goes on to list several additional disparities. (1)

Many factors impact heart health: genetics, lifestyle, nutrition, stress. The impact of lifestyle factors can also differ between men and women. In the famous Framingham Heart Study, a long-term ongoing cardiovascular study, beginning in 1948, on residents of the city of Framingham, MA, obesity increased the risk of heart disease by 64% in women, compared to 46% in men. (2)

Symptoms can also differ by gender. Men are likely to get chest pains when they’re having a heart attack, for example, but women may instead feel discomfort in the neck, jaw, shoulder, back, or arm. Many women also experience nausea, vomiting, or a feeling similar to indigestion. (3)

As there is no magic bullet that will miraculously transform our heart health, certain supplements can make a difference. According to Dr. Tieraona Low Dog, an internationally recognized expert in the fields of integrative medicine, dietary supplements and women’s health, “We make less CoQ10, which is vitally important to our mitochondria, the powerhouses of our cells. This nutrient helps maintain the health of blood vessels, reducing the risk of atherosclerosis. It also keeps our blood pressure from climbing and supports the pumping action of our heart.” (4)

Jarrow’s QH-Absorb is helping to make Ubiquinol, the active antioxidant state of CoQ10, more easily absorbed and bioavailable. Anthony Thomas, science director at Jarrow, explains, “Unfortunately, (Ubiquinol) is not a stable molecule and can be easily oxidized, both within a product on the shelf and within the gastrointestinal tract. QH-Absorb’s proprietary formulation supports stability of QH (Ubiquinol) to protect against oxidation for better absorption.”

As a fat-soluble molecule, QH is hard to break down in the gastrointestinal tract. If it is not broken down, it cannot be absorbed by intestinal cells. Adds Thomas, “QH-Absorb’s proprietary formula utilizes emulsifying substances … thus improving absorption of this molecule that typically exhibits relatively poor absorption.”

Vitamin E is also important for heart support. Typically, we think of tocopherols when discussing vitamin E, but tocotrienols are now emerging as a star antioxidant ingredient. Tocopherols and tocotrienols both have a similar nucleus, which is the site of antioxidant activity. The difference between them is that tocotrienol is responsible for its cholesterol-lowering and other capabilities not shared by tocopherols.

Extensive and ground-breaking work has been conducted by Dr. Barrie Tan of American River Nutrition. “For a more varied approach to women’s cardiovascular health, two clinical trials support the combination of annatto tocotrienol with antioxidant polyphenols to curb inflammation and manage dyslipidemia. In these studies, supplementation led to a significant drop in C-reactive protein (a predictive marker for chronic inflammation).” In another recent clinical trial, results showed that after only four weeks, the optimum daily dose of 250mg decreased total cholesterol by 15%, LDL cholesterol by 18%, and triglycerides by 14%. (5)

Several independent in vivo studies have shown tocotrienol to be effective in improving insulin and glucose sensitivity, aiding cardiovascular function, and ameliorating obesity-related symptoms and fatty liver. In a recently published 12-week double-blind placebo-controlled clinical trial in patients with non-alcoholic fatty liver disease, delta-tocotrienol (derived from the annatto plant) improved Fatty Liver Scores by 11% with accompanying weight loss and led to a decrease in body mass index. (6) American River’s DeltaGold is one of the purest, natural tocotrienol ingredients available — supporting cardiovascular, cholesterol, and metabolic health.

Chromium is another important mineral. The Standard American Diet (SAD) is incredibly low in nutrients, including important trace minerals like Chromium. The more carbohydrates and sugars we consume, the more chaos for our blood sugar regulation.

According to Dr. Chris D. Meletis, director of science and research for Trace Minerals Research, “Research points to the importance of chromium in blood sugar regulation and it is well documented that diabetes and pre-diabetes (metabolic syndrome) are accelerants for both heart disease, stroke and other premature aging processes.” (7) Trace Minerals Ionic Chromium supports cardiovascular health and comes in convenient liquid drops.

Breast Health The ubiquity of pink ribbons, high-profile initiatives like “Race for the Cure,” and other breast cancer-related events are great for awareness; however, the real opportunity for retailers is to promote breast health and cancer prevention. As diagnoses are happening to more women at a younger age (there is a 1 in 8 chance of a woman developing breast cancer in her lifetime) (8), it’s time to start shifting the focus from awareness to prevention. It is never too early for women to start their prevention plan.

Breast health is affected by many factors from diet and nutrition to toxins and hormonal imbalances. Genetics play a role as well but increasingly lifestyle habits and other external factors are helping women keep healthy.

“The most significant lifestyle changes, supported by research, are the following: drink less alcohol; exercise more than 30 minutes, 5 days/week; and manage your weight. Beyond these three, we can venture into the arena of good stress management and mental health support,” says Tori Hudson, ND, Vitanica, of Tualatin, OR. The company’s Breast Cycle Blend is a supplement with vitamin E, gamma linolenic acid (GLA), iodine, and chaste tree berry -- a mixture that supports cyclic changes to a woman’s breast tissue.

In a 2015 study from the American Journal of Cancer Research, (9) ”a group of 1,170 women with confirmed breast cancer was followed for 87.4 months after diagnosis. It was found that … the higher dietary intake of magnesium was inversely associated with risk of all-cause mortality. That means the higher [the] intake of magnesium, the lower the risk of death,” notes Dr. Carolyn Dean, author of The Magnesium Miracle. There are many ways to take magnesium, including a powder form like Trace Minerals Stress-X magnesium powder, which taken in hot water can be a great calming evening tonic. Another bonus is that if taken in the evening, magnesium doesn’t impact calcium absorption if women are taking a morning multivitamin.

Omega-3 Fatty Acids have long been a go-to for antioxidant and anti-inflammatory protection. Scientists have found inflammation plays a significant role in the initiation and growth of tumors. According to Dr. Christine Horner, author of Waking the Warrior Goddess: Dr. Christine Horner's Program to Protect Against & Fight Breast Cancer, “These healthy fats … have four main benefits: they decrease the strength of estrogen in the breast tissue, quell the cancer-promoting fires of chronic inflammation, cause breast tumors to shrink in size and prevent them from metastasizing or spreading. Women with the highest amount of omega-3 fatty acids in their bodies have a 500% lower incidence of metastasis compared to women with the lowest levels of omega-3s.” (10)

Medicinal mushrooms are also a source of breast support. In particular, Maitake mushrooms have been found to be a great immune system booster as a result of beta-glucans. “Besides increasing the ability of macrophages to engulf and destroy cancer cells, microbes, and other foreign cells, the β-glucans stimulate the production of signaling proteins of the immune system, such as interleukin-1, interleukin-2, and cytokines.” (11)

A healthy diet is always the foundation of optimal health. Soy, still controversial to some, is beneficial in whole form (preferably organic). The isoflavones, or plant estrogens, have been associated with both breast cancer prevention and causing breast cancer as these phyto estrogens can mimic estrogen in the body. Recent data seems to reinforce that the likelihood of breast cancer with moderate amounts of soy in the diet should not cause concern. (12)

Vitamin D is another powerhouse. The fat-soluble vitamin is anti-inflammatory, in addition to having an anti-estrogenic effect in breast cancer cells. (13) According to Dr. Joel Fuhrman, an expert in the field of functional medicine and believer in the power of eating high-nutrient (mostly plant-based) foods for optimal health, “Three-quarters of women who have breast cancer are vitamin D deficient, and maintaining sufficient blood vitamin D levels is associated with reduced risk of breast cancer diagnosis or recurrence.” (14) Now Foods has an extensive offering of vitamin D in all forms and dosages.

Fertility “Women’s health in pregnancy can determine whether the next generation experiences diabetes, allergies, asthma - even autism. For the first time in history, children are expected to have a shorter life-expectancy than their parents and these preventable changes start even before pregnancy,” says Dr. Aviva Romm, a Manhattan-based integrative women and children’s physician, and author of the award-winning textbook, Botanical Medicine for Women’s Health.

Natural retailers have an incredible opportunity to help women prenatal and postnatal. One in six women struggles with fertility issues, over 10% have polycystic ovarian syndrome (PCOS), and millions suffer from endometriosis, fibroids, PMS, disruptive menopausal symptoms, and gynecologic cancers.

In general, infertility is defined as not being able to get pregnant (conceive) after one year (or longer) of unprotected sex. Although more and more women are electing to have children later in life, because fertility in women is known to decline steadily with age, some providers evaluate and treat women aged 35 years or older after 6 months of unprotected sex. (15)

Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.

“Ovulation problems are often caused by polycystic ovarian syndrome. PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation interruption. POI occurs when a woman's ovaries stop working normally before she is 40. POI is not the same as early menopause,” explains Trisha Sugarek MacDonald, sr. director of research & development/national educator at Bluebonnet Nutrition Corp., Sugar Land, TX
Common causes that can affect a woman’s ability to get pregnant are:
• Age • Smoking • Excess alcohol use • Stress • Poor diet • Athletic training • Being overweight or underweight • Sexually transmitted infections • Health problems that cause hormonal changes, such as polycystic ovarian syndrome and  primary ovarian insufficiency

Less common causes include: • Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy • Physical problems with the uterus • Uterine fibroids, which are non-cancerous clumps of tissue and muscle on the walls of the uterus.

While some of these causes might require medical intervention, more are based on lifestyle, which means women can take control of their health. The general consensus is that it is never too early to start taking a good prenatal vitamin, like Bluebonnet’s prenatal multivitamin, Early Promise Prenatal Gentle Multiple Caplets.

Adds Sugarek MacDonald, “It may seem strange to start taking a prenatal multiple even when you are not pregnant, but the thing is, once you are pregnant, [the] baby is developing at an exponential rate. Plus, it’s not just any type of nutrients; it’s the right nutrients in the right amounts as well as in the right balance – especially vitamins, minerals and essential fatty acids.”

All women can benefit from supplementing with vitamins and minerals to ensure a healthy pregnancy. In fact, the U.S. daily values (DVs) for some nutrients double during pregnancy.

Another important factor for boosting fertility is to maintain a healthy weight. The impact of obesity on a woman’s health can affect her heart, joints, and potential for diabetes, but it can also deeply affect her chances of getting pregnant.

When body mass index goes past the overweight category (BMI of 25–29.9) into the obese category (BMI of 30 and above), hormonal changes may occur in your body. (16) Obesity can also affect your hormonal balance and lead to insulin resistance, a potential precursor to diabetes, which can affect fertility and create abnormal menstrual cycles and the inability to produce eggs.

“Vitamin C is an important nutrient during pregnancy. Low levels have been associated with an increased risk of preterm birth and premature rupture of membranes, which can be very dangerous to the mother and baby,” explains Dr. Low Dog. “Like folic acid, choline also plays a role in preventing birth defects, but it may also provide the child lifelong protection against anxiety and exaggerated responses to stressors…. most prenatal supplements do not contain choline.” (17)

Choline is known to help the brain and spinal cord of babies to develop properly, and inadequate levels of it in the mother’s body can negatively impact a child’s cognitive development. Choline is a key component in various molecules that strengthen cell membranes, form neurotransmitters, and help nerve cells communicate with one another. A recent study showed that only eight of the top 25 prenatal vitamins contain choline and none provide more than 55mg per daily dose, which is just 12% of the DRI for pregnant women (18) which is 450mg, and 550 for adults in general.

In 2017, the AMA passed a resolution to ensure that all prenatal vitamins help give women the recommended amount. “We are extremely pleased to see the AMA take this step to increase the amount of choline pregnant women will get in their prenatal supplements because there is so much evidence to support the benefits of adequate levels, and the risks of choline deficiency,” said Tom Druke, director of strategic marketing, Balchem Corp., New Hampton, N.Y. Balchem’s VitaCholine is the branded choline product that provides supplement producers a nutrient that is essential for all life stages.

It's important to note that the benefits are experienced throughout different life stages. Adds Druke, "A sizeable study done by the Harvard School of Public Health found evidence that higher levels of choline during pregnancy may positively impact visual memory among seven-year-old children." (19)

Echoing the importance of choline, Jarrow’s Preg-Natal is formulated to meet a woman’s nutritional needs during pregnancy and lactation. Along with choline to support neurological development of the fetus, the supplement contains extra folate, calcium and iron.

Also, for proper infant brain and eye development, Bluebonnet’s Early Promise Prenatal Gentle DHA 200 mg Vegetarian Softgels are derived from marine algae for a truly vegetarian DHA from the inside out.

A recent study by the American Academy of Pediatrics emphasized the significant role adequate nutrition plays in a child's physical and neurological development during their first thousand days of life, laying a foundation for long-term health. By age two, a child's brain has grown more than it will at any other time in their life. However, any setback in brain development resulting from malnutrition during this time cannot be recovered in subsequent years. (20)

Other essential vitamins and minerals important for healthy baby growth are B vitamins, which play a role in brain function, including energy production in both mom and baby (6). Zinc plays a role in growth and development along with immune support (7,8). Selenium also provides antioxidant support (9).

“The first thousand days of life is a critical time point for development of all of the bodily systems, and studies suggest that nutrition during this time has a long-term impact on the health and well-being of the baby,” said Dr. Nicole Avena, neuroscientist, expert in prenatal and early childhood nutrition, and ambassador for Rainbow Light. “Cognitive development and immune functioning, in particular, are sensitive to nutritional status early in life.“

“The Rainbow Light Vibrance For The First Thousand Days line,” adds Susan Piergeorge, MS, RDN with Rainbow Light, “is the first multivitamin line customized for each stage of pregnancy from pre, during and post.”

Another key consideration is the relationship between stress and infertility. When a woman puts too much pressure on herself to conceive, the stress response triggered in her body complicates things even further. Bluebonnet’s Sugarek MacDonald adds “…in 2014, a study by Lynch et al. (21), found that women with higher levels of the stress biomarker alpha-amylase had a twofold increased risk of infertility.” This particular study involved approximately 400 couples over a 12-month span, and the results showed that the women with the highest alpha-amylase levels had a 29% less chance of pregnancy when compared to those with low levels.

To meet this need, Bluebonnet launched EarthSweet CellularActive Methylfolate 400, 800 and 1000 mcg Chewables, targeting women who are dealing with stress and trying to get pregnant. The product contains Methylfolate, the metabolically active form of folic acid. Women find this formulation helpful due to the fact that “this methylated form of folate supports proper functioning of the nervous system, gastrointestinal tract and helps maintain low homocysteine levels, which has been correlated with good cardiovascular and cognitive health.”

And retailers, don’t forget that probiotics are important for babies as well, not just for their gut health, but also for their immune system and brain development. “An imbalance between good and bad bacteria in the infant gut with increased levels of undesirable species (dysbiosis), can lead to gas, bloating, and discomfort that contributes to pain, fuzziness, and crying,” says Jarrow’s Thomas. One of the most important strains of good bacteria is B.infantis. “Bifidobacterium longum subspecies infantis (B. infantis) is the only bacterium that can fully utilize human milk oligosaccharides (HMO), complex sugars in human milk designed to shape the intestinal microbiota in infants,” explains Thomas. While some probiotics mistakenly claim to contain this important strain, Jarrow’s award-winning Jarro-Dophilus Infant contains the genuine B.infantis strain.

Menopause In Asia, menopause is often referred to as the “Second Spring” for women. This important life transition can mean many different things to women and the diverse experiences and symptoms associated with menopause underscore the fact that there is no one-size-fits-all approach. This presents an incredible opportunity for retailers to see how they can help women by being knowledgeable about the many resources women can use to help themselves thrive during this transition.

Symptoms associated with menopause tend to start around 45, but again there are women who start experiencing symptoms much earlier or later. This period is known as perimenopause. Common symptoms can include: hot flashes, night sweats, irregular menstrual cycles, weight gain, insomnia, brain fog, moodiness, anxiety, depression, low libido, dry skin, low-grade fatigue and more.

“During perimenopause and menopause, it’s helpful to include dietary supplements such as Vitamin D, Calcium, Magnesium, B Vitamins, Black Cohosh, Vitex, Soy Isoflavones, Sage, Turkey Rhubarb, and Wild Yam,” says Robin Rogosin, LifeSeasons VP of product development. Their Pausitivi-T product includes many of these ingredients such as: Black Cohosh, long used to support hormonal regulation in women and, in particular, estrogen in the body; Sage leaf, which is traditionally used to help with hot flashes and mood enhancement; soy Isoflavones, which support the body’s ability to regulate hot flashes and ease menopausal symptoms; Turkey Rhubarb, which promotes the health of the digestive tract and bowels; and Wild Yam, used to help support normal reproductive health and hormones in women.

Dr. Christiane Northrup, author of "The Wisdom of Menopause", and one of the foremost experts on women’s health, praises Pueraria Mirifica as a key supplement for women experiencing symptoms. “Without a doubt, I recommend P. mirifica as the treatment of choice for menopausal symptoms. It is the most effective treatment I have ever seen for perimenopausal and post-menopausal symptoms — and also premenstrual symptoms, I might add.” (22)

Her belief is so strong that she started her own line of supplements. P. Mirifica is a green climbing plant found deep in the forests of Thailand, treasured for centuries for its potent youth-restoring powers. In her Amata Life products, the Pueraria Mirifica root extract, “provides a rich source of powerful phytoestrogens. These natural plant estrogens work with your body – not against it.” (23)

Another common concern for women during this time is the health of their hair, skin, and nails. In particular, hair can become noticeably thinner due to changing hormonal levels of estrogen and progesterone. “A few ways to help maintain hormonal balance is to exercise -- which helps with mood and weight management -- eat healthy balanced meals, and take supplementation with natural ingredients known to help with hair growth and skin rejuvenation,” says Rogosin. LifeSeasons’ Beau-T product is packed with all the extra essential nutrients to help with hair, skin, and nail vibrancy. Key ingredients include Biotin, Collagen, MSM, Horsetail, and Turmeric, and other nutrients which help promote healthy tissues throughout the body.
Studies indicate that women who exercise during menopause enjoy much healthier energy, sleep, and mood, as well as less joint or muscle pain
A diet rich in plant proteins, greens, fruits, vegetables, nuts and seeds is essential. Some women may even benefit from lowering or eliminating their caffeine and gluten intake. Again, this is no one-size-fits-all approach. And, let’s not forget exercise. “Studies indicate that women who exercise during menopause enjoy much healthier energy, sleep, and mood, as well as less joint or muscle pain,” says Michael A. Smith, M.D., director of education for Fort Lauderdale, FL-based Life Extension. The company offers a wide array of products geared to helping women with menopausal symptoms and hormonal fluctuations, including Estrogen for Women, a plant-based formula made from soy isoflavones, broccoli, licorice, chasteberry extract, dong quai, and other proven ingredients.

Life Extensions’ Menopause 731 product features extracts from the roots of the Siberian rhubarb plant (R. rhaponticum). “This one ingredient,” says Smith, “shows significant improvements in all major menopausal symptoms.” Research found that R. rhaponticum extract produced up to 83% reduction in total menopausal discomforts, up to 83% reduction in hot flashes, and up to 66% reduction in irritability and mood swings. (24)

And speaking of mood swings, Hudson recommends L-theanine, Lavender extract, GABA, St. John’s Wort, L-tryptophan or 5 hydroxytryptophan and L-tyrosine.

Stress reduction is important in this transition and that might mean yoga, meditation, walks, or simply saying “No” more often. Detoxing negative emotions is also important. On a nutritional level, detoxing the system also has its benefits with hormonal regulation. Jarrow’s DIM + CDG product promotes liver detoxification, estrogen balance, and healthy cell replication. BioResponse DIM provides the cruciferous indole, Diindolylmethane (DIM), which is also involved in the liver’s natural detoxification process. Calcium D-Glucarate (CDG) supports glucuronidation, which is an important pathway in detoxification. These two ingredients together support healthy estrogen and testosterone balance in both women and men.

And, again, let’s not forget choline. Due to decreased levels of estrogen after menopause, the synthesis of choline slows down. Decreased levels of choline in the body can potentially compromise cognitive and liver function. (25)

The communication that occurs between cells in the brain, and the ease with which it occurs, is a mechanistic basis of memory. Messaging is facilitated by better cell-to-cell contact between neurons, greater availability and mobilization of neurotransmitters, and so-called secondary messengers (26), all factors that can be manipulated by choline availability. Women are on a quest for vibrant health at all life stages and are more likely now than ever to advocate on their own behalf by seeking out information to understand the steps they can take to achieve their health goals. Natural health retailers are a trusted source and can provide the kind of authentic information and learning opportunities that today’s women are seeking. WF
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Shelley Huber is a writer and coach on health and human potential. Her company, MindBody360.com, is an online wellness resource offering content and signature programs.