Making the connection between food and key nutrients women need after 40 is important. Here are 7 foods that pack a punch and alternatives that help women thrive at midlife and beyond.
At different developmental stages, certain nutrients become vitally important. The developmental stage of midlife is no different.
Therefore, every woman over 40 should make the connection between food and nutrients, ensuring her body is getting what it needs.
This isn’t about restricting food or saying every woman must eat this or that. It’s about finding creative ways to include nutrient-rich foods midlife women need to thrive.
But first, let’s consider why we need to focus on nutrients as we get older.
The triage theory of aging
Even in developed countries, people fall short on key vitamins and minerals. For instance, 70% are below the recommended amount of vitamin D, 60% vitamin E, 45% magnesium, and 34% vitamin A.
I was intrigued to read about the “triage theory” of aging in the Proceeding of the National Academy of Sciences. This theory suggests that even modest vitamin and mineral deficiencies accelerate the aging process.
That’s because bodies respond to vitamin and mineral shortages by turning on proteins and enzymes that are essential for survival. On the flip side, this turns off the proteins and enzymes needed for long-term health (preventing damage, etc.).
The author of the paper, Bruce Ames from the Nutrition and Metabolism Center, Children’s Hospital Oakland Research Institute (CHORI) puts it this way:
A major aspect of degenerative aging is that the damage is insidious and clinically not obvious because it accumulates slowly over time and is apparent only later in life. The connection to V/M (vitamins and minerals) shortages is underappreciated.
Midlife is the ideal time to invest in nutrition, so as you get older you have the reserves you need to support long-term health.
Here are 7 key foods that help you do just that.
1. Leafy greens
Foods like spinach, kale, arugula, lettuce, and swiss chard contain high levels of nitrates. Although nitrates are not considered nutrients (yet), they are vitally important as we age.
That’s because nitrates help generate nitric oxide, a vital signaling molecule in your body that is responsible for vasodilation, increasing blood flow, and maintaining vascular function.
First identified in research studies in the 80s, three researchers received the Nobel Prize for discovering “nitric oxide as a signaling molecule in the cardiovascular system”.
The two pathways for making nitric oxide
Our bodies make nitric oxide one of two ways. The first is via the cells that line blood vessels (endothelium) by a reaction combining L-arginine with the enzyme nitric oxide synthase (NOS). I’ll refer to this as “eNOS derived NO.”
The second way is from eating inorganic nitrate in foods like spinach, kale, arugula, lettuce, and swiss chard through the “nitrate-nitrite-nitric oxide” pathway. First, bacteria in the month reduce nitrate to the active form nitrite. Then nitrite is swallowed and with help from stomach acid, nitric oxide is produced.
For this process to work, you need nitrate-reducing bacteria in the mouth and stomach acid. So, avoid regular use of mouthwash because it kills bacteria and antacids decrease stomach acid.
Estrogen and progesterone stimulate nitric oxide
What makes matters worse is when women go through menopause, they experience even lower levels of eNOS derived NO because estrogen and progesterone stimulate nitric oxide formation.
Flow-mediated dilation (FMD), is a measure of artery widening and blood flow, and endothelial function. Early perimenopausal women were found to have a 17% decrease in FMD. This doubled (35%) as they progressed to late perimenopause.
This is one of the key reasons heart disease risk – including blood pressure — jumps at menopause. Endothelial dysfunction is one of the very first events of heart disease.
Nitrate-rich foods to the rescue
Nitric oxide expert Nathan Bryan argues that nitrates are so important, they need to be established nutrients. And people over 40 need to boost their nitric oxide through nitrates. This is where leafy greens come in.
The research to date shows that nitrate-rich foods and supplements help lower blood pressure, arterial stiffness, and platelet aggregation and improve endothelial function. They also help improve athletic performance by increasing oxygen utilization during exercise.
A study with postmenopausal women had one group eating two high-nitrate salads per day for 10 days and another group consuming low-nitrate canned vegetables. Not only did women in the first group have higher nitrate concentrations, but they also had higher flow-mediated dilation (FMD).
“What’s interesting about nitric oxide is you can produce it endogenously, which means your body will make it, with estrogen triggering it,” said Johston the lead researcher, in a press release. “But you can also provide your body with dietary nitrates that convert to nitric oxide, and leafy greens are full of nitrates.”
Bottom line: as we age, we benefit from eating greens that can generate nitric oxide and are have other established health benefits. Add arugula to any meal, spinach on sandwiches, and make tasty salads. Greens are a good source but so are root vegetables like beets and celery.
Most days, I make a midlife power salad that includes many foods in this post.
What about supplements
There are a variety of nitric oxide supplements on the market, but not all test their products for nitrates. My favorite ones are from HumanN because not only do they test their products for nitrates, but also for health outcomes like lowered blood pressure.
Yet it has been argued that the long-term safety of taking these supplements hasn’t been confirmed so for now, eating nitrate-rich food along with incorporating supplements periodically may be best.
I’ll be talking about other ways to boost nitric oxide in the future so stay tuned!
2. Brazil Nuts
Brazil nuts are the leading source of selenium, an important mineral for midlife women. Selenium is a potent antioxidant through the formation of selenoproteins but it’s also vital for thyroid function. And because thyroid issues peak in women past 40, women should be aware of their selenium intake.
Research is beginning to unravel the role selenium plays in thyroid health. In a study published in the Journal of Clinical Endocrinology, the risk of thyroid dysfunction was 69% higher in people living in a low-selenium county compared to those who lived in a selenium-sufficient area.
“Selenium is well-known to protect the thyroid,” said researcher Margaret Rayman, in this Endocrine Web article. “The importance is that we have shown that low selenium is associated with an increased risk of thyroid disease.”
Adequate selenium has also been found to play a role in the prevention of cancer, boosting the immune system, and lessening anxiety and depression. The RDA is set at 55mcg although some studies show 100mcg may be optimal. We need more research to know for sure.
Even if you aren’t hypothyroid, having TSH levels in the high normal range has been associated with an increased risk of heart disease and metabolic syndrome, and reduced bone mineral density. Get my FREE biomarker guide to learn about and track your thyroid markers.
Selenium and the U-Shaped Effect
There is a U-shaped effect when it comes to selenium intake, though, meaning there is a narrow range for optimal intake. Taking too little or too much may have adverse effects. Blood levels between 90-120mcg/L are optimal and 85 or less is inadequate.
Because selenium is found in a variety of food, getting it from the diet is a realistic goal, and food sources, RDA, and upper tolerable intake are listed below.
Brazil nuts have high levels of selenium but depending on where they come from this can vary dramatically. For instance, one study found that a single nut from the Mato Grosso area provided 11% daily value compared to 288% brazil nuts from the Amazonas. According to the USDA, there is 96mcg of selenium per nut.
So, if you plan to buy Brazil nuts, ask the manufacturer where they get their nuts and if they test them for selenium. You want to be sure you don’t eat too much as 1-2 is usually enough. After some digging, I found Now Brazil nuts contain 55mcg per 5 nuts through their testing.
What about supplements?
Supplements may be given for thyroid issues, and multivitamins contain varying levels of selenium. It’s recommended not to take over 300mg, but the consensus at this time is getting it from food and some from a multivitamin is your best bet unless otherwise directed by a healthcare provider.
3. Sunflower Seeds
An ounce of sunflower seeds provides 7.4mg vitamin E, getting women to half of the recommended amount of 15mg. This is important because over 90% of Americans fall short on vitamin E.
Vitamin E is a fat-soluble antioxidant that helps tame free radicals that tend to increase with age. Vitamin E also boosts immune function and helps regulate gene expression. According to one review, people who get more vitamin E from the diet are at a lower risk of getting lung cancer.
Vitamin E is also good for your heart. Getting more than 7mg/day can decrease death from heart disease by 35% according to two studies.
In addition to sunflower seeds, vegetable oils like sunflower and canola oil and nuts like almonds, hazelnuts, and peanuts/peanut butter are great sources. I love adding sunflower seeds to my salads and eating nuts for a snack. See the chart below for more ideas.
What about supplements?
In clinical trials, vitamin E supplements have been disappointing, and most benefits come from diets rich in vitamin E. Taking a multivitamin containing vitamin E and adding food sources make the most sense unless otherwise directed by a healthcare professional.
4. Brown rice
We hear about the benefits of almonds, but did you know brown rice contains more magnesium? One cup provides 86mg magnesium, about 27% of the recommended amount.
Magnesium is an abundant mineral in the human body. It’s involved in more than 300 enzymatic reactions that help regulate protein synthesis, nerve and muscle function, blood pressure, and blood sugar.
Magnesium is also needed for energy production and aids the structure of bone and helps convert vitamin D to its active form.
Here’s what we know: people in the lower quartile of intake or who have low serum magnesium are at high risk for heart disease, osteoporosis, diabetes, hypertension, and diabetes.
In a 2018 piece in Open Heart led by Dr. James DiNicolantonio from the Department of Preventative Cardiology, Saint Luke’s Mid America Heart Institute, the authors argue that magnesium deficiency is a key driver in heart disease:
The evidence in the literature suggests that subclinical magnesium deficiency is rampant and one of the leading causes of chronic diseases including cardiovascular disease and early mortality around the globe and should be considered a public health crisis.
Magnesium and Mood
Poor magnesium intake may also affect mood. One study using the 2007-2014 National Health and Nutrition Examination Survey data found that women with the lowest intake of magnesium were more vulnerable to depression. And there’s some evidence magnesium supplementation improves depressive symptoms and sleep, although more research is needed.
Roughly half of adults aren’t getting the recommended amount of magnesium, which is 320mg for midlife women. Some experts argue we need more than this for longevity and the prevention of disease.
I was intrigued and found one study with postmenopausal women showing that 399mg of magnesium helped maintain positive magnesium balance while 100mg did not. We need more studies to know for sure.
And a bigger problem is serum magnesium can be normal when body tissues are low. Unfortunately, there’s not a reliable way to measure magnesium levels in the body.
Other magnesium-rich foods include Brazil nuts, almonds, cereal, avocados, and chickpeas are good sources as you can see below.
What about supplements?
If women can’t get magnesium from food they can supplement as needed. Most multivitamins do not contain much magnesium because it would bulk up the pill too much. I take a magnesium supplement every other day and get a good amount from my diet through nuts. The tolerable upper intake of magnesium from supplements is 350mg.
For more information on choosing supplements, see this post from Jenn Salib Huber, a menopause nutrition expert.
One of the best sources of iodine is dried seaweed. Kelp contains very high levels of iodine but Nori seaweed, which is most often used at Sushi places in the US, contains 232 mcg per 10g serving. That’s more than 100% of the RDA of 150mcg.
Iodine is a real watch out in midlife women. Research shows iodine intake decreased by 50% between 1970 and 2000.
A part of the problem is a small portion of the population has trouble with iodine, which can negatively affect the thyroid. Yet if you don’t get enough iodine, this can also cause thyroid issues. Confused yet?
Research is giving us clues on why iodine can cause thyroid problems. For example, having adequate selenium status may decrease the negative effect of iodine on the thyroid. Iron also plays a key role in thyroid health, so ensuring enough of these key nutrients is also important.
Read: Ferritin: The Blood Test Women Should Get at Every Doctor’s Visit
Iodine is not in many foods
Iodine is found in dairy products, fish, seaweed, and iodized salt. With many giving up dairy, no longer using iodized salt, and not getting fish, it’s a potential problem.
Also, estrogen stimulates the uptake of iodine in the thyroid which may be why thyroid issues peak after 40. So, a woman can be doing fine with the amount of iodine she gets, and then her hormones change, and bam! she’s got some issues.
Iodine is needed to make thyroid hormone, but it also is important for heart and breast health. In fact, one study argues that the increase in breast cancer with distance involvement in younger women may be related to the reduction in iodine intake. And studies suggest people with lower urinary iodine are at increased risk of heart disease.
I found an interesting study that iodine status correlates with symptoms during perimenopause and menopause with no follow-up studies. I have a sneaking suspicion that iodine needs increase in women as we age but the research is lacking.
Until we know more, women should ensure they at least get the RDA of 150mcg and no more than the tolerable upper intake of 1000mcg. Seaweed is a rich source, and you can see the other sources below.
What about supplements?
Some experts on the internet say we need super high levels of iodine to be healthy. I cannot find any evidence to support such high levels although molecular iodine may have benefits, we still need more research.
Most multivitamins contain the RDA for iodine and that along with adding food sources makes sense until we get more information. You can also purchase iodine drops. If you’re curious about whether your diet is supplying enough iodine, ask for a urinary iodine test as I discuss in my free biomarker guide for midlife women.
We all know salmon is a great source of omega-3 fatty acids, DHA and EPA. And I’ve talked about this in-depth in my lifecycle post and my podcast.
Yet as we get older these fatty acids play a key role in a woman’s brain health. That’s because brain volume tends to decline with age, and DHA levels decline as well. Plus, arachidonic acid (AA) is more likely to go through a process called “perioxidation,” increasing inflammation.
For women, menopause exacerbates this as estrogen enhances the conversion of alpha-linoleic acid (ALA) to EPA. After menopause, a woman’s risk for cognitive decline increases as estrogen receptors are found on the hippocampus, the part of the brain responsible for memory.
How DHA and EPA can help
Even though our brains change with age and hormonal shifts, there’s so much we can do to boost brain health and DHA and EPA are part of that.
In the Framingham cohort, people in the top quartile for DHA experienced a 47% lower risk of dementia. And according to a study in Neurology, post-menopausal women with a higher omega-3 index had larger brain volume and hippocampal volume than those with lower omega-3 index. This difference in brain volume equated to about 2 years of brain aging.
According to a 2021 review in Aging Research Reviews, “The greatest bulk of evidence indicates that greater hippocampal volume is associated with higher levels of omega-3.” Overall, the evidence is still considered insufficient, and recommendations are lacking.
The bottom line: Eating fatty fish like salmon and other sources helps increase omega-3 index, which may positively affect brain health. See this post for specific sources.
What about supplements?
To keep the omega-3 index greater than the recommended 8%, most people will need to take supplements along with eating fish. But testing is the only way to know for sure so check out Omega Quant and listen to my podcast about it.
Soybeans contain choline, a nutrient most people don’t think about much.
That’s because the US declared Choline a nutrient in 1998. The recommended amount in adult women is 425mg/day and for men 550mg.
Even though choline is found in a variety of food, 75% of Americans consume less than what is recommended. In a 14-year prospective study, middle-aged women were found to get only 294mg of choline daily.
Choline and the brain
Choline is needed to make acetylcholine, a neurotransmitter involved in mood, memory, and muscle control. It also helps to build cell membranes and regulate gene expression.
In the Framingham Cohort, high choline intake was linked to better cognitive performance and smaller white matter hyperintensities volume (WMHV), which is found to be neuroprotective.
Research suggests adequate choline intake helps maintain the bioavailability of DHA. Without choline, the DHA we get through diets or supplements may not be as effective. That’s because phosphatidylcholine (PC), phospholipids that utilize choline, helps transport DHA in the body.
Of course, soybeans are not the only source of choline as you can see below. But for midlife women, they are beneficial because they are also phytoestrogens. Phytoestrogens are compounds with weak estrogenic activity that may lessen the symptoms associated with perimenopause and menopause.
A 2021 study in Menopause found that ½ cup daily soybeans, in addition to a low fat, vegan diet decreased moderate to severe hot flashes but 84%. More about foods ability to affect symptoms of sex hormone changes in a future post.
What about supplements?
This is where it gets tricky. Most multivitamins do not contain choline. There is also concern that choline can increase trimethylamine and trimethylamine N-oxide (TMAO) in the blood, which has been linked to an increased risk of heart disease.
At this time, foods rich in choline do not seem to increase TMAO, but supplements may. Until we have more research, it’s best to increase sources of choline in the diet and supplement in small amounts.
Sharon Palmer has some good advice on how vegetarians can get the recommended amount of choline.
Check out my interview with Sharon Palmer, The Plant-Powered Dietitian
Nutrients for women over 40
As midlife approaches, we need to be aware of the level of nutrients we are getting. Do we have enough so our body can do the work that’s needed for our long-term health?
Of course, it takes decades to see the effects of less-than-optimal vitamin and mineral intake. But by investing now, we can feel good that we are doing all we can to increase healthspan, feel energetic and be disease-free for as long as possible.
And this is just the tip of the iceberg. I got more posts coming with key nutrients especially those we need to supplement.
What is your biggest midlife nutrition concern?
Want to learn more? Follow Midlife Strong on Instagram or Maryann’s private Facebook group
Thank you! Another fantastic read, only you forgot #8. dark chocolate. just kidding. My serious question is… this is the first time i’ve read about nitrates in a positive way, I’m used to avoiding preservatives containing nitrates and nitrites – can you help me understand the difference between the good, naturally occurring nitrates in leafy greens and the bad preservative nitrates/nitrites? chemically speaking, what do the bad ones do? Assume it has something to do with sodium and a chemical reaction somewhere in the body that is not desirable
Maryann Tomovich Jacobsen, MS, RD says
Thanks Kristen. And yes, chocolate is a must!
I was going to mention the nitrate/nitrite’s negative press but felt the article was already too long. Most of the negative effects are from nitrate/nitrite added to processed meat and the risk of colon cancer. Nitrates/nitrites increase the formation of N-nitroso compounds (NOC), some of which are carcinogenic. Nitrates in veggies don’t have the same effect because they have protective properties (antioxidants and vitamin C) and research shows increased vegetable consumption is associated with a lower cancer occurrence. I hope that makes sense.
Caty K says
This is really helpful, esp the tip about avoiding antiseptic mouthwash, never knew!
Ankit kashyap says
I’m so glad to know about this, This is really important for us know about this. And we know this just about you i really wanna thank to you for share this with us .
marianne Foege says
Thanks Maryann. I enjoy reading the articles you send out. The mouthwash and antacids news flash was a wow learning moment.
Honest information and a good read. Thanks!