Nutrition for Adulthood and Sex-Specific Needs

Nutrition in Adulthood

A life stage where nutrition needs vary by sex, hormones, chronic disease risk, and lifestyle factors

Sex-Specific Nutrition Needs

Nutrient and health considerations that differ based on biological sex and hormonal influences

Polycystic Ovarian Syndrome (PCOS)

A hormonal disorder characterized by polycystic ovaries, androgen excess, and menstrual irregularities

Polycystic Ovaries

Ovaries with multiple small follicles identified through ultrasonography

Androgen Excess

Elevated levels of androgens that can disrupt menstruation and cause physical changes

Androgens

Hormones responsible for physical characteristics; present in all people but typically higher in people assigned male at birth

Hyperinsulinemia

Higher than normal levels of insulin in the bloodstream

PCOS Prevalence

Affects approximately 5–10% of women

Insulin Resistance (IR)

A condition where cells do not respond effectively to insulin

PCOS and Insulin Resistance

PCOS is commonly associated with insulin resistance and hyperinsulinemia

PCOS-Associated Conditions

Hypertension, dyslipidemia, and nonalcoholic fatty liver disease

Dyslipidemia in PCOS

Increased triglycerides, VLDL and LDL cholesterol, and decreased HDL cholesterol

Very Low-Density Lipoprotein (VLDL)

A lipoprotein that carries triglycerides in the blood

Low-Density Lipoprotein (LDL)

Lipoprotein often associated with increased cardiovascular risk

High-Density Lipoprotein (HDL)

Lipoprotein associated with protective cardiovascular effects

Insulin-Lowering Therapies

Treatments that may improve metabolic outcomes in PCOS

Insulin and Cardiovascular Health

Insulin resistance contributes to lipid abnormalities and vascular inflammation

Lipoprotein Lipase

An enzyme that hydrolyzes triglycerides for storage in adipose tissue

Effect of IR on Lipoprotein Lipase

Insulin resistance reduces lipoprotein lipase activity

Lipolysis

Breakdown of fats by enzymes and water in adipose tissue

Insulin and Lipolysis

Insulin normally suppresses lipolysis

Inflammation and IR

Insulin resistance is associated with inflammation that can damage blood vessels

Potential Nutrition Diagnoses for PCOS

Excessive carbohydrate intake, overweight/obesity, altered nutrition-related lab values, or inconsistent carbohydrate intake

PCOS Medical Nutrition Therapy (MNT)

Nutrition strategies aimed at improving insulin sensitivity and reducing chronic disease risk

Weight Loss in PCOS

Recommended when appropriate to improve insulin sensitivity and symptoms

Physical Activity Recommendation for PCOS

At least 30 minutes of moderate-intensity activity most days of the week

Meal Distribution for PCOS

Total energy intake spread across 4–5 meals or snacks per day

Daytime Energy Intake

Greater energy intake earlier in the day may be preferable to evening intake

Carbohydrate Consistency

Eating consistent amounts of carbohydrates to support glycemic control

Whole Grains and Fiber

Dietary components that improve insulin sensitivity and metabolic health

Exercise and Glucose Transport

Exercise increases GLUT4 transporters in muscle cell membranes

GLUT4

A glucose transporter that facilitates glucose uptake into muscle cells

Exercise and Insulin Sensitivity

Muscle cells become more sensitive to insulin following exercise

Women’s Cardiovascular Health

Heart disease is the leading cause of death in women in the U.S.

Sex Differences in Heart Disease

Women may experience different symptoms and higher risk in certain conditions

Angina

Chest pain that may be dull or sharp

Atypical Heart Symptoms in Women

Neck, jaw, throat, upper abdominal or back pain, nausea, vomiting, and fatigue

Sex Differences in Heart Disease Symptoms

Women’s symptoms may differ from men’s and be less recognized

Clinical Trial Representation

Women have historically been underrepresented in clinical trials

Guideline-Recommended Treatment Gap

Women are less likely to receive evidence-based cardiovascular treatments

Sex-Related Health Disparities

Differences in prevention, diagnosis, and treatment between sexes

Breast Cancer

A malignancy influenced by lifestyle and nutrition-related factors

Breast Cancer Nutrition Risk Factors

Obesity, visceral adiposity, physical inactivity, and low vitamin D

Breast Cancer Prevention Strategies

Healthy diet, breastfeeding, physical activity, and soy intake

Soy Isoflavones

Compounds in soy that function as weak estrogens

Soy Controversy

Concerns about hormone disruption from extremely high soy intake

Soy Intake Safety

Moderate soy intake is considered safe and beneficial

Soy Intake Recommendation

Two to four servings per day may reduce risk of heart disease and certain cancers

Soy and Breast Cancer Risk

Intake during youth and adulthood associated with reduced risk

Prostate Cancer

Cancer of the prostate gland located below the bladder in people assigned male at birth

Prostate Function

Important for fertility but not essential for survival

Prostate Cancer Nutrition Risk Factors

Obesity and possibly high dietary fat intake

Unsaturated Fatty Acids

Fat intake associated with decreased prostate cancer risk

Dairy and Prostate Cancer

Evidence is mixed and controversial

Sugar-Sweetened Beverages and Prostate Cancer

Potential association with increased risk

Green Tea and Prostate Cancer

High intake may reduce risk

Sleep Apnea

A sleep disorder involving disrupted breathing

Sex Disparity in Sleep Apnea

Men are 3–5 times more likely than women to have sleep apnea

Sleep-Disordered Breathing Prevalence

More common in men across age groups

Contributors to Sleep Apnea Sex Differences

Obesity, airway anatomy, hormones, and aging

Sleep Apnea Medical Nutrition Therapy

Weight loss when appropriate to improve symptoms

Weight Loss and Sleep Apnea

A 5–10% weight loss may improve outcomes

Transgender Nutrition Care

Nutrition care that is individualized and affirming of gender identity

Affirmative Care

Health care that respects and supports gender identity

Transgender Health Discrimination

Many transgender individuals report negative healthcare experiences

Care Avoidance

Some transgender individuals avoid care due to fear of mistreatment

Sex vs Gender Terminology

Sex refers to biological assignment; gender refers to identity or expression

Eating Disorders in Transgender Individuals

Higher incidence compared to cisgender populations

Hormone Therapy and Weight

Weight gain may occur as a side effect

Estrogen Therapy Effects (MtF)

Changes in lipid levels, blood pressure, and increased bone mineral density

Bone Mineral Density

Measurement of bone strength that may increase with estrogen therapy

Individualized Nutrition Assessment

Nutrition care tailored to medical transition and hormone therapy