The PMS-Free Diet?
What you eat may affect PMS symptoms
By Elaine Magee, MPH, RD
WebMD Weight Loss Clinic - Expert Column
A whole lot of you will answer "yes." According to some estimates, about two-thirds of women report regular premenstrual discomfort, with about one-third seeking help from a health care provider. Up to about 8% of women experience severe impairment (called premenstrual dysphoric disorder).
What kinds of symptoms are included in the catchphrase "PMS"? A cornucopia of complaints, including breast swelling and tenderness, bloating or water retention, headaches, irritability and moodiness, depression, food cravings, and more.
These pesky and sometimes debilitating PMS symptoms occur between ovulation and the start of your period. Here's the bad news for all you 20-somethings out there: PMS becomes increasingly common in women as they move through their 30s. And symptoms can get worse over time.
Now here's some better news for all PMS sufferers. Did you know that what you eat can affect your PMS symptoms? And sometimes, it isn't what you add to your diet but what you take away that helps. Read on for suggestions on foods to choose and foods to lose.
The Calcium Connection
Probably the strongest potential PMS helper is calcium. Several studies have suggested that PMS patients tend to have an altered calcium balance and are also at increased risk of osteoporosis. Other studies have linked adequate intakes of milk and calcium with reduced PMS symptoms.
Further, a Turkish study on PMS symptoms in adolescent girls found that higher milk consumption was associated with reduced bloating, cramps, and food cravings.
How much calcium is enough? Some suggest that we should shoot for 1,200 milligrams a day.
This is very doable with foods alone, as long as you like and tolerate dairy products. Here are some of the top calcium-rich foods:
- 1 cup low-fat yogurt = 448 milligrams calcium
- 3.5 ounces sardines with bones = 380 milligrams
- 1 cup nonfat milk = 300 milligrams
- 1 ounce cheese = 200-270 milligrams
- 1 tablespoon blackstrap molasses = 175 milligrams
- 1/2 cup cottage cheese = 153 milligrams
- 1/2 cup cooked spinach = 140 milligrams
- 1/2 cup tofu = 138 milligrams
- 1/2 cup cooked green soybeans = 130 milligrams
- 1/2 cup soy nuts = 119 milligrams
- 1 cup cooked butternut squash = 100 milligrams
- 1/2 cup cooked collard greens = 100 milligrams
And if you don't like dairy? Supplements may help, too.
In a Columbia University study, women with moderate to severe PMS who took two Tums E-X tablets twice a day (for a total of 1,200 milligrams of elemental calcium), showed a 48% reduction in PMS symptoms.
About 11% of women have moderate to severe breast pain and soreness, according to a recent study.
"Some suggest that a high-fat diet may have something to do with
cyclic breast pain."
Another recent study suggests that flaxseed -- already famed for its healthy omega-3 fatty acids -- may also help women with breast pain.
Researchers at the University of Toronto tested flaxseed's effects on premenopausal women with breast pain. For a six month period, one group of women ate a muffin containing 25 grams of flaxseed every day, while another group ate a muffin without flaxseed.
The flaxseed-eating women reported much less breast pain than the other group. This may be because the lignans in flaxseed are plant estrogens that compete with human estrogen.
A B-6 Bonus?
The reviews are mixed, but it's possible that daily vitamin B-6 helps improve PMS-related depression as well as physical symptoms.
Although some sources suggest 50-100 milligrams per day of B-6, the Daily Value for women aged 19-50 is a mere 1.3 milligrams per day. That's a huge gap, and one that can't be realistically filled with food sources of B-6. You'll see what I mean when I list the top B-6-containing foods:
- 1 banana = 0.7 milligrams B-6
- 3.5 ounces cooked salmon = 0.7 milligrams B-6
- 3.5 ounces cooked light chicken or turkey meat = 0.6 milligrams B-6
- 1 baked potato = 0.4 milligrams B-6
- 3/4 cup prune juice = 0.4 milligrams B-6
- 3.5 ounces cooked halibut = 0.4 milligrams B-6
- 3.5 ounces cooked shrimp = 0.4 milligrams B-6
- 3.5 ounces cooked dark chicken or turkey = 0.4 milligrams B-6
Even on a "good" day (if you ate 3.5 ounces of light chicken or fish a day, 2 cups of colorful fruit, and 2 1/2 cups of colorful vegetables), you'd take in about 2 milligrams of B-6 from food.
Keep in mind, though, that very large doses of B-6 supplements can be toxic over time -- something that can't happen with food sources of B-6. The 1998 Recommended Dietary Allowance/Dietary Reference Intakes committee set the upper limit for B-6 at 100 milligrams per day for people aged 19 and older.
3 More Anti-PMS Strategies
Here are a few more diet and lifestyle tips that may help reduce PMS symptoms -- and won't hurt in any case:
- Keep your blood sugar stable. Given all that's going on in your body during PMS prime time, keeping your blood sugar levels fairly stable should help your mood and energy situation. You can help do this by limiting caffeine, not skipping meals, and eating balanced meals most of the time. It also helps to choose nutritious carbs that contribute fiber, like whole grains, fruits and vegetables, and beans.
- Don't eat a high-fat diet. Some suggest that a high-fat diet may have something to do with cyclic breast pain. One recent study found that women with breast soreness tended to eat more fat throughout their cycles than other women. The way I see it, this is yet another reason to avoid eating a high-fat diet.
- Move it! It just makes sense to exercise regularly. Exercise can enhance energy and lift mood. And a recent review of the research found substantial evidence that exercise can help with PMS.
What about Herbal Therapies?
Of the various herbal supplements touted as possible PMS remedies, chasteberry (a dried extract of the fruit of the chasteberry tree) is the one researchers tend to give the most credence.
There's some evidence chasteberry may improve PMS symptoms, but more study is needed, according to a review of the research published in the American Journal of Obstetrics & Gynecology in 2003.
(Be sure to see your doctor before taking any herbal supplement, especially if you're taking prescription medications.)
Published April 14, 2005.
SOURCES: American Journal of Obstetrics and Gynecology, July 1997; August 1998; May 2003. Journal of the American Dietetic Association, June 2004. Obstetrics & Gynecology, 4th edition, 2002. The New England Journal of Medicine, 2003; vol 348: pp 433-437. American Journal of Clinical Nutrition, March 2000. American Journal Obstetrics and Gynecology, 1998; vol 179: pp 444-452. European Journal of Obstetrics and Gynecological Reproductive Biology; vol 116: pp 201-206. Nutrients in Food, Elizabeth Hands, Lippincott Williams & Wilkins, 2000.
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