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HALF OF YOUNG and middle-aged women complain about premenstrual syndrome, also known as PMS, and up to 10 percent say it is so severe that it affects their ability to function for a few days each month.
Luckily, women can choose foods that make them feel happier and reduce headaches, cramping, fatigue and bloating during this time. Calcium and magnesium seem the most promising nutrients, and there is some evidence that vitamins D, E and B6, plus vegetarian eating patterns, are helpful, too. This gives women many more strategies than the old-fashioned advice to avoid salty foods.
Calcium is the No. 1 nutritional way to ease PMS. The symptoms of PMS are remarkably similar to calcium deficiency, and studies in Ohio and New York show that many women with PMS have low calcium levels in red blood cells and hair.
Two other studies have shown that women with a history of PMS are more likely to develop osteoporosis or brittle bones later in life, which has long been linked to calcium deficiency.
Finally, a trial with more than 400 women in New York City showed that taking calcium supplements all month long halved symptoms of PMS, including bad moods, water retention, food cravings and pain. In that study, the women took 1,200 milligrams a day of calcium, commonly found in Tums and other antacids.
Some smaller studies by scientists in New York and Britain have linked magnesium deficiency to PMS symptoms. They also indicate that mainly too little magnesium for the amount of calcium present can cause problems.
A combination of calcium and vitamin D has also been shown to decrease both PMS and migraine headaches associated with menstruation, although there is much less research on this.
It makes sense to me that magnesium and vitamin D would be involved in PMS, along with calcium, because the same trio of nutrients is needed to prevent osteoporosis.
In the last few years, research has shown most American adults take in less calcium, magnesium and vitamin D than is recommended. Mild deficiencies are widespread. I say mild because these deficiencies are not life-threatening and don't cause any immediate harm. Over time, however, they can weaken bones and are associated with a risk of diabetes, heart disease and colon cancer.
Supplements for PMS?If you eat three servings of dairy products daily, plus beans, nuts and leafy green vegetables such as kale and spinach, you're probably getting plenty of calcium, mag- nesium and vitamin D.
If not, a multivitamin-mineral supplement with no more than 100 percent of the daily value for nutrients is a good start and should provide enough vitamin D. (If you're taking any medication, remember to ask your doctor first, because some supplements can interfere with drugs.)
Most daily supplements do not have enough calcium and magnesium, however, so unless you eat three servings of dairy products daily, I would recommend additional supplements. In my mind, the least expensive way is to take two to four regular-strength Rolaids daily. If you take other supplements, don't exceed more than 1,300 milligrams of calcium; also, no more than 300 milligrams of magnesium from pills, because higher doses can cause diarrhea.
That's all I would recommend: the multivitamin and the calcium-magnesium supplements, plus taking a walk or other physical activity to blow off steam and boost your mood.
Some preliminary studies indicate vitamin B6 and vitamin E may be useful, but I'd like to see more research done before I would spend money on additional supplements.
When 33 women at Georgetown University School of Medicine in Washington ate a low-fat vegetarian diet, they lost weight and reported less PMS and bloating. A vegetarian diet can be completely nutritious and is worth it for anyone who is interested, but probably not the first choice for most people.
Feeling snippy?For women who feel irritable prior to their periods, cutting back on caffeine in coffee, tea and colas can help. Although drinking coffee all day may make you feel perky, studies have shown that caffeine also can increase hostility and anxiousness.
Chocolate is another source of caffeine, but there is less in an ounce of chocolate than in a cup of tea, and, because so many women crave it each month, it seems harmless to indulge in a small amount.
A woman who has severe PMS should always check with a doctor. Diabetes, thyroid problems and a variety of reproductive problems and mental illnesses can masquerade as PMS. Doctors can prescribe antidepressants and hormones that control severe PMS when eating and exercising are not enough.
JENNIFER MOTL welcomes reader questions via her Web site, brighteating.com, or mailed to Nutrition, The Free Lance-Star, 616 Amelia St., Fredericksburg, Va. 22401.