 My name is Caitlin Ross and I am a registered dietitian and I work at the Center for Bariatrics at Bayshore Medical Center. And today I'm gonna be talking a little bit about women's nutrition at every age. So the objective for this webinar is just to focus on essential nutrients that are necessary and important for women's lifelong health. So it's really important to remember that it's not a one size fits all when we are talking about nutrition and essential nutrients that are needed. And everyone is a very unique individual. And today we're really gonna discuss what we should be focusing on more as general guidelines. So it's always important to talk to your doctor to make sure you're making the right choice for your unique needs. But take today as some informative information about what we should be focusing on as women throughout our life. So today's topics that we're going to cover we're gonna be talking about nutrition's impact on all stages of life. We're gonna be talking about macronutrients and specifically going to be focusing on protein and fiber which is our fibers going to be those complex carbohydrates. And then we're also going to be talking about a few essential nutrients that are really specific for women as well including calcium, iron and folate also known as folic acid. So why do women's needs differ from men? So there's three reasons why our nutrition differs from men and why it changes over our lifetime. And a good place to start is when we're looking at the difference between men and women is just to look at multivitamins you see when you're comparing women's and men's multivitamins you're really gonna see a vary in vitamins. And this is because as women we require unique needs at different phases of our life and this is gonna include increased needs for certain nutrients in our diet especially during pregnancy, after menopause and we're gonna talk and take a look at what impacts that. So these are the different points in our life where we're going to have different shifts in our need. So when we talk about reproductive health this is going to include different nutritional needs during menstruation, pregnancy, breastfeeding and menopause when we talk about increased risk for certain comorbidities. Women are at increased risk for osteoporosis, iron deficiency andemia. Those are some big comorbidities that we're at risk for as we age. And then different vitamin and mineral requirements which are increased over time especially for calcium iron and folic acid which we'll talk about today. And then body composition, women overall our calorie intake and our metabolism are relatively lower than men's and this is really due to our body composition. Women naturally have less muscle, more body fat and are of a smaller stature and a lot of that has to go back to the fact that we are childbearing. So there's a lot of things that will change over time due to that as well. So our needs changes our body changes over our lifetime and these are going to be the different changes throughout our life. You're going to see in your teen years we need more calcium, more vitamin D. This is really an important part of our life where we're building strong bones and this is really where we're gonna help to prevent that osteoporosis which can develop later in life especially after menopause. So our teen years are a really crucial time where we should really be focusing on getting an adequate calcium and vitamin D. Then when we move into our young adult life as we grow and our bodies develop we need to really be mindful of our diet and this is where our nutrition takes a huge role and we have to start implementing physical activity into our day-to-day life. So as we shift into young adults we may be starting a career or we may be starting to become parents or we're moving into another phase of our life where physical activity is going to change. Our nutrition becomes more crucial. So it's really important that we start to implement these on a day-to-day basis. Good nutrition and physical activity. And this is also where our calorie intake can outweigh our calorie burn and where we start to see weight gain occur over our life. We tend to start to see weight gain changes in that young adult period. Then we have pregnancy. Pregnancy is when or when we're planning for pregnancy and during pregnancy we do have increased needs for certain nutrients that support yours and your baby's health. So this would include increased needs for protein, calcium, iron, folic acid, and then of course calories. Calories will increase and shift and change throughout pregnancy. Also postpartum too if you are breastfeeding your body's burning a fun fact here and on average of an additional 500 calories just to produce breast milk. So that's like if you did an intense workout. So if you are breastfeeding plan to or have your body is burning a significant amount of calories just to produce that breast milk. So that's gonna be an increased need for hydration, calories are going to be increased, also your vitamin needs. And then we have menopause which is a shift in hormones from where we have lower estrogen levels. And this can actually increase our risk for comorbidities such as heart disease, stroke, diabetes, and osteoporosis. And as you can see over these different phases of our life our nutrition is gonna change. It's going to be impacted from a young age. So it's really important that we start to focus on this at a young age and continue to move through our lifetime focusing on our macronutrient intake and also those essential nutrients. So just real quick I wanted to talk a little bit about balancing your plate. You know how important it is that we are focusing on having a balance of fiber, protein and getting in those essential nutrients whenever possible from our diet. Your diet is the best place to start. So we always wanna start by looking at our plate and actually as a dietitian this is something that I work with with any type of patient, bariatric or non-bariatric. What does your plate look like? What does your diet look like? So when we start focusing more on our protein and our fiber rich meals it's gonna help you to meet those nutrition requirements which is gonna include those macronutrients as well as those vitamins and minerals and also help us to provide our body with adequate calorie intake so that we do burn calories efficiently and we can help ourselves to stay within a healthy weight for whatever stage of our life that we are in. So first I wanna talk about protein. So I'm gonna talk about the two macronutrients protein and the carbohydrates, the complex carbs I'm gonna talk about fiber. So protein, protein's an essential macronutrient. It is the building blocks of our body and it's really important because it's going to help maintain our hair, our bone, muscles, our connective tissue. It's important for our skin and nails. It helps to form hormones, enzymes and on our immune system antibodies. And what's great about protein is that it also helps to burn fat instead of muscle for a healthier weight loss which naturally helps to support your metabolism. When we have adequate protein in our diet our body is gonna burn fat because our body is getting the protein it needs. When we don't take in enough protein in our diet or we have a protein deficiency which can happen to anyone, typically our body pulls from our muscles, it pulls from our hair, skin, nails and that's when you can start to see less strength or feel more fatigued. You can start to notice issues with your hair, your bones, your skin. So protein is essentially the building blocks of our body. So some good benefits when we talk about protein too is that protein is gonna help because it is a lot of energy and hard for your body to break down. It's gonna help to increase your satiety and fullness and it's gonna curb hunger. So when you're getting in enough protein at your meals and throughout the day you should feel hungry and satisfied for a period of time if you have a nice protein and fiber rich meal you should feel full, I would say about three to four hours. So that's important and you should notice that you have that period of time where you feel really energized, you feel full and then as that hunger starts to return it's a good reminder from your body that it's time to eat, your stomach is telling you it's time to eat and that can last that satiety and fullness for several hours if we're getting in enough protein. It's gonna help to also increase muscle mass because your muscles need protein to build and strengthen and as we exercise we need to replenish with protein to help to make sure that our muscles are getting stronger. When we do workout we make little tears in our muscles and how does it replenish and repair and build protein is so important. It also helps to strengthen your bones as well, okay? And it helps us to maintain a healthy weight. So sometimes I get asked a lot like how much protein should I be eating and I don't have this on a slide but I just wanted to give you an idea. Most women need about 0.8 to one kilogram per kilogram of their weight. So if you wanna rate that down so if we have a woman that's say 150 pounds she doesn't do exercise, she has a very sedentary lifestyle. Her kilogram weight would be, she'd be 68 kilograms, okay? So she would need about 54 to 68 grams of protein a day. So if you're going off of needing 0.8 to one kilogram a gram per kilogram that's how much protein she would need for the day for her body to get what it needs to function well and to get all of these benefits. Now if you have an increased physical activity then you're gonna need more protein. So that's when we would actually increase those protein needs and it can vary depending on your activity. But if you wanna write this down taking your weight in kilograms and you would multiply that by 1.2 to two grams per kilogram. So it would increase depending on your physical activity because if you're more active your muscles in your body is going to need more protein. And also your protein needs are going to increase in pregnancy and also during breastfeeding as well. So if you are in that part of your life, right? We wanna make sure we're also increasing those needs as well for the development of the baby throughout the pregnancy. And then also for your body to produce enough milk for your child. So what are our best protein sources? So I have listed here for you the best protein sources. Your animal proteins are always gonna be the best protein sources. But if you don't eat meat or animal products and you're vegan or any type of vegetarian there are a lot of plant-based proteins as well. But the best sources of protein are gonna come from your lean meats, poultry like chicken and turkey, fish. Also low-fat dairy that would include milk, yogurt, cottage cheese, forgot the cheese, your eggs, soy products like tofu, edamame, soy milk and tempa and any other plant-based proteins like lentils, beans, nuts, seeds. These are also going to have a little bit of protein in them. And they also have the benefit of fiber as well which brings us to fiber. So fiber is a complex carbohydrate so it falls into the carbohydrate macronutrient. And I know that carbs can get a pretty bad rep. One thing I always tell any patient that I work with is instead of focusing on how many carbs you're eating I want you to focus on your fiber because your fiber is really going to give you the most benefit. Carbohydrates are our body's main source of energy and we want to make sure that we're getting fiber-filled carbohydrates and that's going to be fiber. And fiber is an essential component for a healthy diet and along with adequate water intake which is really important because fiber needs water to be utilized properly. Fiber helps to bulk the digestion so it can help your digestive tracts functioning. And that also helps with the health benefits of increasing your fullness which can help with weight loss, weight management and avoiding excess hunger. So when we eat protein and fiber together really is a powerhouse when we talk about getting nice satiety and fullness and the nutrients that your body needs. And the average daily intake for most Americans is only 15 grams of fiber a day which is much lower than the recommended amount. So you'll see here we have the recommended intake. These are set for us based on our age. So you'll see here for girls and then there's also for women we have two different age groups here. You're going to notice that the fiber intake does decrease a little bit over time but they still are much higher and then those 15 grams that most Americans are taking in each day. And when we talk about fiber too there's actually two different types of fiber. We have insoluble fiber and soluble fiber and they both do different things. Insoluble fiber is going to help with improving and maintaining bowel functions. And then your soluble fiber is actually going to help to potentially lower cholesterol levels and help with your blood sugar levels. So lots of great benefits here. Some other benefits of fiber are going to, like I mentioned, be increasing fullness and aiding in weight loss if that's your goal improving and maintaining bowel function. So it helps with constipation, bloating, gassiness. A lot of people experience this if they're not taking an adequate fiber or they're taking in a lot of fiber and not drinking enough water. So we want to make sure those go hand in hand. Helps to naturally lower cholesterol and blood sugar levels and can also lower the risk for certain comorbidities such as heart disease, diabetes, some GI related conditions like IDS, a diverticulosis and also colon cancer. So we want to keep this in mind too that these are also some other great benefits of getting in enough fiber. So we'll talk about those best fiber sources. So when we talk about fiber, you're going to find fiber in whole grains. There's lots of whole grains out there. You always want to make sure when you're looking at grain products that the first ingredient is an actual whole grain. So that would be brown rice, quinoa, ferro, black rice, wild rice, oatmeal, plain oatmeal. There's also steel cut oatmeal is another great source, cream of wheat, whole grain breads, whole grain crackers, whole grain cold cereals and whole grain pasta. So these are some very popular whole grain options. And again, we want to make sure that we're looking for something that has the whole grain as the first ingredient, okay? And then we have fruits and vegetables. Fruits and vegetables really are the easiest way to get more fiber in your diet. They're also really low in calories. So I do always encourage to start adding more fiber in with fruits and veggies and try to get at least two to three servings of each of your fruits and your vegetables per day. And if you don't get a lot of fiber in your diet, it's always good to start with one fruit, one vegetable, gradually increase that until you're at that at least two to three servings of each per day. Because if you eat too much fiber too quickly, it can be a shock to the digestive tract and you can actually get a lot of bloating and gassiness and all the things that we don't want to happen can happen if we're eating too much fiber and it's been too quick and it hasn't been a slow progression. Like I said, fruits and veggies are filled with nutrients, fiber, they're very low in calories. A lot of times people will tell me too that they struggle with their fruit and veggies intake because maybe of the pricing or the affordability or their budget or maybe the seasons, the seasons change so do the fruits and veggies that are available. So one thing I can say is that all forms matter whether you're buying it fresh, frozen or canned, it is good to have a variety on hand. You just want to be mindful of how that item is packaged. Fun fact here is that sometimes fresh vegetables and fruits aren't as nutritionally dense as frozen or canned items. These items are actually canned or frozen at peak ripeness. So as something ripens and it becomes a little over ripened, it loses its nutritional value. So when you're eating something that's canned or that's frozen, it keeps that peak nutritional value in there once it's frozen or it's canned. So it's not going to lose nutritional value over time like fresh canned. So if something's not in season or in terms of affordability, frozen veggies are very cheap, so are canned, much cheaper sometimes than fresh, you're okay to eat them. You just want to make sure you're buying things that say no added salt or low in sodium. You're not getting frozen veggies that have sauces added to them. And when you're doing fruits, try to get a canned fruit or a fruit cup that's in its own juice or in water and just rinse all of these things to get off that excess. We don't want heavy syrups or syrups in our fruits because it adds a lot of extra sugar that isn't necessary. And we don't want to get all the extra sodium too in those canned and frozen veggies that have those additives in them. And it's also great to add different seasonings and spices to your fruits and vegetables, flavor them up, they don't have to be boring. There's a lot of great mixes out there too if you go down the seasoning aisle. And then when we talk about legumes, these are going to be your beans, lentils, peas, and then we have nuts and seeds as well. So these are going to be best fiber sources. So I'm gonna talk a little bit about these essential nutrients that I had mentioned. So first we have calcium. Calcium is a mineral and it's really important for your bone health throughout your life. And it's also important for your heart and your muscle strength to help it to function properly. When we're getting an adequate calcium, it helps to lower our cardiovascular disease risk as well. Some studies have actually shown that lower calcium levels have higher risks of developing hypertension, stroke, or osteosclerosis. So we want to remember that calcium can actually attach to our fat and it can reduce the amount of fat your body absorbs. Having normal calcium levels can also help us to reduce our risk for some of these comorbidities that can develop. Calcium is also gonna help reduce the risk of high blood pressure and preeclampsia. Preeclampsia is actually something that can develop later in pregnancy. It's when you have high blood pressure that develops and protein in your urine. And this can cause complications to be increased with both mom and with baby during that pregnancy. And it also can actually help reduce the risk of rectum and colon cancer when we're getting an adequate calcium as well. And vitamin D also will help to absorb calcium within the body. So it's always good to note when you are looking at food products, which we'll talk about, if there's anything that's fortified with calcium, it usually is also fortified with vitamin D. And I'll talk about this too, but if you're doing any supplementation, you're also gonna notice that calcium and vitamin D are usually both found in the same supplement. So calcium deficiency. Unfortunately, this is something that can occur. This is usually can reduce the bone strength and lead to osteoporosis, which is categorized by fragile bones and increased risk of falling. And this will decrease the mineral density and increase fractures. So this can develop at any time throughout your lifetime when we talk about calcium deficiencies, they can also cause rickets, which is actually found in children and other bone disorders in adults. And these disorders are more commonly caused by vitamin D deficiency, but calcium is also related. In children with rickets, their growth cartilage does not mineralize normally, which can lead to irreversible changes in their actual skeletal structure. And then another effect of chronic calcium deficiency is osteomalacia, which can cause bones to soften and can occur in adults and actually children. And then I'm sure we're familiar with osteoporosis. This can also be caused from decrease in the bone strength and also it can increase fractures. And this is very likely to occur after menopause. So this is what a calcium deficiency is here. What you want to keep in mind too is that sometimes the symptoms, it can be asymptomatic. So you may not even actually have symptoms if it's really mild or sometimes too, if it is chronic, you might actually not have real symptoms of hypoglycemia and you might not even experience them and know until your doctor does your blood work and says, oh, your calcium levels are low, you might not even know that you have them. But if you do experience it, there are signs and symptoms that can occur. The most common signs you'll see are tingling in hands and feet, muscle spasms, more serious symptoms can actually impact some of your, like your organs, like your brain or your renal function, which is going to be your kidneys. And sometimes neurological symptoms, like you may feel like signs of depression or you may experience cataracts, these can also be related to low calcium levels. And sometimes certain medications can also cause your calcium levels to decrease. The best way to get your calcium is through your food, but supplementation is sometimes necessary if your diet falls short or you do get diagnosed with low calcium levels. So we'll talk a little bit about that as well. So then we have, before we jump into that, we're gonna talk about some calcium-rich foods. So you're going to find calcium in low-fat dairy products. These are also good protein sources, as I mentioned earlier. You're also gonna find good calcium-rich foods with canned salmon and sardines. If the bones are in there, it is a very good calcium-rich option, which you actually can eat those. Green leafy vegetables, great source of calcium. So we're talking about green leafy vegetables, we're talking about kale, collard greens, broccoli. These are great sources of calcium. Calcium fortified, 100% boot juice and non-dairy milks. So this means that they're actually putting calcium into these products, okay? And calcium fortified, ready to eat foods as well, which is going to be like cereal, you'll see it in. You'll also see it in tofu. If you purchase tofu, if you like that plant-based protein, you'll also see it there. And if you're looking at your labels, there will be, underneath all of the nutrition information on that label, you will see that there is information about different vitamins and minerals. Calcium is one that you will see in there. So you can always check to see if there is calcium in the food product that you're consuming. If something is 20% or more with the calcium, that means it's a high calcium-rich item. So that's something good to keep in mind too. So here I have for you the RDAs for calcium. So these are the average daily levels of intake to meet your nutrient requirements for a healthy individual. So I pulled the charts for these essential nutrients that we're going to be talking about today so I can show you how they change over time and depending on where you're at in your life. So you're gonna notice that calcium varies over the lifespan and you're gonna notice that it's increased in women versus men. And you're also going to notice too when we hit menopause. So there are changes of what we need in terms for calcium over our lifetime and also a difference too, you'll notice between men and women. And after 30, our bones slowly lose calcium. So that's a big reason why you're going to see those levels do increase. And in middle age, our bone loss speeds up and this can lead to weak fragile bones and this is what increases that risk of osteoporosis and fractures, especially once we've hit menopause. So calcium supplementation. Calcium is found in many multivitamins, calcium supplements and also you'll see it with vitamin D supplements as well. And some studies have found that calcium supplements with or without D can actually increase the bone mineral density in older adults or as we age. So vitamin D and calcium supplementation is super, super important and we should always be making sure that we're supplementing any time we're not meeting those needs through our food alone. Calcium and I also wanna make note, calcium is the best absorbed when it's taken in five to 600 milligram doses. A lot of people don't realize this. You don't wanna take all of your calcium at one time because your body is not efficient at absorbing and utilizing more than five to 600 milligrams at a time. So if you're someone who has to take 1,000 milligrams of calcium a day, you wanna make sure that you take that in a 500 milligram dose twice a day. You don't wanna take it all at once. And you don't wanna take it with iron. Iron and calcium will actually interact with each other's absorption. So you never wanna take all your calcium and your multivitamin and everything all at once. You wanna space these things out and also make sure your medications don't interact with them. You can always talk to your pharmacist. You wanna take iron three hours after you take a calcium supplement and you wanna separate that multi if it has iron in it from the calcium. So the best thing to do is take your supplements throughout the day with meals. A lot of people can get a little nauseous too if they're taking vitamins on an empty stomach. I know I personally do and it can set all day long. I have a nauseous feeling. So I always just recommend to take supplements when you're eating calcium as I wanna normally cause the nausea. It's really more a multi or an iron. But just to be safe, you can always take it when you eat. And for remembering too, sometimes it's easier to remember, let me eat, let me take my supplement. Next, we have iron. So iron is one of the few nutrients that females actually between the ages of 14 and 50 need in a higher amount than males at the same age. And this is to reduce our risk of iron deficiency anemia because of this women are actually increased risk for iron deficiency anemia. So that's why you're going to see that the levels will be a little higher when we look at that chart. Iron is really important because it's actually gonna carry oxygen from your lungs to all the parts of your body. And when your iron is low, this is what actually leads to that anemia. And this type of anemia can actually cause a lot of fatigue, like generalized fatigue or weakness, irritability. And you may result too, also if you are pregnant in low birth weight of your infant. So you wanna make sure too, that if you are anemic going into a pregnancy or really at any time of your life that you're always correcting that, having proper supplementation and always listening to your doctor. Iron's also important to pair with vitamin C when you're eating iron rich foods or if you're taking a supplement because it actually helps to increase that absorption. So iron and vitamin C together will increase that absorption of your iron in your foods. And your body absorbs iron from plant sources better if it's eaten with an animal product. If you do eat animal products, pairing plant-based iron rich foods like beans, soy, lentils, you wanna pair them if you can with animal products and foods that contain vitamin C. Some good high vitamin C rich foods would be citrus fruit, strawberries, peppers, tomatoes, broccoli. Really anything that's red or yellow or orange is usually a very high vitamin C option. If you do take iron supplements too, a lot of times you'll notice they do have vitamin C in them as well. So here we have some information about iron deficiency anemia. Short-term low iron doesn't really have a lot of symptoms. And this is because your body actually uses the stored iron in your organs like your muscles, your liver, your spleen, your bone marrow. But when your levels of stored iron become low and depleted, that's when that iron deficiency anemia can really set in because then you're also depleting your stored iron. And this can actually cause your red blood cells to carry less oxygen from your lungs to the rest of your body. And that's when people start to experience those symptoms that I mentioned, that fatigue, that tiredness, that irritability, they feel really weak. They're not getting enough oxygen flow to all areas of their body. Iron deficiency anemia is also common in the US, especially in young children, women under 50 and pregnant women. So this can also increase and occur more often in someone who is vegan or vegetarian, it doesn't eat meat. Or someone who has lost blood or someone who has GI, any type of GI diseases or GI distress. A lot of times that can interfere with the absorption of certain nutrients. And just a poor diet overall, a poor diet can also lead to iron deficiency anemia. So you'll see those symptoms are listed there. Another symptom too, I didn't mention hair loss. If you feel like you're losing a lot of hair, sometimes that's iron deficiency. And a lot of people don't realize that low iron can actually cause hair loss. I just wanna talk about pregnancy really quick too. During pregnancy, the amount of blood in a woman's body increases. So we need more iron for yourself and for your growing baby. And if we're not getting in enough iron during pregnancy, this can actually increase the risk for the woman, that mom to be, to have an iron deficiency anemia and also increase the infant's risk for a low birth weight, premature birth, low levels of iron themselves. So getting too little iron during pregnancy too can also impact the baby as well. So you always wanna talk to your healthcare provider too about iron supplementation, whether you are pregnant, if you've just had a baby, if you're planning, if you're younger, whatever stage you are, always talking to them too about iron because iron deficiency anemia is very, very common in women, especially at a younger age and during pregnancy and postpartum as well. So here we have some iron-rich foods. So you're gonna notice lots of protein foods there. So you really wanna pump up your intake with really good sources of iron. You're gonna find it in those really great protein sources like those lean red meats. You're also gonna find it in iron-fortified cereals and breads. So a lot of products are fortified with iron as well. You'll see that in a lot of cereals and breads too. Other good sources of your iron are going to be your poultry, fish, beans, lentils, green leafy vegetables also have great sources of iron, nuts and some dried fruits like raisins and apricots. So also again, make sure you try to pair vitamin C-rich options with your iron options too. So like strawberries, tomatoes, peppers I had mentioned earlier to help with the increase of the absorption of iron in your diet. Here we have that chart that I was talking about with the calcium. I also wanted to provide you with the iron one. So these are the current iron RDAs. These are for non-vegetarians. If you are a vegetarian, it's important to note that they mentioned that it's 1.8 times higher for the iron requirements for someone who is vegetarian or vegan. So if you are someone who is not vegetarian or vegan, these would be the proper guidelines for you. And you're gonna notice here that there are changes. It differs from men to women. And it also changes, as I mentioned, it gets a little bit higher in those certain times, especially in pregnancy, you're gonna notice that it jumps up a lot our iron requirements. And just keeping in mind that teen girls and women are at increased needs for iron, pregnant women. Also, I mentioned earlier people who have GI disorders, certain types of cancers are also going to need higher iron levels as well. And also heart failure. Heart failure is another comorbidity, too, that you will see higher iron levels are needed. Iron supplementation. So iron is gonna be found in many multivitamins, mineral supplements, and in supplements that just contain iron, you can buy over-the-counter irons in different dosages. A lot of times, too, you can also get a prescription iron if it's needed through your doctor. There's different types of irons that you're going to find, too. It comes in several different forms. You'll see here, I've written four of them. Ivy iron, sometimes infusions, may be needed if you have poor oral absorption. Some people do have poor oral absorption of iron, and if they need IV infusions, you would see hematologists for that. Or if your deficiency is very severe, they may replete you using IV iron infusions to get those levels back up. And it's important, too, that we keep in mind that calcium and iron can interact with each other again, so we want to keep those separate, and we want to space them at least three hours apart. All right, and now onto folate or folic acid. One thing I just want to clarify is the difference between these two things. A lot of people use them interchangeably. Foli is the actual natural form of the B vitamin B9, okay? So folate is what's found in food products. That's the vitamin you're going to find in foods. Folic acid is the synthetic form that's found in supplements. So if you're supplementing, you're supplementing with folic acid, okay? So folate is very important for making DNA and other genetic materials in our body. It also helps to keep our red blood cells nice and healthy. And it's essential in preventing neural tube defects. So this is critical during pregnancy to prevent neural tube defects, like spina bifida is a big one. So we want to keep in mind that that folate or that folic acid is also something that's going to be really important throughout our life, especially if you're planning to become pregnant or you are pregnant. Talk about folate deficiency. So deficiency is pretty rare, but too little folate can cause deficiency. And this would be something called megaloblastic anemia. And this is a blood disorder that causes more weakness or fatigue, trouble concentrating, irritability. It's another form of anemia as well, okay? And this can also increase the risk of developing neural tube defects such as spina bifida during pregnancy. So if a woman is not getting enough of that, their child can develop this. And this is actually tested. They test you for this during pregnancy to make sure that it isn't something that's developing. There's also increased risk for depression with a folate deficiency as well. And with a folate deficiency during pregnancy, this can increase the risk of preterm birth, congenital heart defects as well. So really important that you're taking those prenatal vitamins or your women's multivitamin. Folate rich foods. So I put here folate and folic acid because folate is found naturally in foods. So folate is naturally going to be found in many foods. You're going to see here that these are the best sources out beef liver, vegetables, fruits and fruit juices, nuts, beans and peas are great folate items. So you're going to find the folate, that bad item in these foods naturally. Folic acid is added to enriched breads, flour, cornmeal, pasta, rice, fortified cereals. So if you're looking at a package and you see folic acid is added on the nutrition label, they've actually added it to the product. It wasn't naturally present like the other items we have here on the other side of your slide. And then also wanted to provide you with the current iron RDAs as well. I'm going to notice there's that increased risk, excuse me, that increased need during pregnancy and lactation. So taking your prenatal will definitely to provide for that unless you are deficient, you would also take an extra supplement. And all women and teen girls who plan to become pregnant should really be getting in enough folic acid. So multivitamin is so important and crucial throughout all stages of our life. And then supplementation. So folate is actually the folic acid is actually found in multivitamins and prenatal vitamins. It'll also be found in a B complex supplement. So a B complex supplement is a supplement that contains all the B vitamins in it. Folate is a B vitamin. So it would be found in there. You can also find folate or folic acid supplement on its own if needed. And again, to note all women and teen girls should consume at least 400 micrograms of folic acid from supplementation. So just some final thoughts here. Women's bodies go through many changes during their lifetime and your body is going to require specific vitamin and nutrients to support these changes and make you feel your best. And again, it's not a one size fits all when we talk about nutrition and essential nutrients that are needed. So it's really important to understand that your nutrition is key. If you feel that you struggle with your nutrition or you have a hard time navigating it or you're struggling or having developing deficiencies definitely reach out to a registered dietitian. Most insurance companies do cover nutrition services especially depending on the reason why you're visiting. So you can always talk to your primary doctor if they have anyone that they recommend or you can call your insurance company and see if any dietitians in your area take your insurance. Because it is really important to understand what your personal needs are and to get more of that picture and a registered dietitian would be the person who'd be able to help you with that. And just to remember that you always wanna talk to your doctor to make sure you're making the right choices for your unique health needs. I would never recommend to just start taking lots of extra additional supplements. I know there's a lot of information out there a lot of noise as I like to say supplements are not regulated and we wanna make sure we're taking what we need. We're not overtaking, we're not undertaking because these types of things can cause lifelong issues like there's toxicity level from taking too much of things just like you can get deficiencies and you can get certain symptoms you can also get toxic levels of certain things in your body. And also everyone's very unique. So you wanna make sure that you always run these things by your doctor your dietitian and your pharmacist because you never wanna take something that's gonna interact with any medication that you're taking as well.