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Body Image

By The Jean Hailes Foundation for Women`s Health

This page created 6th July, 2007

Body image is the way we think, feel and picture our body. From childhood through adolescence and on to adulthood, body image changes.  

For women, body image can change through the regular menstrual cycle, pregnancy and at midlife. During the menopause there is often a shift in fat deposits from the lower to the central body. Negative body image may appear to be a problem for some women going through menopause, particularly their distress at a perceived increase in weight.

These negative feelings can also influence self esteem and sexuality. Further, society's negative views of ageing women can be very undermining.

Changes to the body associated with menopause, such as hot flushes, have the potential to make women feel differently about their body image. Some women going through menopause report that they do not know their body any more - "I used to know what to expect from my body, now it is like my body is not under my control".

Weight and Body Image

Even at midlife, the "ideal" look is being about looking thinner to look better. Yet it is important for the individual to be at their own healthy and comfortable weight not compared to anyone else. 

While diet, exercise and other behavioural patterns influence the risk of disease beyond the reproductive years, it is never too late to modify lifestyle to optimise health and wellbeing. 

Useful Resources for Body Image

Exercise - Adults need at least 30 minutes of moderate exercise (such as walking) most days of the week

Healthy Eating - Food variety has been shown to benefit health and improve longevity 

Nutritional Supplements - Dietary recommendations for women aged 40 and over 

Exercise

Australia's national physical activity guidelines recommend that adults accumulate at least 30 minutes of moderate intensity activity (such as walking) most days of the week.

These guidelines are based on evidence which shows that activity at or above this level is associated with a number of health benefits, including:

• reduced risk of coronary heart disease, hypertension, diabetes mellitus and colon cancer, and 
• reduced risk of premature mortality. 

• Exercise recommended for osteoporosis prevention includes:
• activities that stress the skeleton through the impact of  weight-bearing exercise (eg, brisk walking, aerobics or tennis) or 
• through muscle pull from resistance strength training.

Such exercises may reduce the risk of osteoporosis directly by maintaining or reducing bone loss, or indirectly by reducing the risk of falling by improving muscle strength, balance and coordination. 

Regular physical activity is also linked to psychosocial health. Activity reduces depression and anxiety, improves mood, and has also been associated with increased ability to perform daily tasks. Unfortunately, many Australians do not fully recognise the health benefits of moderate-intensity activities such as walking.

Despite the many benefits of physical activity, population surveys show that large numbers of Australian women are not sufficiently active to promote health and protect against disease. 

A recent statewide study in Victoria showed that:

• 12% of women were sedentary, 
• a further 39% engaged in only low levels of physical activity, 
• leaving only 51% who were adequately active. 
• In addition, the proportion of women considered inadequately active increased with age:
• Twenty-seven per cent of women aged 18-24 years were inadequately active; 
• this increased to 56% of women aged 65-75 years. 

There is evidence that decreased participation in physical activity among females may begin in childhood, and physical inactivity in childhood has been reported to be a risk factor for inactivity in adulthood. There are also limited data that support the notion that exercise behaviours in childhood influence attitudes to physical activity during adulthood. 

Thus, increasing the physical activity levels of middle-aged and older women may be achieved by developing long term initiatives aimed at increasing activity levels and improving attitudes to physical activity in young girls.

Older women more often report injury or poor health as factors that inhibit their capacity to be physically active. Thus, for older women, moderate-level activities such as walking are probably more likely to be adopted and maintained than those that promote more vigorous forms of exercise. Walking groups have been successful in attracting older women, with the social aspects of these groups an important consideration for many women.

Summary

• Significant health benefits are associated with moderate-intensity physical activity. 
• Only half of the women in Australia are adequately active. 
• Strategies aimed at promoting physical activity among women should provide suitable activities and take into account the dominant barriers faced by women at different life stages.

Healthy Eating

I. Focus on Healthy Eating 

Food Variety

Food variety has been shown to benefit health and improve longevity. Including between 20-30 different foods each day can be achieved by selecting foods from each of the food groups including a variety of grains, an assortment of fruits and vegetables, nuts and seeds.

Nutrient Density 

Emphasis should be placed on incorporating foods that provide the nutrients at risk in the diet of the 40+ woman, specifically calcium, zinc and dietary fibre. Lower intakes of these nutrients correlate with low intakes of foods which are good sources of these nutrients, namely breakfast cereals, dairy products such as milk, yoghurt and cheese, fruits, vegetables, red meat, fish and seafood.

Antioxidants and Dietary Fibre

Women who have greater intakes of vitamins A, C, E and fibre in their diet have a lower risk of breast cancer. Large amounts of antioxidant vitamins A, C and E as supplements do not appear to protect against breast cancer. The multiple nutrients in foods, like vegetables, may have a synergistic effect on breast cancer risk. Studies to date suggest food, not supplements, are a more ideal way to obtain these compounds.

Alcohol

A reduction in alcohol consumption by women who consume alcohol on a regular basis may be a potential means to reduce breast cancer risk.

Zinc

Women 40+ should increase their intake of zinc through food sources such as oysters, lean red meat, fortified breakfast cereals and breads.

II. Promotion of Physical Activity 

Regular physical activity combined with healthy eating is the key to weight management, bone and heart health as well as mental well being.

Moderate to vigorous exercise of half an hour per day can decrease mortality.

So that physical activity can be incorporated long term, the type, duration, intensity and frequency of the activity needs to be realistic, achievable and pleasurable.

III. Management of a Healthy Body Weight 

Nutrition 

Emphasis should be placed on eating more nutrient dense foods rather than energy dense foods. Specifically promoting a low saturated fat diet, more breads and cereals, fruits and vegetables and more low fat calcium containing foods.

Energy dense foods like fats need to be kept low however small amounts of fats can be included in the diet and should come from monounsaturated and polyunsaturated sources, such as olive and canola oils, fish, grains, nuts, seeds and legumes.

Nutritious snacks are important for topping up energy levels during the day and can also be a valuable source of nutrients lacking in the diet.

The rate of weight loss needs to be gradual and in small increments.

Avoid very low fat diets and quick weight loss diets that reduce lean body mass.

Physical Activity 

The benefits include:

Reducing total and central obesity, reducing the risk of type 2 diabetes, improving muscle insulin sensitivity and maintenance of lean muscle mass

Aim for more than 30 minutes per day of physical activity. Keep moving; the more movements in day-to-day activities the better.

IV. Improving Heart Health 

Nutrition 

The consumption of diverse and balanced diets, which are rich in foods containing many nutrients including antioxidants and phyto-oestrogens, can be safely recommended.

Foods rich in antioxidants include olive oil, fruits, vegetables, grains, red wine and garlic.

The consumption of isolated supplements for prevention of cardiovascular disease is not recommended, as there is insufficient data to substantiate their efficacy.

Women should be encouraged to increase their whole grain intake as eating at least one serving of whole grain foods a day can substantially lower the risk of mortality to coronary heart disease compared with women who report eating no whole grain products.

Women should consider eating less saturated fat and including more foods higher in mono and poly unsaturated fats, eg. fish, nuts, seeds and olive and canola oil.

V. Improving Bone Health 

Nutrition 

Dairy foods provide the major, readily absorbed sources of calcium. It is recommended that women over 40 consume 3-4 serves of low fat dairy food per day. Other non-dairy sources of calcium include fortified breakfast cereals, canned fish with edible bones, some nuts, seeds and green vegetables.

If calcium supplements are required, the best absorption rate is from a dose of 500-600mg of calcium once or twice at night with food.

Vitamin D supplements may be necessary for women with inadequate sun exposure.

Physical Activity

Exercise reduces the risk of osteoporosis by maintaining or reducing bone loss. It must stress the skeleton or be weight bearing, eg. brisk walking, aerobics or tennis.

Strength training is important for maintaining muscle strength.

The benefits of exercise can be indirect, by reducing the risk of falling through improved muscle strength, balance and coordination.

Exercising for one hour, 3 times a week will have a significant effect on bone health.

VI. Mental Wellbeing 

Nutrition

For overweight women a weight loss of a few kilograms can assist with the effects of lowered mood. Weight reduction should occur slowly.

Omega 3 polyunsaturated fatty acids play a role in mental well being. Try to include foods rich in omega 3’s on a regular basis, such as seafood, flax seed, canola oil, soybean oil and walnuts.

Include breakfast regularly for improved mood, better memory, more energy and feelings of calmness.

Physical Activity

Regular physical activity reduces depression and anxiety, improves mood and has been associated with increased ability to perform daily tasks.

Nutritional Supplements

Dietary Recommendations 

For women aged 40 and over dietary recommendations include general food guidelines, such as The Australian guide to healthy eating 1, and specific nutrient recommendations, as outlined in the Recommended dietary intakes for use in Australia. 2 Recent advances in nutritional science and research have prompted review of recommended dietary intakes (RDIs), and this may result in future recommendations for novel food components such as phytoestrogens and antioxidants. 3 

Currently, RDIs for adult women are divided into two age groups:

• 19-54 years and 
• over 54 years. 

RDIs for women over 54 years more closely reflect the needs of women aged 40 and over, particularly menopausal women.

Suggested food servings to achieve a healthy diet for women*

Food	Serves per day†	Sample serving size	Further suggestions
Breads, cereal, rice, pasta, noodles	4-9	2 slices bread, 1 bread roll, 1 cup rice	Try rye breads, fruit breads, multigrain breads, pasta, noodles. Encourage wholegrain choices
Vegetables	5-7	1/2 cup cooked vegetables, 1 cup salad vegetables, 1 small potato	Include a wide variety of colourful vegetables
Fruit	2-3	1 medium piece of fruit, 2 smaller pieces of fruit, 1 cup diced or canned fruit
Milk, yoghurt, cheese	3-4	1 cup milk, 200g yoghurt, 1 cup soy milk (calcium fortified) Choose low fat varieties.	Include some fermented products
Meat, fish, eggs, nuts, legumes	1-1.5	65-100g lean meat, or 80-120g cooked fish (1 small fillet), or 1/2 cup dried beans or lentils, 1/3 cup peanuts or almonds, 1/4 cup seeds (eg, sesame seeds)	Include fish 1-2 serves per week (1 medium fillet), includes tinned fish, sardines, tuna
Extra foods‡	0-2.5	Plain biscuits, cake, alcohol, chocolate, crisps, pastries, oils and fats	Additional foods can be included if energy requirements are high. Obtain oils through foods such as olives, raw nuts, seeds, grains and legumes, olive and canola oils and seed oils. Watch for fat content of processed foods

 

*Adapted from The Australian guide to healthy eating. 1

†The wide variation in serves is because of individual variation in activity.

‡In addition to the 1-2 serves of extra foods, the guide also recommends modest consumption of margarine on foods like bread and toast and modest amounts of margarine or oil in food preparation.

Source: http://www.jeanhailes.org.au/issues/em_body_image.htm

The Jean Hailes Foundation for Women's Health