With the rapid changes that are occurring in our health care system, interventions that enhance patients' health will prove to be the most satisfactory and provide the most cost savings over time. Data support a strong relationship between diet and health and disease. Although life expectancy in the United States is increasing in women, longevity is also associated with increasing morbidity. As a nation, we may live longer, but not necessarily better, lives. Dietary modification can improve health and reduce disease incidence; thus advice on good nutrition and appropriately selected vitamin and mineral supplements becomes paramount. Because women are the primary providers of meals to their families, a woman's food selections have an impact not only on her health but also on the health of her entire family. Accumulating evidence suggests that maternal nutrition, intrauterine events, birth weight and weight at 1 year of age all have an impact on adult morbidity and mortality. In females, body weight and body composition affect sexual maturation, onset of menstruation, ovulation, and fertility. With pregnancy, further body compositional changes occur with increased deposition of fat stores, especially in the hips and thighs. Recurring pregnancy, a sedentary lifestyle, and an abundance of food contribute to obesity, which is on the rise in the United States. With menopause, a decline in fat-free mass, bone mass, and lean tissue occurs. This loss in lean tissue includes not only muscle but also neuronal and connective tissue. Furthermore, with menopause fat is redistributed in the body with an increase in truncal deposition of adipose tissue, which is associated with an increased risk of coronary heart disease (CHD) and breast cancer. These risk factors can be attenuated through appropriate diet, hormone replacement therapy, and exercise, which emphasizes resistance training. One approach to an appropriate diet would focus on ''culturally based'' dietary patterns. A Mediterranean-based diet, an Asian-based diet, or other ancestral-based diets have recently been suggested. These dietary patterns are associated with the decreased incidence of many chronic diseases and the maintenance of long-term health. The type of fat in the diet influences many aspects of health. Saturated fats, whether derived from animal or vegetable sources, are associated with increased risk for cardiovascular disease and certain cancers. Fats derived from fish oils appear to be cardioprotective and are associated with decreased incidence of breast cancer in epidemiologic and animal studies. Monounsaturated fats, such as those found in olive oil, appear to decrease serum triglycerides and may reduce the risk for breast cancer. A greater consumption of vegetables and fruit is associated with a decreased incidence of heart disease and many types of cancer. The protective factors in plant-derived foods include fiber, folic acid, antioxidant vitamins, carotenoids, and nonnutritive chemoprotective factors such as genistein, deidzen, and lignans. Plant-derived foods are also high in magnesium and calcium, which are associated with cardioprotection, reduced risk for certain cancers, and attenuation of osteoporosis. The ideal diet is based on the eating habits of our ancestors, It emphasizes the use of unrefined food products and drastically reduces the consumption of highly processed flours and grains and simple sugars that are added to most foods, Optimal recommendations include the daily consumption of large amounts of fresh fruits and vegetables, Animal-based protein would be replaced with plant protein and fish. Selective supplementation,vith vitamins and minerals would be encouraged for patients who are unwilling or unable to modify their eating habits and where scientific data support their use.
