Women must begin very early in their lives to build the bone density and strength that are needed to reduce the risk of osteoporosis and related bone fractures. Practicing good nutrition, especially from preadolescence through the onset of menopause, in combination with other preventive measures, such as exercise, will be effective in decreasing the incidence of osteoporosis.

Nutrition is a key to reducing the risk of osteoporosis.

It. is the combination of nutrients, rather than the singular effect of calcium, that influences bone. Studies have shown that:

dietary calcium intake from pre-adolescence through late adolescence is critical for building high bone density; and sodium and protein intake decrease calcium retention, although when phosphorus is consumed along with protein, it can diminish the negative effect of the protein.

High calcium intake is critical during the years between menarche and late adolescence when it plays an important role in the attainment of optimal bone mineral density.

High calcium intake in the early postmenopausal period has a minimal effect on the rapid bone loss taking place.

High calcium intake in later years does retard the bone loss associated with senile osteoporosis.

Vitamin D, whether consumed in food, supplemental pills or through sun exposure, enhances calcium absorption and bone maintenance.

In addition to nutrition, other factors known to increase osteoporosis risk are:

little physical activity; smoking and heavy drinking, which decrease bone maintenance; and the decreased levels of estrogen found in women who experience amenorrhea, which increase the likelihood of low bone density

Breast cancer strikes 182,000 women in the U.S. each year and kills 46,000. Yet we know very little about why women get breast cancer. Although there is a need for further study in this area, it may well be that diet can make a difference between promoting the growth of breast lesions and preventing the disease. Until further research provides a more definitive understanding of the role of nutrition in breast cancer, it appears that a diet low in fat and high in fiber, fruit and vegetables is sound advice.

The risk of breast cancer increases with age, early menarche, late menopause, late first full-term pregnancy, single marital status, family history of breast cancer, obesity in postmenopausal women, ovarian and endometrial cancer, and exposure to ionizing radiation. In short--all American women are at risk.

Breast cancer is more common in countries where women have a high average intake of total and saturated fat, animal protein and total energy.

As dietary fat increases, estrogen levels in the tissue increase, and studies have implicated estrogen in the promotion of growth of breast lesions.

Some studies indicate that dietary fiber, vitamins A and C, and betacarotene decrease risk of breast cancer.

This year alone, heart disease will kill over 500,000 women, and 39% of women who have heart attacks will die within a year. Nutrition intervention is effective in preventing and treating heart disease in women. The major risk factors for this disease in women include: elevated blood lipids and lipoproteins, excess body weight, hypertension, and cigarette smoking. Good nutrition can prevent and alleviate the most common risk factors associated with heart disease in women--high cholesterol, excess body weight and hypertension.

Twenty-seven percent of women exhibit risk factors for coronary heart disease that respond to nutrition intervention: elevated blood lipids/lipoproteins, excess body weight and possibly hypertension.

Nutrition treatment, in the form of major lifestyle changes and rigorous diets, is effective in treating heart disease in women and can help reduce the likelihood of future coronary events.

Studies have shown that women respond well to dietary intervention, making them good candidates for nutrition prevention and treatment.

The cost of treating diabetes and its complications constitutes a tremendous portion of this nation's health care budget--in 1992, diabetes cost $92 billion in medical care and lost productivity. Diabetes occurs in more than 13 million persons in the United States, and approximately 60 percent of the new cases are diagnosed in women. The prevalence of diabetes is higher in Native-American, black, and Hispanic women than in white women.

Diet is the cornerstone of treatment in all types of diabetes and contributes to diabetes prevention through weight management. Heart disease and obesity--which are often associated with diabetes--can also be modified by nutrition.

Diet and nutrition are linked to the prevention and treatment of diabetes and its complications.

The relationship between diet and incidence of diabetes may be influenced by ethnicity or culture.

Although dietary strategies related to nutrient intake have not produced consistent results in preventing diabetes, weight management can play an important role in preventing the development of diabetes.

Women with diabetes have a variety of increased health risks, many of which are responsive to nutrition related interventions.

Diabetes is three times more prevalent in people whose body weight is more than 140 percent of their desirable weight than in people near their desirable body weight.

Those people with upper-body obesity may be at even greater risk for diabetes.

There is evidence of a reduced incidence of non-insulin-dependent diabetes in white women who exercised vigorously once a week.

Effective diabetes self-management for obese persons is based on blood glucose control rather than on weight loss.

Women with insulin-dependent (Type 1) diabetes run high risks of developing maternal and fetal complications in pregnancy such as toxemia, excess amniotic fluid, and major congenital malformations in infants.

Women with non-insulin-dependent diabetes (Type 11) have been shown to have diets that are deficient in calcium, zinc, and magnesium, but that exceed the recommended level for vitamin C.

Excess weight is a serious problem for American women, 27 percent of whom are overweight. The prevalence of overweight is greater among women of color. Seventy percent of young women try to lose weight and dissatisfaction with body weight continues into adulthood.

Strategies to maintain healthy weight and prevent further weight gain are vital to improve women's health and quality of life. Dietitians are essential in assisting women to deal with their weight in terms of health rather than cosmetics.

Women have greater overall weight gains and experience more notable weight fluctuations than men.

Fifty-two percent of women consider themselves to be overweight, and 40 percent are trying to lose weight.

Obesity increases women's risk for at least five of the leading causes of death--heart disease, stroke, diabetes, atherosclerosis, and some types of cancer.

Seventy percent of obese children remain obese as adults.

Weight alone is not a sufficient measure to assess disease risk. Total body fat, fat distribution, and the consequences of dieting must be considered as well.

The racial and ethnic differences in prevalence of excess weight are striking: 45 percent in African American women; 41 percent in Mexican American women; 40 percent in Puerto Rican American women; 32 percent in Cuban American women; and 25 percent in white women.

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