For women only.Men die younger of heart attacks. Men don't get menstrual periods. Men can't get pregnant. Men do most of the research. Which of these reasons ex lain why scientists have done far more studies on diseases in men than in women? Any and all. But that's beginning to change. In 1990, the National Institutes of Health set up an Office of Research on Women's Health Women's Health Definition Women's health is the effect of gender on disease and health that encompasses a broad range of biological and psychosocial issues. to help solve the problem. Now we've got the Women's Health Study, the Women's Health Initiative Women's Health Initiative A 15-yr, $628 million project involving 1. An observational study of the health habits and medical Hx of ±100,000 ♀ 2. , the Women's Antioxidant antioxidant, substance that prevents or slows the breakdown of another substance by oxygen. Synthetic and natural antioxidants are used to slow the deterioration of gasoline and rubber, and such antioxidants as vitamin C (ascorbic acid), butylated hydroxytoluene and Cardiovascular Disease Cardiovascular disease Disease that affects the heart and blood vessels. Mentioned in: Lipoproteins Test cardiovascular disease Study, and more. All told, they involve hundreds of thousands of American women. This month, Nutrition Action talks to Harvard Medical School Harvard Medical School (HMS) is one of the graduate schools of Harvard University. It is a prestigious American medical school located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts. researcher JoAnn E. Manson, one of the architects of those massive studies. Though the studies won't be finished for years, says Manson, there's quite a bit we already know about women, diet, and disease. Q: Do women know which diseases really threaten their lives? A: Many don't. A woman's risk of dying from heart disease is six times as great as her risk of dying of breast cancer. Fully one-third of all women will die of heart disease. Most women, however, think that breast cancer is the leading cause of death. It's understandable that there's a lot of anxiety concerning breast cancer. It does kill more premenopausal pre·me·no·paus·al adj. Of or relating to the years or the stage of life immediately before the onset of menopause. premenopausal adjective women than heart disease. But over their lifetimes, women are much more likely to die of heart disease. Q: Why do people think that heart attacks strike only men? A: Women get heart attacks ten to 15 years later than men. So we're really talking about a postmenopausal post·men·o·paus·al adj. Of or occurring in the time following menopause. postmenopausal Change of life Gynecology adjective Referring to the time in ♀ when menstrual periods stop for ≥ 1 yr disease. But the stage is set for heart disease in adolescence and young adulthood. It develops over a lifetime. Q: So fatty foods clog arteries in younger women and girls, but it happens much more slowly? A: Yes. If you're 35, you're likely to have more fatty blockage in your blood vessels Blood vessels Tubular channels for blood transport, of which there are three principal types: arteries, capillaries, and veins. Only the larger arteries and veins in the body bear distinct names. than if you're 20. The process speeds up after menopause. I don't want to "I Don't Want To"/"I Love Me Some Him" is the third single released from Toni Braxton's multiplatinum second album, Secrets. Written and produced by R. Kelly, this ballad describes the agony of a break-up. make a young premenopausal woman worry about developing a heart attack at any moment, but I also don't want women to be complacent about it. No one is immune from heart disease, and it's very important to adopt a healthy lifestyle early on. Q: Are women with heart disease treated differently than men? A: Yes. Symptoms of heart disease like angina - chest pain that occurs with exertion - are more likely to be ignored or overlooked in women. Women tend to get into an emergency room much later after having a heart attack and tend to get less aggressive management of their heart disease. Women are nearly twice as likely as men to die in the year following a heart attack. And women who undergo coronary bypass surgery Coronary bypass surgery A surgical procedure which places a shunt to allow blood to travel from the aorta to a branch of the coronary artery at a point past an obstruction. Mentioned in: Cardiac Catheterization, Thallium Heart Scan or angioplasty also do worse than men. But all of these adverse outcomes may be because women are older and have more advanced disease at the time that they're diagnosed and treated. LESS DATA ON DRUGS Q: Do we know less about heart disease in women than in men? A: Yes. For example, there is evidence that cholesterol-lowering drugs help women - or men - who have a prior history of cardiovascular disease. But should you put healthy people on cholesterol-lowering medication when they have mildly or moderately elevated cholesterol? For men, the answer is yes. For women, we don't know Don't know (DK, DKed) "Don't know the trade." A Street expression used whenever one party lacks knowledge of a trade or receives conflicting instructions from the other party. . Q: What about diet? A: Eating less saturated fat saturated fat, any solid fat that is an ester of glycerol and a saturated fatty acid. The molecules of a saturated fat have only single bonds between carbon atoms; if double bonds are present in the fatty acid portion of the molecule, the fat is said to be and dietary cholesterol lowers blood cholesterol in both men and women, although genetics also plays a role. Every one percent drop in blood cholesterol should translate into a two to three percent fall in the risk of heart disease. Q: How little sat fat is best? A: Less than seven percent of calories is desirable. Less than recommended. And there is increasing evidence that the trans fats in margarines and partially hydrogenated oils raise heart disease risk, perhaps by lowering HDL (Hardware Description Language) A language used to describe the functions of an electronic circuit for documentation, simulation or logic synthesis (or all three). Although many proprietary HDLs have been developed, Verilog and VHDL are the major standards. ["good"] cholesterol as well as raising LDL LDL - ["LDL: A Logic-Based Data-Language", S. Tsur et al, Proc VLDB 1986, Kyoto Japan, Aug 1986, pp.33-41]. ["bad"] cholesterol. Total fat should stay below 30 percent of calories to reduce the risk of cancer, heart disease, and obesity. Q: Are other causes of heart disease the same in women and men? A: Most are. For example, smoking is a potent risk factor. So is a family history of heart attack before age 60. And high blood pressure is extremely important. It increases the risk three to four times above that of a woman with normal blood pressure. Obesity is a very strong risk factor in both men and women, but physicians are more complacent about obesity in women. Q: Why? A: One reason is that a woman's fat tends to be distributed more in her lower body - hips, buttocks buttocks /but·tocks/ (but´oks) the two fleshy prominences formed by the gluteal muscles on the lower part of the back. , and thighs - than in her upper body, especially the waist and abdomen. Lower-body obesity may be less of a risk factor for heart disease, diabetes, and high blood pressure than upper-body obesity, but it's not substantially increases the risk of diabetes. And many women - as well as men - have upper-body obesity. Q: What about exercise? A: Physical activity is very protective in both men and women, though it has been studied much less in women. It increases HDL cholesterol HDL cholesterol n. See high-density lipoprotein. HDL Cholesterol About one-third or one-fourth of all cholesterol is high-density lipoprotein cholesterol. , lowers the risk of diabetes, lowers blood pressure over the long term, lowers the tendency for blood to clot, and is good for reducing stress [see "What Women Can Do"] THE DIFFERENCES Q: What risk factors differ for men and women? A: Diabetes increases the risk of heart disease five to seven times in women and only two to three times in men. Q: Why? A: It isn't known. But some studies suggest that diabetes increases blood pressure more in women, and that it seems to lower HDL cholesterol more in women than it does in men. Women can avoid diabetes by avoiding obesity and increasing physical activity. Q: How many excess pounds are too many? A: Even average weight in the U.S. increases the risk of diabetes and heart disease [see "Get (1959) Met"] In the Nurses' Health Study Nurses' Health Study Cardiology A large cohort study that evaluated the effect of exogenous HRT on the risk of cardiovascular disease. See Estrogen replacement therapy, Osteoporosis. , we found an 80 percent higher risk of heart disease in women who were 15 to 30 percent above desirable weight, and triple the risk with higher weights. And women who gained 20 or more pounds in early adulthood - between the age of 18 and when they entered the study at 30 to 55 - had double the risk of heart disease. Obesity increases the risk of diabetes by an even greater amount. HDL MATTERS MORE Q: Are other things riskier for women than men? A: Yes. In women, having low HDL ["good"] cholesterol appears to be more of a risk for heart disease than having high LDL ["bad"] cholesterol. That doesn't appear to be the case in men. In women, a high LDL hasn't yet been documented to increase the risk of heart disease as powerfully as it does in men. That's one reason we aren't sure that cholesterol-lowering drugs prevent a first heart attack in women, as they do in men. And in women, having high blood triglycerides Triglycerides Fatty compounds synthesized from carbohydrates during the process of digestion and stored in the body's adipose (fat) tissues. High levels of triglycerides in the blood are associated with insulin resistance. may be more of a risk than it is in men, though that's controversial. Q: How high is "high" triglycerides? A: A rough rule of thumb is that if it's above 300, you would certainly want to lower the level, in both women and men. Q: What lowers triglycerides? A: Exercising, quitting or lowering your alcohol intake, and losing weight if you're overweight. Also, the omega-3 fats in fish may lower triglycerides, blood pressure, and the risk of blood clotting blood clotting, process by which the blood coagulates to form solid masses, or clots. In minor injuries, small oval bodies called platelets, or thrombocytes, tend to collect and form plugs in blood vessel openings. . Except for cutting back on alcohol, these are the same factors that raise HDL ["good"] cholesterol. DRINKING WOMAN'S DILEMMA Q: Is drinking healthy for women? A: Moderate alcohol consumption is associated with about a 40 percent reduced risk of heart disease in both men and women. But mild to moderate alcohol consumption may increase a woman's risk of breast cancer. Q: What's mild to moderate? A: Between one drink a week and two drinks a day. It's a matter of balancing one's risks. If a woman is at very low risk of heart disease - if she has no cardiovascular risk factors like smoking or high blood pressure - and if she is below the age of 50, there does not appear to be any evidence that she will increase her longevity by drinking. She may, in fact, reduce her lifespan by increasing her risk of breast cancer. Q: Should women who now enjoy drinking stop? A: That would be going too far. And for women who are older than 50 or who have other cardiovascular risk factors, alcohol may increase their life-span. But it would definite be premature to recommend that women - or men - take up drinking to lower their risk of heart disease. The broader risks of alcohol abuse - including motor vehicle and industrial accidents, homicides, suicides, drownings, injuries from falls and fires, and cirrhosis of the liver Cirrhosis of the liver A type of liver disease, most often caused by chronic alcohol abuse. It is characterized by scarring of the liver, which leads to an increase in the blood pressure in the portal veins. Mentioned in: Bleeding Varices - are too great. AN ASPIRIN A DAY? Q: Do other risks and benefits differ for men and women? A: Yes. For example, we know from the Physicians' Health Study that the benefits of taking aspirin outweigh the risks in men, but we don't yet know about women. Our Nurses' health Study suggested that women who took one to six regular aspirins a week had about a 30 percent lower risk of heart attacks than non-users. But that study wasn't a clinical trial in which participants were randomly assigned to take low-dose aspirin low-dose aspirin Vascular disease A minimal dose of aspirin administered daily to a person known to be at risk for coronary artery occlusion or a placebo. We're looking at that now in the Women's Health Study. Q: What are the risks of taking aspirin? A: Aspirin can cause serious gastrointestinal bleeding gastrointestinal bleeding Any hemorrhage into the GI tract lumen, from esophagus–eg, from ruptured esophageal varices, to anus–eg from hemorrhoids and shouldn't be used without consulting a physician first. And in the Physicians' Health Study of men, aspirin seemed to increase modestly the risk of hemorrhagic stroke hemorrhagic stroke Neurology An ischemic stroke in which blood enters necrotic brain tissue, which may not be accompanied by a worsening clinical status Risks for HS Hemophilia, thrombocytopenia, sickle cell anemia, DIC, anticoagulants, HTN. See Stroke. , though that may not be borne out in future studies. But as irin also drastically lowered the risk of first heart attack, which is much more common than stroke in men. Q: How might women differ? A: Women have a risk of stroke that's about the same as men's, but - until they're older - a much lower risk of heart disease. So the benefits may not outweigh the risks for them. Q: So women should ask their doctors about aspirin? A: Yes, unless they're younger than 40 and are at low risk of heart disease, which means they don't need aspirin. And that's likely to apply to men, too. Also, aspirin has been conclusively demonstrated to reduce the risk of a subsequent heart attack or stroke in both men and women who have already had a heart attack, a transient ischemic attack Transient Ischemic Attack Definition A transient ischemic attack, or TIA, is often described as a mini-stroke. Unlike a stroke, however, the symptoms can disappear within a few minutes. - which often precedes a stroke - or a stroke, unless it was a hemorrhagic stroke. A lot of lives could be saved by the regular use of aspirin in these highrisk individuals. Yet it's not being prescribed as widely as it should be. LUNG, BREAST, AND COLON CANCER colon cancer, cancer of any part of the colon (often called the large intestine). Colon cancer is the second most common cancer diagnosed in the United States. Q: What about diet and cancer? A: The best bet at this point is to eat more fruits, vegetables, and whole grains and to lower your intake of fat, especially saturated fats and red meat. The strongest evidence for fruits and vegetables is that they might reduce the risk of lung and colorectal cancer colorectal cancer Malignant tumour of the large intestine (colon) or rectum. Risk factors include age (after age 50), family history of colorectal cancer, chronic inflammatory bowel diseases, benign polyps, physical inactivity, and a diet high in fat. . Q: And breast cancel? A: The jury is still out on whether a low-fat diet low-fat diet A diet low in fats, especially saturated fats, which has a positive effect on arthritis, CA, ASHD, DM, HTN, obesity, and strokes. See Diet, Low-fat snack; Cf Animal fat, High-fat diet. reduces the risk. The Women's Health Initiative is now addressing that question [see "Ready to be Randomized ran·dom·ize tr.v. ran·dom·ized, ran·dom·iz·ing, ran·dom·iz·es To make random in arrangement, especially in order to control the variables in an experiment. ?"]. The evidence is stronger for colorectal cancer. But it certainly seems prudent at this point to try to avoid fat. Some studies suggest that it's not so much the total fat as the saturated fat or even red meat that's linked to colorectal cancer, prostate cancer prostate cancer, cancer originating in the prostate gland. Prostate cancer is the leading malignancy in men in the United States and is second only to lung cancer as a cause of cancer death in men. , and heart disease. Q: How much red meat should women eat? A: The less the better. Certainly less than once a week, if not less than once a month. Some would say you should never eat it. And that includes lean red meat, because there's a hypothesis - though so far little evidence - that the meat protein, and not the fat, is responsible. Then there's the question of whether calcium will reduce the risk of colorectal cancer. There's a hypothesis that calcium binds the bile salts that the liver secretes into the intestines, which may prevent damage to the intestinal lining by the bile salts. The Women's Health initiative is looking at whether calcium can prevent colorectal cancer and osteoporosis. BONING UP ON CALCIUM Q: Should women worry about calcium? A: Yes. Because osteoporosis is such a major cause of disability and illness in women, from an early age they should be vigilant about getting enough calcium and vitamin D vitamin D Any of a group of fat-soluble alcohols important in calcium metabolism in animals to form strong bones and teeth and prevent rickets and osteoporosis. It is formed by ultraviolet radiation (sunlight) of sterols (see steroid) present in the skin. . That should maximize their peak bone mass in young adulthood and reduce the risk of fractures later in life. Q: Do the calcium and vitamin D have to come from food? A: No. Sunlight will help supply the vitamin D. I'm not against calcium supplements if there's any problem like lactose intolerance Lactose Intolerance Definition Lactose intolerance refers to the inability of the body to digest lactose. Description Lactose is the form of sugar present in milk. that interferes with getting calcium from food. A lot of women don't like milk. And some dairy products like cheese often increase the fat and salt in the diet, so supplements may be a good way to go. Q: Should women take folic acid folic acid: see coenzyme; vitamin. folic acid or folate Organic compound essential to animal growth and health and needed by bacteria as a growth factor. ? A: If a woman could become pregnant, there's no question tllat she should get enough - 400 International Units international units, n.pl a unit of measurement that evaluates the potency of a substance. Because it measures potency instead of quantity, there is a different international unit-to-mg conversion ratio for each particular substance. a day, either from food or a multivitamin mul·ti·vi·ta·min adj. Containing many vitamins. n. A preparation containing many vitamins. multivitamin - in order to prevent neural tube neural tube n. A dorsal tubular structure in the vertebrate embryo that develops into the brain and spinal cord. [birth] defects. Waiting until a woman has her first prenatal visit is going to miss the boat because these defects develop during the first few weeks of pregnancy. And, irrespective of pregnancy, adequate folic acid may help prevent cancer and heart disease in both women and men. Ready to Be Randomized? It's the largest study ever done on women. And you can be part of it. In September 1993, researchers around the country started recruiting 160,000 healthy postmenopausal women aged 50 to 79 for the Women's Health Initiative. It will test whether: * a low-fat diet (up to 20 percent of calories from fat) reduces the risk of breast cancer, colorectal cancer, and heart disease, * calcium (1,000 mg a day) and vitamin D (400 IU a day) help prevent osteoporosis and colorectal cancer, and * the potential benefits of hormone replacement therapy Hormone Replacement Therapy Definition Hormone replacement therapy (HRT) is the use of synthetic or natural female hormones to make up for the decline or lack of natural hormones produced in a woman's body. (like lower risk of heart disease and osteoporosis) outweigh its possible risks (higher risk of breast cancer). Women can participate in one or more parts of the study, so you needn't take honnones if you don't want to. But if you're not willing to end up in the placebo-taking group, it's not for you. If you participate, you'll get several free medical tests like mammograms and Pap smears, and you'll be followed for eight to twelve years. Interested? Call (800) 54-women. Vive La Difference Both men and women have a higher risk of heart disease if they smoke, have high blood pressure or high cholesterol Cholesterol, High Definition Cholesterol is a fatty substance found in animal tissue and is an important component to the human body. It is manufactured in the liver and carried throughout the body in the bloodstream. , don't exercise, and are overweight. Here's how men and women differ: * Diabetes. Having diabetes increases a woman's risk of heart disease relatively more than it does a man's. * HDL. It appears to be more dangerous for a woman to have low HDL ("good") cholesterol than high LDL ("bad") cholesterol. There is more evidence that high LDL is dangerous for men. * Triglycerides. High blood triglycerides may be more likely to increase the risk of a heart attack in women than in men. * Chest pains. Women often have chest pains on and off for years before they have a heart attack. When men have chest pains, it's more likely to mean that a heart attack has begun. * Death rates. Women are twice as likely as men to die within two months after having a heart attack and Kvice as likely to die after coronary bypass coronary bypass Surgical treatment for coronary heart disease to relieve angina pectoris and prevent heart attacks. It became widely used in the 1960s. One or more blood vessels—usually an artery in the chest or a vein from the leg—are transplanted to create surgety, perhaps because they are older when they get sick. * Aspirin. The benefits of taking aspirin outweigh the risks in men over age 40 who have never had a heart attack as well as in women and men of any age who have already had one. Researchers don't know if the benefits outweigh the risks in women who have never had a heart attack. * Drugs. Cholesterol-lowering drugs reduce the risk of a heart attack in men, and in women who have already had a heart attack. The jury is still out on women who have never had a heart attack. * Alcohol. Women who drink regularly, even as infrequently as once or twice a week, have to weigh an increased risk of breast cancer against a lower risk of heart disease. WHAT WOMEN CAN DO * Don't smoke cigarettes. * Exercise for at least 20 to 30 minutes three or four times a week. It should increase your heart rate, but you needn't break into a sweat. * Shoot for an optimal body weight (see "Get (1959) Met"). * Get your blood pressure checked at least once every year or two and your cholesterol checked at least once every five years (more frequently if you've had high levels before). * Learn the signs of a heart attack: chest pain (often radiating to the arm or neck), nausea, lightheadedness, shortness of breath Shortness of Breath Definition Shortness of breath, or dyspnea, is a feeling of difficult or labored breathing that is out of proportion to the patient's level of physical activity. , or cold sweats. WHAT WOMEN SHOULD EAT * Cut back on fats, especially saturated fats. Eat red meat no more than once a week. (Load up on beans, pasta, rice, cereals, and seafood instead.) * Eat at least five to nine servings of fruits and vegetables every dax,. * Cut sodium to no more than about 2,400 mg a day. * Get the Daily Value (400 Iti) of folic acid, either from a multivitamin or from a variety of foods like orange juice, leafy green vegetables, and beans, especially if you could become pregnant. * Get enough calcium 1,200 milligrams a day if you're 11 to 25; 1,500 mg a day if you're over 50 and not taking estrogen; 1,000 mg a day for other adults) from a supplement and/or from foods like skim milk skim milk n. The milk from which the cream has been removed. skim milk the residue from whole milk after the cream has been skimmed off. In today's usage it is the residue after the butterfat is removed. , yogurt, cheese, leafy green vegetables, tofu tofu Soft, bland, custardlike food product made from soybeans. Believed to date from China's Han dynasty (206 BC–AD 220), tofu is today an important source of protein in the cuisines of East and Southeast Asia. , or fortified fortified (fôrt  ´fīd),adj containing additives more potent than the principal ingredient. orange juice, Get the Daily Value (400 IU) of vitamin D from milk, a multivitamin, or sunshine. Get (1959) Met How much should you weigh? Check this table - issued by the Metropolitan Life Insurance Company in 1959 - to find out. Tables published later say that you can be chubbier, but those extra pounds increase your risk of diabetes and heart disease. Height Weight (lbs.) (without shoes) (without clothes)
Women Men
5'0" 103-115 -
5'1" 106-118 111-122
5'2" 109-122 114-126
5'3" 112-126 117-129
5'4" 116-131 120-132
5'5" 120-135 123-136
5'6" 124-139 127-140
5'7" 128-143 131-145
5'8" 132-147 135-149
5'9" 136-151 139-153
5'10" 140-155 143-158
5'11" - 147-163
6'0" - 151-163
6'1" - 155-173
6'2" - 160-178
6'3" - 165-183
Source: JAMA 257: 353, 1987. |
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