Breaking Health News, May 12, 2004

Women Encouraged To Take Charge Of Their Health

This Is National Women's Health Week

< May 12, 2004 > -- When women take even the simplest steps to improve their health, the results can be significant, say national health officials during National Women's Health Week.

Women need to be empowered to choose the most effective steps for their individual lifestyles and circumstances, according to the National Women's Health Information Center.

Women around the US will join together this week to celebrate National Women's Health Week, a program of the US Department of Health and Human Services.

Experts say that women need to be informed and take responsible actions to improve their own health. For example, heart disease is the number one cause of deaths among women, yet cancer ranks first among Asian/Pacific Islander women.

When it comes to lung cancer, however, Caucasian women have the highest mortality rate, while African-American women have the highest mortality rate from heart disease.

Stroke is the third leading cause of death for US women, but it occurs at a higher rate among African-American and Latina women.

These differences show the importance of taking appropriate health actions based on individual backgrounds and risk factors, say health experts at the US Preventive Services Task Force.

Screening Tests: What You Need and When

Screening tests, such as mammograms and Pap tests, can find diseases early when they are easier to treat. Some women need certain screening tests earlier, or more often, than others.

Women should talk with their physicians about which of the tests listed below are right for them and how often to schedule them.

The Task Force has made the following recommendations, based on scientific evidence, about which screening tests women should have.

• Mammograms: The National Cancer Institute recommends women age 40 and older should have a screening mammogram every one to two years. The American Cancer Society recommends women age 40 and older should have a screening mammogram every year.
• Pap tests: ACS and ACOG recommend annual screening with regular Pap tests, or every two years screening with liquid-based tests (Thinprep) until age 30. Women who are age 30 or older, who have had three normal test results in a row, may get screened every two to three years. However, women with certain risk factors such as human immunodeficiency virus (HIV) infection, a weak immune system, in utero DES exposure, or a previous diagnosis of cervical cancer may need more frequent screening. Women 65 to 70 years of age who have had at least three normal Pap tests and no abnormal Pap tests in the last 10 years may decide, upon consultation with their healthcare provider, to stop cervical cancer screening.
• Cholesterol checks: Everyone age 20 and older should have their blood cholesterol measured at least once every five years. It is best to have a blood test called a lipoprotein profile to find out total cholesterol, LDL (bad cholesterol), HDL (good cholesterol), and triglycerides. If a person knows numbers for a total cholesterol and HDL cholesterol, this provides helpful information.
• Blood pressure: Have blood pressure checked at least every two years. According to the National Heart, Lung, and Blood Institute, high blood pressure for adults is defined as:
  
  140 mm Hg or greater systolic pressure
  and
  90 mm Hg or greater diastolic pressure
  
  
  In an update of the guidelines for hypertension in 2003, a new blood pressure category was added called prehypertension:
  120 mm Hg – 139 mm Hg systolic pressure
  and
  80 mm Hg – 89 mm Hg diastolic pressure
• Colorectal cancer tests: Have a test for colorectal cancer starting at age 50. Colorectal cancer screening guidelines for 2004 from the American Cancer Society for early detection include:
  • fecal occult blood test (FOBT) every year
  • flexible sigmoidoscopy (FSIG) every five years
  • annual FOBT and FSIG every five years
  • double-contrast barium enema every five years
  • colonoscopy every 10 years
  
  People with risk factors such as a strong family history of colorectal cancer or some other special conditions should begin screening procedures at an earlier age and be screened more often.
• Diabetes tests: A woman should have a test to screen for diabetes if she has high blood pressure or high cholesterol and is over the age of 45.
• Depression: A woman should talk with her physician about screening for depression when feeling "down," sad, or hopeless, and little interest or pleasure in doing things for two weeks straight.
• Osteoporosis tests: Have a bone density test at age 65 to screen for osteoporosis (thinning of the bones). Women between the ages of 60 and 64 and weighing 154 pounds or less should talk with a physician about testing.
• Chlamydia tests and tests for other sexually transmitted diseases: Chlamydia tests are for women who are 25 years old or younger and sexually active. Women who are older should talk with a physician to see whether or not to be tested.

Taking Medications to Prevent Disease

The Task Force has made the following recommendations:

• Hormones: According to recent studies, the risks of taking estrogen alone or the combined hormones estrogen and progestin after menopause to prevent long-term illnesses outweigh the benefits. Women should talk with their physicians about whether starting or continuing to take hormones is right for them.
• Breast cancer medications: If a woman's mother, sister, or daughter has had breast cancer, risks and benefits of taking medications to prevent breast cancer should be discussed with a physician.
• Aspirin: When a woman is older than 45 and has high blood pressure, high cholesterol, diabetes, or smokes, she should talk with a physician about taking aspirin to prevent heart disease
• Immunizations: Stay up-to-date with immunizations:
  • Have a flu shot every year starting at age 50.
  • Have a tetanus-diphtheria shot every 10 years.
  • Have a pneumonia shot once at age 65.
  • Talk to your doctor to see whether you need hepatitis B shots.

What Else Can A Woman Do To Stay Healthy?

• Do not smoke. Talk to a physician about quitting. Medication is available as well as counseling. Make a plan and set a quit date. Ask for family and friend support.
• Eat a healthy diet. Eat a variety of foods, including fruits, vegetables, animal, or vegetable protein (such as meat, fish, chicken, eggs, beans, lentils, tofu, or tempeh) and grains (such as rice). Limit the amount of saturated fat.
• Be physically active. Walk, dance, ride a bike, rake leaves, or do any other physical activity you enjoy. Start small and work up to a total of 20-30 minutes most days of the week.
• Stay at a healthy weight. Balance the number of calories you eat with the number you burn off by your activities. Remember to watch portion sizes. Talk to your doctor if you have questions about what or how much to eat.
• Drink alcohol only in moderation. If a woman drinks alcohol, one drink a day is safe unless she is pregnant. Avoid alcohol during pregnancy.

Always consult your physician for more information.

Online Resources

(These links are provided for the education and convenience of our Neighbors. AAMC is not responsible for the content of Internet sites.)

American Heart Association

American Cancer Society

Centers for Disease Control and Prevention (CDC)

HealthierUS.Gov

National Cancer Institute, Eat 5 to 9 a Day

National Diabetes Information Clearinghouse

National Heart, Lung, and Blood Institute

National Institutes of Health (NIH)

National Library of Medicine

Women's Health Information Resources, 4Women.gov

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Overweight and Obesity Health Concerns

The US Surgeon General states that one in three US adults are overweight or obese.

Public health officials say physical inactivity and poor diet are catching up to tobacco as a significant threat to health.

Currently, about 35 percent of women and 31 percent of men are considered seriously overweight. Obesity is a serious, chronic disease that can inflict substantial harm to a person’s health.

Obesity has a far-ranging negative effect on health and causes an estimated 300,000 premature deaths in the US. The health effects associated with obesity include, but are not limited to, the following:

high blood pressure - Additional fat tissue in the body needs oxygen and nutrients in order to live, which requires the blood vessels to circulate more blood to the fat tissue.

This increases the workload of the heart because it must pump more blood through additional blood vessels. More circulating blood also means more pressure on the artery walls. Higher pressure on the artery walls increases the blood pressure.

diabetes - Obesity is the major cause of type 2 diabetes. This type of diabetes begins in adulthood. Obesity can cause resistance to insulin, the hormone that regulates blood sugar.

When obesity causes insulin resistance, the blood sugar becomes elevated. Even moderate obesity dramatically increases the risk of diabetes.

heart disease - Atherosclerosis (hardening of the arteries) is present 10 times more often in obese people compared to those who are not obese. Coronary artery disease is also more prevalent because fatty deposits build up in arteries that supply the heart.

Narrowed arteries and reduced blood flow to the heart can cause chest pain (angina) or a heart attack. Blood clots can also form in narrowed arteries and cause a stroke.

joint problems, including osteoarthritis - Obesity can affect the knees and hips because of the stress placed on the joints by extra weight.

Joint replacement surgery, while commonly performed on damaged joints, may not be an advisable option for an obese person because the artificial joint has a higher risk of loosening and causing further damage.

sleep apnea and respiratory problems - Sleep apnea, which causes people to stop breathing for brief periods, interrupts sleep throughout the night and causes sleepiness during the day. It also causes heavy snoring.

Respiratory problems associated with obesity occur when added weight of the chest wall squeezes the lungs and causes restricted breathing.

cancer - In women, being overweight contributes to an increased risk for a variety of cancers including breast, colon, gallbladder, and uterus. Men who are overweight have a higher risk of colon and prostate cancers.

metabolic syndrome - The National Cholesterol Education Program has identified metabolic syndrome as a complex risk factor for cardiovascular disease.

Metabolic syndrome consists of six major components: abdominal obesity, elevated blood cholesterol, elevated blood pressure, insulin resistance with or without glucose intolerance, elevation of certain blood components that indicate inflammation, and elevation of certain clotting factors in the blood.

In the US, approximately one-third of overweight or obese persons exhibit metabolic syndrome.

psychosocial effects - In a culture where often the ideal of physical attractiveness is to be overly thin, people who are overweight or obese often suffer disadvantages. Overweight and obese persons are often blamed for their condition and may be considered to be lazy or weak-willed.

Always consult your physician for more information.

Eating Well for a Healthy Weight

High-fat foods generally have more calories than foods that are high in carbohydrates or protein, but the truth is, the best way to lose weight is to eat fewer calories than you burn each day.

Fruits, vegetables, and other foods that are low in fat and calories can also help reduce your risk of heart disease, stroke, and cancer.

Start your day off right by eating breakfast. Drink 100 percent fruit juice with breakfast, or take a can to drink at work. Spruce up your breakfast - a banana or handful of berries will liven up your cereal, yogurt, waffles, or pancakes. Take a piece of fruit to munch on during your commute.

Use butter and margarine sparingly. Even better, switch to reduced-fat margarine or try jelly on your bread, bagels, and other baked goods.

Use "lite" or low-fat dairy products (such as milk, cheese, yogurt, or sour cream). Use in recipes and/or drink 1percent or skim milk. You will still get the nutrients and taste but not the fat.

When you make or buy a salad, a little bit of salad dressing, about 1 tablespoon, goes a long way. Even better, use "lite" or fat-free salad dressing. The same principle applies.

Choose the leanest cuts such as beef round, loin, sirloin, pork loin chops, turkey, chicken, and roasts.

Use oils sparingly (try olive and canola oils). Bake chicken without the skin. Substitute a baked potato for french fries.

Choose healthy, quick, and easy-to-grab foods such as celery sticks, cucumber wedges, and cherry tomatoes. Or, make healthier choices for snacks that are store-bought, such as pretzels.

Eat when you are hungry and stop when you are full. Take smaller portions. Never go back for seconds.

Typical restaurant servings are often twice the size of a single serving. When dining out or ordering in, ask for half of a serving or a "doggy bag." That way you will not be as full, and you can have some tomorrow.

Fast food does not have to be high in fat and calories if you are careful. Try ordering a lean roast beef or grilled chicken sandwich. Keep the portions to regular and small. No "double" anything or "going large." Order items without the cheese.

Always consult your physician for more information.