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Women’s Health
Contributed by Shawna Gornick-Ilagan, MS, RD, CWPC
Review Date 10/09 G-1121
Objectives
• Leading cause of death
• How to prevent or manage leading health
conditions
• Other health concerns for women
• Importance of screenings
Objectives
• Leading cause of death
• How to prevent or manage leading health
conditions
• Other health concerns for women
• Importance of screenings
What Do You Think Are The
Leading Causes of Death
for American Women?
Leading Cause of Death:
2004
Source: Centers for Disease Control and Prevention.
Available at: http://www.cdc.gov/Women/lcod.htm.
Facts
• Heart disease kills six times as many
women as breast cancer
Source: Mayo Clinic. Available at:
http://www.mayoclinic.com/health/heart-disease/hb00040.
Can Anyone Tell Me the
Difference Between a
Heart Attack and a Stroke?
Stroke vs Heart Attack
• Stroke—blocked blood flow to the brain
• Heart attack—blocked blood flow to the
heart
• Risk factors are the same for both
What Causes Heart
Disease/Stroke?
• Arteries—blood vessels that carry blood
away from the heart to the rest of the
body
Normal Artery
Plaque Starts to
Build Up
Tear in
Tear in Artery
Artery Wall
Wall
Plaque Can Grow
and Harden and
Obstruct the Artery
Atherosclerosis
Tear in
Tear in Artery
Artery Wall
Wall
Ischemic Stroke
Heart Attack
What Increases Risk?
You Can Not Help
• Age
– Men: >45 years
– Women: >55 years
• Sex
• Race
• Family history
You Can Help
•
•
•
•
•
•
•
•
Smoking
Alcohol
Poor diet
Overweight/obesity
Diabetes
Physical inactivity
High cholesterol
High blood pressure
What Percentage of Heart
Disease Do You Think Is
Preventable?
80% of All Heart
Disease
Preventable
7 Steps to a Healthier
You!
1. Know your numbers
2.
3.
4.
5.
6.
7.
–
–
–
–
Cholesterol (LDL=lousy, HDL=healthy)
Triglycerides
Blood pressure
Glucose
Maintain a healthy weight
Stay physically active
Manage stress
Do not smoke
Do not drink alcohol excessively
Eat heart healthy
HDL=high-density lipoprotein, LDL=low-density lipoprotein
Cancer Cases in Women:
2007
•
•
•
•
•
•
•
•
•
•
•
26% breast
15% lung and bronchus
11% colon and rectum
5% uterine corpus
4% non-Hodgkin's lymphoma
4% melanoma of skin
4% thyroid
3% ovary
3% kidney
3% leukemia
21% all other sites
Cancer Prevention
• Avoid smoking and second-hand smoke
• Practice safe sex and limit your partners
(80% of women have HPV)
• Get regular Pap smears
• “No thanks” to alcohol
– Women who consume two to five drinks a day
are 1.5 times more likely to develop cancer
• Eat a low-fat, sensible diet
HPV=human papillomavirus
Cancer Prevention
(cont’d)
•
•
•
•
Protect yourself from the sun
Maintain a healthy body weight
Know your family history of cancer
Get moving
Other Common Health
Concerns for Women
•
•
•
•
Osteoporosis
Depression
Iron
Menopause/weight management
What Percentage of American
Women Get Osteoporosis in
Their Lifetime?
Osteoporosis
• One out of every two women age 50 and
older will have an osteoporosis-related
fracture in their lifetime
• One out of every four men age 50 and
older will have an osteoporosis-related
fracture in their lifetime
Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Available at:
Osteoporosis
Progression
Normal
bone
Osteoporosis
Osteopenia
Severe
osteoporosis
Bone Health and
Osteoporosis
Normal bone
Osteoporosis
What’s the Big Deal?
• Affects 44 million Americans
• One in two women and one in four men over
age 50 will have an osteoporosis-related
fracture in their remaining lifetime
• No early warning signs (silent disease)
• Broken bones usually are the first signs
(50%)
• 20% of seniors who suffer a hip fracture die
within 1 year
• 20% of seniors with a hip fracture end up in
a nursing home within 1 year
How Can We Prevent
Osteoporosis?
• If under the age of 25, one can attain a
higher peak bone mineral density
• If older than age 25, one can maintain or
improve bone mineral density:
– Exercise
– Nutrition
Exercise for Prevention
• 30 minutes of weight-bearing
exercise (walking or jogging)
three times a week is all it takes
• Physical activity reduced the risk
of bone-breaking falls by 25%
• Aerobic:
– Walking
– Running
– Cycling
• Resistance exercises:
– Weight training
Nutrition for Prevention
• Males and females only ingest calcium for
storage until age 21-26
• At that age, the epithelial plate closes and
no more calcium is ingested for storage,
only for blood maintenance
• You have reached the peak at this age—
the higher the density peaks, the less
chance for bone disease
Nutrition for Prevention
(cont’d)
• After the epithelial plate closes, you must
consume 1000 milligrams (mg) of
calcium/day (even greater amounts if you
are older than age 50) to maintain blood
levels
• If not maintained, you body will take
calcium from the bone
Recommended Calcium
Intake
Ages
Birth-6 months
6 months-1 year
1-3 years
4-8 years
9-18 years
19-50 years
51+ years
Amount (mg/day)
210 mg
270 mg
500 mg
800 mg
1300 mg
1000 mg
1200 mg
Calcium
Sources
What If You Do Not
Drink Milk?
• You can get calcium from other foods,
including:
–
–
–
–
–
–
Cheese
Cream soups
Custard
Pudding
Ice cream
Canned fish with edible bones
 Canned salmon, sardines, and mackerel are
good choices
– Milk used in cooking, such as in mashed
potatoes
What if You Do Not
Drink Milk? (cont’d)
• Other options are fortified foods, such as:
– Fortified orange juice
– Calcium supplements
Where to Look for
Calcium
• Add a “0” to the %
to find out how
many milligrams of
calcium in a food
• The Daily Value for
calcium on food
labels is 1000 mg
Calcium Absorption
• Less calcium is absorbed as you age
• Many factors may decrease the calcium
you are able to absorb from the foods you
eat or increase the amount of calcium that
comes out of your bones and into your
blood
• Both lower your bone density
• You only can absorb 300-500 mg in one
sitting
What Decreases
Absorption?
• Sodium
• 2.3 grams (g) excretes 24-40 mg of
calcium
• As dietary protein increases, the urinary
excretion of calcium also increases
– The average intake of protein in the US is two
times higher than the RDI
– Estimated that each 1-g increase would
require an additional 5.8 mg of calcium/day to
offset the calcium loss
RDI=reference daily intake
What Decreases
Absorption? (cont’d)
• Caffeine
• Smoking
• Alcohol
How to Increase Your
Calcium Absorption
• Adequate amounts of vitamin D
• Sugar (lactose) and vitamin C increase
absorption
• How much calcium can you absorb at one
time?
– Most people can only absorb 300 mg, but other
can absorb up to 500 mg
How to Increase Your
Calcium Absorption
• To get adequate amounts of calcium,
consume calcium once in the morning,
afternoon, and night
• 300 mg four times/day (8 AM, noon, 4 PM,
8 PM)
• Calcium is better absorbed later at night
Why Is Vitamin D
Important?
• Vitamin D helps your body absorb calcium
and deposit the calcium in your bones to
help keep your bones strong
• The best food sources of vitamin D are
fortified milk products and fatty ocean
fish
• Recommended amount: 400 IU daily
IU=international units
Tips for Increasing
Calcium in the Diet
•
•
•
•
Drink calcium-fortified orange juice
Make oatmeal with milk, instead of water
Put cheese on your sandwiches
Put milk instead of half-and-half or
powdered creamer in your coffee or tea
• Make your own pudding with milk, instead
of buying convenience prepackaged
pudding
• Add nonfat dry-milk powder to gravies,
peanut butter, and other foods
It Is Not Too Late
• Studies in Wisconsin have shown that
women in their 80s and 90s can increase
bone hardness
• So, it is never too late to increase you
bone hardness
Calcium
Supplementation
• Calcium citrate:
– Best absorbed in an acidic environment
– Best absorbed supplemental form of calcium
– Does not require extra stomach acid for
absorption; so, you can take it anytime during
the day, even on an empty stomach
• Calcium carbonate (Tums® or Caltrate®)
– Most calcium pills in the market are in this
form
– Requires extra stomach acid for better
absorption; best taken after meals
Step 4: Manage Stress
Step 4: Manage Stress
Manage Stress
• If left unmanaged, stress can cause
emotional, psychological, physical
problems (heart disease, high blood
pressure, chest pain, and irregular heart
beat)
• Stress also may cause you to overeat,
exercise less, and possibly smoke more
• You can think yourself into clinical
depression
Stress: Common Warning Signs
Tips to Reduce Stress
• Identify the stressor first
• Avoid hassles and minor irritation, if
possible
• Try to continue doing the things that you
enjoyed before the change that caused
stress occurred in your life
• Learn how to manage your time efficiently
• Do one thing at a time
• Learn to take a break
• Ask for help when you need it
Depression
• About twice as many women as men
experience depression
• As a woman, several factors increase your
risk of depression, including:
– Your unique biology
– Your life situation
– Your culture
Depression: What Can
You Do?
• Engage in mild activity or exercise
– Go to a movie, ballgame, or another event or
activity that you enjoyed before
– Participate in religious, social, or other
activities
• Set realistic goals for yourself
• Break large tasks into smaller ones
– Set some priorities
– Do what you can as you can
Depression: What Can
You Do? (cont’d)
• Try to spend some time with other people
– Confide in a trusted friend or relative
– Try not to isolate yourself
– Let others help you
• Expect your mood to improve gradually,
not immediately
– Do not expect to suddenly “snap out of” your
depression
– Often during treatment for depression, sleep
and appetite will begin to improve before your
depressed mood lifts
Depression: What Can
You Do? (cont’d)
• Postpone important decisions, such as
getting married or divorced, or changing
jobs
– Wait until you feel better to make important
decisions
– Discuss decisions with others who know you
well and have a more objective view of your
situation
Depression: What Can
You Do? (cont’d)
• Keep confident and know that your
positive thinking will replace negative
thoughts as your depression responds to
treatment
• Psychotherapy and medication: Talk to
your doctor
Iron RDA
Menopause and Weight
Gain
• Hormones play a critical role in weight
gain during and after menopause
• Estrogen—the female sex hormone stored
in fat
• During menopause, production decreases
and the body looks for estrogen in fat
stores
• The body also stores more fat during this
time to compensate for declining estrogen
production
Weight Management
• Meal plan
– Start your day with a good breakfast
– Eat from all food groups
– Include whole grains, low-fat dairy,
vegetables, lean protein, fruit, and healthy
fats in your diet
– Choose healthy snacks
– Read nutrition labels
– Remember “moderation”
• Exercise
– Exercise a minimum 30 minutes most days
Why Reduce Calories?
• Reduce your calories if you are overweight
and want to lose weight
• Calories are the energy in food that
contribute to weight loss and weight gain
• 1 pound of fat=3500 calories
Other Benefits of
Exercise
• Sedentary women suffer more from:
– Chronic back pain
– Stiffness
– Insomnia
– Gastrointestinal (GI) irregularity
– Poor circulation
– Muscle weakness
– Shortness of breath
– Depression
Other Benefits of
Exercise (cont’d)
• Active women who walk, jog, swim, bike,
etc:
– Have less chronic back pain, stiffness,
insomnia, GI irregularity, poor
circulation, muscles weakness,
shortness of breath, and depression
– Achieve higher HDL levels