Cholesterol and the Menstrual Cycle
Posted by on August 10, 2010 - 3:36pm

Women's cholesterol levels vary with phase of menstrual cycle
NIH findings suggest a need to consider phase of cycle when measuring cholesterol

National Institutes of Health researchers have shown that women's cholesterol levels correspond with monthly changes in estrogen levels. This natural variation, they suggest, might indicate a need to take into account the phases of a woman's monthly cycle before evaluating her cholesterol measures. On average, the total cholesterol level of the women in the study varied 19 percent over the course of the menstrual cycle.

In a typical cycle, estrogen levels steadily increase as the egg cell matures, peaking just before ovulation. Previous studies have shown that taking formulations which contain estrogen — oral contraceptives or menopausal hormone therapy — can affect cholesterol levels. However, the results of studies examining the effects of naturally occurring hormone levels on cholesterol have not been conclusive. According to the NIH’s National Heart, Lung and Blood Institute, high blood cholesterol levels raise the risk for heart disease.

The researchers found that as the level of estrogen rises, high-density lipoprotein (HDL) cholesterol also rises, peaking at the time of ovulation. HDL cholesterol is believed to be protective against heart disease.

In contrast, total cholesterol and low-density lipoprotein (LDL) cholesterol levels — as well as another form of blood fat known as triglycerides — declined as estrogen levels rose. The decline was not immediate, beginning a couple of days after the estrogen peak at ovulation. Total cholesterol, LDL cholesterol and triglyceride levels reached their lowest just before menstruation began.

The findings were published online in The Journal of Clinical Endocrinology and Metabolism.  To read the full NIH Press Release click here.

Tobacco Smoke Exposure Increases Chronic Disease in Children
Posted by on August 10, 2010 - 2:45pm

In July, a commentary in the journal Pediatrics discussed several new studies that have increased our knowledge of the  association between tobacco smoke exposure and childhood morbidity and mortality.  Collectively, these new reports demonstrate that in several categories of chronic childhood illness (asthma, obesity, and mental health disorders) there are small-to-moderate independent associations with tobacco smoke exposure either during pregnancy or in the postnatal period.   A moderate association with tobacco smoke and dental caries (cavities) in children was also reported.   One study found an association between smoke exposure of pregnant women and subsequent childhood overweight in offspring.   What was especially significant about the latter study was the fact that it was conducted in pregnant women who did NOT smoke but were exposed to smoke from the father.  Studies looking at mothers who smoke continue to show an association to their children's mental health status that affects their children's  ability to participate in social activities and make friends.

Fit More Fiber into your Diet
Posted by on August 5, 2010 - 10:48am

We all hear that fiber is good for you yet many American's don't get enough of it in their diets.  Experts recommend that men get about 38 grams of fiber a day and women get about 25 grams.  Unfortunately, the average intake in the United States is only 14 grams a day.

Dietary fiber is found in fruits, vegetables, nuts and whole grains.   It is often referred to as "bulk" or "roughage" and it helps with digestion and it passes through the digestive system relatively unchanged.  Besides helping relieve constipation and other bowel problems, high fiber diets have been shown to help with weight loss and reduce the risk of cardiovascular disease, diabetes and certain cancers.

Different types of fiber affect your health in different ways.  There are two types of fiber:   soluble and insoluble.   Soluble fiber may help lower blood sugar and cholesterol and it is found in oat bran, beans, peas, and most fruits.   Insoluble fiber is most used to treat GI conditions like diverticulosis, and is found in wheat bran and some vegetables.

Store shelves are filled with fiber-fortified products including yogurt, juices, etc.   Added fibers, like those in these products, are "isolated" fibers, such as inulin and maltodextrin and are listed among the ingredients.  Research suggests that these isolated fibers may not be as beneficial as those found naturally in foods.  However, most experts say the type of fiber you eat is less important than making sure you eat enough!

To learn more about fiber, check out a recent publication from the NIH.

Maternal Deaths: Decreasing…Slowly
Posted by on August 3, 2010 - 4:01pm

The health of pregnant women can say a lot about a region. It can indicate the accessibility and affordability of health care, as well as how much recognition maternal health receives in the region. A healthy pregnancy results in healthier children and decreased risk for maternal death. Conversely, measuring maternal mortality rates can also indicate the level of health resources within a country

In 2000, the United Nations adopted the Millennium Declaration, which established a series of goals including Millennium Development Goal 5. The goal aimed for a 75% reduction in the maternal mortality ratio (MMR) from 1990 to 2015. The MMR is a common statistic used to indicate the number of women, that die while pregnant or within 42 days of giving birth, for every 100,000 live births.

The Bill and Melinda Gates Foundation funded a study looking at maternal mortality rates over the past 28 years. In a report published in the Lancet this May, the authors examined the MMR across the globe using a variety of national and regional reports.

Using this data, the authors determined that there were about 340,000 maternal deaths in 2008 compared with 530,000 deaths in 1980. Between 1980 and 2008, the authors found some interesting trends. India had the largest number of maternal deaths of any country overall but the MMR substantially decreased over time. Eastern Asia reported the greatest reduction in maternal deaths while maternal mortality actually increased in sub-Saharan Africa during the 1990s. As of 2008, sub-Saharan Africa made up 52% of the global maternal deaths.

Additionally, in 2008, all the countries in western Europe, Canada, and Australia had maternal mortality rates below 10 (Italy was lowest with 4). The USA, on the other hand, had an MMR of 17, an increase from 1980, which the authors say may be due to increased reporting.

In contrast, over 21 countries had no data for the entire period between 1980 and 2008. Many of these countries are in northern Africa and the Middle East, which may indicate a low awareness of maternal mortality issues.

While the global MMR decreased over the past 28 years, the spread of HIV over the 1980s and 1990s initially caused maternal deaths to increase. Better treatment of HIV-positive women now prevents many of these maternal deaths (and decreases the spread of the virus during childbirth). Over this time period, the MMR was estimated to decrease 1.5% a year. While an improvement, it does not meet the 5.5% annual MMR decrease needed to meet Millennium Development Goal 5.

While the authors could only speculate on the direct causes of decreased maternal death rates, they do suggest some possibilities. During this same time period as the study, the total fertility rate decreased, which usually correlates with decreases in maternal mortality. In addition, income per person rose, particularly in Asia and Latin America. This can affect maternal and child mortality by increasing nutritional status and access to health care. Maternal education levels and birth assistance by a skilled professional also increase maternal health.

While it appears that the maternal mortality ratio will not meet the 2015 goals of the Millennium Declaration, continued efforts are being put forth to promote this important issue. President Obama has also proposed the Global Health Initiative, which will invest federal dollars to help other countries strengthen their health systems, with an emphasis on maternal and child health. In addition, public health advocacy groups also work around the globe to support this mission, including the White Ribbon Alliance. By working together, these organizations may continue to increase the awareness of health care for pregnant women and reduce maternal deaths.

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To read Kate’s posts about issues surrounding cancer and fertility, go to the Oncofertility Consortium Blog.

Emergency Contraception Update
Posted by on August 2, 2010 - 2:03pm

A recent fact sheet from the Kaiser Family Foundations, points out that even though health care providers have known about Emergency Contraception (EC) for several decades, the public at-large is less aware of its availability.   In June 2010, the federal Emergency Contraception Education Act (S. 3504/HR 5561) was introduced to provide funding for national awareness campaigns.  This new fact sheet reviews current national and state policies around EC, including new product availability and access issues.   To review the entire fact sheet, click here.

Safe Cosmetic Act of 2012
Posted by on July 29, 2010 - 2:26pm

Reps. Jan Schakowsky (IL), Ed Markey (MA) and Tammy Baldwin (WI) introduced legislation that would toughen safety standards for cosmetics and give the U. S. Food and Drug Administration (FDA) the authority to check personal care products for harmful ingredients.  Current law allows the FDA to defer decisions about ingredient safety to the cosmetic industry.  In other words, the cosmetic industry is regulating itself.  According to the Campaign for Safe cosmetics,  provisions in the legislation will:

  • Phase out ingredients linked to cancer, birth defects and developmental harm;
  • Create a health-based safety standard that includes protections for vulnerable populations, like children;
  • Close labeling loopholes by requiring full ingredient disclosure on product labels, web sites;
  • Give workers access to information about unsafe chemicals in personal care products;
  • Require data-sharing to avoid duplicative testing;
  • Provide funding to the FDA so it has the resources it needs to provided effective oversight; and
  • Level the playing field so small businesses can compete fairly.

 

Editor's Note:   As of November 2012  this bill has not passed yet.

Colorless Diet for Weight Loss?
Posted by on July 28, 2010 - 4:00pm

I just received a FDA email about the safety of color additives in food.   What caught my eye was the subheading:  "Without color additives, colas wouldn't be brown, margarine wouldn't be yellow and mint ice cream wouldn't be green."   I  wonder if colorless food could help reduce the obesity epidemic!!!   Seriously, to read the article, click here.

Lack of Representation of Women in Research Studies
Posted by on July 27, 2010 - 10:30am

Recent publications in Nature and Women's Health by Institute Director Teresa K. Woodruff and her post docs have seemed to hit a nerve among other science writers who are beginning to explore issue raised by Dr. Woodruff.    A few days ago an interesting article appeared in Slate, a daily magazine that has won numerous awards for excellence in online publishing.  An article posted by Melinda Wenner Moyer further explores issues raised by Woodruff including why the study of sex differences is critical to advancing science and why scientists often do not include males and females in their studies.  Moyer cites several reports that include data that shows how male centric science continues to be conducted despite mandates that require equal inclusion.

To learn what the Institute for Women's Health Research at Northwestern University is doing to advance research in women's health, check our website.

Wrist Fracture Impact on Women
Posted by on July 21, 2010 - 12:36pm

CHICAGO --- Wrist fractures have an important personal and public health impact and may play a role in the development of disability in older people, according to a Northwestern University study published by the British Medical Journal.   Beatrice Edwards, M.D., associate professor of geriatrics at Northwestern University Feinberg School of Medicine, was the lead author of the study.

Wrist fractures are the most common upper extremity fractures in older adults and can affect everyday tasks like carrying heavy objects, opening doors, cutting food, pouring liquid, turning the key and getting out of a chair. But their precise impact on ability to carry out usual daily activities has not been well studied, until now.

Edwards and a team of researchers set out to quantify the clinical impact of wrist fractures in a group of older women.They identified 6,107 healthy women, aged 65 years and older, without prior wrist or hip fracture. Five activities of daily living were used as a measure of functional decline (meal preparation, heavy housekeeping, ability to climb 10 stairs, shopping and getting out of a car). Participants were examined approximately every two years for an average of 7.6 years.

During the study period, 268 women had a wrist fracture. These women were approximately 50 percent more likely to experience clinically important functional decline compared to women without a wrist fracture, even after accounting for demographic, health and lifestyle factors.  In fact, the effect of a wrist fracture on functional decline was clinically as significant as other established risk factors such as falls, diabetes and arthritis.

"Our findings highlight the personal, public health and policy implications of wrist fractures," said Edwards, who is also the director of the bone health and osteoporosis program at Northwestern.   They call for greater public health awareness of the impact of wrist fractures, including measures such as bone density screening and treatment of women with osteoporosis, to prevent wrist fractures and prompt rehabilitation after a wrist fracture to help improve recovery.

By  Erin White. Contact her at ewhite@northwestern.edu

Barriers to Women's Advancement in Science
Posted by on July 19, 2010 - 12:05pm

I recently received a copy of an article written in 2007 by Molly Carnes, MD and Judyann Bigby, MD.   One of the obstacles to the advancement of women in academic medicine is discussed in terms of the Jennifers vs the Janets.   Jennifers refer to the younger women who are just coming out of medical school, who may be junior faculty and are starting their careers with great optimism.   Janets are the women who graduated in the 1980s and are at the pinnacles of their careers--experienced, competent, and who have earned the competence for leadership positions.    At first, this sounded like a "cutesy" approach but if you consider that Jennifer is a very popular, hip name today, and Janet a more old-fashioned term, the irony works.

To give you some background on this issue, please look at the earlier blog from a few days ago, Sex, Science and Success.

In the Carnes-Bigby article, the authors discuss how men in academic medicine (referred to as Daves), always refer to the younger generation when  talking about how far we have come in advancing women in medicine.  The Jennifers seem to be pleased with this picture as they look forward to a rosy future.  Rarely, do the Daves  talk about the women who are at the peak of their careers but are overlooked for promotions (often given to other Daves).  Instead, the 'seasoned' women are appointed to committees and task forces that do little for their personal career trajectory.   Perhaps there is an underlining threat to Daves in putting well qualified women into leadership positions.  Hmmmm.   Kind of reminds me of "trophy" wives (if you are old enough to know that term!)

It's an interesting premise and the article by Carnes and Bigby is provocative.

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