Posted by on April 7, 2014 - 8:41pm

Drinking milk is not just for kids but also for post-menopausal women, new research shows. A new study from the Women's Health Initiative just published by the North American Menopause Society, reveals that calcium and vitamin D after menopause can improve women's cholesterol profiles.

Over 600 women took either a supplement containing 1,000 mg of calcium and 400 IU of vitamin D3, or a placebo, daily. Women who took the supplement, unsurprisingly, were two times more likely to have sufficient vitamin D levels (at least 30 ng/mL), in comparison to the women were taking placebo. Women who were taking supplements also had LDL (the "bad" cholesterol) numbers that were 4 to 5 points lower than the women taking placebo. The women on supplement also had higher levels of HDL (the "good" cholesterol) and lower levels of triglycerides.

Researchers agree that more work needs to be done to see whether or not supplementing one's diet with calcium and vitamin D can lower cholesterol levels and ultimately improve rates of cardiovascular disease in women after menopause. These results, however, show that there may potentially be extra benefits for those with calcium and vitamin D deficiencies to start supplements. Supplementing may be key for strengthening both the heart and bones after menopause. To learn more about healthy choices you can make after menopause, visit Northwestern's menopause website here.

“Calcium/vitamin D supplementation, serum 25-hydroxyvitamin D concentrations, and cholesterol profiles in the Women’s Health Initiative calcium/vitamin D randomized trial,” will be published in the August 2014 print edition of Menopause.

 

Posted by on December 30, 2013 - 1:11am

New research shows that women with high blood pressure during pregnancy may be at higher risk of having troublesome menopausal symptoms in the future. A research study from the Netherlands examined the relationship between hypertensive diseases and hot flashes and night sweats.

Investigators looked at 853 women who regularly visited a cardiology clinic. Among these women, 274 had a history of high blood pressure during their pregnancy, such as preeclampsia. Participants were classified as having hypertension (high blood pressure) if her systolic blood pressure was 140 mmHg or higher, if her diastolic was 90 mmHg or higher, or if she took antihypertensive medication.

The study revealed that women with a history of hypertensive pregnancy disease were more likely to have vasomotor symptoms of hot flashes and night sweats during menopause. Hot flashes and night sweats are considered vasomotor because of sudden opening and closing of blood vessels near the skin. 82% women with history of hypertension during pregnancy had hot flashes and night sweats, compared to 75% women without. Moreover, women with hypertension during pregnancy reported experiencing hot flashes and night sweats for a longer time period.

Researchers concluded that the findings were modest but more research needs to be done to establish a definite association. One must also consider that every woman experiences menopause differently; you  might have symptoms that are barely noticeable, while your friends could experience almost all of them. To learn more about the different types of symptoms during menopause, visit the Women's Health Research Institute's menopause website here.

 

 

 

Posted by on October 17, 2012 - 1:18pm

Our success as researchers is measured by our ability to translate our findings, according to the often-used phrase, from bench to bedside.  In other words, if we can apply our basic science findings to clinical care, we have the ability to impact countless lives.  This pipeline is a national priority, and in fact, many Academic Medical Centers have established programs to facilitate rapid clinical translation.  However, equally as important, and perhaps less appreciated is the need to translate basic science findings into relevant policies that protect and influence the general public.

Reproductive science and medicine are greatly impacted by the environment. Trends in reproductive health demonstrate that reproductive function has declined since the mid-20th century in certain populations and locations [1].  Coincident with this decline in reproductive function is the large and ever-increasing number of natural and synthetic chemicals to which humans are exposed [2, 3].  Basic, clinical, and epidemiological research has demonstrated that exposure to certain compounds and contaminants, such as Endocrine Disrupting Chemicals (EDC), can have negative impacts on reproductive health. These compounds interfere with the production, transport, activity, and metabolism of natural hormones in the body. As we, as basic scientists and clinical researchers, understand the mechanisms by which these environmental exposures to such compounds affect developmental, reproductive, and neuroendocrine functions, we must also be able to inform and educate the implications of these specific reproductive health findings to the decision makers in Washington, DC.  The question is: How?

In  2010, the Program on Reproductive Health and the Environment at the University of California, San Francisco developed the Reach the Decision Makers Fellowship with the exact intent of providing interested individuals and teams with the resources to advance science-based policy solutions.  Specifically the Reach Program serves to provide individuals with a distinct interest in reproductive health and the environment, with mechanisms to interact with the United States Environmental Protection Agency (US-EPA).  Over the past two years, the Reach program directed by Tracey Woodruff, PhD, MPH, an esteemed leader in the field, has trained over 75 individuals nationwide based on the principles of participatory democracy, social justice, and taking action to prevent harm (for more recent news about the Reach Program, check out the following blog written for the Physicians for Social Responsibility).

Table 1. Our interdisciplinary team

To take advantage of this unique program, we assembled an interdisciplinary team of six individuals committed to reproductive health and the environment (Table 1).  Our team is comprised of professionals from academia, health care, government, and the community, and collectively we have experience in research, policy, advocacy, teaching, and communication (Table 2).   Prior to joining the Reach Program, our team has worked together at Northwestern University and Northwestern Memorial Hospital in various settings including the Women’s Health Research Institute, the laboratory of Teresa K. Woodruff, PhD, the Oncofertility Consortium, the National Physicians Cooperative, the Oncofertility Saturday Academy, and the proposed Northwestern University Superfund Research Center in Reproductive Health Hazards. We joined the Reach Program with the goal of ensuring that the manner in which the US-EPA evaluates reproductive health and toxicity is in line with the current state of scientific knowledge.

Table 2. Team backgrounds

As Reach Program fellows, we have participated in a rigorous training program to define a reasonable “ask” in relation to our goal, to perform research on the topic, and to learn how to identify the key decision makers within the US-EPA who will listen to our request and affect change.   Over the past six months, we have engaged in a first trip to Washington, DC where we attended presentations from policy experts regarding the US-EPA hazard evaluation procedures and how scientists can inform the agency on emerging research regarding the effects of environmental toxins on reproductive health. Meetings at the US-EPA gave the team a greater understanding of the overall institution and current initiatives of the agency. We have also participated in nine webinars covering topics spanning from the effects of environmental toxins on reproductive health to identifying policies and policy makers at the US-EPA.

We also developed our policy project by systematically gaining an understanding of the US-EPA as an agency and the documents and guidelines that inform its staff. Members of the US-EPA helped us identify a principle document in reproductive health and the environment, the Guidelines for Reproductive Toxicity Risk Assessment. This document was written in 1996 and has not been revised since that time so our group decided to focus on some of the significant opportunities to improve upon the guidelines. Since 1996, the state of reproductive research has advanced and we identified three specific areas of research that could be prioritized during the updating of the Guidelines for Reproductive Toxicity Risk Assessment, as follows:

  • While the Guidelines acknowledged the importance of non-reproductive consequences of an impaired reproductive system, such as osteoporosis and increased risk of stroke, they did not include these outcomes as endpoint measures for further research study.
  • Model organisms are necessary for advancing research in reproductive and environmental health. In the Guidelines, the authors state that effects seen in one organism may be assumed to occur in another. While this is meant to be protective for unstudied species, it is also true that certain species are ideal to investigate different aspects of science and health. Thus, we encourage the study of multiple model organisms in reproductive health and the environment.
  • Research advances over the past decade have shown that significant sex differences are seen in the way males and females respond to different drugs and environmental toxins. This warrants the need to include both sexes in reproductive research, a consideration that could strengthen the updated Guidelines.

Our team developed these ideas into a position statement to inform US-EPA staff and interested parties of the need to advance reproductive health and the environment. This project culminates tomorrow, Thursday, October 18, 2012 when the team will fly to Washington, D.C. to meet with Nica Louie (Environmental Health Scientist at the National Center for Environmental Research), Brenda Foos (Director, Regulatory Support and Science Policy Division, Office of Children's Health Protection), and Daniel Axelrad (Environmental Scientist, Office of Policy) at the US-EPA. We hope to gain a greater understanding of the procedures of the agency at these meetings and advocate for the need to update Guidelines for Reproductive Toxicity Risk Assessment.

Virginia Neale, the Associate Director of Government Relations for Northwestern University, will also join the team and bring her expertise in bridging academia and the government to the project. Neale also facilitated a meeting between team members and legislative assistants to the House of Representatives congresswoman Jan Schakowsky (D-IL), who resides over Northwestern University’s Evanston campus. As congressional requests to the US-EPA are often needed to gather teams of experts and update guidelines, we will ask Schakowsky’s office to make such a request to gather the National Academy of Sciences and revise the Guidelines for Reproductive Toxicity Risk Assessment.

The work done this week, and over the past six months, by this interdisciplinary group, will build the foundation for the team to continue communicating evidence-based reproductive health findings to the policy makers in Washington D.C. who have the ability to affect change on a federal level. The relationships we develop this week will be fostered in the coming months and years to ensure that reproductive health is promoted at the highest level within the EPA and advocate that US-EPA guidelines are updated to include the most recent advances in reproductive research

This blog was Contributed by Francesca Elizabeth Duncan, PhD and Kate Waimey Timmerman, PhD    Read more about the team here in a Northwestern University press release.

1.         Woodruff, T.J., J. Schwartz, and L.C. Giudice, Research agenda for environmental reproductive health in the 21st century. Journal of epidemiology and community health, 2010. 64(4): p. 307-10.

2.         Sutton, P., L.C. Giudice, and T.J. Woodruff, Reproductive environmental health. Current opinion in obstetrics & gynecology, 2010. 22(6): p. 517-24.

3.         Woodruff, T.J., et al., Proceedings of the Summit on Environmental Challenges to Reproductive Health and Fertility: executive summary. Fertility and sterility, 2008. 89(2 Suppl): p. e1-e20.

Posted by on August 26, 2012 - 8:41am

For years we criticized heart researchers for not including women in the early studies that recommended aspirin to prevent heart disease.  We asked:  How can you recommend aspirin in women when all the studies took place in males!  In 2007, after additional studies that included females, the American Heart Association released guidelines for the CVD preventive care in women including aspirin. Their recommendations:

  • Primary prevention (other at-risk or healthy women):   Consider aspirin therapy in women >65 years if blood pressure is well-controlled and benefit for ischemic stroke and myocardial infarction prevention is likely to outweigh the risk of gastrointestinal bleeding and hemorrhagic stroke.
  • Secondary prevention (high risk):  Aspirin therapy should be used in high-risk women (established coronary heart disease, cerebrovascular disease, peripheral arterial disease, abdominal aortic aneurysm, end-stage or chronic renal disease, diabetes, and 10-year Framingham risk>20%) unless contraindicated.

A recent study, using a web-based risk assessment tool found that the majority of women for whom aspirin is recommended were not following national guidelines.  The authors led by Cathleen Rivera, MD at Scott and White Healthcare in Texas concluded that there is a need for more education about aspirin among clinicians and women for increased prevention of heart disease.  Given the rising direct and indirect costs of cardiovascular disease, it makes sense that health care providers take a closer, serious look at the increased use of low cost aspirin in lieu of designer heart meds.!

Source:  Rivera C, Song J, Copeland L et al.  Journal of Women's Health, Vol. 21, 2012.

Posted by on August 15, 2012 - 8:40am

It is no wonder why the weight-loss industry is a $20 billion per year industry.  Dieters spend money on diet books, diet drugs and weight-loss surgery.  108 million people in the United States are on diets and typically attempt four or five diets a year.  85% of dieters are women.

Some diets preach low-calorie, some are low-carbohydrate.  Some allow for only eating grapefruit or cabbage soup.  Some say it’s only about how much you eat and the amount of time spent exercising, while others say not all calories are created equal and it is about what we eat as well as how much of it.  We are constantly bombarded by different information and different diets.  No wonder we cannot keep the weight off.

A promising study published in the Journal of the American Medical Association may finally set the record straight.  It found that a specific mix of carbohydrate, fat and protein might be ideal.  It also suggested that not all calories are created equal, meaning that calories can have different effects on the body.

The study followed 21 adults ages 18 through 40 for four years to determine the effects of various diets on the ability to burn calories following weight loss. At the start of the study, the participants had a BMI over 27, which is considered overweight or obese.  The participants were originally placed on a diet to lose 10%-15% of their body weight.  After the initial weight loss, researchers placed the participants on three different diets in a random order each for four weeks at a time.  All diets maintained the same total number of calories.  However, they did differ in their carbohydrate, fat and protein content.

The low-fat diet required that 60% of calories came from carbohydrates, 20% from fat and 20% from protein.  The low-glycemic diet required that 40% of calories be derived from carbohydrates, 40% from fat and 20% from protein in order to prevent spikes in blood sugar.  The very low-carbohydrate diet (“Atkins”) required that 10% of calories came from carbohydrate, 60% from fat and 30% from protein.

Researchers measured participants’ energy expenditure as well as other aspects of metabolism and concluded that the total number of calories burned daily differed with each diet.  Researchers also studied hormone levels and metabolic measures concluding that they too varied by diet.

On average the very-low carbohydrate diet burned calories most efficiently with participants burning 3,137 calories daily.  The low-glycemic diet burned 2,937 calories per day, 200 less than the very-low carbohydrate.  The low-fat diet burned 2,812 calories daily.

While researchers did conclude that it improved metabolism the best, don’t switch to the very-low carbohydrate diet just yet.  The participants showed higher levels of risk factors for diabetes and heart disease, including the stress hormone cortisol.

The low-glycemic diet resulted in only a 200 calorie difference and showed similar benefits to the very-low carbohydrate diet, with less negative effects.  A low-glycemic diet consists of less-processed grains, vegetables and legumes.  According to researchers, this may be the best diet for both long-term weight loss and heart disease prevention when coupled with exercise.

A low-glycemic index diet emphasizes foods based on how they affect blood sugar levels.  Foods, specifically carbohydrates since they have the most effect on blood sugar, are given a score between 0 and 100.  High scores of 70 and up include white and brown rice, white bread, white skinless baked potato, boiled red potatoes and watermelon.  Medium scores between 56-69 include sweet corn, bananas, raw pineapple, raisins and some ice creams.  Examples of low scoring foods of 55 and under include raw carrots, peanuts, raw apple, grapefruit, peas, skim milk, kidney beans and lentils.

The diet does not require counting carbs, counting calories or reducing portion sizes.  It only directs dieters to the right kind of carbohydrates in order to keep blood sugar levels balanced.  Specifically, lower glycemic diets are digested less rapidly by the body, which raises the blood sugar in a regulated, balanced way; whereas higher glycemic foods and beverages are digested more rapidly causing a blood sugar spike followed by a drastic decline.  Since low-glycemic index foods are digested more slowly, they remain in the digestive tract longer, potentially controlling appetite and hunger.  This can also reduce the risk of insulin resistance.

The study shows that a low-glycemic diet can work for long-term weight-loss, as it is easily sustainable because whole food groups are not removed.  Furthermore, it may reduce the risk of serious diseases such as diabetes and cardiovascular disease.

Sources:

Weight-Loss Stats: http://abcnews.go.com/Health/100-million-dieters-20-billion-weight-loss-industry/story?id=16297197#.UBBfZo7p7ao

NIH: http://www.nih.gov/researchmatters/july2012/07162012weight.htm

Mayo Clinic on the Low-Glycemic Diet: http://www.mayoclinic.com/health/glycemic-index-diet/MY00770

 

Posted by on April 22, 2012 - 6:29am

Heart disease is the leading cause of death among women, and evidence-based national guidelines promote the use of daily aspirin for women at increased risk for cardiovascular disease. However, less than half of the women who could benefit from aspirin are taking it, according to an article  available free online at the Journal of Women's Health website*.

"Based on this survey, it is evident that the majority of women for whom aspirin is recommended for prevention of cardiovascular disease are not following national guidelines," says Susan G. Kornstein, MD,  Executive Director of the Virginia Commonwealth University Institute for Women's Health.

Among more than 200,000 women participating in a web-based survey to assess their risk for cardiovascular disease, only 41%-48% of women for whom aspirin is recommended reported that they took an aspirin daily, according to the study authors, Cathleen Rivera, MD and Texas-based colleagues. The women were more likely to use aspirin if they had a family history of cardiovascular disease or had high cholesterol, as reported in the article "Underuse of Aspirin for Primary and Secondary Prevention of Cardiovascular Disease Events in Women." The authors conclude that improved educational programs are needed to increase awareness of the benefits of aspirin use to prevent heart disease among women.

References:
Mary Ann Liebert, Inc./Genetic Engineering News  "Should More Women Take A Daily Aspirin To Prevent Heart Disease?." Medical News Today. MediLexicon, Intl., 9 Apr. 2012. Web.
12 Apr. 2012.

Posted by on March 13, 2012 - 6:42am

Maintaining a healthy lifestyle from young adulthood into your 40s is strongly associated with low cardiovascular disease risk in middle age, according to a new Northwestern Medicine® study.

“The problem is few adults can maintain ideal cardiovascular health factors as they age,” said Kiang Liu, PhD, first author of the study. “Many middle-aged adults develop unhealthy diets, gain weight, and aren’t as physically active. Such lifestyles, of course, lead to high blood pressure and cholesterol, diabetes and elevated cardiovascular risk.”

“In this study, even people with a family history of heart problems were able to have a low cardiovascular disease risk profile if they started living a healthy lifestyle when they were young,” Liu said. “This supports the notion that lifestyle may play a more prominent role than genetics.”   Published Feb. 28 in the journal Circulation, this is the first study to show the association of a healthy lifestyle maintained throughout young adulthood and middle age with low cardiovascular disease risk in middle age.

The majority of people who maintained five healthy lifestyle factors from young adulthood (including a lean body mass index (BMI), no excess alcohol intake, no smoking, a healthy diet and regular physical activity) were able to remain in this low-risk category in their middle-aged years.

In the first year of the study, when the participants’ average age was 24 years old, nearly 44 percent had a low cardiovascular disease risk profile. Twenty years later, overall, only 24.5 percent fell into the category of a low cardiovascular disease risk profile.    Sixty percent of those who maintained all five healthy lifestyles reached middle age with the low cardiovascular risk profile, compared with fewer than 5 percent who followed none of the healthy lifestyles.

If the next generation of young people adopt and maintain healthy lifestyles, they will gain more than heart health, Liu stressed.

“Many studies suggest that people who have low cardiovascular risk in middle age will have a better quality of life, will live longer and will have lower Medicare costs in their older age,” he said. “There are a lot of benefits to maintaining a low-risk profile.”

Liu is a professor and the associate chair for research in the Department of Preventive Medicine at Northwestern University Feinberg School of Medicine.

Source:  Erin White, Northwestern NewsCenter

 

Posted by on August 26, 2011 - 6:54am

The sex hormone estrogen could help protect women from cardiovascular disease by keeping the body's immune system in check, new research from Queen Mary, University of London has revealed.

The study has shown that the female sex hormone works on white blood cells to stop them from sticking to the insides of blood vessels, a process which can lead to dangerous blockages.

The results could help explain why cardiovascular disease rates tend to be higher in men and why they soar in women after the menopause.

The researchers compared white blood cells from men and pre-menopausal women blood donors. They found that cells from premenopausal women have much higher levels of protein called annexin-A1 on the surface of their white blood cells.

The scientists also found that annexin-A1 and estrogen levels were strongly linked throughout the menstrual cycle.

White blood cells play a vital role in protecting the body from infections. When they are activated they stick to the walls of blood vessels. This process normally helps the cells to tackle infection but if it happens too much, it can lead to blood vessel damage, which in turn can lead to cardiovascular disease. However, when annexin-A1 is on the surface of these white blood cells, it prevents them from sticking to the blood vessel wall.

The new research shows that estrogen can move annexin-A1 from inside the white blood cell, where it is normally stored, to the surface of the cells, thereby preventing the cells from sticking to blood vessel walls and causing vascular damage. This may have important implications in cardiovascular disease.

Dr Suchita Nadkarni from the William Harvey Research Institute, Queen Mary, University of London, who led the research, said: "We've known for a long time that estrogen protects pre-menopausal women from heart disease, but we don't know exactly why. This study brings us a step closer to understanding how natural estrogen might help protect our blood vessels.

"We've shown a clear relationship between estrogen levels and the behaviour of these white blood cells. Our results suggest that estrogen helps maintain the delicate balance between fighting infections, and protecting arteries from damage that can lead to cardiovascular disease.

"Understanding how the body fights heart disease naturally is vital for developing new treatments."

The study is published in American Heart Association journal Arteriosclerosis, Thrombosis and Vascular Biology. It was co-funded by the British Heart Foundation, the Wellcome Trust and the National Institutes of Health Research (NIHR).

15 Aug 2011

Posted by on April 4, 2011 - 8:45am

High-fiber diets during early adult years may lower lifetime cardiovascular disease risk

A new study from Northwestern Medicine shows a high-fiber diet could be a critical heart-healthy lifestyle change young and middle-aged adults can make. The study found adults between 20 and 59 years old with the highest fiber intake had a significantly lower estimated lifetime risk for cardiovascular disease compared to those with the lowest fiber intake.  This is the first known study to show the influence of fiber consumption on the lifetime risk for cardiovascular disease.

“It’s long been known that high-fiber diets can help people lose weight, lower cholesterol and improve hypertension,” said Donald M. Lloyd-Jones, M.D., corresponding author of the study and chair of the department of preventive medicine at Northwestern University Feinberg School of Medicine. “The results of this study make a lot of sense because weight, cholesterol and hypertension are major determinants of your long-term risk for cardiovascular disease.”

A high-fiber diet falls into the American Heart Association’s recommendation of 25 grams of dietary fiber or more a day.  Lloyd-Jones said you should strive to get this daily fiber intake from whole foods, not processed fiber bars, supplements and drinks.

“A processed food may be high in fiber, but it also tends to be pretty high in sodium and likely higher in calories than an apple, for example, which provides the same amount of fiber,” Lloyd-Jones said.

For the study, Hongyan Ning, M.D., lead author and a statistical analyst in the department of preventive medicine at Feinberg, examined data from the National Health and Nutrition Examination Survey, a nationally representative sample of about 11,000 adults.  Ning considered diet, blood pressure, total cholesterol, smoking status and history of diabetes in survey participants and then used a formula to predict lifetime risk for cardiovascular disease.

“The results are pretty amazing,” Ning said. “Younger (20 to 39 years) and middle-aged (40 to 59 years) adults with the highest fiber intake, compared to those with the lowest fiber intake, showed a statistically significant lower lifetime risk for cardiovascular disease.”  In adults 60 to 79 years, dietary fiber intake was not significantly associated with a reduction in lifetime risk of cardiovascular disease. It’s possible that the beneficial effect of dietary fiber may require a long period of time to achieve, and older adults may have already developed significant risk for heart disease before starting a high-fiber diet, Ning said.

As for young and middle-aged adults, now is the time to start making fiber a big part of your daily diet, Ning said.

Erin White is the broadcast editor. Contact her at ewhite@northwestern.edu