True or False? Breast cancer is the number one health issue for women.
True or False? Heart disease is a man’s disease.
True or False? Chest pain is always the first sign of a heart attack.
If you answered “true” to any of these questions, read on. It could save your life or the life of a woman who is important to you. The National Heart Lung and Blood Institute has been working to raise awareness that heart disease kills one in four women or one woman every minute of every day. The “Heart Truth” campaign slogan is “Heart disease doesn’t care what you wear-it’s the number one killer of women.”
There Is an Urgent Need for Greater Attention to
The Particular Risks of Heart Disease for Women
February’s “National Wear Red Day” and the annual unveiling of the “Red Dress Collection” during New York’s fashion week have begun to put heart disease at the center of the conversation about women’s health. The American Heart Association launched its “Go Red for Women” initiative in 2004 with the goal of changing the public perception of heart disease as “an older man’s disease.” Today, 55 percent of women recognize heart disease, not breast cancer, is their primary risk but less than half know the healthy levels for risk factors such as blood pressure or cholesterol. In the past, most heart disease research was focused on men and this led to guidelines for prevention and treatment of heart disease that were not necessarily appropriate for females.
What are the risk factors for women?
• High blood pressure – readings greater than 120/80
• Cholesterol – total cholesterol greater than 200, HDL (good cholesterol) of less than 50, LDL (bad cholesterol) greater than 100
• Obesity – extra weight stored around the mid-section (apple-shaped body) specifically a waist-to-hip ratio of greater than .85.
• Physical inactivity – one-third of Americans report no regular physical activity. Women are more likely than men to report zero leisure time activity.
• Family history of a first-degree relative with heart disease at an early age – younger than 65 for a male, or younger than 55 for a woman.
• Systemic autoimmune disease such as lupus or rheumatoid arthritis
• History of pregnancy complications – gestational diabetes, preeclampsia, or pregnancy-induced high blood pressure.
• Poor diet – too much sodium, high saturated fat and trans-fat intake, low fruit and vegetable intake.
• Diabetes – increases heart disease risk by 2 to 4 times (10 million women have physician diagnosed diabetes and 33.4 million women have pre-diabetes).
These are the official risk factors for women, but research studies have suggested other less obvious issues may play a part in the development of heart disease.
How much sleep do you get each night?
Over the past twenty years, the average number of hours we sleep has gradually decreased. Twenty percent of Americans report sleeping fewer than six hours daily. Chronic sleep deprivation is linked to increased risk of diabetes, heart disease and stroke. Inadequate rest is also a recipe for weight gain.
One study compared two groups of women age 35 to 59 who were interested in weight loss. Half the study group was allowed eight hours of sleep nightly while the other half was only allowed five and a half hours of rest. During the study period, the sleep-deprived participants reported more hunger, burned fewer calories per day, lost less total weight, lost less body fat and lost more muscle than the well-rested dieters.
In today’s faced-paced world, where women may be employed outside the home, raising children and taking care of aging parents all at the same time, who has time to sleep? This brings us to another significant consideration: stress and depression.
What are the symptoms of stress and depression?
• Persistent feelings of sadness or despair
• Low-self esteem and withdrawal from others
• Lack of motivation and decreased energy levels
• Changes in appetite- eating too much or too little
• Difficulty sleeping, oversleeping or waking very early
• Forgetfulness or difficulty concentrating or making decisions
• Feeling pessimistic or negative
• Loss of interest in hobbies or personal relationships
• Body aches or pains, frequent headaches
• Feeling worthless or thoughts of suicide
We have known for many years that stress hormones can cause blood pressure, blood sugar and heart rates to rise to unhealthy levels. Health care providers are beginning to identify depression as an independent risk factor for heart disease and stroke. Depression is associated with higher rates of smoking, alcohol and drug abuse, lack of physical activity and overeating. Patients who are depressed may not take care of themselves, take medications as prescribed, exercise regularly or keep appointments with health care providers. The American Heart Association suggests that health care providers add depression screening to their annual physical checklist.
What are the signs of heart disease or a heart attack for women?
Chest pain may be a symptom for women just as it is for men, but women may be more likely to have pain in one or both arms, the jaw, back or stomach. Shortness of breath may be a sign of heart attack with or without chest discomfort. Some women experience nausea or lightheadedness and may break out in a “cold sweat.” Other women report flu-like symptoms. Fatigue or lack of energy can also be a vague symptom for a woman with arteries that are clogged and are not able to deliver enough oxygen to all the body tissues. These symptoms are also associated with stress and anxiety. Many women ignore the tell-tale signs of an impending heart attack. Some health care providers may miss these warning signs or chalk them up to indigestion or perhaps a panic attack.
What can women do to reduce the risk of heart disease?
The first step is to take inventory and identify risk factors that you may have. The second step is to make an appointment and discuss these risk factors with a health care provider.
Once you have identified areas for improvement, make a list of small steps you can take toward a heart healthy lifestyle. Keep it simple, realistic and tackle only one or two changes at a time.
• If you are currently inactive, get medical clearance to start a walking program. Purchase an inexpensive pedometer, a device that counts the number of steps you take each day. Gradually increase the number of daily steps by taking the stairs instead of the elevator or parking farther from the office and the shopping center. Aim for at least 10,000 steps per day for weight maintenance and 12,000 to 15,000 steps per day for weight reduction.
• Other guidelines recommend getting at least 150 minutes of brisk walking per week for weight maintenance or 60 minutes per day for weight loss. Walking time can be split into 15-minute sessions.
• Keep a diary or exercise calendar so that you can see how much progress you are making.
• It is not necessary to purchase special “diet” foods or to cook two different meals. The whole family can benefit from small changes in the way foods are prepared and heart healthy snack choices.
• Add flavor with herbs, spices, lemon juice, wine, onions, garlic, peppers and low-sodium broths. Limit saturated fats such as lard, stick butter or margarine, bacon fat, or shortening.
• Serve all gravies, sauces and salad dressings “on the side” and dip your fork in the sauce before each bite of food.
• Add more fruits and vegetables to the daily menu. Selections can be fresh, frozen, or canned without added sugars or salt. Buying fresh items “in season” will save money.
• Include low-fat or fat-free dairy products 2 to 3 times a day to keep bones and teeth strong. Check out lactose-free milk if you have digestive upset with regular milk.
• Choose lean meats and trim off excess fat. Plan a few meatless supper meals each week using beans or peas as the protein source. Try a quarter cup of dry roasted nuts for a snack several days a week.
• Include whole grains and read labels to identify higher fiber choices.
• Measure food portions and choose a smaller plate for meals. Choose vegetables or fruit for second helpings if you are still hungry after the first plate of food.
Go to www.nhlbi.nih.gov/health/public/heart/hbp/dash/dash_brief.pdf for a great heart healthy eating plan called the DASH diet.
Dealing with Stress and Depression
• Recognize the sources of stress in your life. Make a list of the things you can change to reduce stress. Think about things that you can do to relax for a few minutes several times a day. Meditation, exercise and relaxation techniques are all very effective.
• Women tend to care for everyone else first and find it difficult to carve out time to take care of themselves. Make your health a priority so you can be there for your family.
• Talk with a health care provider, counselor or spiritual advisor if you have symptoms of depression. There are many options for treatment.
Helpful Free Resources available at www.goredforwomen.org
“Better U” – This is a new 12 week health makeover program that guides participants through step-by-step lifestyle changes.
“Better Me” – This program offers an on-line nutrition and fitness coaching tool that includes a weekly calendar and journal to keep you on track. Forum offer an opportunity for women to discuss challenges and receive valuable support from peers.
Put heart health at the top of your “to-do” list.
Kathy Warwick, RD, CDE is a Registered Dietitian and certified diabetes educator with 29 years of experience in several areas of dietetics practice. She is owner of Professional Nutrition Consultants, L.L.C. in Madison, MS, providing outpatient diabetes education, wellness program services, media communications and medical-legal consultation. Kathy speaks regularly to medical and professional groups, serves on several advisory boards, and authors a weekly newspaper column on current nutrition topics. She is Past-President of the Mississippi Dietetic Association and currently serves as media spokesperson and State Policy Representative for MDA.
The articles written by guest contributors are the sole responsibility of the individual writers in terms of factual accuracy and opinion and do not necessarily reflect the views of the publisher of this blog.