Wednesday Bubble: Nuts!
Last month my friend Mollie Katzen spoke to me about the importance of incorporating more good fats into your diet, including nuts. Well, it turns out that nuts are a lot better for you than many of us realize, especially those of you who are thinner and have higher LDL-cholesterol levels (the “bad” cholesterol that can build up in the arteries and form fatty deposits known as plaque). In fact, results of an extensive analysis of 25 studies shows that individuals who are thinner and have higher initial cholesterol levels and who eat about 2.4 ounces or (~2 servings) of nuts (e.g.almonds, cashews, peanuts, pecans, pine nuts, pistachio nuts, macademia nuts, hazelnuts or walnuts) daily can significantly lower their cholesterol over time.
In this analysis, which was published in the Archives of Internal Medicine this week, researchers examined data collecte4d from 583 men and women with either normal or high cholesterol levels and whose body-mass indices ranged from 17 to 49. The findings showed that compared to nutless diets, nut diets reduced total cholesterol by as much as 5% and LDL by as much as 7%. People with high triglyceride levels experienced declines by as much as 21%. Although different types of nuts had similar effects on blood fats, the most dramatic effects were seen among people who were thinner, ate more Western-type diets (i.e. higher in saturated fats) had higher LDL cholesterol levels.
What this implies is that nuts can help lower blood fat and cholesterol levels and in turn, help prevent heart disease. Although the studies included in the analysis did not last longer than 8 weeks, the researchers did note that the benefits of eating nuts can be expected at least in the short-term. For menopausal women in particular, this is fantastic news, not only because nuts are an excellent protein and energy source, but because the transition is associated with a dramatic increase in cholesterol and turn, heart disease.
The bottom line? Don’t go nuts….but start getting those nuts into your diet!
Read MoreWISHFIT: women’s research takes a village.
I was heartened to read that the folks at Rush University Medical Center in Chicago have partnered with a community of local women to fight obesity and promote a healthier menopausal transition. What’s especially novel about this program, which is called WISHFIT (Women in Southside Health FIT), is that during the first year of the five-year study, it will be relying on “pioneers” for guidance in designing and testing the program and subsequently spreading the word. One of the program’s primary researchers, Dr. Sheila Dugan, who is an Associate Professor in the Department of Physical Medicine and Rehabilitation at Rush University Medical School, characterizes the approach as “community-based participatory medicine,” with a critical grassroots component. I would go one step further and call it a health 2.0, social media approach to medical research.
The goals of WISHFIT are to ultimately change the behavior of women who are sedentary or engage in physical activity only occasionally in order to help reduce the fat rolls around the midsection (called visceral fat). If you’ve been reading Flashfree for awhile, you will recall that visceral fat is a common problem in menopausal women that is likely related to fluctuating hormone levels as we age. Not only is it unattractive, but the development of fat around the midsection is dangerous because it has been linked with metabolic syndrome, a variety of symptoms that in concordance, increase the risk for heart disease.
Importantly, the National Institutes of Health, National Cancer Institute, National Institute of Diabetes, Digestion and Kidney Diseases are joining forces with Rush to take the study out of the laboratory setting and into the community. In fact, Dr. Dugan explains that research has shown that “there are millions of studies out there that show if we bring women into the University and have them exercise, they will lose weight and improve their fat composition. But when they are left to their own devices, they go back to themselves.” She says that by having a community of postmenopausal women involved in developing a ‘tool kit’ of physical and stress-reducing activities or activities that help them to embrace healthier eating habits, the researchers are hoping that they can help their premenopausal peers incorporate new ways of thinking and acting so that they can get through menopause in healthier ways. She also points to data showing that change is better maintained not only by motivating the individual but also through the support of friends and social networks, which are needed for change to last.
Dr. Dugan notes that two Southside Chicago communities- Beverly and Morgan Park – have been the subject of prior research (Study of Women’s Health Across the Nation or SWAN) that identified the link between hormonal changes and visceral fat. In fact, some of the data also firmly established the link between markers of chronic disease and stress and sedentary lifestyles. The 30 Pioneers selected to lead the project will be women who participated in SWAN.
The five-year program also includes two studies examining 1) how social networks play a role in influencing health behaviors, and 2) if positive reinforcement works as well as financial incentives in getting women to change their lifestyle and become more physically active. An additional component entails before and after ‘person on the street’ interviews to educate and engage the community about what happens during menopause, heart disease and other risks and steps that can be taken to combat it.
“Midlife women already have all sorts of concerns on their minds. They need to have support around allowing themselves to take care of themselves and give themselves the freedom to actually step out of all their roles to do so. Our goal,” she emphasizes,”is to bring energy — spiritual and financial — to the community because we truly believe that the only way that these women will have a chance to take care of themselves is by everyone around them buying into how important it is.”
Noting that they are taking a three-pronged attack that entails community, social and individual level interventions, Dr. Dugan adds that community and social support are the links that have been missing in obesity research in particular. I’d like to believe that these links have also been missing in gender research that focuses on women; in fact, perhaps this model isthe breakthrough that is needed to change some gender inequities in our healthcare.
It really does take a village, doesn’t it? Only time will tell.
Read MoreTrans fats are not your friend
Do you want to live well past menopause? One way to do it is to cut out the trans fats (or partially hydrogenated oils) now!
Trans fats are found mostly in fried (e.g. french fries, donuts) and processed foods (e.g. pastries, pizza dough, cookies, crackers). In the body, trans fats significantly raise LDL cholesterol levels and lower HDL cholesterol levels (read: raise bad fats, lower good fats). And since we already know that elevated cholesterol right around menopause is a major factor in heart disease in women, it makes sense that the stroke risk might also come into play.
In a study presented last week at the American Stroke Association International Stroke Conference 2010, researchers analyzed data culled from 87,230 women who had participated in the Women’s Health Initiative and followed for about 8 years. After adjusting for possible factors that might influence results (e.g.s age, race, smoking, physical activity, alcohol, body mass index, hormone therapy, diabetes, aspirin use, fruits, vegetables and dietary fiber intake) they found that women who ate the most total fat had a 40% increased risk for ischemic stroke. Women who ate trans fat in particular, had a 30% increased risk for ischemic stroke. (Ischemic stroke is caused by blocked blood vessels in or leading to the brain.) So, how much fat were these women eating? Women who reported eating the most fat averaged about 86 grams of total fat and 7 grams of trans fat daily (compared to 26 grams and 1 gram, respectively, in women who ate the least).
It seems pretty simple, doesn’t it? Cut down on the fats and processed food and increase the healthy stuff. In the supermarket, stick to the store periphery where fruits, vegetables and all the good stuff can be found. Read the label…often.
Truly, trans fat is not your friend.
Read MoreWednesday Bubble: Another nail in the coffin for HRT
Still hearing that HRT can’t hurt your heart? Findings from yet another study, this time published in the February 16 edition of Annals of Internal Medicine, confirm the dangers that HRT poses to your heart, especially in the short-term.
In this latest analysis, researchers evaluated data derived from 16,608 postmenopausal women enrolled in the Women’s Health Initiative trial who still had their uterus. The findings?
Compared to women who had never used hormone replacement therapy, those who had used it continuously over 10 years had more than twice the risk of developing heart disease over the first 2 years, and more than 1.5 times the risk over the subsequent 8 years. For women who started hormone therapy after 10 years of entering menopause, there was also a trend towards developing heart disease over the first 2 years. Of note, researchers did observe a possible protective effect after 6 years in the women who started therapy closer to menopause as risk did start to level off at this time.
The upshot is that the first two years of taking HRT can be a dangerous time for women regardless of whether they start hormones closer to menopause.
Another nail? Yes, I’d say so.
But don’t take my word for it. Knowledge is power. Educate yourselves. And if you’d like to learn more about heart disease and menopause, I’ve written about it numerous times on this blog. I also encourage you to visit the American Heart Association website. Finally, I’d love for you to take a stand. Don’t you think it’s time for the FDA to start paying attention? These drugs are dangerous for women. Yet, they remain on the market and are prescribed daily. Whose nail, whose coffin?
Read MoreBaby got back
[youtube=http://www.youtube.com/watch?v=2ImZTwYwCug]
Maybe Sir Mix-a-Lot has a point. It seems that a large derriere and thighs may actually extend your life. The reason? Researchers say that fat particles that end up in these areas help trap harmful fatty acids in our diet.
Although they are unsure of the exact reasons why, researchers do say that unlike abdominal fat, which has been linked to metabolic syndrome, lower body fat, i.e., fat that accumulates in the thighs and backside, has actually been confirmed to play a protective role in the body. In fact, it not only stores unhealthy fatty acids, but may also release harmful compounds more slowly than say, abdominal fat.
So if you’ve got back, are you in the clear to eat whatever you want? Not so fast. Even though “back” may offer a protective role, there are other reasons to eat and stay healthy – not only to maintain optimal cholesterol levels, but also to counteract some of the natural effects of declining estrogen, such as weakening bones.
(The study appeared in the January 12 online edition of the International Journal of Obesity.)
Read MorePreventing heart disease in menopause. It’s as simple as L-D-L
Aging. It’s associated with all sorts of diseases. In women in particular, heart disease is a big red flag since there is a lot of evidence showing that after age 40, risk for developing heart disease rises and continues to rise.
So, is increased risk due to to aging in general or to menopause in particular? Moreover, is there anything you can do now to reverse the trend?
Researchers have recently solved an important piece of the puzzle, discovering that significant increases in cholesterol coincide with the period right before and immediately after menopause sets in. Coincidentally, at the same time, women experience significant declines in estrogen. In this particular trial, which involved over a thousand women, researchers examined various factors that might contribute to increased heart disease risk (e.g. blood fat levels, blood sugar and blood pressure). They then compared changes in these factors over time and whether they were more in sync with aging or with ovarian changes associated with menopause.
Over the course of three to five years before menopause, a year after, and then three to five years thereafter, substantial changes were noticed in blood fats, namely low-density lipoprotein (LDL) cholesterol, which rose as average of 12 points between the first two time periods and then leveled off a few points higher (from 113 and 116, to 125 to 130. Current guidelines suggest that optimal LDL levels are below 100 and that at the very least, individuals attain LDL cholesterol levels of <130 if they have two more heart disease risk factors (and preferably, lower).
So, what are the take-away messages?
- First, declining levels of estrogen place women at risk for heart disease as they approach menopause, namely due to significant increases in LDL and total cholesterol.
- Second, women nearing menopause need to know their cholesterol numbers and insure that that becomes a priority during a normal checkup.
- Lastly, exercise and diet are key to lowering cholesterol levels, at least initially.
Both the National Lung Blood and Lung Institute and the American Heart Association recommend diets low in saturated fat, trans fat and cholesterol, and rich in whole grains, fiber, fish, lean meats and poultry. Exercise is essential, at least 30 minutes worth daily. Finally watch those risk factors and talk to your practitioner about those that may be problematic and what you can do to address them.
We may not be able to control declining estrogen but we can take positive steps to make sure that it doesn’t affect our risk for heart disease.
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