Women’s Health: Beyond the Noise

Stephan Esser MD, USPTA

Disclosures

• I am NOT a woman

• I have never been a woman

• I will NEVER fully understand women

Women’s Health?

What Matters• Health

– Breast/Ovarian/Uterine– Heart– Stress– Osteoporosis Other: Amazing things

• Image:– Clothes/Skin/Image– Body Type/Shape– Exercise Types

Goals

• What Kills Women

• What Sickness affects Women

• What Stresses Women

• What do Women Prioritize

How Plant Based Nutrition is Part of the

Answer

How Plant Based Nutrition is Part of the

Answer

1 in 4 Women will die of Heart Disease

1 in 4 Women will die of Heart Disease

Obesity

32-50%32-50%

Prevalence of high blood pressure in Adults age 20 and older, by age and sex Prevalence of high blood pressure in Adults age 20 and older, by age and sex (NHANES: 2003-2006).(NHANES: 2003-2006). Source: NCHS and NHLBI.Source: NCHS and NHLBI.

12.2

38.4

54.1

70.8

24.4

38.8

53.2

65.4 64.6

6.6

77.3

16.2

0102030405060708090

20-34 35-44 45-54 55-64 65-74 75+

Per

cent

of P

opul

atio

n

Men Women

High Blood Pressure

15%15%

Cancer deaths per year

Cancer Risk

Total 1:3Total 1:3

Breast 1:8Breast 1:8

Uterus 1:37Uterus 1:37

Cervix 1:117Cervix 1:117

Obesity

Plants and Risk of……

• Obesity– Health aspects of vegetarian diets JT Dwyer 1988– Diet and body mass index in 38 000 EPIC-Oxford

meat-eaters, fish-eaters, vegetarians and vegans International Journal of Obesity (2003) 27, 728–734.

•Vegans had the lowest weight gain per year•Least weight gain was in those who adopted more plant based eating during the time

•Vegans had the lowest weight gain per year•Least weight gain was in those who adopted more plant based eating during the time

Heart Disease

Plants and Risk of……

• Heart Disease– Inc plants = Lower Heart disease risk• Reduced Cholesterol: LDL/Trigl and Tchol• If Unprocessed = < Na

– Eg: Total Calories > Total mg Na

• Inc Fiber/Phytonutrients = Powerful protective effects– Blood Vessels– Intestinal Tract– Kidneys

No Face, no Mother = No CholesterolNo Face, no Mother = No Cholesterol

Brachial Artery IndexBrachial Artery Index

Diabetes

Diabetes• Does a vegetarian diet reduce the occurrence of

diabetes? American Journal of Public Health, Vol. 75, Issue 5 507-512

– 25,698 adult White Seventh-day Adventists identified in 1960 followed for 21 years– vegetarians had a substantially lower risk than non-vegetarians of diabetes as an

underlying or contributing cause of death

• Fruit and Vegetable Consumption and Diabetes Mellitus Incidence among U.S. Adults Preventive Medicine Vol 32 Iss 1 January 2001. Pages 33-39

– Appr. 10, 000 participants, highest fruit and vegetable consumption = lowest risk of T2D

• Dietary Patterns and the Incidence of Type 2 Diabetes Am. J. Epidemiol. (2005) 161 (3): 219-227.

– 4,000 Finnish en and women, followed 23 years– Highest consumption of fruits/vegetables in prudent diet resulted in decreased risk

A Low-Fat Vegan Diet Improves Glycemic Control and Cardiovascular Risk Factors in a Randomized Clinical Trial in Individuals With Type 2 Diabetes

Diabetes Care August 2006 vol. 29 no. 8 1777-1783

– 100 people randomized vegan vs ADA diet 22 weeks– 43% VG 26% ADA reduced diabetes medications.

– HbA1c (A1C) 0.96 points VG 0.56 points in the ADA group

– Excluding those who changed medications, A1C fell 1.23 points in the vegan group compared with 0.38 points in the ADA group

– Body weight 6.5 kg VG and 3.1 kg ADA – LDL cholesterol 21.2% in the vegan group and 10.7% in

the ADA group (P = 0.02). – urinary albumin reductions 15.9 mg/24h VG than in the ADA

group 10.9 mg/24 h

A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial

Clin Nutr May 2009 vol. 89 no. 5 1588S-1596S

Weight loss was significant within each diet group but not significantly different between groups (−4.4 kg in the vegan group and −3.0 kg in the conventional diet group, P = 0.25) and related significantly to Hb A1c changes (r = 0.50, P = 0.001). Hb A1c changes from baseline to 74 wk or last available values were −0.34 and −0.14 for vegan and conventional diets, respectively

(P = 0.43). Hb A1c changes from baseline to last available value or last value before any

medication adjustment were −0.40 and 0.01 for vegan and conventional diets,

respectively (P = 0.03). In analyses before alterations in lipid-lowering medications, total cholesterol decreased by 20.4 and 6.8 mg/dL in the vegan and conventional diet

groups, respectively (P = 0.01); LDL cholesterol decreased by 13.5 and 3.4 mg/dL in the vegan and conventional groups, respectively (P = 0.03).Conclusions: Both diets were associated with sustained reductions in weight and plasma lipid concentrations. In an

analysis controlling for medication changes, a low-fat vegan diet appeared to improve glycemia and plasma lipids more than did conventional diabetes diet recommendations.

Whether the observed differences provide clinical benefit for the macro- or microvascular complications of diabetes remains to be established.

Toward Improved Management of NIDDM: A Randomized, Controlled, Pilot Intervention

Using a Low-fat, Vegetarian DietPreventive Medicine, Volume 29, Number 2, August 1999 , pp. 87-91(5)

28% mean reduction in fasting serum glucose of the experimental group, from 10.7 to 7.75 mmol/L (195

to 141 mg/dl), was significantly greater than the 12% decrease, from 9.86 to 8.64 mmol/L (179 to 157

mg/dl), for the control group (P < 0.05). The mean weight loss was 7.2 kg in the experimental group,

compared to 3.8 kg for the control group (P < 0.005).

Cancer

Plants and Risk of……

• Cancers– Vegans have a lower risk of Cancer Vegetarian Diets and the Incidence of

Cancer in a Low-risk Population Cancer Epidemiol Biomarkers Prev February 2013 22; 286

– Red and Processed Meat Intake increase risk of:• Colon Cancer: Meat consumption and risk of colorectal cancer: A meta-analysis of prospective studies

International Journal of Cancer 2006

• Breast Cancer: Meat consumption and risk of breast cancer in the UK Women's Cohort Study British Journal of Cancer (2007) 96, 1139–1146

• Lung Cancer: Meat consumption and risk of lung cancer; a case-control study from Uruguay Lung Cancer 1996

• Uterine Cancer: Diet, Body Size, Physical Activity, and the Risk of Endometrial Cancer1Cancer Res November 15, 1997 57; 507

•Other

Plant Based Nutrition and…

• Athletic Performance

• Accelerate Recovery/Reduce Muscle Damage/Fatigue/Oxidative Stress and Pain – Blueberries: Effect of NewZealand blueberry consumption.Journal of the International Society of Sports Nutrition 2012

– Tart Cherries: The role of cherries in exercise and health Scandinavian Journal of Medicine & Science in Sports 2014

– Purple Sweet Potato Leaves: Effect of purple sweet potato leaves consumption on exercise-induced oxidative stress and IL-6 and HSP72 levels Journal of Applied Physiology 2010

– Ginger: Effects of ginger (Zingiber officinale Roscoe) supplementation and resistance training on some blood oxidative stress markers in obese men Journal of Exercise Science & Fitness 2014

• Plants appear to have a positive affect

Plant Based Nutrition and….

• Premenstrual Symptoms• Water retention, weight gain, Moodiness,

Dysmennorhea

– Diet and Sex-Hormone Binding Globulin, Dysmenorrhea, and Premenstrual Symptoms Obstetrics & Gynecology 2000

– Soy, fat and other dietary factors in relation to premenstrual symptoms in Japanese women BJOG 2004

– Anecdote

Arachidonic Acid

ProstaglandinsPGf2α

Arachidonic Acid

ProstaglandinsPGf2α

Cox 1-2Cox 1-2

Plant Based Nutrition and…..

• Menopause

• Average Age: 51

– Reduction in Hot Flashes/Vaginal Dryness• Short-term Effects of Phytoestrogen-rich Diet on Postmenopausal Women Menopause 1997

Plant Based Nutrition and…

• Gallstones– Fruit and Vegetable Consumption and Risk of Cholecystectomy

in Women The American Journal of Medicine 2006

– ½ of the risk• Dietary factors in the aetiology of gall stones: a case

control study. Gut 1988

– No benefit• The effect of alcohol, tobacco and caffeine

consumption and vegetarian diet on gallstone prevalence European Journal of Gastroenterology & Hepatology 2010

• Conclusion

Conclusion

• Plant Based Nutrition• Reduces the Risk of

– Obesity– Heart Disease: High Blood Pressure/High Cholesterol– Most Cancers– Diabetes– Gallstones..?

• Enhances– Athletic Performance

• May Improve – Premenstrual/Postmenopausal Symptoms

Conclusion

• Whole Food Plant Based Nutrition– Can make you… • Feel Lighter• Feel Cleaner• Look “brighter”• Smell Better• Taste Better•

Plant Based Nutrition

• To maximize health and vitality

• To reduce primary disease risk

• To engage life most fully

www.EsserHealth.comwww.EsserHealth.com

Thank You!