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Preventing, Treating, and Reversing Chronic Disease With Nutritional Interventions
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Alexandra Lessem, Caroline Trapp
Several large-scale research studies are underway to better understand many aspects of health and disease. Project Baseline is cosponsored by the Stanford School of Medicine, Duke School of Medicine, the American Heart Association, and Google to gather clinical and lifestyle data from diverse participants and study their impact on cardiovascular disease, diabetes, mood, and overall health (www.projectbaseline.com/). The aim of the project is to develop “new tools and capabilities for learning about health and preventing, treating, and reducing disease” (www.projectbaseline.com/). The Women’s Health Initiative (WHI) is a large-scale ongoing study of over 161,000 participants aimed at better understanding how to prevent heart disease, breast and colorectal cancer, and osteoporosis in postmenopausal women (www.whi.org). Recent WHI studies have found an increased risk of CVD and all-cause mortality among postmenopausal women with higher cholesterol and egg intake (Chen et al., 2020) and the presence of three or four nutrition-related cardiometabolic risk factors (waist circumference, hypertension, high cholesterol, and type 2 diabetes) to be associated with increased all-cause, CVD, and cancer-specific mortality among postmenopausal women diagnosed with cancer over 10 years of follow-up (Simon et al., 2021). As these and other large studies continue to collect data, the evidence supporting a healthful diet for disease prevention and treatment will surely continue to accumulate.
Your Voice of Self-Advocacy
Published in Carolyn Torkelson, Catherine Marienau, Beyond Menopause, 2023
Carolyn Torkelson, Catherine Marienau
I have read the latest articles on the Women’s Health Initiative. The study reports that breast cancer risk is low in the first 3–5 years of hormone therapy. However, a recent meta-analysis on hormone therapy indicates a greater risk of breast cancer than what is reported in the Women’s Health Initiative study. I am a critical thinker and need more convincing evidence before starting on hormone therapy.
Hormones and Cardiovascular Disease
Published in Stephen T. Sinatra, Mark C. Houston, Nutritional and Integrative Strategies in Cardiovascular Medicine, 2022
What happens when women go through perimenopause and menopause without hormonal support? Heart disease rises after menopause.34 The reduction in estradiol levels associated with the menopausal transition may cause a proatherogenic lipid profile.35 According to the Framingham study, risk of CVD for women aged 45–54 is doubled compared to those aged 40–44.36 Now we have an unprecedented experiment in progress since the publication of the Women’s Health Initiative in 2002—more women than ever are suffering through the changes of menopause without exogenous hormone therapy. Overall, use of hormone therapy fell approximately 80% since 1999.37
Diet-Driven Inflammation and Insulinemia and Risk of Interval Breast Cancer
Published in Nutrition and Cancer, 2022
Zhenzhen Zhang, Fred K. Tabung, Qi Jin, Grace Curran, Veronica L Irvin, Jackilen Shannon, Ellen M. Velie, JoAnn E. Manson, Michael S. Simon, Mara Vitolins, Celina I. Valencia, Linda Snetselaar, Sonali Jindal, Pepper Schedin
The current study used data from post-menopausal women enrolled in two of the clinical trials in the WHI, Hormone Therapy (HT) trials and Dietary Modification (DM) trial. Women between the age of 50 and 79 (post-menopausal) at entry, with no previous breast cancer, and entry mammogram not suspicious for breast cancer, were included. Mammography was protocol-mandated annually for women in the HT trial and biannually for women in the DM trial. Women who did not follow protocol-mandated screening guidelines during their enrollment period, had contradictory data, or were missing data on mammography information, were excluded. The WHI protocol was approved by the institutional review boards at the Clinical Coordinating Center at the Fred Hutchinson Cancer Research Center in Seattle, WA, and at each of the 40 participating Clinical Centers (17). The specific questionnaires for the information collection used by WHI can be retrieved from the WHI website: https://www.whi.org/formList. The present study was deemed exempt by Oregon Health & Science University Institutional Review Board.
The role of estrogens in osteosarcopenia: from biology to potential dual therapeutic effects
Published in Climacteric, 2022
A. Mandelli, E. Tacconi, I. Levinger, G. Duque, A. Hayes
With the onset of menopause, the rate of bone remodeling increases by 2-fold to 4-fold [61]. Since a decline in estrogen levels characterizes menopause, hormone therapy with estrogens has been widely used in the prevention and management of its associated musculoskeletal decay. The first randomized trial showing evidence that ET maintains BMD was the Postmenopausal Oestrogen/Progestin Intervention (PEPI) trial [62]. Later, the Women’s Health Initiative (WHI) proved that hormonal therapy (HT) reduces the incidence of all osteoporosis-related fractures in postmenopausal women [63]. However, this study also highlighted the risks associated with ET (stroke, breast cancer, pulmonary emboli and deep vein thrombophlebitis), to the point that the US Food and Drugs Administration (FDA) recommended firstly considering approved non-estrogenic treatments as treatment for and prevention of osteoporosis [61].
Effects of royal jelly on bone metabolism in postmenopausal women: a randomized, controlled study
Published in Climacteric, 2021
H. Matsushita, S. Shimizu, N. Morita, K. Watanabe, A. Wakatsuki
Estrogen plays a fundamental role in the physiology of the reproductive, cardiovascular, skeletal, and central nervous systems1,2. Therefore, loss of ovarian function and the subsequent deficiency of endogenous estrogens leads to increased risk of various chronic diseases in postmenopausal women3. Estrogen therapy has been documented to prevent postmenopausal bone loss and reduce the risk of fracture4. However, estrogen therapy has positive and negative effects on many tissues. The Women’s Health Initiative trials demonstrated that the beneficial effects of estrogen on fractures and colon cancers were counterbalanced by the increased risk of cardiovascular, cerebrovascular, and venous thrombotic events4–6. Therefore, the use of estrogen as a bone-protective therapy has been controversial, which has heightened interest in the consumption of foods containing phytochemicals or phytoestrogens as an alternative to estrogen therapy to minimize postmenopausal bone loss7,8.