For Women, Especially: A Healthy Diet Protects against Coronary Disease

A healthy heart is influenced by a variety of factors, such as genetic influences, diet and physical exercise. For example, when men and women get angry, the heartbeat increases and the chance of clogging the arteries increases as well. Interestingly, medical researchers have
confirmed recently that moderate drinking of alcohol protects against coronary disease in men and women alike. (There is an important warning, however: For some women, alcohol appears to be associated with an increase in the risk of breast cancer.) Few doctors, however, are likely to recommend that their patients take up drinking as a way to stave off heart disease.

In the area of nutrition, research has verified what common sense suggests, says Harvard Walter Willett, Professor of Epidemiology and Nutrition and principal investigator of the Nurses' Health Study II: if something is unhealthy for a man's heart, it is unhealthy for a woman's. "We've found that diets high in partially hydrogenated vegetable fats increase the incidence of heart disease in men and women," he remarks. "And we've found that diets high in vitamin E are associated with lower rates of heart disease, again, in both sexes."

In terms of diet and exercise, "everything we've studied indicates that the advice for men and women is basically the same," Willett says. "Eat a well-balanced diet low in saturated fats and trans fats and high in fruits, vegetables, and grains. Get regular exercise, and don't put on extra weight."

A recent study by Willett and his colleagues redoubles the reasons for women to stay slim. Current federal guidelines suggest that it's normal-even healthy-for women to gain weight as they age. But Willett found that women who add as little as 11 to 18 pounds in midlife have a 25 percent greater chance of suffering a heart attack than do women who gain less than 11 pounds. Although the study focused on women, weight gain is almost certain to be just as harmful for men, he says.

The paucity of studies investigating coronary disease in women may therefore not be as worrisome as it initially seems. "Heart disease is often discussed as though men and women are different species," says the New England Journal of Medicine's Angell. "But there are strong reasons for suspecting that men and women face the same risk factors." She adds, however, that suspicions are insufficient (not to mention scientifically untenable) proof, and that coronary disease deserves to be as thoroughly studied in women as it has been in men.

That is beginning to happen, most notably with the launching of the Women's Health Initiative by the National Institutes of Health. This massive clinical and epidemiologic study--the largest ever to focus specifically on women's health--aims to correct the imbalance that historically has slighted women as subjects of biomedical study. Addressing the major causes of death and disability in middle-aged and older women, the study is focusing on cardiovascular disease, cancer, osteoporosis, and a range of other conditions.

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