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Highlights from 2003




Women’s Health

Last year's news about the stopping of the Women's Health Initiative (WHI) study of post-menopausal women receiving hormone replacement therapy with estrogen and progestin was a shock to many of the 6 million American women who were taking the same, or similar treatments. It also was unexpected news to their providers of medical care. This became one of the Top 10 Medical/Health Stories of 2002, and marked the end of a long period of enthusiasm about hormone replacement therapy (HRT) used for the prevention of chronic diseases in postmenopausal women.

On July 9, 2002, the National Institutes of Health's National Heart, Lung, and Blood Institute announced that it had terminated the arm of the Women's Health Initiative (WHI) study that involved estrogen plus progestin for healthy menopausal women. The findings of the WHI were reported the following week in the July 17 issue of JAMA, only 2 weeks after 2 equally concerning studies of HRT from the Heart and Estrogen/progestin Replacement Study Follow-up (HERS II) were published.

At this time, the existing evidence makes it difficult to justify HRT for any indication other than for the short-term relief of menopausal symptoms. This presents women with many questions about what they should do to protect their health during and after menopause. There are many options, and all women should consult their physicians before making any decisions about HRT. For more information on this subject visit some of the resources listed below.

Resources

From the National Institutes of Health

The Red Dress Project and more

The Women's Health Initiative (WHI)

Postmenopausal hormone therapy web site

The NHLBI Women's Heart Health Education Initiative (WHHEI)

The Healthy Heart Handbook for Women--2003 Edition

Facts About Postmenopausal Hormone Therapy

The Heart Truth for Women

Facts About The Women's Health Initiative

Heart-Healthy Home Cooking African American Style

Facts About Heart Disease and Women: Be Physically Active

Controlling High Blood Pressure: A Woman's Guide

Facts About Heart Disease and Women: Kicking The Smoking Habit


From the American Heart Association

Women & Cardiovascular Disease


From the Centers for Disease Control and Prevention and Prevention

The WISEWOMAN Program
(Well- Integrated Screening and Evaluation for Women across the Nation)


From the National Women's Health Information Center

Office on Women's Health (OWH)

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"Tracking" the Obesity Epidemic

Obesity has become a modern epidemic. Currently, 64.5 percent of U.S. adults age 20 years and older are overweight, and 30.5 percent are obese. The frequency of severe obesity is now 4.7 percent, up from 2.9 percent reported in the 1988 - 1994 National Health and Nutrition Examination Survey (NHANES) by the Centers for Disease Control and Prevention (CDC).

Although approximately 40 percent of women and 25 percent of men attempt to lose weight at any given time the situation is worsening rather than improving. The number of adults who are overweight or obese has continued to increase although the American consumers spend about $30 billion per year trying to lose weight or prevent weight gain.

The issue is goes beyond “good looks.” Overweight and obesity are demonstrated, important risk factors for conditions such as diabetes, elevated blood pressure, abnormal levels of fats in the blood, and debilitating disease of the joints and the skeleton (see details, below). As a result, obesity has become the second leading cause of preventable death in the U.S., and the fastest-growing cause of preventable disease in America.

Overweight and obesity are known risk factors for:

• diabetes
• heart disease
• stroke
• hypertension
• gallbladder disease
• osteoarthritis (degeneration of cartilage and bone of joints), impaired mobility
• sleep apnea and other breathing problems
• some forms of cancer (uterine, breast, colorectal, kidney, and gallbladder)

Obesity is also associated with:

• high blood cholesterol
• complications of pregnancy
• psychological disorders such as depression, social isolation
• increased surgical risk
• increased risk of deaths from all-causes

Stat Sheet: Approximately 127 million adults in the U.S. are overweight, 60 million obese, and 9 million severely obese.

Nearly two-thirds of U.S. adults are overweight
(BMI > 25, which includes those who are obese)

All adults (20+ years old): 129.6 million (64.5 percent)
Women (20+ years old): 64.5 million (61.9 percent)
Men (20+ years old): 65.1 million (67.2 percent)

Nearly one-third of U.S. adults are obese (BMI > 30)

All adults (20+ years old): 61.3 million (30.5 percent)
Women (20+ years old): 34.7 million (33.4 percent)
Men (20+ years old): 26.6 million (27.5 percent)

For more information on understanding obesity and on how to act for a healthy weight, see the resources listed below.

Resources

Understanding Obesity

Trends in the U.S. - CDC (National Center for Chronic Disease Prevention and Health Promotion)

Understanding Adult Obesity - National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

BMI calculator - National Heart, Lung and Blood Institute (NHLBI)

Obesity and Heart Disease. A Statement for Healthcare Professionals From the Nutrition Committee, American Heart Association. Circulation 1997;96:3248-3250.)

Obesity and Overweight in Children. American Heart Association Recommendation


Obesity Prevention and Treatment

The Joint WHO/FAO Expert Report, Diet, Nutrition and the Prevention of Chronic Diseases, April 23, 2003

American Heart Association Guidelines for Weight Management Programs for Healthy Adults

Healthy Lifestyle American Heart Association

The Surgeon General's Call To Action To Prevent and Decrease Overweight and Obesity

Weight Loss and Control- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults- National Heart, Lung and Blood Institute (NHLBI)

Aim for a healthy weight -National Heart, Lung and Blood Institute (NHLBI)

Obesity Education Initiative, National Heart, Lung and Blood Institute (NHLBI)

Shaping America's Youth, a national cross-sector initiative to promote childhood and adolescent physical activity and healthy lifestyles. U.S. Surgeon General, the American Academy of Pediatrics AND Nike, McNeil Nutritionals , November, 2003


Associations and Organizations

American Obesity Association

The North American Association for the Study of Obesity (NAASO)

International Association for the Study of Obesity


Scientific Journals

Obesity research

International Journal of Obesity

Obesity Reviews

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