National Women’s Health Week

Heart Disease and More

By Hanna Chapman, FNP-BC, MSN

View Hanna’s webinar recording with extended Q&A

COVID-19 has had profound effects on all aspects of our lives. Women in particular are disproportionately responsible for caring for elderly family members, balancing work and childcare, or simply ensuring everyone in their community is happy and well. These added responsibilities can be stressful because they often take precedence over their own health.   

This National Women’s Health Week we want to encourage women to make their health a priority, especially during COVID-19 where the number of people seeking medical care across the country is down drastically.

Many people have chronic conditions or health concerns that may need urgent attention from their provider. For women specifically, there are a number of health concerns that will not wait for the pandemic to subside. Three of the top concerns include:

• Heart disease
• Anemia
• Irritable bowel syndrome

These conditions cause serious threats to wellness, and a key to managing them is by adopting healthier lifestyle habits. We recommend women learn more below and take this time to connect with one of our providers about reducing their risk factors.  

Heart Disease

Heart disease was often believed to be a man’s disease, but more women die from heart disease than men each year. In fact, the CDC reported heart disease as the leading cause of death for women in the United States. 

Here are three tips to help you evaluate and reflect on your daily habits that influence the quality of your heart health:

1. No smoking and avoid secondhand smoke
2. Maintain a blood pressure within normal limits
3. Exercise regularly

1. No smoking and avoid secondhand smoke

The best thing women can do for their health is to not smoke and avoid secondhand smoke. Studies suggest that women who smoke are twenty-five percent more likely to develop heart disease than men who smoke. Firsthand and secondhand smoke are both harmful to the heart. The nicotine in smoke (and tobacco products) activates the sympathetic nervous system, igniting the fight-or-flight response. This causes vasoconstriction (narrowing of blood vessels) all over the body and makes the heart work overtime by increasing the heart rate as much as 10-15 beats per minute, myocardial contractility (heart contractions) and blood pressure as much as 5-10 mm Hg. 

The Surgeon General’s Report on Smoking explains how the benefits from smoking cessation are tremendous and immediate. The risk of a heart attack drops  in the first year of quitting. And within five years, women who have quit smoking can see their stroke risk drop to that of a nonsmoker. If you do smoke and want to learn more about the steps to quit, consider speaking to one of our providers or visit women.smokefree.gov. 

2. Maintain a blood pressure within normal limits

The World Health Organization reports one in five women suffer from high blood pressure across the globe. High blood pressure can cause headaches, chest pain, or dizziness, but often has no symptoms at all. The best way to know if your blood pressure is high is to have it tested. FDA approved sphygmomanometers, also known as blood pressure machines, can be found online for delivery or at a local pharmacy for around $30. You can also contact our partner Capsule to have one delivered. 

The American Heart Association (AHA) explains how to understand your readings:

• The first (systolic) number represents the pressure your blood is exerting against your artery walls when your heart beats.
• The second (diastolic) number represents the pressure your blood is exerting against your artery walls when your heart is resting between beats.

The AHA considers <120/<80 to be normal. Check your blood pressure when sitting in a chair with both feet flat on the ground and legs uncrossed. Give yourself at least five minutes of quiet rest before taking the measurement. Keep your arm supported on a flat surface (such as a table) with your upper arm at the heart level. If the first number is >120 or the second number is >80, track your readings in a BP log and share with one of our providers via a telemedicine consult. We can review any medications and medical conditions that could be causing high blood pressure to help you bring your blood pressure back down to normal. 

AHA 2020

3. Exercise Regularly

All forms of exercise lower the risk of heart disease. The American College of Cardiology recommends 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity per week. Brisk walking, yoga, and gardening provide moderate activity. Cycling, running, and virtual aerobics classes are examples of vigorous activity. Start with 20-30 minutes of activities you enjoy and try to incorporate those into your daily schedule. If you are a swimmer, remember to cross train with weight-bearing exercises because the pull of gravity on your bones keeps them strong. Beyond the cardiovascular benefits, weight-bearing exercises are especially important for women to prevent and treat osteoporosis.

If you are unable to exercise due to an injury, consider scheduling a telemedicine visit with our Director of Physical Therapy, Shraddha Bhatia, PT, DPT. She can work with you to help you regain your strength and mobility from the comfort of your home.

Iron Deficiency and Anemia

Iron deficiency anemia (IDA) is the most common nutritional deficiency worldwide and can cause symptoms of extreme fatigue and lightheadedness. It is more likely to affect women than men. IDA occurs when you do not have enough iron in your body to produce hemoglobin (Hgb). Hgb is the part of red blood cells that gives blood its red color and carries oxygen throughout your body.  

Iron is often overlooked, but it is an essential mineral for a healthy immune system. The Food and Nutrition Board recommends a daily intake of 18 mg of iron for women of childbearing age and 27 mg of iron for women who are pregnant.

But let’s explore deeper. 

Your body gets iron from the foods you eat. Food has two types of iron: heme iron and non-heme iron. Heme iron is found in meat like beef, fish, and poultry. Non-heme iron is found in plant-based foods such as fruits, vegetables and nuts. You absorb 30 percent of heme iron from meat, but only 10 percent of non-heme iron from plant-based foods. Vegetarians, vegans, and all women at risk for IDA  should remember to consume foods high in vitamin C (like orange juice) with their iron supplements because it promotes the absorption of non-heme iron.  

Don’t worry if you are still having trouble incorporating enough iron into your diet. Schedule a telemedicine appointment with our Director of Nutrition, Adena Neglia MS, RDN, CDN. 

Beyond a lack of iron in the diet, the body attempts to make up for blood loss by using iron stores to make more hemoglobin. 

Heavy menstrual cycles may decrease iron levels enough to cause anemia. Evaluate your menstrual flow by asking yourself these four questions: 

1. Are your periods longer than 7 days? 
2. Do you find yourself restricting daily activities due to your menstrual cycle? 
3. Are you needing to change your pad or tampon every 2 hours?
4. Do you wake up to change your sanitary protection at night? 

If you answered yes to any of the above, schedule a virtual consultation with one of our providers. We can work together to evaluate your risk of anemia and create a treatment plan.

The Food and Nutrition Board recommended daily intake of iron for non-vegetarians:

*Adequate Intake (AI)

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a functional disorder of the gut that is characterized by recurring abdominal discomfort. It is associated with constipation, diarrhea, or both. The American College of Gastroenterology reports women are 1.5 – 2 times more likely to suffer from IBS than men.  

Here are three tips to help you evaluate and reflect on your dietary habits that influence the quality of your gastrointestinal health:

1. Limit gas-producing foods
2. Gradually incorporate fiber into your diet
3. Keep a food diary

1. Limit gas-producing foods

One important way to manage IBS is by limiting or eliminating foods that may trigger symptoms of diarrhea, constipation, gas, and bloating. Gas-producing foods, also known as high-FODMAP foods, increase gas in the intestines and can cause abdominal pain. Examples of high-FODMAP foods include fructose (fruit sugar), lactose (milk sugar), beans, onions, broccoli, and cabbage. Furthermore, carbonated drinks like champagne and seltzer can also introduce gas into the intestines. Last, but not least, chewing gum is not only bad for your teeth, it may also lead to a significant amount of air being swallowed, thereby adding to irritating gas bubbles in the gut. 

2. Gradually incorporate fiber into your diet

Fiber is widely recommended in the treatment of IBS. Psyllium husk is a type of soluble fiber commonly used as a dietary supplement. It is made up of the outer hull of the psyllium seed and contains high amounts of muscilage. Similar to the beta-glucans found in barley, muscilage gently stretches the bowel wall which reduces tension and helps you absorb nutrients from food. Talk to one of our providers about adding fiber to your diet. If you suffer from IBS, fiber may aggravate bloating, so it is important to start with a small amount and increase it slowly.  

3. Keep a food diary

Remember that you are your greatest historian. Keep a food diary and record your food intake for one week. Write down what you eat and how it made you feel. When you flip through the pages, notice any connections between certain foods and your IBS acting up. You may even find foods you previously thought were healthy, like avocados, are actually a trigger for your IBS symptoms.  Avoid foods you find aggravate your IBS symptoms. If you feel overwhelmed, you are not alone. Schedule an appointment with one of our providers to talk more about eliminating your triggers. Diet modifications are most successful under the supervision of a licensed dietician.

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