The decrease in hormones that occurs soon after menopause can cause a number of uncomfortable symptoms, but the long term effects of hormonal loss can produce devastating (and potentially life threatening) consequences. Estrogen protects the heart and bones from aging. With the loss of this hormone, the incidence of osteoporosis and heart attacks increases with age in high risk women. Breast cancer also occurs much more commonly in postmenopausal women, since immune function diminishes with age. This chapter presents basic facts about these three postmenopausal health problems and offers suggestions for vitamins, minerals, and herbs which can help to prevent them.
One of the most serious consequences of postmenopausal aging is the development of osteoporosis. In fact, osteoporosis is a major health problem affecting more than 20 million older Americans, 90 percent of whom are women. One out of three American women will develop osteoporosis after menopause.
The statistics surrounding osteoporosis are astounding. More than 1.3 million fractures occur in the United States each year because of this condition, including 250,000 hip fractures. Eighty percent of these fractures occur in women over 65 with osteoporosis. About one-quarter of these women die within one year from complications caused by their fractures, such as blood clots and pneumonia. Another one-third never regain the ability to function physically or socially on their own. These women spend the rest of their lives requiring long term care in nursing facilities. Besides causing hip fractures, osteoporosis is also responsible for loss of bone in the jaw, gum recession (both of which are early signs of this condition), dowager’s humps, loss of height, back pain due to compression and fractures of the vertebra, and fractures of the wrist (known as colles fractures by physicians).
Often these fractures occur in situations that put only mild stress on the bone, and would not normally cause such an outcome. This can include missing a step and falling down, falling on an extended arm, or lifting a heavy object. Because of the underlying weakness of the bone, fractures can also occur spontaneously without any preceding trauma. This is often the case with vertebral fractures.
Risk Factors for Osteoporosis
Not all women have the same risk of developing osteoporosis. Some women maintain strong and heavy bones throughout the lives, while other women develop accelerated bone loss soon after menopause. If you suspect you are at higher risk of developing osteoporosis, become knowledgeable about which factors have actually been linked to a higher incidence of this disease. This will help you and your physician evaluate your own risk when planning an optimal treatment program. These factors include racial background, family history, hormonal status, lifestyle habits, and preexisting health conditions.
Skin pigmentation appears to correlate with bone mass. Black women are less likely to develop osteoporosis than white women. In fact, women at the highest risk are small and fairskinned. These are typically women of northern European ancestry such as Dutch, German, or English background with blond, reddish, or light brown hair and pale skin. Asian women also have a higher risk of developing osteoporosis.
If your close female relatives suffered from osteoporosis, you run a higher risk of developing this problem. Many women have seen their own mothers or grandmothers develop a dowager’s hump or become disabled from fracturing their hips. This can be quite upsetting for the entire family who must deal with the long term disability.
The age at which women begin menopause and how much hormonal support they maintain during their postmenopausal years affects bone density. Women who have had a surgical menopause before the age of 40, with removal of their ovaries, are at high risk of developing osteoporosis because of the abrupt withdrawal of estrogen at a young age. Similarly, women who go through an early natural menopause are at high risk of osteoporosis. A woman going through early menopause at age 35 or 40 has as much as 10 to 15 years less estrogen protection of her bones than a woman going through menopause at age 50. Thus, the older you are when going through menopause, the more years of hormonal protection you provide for your bones.
While obesity is a health risk for many diseases such as osteoarthritis and uterine cancer, being overweight does confer some protection against osteoporosis in postmenopausal women. This is because the fat cells produce estrone, a type of estrogen, through conversion of the adrenal hormone androstenedione. This type of estrogen does provide some support for the bones once the ovarian source of estrogen has dwindled.
Women who engage in regular physical exercise and are more muscular have a lower risk of developing osteoporosis. Physical activity helps keep women flexible and agile, which also reduces the likelihood of fractures. Conversely, inactivity increases the risk. Even young men or women confined to bed for long periods of time show a decrease in bone mass.
Many nutritional factors affect the risk of developing osteoporosis. Women who drink more than two cups of coffee per day or excessive amounts of other caffeine containing beverages like black tea or colas, or consume more than two alcoholic drinks per day are at higher risk. High protein or high salt intake are risk factors, as is inadequate calcium intake. Smokers also run a higher risk of osteoporosis.
Preexisting Health Issues
Women with a history of bulimia, anorexia, or malabsorption syndrome run a higher risk of poor calcium absorption or low estrogen levels. This is often the case in women with anorexia who don’t have enough body fat to produce adequate estrogen. Women who use thyroid medication, or cortisone for a variety of conditions or who suffer from an overactive thyroid gland are at higher risk. This is also true of women with chronic kidney disease. All of these conditions can adversely affect the calcium balance in the body.
Diagnosis of Osteoporosis
Excellent tests now exist to evaluate the likelihood of developing osteoporosis. They also allow physicians to diagnose osteoporosis in the early stages before the bone loss is so severe that it causes fractures. These tests include the single photon densitometer, which measures the density of the forearm bone; the dual photon densitometer, which measures the spine or hip bone; and the computerized axial topography scan (also called a CAT scan), which measures bone density in the spine. The CAT scan uses higher amounts of X rays and is a more expensive test. These tests are much more sensitive than the conventional X ray, which picks up osteoporosis only when 30 percent or more of the bone mass is lost.
You may want to have a bone density test if you are trying to decide whether or not to use hormonal replacement therapy (HRT). If the tests show accelerated bone loss for your age group, you should seriously consider the use of HRT unless other major health issues contraindicate the use of hormones. The use of estrogen and progesterone, in combination, not only help to retain calcium in the bones, but appear to promote the growth of new bone. A vegetarian-based diet is optimal for prevention of osteoporosis. A diet high in meat tends to promote loss of calcium from the body.
Cardiovascular disease is the major cause of death for American women, claiming the lives of half a million women per year. This is twice the number of women who die from cancer per year. While younger women do die of heart disease, it is a rare occurrence; the numbers tend to escalate as women age. Cancer is the main cause of death in women from age 30 to 60 (with heart disease in second place from age 40 to 60). Heart disease becomes the leading cause of death in women by age 60.
Most women die from heart attacks due to coronary artery disease. With coronary artery disease, there is a narrowing of one or more of the arteries that supply blood and oxygen to the heart. This narrowing is due to the formation of plaque in the arteries. Plaque is a thick, waxy, yellowish substance consisting primarily of cholesterol, smooth muscle cells, and foam cells. As the formation of plaque progresses, it can obstruct the flow of blood through the blood vessels. Over time,
this can seriously compromise the function of the heart, finally leading to a heart attack. Unfortunately, the obstruction is usually quite advanced before it even begins to cause symptoms. Usually the symptoms consist of chest pain (angina) and shortness of breath on mild exertion.
Risk Factors for Heart Disease
Much research has been done over the past few decades to determine if certain women run a higher risk of developing heart disease. A number of studies have pinpointed factors that appear to be linked to a higher likelihood of developing this disease. These include specific physical characteristics: health factors such as family history, blood lipid profile, hypertension, and diabetes; and lifestyle factors such as smoking, lack of activity, and stress.
Age. As mentioned earlier, the older the woman, the greater her risk of developing heart disease. The highest incidence is in women over 65 years of age.
Body Weight.Women who are between 20 to 30 percent over their ideal weight are considered to be at greater risk of developing heart disease. This was noted in a study done by Harvard Medical School, which tested more than 115,000 women over eight years. Excess weight was found to be a significant factor in women developing coronary artery disease during the period of the study.
Body Shape Distribution of Fat.Not only is overall obesity a risk factor, but how fat is distributed on the body affects heart disease risk, too. Women who distribute their excess weight in their middle or are rounder, shaped like apples, have a higher risk of coronary artery disease than pear-shaped women who distribute their fat in their hips and thighs.
Family History of Heart Disease. You are at higher risk of developing heart disease if your close relatives have had a heart attack at an early age. Statistically, your risk is increased if your father had a heart attack before age 56 or your mother before age 60. Similarly, you are at a higher risk if your grandparents had a heart attack at a young age.
Blood Lipid Profile. Triglycerides are the form in which fat is stored in the body’s tissues: three fatty acid molecules hooked to a glycerol backbone. Women with Elevated triglycerides, or triglycerides elevated in the blood to a level of 190 mg/dl or greater, run a higher risk of developing coronary artery disease.
Elevated total cholesterol and LDL cholesterol.Cholesterol is a yellowish, waxy substance manufactured in our body primarily by the liver and, to a lesser extent, by the intestines. We also ingest cholesterol when we eat dairy products or red meat. How effectively cholesterol is used depends upon how efficiently it is transported throughout the body and how well the body can store or dispose of any excess. Transportation in the body is potentially a problem because the fatty cholesterol isn’t soluble in blood, which is mostly water. To solve this problem, the body packages the cholesterol with a protein that allows the fat to be mixed with the blood. This process takes place in the liver, where several types of cholesterol-protein mixtures are produced.
The major type of cholesterol-protein manufactured is the low density lipoprotein, or LDL. LDL is the body’s main carrier of cholesterol. When levels of LDL are elevated they remain in the body streams and injure the endothelium (the inner lining of the blood vessel wall), thereby initiating plaque formation. Thus, LDL is considered to be the “bad” type of cholesterol. Women with a total blood cholesterol above 240 mg/dl and a LDL level above 160 mg/dl are thought to be at high risk of heart disease. Ideally, the total cholesterol should be below 180 mg/dl and the LDL below 130 mg/dl for the greatest degree of protection.
Decreased HDL cholesterol.The liver also makes another type of cholesterol-protein called the high density lipoprotein or HDL. The HDL is considered to be the “good” type of cholesterol. This is because HDL picks up and carries the excess cholesterol back to the liver, where it is secreted into the bile. The bile empties the excess cholesterol into the intestinal tract, where it is excreted from our bodies through bowel movements. When her HDL is less than 35 mg/dl, a woman is considered to be at high risk of coronary artery disease. The HDL should ideally be about 55 mg/dl.
Elevated LDL to HDL ratio.The ratio between the LDL and HDL is also an important indicator of heart disease risk. Ideally, your LDL to HDL ratio should be no higher than 4:1. For example, if your HDL is 30 and your LDL is 150, then your ratio is 5:1, which puts you in the high risk category.
Hypertension. High blood pressure is a significant risk factor for developing coronary artery disease. Sixty million Americans have elevated blood pressure readings, and nearly half of these people are women. Blood pressure is considered to be elevated when readings are above 140/90. The upper number is called the systolic pressure, which is the pressure that occurs when the heart contracts and pushes blood through the arterial circulation. The bottom number is called the diastolic blood pressure. This is the pressure in the arteries when the heart relaxes between beats. Not only does hypertension increase the likelihood of heart attacks, but it also increases the risk of strokes and kidney disease.
Diabetes. The Framingham Study, an important study of cardiovascular disease risk that has been ongoing in Massachusetts since 1949, found that women with diabetes are twice as likely to have a heart attack as nondiabetic women. Diabetic women are also at higher risk of developing serious visual problems and kidney complications, as well as hypertension and higher cholesterol levels.
Cigarette Smoking. Because smoking narrows the diameter of the blood vessels, impairing circulation, smokers have an increased risk of heart attacks and strokes. Smokers are also more likely to have higher levels of the bad LDL and lower levels of the good HDL. Unfortunately, 27 percent of all women smoke and this percentage is not declining rapidly, despite the great amount of public information on the health perils of smoking. Women smokers also enter menopause two to three years earlier than nonsmokers.
Physical Inactivity. Women with sedentary lifestyles have three times the risk of developing heart disease than women who are physically active. The heart is a muscle that needs to be exercised. Women who engage in aerobic exercise, such as walking at least three times a week for a half hour, have lower resting heart rate, greater lung capacity, and an improved ability to handle stress.
Stress. Several studies suggest that severe stress is a risk factor in developing coronary artery disease, though this link has been researched much less in women than in men. Many studies have been done on the Type A, hard driving, aggressive male personality. However, women with multiple home and work responsibilities are often as hard driving and stressed as men. This can predispose certain women over time to an increased risk of heart attack.
Female-Related Risk Factors
Menopausal Status. The risk of coronary artery disease increases twofold to threefold once a woman enters natural menopause. Research studies, including the Framingham Study, have confirmed that premenopausal women with intact ovarian function enjoy significant protection against the development of heart attacks.
Surgical or Natural Menopause Before Age 45. Recent studies have shown that women who, during their premenopausal years, undergo a hysterectomy involving removal of their ovaries have three times the risk of coronary artery disease compared to women who cease menstruating at a later age. Similarly, a study of 122,000 nurses found that women who went through surgical menopause before the age of 35 have two to seven times the risk of heart attack. The risk is also higher in women who go through natural menopause at an early age. Estrogen appears to confer significant protection against heart attacks during the active reproductive years. The longer a woman menstruates, the more years her vascular system has estrogenic protection.
Hormonal Therapy for Heart Disease Prevention. Both estrogen alone and combined estrogen-progestin therapy have been studied for the effects on the cardiovascular system. Estrogen appears to be beneficial; it lowers the levels of LDL cholesterol, which is linked to heart attacks, and raises the level of HDL cholesterol, which appears to confer protection. The one negative factor noted on studies of estrogen users was a moderate rise in triglycerides. On the other hand, however, physicians believe the use of estrogen will confer protection against heart attacks. The addition of progesterone to an estrogen treatment program does not appear to negate estrogen’s positive effects on the heart.
The incidence of breast cancer has increased dramatically over the past two decades. During the 1950s, it was estimated that one out of every twenty Americans would develop this disease. These estimates have been revised many times over the past forty years as the incidence of breast cancer has skyrocketed. It is currently estimated that one out of eight women, or 12 percent of all women in this country, will develop breast cancer during her lifetime. This is a staggering number, placing breast cancer as the most common cancer of American women today. It is the second most common cause of cancer deaths in women, behind only lung cancer in its mortality rate. In absolute numbers, 180,000 new cases of breast cancer were projected for 1993, as well as 46,000 deaths from this disease.
Breast cancer cells, like other malignancies, invade and destroy normal tissue (unlike benign tumors, which remain confined within a specific area). Breast cancer cells first grow within the breast tissue itself. In the later stages of the disease, the cancerous cells spread to other parts of the body near or adjacent to the breast (as with invasion to the lymph nodes). The cancerous cells can also invade distant sites, like the liver and the bones.
How high a woman’s chance of survival is depends on how early the cancer is detected. The earlier the detection and the more localized a tumor is to the breast tissue itself, the more likely a woman is to have a long term recovery from this disease (five years or more). For example, women with localized tumors are eight times more likely to survive the disease long term than a woman with an advanced case that has spread throughout her body.
Risk Factors for Breast Cancer
Not all women have the same risk of developing breast cancer. While any woman can develop the disease, certain factors do put some women statistically at greater risk:
- Previous history of breast cancer.
- Family history of breast cancer. This is particularly pertinent if a woman’s mother or sisters had the disease.
- Early onset of menstrual periods.
- Late menopause – Women who menstruate for more than 40 years seem to be at particular risk of breast cancer.
- Postmenopausal age. Most breast cancers occur after age 50.
- Childlessness or having a first child after age 30.
- Bottle feeding. Women who nurse their children appear to be at lower risk.
- Certain types of “atypical” cell patterns with benign (noncancerous) breast disease.
- High fat diet – This seems to be a risk factor for some cases of breast cancer.
- Obesity – A high-fat and too-rich diet causes women to be overweight, which is a risk factor for the development of this disease.
- Alcohol use — more than nine drinks per week significantly increases the risk.
- Height or tallness is a risk factor.
- Affluence or degree of wealth.
- Radiation exposure.
- Prolonged estrogen and progesterone use (this is still a controversial area in medicine, with some studies supporting this view and other studies contradicting it).
- Urban lifestyle.
Diagnosis of Breast Cancer
Breast cancer is often discovered by the woman herself on breast examination or by her physician during a medical visit. A woman can usually feel a hard, nontender mass that is not particularly movable within her breast tissue. Other signs of breast cancer can include swelling, dimpling, or redness of the breast tissue. If the cancer has spread to the lymph nodes under the armpit or above the collarbone, they may feel enlarged and hard.
Mammography, or an X ray of the breast, is a tremendously helpful diagnostic tool to pinpoint breast cancer. In fact, many early stage cancers, too small to be felt manually, can be detected by mammography. As a matter of fact, it can detect 90 percent of all breast cancers. Undoubtedly, the use of mammography has saved many women’s lives through early detection. Other techniques such as thermography, which detects heat changes in the breast tissue, and ultrasound, which uses highfrequency sound waves, are diagnostic tools used less often.
Despite the usefulness of all of these techniques, the definitive diagnosis of breast cancer can only be made by doing a surgical biopsy. This allows the tissue sample removed from the breast to be looked at under the microscope and examined for cancerous cells.
Once breast cancer is diagnosed, many treatment options are available. These include surgery and removal of the breast and lymph nodes, if indicated. Less radical surgery, which leaves the breast intact, is being used more for localized cancer. Radiation therapy and chemotherapy are also used with various treatment regimens. What regimen is finally selected depends on how localized or disseminated the tumor is, as well as the preference of the patient and physician. Women interested in prevention should follow a diet low in saturated fat and limit their alcohol intake.
Vitamins and Minerals for Prevention of Osteoporosis
These are nutrients that can be of help in promoting prevention:
Calcium. There are dozens of studies that reinforce the importance of calcium for the prevention of osteoporosis. Calcium is the most abundant mineral in the body, and 99 percent of it is deposited in the bones and teeth. (The other 1 percent of calcium is involved in blood clotting, nerve and muscle stimulation, and other important functions.) As a result, calcium is the most important structural mineral in bone. Along with phosphorus, calcium helps to build and maintain strong and healthy bones. However, calcium absorption becomes much less efficient by the time women reach their postmenopausal years due to the aging of the digestive tract. Calcium needs an acid environment in the stomach for proper digestion. As many as 40 percent of postmenopausal women lack sufficient stomach acid for proper calcium absorption.
Unfortunately, most women have too little calcium intake in their diets. The average American woman takes in 400 to 500 mg per day. This is far less than the recommended daily allowance (RDA) of 800 mg per day for women during their active reproductive years and the 1200 to 1500 mg per day needed by postmenopausal women.
As a result, adequate calcium supplementation is of major importance to prevent bone loss. The type of calcium used must be considered, also. The main type of calcium used in supplements has been calcium carbonate. This is an alkaline form of calcium and isn’t absorbed well by some women. In contrast, calcium citrate, an acidified form of calcium, is well absorbed and a good source of this nutrient for women. Be sure to check the label of any calcium supplement to make sure the dosages and the type of calcium used are optimal for your needs.
Phosphorus. Phosphorus is the second most abundant mineral in the body, found in bones and soft tissues. A major structural mineral of bone, it is present in a specific ratio of 2.5 parts calcium to 1 part phosphorus. This balance is important for both minerals to be used efficiently by the body. Because the American diet contains abundant phosphorous in foods such as meat, eggs, grains, seeds, nuts, and soft drinks, phosphorus deficiency is relatively rare. In addition, phosphorus is easily absorbed from the digestive tract, with an absorption rate of approximately 70 percent. The RDA for phosphorus is 800 ma.
Magnesium. This is another important mineral for healthy bones. While not as prevalent as either calcium or phosphorus in bone, it is equally important. Magnesium is needed for bone growth, as well as for proper calcium absorption and assimilation. If the body has too little magnesium available, it deposits calcium pathologically in tissues and organs, so calcium accumulates in the muscles, heart, and kidneys. In susceptible women, calcium deposited in the kidneys can cause kidney stones. Therefore, a woman who increases her calcium intake should also increase magnesium intake in a ratio of 2:1 or 10:4 calcium to magnesium. Other minerals, like zinc, copper, manganese, and silicon, are also needed in trace amounts for healthy bone growth and regulation of bone metabolism.
Vitamin D. This fat soluble vitamin can either be ingested in the diet or formed on the skin by exposure to sunlight. Sunlight activates a type of cholesterol found in the skin, converting it to vitamin D. Vitamin D is usually included in multivitamin products and is also found in fish liver oil supplements, along with vitamin A and fortified milk.
Vitamin D helps prevent osteoporosis by aiding in the absorption of calcium from the intestinal tract. It is needed for the synthesis of enzymes found in mucous membranes, which are, in turn, needed for the active transport of calcium. It also helps break down and assimilate phosphorus. A deficiency of vitamin D causes inadequate absorption of calcium from the intestinal tract and retention of phosphorus by the kidneys. This causes an imbalance in the calcium-phosphorus ratio, leading to faulty mineralization of the bones. Menopausal women should be sure to take the RDA of 400 IU per day of vitamin D.
Herbs for Prevention of Osteoporosis
Herbs as Mineral Sources. While they are not the primary source of calcium
and other minerals for most women, herbs can still provide a valuable source of minerals along with other foods in the diet. Certain plants like kelp and other sea vegetables, as well as dandelion root, horsetail, and oat straw, are good sources of calcium, magnesium, and trace minerals needed for strong and healthy bones. Kelp and the other sea vegetables can be used as condiments to flavor food such as soups, casseroles, and salads. The other herbs may be taken in capsule form as supplements.
Vitamins and Minerals for Cardiovascular Disease Prevention
Beta Carotene. Oxygen-related damage to LDL cholesterol has been linked to the development of cardiovascular disease. Laboratory testing and a few clinical studies suggest that beta carotene can prevent this oxygen-related damage and, thereby, help protect the blood vessels from the disease process. It does this by inactivating singlet oxygen, a form of oxygen that is unstable and attacks cells in the body to gain a second electron. While the protective benefits of beta carotene have not been definitively proven, the studies to date suggest that its use may be beneficial in preventing heart disease. The U.S. Physicians’ Health Study found that in a group of 333 participants with chest pain but no prior history of heart attack, beta carotene appeared to have a protective effect (with 50 percent fewer major cardiovascular events, such as heart attacks, strokes, and cardiac related deaths). I recommend the use of beta carotene or beta carotene-containing foods because of its many benefits for good health, aside from any possible cardiovascular protection.
Vitamin C. Like beta carotene, vitamin C is a water soluble vitamin that appears to be helpful in preventing LDL cholesterol oxidation, a process which can initiate atherogenesis (the destruction of the blood vessel wall and the formation of plaque) and eventually, major incidents like heart attacks and strokes. In the recent Nurses’ Health Study, sponsored by Harvard University, in which over 87,000 women between the ages of 34 and 54 were tested, the association between dietary intake of vitamin C and the risk of developing coronary artery disease was evaluated. The risk of developing heart disease was at least 42 percent lower for women who took high doses of vitamin C than for women with a low vitamin C intake. Another study done in the Boston area found that both male and female users of vitamin C supplementation had lower levels of blood pressure, lower LDL cholesterol, and higher levels of HDL cholesterol (the type of cholesterol that confers protection against coronary artery disease) than participants with a lower vitamin C intake. Vitamin C is also necessary for the regeneration of vitamin E in the body, another important antioxidant nutrient. These results make a good case for vitamin C’s cardiovascular protective effects.
Vitamin E. This nutrient completes the triumvirate of antioxidant vitamins that appear to confer protection against cardiovascular disease. Vitamin E is the main fat-soluble antioxidant nutrient in the body. It lodges within the membranes inside and surrounding the cells, protecting the body against attack by singlet (unstable) oxygen and other free radicals that cause cell destruction. As mentioned earlier, singlet oxygen or other free radical destruction of LDL cholesterol may be one of the early steps leading to atherogenesis and ultimately, cardiovascular disease. Vitamin E, along with beta carotene and vitamin C, provides protection for both the water compartment as well as the fat compartment of our cells. This is necessary for the most complete protection against oxidative damage. Vitamin E also has a beneficial anticlotting effect on the blood. While a diet high in saturated fat tends to make blood cells become sticky and clump together, vitamin E causes the cells to disperse. This helps prevent blood clots from forming, an advantage for women past midlife who are at higher risk of stroke and heart attack.
Essential Fatty Acids. The supplemental use of Omega-3 fatty acids derived from fish oils like mackerel, salmon, and halibut, as well as plants like flax seed, pumpkin seed, and soybeans, have protective effects against cardiovascular disease. A number of studies have shown that these fatty acids can relax and dilate the blood vessels, as well as inhibit platelet cell aggregation (important in preventing clot formation). In addition, the Omega-3 fatty acids lower triglyceride level. This is beneficial because the elevation of triglycerides is a risk factor for coronary artery disease. However, the evidence for reduction of LDL cholesterol is not as conclusive. Also, since fish oil consumption can impair insulin secretion and increase blood glucose, its intake should be monitored in diabetics. Otherwise, the use of Omega-3 fatty acids may be a good idea for women wanting to prevent cardiovascular disease.
Herbs for Cardiovascular Disease Prevention
Anticlotting Herbs. Garlic and ginger are two delicious herbs which are used commonly as flavoring agents. They are also tremendously beneficial in reducing the risk of heart disease. These two plants should be used frequently as part of your preventative program if you have a strong family history of heart disease with early mortality (parents or siblings dying in heir 50s or 60s of heart disease.) They should also be used if you have many risk factors yourself, such as hypertension or elevated cholesterol. Both garlic and ginger have been researched for their ability to prevent aggregation or clotting of the blood. This is important for the prevention of strokes and heart attacks. In addition, both herbs help reduce cholesterol levels. Garlic has the additional benefit of reducing blood pressure.
If you find these foods too spicy for your taste, they can be taken in capsule form
or as a liquid tincture. Women taking these herbs for cardiovascular disease prevention may want to eat several raw cloves of garlic a day or as many as 6 capsules of the herb used as a supplement. I also recommend as many as 4 capsules of ginger per day, if you do not use it as a food favoring. These are maximum dosages; you may find that 1 to 2 capsules per day suit your needs better.
Vitamins and Minerals for Breast Cancer Prevention
Vitamin A. Beta carotene, the provitamin A found in fruits and vegetables, has been cited in a number of studies as an important nutrient in breast cancer prevention. In the Nurses’ Health study mentioned earlier, beta carotene proved protective against breast cancer for more than 87,000 women. A study published in 1992 by the State University of New York compared 310 women having breast cancer to 316 women without the disease. The study found that the cancer-free group ate many more beta carotene-containing fruits and vegetables than he women with breast cancer. In addition, the National Cancer Institute studied 83 women with breast cancer and found that they had lower blood levels of beta carotene. Beta carotene both in supplemental form and in foods like fresh fruits and vegetables should be included in your diet if you are interested in breast cancer prevention.
Vitamin C. In a 1991 review of 46 studies of the protective effect of vitamin C on cancer, in 33 studies vitamin C helped safeguard against the development of many cancers. This included nonhormone-dependent breast cancer. Vitamin C did not appear to confer any protection against hormone-dependent (including estrogen-dependent) breast cancers.
Fruits and vegetables are rich sources of both beta carotene and vitamin C. Supplemental vitamin C is helpful for women who want to lower their cancer risk for all types of cancer (including certain breast cancers).
Herbs for Breast Cancer Prevention
Anticancer Herbs. Many herbs show promise in the prevention and treatment of many human cancers, although their specific role in treating breast cancer is not clear. Herbs with possible anticancer activity include garlic, burdock root, alfalfa, and a host of others. One herb, in particular, may hold some promise for breast cancer prevention. This is red clover, an herb traditionally used by several different cultures to treat cancer. Research done at the National Cancer Institute has found anticarcinogenic compounds in red clover, including several bioflavonoids, genistein and daidzein, which are both weakly estrogenic and antiestrogenic (as described earlier in this book). Women who have preexisting breast cancer may want to check with their own physicians to see if red clover can be used safely as a nutritional adjunct to their regular medical program.
Two compounds that have been linked to a lower risk of breast cancer are bioflavonoids and lignans. Both are natural plant sources of very weak estrogens. Rich sources of biofavonoids include soy, buckwheat, alfalfa sprouts, the inner peel of citrus fruits, and many berries. Lignans are particularly abundant in raw ground flax seed and are also found in whole grains and legumes. Diets that are rich in these foods seem to be a factor in preventing the development of breast cancer in women. There is also evidence to suggest that such a diet may help decrease the mortality rate of men from prostate cancer. In Asia, most notably in Japan, the rates of hormone-dependent cancers are significantly lower than those in Western Countries.